Section 25.2: Where to Find Information Fast (Policies, Order Sets, People)

25.2.1 The “Why”: Speed to Answer is a Core Competency

In your first few months as a hospital pharmacist, you will be asked hundreds of questions to which you do not know the answer. This is not a sign of weakness; it is an expected reality of transitioning into a complex new environment. Your value as a professional is not defined by having every answer memorized, but by your ability to find the correct answer with speed and accuracy. An answer that takes you 30 minutes to find is often clinically useless, as the decision has already been made without you. An answer that takes you two minutes to find can change the course of a patient’s care.

Therefore, learning the hospital’s information architecture is as important as learning its pharmacology. In retail, your resources were likely centralized and familiar: your dispensing system, a trusted drug information database, and a well-known group of colleagues. In a hospital, the information is vast, decentralized, and exists in three distinct domains: written policies (the “laws”), EHR order sets (the “guardrails”), and the unwritten, experiential knowledge of people (the “oral tradition”).

Being an effective information navigator means knowing which domain to access for which question. A question about heparin dosing is answered by a policy. A question about the standard orders for a stroke patient is answered by an order set. A question about why the ADC on a specific unit is behaving strangely is answered by a person. This section is your orientation to this new, complex library. We will give you the card catalog, show you the different wings of the building, and teach you the most important skill of all: knowing when to stop searching the stacks and ask the head librarian.

25.2.2 The Analogy: From a Familiar Website to a University Library

Masterclass Part 1: The Digital Rulebook — Navigating Policies and Protocols

The hospital intranet is the central, single source of truth for all official policies. A passing conversation in the hallway or a tip from a colleague is not a substitute for the written policy. In any moment of ambiguity or disagreement, the written policy is the final arbiter. Knowing how to find and interpret these documents is a foundational skill.

25.2.3 Your “Must-Read” Policy Library

During your first month, you should make it a personal objective to locate, download, and at least skim the following key policies and protocols. These documents govern the highest-risk medication use scenarios you will encounter daily. Knowing what they say—or at least knowing where to find them in seconds—is non-negotiable.

Masterclass Part 2: The Digital Workflow — Finding and Deconstructing Order Sets

Order sets are the guardrails of standardized care in the hospital. They are pre-built collections of orders for a specific diagnosis or procedure, designed by multidisciplinary teams to reflect best practices. Understanding how to find and interpret them gives you a powerful insight into the hospital’s standard of care and helps you anticipate provider needs.

25.2.4 Deconstructing a Common Order Set: Community-Acquired Pneumonia (CAP)

Let’s take one of the most common admission diagnoses and break down its associated order set. Your goal is not to memorize every order, but to understand the structure and the logic.

Section of Order Set	Example Orders	The “Why” from a Pharmacist’s Perspective
Admission & Diagnosis	– Admit to Medical/Surgical Unit – Diagnosis: Community-Acquired Pneumonia	This establishes the level of care and the primary indication, which drives all subsequent medication choices.
Nursing Orders	– Vitals q4h – Continuous pulse oximetry – Diet: Regular – Encourage incentive spirometry	These orders give you clues about the patient’s stability. A patient on a regular diet is a potential candidate for PO medications. Continuous pulse oximetry suggests a higher level of respiratory distress.
Laboratory Orders	– CBC with differential – Basic Metabolic Panel (BMP) – Blood cultures x 2 – Sputum culture	This is your data mine. The BMP gives you the renal function (Cr) needed for dose adjustments. The CBC gives you the WBC count to trend response to therapy. The cultures will eventually allow for de-escalation of antibiotics.
Medications – Antibiotics	– Option A (Standard): Ceftriaxone 1g IV daily AND Azithromycin 500mg IV/PO daily – Option B (PCN Allergy): Levofloxacin 750mg IV daily – Option C (MRSA/Pseudomonas Risk): Vancomycin + Piperacillin-Tazobactam	This is the heart of the order set for pharmacy. It presents the evidence-based, guideline-recommended antibiotic choices. Your first job on verification is to ensure the provider has chosen the correct option based on the patient’s allergies and risk factors. Understanding this structure helps you make quick, confident interventions.
Medications – Symptomatic Care	– Albuterol nebulizer q4h PRN shortness of breath – Acetaminophen 650mg PO q6h PRN fever/pain – VTE Prophylaxis: Enoxaparin 40mg SC daily	These are the standard supportive care orders. Your role here is to check for appropriateness. Does the patient need VTE prophylaxis? Is the dose correct for their renal function? Is the PRN acetaminophen duplicative with any of their home medications?

Masterclass Part 3: The Human Library — Knowing Who to Ask and How

You can be the best policy-finder and EHR-navigator in the world, but there will be countless situations where the fastest, most effective, and only way to get the information you need is to ask another human being. The art is in knowing who to ask for what, and how to do so in a way that respects their time and builds your relationship.

25.2.5 Your Human Search Engine: A Tactical Directory

The following table is your cheat sheet for routing your questions to the right person. Going to the correct source first saves everyone time and builds your reputation as an efficient colleague.

When you need to know…	Primary Person to Ask	Secondary Person to Ask	Example Script
“How do I…?” (A process/EHR question)	Your Preceptor They are your designated trainer. Their job is to answer these questions.	A Friendly Pharmacist Colleague Someone you’ve built rapport with.	“Hi [Preceptor Name], I’m trying to add a comment to this order. I’ve looked in the usual spots, but I can’t seem to find the right button. Can you show me how you do it?”
“Where is…?” (A physical item/medication)	An Experienced Pharmacy Technician They are masters of pharmacy logistics and inventory.	The Charge Nurse on the Unit They know their unit’s supply quirks.	“Hey [Tech Name], I know you’re super busy, but I have a nurse from 6N calling about a missing dose of amiodarone. The system says it was delivered. Do you have any idea where it might have gone?”
“What’s the plan for…?” (The medical strategy for a patient)	The Intern or Resident They are executing the day-to-day plan and should know the immediate next steps.	The Senior Resident They are supervising the plan and have the bigger picture.	(To the Intern via secure chat) “Hi Dr. Smith, for Jane Doe in 602, I see her cultures are back. Just wanted to follow up and see what your thoughts were on de-escalating her antibiotics today.”
“What’s happening *right now*…?” (Real-time patient status)	The Patient’s Primary RN They are with the patient and have the most up-to-the-minute clinical assessment.	The Charge Nurse They have an overview of all the patients on the unit.	(Calling the RN) “Hi Sarah, this is [Your Name] from pharmacy. Dr. Jones just put in a STAT order for labetalol for Mrs. Chen. Can you tell me what her blood pressure is right now?”
“Why do we…?” (Deep clinical or historical rationale)	A Clinical Specialist or Your Preceptor They have the deep therapeutic knowledge and institutional memory.	Your Clinical Manager They are involved in policy and protocol development.	(Catching the ID pharmacist) “Hi Dr. Evans, quick question for you when you have a free second. I noticed our CAP order set prefers azithromycin over doxycycline. I was just curious about the historical reason for that choice at our hospital.”