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In this role, the pharmacist provides exceptional care to patients throughout their peri-operative journey, including pre-operative, intra-operative, and post-operative phases of medication management. Decentral clinical services consist of collaborative practice with multidisciplinary teams, identification of drug-related problems, provision and documentation of recommendations through progress notes regarding optimization of drug therapy, admission and discharge medication reconciliation, transition of care planning, participation on discharge rounds, intermittent surgical team rounds, and direct patient care.