The Pharmaceutical Journal/Louise Organista
The ways in which Louise Organista, advanced clinical pharmacist in frailty at University Hospitals of Derby and Burton NHS Foundation Trust, has improved care for her patients are almost too numerous to count. The judges highlighted her “profound understanding” of the complexities of medicines for older people, her patient-centred approach and “exemplary leadership”.
She is “clearly self-motivated to work beyond her direct role” to benefit those around her, they commented.
It took Organista some time to find the role, in which she is so clearly at home. Choosing pharmacy because she was interested in research, she was far too shy as a student at Queen’s University Belfast from 2009 to 2013 to imagine herself speaking to patients. She did come out of her shell but was still considering a career as a chef. In 2014, she moved to England and started working as a pharmacist at Nottingham University Hospital.
Travel beckoned and she trotted the globe working in kitchens along the way, but as much as she enjoyed it, she realised that pharmacy was what she wanted to do and had a renewed sense of purpose. “That really helped me decide that pharmacy is such a great job. Food could be my side hobby,” she says.
In her next role in an admissions unit at Nottingham University Hospital, she started to have more contact with older patients. In 2021, she started working as a frailty pharmacist at University Hospitals of Derby and Burton NHS Foundation Trust. “That’s when I really fell in love with what I do and gained such a passion,” she says. “I get so much job satisfaction from it.”
There’s so much patient contact, working together alongside a patient to come up with a shared care plan, and it can be messy
Organista’s approach is to not only think about medicines but to consider the whole person: their social circumstances, mental health, how well they sleep, physical mobility and support. A big part of her job is minimising the risk of harms from medicines, but her holistic management plans are far from drug-based.
“There’s so much patient contact, working together alongside a patient to come up with a shared care plan, and it can be messy. You’re seeing their whole lives. It’s not just one problem going on. There’s a lot of different things coming together,” she says. Organista is as surprised as anyone that this is where that shy 18-year-old ended up.
Working as part of a multidisciplinary team, Organista goes to great lengths to ensure that when she is deprescribing, she carefully explains why. Communication with primary care and secondary care medics on the wards is essential, she says.
Based in an emergency department, patients get a full comprehensive geriatric assessment. During the assessment, Organista works alongside a physiotherapist and occupational health nurse to conduct a medicines review, assess patients’ cognitive abilities, anxiety levels and sleep quality, as well as assess their risk of falls. The patients highly value this, alongside the medical assessment, she adds. More than half (56%) of patients are seen as part of these assessments, which helps avoid admissions. She also sees 100 patients per month for medicines optimisation.
Organista has developed teaching material for a prescribing module at the University of Nottingham around frailty and polypharmacy, has carried out audits of junior doctor prescribing within the medical admissions unit and is the project manager on the ‘CHARMER’ study, a clinical trial for deprescribing, at her trust.
She also developed an anticoagulation referral service in Derby, Derbyshire, ensuring that patients who began direct oral anticoagulants (DOACs) received the necessary follow-up, proactively reaching out to drug companies for resources and collaborating with the anticoagulation team to improve patient safety. She also led the transition of her team’s handover processes from paper-based systems to digital platforms, boosting their efficiency.
Organista is actively involved with the British Geriatrics Society (BGS), co-chairing the pharmacist professional group. Yet she had to push for this group to be set up after she realised pharmacy professionals did not have a space within the organisation. Since then, she has been invited to speak at the BGS spring meeting in 2024 on medicines reconciliation.
Her career has not always been straightforward. When she joined her current frailty team, she was the only full-time pharmacist available. With minimal handover from her predecessor, she had to navigate the role independently and quickly adapt to the systems and expectations of her team. It was a steep learning curve, but it also got her to the place she is today.
Her ambition for the future is to integrate research into her clinical practice to further improve patient care — and has applied for funding to boost her skills. She is also participating in the NHS Mary Seacole programme, which was set up to develop leadership skills in those with responsibilities for people and services in the NHS. One day, she hopes to be a consultant frailty pharmacist, combining her expertise in clinical practice, leadership, research and education, she says.
Having grown up on a farm in Northern Ireland, Organista still lives in the countryside, enjoying the outdoors. She also still loves to cook, experimenting with sourdough bread and other complicated recipes. It seems she has indeed found a way to embrace both of her passions.
Panel comments
“Clearly self-motivated to work beyond direct roles and in roles that benefit others. She has shown demonstratable impact and outcomes of projects she led.”
“Very strong nominee whose work directly improves patient care.”
- Meet the rest of The Pharmaceutical Journal’s Women to Watch 2024 here
