浅谈中药房的风险管理

为适应现代社会的发展,医院药房必须引入现代管理理念,转变医院药房职能,健全完善管理制度,激活药房人员积极性,提高药房工作效率与效益,提升药学人员服务水平和竞争优势.药房风险管理是指对药房工作中存在或潜在的风险因素进行识别、评估,采取应对策略,制定相关措施,规避各项管理风险,控制并保障药房工作有效开展,保证医院业务、服务和工作质量,维护医院和员工的发展利益,以最低成本实现最大安全保障的科学管理方法.对药房进行风险识别、评估,并采取有效的风险控制措施,对保证患者正确、安全用药,降低医患纠纷发生的可能性都有重要作用.加强医院药房风险管理,做好药房差错预防工作是药房工作中不容忽视的问题.本文主要从医院中药房的主要风险因素和应对风险的措施进行综述.     

Role of Pharmacy Residency Training in Career Planning: A Student’s Perspective

Pharmacy students typically become more focused on career planning and assessment in the final year of their PharmD training. Weighing career options in the advanced pharmacy practice experience year can be both exciting and stressful. The goal of this article is to provide a primer on how pharmacy students can assess how a residency can fit into career planning. This article will describe the various career paths available to graduating students, highlight ways in which a residency can complement career choices, review the current state of the job market for pharmacists, discuss the current and future plans for residency programs, and present thoughts from some current and former residents on why they chose to complete a residency. Most career paths require some additional training, and a residency provides appropriate experience very quickly compared to on-the-job training. Alternative plans to residency training must also be considered, as there are not enough residency positions for candidates. Directors of pharmacy must consider several factors when giving career advice on pharmacy residency training to pharmacy students; they should provide the students with an honest assessment of their work skills and their abilities to successfully complete a residency. This assessment will help the students to set a plan for improvement and give them a better chance at being matched to a pharmacy residency.Students typically become more focused on career planning and assessment in the final year of their PharmD training. That year is reserved for advanced pharmacy practice experiences (APPEs), in which students rotate for a minimum of 1,500 hours at 9 often unique practice sites under the guidance of a preceptor and additional staff. Throughout this year, the students are exposed to many different aspects of pharmacy including community, ambulatory care, hospital/health system, inpatient/acute care, and elective rotations. The exposure to the different pharmacy practice settings often causes the students to reevaluate or reconsider their chosen career path. In addition, family members, preceptors, friends, and colleagues often inquire about the students’ job plans, further education, or training. This time of exploring career options can be exciting, as well as stressful, for students on the verge of graduation. Often the decisions students make during the final year of the PharmD program are binding for many years following graduation, possibly even limiting their future career goals. Some students may make decisions based on the necessity to pay off a heavy school loan debt or the desire to work in a particular geographic area due to family concerns.Students often request career advice from pharmacy directors, who are acting as either their APPE preceptor or in connection with their employment. The pharmacy profession and job market have changed drastically in the last 10 to 15 years, making a student’s viewpoint on career planning and assessment very different from that of a pharmacy director who has been in the profession for many years. Acting as a mentor, the pharmacy director can help the students explore the following questions: How much school debt do I have? What personal concerns will influence my career plan? What aspects of pharmacy do I enjoy? Where do I see myself in 20 years? How is the profession of pharmacy changing? Should I pursue a residency?To the last question, and as part of the career planning and assessment process, students need to decide whether to pursue a residency or an entry-level pharmacist position upon graduation. Postgraduate residencies are becoming an increasingly popular option as the competition in the job market increases; the additional years of training may provide better preparation for a specific position.Despite the increase in students pursuing residency training, most PharmD students have chosen to work in community practice upon graduation. These practice areas do not require the completion of postgraduate training. According to the 2014 Pharmacy Student Graduating Survey conducted by the American Association of Colleges of Pharmacy (AACP), 5,827 of 9,527 (61%) responding students indicated that they planned to work in a chain community pharmacy upon graduation.¹ For those students entering hospital pharmacy, 3,147 of 9,527 (33%) responding students planned to pursue a staff position. There were 2,461 (25%) responding students who had plans to pursue a pharmacy residency program upon graduation.¹Residency training provides knowledge and experience at a faster pace and in a more systematic manner than can be obtained in an entry-level pharmacist position. Residency training also provides the opportunity for interprofessional collaboration, instills personal and professional confidence, provides avenues in which to advocate for the profession of pharmacy, and broadens clinical decision-making abilities. With the profession of pharmacy becoming an increasingly clinically focused profession, residency training enables a pharmacist to practice at the “top of their license” and provide exceptional patient care. It can also enable a pharmacist to become a sought after candidate by employers.The goal of this article is to provide a primer on how pharmacy students can evaluate the role of a pharmacy residency in their career planning. The article will describe the various career paths available to graduating students, highlight ways in which a residency can compliment career choices, review the current state of the job market for pharmacists, discuss the current and future plans for residency programs, and present thoughts from some current and former residents on why they chose to complete a residency. The information in this article will help students in deciding whether or not to pursue postgraduate education. In addition, this article may provide a helpful student perspective for pharmacy directors as they serve as mentors for students and young pharmacists.     

Pharmacy curriculum outcomes assessment for individual student assessment and curricular evaluation

The Pharmacy Curriculum Outcomes Assessment (PCOA) is a standardized examination for assessing academic progress of pharmacy students. Although no other national benchmarking tool is available on a national level, the PCOA has not been adopted by all colleges and schools of pharmacy. Palm Beach Atlantic University (PBAU) compared 2008-2010 PCOA results of its P1, P2, and P3 students to their current grade point average (GPA) and to results of a national cohort. The reliability coefficient of PCOA was 0.91, 0.90, and 0.93 for the 3 years, respectively. PBAU results showed a positive correlation between GPA and PCOA scale score. A comparison of subtopic results helped to identify areas of strengths and weaknesses of the curriculum. PCOA provides useful comparative data that can facilitate individual student assessment as well as programmatic evaluation. There are no other standardized assessment tools available. Despite limitations, PCOA warrants consideration by colleges and schools of pharmacy. Expanded participation could enhance its utility as a meaningful benchmark.     

Ensuring continuing fitness to practice in the pharmacy workforce: Understanding the challenges of revalidation

BackgroundRevalidation is about assuring that health practitioners remain up to date and fit to practice, and demonstrating that they continue to meet the requirements of their professional regulator.ObjectivesTo critically discuss issues that need to be considered when designing a system of revalidation for pharmacy professionals. Although providing international context, the article focuses in particular on Great Britain (GB), where both pharmacists (Phs) and pharmacy technicians (PTs) are regulated.MethodsFollowing a brief historical overview, the article draws on emerging evidence in context.ResultsRevalidation may involve discrete periodic assessment or a continuous process of assessment against clearly identified standards. The evolving scope of pharmacy practice involves increasingly clinical roles and also practitioners in nonpatient-facing roles. The potential risk to patients and the public may require consideration. Although revalidation, or systems for recertification/relicensure, exist in numerous jurisdictions, most center on the collection of continuing education credits; continuous professional development and reflective practice are increasingly found. Revalidation may involve assessment of other sources, such as appraisals or monitoring visits. Existing revalidation systems are coordinated centrally, but particularly in larger jurisdictions, like GB, where approximately 67,000 pharmacy professionals are regulated, some responsibility may need to be devolved. This would require engagement with employers and contracting organizations to ensure suitability and consistency. Existing systems, such as company appraisals, are unfit for the assessment of fitness to practice owing to a focus on organizational/business targets. Certain groups of pharmacy professionals may pose particular challenges, such as self-employed locums, pharmacy owners, those working in different sectors, or returning after a break.ConclusionsTo ensure proportionality, it must be considered whether the same standards and/or sources of evidence should apply to all pharmacy professionals, either dependent on whether they are patient facing, their scope of practice, or whether Phs and PTs should be treated differently.     

A systematic review of community pharmacies' staff diagnostic assessment and performance in patient consultations

BackgroundIncreases in patients seeking advice at pharmacies has led to pharmacy staff engaging in diagnostic behaviours. Approaches to diagnosis include using mnemonics and clinical reasoning.ObjectivesThe primary aim of this review was to assess the degree to which the criteria researchers use to evaluate diagnostic performance in pharmacy consultations, in studies that have simulated patients or vignettes, conform with a clinical reasoning and a mnemonic framework. A secondary aim of the review was to characterize staff performance in the studies, based on the authors' comments of their results.MethodsMEDLINE, EMBASE and Web of Science were searched between October 2016 and April 2017. Only peer-reviewed studies assessing pharmacy staff's diagnostic performance using simulated patients or vignettes were eligible for inclusion. Data were extracted about how each study's criteria conformed with clinical reasoning and mnemonic frameworks. A scoring system between 0 and 4 was devised to determine the degree to which studies aligned to these two approaches. Risk of bias was assessed using the NHI Study Quality Assessment Tools. The review was registered in PROSPERO with identification number CRD42017054827.ResultsSixty-eight studies (55 cross-sectional, 11 educational interventions and 2 RCTs) with sample sizes between 10 and 2700 were included in the review. Most studies were of poor or fair quality. Performance of pharmacy staff was overwhelmingly reported as poor by study authors. This was the case regardless of geography, scenario used, or assessment framework adopted. Scrutiny on how authors arrived at these conclusions revealed that mnemonic criteria were employed to assess pharmacy staff's diagnostic performance rather than a clinical reasoning approach.ConclusionsPotentially important aspects of the decision-making process, such as clinical reasoning, were left unexplored. The number and geographic distribution of the included studies is a strength of this review; however, a validated tool was not employed.     

A Model for Assessing Reflective Practices in Pharmacy Education

Objective. To research the literature and examine assessment strategies used in health education that measure reflection levels and to identify assessment strategies for use in pharmacy education.Methods. A simple systematic review using a 5-step approach was employed to locate peer-reviewed articles addressing assessment strategies in health education from the last 20 years.Results. The literature search identified assessment strategies and rubrics used in health education for assessing levels of reflection. There is a significant gap in the literature regarding reflective rubric use in pharmacy education.Conclusion. Two assessment strategies to assess levels of reflection, including a reflective rubric tailored for pharmacy education, are proposed.     

Medication errors: hospital pharmacist perspective

In recent years medication error has justly received considerable attention, as it causes substantial mortality, morbidity and additional healthcare costs. Risk assessment models, adapted from commercial aviation and the oil and gas industries, are currently being developed for use in clinical pharmacy. The hospital pharmacist is best placed to oversee the quality of the entire drug distribution chain, from prescribing, drug choice, dispensing and preparation to the administration of drugs, and can fulfil a vital role in improving medication safety. Most elements of the drug distribution chain can be optimised; however, because comparative intervention studies are scarce, there is little scientific evidence available demonstrating improvements in medication safety through such interventions. Possible interventions aimed at reducing medication errors, such as developing methods for detection of patients with increased risk of adverse drug events, performing risk assessment in clinical pharmacy and optimising the drug distribution chain are discussed. Moreover, the specific role of the clinical pharmacist in improving medication safety is highlighted, both at an organisational level and in individual patient care.     

Combined Exposure to Multiple Mycotoxins: An Example of Using a Tiered Approach in a Mixture Risk Assessment

Humans are exposed to mycotoxins on a regular basis. Exposure to a mixture of mycotoxins may, therefore, result in a combination of adverse effects, or trigger the same effects. This should be accounted for when assessing the combined risk of multiple mycotoxins. Here, we show the outcome of using different approaches in assessing the risks related to the combined exposure to mycotoxins. We performed a tiered approach using assessment groups with a common target organ (kidney, liver and haematologic system), or a common adverse effect (phenomenon) (reduced white blood cell count), to combine the exposure to mycotoxins. The combined exposure was calculated for the individuals in this assessment, using the Monte Carlo Risk Assessment (MCRA) tool. The risk related to this combined exposure was assessed using toxicological reference values, e.g., health based guidance values. We show that estimating the combined risk by adding the single compounds’ risk distributions slightly overestimates the combined risk in the 95th percentile, as compared to combining the exposures at an individual level. We also show that relative potency factors can be used to refine the mixture risk assessment, as compared to ratios of toxicological reference values with different effect sizes and assessment factors.     

Performance based assessment in pharmacy education

An objective structured procedure using simulated patients has been developed for assessing the abilities of pharmacy students to interview and counsel patients presenting ailments considered to be representative of those encountered in community pharmacy. Structured marking schedules have been used in the assessment. The results of the assessment can be used to determine the strengths and weaknesses of the students in patient interviewing skills. Results from semi-structured interviews and anonymously completed evaluation questionnaires have shown the procedure to be acceptable to students and examiners.     

Addressing social determinants of health in community pharmacy: Innovative opportunities and practice models

Social determinants of health (SDoH) account for up to 90% of health outcomes, whereas medical care accounts for only 10%-15%; despite this disparity, only 24% of hospitals and 16% of physician practices screen for the 5 social needs. Community-embedded and highly accessible, pharmacies are uniquely positioned to connect individuals to local community and social resources and thereby address SDoH. In this article, we explore novel community pharmacy practice models that address SDoH, provide real-world examples of these models, and discuss pathways for reimbursement and sustainability. A number of innovative community pharmacy practice models that focus on social issues are currently being explored. These include integrating community health workers (CHWs) or SDoH specialists, wherein CHWs are frontline public health workers who can effectively bridge the health care system and their community, whereas SDoH specialists are pharmacy team members trained with substantial SDoH knowledge and how to use it to connect pharmacy patients to community resources. Three community pharmacy networks have implemented pilot programs using either a CHW or SDoH specialist model. An essential component for program success in all cases has been partnership development and increased interdependence between the pharmacies, local community organizations, and the public health sector. New payment models and financial incentives will be necessary to expand and sustain these programs. A potential Approach may be the use of Z codes, a subset of ICD-10-CM codes specific to assessing SDoH. Although opportunities are developing for community pharmacies to play a major role in sustainably addressing SDoH, additional work is needed before there is a widespread acceptance of pharmacies becoming service referral destinations for patients with social needs. Evaluation of these models on a wider scale will be necessary to fully evaluate their effectiveness, costs, and implementation within different community pharmacy settings.     

Evaluation of methods used for estimating content validity

The assessment of content validity is a critical and complex step in the development process of instruments which are frequently used to measure complex constructs in social and administrative pharmacy research. The aims of this study were to investigate the elements of content validity; to describe a practical approach for assessing content validity; and to discuss existing content validity indices. This is a narrative review of the assessment and quantification of content validity. It describes the key stages of conducting the content validation study and discusses the quantification and evaluation of the content validity estimates. Content validity provides evidence about the degree to which elements of an assessment instrument are relevant to and representative of the targeted construct for a particular assessment purpose. The assessment of content validity relies on using a panel of experts to evaluate instrument elements and rate them based on their relevance and representativeness to the content domain. It is a three-stage process that includes; the development stage, judgment and quantifying stage, and revising and reconstruction stage. To quantify the expert judgments, several indices have been discussed in this paper such as the content validity ratio (CVR), content validity index (CVI), modified–Kappa, and some agreement indices. A practical guide describes the process of content validity evaluation is provided. In summary, content validation processes and content validity indices are essential factors in the instrument development process, should be treated and reported as important as other types of construct validation. Determining item CVI and reporting an overall CVI are important components necessary to instruments especially when the instrument is used to measure health outcomes or to guide a clinical decision making. Content validity deserves a rigorous assessment process as the obtained information from this process are invaluable for the quality of the newly developed instrument.     

Curricular-driven screening for atrial fibrillation at community pharmacies

BackgroundAtrial fibrillation (AF) increases the risk of stroke. It can be asymptomatic and patients may be unaware they have AF. Therefore, there is a need to develop a sustainable community model to screen for unrecognized AF.ObjectiveThe objective is to assess a curriculum driven model developed by the University of New Mexico College of Pharmacy (UNM-CoP) to evaluate AF screening at 3 community pharmacy sites.MethodsScreenings and education for AF were performed by fourth year pharmacy students during their advanced pharmacy practice experience (APPE) community rotation at pre-selected independent pharmacies. Patients were screened using the KardiaMobile device (AliveCor®, Mountain View, CA), an FDA-cleared device that interprets a medical-grade ECG in 30 seconds. All screening materials and devices were provided by UNM-CoP. Semi-structured interviews with each targeted pharmacy were conducted to assess the logistics, value, and sustainability of the program (N=5 pharmacists).ResultsAF assessment was performed over a 7-month period by 8 students at three pharmacies. Students screened a total of 63 patients (62% female, 56 ± 14 years of age) with 92% of the encounters taking less than 10 minutes to complete. Three patients (4.7%) were found to have possible AF. Positive scores were noted when assessing value to the pharmacy (8.8 ± 0.8, scale 1-10 with 10 being high value) and professionally (9.7 ± 0.6).DiscussionStudent-pharmacists provides a likely pathway for sustainability for this clinical initiative and provides for a novel and measurable APPE patient interaction.ConclusionCurricular driven AF assessment in community pharmacies was shown to be a feasible model. Additional studies are needed to assess whether population-based real-time assessment and detection of AF can reduce the risk of stroke in previously undetected AF. If stroke reduction is realized, reimbursement for service is likely and can contribute to further sustainability.     

Pharmacy care perspectives on problems with HIV antiretroviral therapy in Sweden

Objective This study has three main objectives (1) to identify the major problems or difficulties pharmacy staff in Sweden experience regarding pharmacy care of patients receiving antiretroviral therapy, (2) to identify the perceptions of pharmacy staff regarding what are patient-related concerns with antiretroviral therapy and (3) to compare the extent to which pharmacy staff awareness matches patient perceptions regarding what are the major problems or difficulties associated with antiretroviral therapy. Methods A problem detection study (PDS) containing two questionnaires was conducted: one to be completed by pharmacy staff and another to be completed by both pharmacy staff and patients. In the latter survey, staff were asked about what they thought that patients would have responded. Staff and patient responses were then matched and compared with one another. Results The pharmacy staff expressed their need for continuous education so as to assist the patients with their complex regimens. The staff were aware that patients were worried about therapy failure and viral resistance, medication-related problems and negative attitudes from the public. The staff however were less aware of the extent to which patients worried about not having their HIV infection under control. The staff also valued written patient information to a much higher extent than the patients. Conclusions The pharmacy staff’ awareness of the major problems HIV patients are experiencing seems incomplete and may lead to lack of concordance between the patients and pharmacy staff. This in turn may lead to non-adherence and poor therapy outcomes. Pharmacy staff should be encouraged to improve and systematically assess patient issues regarding antiretroviral therapy. Through assessing patient needs and concerns, the pharmacists can better identify patient needs and thus better tailor their educational and behavioural interventions to improve therapy outcomes.     

An Advanced Objective Structured Clinical Examination Using Patient Simulators to Evaluate Pharmacy Students’ Skills in Physical Assessment

Objective. To implement an advanced objective structured clinical examination (OSCE) in the curriculum and to evaluate Japanese pharmacy students’ skills in physical assessment such as measuring pulse and blood pressure, and assessing heart, lung, and intestinal sounds.Design. An advanced OSCE was implemented in a hospital pharmacy seminar as a compulsory subject. We programmed patient simulators with 21 different patient cases in which normal and abnormal physiological conditions were produced. The virtual patients were then used to evaluate the physical assessment skills of fifth-year pharmacy students.Assessment. Significant differences were observed between the average of all the detailed evaluations and the mean results for the following skills: pulse measurement, blood pressure measurement, deflating the cuff at a rate of 2-3 mmHg/sec, listening to heart sounds, and listening to lung sounds.Conclusion. Administering an advanced OSCE using virtual patients was an effective way of assessing pharmacy students’ skills in a realistic setting. Several areas in which pharmacy students require further training were identified.     

Principles and practices of health risk assessment under current EU regulations

Risk assessments serve as the foundation of regulatory decision-making on whether to take actions to reduce (or otherwise manage) a toxicological or ecotoxicological risk or not. To understand the complex process that leads from the generation of scientific data, via risk assessment to risk management decision-making, close studies of the scientific basis and risk assessment methods must be undertaken. This paper consists of two main parts. In the first part the principles of the European Union process for risk assessments, as defined by legislations and official guidelines, are briefly outlined. In the second part the actual workings of this system are exemplified by the results from case studies of the risk assessment processes for trichloroethylene and for acrylamide. The analysis and comparison of these two cases illustrates: (1) that generation of a large amount of data does not ensure consensus among risk assessors, (2) that controversy can regard different levels of detail, (3) that controversy can arise at different organizational and theoretical levels, (4) that risk assessments may be subject to (public) criticism even if the experts agree, and (5) that "scientific" controversies have a significant policy component.     

A Progress Assessment to Evaluate Pharmacy Students' Knowledge Prior to Beginning Advanced Pharmacy Practice Experiences

Objective

To develop an assessment that would (1) help doctor of pharmacy (PharmD) students review therapeutic decision making and build confidence in their skills, (2) provide pharmacy practice residents with the opportunity to lead small group discussions, and (3) provide the assessment committee with program-level assessment data.

Design

A case-based interactive assessment was developed and delivered to PharmD students immediately prior to advanced pharmacy practice experiences (APPEs). The assessment used an audience response system to allow immediate feedback followed by small group discussions led by pharmacy-practice residents. Students self-assessed their knowledge and confidence levels and developed personalized learning objectives for APPEs.

Assessment

Eighty-nine percent of students found the assessment useful, and pharmacy practice residents reported that it was helpful in developing precepting skills. The college assessment committee was able to use the data to supplement the ongoing College curricular mapping process.

Conclusions

An interactive assessment process can help students build confidence for experiential training, provide a learning opportunity for pharmacy residents, and produce program-level data for college assessment purposes. Planned modifications of the assessment include expanding the content areas covered and adding ability-based assessments such as communication skills.     

Human factors and ergonomics methods for pharmacy research and clinical practice

BackgroundHuman factors and ergonomics (HFE) is a scientific and practical human-centered discipline that studies and improves human performance in sociotechnical systems. HFE in pharmacy promotes the human-centered design of systems to support individuals and teams performing medication-related work.ObjectiveTo review select HFE methods well suited to address pharmacy challenges, with examples of their application in pharmacy.MethodsWe define the scope of HFE methods in pharmacy as applications to pharmacy settings, such as inpatient or community pharmacies, as well as medication-related phenomena such as medication safety, adherence, or deprescribing. We identify and present seven categories of HFE methods suited to widespread use for pharmacy research and clinical practice.ResultsCategories of HFE methods applicable to pharmacy include work system analysis; task analysis; workload assessment; medication safety and error analysis; user-centered and participatory design; usability evaluation; and physical ergonomics. HFE methods are used in three broad phases of human-centered design and evaluation: study; design; and evaluation. The most robust applications of HFE methods involve the combination of HFE methods across all three phases. Two cases illustrate such a comprehensive application of HFE: one case of medication package, label, and information design and a second case of human-centered design of a digital decision aid for medication safety.ConclusionsPharmacy, including the places where pharmacy professionals work and the multistep process of medication use across people and settings, can benefit from HFE. This is because pharmacy is a human-centered sociotechnical system with an existing tradition of studying and analyzing the present state, designing solutions to problems, and evaluating those solutions in laboratory or practice settings. We conclude by addressing common concerns about the implementation of HFE methods and urge the adoption of HFE methods in pharmacy.     

Assuming a Pharmacy Organization Leadership Position: A Guide for Pharmacy Leaders

Important and influential pharmacy organization leadership positions, such as president, board member, or committee chair, are volunteer positions and require a commitment of personal and professional time. These positions provide excellent opportunities for leadership development, personal promotion, and advancement of the profession. In deciding to assume a leadership position, interested individuals must consider the impact on their personal and professional commitments and relationships, career planning, employer support, current and future department projects, employee support, and personal readiness. This article reviews these factors and also provides an assessment tool that leaders can use to determine their readiness to assume leadership positions. By using an assessment tool, pharmacy leaders can better understand their ability to assume an important and influential leadership position while achieving job and personal goals.Pharmacy directors work diligently to ensure that their departments have the resources needed to meet patients’ needs. In addition to their job commitments, many health-system pharmacy leaders externally advocate for the profession through membership in professional organizations. A small number of those leaders who participate in professional organizations aspire to assume important and influential leadership positions in those organizations, such as president, board member, or committee chair. These positions require a time commitment that often conflicts with personal commitments such as family duties/priorities, friends and community activities, and work. The following case illustrates how assuming a high-profile leadership role in a professional organization impacts a pharmacy director.A pharmacy leader has been a director for over 10 years in a 450-bed acute care community hospital. They have 10 direct report employees and nearly 100 other staff members. The director has always been involved with local and national pharmacy organizations and has the opportunity to run for president of a national organization. The director decides to place their name on the ballot and discusses the time commitment with their executive administrator and staff; they are given approval to dedicate up to 20% of the workweek to the position. The director is also given approval for a 10% to 15% time commitment during the following year as the former president. As the director’s presidential year begins, it is evident that the actual time commitment for the position greatly exceeds 20%.The management team and employees within the pharmacy department begin to feel abandoned and unsupported in making decisions and running their departmental areas. Major projects within the department are delayed or must be completed with minimal oversight, resulting in poor quality. The executive administrator also recognizes the director’s absence and realizes the commitment as president is larger than originally approved. Upon completion of 2 years as president and past president, the director returns to a pharmacy department where many decisions have been made without seeking the their input. However, the value of the director having assumed this high-profile position results in their increased ability to recruit the best pharmacists; the department is also recognized by the hospital’s administration as a leader across the country. This recognition affects the medical staff as well – who lobby for and secure additional resources for the pharmacy. The director is asked to sit on various national committees and is nominated for several awards as a result of their work as the president of the professional organization. Despite these advantages, the director recognizes how their relationships with employees, management team, and the executive administrator have been negatively impacted by assuming the leadership position. The director implements a focused effort to correct some departmental deficiencies as a result of their absence and to regain the confidence of those who previously supported them.Holding important and influential leadership positions in pharmacy organizations has many advantages and provides excellent opportunities for personal leadership growth and advancing the department and the profession. Understanding the personal and professional considerations in assuming a highprofile leadership position is critical in preventing the scenario described above.This article describes the factors necessary to consider when making the decision to assume a highprofile pharmacy organization leadership position. It also presents an algorithm to be used as a tool in making the decision to assume such a leadership position. Specifically the aims of this article are to (1) define what is meant by a high-profile pharmacy leadership position, (2) list the commitments necessary to assume such a position, (3) list the personal and professional impacts of assuming high-profile leadership positions, and (4) describe a tool that can be used as part of the decision-making process in considering a high-profile leadership position. We hope that readers will use this article as a tool to aid them in making a decision to run for a leadership office in a professional organization. Assuming and completing a high-profile position in a pharmacy organization can have lasting positive benefits on a department’s patient-centered pharmacy services, but the new commitment must be made with thought and transparency about its impact on various parts of the pharmacy director’s life and career.