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Best of Patient Focused Efforts 

Patient Screening, Triage, and Working with Care Team Members

Best Practice: Giving Preference for Pick-up to High Risk Patients 

  • Since we are local, community-minded and small shops compared to larger operations, and don’t have the advertising resources in most cases, we have to use our agility to our advantage.

  • We can promote with signage outside the pharmacy that lets our patients know that we care about our most “at risk” clientele so we make special exceptions by letting them come into the pharmacy (if we are letting them into the store) as soon as they arrive.

  • If they don’t need to come in the pharmacy and they want curbside or sidewalk pickup- they absolutely get to go to the front of the line.

  • Considerations for Signage 

    • Seniors get preferential treatment - everyday regardless of time of day.

    • If you're 65 or older, come to the front of the line and check in with our manager

    • Seniors, call ahead for special assistance, and you will get special treatment everyday at any time.

Best Practice: Following DHHS Guidance on Authorizing Licensed Pharmacists to Order and Administer COVID-19 Testing

  • Amina Abubakar (RxClinic Pharmacy Owner and CPESN USA Luminary) offered tips as of April 10, 2020 at 4 pm EST on following the DHHS Guidance

    • For those that are going to be offering the COVID-19 Testing (PCR, Antigen, or Antibody), be sure to follow proper guidance. ​

    • See graphic below in Understanding the Testing Opportunity for Pharmacies that goes along with the following text.

    • In order for pharmacies to offer COVID-19 testing:

  1. Pharmacies must have a CLIA Certificate of Waver (aka CLIA Waver) 

    • If you do not have a CLIA Waver, you can apply for one utilizing this form.​​​

  2. The Emergency Use Agreement (EUA) Letter must have listed for the "Authorized Laboratories and Other Authorized Locations" section: "Other Authorized Testing Locations: patient care settings..."

  • ​Click here for an example.

  • Note: If this section states only the following, pharmacies may not offer the testing: "Authorized Laboratories - laboratories certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA), 42 U.S.C.§263a, to perform high and moderate complexity tests." Click here for an example.

  • Click here to search for a company's FDA EUA status.​​

  • APhA has put together a guidance document, which includes companies that pharmacies can consider for partnership. See Page 6.

Best Practice: COVID-19 Testing at Community Pharmacies

  • Review the NCPA informative document, which is constantly updated.

    • Describes the 3 regulatory oversights​ for testing; Collaborative testing scenarios; Business feasibility 

  • NCPA Webinar: Opportunities for Pharmacy Testing during COVID-19 on April 8, 2020

    • Review slides by clicking; The recording and slides can be accessed​ by navigating to the Webinars section of the NCPA website: Click here

  • Stay tuned for more information as this topic is being updated constantly

Best Practice: Immunizations

  • Administration of immunizations requires the opposite of social distancing. The CDC recommends in areas with community transmission of COVID-19 immunizations ​should be postposed except when:

    • An in-person visit (e.g., MTM encounter) must be scheduled for some other purpose and the clinical preventive service can be delivered during the visit with no additional risk or

    • An individual patient and their clinician believe that there is a compelling need to receive the service based on an assessment that the potential benefit outweighs the risk of exposure to COVID-19

  • If continuing with an immunization, screen patients for signs and symptoms of COVID-19 by utilizing/modifying the “Screening Form Example” updated 4/7/2020.

    • Consider offering immunization while the patient remains in their car.​

  • If continuing with an immunization, require the patient to check temperature at home or in the pharmacy prior.

    • Patients with a fever should wait until 14 days fever-free before presenting to the pharmacy for immunization

Best Practice: Locations of COVID-19 Test Sites

  • Castlight Health Launches First Nationwide Directory Of COVID-19 Testing Sites

  • Read about the free service that covers all 50 states: Click here

Best Practice: Screen patients that are at risk

  • Patients who mention having a symptom affiliated with COVID-19 or a general comment of feeling unwell, utilize the CDC Coronavirus Self-Checker to help triage the patient as for next steps. 

  • Patient cohorts to consider:

    • Patients who you are calling for medication synchronization​

    • Patients coming into the pharmacy, curbside delivery, or drive through

  • Refer to the plan of care to assist with determining next steps

Best Practice: Who can get tested and where? (Create Patient Flyer)

  • Patients coming to the pharmacy in Bronx, New York at Mt. Carmel Pharmacy are asking who should be tested and where to go for the tests

  • Flyer should include:

    • 1) Who should be tested​

      • List criteria during patient interaction and/or in the pharmacy's messaging whether on posters, social media, website, etc.

    • 2) Where should I go to be tested

      • Each locale is going to have sites in their area. It's important to make ourselves resources for where to go ​

      • A quick google search will give you the test sites in your area. Ensure a list of these places are updated by staff regularly as number of test sites will likely increase as the positive cases continue to grow.

  • "I’ve created these and posted the patient flyer outside the pharmacy and at both counters. In order to not spread, I’ve instructed my team to have anyone interested to take a pic with their phones. If they don’t have a phone, call ya when they get back to their home (or wherever they’re next destination is)" - Roger P. 

Best Practice: Proactively educating patients with chronic respiratory conditions

  • Run a report within your pharmacy system(s) for patients on chronic respiratory condition medications

  • Call patients to counsel on adherence importance to these medications and educate about risk associated with COVID-19.

  • "Many patients in my community are not as adherent to these medications due to cost, so we are taking extra measures to get formulary substitutes, get coupons, and doing administration counseling." - Traci P.

Best Practice: Ask your local primary care provider how you can help

  • Identify a PCP in your area that you have a good relationship with and share many mutual patients

  • Ask how you can help during this time (also, a great idea to let them know of all the services your pharmacy provides)

  • An idea shared by Duvall Family Drugs:​

    • Provide Personal Protective Equipment to office

    • Develop a protocol for mutually​ shared patients who are in your med sync program. Those patients with zero refills on chronic medications with consistent fill history may receive 1-3 months of refills without contacting the PCP.

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