Celebrating Pharmacists: The Growing Recognition for Transitions of Care Pharmacists

In this conversation, Crystal Toribio, PharmD, Transitions of Care Clinical Pharmacist at St. Francis Hospital discusses the impact of direct patient care within her role and how future leadership roles that could aid the entire pharmacy team. Toribio emphasizes that the role of Transitions of Care Pharmacists is becoming more valued within the pharmacy space.

Pharmacy Times

Can you introduce yourself?

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Crystal Toribio

My name is Crystal Toribio, I am a Transitions of Care Clinical Pharmacist at St. Francis Hospital. I graduated from Long Island University in New York. I completed pharmacy residency in Mount Sinai Beth Israel, in the city. I work there as a translation software manager since 2021. I recently moved to St. Francis Hospital back in March this year, so I'm new here.

Pharmacy Times

How have you seen the profession change over your career?

Crystal Toribio

My graduate life has been actually very short. I graduated in 2021 and I was part of the COVID year of residence. I would say the role from my perspective, but I see change and a goal has been towards direct patient care. From medication related outcomes like medication reconciliation and patient education. When I graduated from pharmacy residency, I told everybody ‘Oh, I want to be a transitions of care pharmacist, because we focus on mentoring and education.' There weren't even PGY-1 [programs] available whenever I tried to search, and at ASHP people didn't know exactly what transitions of care pharmacy was about, or what was the purpose of having a transitions of care program in different hospitals. They also didn't know much about ambulatory care services for telehealth, but then COVID happened. Now all these services that are geared towards patient education have boomed. I had the opportunity to see some clinics and they expanded their telehealth services. In some places, you see new remote programs for heart failure, hypertension, COPD. This is again, pharmacists having roles with direct patient care to do education, to even assess like patients for grant presentations and reach out to the providers that can help. I see a leading role there that I didn't see before I did my residency. Last year, I was invited to be a panelist for the New York Society Council of Health System Pharmacists, as a pilot of these transitions of care. It was the very first time we have this platform to talk about transitions of care, and the program in my previous hospital was over for five years. So that was new for us, like oh my god, they want us to go there to talk about what we do, and how we open this program and how we run this program successfully every day. So that was quite exciting. Then I went to meet here, three months after and there was another panel about transitions of care and metrics and how providers are collaborating with pharmacists and a whole interdisciplinary team to improve patient outcome. I was very excited to see the role finally picking up and be recognized in the profession. I went to see some of the restaurants and posters and a lot of them were about transitions of care, or medication impact performances of metrics. I was like, 'Oh, my God, our time has finally come!' Now they see the value of all we do and talking to patients and doing metrics and calling patients at home via telehealth to see how they're doing to prevent readmissions. That was quite exciting for me, because that's what I do, that's where I see the most progress that we have done. We went to a showcase last week on Friday and I was telling people I am a transitions of care pharmacists, and they knew what it was. They said, 'Oh I wish my hospital had a program for that, when you guys were married, I didn't have to explain what I do — what is the transitions of care. From 2020 to 2023, it's like I don't have to explain what I do anymore— people know what we do as physicians of pharmacy. So, I felt very good about that.

Pharmacy Times

How are you celebrating this American Pharmacists Month?

Crystal Toribio

We love this week, we get a lot of delicious food, so our department has been taking care of that for us. But also, we got a lot of gifts from the hospital. They are giving us sweaters and the only the pharmacists, but administration of the hospital is also giving us like a token of appreciation for the services that we do. They have sent messages to the whole hospital about the great work that our pharmacy team does. It feels great to be recognized in that way. I recently helped the department creating our very first pharmacy week annual report and it was I had a blast making it. It was just a way of highlighting what our team does on an everyday basis. I feel like when you work every day and you're so busy with the daily things, the little wings in progress, people don't notice them — they go unnoticed by different people. But putting this report together and seeing how much our team has done and how many initiatives we have collaborated with the interdisciplinarity and how well this initiative has been received. It is great to see the big picture and how much our team has helped the hospital. This was said last night, when our staff says today that they really feel appreciated and that what they do really matters— even when they might not feel it on an everyday basis. That is because they have amassed so much within the year. That was a very good thing for me because I'm very new on this hospital. I've been here for six months, so typing all these things, editing, and putting pictures of the pharmacists, I was like, oh my god, I'm so proud of my pharmacy team and my pharmacy leadership. I really hope they feel that way when they see it.

Pharmacy Times

What is the value of the pharmacists to you personally, and to the overall health care system?

Crystal Toribio

To me, I think it depends on the team that you're a part of. I'm part of an interdisciplinary team, which is mainly care management, quality department and nursing and me, as a transitions of care pharmacist.I see my value as a pharmacist in coming up with creative solutions to achieve the outcomes that will be not only for my role as pharmacists as the drug expert, but something that can help the whole team to elevate us all together to achieve or outcomes. Something that we been doing is creating discharges. I'm only making sure our drugs are there and patients are being discharged on the right drugs, on the optimal drug. I'm also helping older, ecomanagement and other departments to have their metrics also being achieved by creating this list, which encompasses my pharmacy part, their part, the providers part. As become leaders in interdisciplinarity collaboration, what I see is a value that we now have, as pharmacists is normally, I know my meds I know I can talk to patients, I can go to the room and X, Y and Z, but it's like how I can elevate my whole team to achieve this outcomes. Because I deal with patients, for me, it's very, very important to build an empathetic and trustful relationship with my patients. When they go home, and they call me because they have some issues with their meds — whether I can help them fix those issues, or I can reach out somebody, the fact that they call me, that I'm one of those first people that I think can help them with something, is something that's very gratifying for me. It makes me feel I have achieved my value towards that patient care if the patient feels comfortable enough to come to me to tell me when something is wrong. They know I won't be judging them, but I will really try to help them. So, I see those values in their performances.

Pharmacy Times

How do you see the future of pharmacy evolving?

Crystal Toribio

I think it's going to be very focused on what kind of leadership roles we're having in these teams. That will require us as pharmacists to step out of our comfort zones and think outside the box to come up with solutions that can help the whole team. How can we help all department to reduce costs, but also how can we help the hospital to decrease? Can we help the hospital or the team to prevent readmissions? What can I come up as a pharmacist to help my team? I see that the role is going to keep changing because that's the demand I'm seeing that the current hospitals that I've been, is what is your role? Are you a key player in this team or just in the background? And I think we're going to have to rise out to meet those expectations.