MethodistLeBonheurHealthcare

MethodistLeBonheurHealthcareisanintegrated,not-for-profit,six-hospitalhealthcaresystemlocatedinwesternTennesseethatisrootedinservice,quality,integrity,teamwork,andinnovation.PharmacyresidencypracticesitesatMethodistLeBonheurHealthcareincludeMethodistUniversityHospital(MUH),LeBonheurChildren’sHospital,andMethodistLeBonheurGermantownHospital.MUH,thehealthsystem’smaincampusandthelargest,mostcomprehensivehospitalinthehealthcaresystem,isatertiarycareacademicmedicalandreferralcenterlocatedinMemphis,Tennessee,withover50yearsofexcellenceinpharmacyresidencytraining.MUH,whichservesastheprimaryteachinghospitalfortheUniversityofTennesseeHealthScienceCenter,hasover600bedsandhasreceivedAdvancedComprehensiveStrokeCertificationfromtheAmericanHeartAssociation/AmericanStrokeAssociationasoneofthebusieststrokecentersinthecountry.

Currently,MUHhas13pharmacyresidentsandsixuniquetrainingprograms:PGY1PharmacyPracticePGY1/2Health-SystemPharmacyAdministrationPGY2InternalMedicinePGY2CriticalCarePGY2EmergencyMedicinePGY2SolidOrganTransplantation

TheresidencytrainingenvironmentatMUHincorporatestechniquesthatallowforresidentdevelopmentinseveralcoreareas,includingclinicalapplication(directpatientcare),scholarlyactivity(teaching,research,publication),leadership(local,state,andnationalorganizations),andoperationalactivities(centralpharmacydistributionandworkflow).ThemissionoftheMUHPGY1andPGY2residencyprogramsistograduateversatilepractitionerscapableofexcellinginpatientcare,research,andeducation.(1)PatientCareOneofthemostimpressivecharacteristicsofMUH’strainingenvironmentforpharmacyresidentsisthepatient-centeredintegratedpracticemodelthatisnowembeddedintheMethodistculture.Patientsassignedtothepharmacyresident’sunitorroundingteamareembodiedintheresident’scarefromstarttofinishinconjunctionwithphysician,nursing,socialwork,casemanagement,andadministrationteams.MUHcurrentlyhasalmost50preceptorsandprovidesover25rotationsatmultiplesitesthatrangefromtraditionalcorerotations,suchasinternalmedicine,criticalcare,andadministration,tospecializedrotationsinsolidorgantransplantation,oncology,cardiology,nephrology,andhepatology.

Currently,pharmacyresidentsareresponsibleforallpharmacokineticdosingofantibiotics,anticoagulationdosing,evaluationofheparin-inducedthrombocytopeniawithinitiation/dosing/monitoringofdirectthrombininhibitors,managementofparenteralnutrition,consultsforpulmonaryarterialhypertensionmedications,evaluationofbloodandurineculturepositivealerts,andevaluationofcontinuousrenalreplacementtherapyorders.Inaddition,

pharmacyresidentsareresponsiblefordevelopingtheprotocolsandformularyreviewspresentedatvariouscommitteeswithinthehospital,oneofwhichistherequiredmedicationuseevaluation.Severalpoliciesallowpharmaciststoindependentlyorderalllaboratoryresultsinvolvedwithapatient’stherapy,convertcertainIVmedicationstoPO,andmaketherenaladjustmentsforspecificmedications.Residentsalsoparticipateina24-hour/dayclinicalon-callprogram.

Finally,MUHexposespharmacyresidentstooperationalactivitiesthroughtheirservice

componentofresidencytraining.Residentscannavigatetheinnerworkingsofthepharmacydepartmentaftercompletinglearningexperiencesinthecentralpharmacy,IVroom,surgery,transplant,oncology,andinternalmedicine/criticalcaresatelliteareas.The“staffing”componentoftheMUHresidencyprogramcurrentlyconsistsofoneeveningshiftinthecentralpharmacyeveryotherweekandeverythirdweekend,alternatingwithclinicalpharmacyservicesininternalmedicine/criticalcaresatelliteareasandcentralpharmacyoperations.TheclinicaldevelopmentandpracticemanagementskillsthatresidentsobtainarecomplementedwithlongitudinalResidencyConferencesandaLeadershipDevelopmentSeries.ResidencyConferences,whichrotatethroughcoresubjectareasandoccurthreetimesmonthly,includeajournalclub,caseconference,andlecturepresentation.TheLeadershipDevelopmentSeriesinvolvesdiscussionwithpharmacydepartmentleaderstogaininsightintophilosophiesthatfocusonhowtoleadoneself,others,andtheprofession.(2)ResidencyResearchAlthoughnotarequirement,MUHhascreatedaculturethattrulybelievesthatcontributingtotheliteratureisaprofessionalobligationthatallowsthepharmacydepartmenttoinfluencepatientcareonaninternationallevel.Since2012,membersofthepharmacydepartmentatMUHhavewrittenover280scholarlyworks,with120involvingpharmacyresidents(51manuscriptsand69posters).Thegoalistoreinforcethatcontributingtotheliteratureisanobligationofthepharmacyprofessionthatinfluencespatientcareonthebroadestlevel.Theprogramfostersthisgoalthroughastructuredprocesscomposedofthreeprimarycomponents:theResidencyResearchOversightCommittee,PersonalProjectCommittee,andResearchDevelopmentSeries.

TheResidencyResearchOversightCommitteesolicitsandvetsideas,completesprojectassignment,tracksprogresstowardpublication,andassesseschangesannually.Eachresidentischargedwithpresentinganddefendinghisorherprojecttothiscommittee,simulatingtheexperienceofpresentingbeforeafullinstitutionalreviewboard(IRB).ThePersonalProjectCommitteeconsistsoffourclinicalpreceptorswhoworkwiththeresidenttoassistwithplanning,implementing,analyzing,andpresentingtheresultsoftheproject.Oneofthepreceptorsinthecommitteeisa“novice”tothatspecialtyarea,whichensuresthatresidentscandescribetheirprojectstosomeonewithoutkeyknowledgeofthesubjectandbringsclarityinprojectdesign.Finally,theResearchDevelopmentSeriesisasequentiallearningexperiencethatcomplementstheactualprojectbyprovidinginteractivelecturesinstudydesign,projectmanagement,theIRBsubmissionprocess,databasedesignanddevelopment,statisticalmethodology,andmanuscriptdevelopmenttips.

(3)EducationTheMUHpharmacyresidencyhasextensiveinvolvementwiththeUniversityofTennesseeCollegeofPharmacy.BecausetheuniversityoffersaTeachingandLearningProgram,pharmacyresidentscanbeappointedasadjunctclinicalprofessorsandhavemanyopportunitiestoparticipateindidacticlecturesandactivelearningenvironments.Residentsarepreparedfortheseendeavorsthroughseveralseminarsthroughouttheyear,suchasexam-questionwritingandpreparationinleadingactivelearning.

WithinMUHspecifically,pharmacyresidentshaveadditionalopportunitiestopreceptpharmacystudentsthroughoutalmostanyrotation,giventhatstudentsareacceptedfromthreecollegesofpharmacy.Moreover,residentshavemanyopportunitiestoeducatemedicalresidentsandnursesthroughmorningreports,journalclubs,andin-servicesonrounds.Theseexperiencesarecomplementedthroughpreceptormentorshipand,incollaborationwiththeTeachingandLearningProgram,lecturesinpreceptordevelopmentandappropriatestudentevaluations.

FormoreinformationabouttheMUHPGY1orPGY2residencyprograms,pleasevisitthe

MUHprogramwebsite(www.methodisthealth.org/education/pharmacy-residency-programs/pgy1-and-pgy2-residency-programs.dot)orcontactprogramleadership.JenniferTwilla,Pharm.D.,BCPSPGY1ResidencyProgramDirectorjennifer.twilla@mlh.orgAndreaCurry,MHA,CPhTPharmacyProgramCoordinatorandrea.curry@mlh.orgSubmittedby:TaylorMorrisette,Pharm.D.PGY1PharmacyResidentatMethodistUniversityHospital