nutrition and arthritis

http://www.arthritis.org/living-with-arthritis/arthritis-diet/anti-inflammatory/rheumatoid-arthritis-diet.php

Medication errors

The other day I had a private rx from a hospital for amitriptyline and domperidone showing on my PC as severe interaction.  Investigated it in stockley's and it was a red interaction leading to prolongation of the QT and potential heart problems.  At that point I thought it was my duty to check with the doctor before going ahead and dispensing but the patient's husband said that the doctor is always right.  I offered to call the doctor and take a telephone number for the patient and give the patient a ring back when it is ready.  But the patient representative wanted the medicine there and then.  I refused to take responsibility for this interaction without checking and hence he took the prescription somewhere else.  I do not know if it was dispensed or not in the other pharmacy but despite me having had a trainee HCA in the healthcare counter (completed three fifths of her course) and a trainee dispenser (second week in the pharmacy), I did find the time to look out for this interaction which could have easily been missed!
On a similar note, we are given 0.1minutes for a clinical check, but a couple of week ago I received that Rx from the local out of hours for Procyclidine 5mg tabs 1 tds.  Procyclicine is not a medicine I see very often and hence unfamiliar with it, I looked it up on BNF!  It was for Parkinsonism symptoms and 5mg tds was not a starting dose!  I asked the patient representative what was the treatment for.  To my surprise she said she has looked the medicines up herself and did not think her partner who has been having a stomach flu for the past week has been prescribed the right medicine.  At which stage it clicked on me, the rx must have been for Prochlorperazine 5mg tabs 1tds.  Then I had to find the doctor and change that rx.  Thought it was a easy job.  But it took 4 hours to find the doctor!  I did try to ring the local out of hours office but there was no answer.  The number at the bottom of the Rx went through a call centre to an unrelated town and they were not very helpful.  Tried to find a different number online and it also went through a phone centre.  In the end I decided to google the doctor's name and see if he works in one of the local surgeries and whether he remembered doing this rx the previous day.  He confirmed that it should have been prochlorperazone 5mg tabs 1tds.  But I always think that in this case I am lucky enough to have had an excellent and very supportive dispenser who helped me resolve the issue with the rx.  But in a different setting I might have not had the time to spend 4 hours (include the 5 minutes initial clinical check, the 6* 30 minutes of waiting time per phone call, the time waiting for the fax to arrive and the time for the final dispensing of the rx) vs 0.1minute for a clinical check.
I am sharing this video I watched this morning:
https://youtu.be/Ci5noQyQ3oM

Thyroid pharmacist blog

http://www.thyroidpharmacist.com/supplements.html

Successful Recruitment and Hiring Strategies

A few notes from the book Pharmacy Management, Leadership, Marketing and Finance about the

Hiring Process:

1) Evaluate current staffing needs

Rushing leads to poor matches for the job or the environment.
Unwise hiring leads to extra liability, as safety and care might be compromised and satisfaction reduced.
Hence be THOUGHTFUL when hiring!
Think about:

The type of work and workload
(General: Single dispenser in store hence being a master of everything vs Specific: Just doing dossette boxes)
Reorganisation of the workload
(Use different tools and technology to help you manage your workload in a different way, delegate certain jobs to customer or healthcare assistants while having a trainee dispenser e.g. date checking can be done by a HC and that gives time to a trainee dispenser to do her training)
Skills and abilities needed and if they have changed over the years
(e.g. Maths skills, IT skills, learning ability and type of learner, multitasking skills, first aid skills, HC knowledge, customer facing skills, driving license)
Level of position required to meet the needs
(Trainee or trained person required?)
Time required to fulfil duties
(part time vs full time)

2) Define Position Requirements

AKA JOB DESCRIPTION:

Well designed and detailed description always works best!

When:

Duties
Required skills
Education
Experience
Performance expectations
Training time

are clear it is easier to

recruit qualified people
assess their ability to perform the work
compare their work against others to determine a fair rate of pay
ensure necessary training
develop reasonable performance contracts

GENERIC descriptions DO NOT FIT all POSITIONS

HAVE REVELANT AND UP-TO-DATE INFORMATION TO THE CURRENT POSITION

DO NOT FORGET TO MAKE REASONABLE ACCOMMODATION (DISABILITY ACT)

A useful tool:
http://www.onetonline.org/link/summary/29-2052.00
http://www.onetonline.org/link/summary/31-9095.00
http://www.onetonline.org/link/summary/29-1051.00
http://www.onetonline.org/link/summary/11-9111.00

3) Decide who will be involved in the hiring process

It is advisable for the manager who is going to make the ultimate decision to consult the colleagues before making the final decision.  For example when replacing a dispenser, the previous dispenser could be consulted, the store-based pharmacists could also be consulted before offering the position to one particular individual.

Also make sure you have seen any relevant certificates before hiring the person.
https://www.pharmacyregulation.org/education/support-staff
Otherwise if you have not made the right checks you will end up having to train that person when you do not necessarily have the time or people to train the new member of staff.

Diagonal selection is also another way of successful hiring where a colleague from a different sector of the business trains for a different role.

4) Develop a Sourcing Strategy

This is the set of approaches an organisation uses to seek applicants for vacancies.

In a bigger organisation there are several tools but not all of them are always used.

According to the book these include:

Networking
Advertising in professional journals
Seeking employee referrals
Attending career fairs
Engaging search firms working with colleges of pharmacy
Developing apprenticeship program with a local college or university
Social Media (Facebook, linden, twitter)
Training, Developing, Promoting internal applicants
Headhunting

But some ways, I would recommend from experience are:

A)  Create more videos like the above, UK-based
B)  Get people through the job centre
https://www.gov.uk/moving-from-benefits-to-work/work-experience-and-volunteering
The advantage of work experience is that you do not necessarily need to employ the person but you can arrange a few work placements with different people and find who has the most appropriate skills to meet your needs.
C)  Could do pharmacy-based academies to train dispensers and HCA
https://www.gov.uk/moving-from-benefits-to-work/job-search-programmes
I think that might be a very good idea when you cannot find trained personnel and need to cover a position quickly.  Employers could run an intensive training programme and get a few of the keenest learners to do a trial on the job training and employ the most suitable one to carry on training.
D) Presentations in schools and even university career fairs.  The best dispensers/manager I have met have Bachelor or even Master degrees in English, Law, Biology, PR, Teaching etc and are very keen learners and bring excellent skills into practice and I know they can contribute towards my development as a pharmacist as much as I can contribute towards theirs.

5) Design a Screening and Evaluation Process

Do comparison tables based on CV, cover letter, interview (situational, behavioural, informational and case study based), colleague feedback about required competencies, criminal background checks (DBA), reference and qualification checks (if qualification and background checks not performed, organisations could be sued for negligent hiring) to help you decide who is the best.

6) Negotiate an Employment Offer

Candidates should be made aware of any benefits (both tangible and intangible) related to the job.  Retention bonuses is a good tool to retain staff members who are considering of leaving.

7)  Provide a Thorough and Welcoming Orientation Experience to Position the New Hire for Success

Orientation to Position, Department and Organisation are all important.

Need to ensure there is sufficient time to train the new member of staff in essential hard and soft skills.  But sometimes you might need to fast track somebody's training if time is limited but ideally information overload is best to be avoided and the person to adjust to the new role.

8) Evaluate the Effectiveness of the Hiring Process after the Candidate is on the Job
It is important for managers and H&R staff to review the hiring process and listen to feedback of other colleagues and know what improvements to make next time they need to repeat the process.