Community Pharmacy Foundation Grant Aids Pharmacist in Building Wellness Program, Health Care Partnership

When applying for a grant for Realo Discount Drug’s Transition to Wellness Program, Christina Nunemacher’s goal was to show that involving pharmacists in the hospital discharge process can reduce rates of readmission.

A clinical pharmacist from Realo Discount Drug, an independent pharmacy chain in Jacksonville, NC, created a successful community pharmacist onboarding model with a grant from the Community Pharmacy Foundation (CPF).

Christina Nunemacher, PharmD, BCGP, clinical pharmacist at Realo Discount Drug and certified in geriatric pharmacy, has extensive pharmacy experience in hospital and chain pharmacies. At Realo, Nunemacher works with vendors and hospital partners to maintain quality clinical services on a fee-for-service basis.

Ashley Abode, PharmD, Director of Clinical Services at Realo, told Nunemacher about grants available through CPF – a nonprofit organization led by Executive Director Anne Marie (Sesti) Kondic, PharmD – which supports the advancement of practice in community pharmacy. At the time, Nunemacher had a close conversation with the local hospital, Onslow Memorial Hospital, in Jacksonville, North Carolina, and she knew that as community care providers they could think things through and solve problems together. patients.

When applying for a CPF grant for Realo’s Transition to Wellness Program, Nunemacher’s goal was to show that involving pharmacists in the discharge process can reduce readmission rates. Patients were confused about disease management and the importance of their prescribed medications. Many patients did not even collect their medication when they were discharged. Nunemacher knew that involving pharmacists in the process would help solve this problem.

Once the wellness transition program is in place, pharmacists and residents would follow enrolled patients from admission, through hospital stay and after discharge. At the time of release, Realo pharmacists complete the membership packaging. Then, a pharmacy resident delivers medications to the patient’s bedside and provides in-depth advice.

Realo pharmacists ensure that their patients have the necessary appointments and that transportation is available. Pharmacists and residents look at all the pieces of the puzzle and, if anything is missing, work with the doctor.

“We look at all of the social determinants of health,” Nunemacher said. “Does someone with heart failure weigh themselves every day and do they have a scale at home? Does the COPD patient have a rescue inhaler and a plan? »

According to Nunemacher, doctors and hospital staff “have been incredibly supportive and enthusiastic – they want what’s best for the patient.” Hospital workers respect the pharmacy team and often turn to them for help.

“When the chief hospitalist asked, ‘can you help me with my patient?’, it was an amazing feeling,” Nunemacher said.

Nunemacher thanks its PGY-1 residents Sara Jones, PharmD, Sha-Phawn Williams, PharmD and Melissa Beers, PharmD for being instrumental in the Transition to Wellness program and the development of other clinical services . Once the ward was up and running, Nunemacher depended on her residents to carry out the day-to-day run – handling referrals, visiting patients, making follow-up calls, and coordinating prescriptions and compliance conditioning – as she went. next steps: evaluating progress and creating new services.

Regarding the original goal of reducing hospital readmission rates, Nunemacher reported that rates had come down, but there were not enough patients enrolled to show the impact she hoped. .

“There was no doubt it made a difference,” she said. “Changing the whole process was more of a marathon than a sprint.”

From her work with the Wellness Transition Program, Nunemacher said she realized that community pharmacists weren’t being used enough.

“We should never be left out of care transition conversations. Community pharmacists are a secret weapon,” she said.

Nunemacher acknowledged that getting paid for services in today’s market is extremely difficult and requires a lot of creative thinking. She noted that her team had not been paid by the hospital for the program, but when the team showed how much they could contribute, providers began to approach pharmacists for paid partnerships, seeking help. assistance with chronic disease management and wellness visits.

Thinking about quality measures and value-based care, Nunemacher suggests connecting with local doctors and home health aides, and explaining what kind of services a pharmacy can provide to help them.

Nunemacher also recommended having rotational students in pharmacy schools and training them well. “They can help you expand your reach,” she said.

The hospital often calls Nunemacher, asking him to send students to help out at health fairs. A PGY-1 residency is a very valuable asset for an independent pharmacy in particular. “These students come out of school clinically trained and enthusiastic.”

Nunemacher recognizes the importance of word of mouth. “Once people realize the level of excellent care your pharmacy provides, prescriptions and paid clinical services will naturally follow.”

Nunemacher’s urged pharmacists to innovate. “We have to think outside the box, look at the landscape as a whole. Create links. Little things can go a long way – think beyond the brown bag. Everyone should see us as service providers, not distributors,” she said. “Show other healthcare providers what we can do as a valuable member of the patient care team.

“Patients just need that extra touch, and who better to do that than their local community pharmacist?”

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