Preceptor Spotlight | Stephen Gunadi '11 Practices Transition of Care

Most pharmacy programs don’t include training on transition of care services.

But students in the Pacific University School of Pharmacy can complete a rotation on the growing field with preceptor — and alumnus — Stephen Gunadi PharmD ’11.

A relatively new service in pharmacy practice, transition of care is designed to provide a bridge for patients throughout the healthcare system.

“It’s really focused on transitioning a patient from one care setting to another,” Gunadi said. “Oftentimes, patients come back to the hospital because of fragments in the healthcare system. Basically, we are a bridge, filling and closing gaps so that patients are not re-admitted.”

After graduating from Pacific’s three-year doctoral program in pharmacy, Gunadi completed a post-doctoral residency at Providence St. Peter Hospital in Olympia, Wash., where his project was to develop a pharmacy-led transition of care program for heart failure patients. Today he works in the program he helped design.

Pharmacists at Providence St. Peter work directly with admitted patients to review medication lists, optimize therapies, and provide education and counseling to patients.

“We make sure patients are on the right medications and that there are no errors on the medication list, both at the time they are coming into the hospital and when they are leaving,” he said. “A lot of time we’re at the bedside, coming up with a care plan that’s going to be passed on to primary care. We make sure there is continuity of care from the hospital into the outpatient setting.”

Pharmacists even fill discharge prescriptions for patients and deliver medications to the room before a patient leaves.

“It improves compliance,” he said. “We physically go to the patients room, deliver their medications, and … go through the spiel on how to take care of themselves when they get home. Then, we pass that on to their primary care or cardiologist, so that when they are seen by a physician within seven days, they’ll have an idea about what transpired while they were here.”

Transition of care is relatively new in the healthcare world but is growing rapidly due to changes in healthcare law under the Affordable Care Act. Gunadi said it is a valuable field for future pharmacists to learn, though it hasn’t yet been integrated into standard curriculum.

That’s why he also serves as a preceptor for pharmacy students, providing them a chance to learn at his side during their rotations — which also provides additional staff resources for the hospital.

“I get them to do a lot of reading, then I train them in terms of the workflow, what they do every day,” he said. “Then I have them seeing patients independently, with appropriate supervision.

“I get them out there, seeing patients on their own, coming up with good recommendations and doing education and counseling themselves,” he said. “The students are learning, and we have their help to perform some of the work. It’s a win-win situation.”