1. Serves as a therapeutic consultant by attending medical rounds and conferences with the physicians to provide information used in evaluation and implementation of optimal medication plans for inpatients and outpatients. Performs a comprehensive review of the patient's medical history. Analyzes selected medication programs for accuracy, incompatibilities, contraindications, and appropriate doses. Confers with the physician for required monitoring procedures and laboratory tests. Monitors patient medication therapy for effectiveness, side effects, and adverse reactions. Recommends alternate therapy to the physician when appropriate. Initiates orders for selected drug therapies and diagnostic tests according to established protocols and within the parameters of approved clinical privileges. Develops, orders, and adjusts individualized medication regimens per protocol or consent of physician. Administers medications according to providers guidance and pre-established protocols. Provides medication information to patients, evaluates the likelihood of patient medication adherence, and provides suggestions to the patient and the physician for improvement of the therapy regimen. Counsels patients on the use and proper method of administration of medications, side effects, precautions, and other general information prior to discharge. Monitors usage and compliance of medications prescribed in the treatment of selected diagnoses after the patient is discharged. 2. Establishes and maintains a comprehensive pharmaceutical dosing service. Develops individual dosing regimens based upon pharmacokinetics of drugs employed, disease states, and medication history of the patient. Monitors selected medication levels and disease physiology for optimal pharmacokinetic dosing. Adjusts medication per established guidance or provides recommendations to the physician related to possible changes in dose, interval of medication administration, and appropriate times to draw laboratory samples. Coordinates with the pharmacy to ensure optimal provision of medication therapy. Guides the medical staff in designing, coordinating, and accomplishing an effective medication utilization evaluation (MUE) program to promote and sustain optimal therapeutic effectiveness and reduce waste. Conducts studies and audits of drug use. Initiates cost effectiveness analysis, and reviews specific drug use and total drug therapy for high cost/high volume disease states. Makes recommendations to the physician and to the Pharmacy and Therapeutics Committee for effective utilization of resources. 3. Performs formal educational activities by supporting and providing routine and complex drug information to patients, physicians, and other staff through literature analysis and research. Provides lectures for continuing education to pharmacy, nursing, and medical staffs on a variety of subjects including general pharmaceutical information and complex topics such as pharmacokinetics, therapeutics, and pharmacology. Serves as a pharmacy preceptor, instructor, and clinical consultant to support or train staff, students, or volunteers. Directs and monitors student/resident projects and presentations. Provides drug education to patients on correct use of medications, potential side effects and unique medication packaging through verbal and written means. 4. Establishes the operational policies of the pharmacy for the clinical area and the functional direction of pharmacy staff members performing tasks related to clinical services such as preparing discharge medications, bedside medication, medication labeling, and adjusting specific intravenous drug preparations. Provides leadership and accountability for clinical activities of pharmacy students, residents, Reservists, and staff members in the clinical area. Operates the facility's Adverse Drug Event Program to include reviewing charts, collating data, and contacting physicians, recommending actions, preparing required reports, and maintaining files. Serves as the primary investigator or assists the primary investigator in the preparation of clinical research protocols and in the analysis of data relating to medication use. Serves as the Pharmacy Department/Service's subject matter expert on Medical Treatment Facilities committees. Performs medications distribution functions by conducting activities such as filling, checking, counseling, and dispensing of outpatient prescriptions, preparation of intravenous admixture and filling, checking, and dispensing of unit dose medications. PERFORMS OTHER DUTIES AS ASSIGNED.