Medical Pharmacy in Ottawa’s east end isn’t your usual neighbourhood drugstore, with customers picking up prescriptions or vitamins. But every day its staff are busy preparing and delivering sophisticated intravenous compounds and chemotherapy treatments for thousands of patients.
By Talbot Boggs
Photos by Ben Welland
“If you walked by, you wouldn’t even know we are a pharmacy,” says manager and pharmacist Kelly Crotty. “We are a home care pharmacy with a special focus on delivering care and treatment to patients with complex conditions in long-term care (LTC) homes, group homes, hospices, shelters, and in patients’ own homes.”
The 4,000 sq. ft. pharmacy employs nine pharmacists, three regulated technicians, more than 40 assistants in its intravenous and LTC departments, and 50 dispatchers and delivery drivers. It also features a specialty store, Ontario Medical Supply, selling medical products and pharmaceutical supplies.
In 2012, Crotty and her colleagues launched an “IV in LTC homes” program, replacing the service offered by local Community Care Access Centres (CCACs). Pharmacy personnel now deliver medications to LTC residents in Ottawa and surrounding communities including Brockville, Cornwall, Perth and Smiths Falls, and coordinate the administration of infusions, and training of LTC staff by local nursing providers. The program reduces patient transfers to hospitals by allowing them to receive treatment in the comfort of their homes.
The pharmacy team is introducing the use of the Elastomeric IV pumps at area LTC homes, which deliver single doses of medication and are much easier to use than infusion pumps. “In the past, patients would have to go to hospital to get these treatments, but now we are bringing them directly to where they live, so there is less disruption to their routines,” says Crotty. “This is all part of the progression and emphasis in healthcare today to keep patients out of hospital and treat them at home.”
Crotty’s pharmacy is open 365 days a year and stocks and delivers a variety of palliative care medications, many of which are not routinely stocked in retail pharmacies. Staff at Medical Pharmacy work with patients and physicians to assist with access and coverage for the medications. Working in multi-disciplinary teams alongside doctors and nurses, Crotty and her staff travel to the hospice to review patient medications and make recommendations to improve their therapies.
She is also part of an advisory group for The Champlain Hospice Palliative Care Program, which created a hospital discharge checklist for palliative care patients, designed to ensure they have all the medications and supplies required to continue care at home. As well, she is part of a Total Parenteral Nutrition (TPN, which delivers nutrition through a needle or catheter placed in a vein) outpatient clinic at Ottawa Hospital, working with doctors, nurses and dieticians to counsel patients, review their medications and find ways to optimize therapy at home.
Crotty started her career in community pharmacy but became involved in IV compounding and LTC when she joined Desjardins Pharmacy. About 18 months ago Desjardins became part of the Medical Pharmacies Group with pharmacies in Ontario, British Columbia and Alberta. She has developed much of her expertise in the area through hands-on experience and shares the knowledge she has gained as a speaker and educator on palliative care issues.
“Coming from a retail environment, there was a learning curve,” Crotty says. “There are few training programs available, so you learn by doing. There is a growing need for this specialty as the healthcare system places greater emphasis on home treatment. We’re trying to make the system seamless, so patients can stay in their homes or return to home earlier without the need to go back to hospital for treatments.”