Pharmaceutical Care Services

The Pharmaceutical Care Division of King Faisal Specialist Hospital and Research Center (KFSHR&RC) is well reputed for its excellence in patient care services, state-of-the-art pharmacy informatics and automation systems, unmatched quality of education and training, and practice and clinical research. The current organizational structure of the Pharmaceutical Care Division is geared towards integrated clinical services model. Specifically, to reduce the perceived and real barrier between what is considered clinical work and pharmacy operation, and to ensure the safe and effective use of medications. The Division provides comprehensive, 24-hour computerized services patient-centered care and integrated model of pharmaceutical care, in both inpatients and outpatients settings. Its exceptional multinational staff, cutting edge technology, state-of-the-art informatics resources, and facilities have undoubtedly made it one of the leading hospital pharmacies in the Middle East. It employs approximately 300 personnel with more than 35 clinical pharmacy consultants, clinical pharmacy specialists and clinical pharmacists in different clinical practice areas such as anticoagulation, cardiology, drug information, internal medicine, infectious diseases, nephrology, oncology, pediatrics, adult and pediatric critical care, parenteral nutrition, solid organ transplantation, and surgery, and others.

The Pharmaceutical Care Division is composed of four departments:

• Ambulatory Care Pharmacy
• Medical and critical Care Pharmacy
• Oncology Pharmacy (King Abdullah Center for Oncology an Liver Diseases, KACOLD)
• Medication Safety/Clinical Pharmacy Support Services

Pharmacy Mission:

To provide comprehensive pharmaceutical care that will yield safe and cost-effective drug therapy in an integrated education, training, and research settings

Goals and Objectives:

• To maximize rational, cost-effective drug use by increasing pharmacists presence in patient care areas and by contributing to the medication use evaluation process, formulary control and medication therapy monitoring.
• To exceed standards for medication use established by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO, JCIA).
• To exceed standards of pharmacy practice established by the American Society of Health-System Pharmacists (ASHP), American College of Clinical Pharmacy (ACCP) and central board for accreditation of healthcare institutions (CBAHI).
• To create a center of excellence for pharmacy practice in the region.

Values:

• Patient Focus: We put the needs for our patients first.
• Integrity: We adhere to high ethical principles to be truthful, transparent, equitable and trustworthy.
• Quality: We strive for excellence and high quality through creativity and innovation.
• Compassion: We treat patients, families, and team members with dignity and kindness.
• Teamwork: We work well together to ensure that knowledge and wisdom are shared for the benefit of all.

Scope of Services:

Department of Ambulatory Care Pharmacy

Ambulatory care pharmacy department is one of the three departments under the Pharmaceutical Care Division including:

• Main Outpatient Pharmacy
• North Tower Pharmacy
• Discharge Pharmacy
• Emergency Pharmacy

Department of Medical/Critical Care Pharmacy

• Satellite Pharmacy: Located in different areas of the hospital to enable immediate delivery of pharmaceutical care to medical and critical patient care areas. The location of the satellites was determined based on acuity level of the patients, volume and nature of medical orders generated by various areas. These satellite pharmacies provide pharmaceutical care to more than 312 beds in 19 different nursing units.

• King Fahad National Center for Children’s Cancer (KFNCCC) Pharmacy: provides a full range of pharmaceutical care for all pediatric hematology/oncology patients, utilizing state-of-the-art automation technology, with highly educated and trained staff. The pharmacy resembles a miniature of the main pharmacy having a Unit Dose Pharmacy, Ambulatory Care Pharmacy, Day Treatment Pharmacy, IV Admixtures/Chemotherapy Preparation Services, Clinical and TPN Pharmacy Services.

• Pharmacy Residency Program (PGY-1): it is the first accredited pharmacy residency program by the ASHP outside the United States. The two years residency program is designed to provide high-quality training to residents both in general pharmacy practice areas and clinical services. For details, please refer to pharmacy practice residency.

Department of Oncology Pharmacies (KACOLD)

King Abdullah Center for Oncology & Liver Diseases (KACOLD) pharmacies consist of the infusion pharmacy, inpatient pharmacy, and outpatient pharmacy. Our pharmacists are an extension of the patient care team and work closely with other healthcare providers.

• Inpatient Pharmacy: Provides comprehensive, 24-hour inpatient pharmacy service to patients. It utilizes evidence-based therapeutic guidelines and emerging technologies to provide excellent pharmaceutical care to patients. Our highly trained pharmacists work side-by-side with physicians and nurses to ensure optimal patient outcomes. Pharmacists are readily available at the bedside or by phone 24 hours a day.
• Outpatient Pharmacy: Provides prescription services and specialized dispensing primarily for oral oncology medications in addition to selective supportive care medications. Pharmacists provide private counseling to patients on their medications.
• Infusion Pharmacy: Provides drug distribution services primarily for sterile preparation. The members of infusion pharmacy team have special training in preparing chemotherapy drugs. In addition, they use cutting-edge technology to compound chemotherapy. The Infusion Pharmacy is among the first cancer centers in the country to use APOTECA® robotic technology to compound patient-specific hazardous doses.

Department of Medication Safety/Clinical Pharmacy Support Services

• Inpatient Pharmacy: provides 24/7 state of the art pharmaceutical care to all hospital floors according ASHP and JCIA standards. This pharmacy covers most non critical units during day hours, and takes over all units after midnight, hence, making it an area of great complexity.

• Sterile Preparation Pharmacy: the first USP-797 compliant sterile preparation pharmacy in the Middle East. It is responsible for compounding sterile products (CSPs) including; Total Parenteral Nutrition (TPN), chemotherapy agents and other medications, various extemporaneous preparations. These services are provided by highly skilled and certified pharmacy staff.

• Total Parenteral Nutrition (TPN) Pharmacy: composed of the core team whose duties are to respond and consult for adult and pediatric TPN throughout the hospital, in addition, a peripheral team of pharmacist that is composed of clinical pharmacists who are responsible for TPN consults within their service. TPN pharmacist is also responsible for patient assessment, if they are deemed candidates for TPN, prescribing TPN, and followed the patient until he/she is able to be fed enterally.

• Medication Safety and Quality Service: this service is involved in the continuous monitoring and improvement of the medication use process in the hospital, with the purpose of assuring safe and timely process and facilitates continuous evaluation of the medication management system to implement strategies that reflect medication safety best practices and eliminate actual and potential system failures and errors. It also ensures compliance with the related accreditation standards.

Others:

• Drug Information Center (DIC): DIC center ultimate goal is to provide accurate, adequate, evidenced-based drug information as well as patient–specific pharmacotherapy consultation service to all persons requesting such information in a timely manner. Additionally, the DIC staff provides real time update to the online hospital formulary. DIC also operates the adverse drug reaction program in KFSH&RC. The program was established in the 80s and is the first program in the region.

• Investigational Drug Service (IDS): it provides support to all approved national and international clinical trials conducting in the hospital. Also, it is responsible for coordinating, planning, monitoring, and dispensing non-formulary agents to KFSH&RC patients.

• Pharmacy Automation and Support Service: This section is responsible for designing, developing, implementing and providing support to different pharmacy systems that support pharmaceutical care process and workflow. Some of the provided services include; maintenance of pharmacy information system and pharmacy applications. Troubleshooting of pharmacy robotics and automation system (e.g. automated dispensing cabinets, out-patient pharmacy robotics systems, intravenous (IV) compounding robotics systems, smart IV infusion pumps and point-of-care medication scanning technologies).

• Narcotic/Controlled Medications Pharmacy Services: it is responsible for all issues involving any narcotic/controlled medications such as procuring, clearing, receiving, storing, and dispensing of this type of medications. CII SafeTM used as narcotic inventory system to tracks and monitors the replenishment of controlled substance inventory within hospital.

 Unique Expertise:

• First to establish ASHP practice advancement initiative (PAI) in the Gulf region.
• A regional leader in the Pharmacy Automation and Informatics field, with highly trained and experienced staff.
• Specialized clinical pharmacy services in various areas, which is considered the largest and most sophisticated clinical pharmacy coverage nationwide.
• Comprehensive medication management (MM) incorporating safe and cost-effective drug selection and timely delivery of drug therapy to achieve optimal patient outcomes.
• Medication safety initiatives including identifying and flagging high alert medications, implementing automated dispensing system with image identification, bar-coding technology, and developing medication safety learning modules designed for all healthcare providers.

State-of-the-art Technology:

• Automated Dispensing Cabinet (Pyxis ES)
• Anesthesia Medication System (Omnicell™)
• Automated Dispensing Robotic Machine (ScriptPro)
• Prepackaging System (JVM)
• IV Robotic System (RIVA and APOTECA®)
• Pharmacy Management System (Cerner PharmNet Application) and Ambulatory Management System (ScriptPro PMS)
• Medication Tracking System (Medkeeper)
• Safety labeling system (Codonics ©)
• Narcotic Inventory System (CII Safe™)
• Parenteral nutrition compounding machine (Exactamix ©) and calculation software (Abacus)
• CompoundAssist software for extemporaneous preparation system
• Pharmacy Inventory Management system (Pyxis Pharmogistics and Scriptpro IMS)
• Smart Infusion Pump (BD Alaris)

New Services:

Staff Clinical pharmacy coverage under integrated ASHP practice advancement initiative (PAI) by PGY1- residency program graduates to areas lacking clinical pharmacy services.

Academic & Training Activities

• Pharmacy residents: around 30 residents
• Training activities: around 200 students
• Staff from other hospitals: around 15 staff trainees
• Other training programs (trainees from other hospitals, health outreach hospitals, international trainees, and diploma trainees): more than 40 trainees

Collaborations/ Affiliations:

• AlFaisal University, Riyadh, Saudi Arabia
• Alqassim University service contract for training and teaching Pharm.D. students, Saudi Arabia
• St. John Fisher College, Wegmans School of Pharmacy, Rochester, NY, USA
• University of Maryland Medical Center, Baltimore, Maryland, USA
• University of Toledo, College of Pharmacy & Pharmaceutical Sciences, Ohio, USA

Significant Achievements:

• Successfully received and maintained accreditation from the American Society of Health-System Pharmacists (ASHP) as the first hospital outside the USA for PGY1- residency program.
• Successfully received PGY2- (Solid Organ Transplant, Cardiology, and Oncology) residency programs as the first and only hospital outside the USA.
• Successfully received re-accreditation from the Accreditation Council for Pharmacy Education (ACPE) as pharmacy education provider as the first & only hospital outside USA without any observation/citation.
• Reference center for pharmacy automation and informatics in the Middle East.

Certificates, Awards, & Accreditations:

• ASHP accreditation on Pharmacy Practice Residency (PGY-1) - since May 2009
• ASHP accreditation on Specialty Residency (Solid Organ Transplantation) - since April 2015, the only program accredited outside USA
• ASHP Candidate Status on Specialty Residency (Cardiology) - since April 2017, the only program accredited outside USA
• ASHP accreditation on Specialty Residency (Oncology) - since April 2018, the only program accredited outside USA
• ACPE accreditation - since January 2011