Ontario Renal RPh roll call / staffing questions

[Derrick Soong]

Hi everyone,

I’m just curious about how other centres staff renal pharmacists, particularly the ‘have not’ (ie non-teaching) centres with respect to:

a) # renal RPh FTEs

b) # patients they manage (outpatient HD, PD, MCKC, home dialysis, satellite HD units, as well as inpatients, if applicable)

c) what they manage

d) work hours

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For instance … my name is Derrick Soong and I work at Windsor Regional Hospital in Windsor, ON.

a) We have 2 full-time renal RPh FTEs.

b) Our program: HD main unit ~230 patients, PD ~80 patients, MCKC ~300 patients. One satellite (Leamington ~ 30 HD patients)

c) We have a hybrid model where the 2 renal RPhs manage all the HD/PD patients, regardless of where they are (outpatient or admitted). We complete med histories for inpatients, update our electronic MAR (ie Nephrocare), refill chronic medications, anemia management (dose Eprex, IV / PO iron), antimicrobial stewardship (ie we review all the cultures and prescribe antibiotics where needed — wounds, blood cultures, peritonitis), anticoagulation (ie dose warfarin, start or stop anticoagulation / bridge therapy for procedures, adjust Fragmin intradialysis), adjust BP meds, round with the nephrologists, patient counselling on any meds / med changes by family MDs, liaise with community pharmacists for LU codes / medication adherence, and take on pharmacy residents / students. Our renal program has 1 satellite (Leamington), where we travel there (no mileage reimbursement) to round on those patients once a month. We are now being asked by our managers to cover the MCKC clinic, on top of our current workload.  NB: our program does not have NPs, PAs, or charge nurses, so the renal RPh acts like all 3 roles, including RPh.

d) We work 5 days a week (M-F), usually 8-4 or 9-5 but we split the HD group in half (MWF, TTS) … we each see half of our respective outpatient HD group weekly, so we each have to stay late 1 night/week (to see the late group). We are unofficially on-call while the HD unit is open, and as a courtesy, we help answer inpatient issues on the weekend when the weekend staff are unsure what to do (very rarely called — maybe 1 call / month). Of course, our nephrologists will ask us questions PRN.

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How does your site compare?  If you could kindly share your program’s demographics / your job description, I’d really like to compare / advocate ORN to standardize the workload across the province, similar to the Manitoba program (https://www.cjhp-online.ca/index.php/cjhp/article/view/1302/1841).

Thanks.

[Lori Wazny]

Hi Derrick,

MB Renal Program still funds renal pharmacists at the ratios listed in the linked article but an update is that all renal pharmacists are now 100% clinical (i.e. no duties in inpatient dispensary).

Lori Wazny, PharmD.

 

 

[Ian McDormand]

Lori,

A question about the ratios:

1.0 FTE for 100 HD, 200 PD/HHD or 300 CKD (ie. 1.0 FTE covers either 100 HD or 200 PD or 300 CKD)

or,

1.0 FTE for 100 HD, 200 PD/HHD AND 300 CKD (ie. 1.0 FTE responsible for 600 patients)

Thanks,

Ian

[Lori Wazny]

Hi Ian,

Just seeing your question now.  It is the first one:

1.0 FTE for 100 HD, 200 PD/HHD or 300 CKD (ie. 1.0 FTE covers either 100 HD or 200 PD or 300 CKD)

Lori

 

[Ian McDormand]

Great, thanks.

[Morgan Harrison]

Hi there!

Hoping to touch base with other renal programs in Ontario to share their pharmacist or technician compliments for renal program coverage.

We currently have 1.7 FTE for 164 HD (spread over 3 dialysis units), 60 PD, 335 MCKC and 189 nephrology patients (stage 1-3).

Do other sites have pharmacy technician help for BPMH completion?

What are your BPMH goals? ie done at each clinic?  or every 90 days?

Thanks in advance!

 

 

 

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