Summary

The CPS in Hospice and Palliative Care practices at an advanced clinical level, working independently and with palliative, primary, and specialty providers. The CPS may lead goals-of-care discussions and provides specialized medication management for veterans with serious diagnoses and their families, ensuring therapy aligns with patient goals throughout the disease process.

Duties

Help

Responsibilities of this position include, but are not limited to: presenting patients and families with the tenants of palliative care philosophy, assisting patients in identifying and updating goals of care, and designing, implementing, assessing, monitoring, altering and documenting care plans accordingly. The CPS will provide expertise in pain and symptom management at the end of life; will play a key role in educating & precepting pharmacy residents and others in this specialty area.

FUNCTIONS OF THE POSITION:

A. Clinical - Direct Patient Care Activities that require a scope of practice

1) Core functions include face-to-face, telephone or video encounters with patients, medication management in practice areas identified in the individual scope of practice.

2) Functions as an integral member of the palliative care team to guide discussions with patients, families, and providers on goals of care and end of life issues, including medical therapy decisions and options.

3) Functions as a mid-level provider to design, implement, monitor, and adjust therapeutic drug plans to achieve patient goals of care through direct interactions with patients and providers in assigned areas.

4) Orders, performs reviews, and analyzes appropriate laboratory tests and other diagnostic studies necessary to monitor and support the patient's drug therapy.

5) Follows-up with patients on lab or test results to discuss the plan of therapy, i.e. changes in medication therapy, monitoring, clinical symptom management, and additional testing requirements.

6) According to patient goals, reduce the burden of medical procedures such as laboratory tests and deprescribing unnecessary medications; use non-invasive means to monitor toxicity and efficacy.

B. Clinical - Indirect Patient Care Activities

1) Provide chart review and recommendations for providers on pain and symptom management for seriously ill patients.

2) Facilitate continuity of medication management among providers and across transitions of care.

3) Monitor and report drug errors, adverse drug reactions, allergies, and patient compliance issues. Document findings regarding facility procedures.

4) Apply knowledge of normal laboratory values in the evaluation of patient care, recognize abnormalities and their clinical significance in the patient's palliative care, and make therapeutic adjustment recommendations based on objective laboratory findings.

5) Serve on Pharmacy and Therapeutics Committee and/or assist pharmacy service leadership with medication use evaluations and other quality and safety initiatives.

6) Promote and monitor compliance with established drug therapy policies.

7) Work with providers to ensure compliance with national, VISN, and local policy, directives, standards, and initiatives.

C. Pharmacy Operations

1) Maintain a working knowledge of all operational aspects of pharmacy service, including all electronic medical record software, automation, distribution, labeling, bar code medication administration, packaging, documentation, controlled substance accountability, and inventory management. 2) Enforce national and local formulary decisions and adjudicate prior authorization drug requests in accordance with VA guidelines and clinical judgement. Assist providers in navigating this process and recommend formulary alternatives when appropriate.

D. Education and Research

1) Maintain own professional competence by keeping abreast of information on new medications, current palliative care pharmacotherapy guidelines, innovations in pharmacy practice, and integrating this information into practice.

2) Participate in the training and in-servicing of pharmacists, pharmacy technicians, pharmacy students, pharmacy residents, and other staff on assigned teams.

3) Demonstrate skill at using both written and verbal communication techniques in teaching others.

E. Drug Information

1) Serve as an authority on drug usage, interactions, over-dosages, compliance, pharmacotherapeutic symptom management and palliative care principles to medical staff, nursing staff, technicians, and students. Use appropriate references to research drug information.

2) Demonstrate a good working knowledge of information resources, both written and electronic, as well as a solid grasp of the principles of literature evaluation and biostatistics.

3) Maintain a current knowledge of therapeutics and disease management, focusing on palliative care and symptom management.

F. Program Management

1) Serve on medical center, VISN and/or national committees as requested.

2) Adhere to all medical center and department policies and procedures.

3) Maintain the security of pharmaceuticals according to local policies and federal and state regulations.

Work Schedule: Full-Time, Monday through Friday, 07:30am - 4:00pm

Telework: Not available

Virtual: This is not a virtual position.

Functional Statement #: 000000

Relocation/Recruitment Incentives: Not authorized

Permanent Change of Station (PCS): Not authorized

Qualifications

All requirements must be met at the time of the announcement closing.

Basic Requirements:

• United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
• English Language Proficiency: Pharmacists must be proficient in spoken and written English as required by 38 U.S.C. 7402(d), and 7407(d)
• Education:
  
  • Graduate of an Accreditation Council for Pharmacy Education (ACPE) accredited College or School of Pharmacy with a baccalaureate degree in pharmacy (BS Pharmacy) and/or a Doctor of Pharmacy (Pharm.D.) degree. Verification of approved degree programs may be obtained from the Accreditation Council for Pharmacy Education, 20 North Clark Street, Suite 2500, Chicago, Illinois [redacted]; phone: [redacted], or through their Web site at: http://www.acpe-accredit.org/. (NOTE: Prior to 2005 ACPE accredited both baccalaureate and Doctor of Pharmacy terminal degree program. Today the sole degree is Doctor of Pharmacy.)
  • Graduates of foreign pharmacy degree programs meet the educational requirement if the graduate is able to provide proof of achieving the Foreign Pharmacy Graduate Examination Commission (FPGEC) Certification, which includes passing the Foreign Pharmacy Graduate Equivalency Examination (FPGEE) and the Test of English as a Foreign Language Internet-Based Test (TOEFL iBT)
• Licensure: Full, current and unrestricted license to practice pharmacy in a State, Territory, Commonwealth of the United States (i.e., Puerto Rico), or the District of Columbia.
  
  • Exception. Non-licensed pharmacists who otherwise meet the eligibility requirements may be given a temporary appointment at the entry level as a Graduate Pharmacist under the authority of 38 U.S.C. a7 7405(c)(2)(B). The appointing official may waive the requirement of licensure for a period not to exceed 2 years for a pharmacist that provides care under the supervision of a licensed pharmacist. For grade levels above the GS-11, the candidate must be licensed.

NOTE: Individuals who have or have had multiple licenses and had any such license revoked for professional misconduct, professional incompetence or substandard care, or who surrendered such license after receiving written notice of potential termination of such license by the State for professional misconduct, professional incompetence, or substandard care, are not eligible for appointment to the position unless such revoked or surrendered license is fully restored (38 U.S.C. a7 7402(f)). Effective November 30, 1999, this is a requirement for employment. This requirement does not apply to licensed pharmacists on VA rolls as of that date, provided they maintain continuous appointment and are not disqualified for employment by any subsequent revocations or voluntary surrenders of State license, registration or certification.

1. Failure to Obtain License. In all cases, pharmacists must actively pursue meeting state prerequisites for licensure starting from the date of their appointment. At the time of appointment, the supervisor will provide the unlicensed pharmacist with the written requirement to obtain licensure, the date by which the license must be acquired, and the consequences for not becoming licensed by the deadline. Failure to become licensed within 2 years from date of appointment will result in removal from the GS-0660 Pharmacist series and may result in termination of employment.

• Grandfathering Provision. All licensed pharmacists employed in VHA in this occupation on the effective date of this qualification standard are considered to have met all qualification requirements for the title, series and grade held, including positive education and licensure/certification/registration that are part of the basic requirements of the occupation.

May qualify based on being covered by the Grandfathering Provision as described in the VA Qualification Standard for this occupation (only applicable to current VHA employees who are in this occupation and meet the criteria).

Grade Determinations:

GS-13 Clinical Pharmacy Specialist

• Experience: In addition to the GS-12 requirements, must have 1 year of experience equivalent to the next lower grade level, GS-12. The GS-12 requirements include:
  
  • Knowledge of professional pharmacy practice.
  • Communicate orally and in writing to both patients and health care staff.
  • Knowledge of laws, regulations, and accreditation standards related to the distribution and control of scheduled and non-scheduled drugs and pharmacy security.
  • Skill in monitoring and assessing the outcome of drug therapies, including physical assessment and interpretation of laboratory and other diagnostic parameters. AND
• Knowledge, Skills, and Abilities (KSAs): Pharmacists assigned to this position must demonstrate the following KSAs:
  
  • Ability to communicate orally and in writing to persuade and influence clinical and management decisions.
  • Expert understanding of regulatory and quality standards for their program area.
  • Ability to solve problems, coordinate and organize responsibilities to maximize outcomes in their program area or area of clinical expertise.
  • Expert knowledge of a specialized area of clinical pharmacy practice or specialty area of pharmacy.
  • Advanced skill in monitoring and assessing the outcome of drug therapies, including physical assessment and interpretation of laboratory and other diagnostic parameters.

Creditable Experience:

(1) Knowledge of Professional Pharmacy Practices. To be creditable, the experience must have demonstrated the use of knowledge, skills, and abilities associated with professional pharmacy practice. Professional practice means paid/non-paid employment as a professional or unlicensed graduate pharmacist as defined by the appropriate licensing board.

(2) Residency and Fellowship Training. Residency and fellowship training programs in a specialized area of clinical pharmacy practice may be substituted for creditable experience on a year-for- year basis. The pharmacy residency program must be accredited by the American Society of Health- System Pharmacists (ASHP). A fellowship program that is not accredited by the American College of Clinical Pharmacy (ACCP) will need to have comparable standards for experience to be creditable (Professional Standards Board refers to the Deputy Chief Consu