Before exploring the downstream effects of this right, there needs to be some discussion of what is an indicated medication. Criteria used to determine whether a medication is indicated include the patient's diagnosis, physical characteristics, past medical history, and level of care (acuity) and the medication's relative cost-effectiveness. Given that understanding, the pharmacy department must then decide how to position itself to make sure that this right is not violated. One thing that becomes clear is that the pharmacy must know as much about the patient as possible. Any opportunity to have a pharmacist participate in patient care rounds should be taken advantage of. Although the benefits of pharmacist participation in these rounds have been well established,1'2 many departments may view the benefits as intervention-based. That is, the pharmacist is there to intervene and make recommendations. It is true that pharmacists can improve patient care by making recommendations on rounds, but this does not mean that if a pharmacist does not make a recommendation on rounds, then there was no benefit to the patient. Going on rounds provides the pharmacist access to knowledge about the patient that may otherwise be hard to discover. Another thing that becomes clear when viewed from the perspective of the patient is that this information must be utilized. The pharmacist who knows the most about the patient is in the best position to ensure that the patient gets the indicated medications ordered and administered. Therefore, this right can help drive a pharmacy department to integrate the rounding pharmacist into the distributive process (eg, verifying orders if the hospital has a computerized prescriber order entry system).
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