Transitions of Care Pharmacist

Position Summary

The Transitions of Care (TOC) Pharmacist supports safe and effective medication use upon admission and at discharge. They provide comprehensive pharmaceutical care with a focus on accurate medication reconciliation, evidence-based medication management, and safe transitions between inpatient and outpatient settings.

Principal Duties and Responsibilities

• Obtain the best possible medication history for high-risk patients on admission to ensure an accurate and complete medication profile.
• Perform admission medication reconciliation to identify discrepancies and communicate clinically significant findings to the admitting team in a timely manner.
• Perform discharge medication reconciliation for high-risk patients by reviewing the discharge medication list for accuracy, appropriateness, duplications, omissions, and potential interactions.
• Participate in quality improvement initiatives to enhance medication reconciliation accuracy and workflow efficiency while monitoring key performance metrics and ensuring compliance with regulatory.
• Contribute to the development of workflows, guidelines, and best practices for TOC services, and support training and education for pharmacists, nurses, and other stakeholders involved in medication reconciliation and transitions of care.

Essential Job Outcomes

• High-risk patients have complete and accurate medication histories on admission, reducing medication-related errors and supporting safe initiation of inpatient therapy.
• High-risk patients are discharged with medication lists that are accurate, clinically appropriate, and free of discrepancies, duplications, omissions, or unsafe interactions.
• Standardized workflows and best practices improve the efficiency and consistency of medication reconciliation across care settings.
• Improvement in key performance metrics such as overall medication reconciliation completion rate, admission medication reconciliation rate within 24 hours and 48 hours.

Minimum Requirements

• Active Registered Pharmacist license in state of CA (required)
• Minimum of 3 years of clinical pharmacy experience in an acute care setting (required)
• Direct experience performing admission and/or discharge medication reconciliation (preferred)
• Successful completion of an accredited PGY1 Pharmacy Residency Program (preferred) or completion of an accredited PGY2 Transitions of Care Pharmacy Residency Program (strongly preferred)
• Strong communication and collaboration skills with the demonstrated ability to work collaboratively in a multidisciplinary team environment