Pharmacists, students partner with Open Door Mission

A partnership with the Open Door Mission and Lydia House of Omaha to create a pharmacist-run clinic is providing comprehensive medication management and pharmacy services to people who might not have access to it otherwise.

The goal of the clinic is to increase medication understanding, assist with access to affordable medications and help patients take control of and better comprehend their complex disease states. 

Nurse Chris Hedger and Ali Tanbouza-Husseini, UNMC College of Pharmacy student and pharmacist intern, review and update medication profiles in the electronic medical record.

Nebraska Medicine prescribing primary care providers, Dale Agner, MD, physician assistant Tamara Dietz and nurse practitioner Ashley Barajas also hold clinics at the Open Door Mission and refer and recommend patients for pharmaceutical services.

The clinic, organized by Maggie Hitzeman, Nebraska Medicine ambulatory cardiology pharmacist and community engagement committee member, is staffed by volunteers from the Nebraska Medicine Inpatient and Outpatient Pharmacy teams as well as UNMC College of Pharmacy pharmacists and students. 

"It has been amazing to see the Open Door Mission partnership expand beyond financial assistance under the leadership of Maggie," said Randy Moore, PharmD, manager, specialty pharmacy operation. 

It is open in the evening on the first and third Thursday of each month and can serve four to six patients per clinic. The clinic currently is staffed by up to two clinical pharmacists and two pharmacy student volunteers, as well as an on-site registered nurse.  

Services offered include:

• Medication education
• Complete disease state teaching where pharmacists and students help patients understand and take ownership of diseases in an effort to increase their comfort level with navigating complicated medication regimens used for treatment

The pharmacists and interns also work with the nurses on staff to arrange for follow-up for medication titration, assure that medications are refilled appropriately, recommend lab work for medication safety or monitoring, and refer patients for further workup by primary care or other specialists.  

Maddie Koenig, a UNMC College of Pharmacy student and Nebraska Medicine Pharmacy intern, has seen firsthand how beneficial this clinic is.

"I’ve witnessed the difference pharmacy students have made on the guests’ quality of life," she said. "Whether providing diabetes management education or identifying medication-related side effects, the students are medication advocates. The guests are so grateful to have medication experts available and our students are incredibly happy to help."   

Referrals to the clinic originate from the nurses on staff, other on-site volunteer clinics, or from the patient’s primary care provider. Patients seen in the clinic may have recently been discharged from the hospital, struggle with medication adherence, understanding, or access, or may have uncontrolled blood pressures or blood sugars.

Nebraska Medicine partnered with the Open Door Mission in 2019 to provide grant funding through the 340B Drug Pricing Program to improve medication access for Open Door Mission clients. The pharmacy clinic at Open Door Mission was initially slated to start in April of 2020, but due to the COVID-19 pandemic, plans had to be altered and instead of in-person visits, the clinic team began offering telehealth services in August that year. Additional offerings at Open Door Mission through this partnership included vaccine clinics, health fairs and screenings.

"The Nebraska Medicine Pharmacy and UNMC College of Pharmacy help make the impossible possible at the Open Door Mission’s free health and healing clinic," said Terry Jo Crouse, director of health and wellness at Open Door Mission. "When a patient comes from prison, homeless encampment, other states/countries, or disconnected from social services, they may not have insurance to fund needed medications. Our Open Door Mission staff is incredibly grateful for this partnership. The value of it is seen every day in the faces of our chronically ill guests. We can encourage the patients to take ownership of their health care, this can be a foundational building block out of homelessness or poverty."