AmBuLaToRY CaRe

Posted by Melanie at Saturday, April 07, 2012

I am halfway through my ambulatory care rotation. Let me tell you about my experience so far:

On Mondays I am in clinic at Chelsea Health Center with Dr. Shimp. On Tuesdays I am in clinic at Livonia Health Center with Dr. Tingen, and on Wednesdays I am at the Saline Health Center with Dr. Shimp.

Prior to clinic, it is necessary to work up the patients by recording their most recent labs, looking through their medical record and especially concentrating on past pharmacy notes and physician notes, and developing a plan for their appointment.

The pharmacists that I work with are in a collaborative agreement and can make medication changes, including initiating and discontinuing medications, as well as making dosage changes. They manage hypertension, hyperlipidemia, and diabetes, as well as polypharmacy.

During the appointment, the patient's blood pressure, weight, and pulse are gathered. I was even in an appointment where an A1C was taken. We talk to the patient and gather information that we need. Once we have the information, we come up with a plan. We provide education for patients ranging from administering insulin to carbohydrate counting to hypoglycemia counseling. Medication adjustments are made if needed and followup is discussed.

After seeing the patient, a Careweb note must be generated to put into the medical record that details what we covered and the plan we established.

Other activities for the rotation include journal club, topic discussion, and patient care presentations.

My ambulatory care experience has been very unique and it is very inspiring to see pharmacists having patient referrals from physicians and managing medications.