Team approach in providing clinical pharmacokinetic services

A team approach to clinical pharmacokinetic services at a university hospital is described. The clinical pharmacokinetics team (CPT) developed as an outgrowth of a clinical pharmacokinetic service (CPS) as the workload of the service expanded. The CPT serves to: (1) maximize the quality and continuity of clinical pharmacokinetic care; (2) provide a teaching medium for students at the baccalaureate and graduate level; and (3) stimulate the development of clinical pharmacokinetic research. The CPT is responsible for patients in those medical services that are not regularly served by a clinical pharmacist. The structure of the CPT includes an attending clinical pharmacist with a hierarchy of subordinate practitioners ranked by their individual didactic and clinical experience in pharmacokinetics. Students participate in (1) work rounds, where collective discussions of patient evaluations occur, and (2) one-to-one student-preceptor clinical assessments of patients' drug therapy. The attending clinical pharmacist conducts CPT rounds daily, and the students and residents must convey information to the team on: (1) the drug therapy prescribed and the appropriate monitoring methods, (2) the working diagnosis and plan of treatment, (3) results of laboratory and clinical assessments, and (4) details of patient interviews. The CPT is also responsible for ongoing clinical pharmacokinetic research. The team approach to clinical pharmacokinetic services has provided a framework for the education of clinical pharmacists while stimulating research and providing direct patient care.