Impact of Clinical Pharmacy Services Provided Through Advance Practice Pharmacy Rotations in a Rural Medical Center

Objectives:  To measure the impact on clinical interventions and cost savings after establishment of an advance practice rotation for pharmacy students at a rural community hospital.  Method:  Coastal Carolina Medical Center is a for-profit 40 bed community hospital that employees a Director and two per diem pharmacists. In March of 2007, a faculty member from South University was placed at this site to develop an advanced practice rotation. The interns, under the guidance of the preceptor, would perform clinical functions including IV to PO transition, renal dosing, kinetic dosing, review of antibiotic orders for appropriateness, medication reconciliation, patient counseling and performing formulary reviews.  Results:  After establishing the practice site, the students will now be able to participate in weekly meetings evaluating medication therapy for rehabilitation unit patients and counseling patients in a local internal medicine clinic. Students participate in daily rounds with the hospitalist providing a variety of clinical services that were not available previously including medication reconciliation, patient counseling and nursing education. When possible, interventions were documented in the patient chart and co-signed by the preceptor. To date the average number of interventions per month has risen from 28 to 52 resulting in a cost savings of $7500 per month.  Implications:  The development of an advanced practice rotation site at Coastal Carolina Medical Center may serve as a guide to other rural community hospitals with staffing restrictions due to its impact on clinical services leading to cost savings.