Steve Danylchuk is a clinical pharmacist in the emergency department at the Red Deer Regional Hospital in Red Deer, Alberta. He also completed the PharmD bridging program in 2017.
Where They're Working
Born in Timmins – a small Ontario town about 3.5 hours north of Sudbury – Steve wanted to be a pharmacist since he was sixteen. He worked at a pharmacy as a teenager, and the mentorship of two pharmacists there led him to the University of Waterloo.
After graduation, he travelled to Provost, Alberta and then to Red Deer, where he works in a regional hospital that serves a population of approximately 500,000. As an emergency department pharmacist, his main role is an expert consultant on medications; he works collaboratively with emergency department physicians, internists, nurses, the homecare team, and more.
He also assesses patients in the emergency department, identifying patients that would most benefit from a pharmacist work up.
“Often this means identifying acute patients presenting with medication related causes, those with infectious diseases or palliative patients in a pain crisis,” says Steve. “I look at their condition and medications and make adjustments as necessary with the goal of providing proactive care instead of retroactively addressing problems after they happen.”
Reflections on the Program
“Co-op drew me to Waterloo Pharmacy – healthcare training follows a hands-on model for all other health professions, so it made good sense to choose a pharmacy school where I’d get the same kind of experience.”
As an Alberta pharmacist with additional certification, Steve has full prescribing rights that he makes use of daily in these work ups and in patient follow-ups.
While doing all this, Steve is also part of the trauma response team, and at any moment his day may be interrupted with an overhead page – ‘trauma team to trauma room 1’. There, under the leadership of an emergency department physician, Steve and a team of healthcare providers respond to urgent situations like cardiac arrests, overdoses, car accidents, and more.
Steve in the resuscitation bay.
“In this setting our ability as a team to prioritize is key,” Steve explains. “What is the problem – what needs to be addressed right away? Sometimes we need eight interventions but we can only do two at once. What’s the priority and which tasks do we perform first?”
Being on a trauma team requires efficient communication skills and rapid decision-making ability.
“You’re often faced with incomplete information, and you have to quickly make calls using the information available at the time. It’s a rapidly changing environment, but often these changes can be predicted. So we’re always thinking two steps ahead, anticipating what we should get ready for next.”
The work is challenging and fast-paced, but Steve has the kind of personality that thrives in that environment.
“I enjoy the challenge of solving the puzzles that’s offered both in trauma settings and from the variety of patients we see in the ED. In some practice environments, you consult patients and send them on their way without being able to directly see the result of your intervention. In emergency, you immediately get to see what your involvement on a team has done. A resuscitation that gets a pulse back. A patient that has a COPD exacerbation and can’t speak, who you can then have a full conversation with two hours later. It’s incredibly rewarding to see the impact of our interventions.”
Alumni Answers
UW: Working on a trauma team in high-stakes, fast-paced environments is daunting. How do you get started in this specialty?
SD: No one shows up day one as an expert and the skills involved come through practice and training. We have an extensive on-boarding process at the hospital as well as a variety of other specific training courses to account for expertise that is outside of the traditional pharmacist skillset. Examples include training for responding to codes and resuscitations, practice simulations and training specific to populations like pediatric or neonatal.
UW: You’re involved in Alberta’s Connect Care project to implement software that will share hospital medical information between all of Alberta’s hospitals and patients. Can you tell us about this project?
SD: I’ve been selected as a subject matter expert to provide input on the province’s new clinical information system. The goal of this project is to help hospitals across Alberta work in a consistent manner, utilizing the same software. I’ve provided input and feedback on processes related to pharmacist practice, sterile compounding and other areas, and it’s exciting to be part of this project that will improve and standardize workflows across the province.
UW: You’ve also conducted a research project examining the impact of pharmacist involvement on a stroke response team. Can you share some of your results?
SD: Door-to-needle time – the time between hospital presentation and receiving treatment – is critical for stroke patients. After a person has a stroke, every minute they don’t receive treatment results in 2 million neurons dying. We conducted a retrospective cohort study that showed, with statistical significance, that pharmacist involvement on a stroke response team was associated with an 8 minute reduction in door-to-needle time. To put this into perspective, our goal is a door-to-needle time of 30 minutes.
Non-Pharm Fun
