Tyree H. Kiser, Pharm D.

The variety, fast-paced environment, and instant gratification of pharmacotherapy interventions was what originally drew me to the critical care pharmacy specialty. Patients admitted to the ICU are complex and present unique medication challenges, most of which are never covered in a classroom.

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Even if you understand the basic pharmacology of the medication, you need advanced knowledge of the pharmacokinetics and pharmacodynamics specific to the critically ill patient you are treating. These challenges, and the specific skillset required, create an excellent niche for the critical care pharmacist. The multidisciplinary approach to patient care in the ICU environment is promoted by physicians and hospital administrators and ultimately considered obligatory for optimizing ICU patient outcomes.

Research over the last two decades has demonstrated that incorporation of a critical care pharmacist reduces medication errors and adverse events, saves money, and improves patient out-comes. Critical care pharmacy services are recognized as fundamental by the 

Where does board certification in critical care pharmacy fit in? 

Does a patient in the ICU receive better care from a board-certified critical care pharmacist (BCCCP) who is one year out of a critical care residency or from a critical care pharmacist who has been practicing for more than 20 years and chooses not to become board certified? Likely not.

There is actually little information available correlating board certification with improved patient outcomes or cost within any healthcare discipline. However, even without data, governing bodies believe in the credentials. Some states already use board certification as a minimum qualification for collaborative practice agreements and prescribing authority.

A training path for critical care pharmacists that includes a PGY1 residency and a PGY2 residency in critical care is already well established. Board certification provides an opportunity to recognize the culmination of learning and sets a minimum competency for practicing critical care pharmacists. As a specialty group, we should embrace and encourage certification of our newly-trained colleagues. Those of us who have been practicing for many years should lead by example and become certified ourselves.

There are no set requirements for pharmacists who already have a well-established career in critical care. Board certification is optional for everyone at this point. A critical care pharmacist with five years of experience (and zero residencies completed) qualifies to sit for the board exam. They do not need to go back and complete a residency. They just need to take the boards if they want to become certified.

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Board certification is required for critical care physicians, so it is a certification well understood and expected in most advanced healthcare environments. I foresee board certification in critical care pharmacy following a similar path.

Will you join the nearly 2,000 critical care pharmacists who have already become BCCCPs? I know that I will, after I finish my term on the Board of Pharmacy Specialties Critical Care Specialty Council and become eligible to sit for the exam. I would encourage everyone to embrace this opportunity for the profession and support the mission to ensure the safe and effective use of medications in critically ill patients.

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Author | Tyree H. Kiser, Pharm D.

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