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1
Pharmacy Practice Residency Manual (2011-2012)
Table of Contents
Section I Training Manual Page
1. Purpose and philosophy 3
2. Organization Structure 4
3. Program Goals 5
4. Residency Program Structure 6
5. Benefits 7
6. Verification of licensure 8
7. Supervision and Work Ethic 8
8. Policy Access 8
9. Required experiences and activities 10-11
10. Tracking Form 12-13
11. Residency Project 14
12. Residency Project Worksheet 15
13. Past Residency Project List 16-17
14. Project/Activity Timeline 18
15. Evaluations 20
16. Documentation 21
17. Hospital Pharmacy Practice (Staffing) Overview 22
Section II Schedules / Calendars
1. Resident Rotation schedule 27
2. Evaluation Due Date Schedule 28
3. Residency Council Dates 29
4. Presentation Calendar 30
5. Orientation Discussion schedule 31
6. Orientation Checklist 32-35
7. Orientation Schedule 36
Section III Resident Portfolio
1. Presentations
2. Projects
3. Assignments
4. Evaluations
2
Pharmacy Practice Residency Program:
Structure
Purpose and Philosophy
Departmental Organization Chart
Program Goals
Program Structure
Benefits
3
PURPOSE AND PHILOSOPHY
The purpose of this residency is to develop a pharmacist with the skills and abilities
to successfully practice as an acute care pharmacist, adjunct faculty member and/or
be prepared to pursue and complete PGY2 residency training.
Philosophy
The ASHP accreditation standard provides criteria that every program must meet in
order to receive and maintain accreditation. Although the standard requires
experiences in certain core areas, there is room for concentration in a practice area
and for additional experiences. The mission of our program includes developing a
core skill set in drug information and literature evaluation, pharmacotherapy
evaluation and management, project based research and team functioning,
presentation development and delivery, and direct patient interaction.
4
5
PROGRAM GOALS The residency program will provide each resident with specific learning/practice experiences designed to enable the resident to expand the scope of
his/her practice skills. Outcomes
R1 Manage and improve the medication-use process.
R2 Provide evidence-based, patient-centered medication therapy management with interdisciplinary teams.
R3 Exercise leadership and practice management skills. (Overall Performance and Administration Rotation)
R4 Demonstrate project management skills. (Projects)
R5 Provide medication and practice-related education/training
R6 Utilize medical informatics.
E2 Exercise added leadership and practice management skills.
E6 Provide drug information to health care professionals and/or the public.
E7 Demonstrate additional competencies that contribute to working successfully in the health care environment.
E8 Demonstrate additional competencies that contribute to working successfully in the health care environment (additional)
Patient Care
R2.10 Evaluate patients’ progress and redesign regimens and monitoring plans..
R2.11 Communicate ongoing patient information
R2.12 Document direct patient care activities appropriately.
R2.2 Place practice priority on the delivery of patient-centered care to patients.
R2.3 As appropriate, establish collaborative professional pharmacist-patient relationships.
R2.4 Collect and analyze patient information.
R2.5 When necessary, make and follow up on patient referrals.
R2.6 Design evidence-based therapeutic regimens.
R2.7 Design evidence-based monitoring plans.
R2.8 Recommend or communicate regimens and monitoring plans.
R2.9 Implement regimens and monitoring plans.
Practice Foundation Skills
R1.5 Provide concise, applicable, comprehensive, and timely responses to requests for drug information from patients, health care providers, and the public.
E8.1 Use approaches in all communications that display sensitivity to the cultural and personal characteristics of patients, caregivers, and health care colleagues.
E8.2/7.2 Communicate effectively.
E8.3/7.3 Balance obligations to oneself, relationships, and work in a way that minimizes stress.
E8.4/7.4 Manage time effectively to fulfill practice responsibilities.
R2.1 As appropriate, establish collaborative professional relationships with members of the health care team.
R3.1 Exhibit essential personal skills of a practice leader.
R3.3 Exercise practice leadership.
Practice Management
E1.1 Design, execute, and report results of investigations of pharmacy practice-related issues.
E2.2 Understand the pharmacy procurement process.
E2.6 Understand the process of managing the practice area's human resources.
E6.1* Participate in the organization’s formulary process.
E7.1 Identify a core library, including electronic media, appropriate for a specific practice setting.
E8.5 Make effective use of available software and information systems.
R1.1 Identify opportunities for improvement of the organization’s medication-use system.
R1.2 Design and implement quality improvement changes to the organization’s medication-use system.
R1.3 Prepare and dispense medications following existing standards of practice and the organization’s policies and procedures.
R1.4 Demonstrate ownership of and responsibility for the welfare of the patient by performing all necessary aspects of the medication-use system.
R3.2 Contribute to departmental leadership and management activities.
R4.1 Conduct practice-related investigations using effective project management skills.
R5.1 Provide effective medication and practice-related education, training, or counseling to patients, caregivers, health care professionals, and the public.
R6.1 Use information technology to make decisions and reduce error.
6
STRUCTURE
Orientation (required) Core Rotations (required) Transitional Elective Rotations
(choose 4) Hospital Orientation Residency/RLS Computer Training Hospital Practice
Administration General Internal Medicine Critical Care (pick one) Surgical ICU Trauma ICU
Hospital Pharmacy Practice Projects ASHP Midyear
Solid Organ Transplant Bone Marrow Transplant General Pediatrics Hematology/Oncology Nutrition Infectious Disease Critical Care Medicine Trauma Burn Surgical Geriatrics Coumadin Clinic HIV/AIDS Cardiology ICU Pediatrics NICU Pediatrics Informatics
Longitudinal (required)
Drug Information P&T MUE Journal Club Case Conference Hospital Pharmacy Practice Staffing (operational and clinical) Residency Project Seminars Tx Exg CE 60min Residency Project 15-30min Criteria Based Skill Assessments (CBAs)
7
BENEFITS
Educational leave Full access to Biomedical Library
Books directly related to the residency Lab coats are the responsibility of the resident, but
can be purchased through the hospital
Two weeks paid vacation, select holidays Sick leave
Travel & relocation expense directly related (moving company, rental, fuel, hotel) to the move –
up to $1500
Financial support and professional leave for the University of Tennessee
Annual Residency Program, the ASHP MYCM and the Annual Southeastern Residency Conference in Athens, GA
Life insurance Discounts at local merchants
Professional liability insurance supplied by the Medical Center
Limited financial support for presentations at Vanderbilt and outside the campus – depends on the residents activities at the
meeting (officer, presentation, etc)
Health care plan options, including an HMO plan All ACPE approved continuing education provided by the
Department of Pharmaceutical Services
Payment of Tennessee Board of Pharmacy license fee in June – license fee and professional tax.
We do not pay NABPLEX fees or for reciprocation of license to TN. We will pay for transfer of NABPLEX scores.
Immunizations and other health related costs required by the Medical Center
Photocopying directly related to residency House staff & hospital orientation programs
Office space & computer workstation Competitive stipend
Employee Assistance Program Employee Wellness Program
Concierge Service
Provision of personal electronic devices will be supplied by the hospital if they are essential to the work of the resident.
Membership in professional organizations is the responsibility of the resident
Purchase of software, books, or other materials must be directly related to the achievement of residency objectives, and must be approved beforehand by the Residency Director.
Explanation of Time Off: Residents (Exempt Status) o Fifteen vacation days are accrued over the course of the year. Ten (10) vacation days are available for
use and must be taken during the year. Each resident must sign up for and take no less than one week of
vacation time prior to January 15 of the residency year. (Residency Director may approve alterations in
certain situations). Maximum of five (5) of the 15 days accrued may be paid out to each resident at the
completion of the residency (these may be used during the year for extraneous circumstances if deemed
appropriate by the Residency Director). Vacation may not be taken during ASHP Midyear Meeting or
SERC meeting days, or scheduled holidays/weekends in the staffing component of the residency.
Vacation requested for June is discouraged and will be reviewed on a case by case basis by the
Residency Director. Residents may not be absent more than 5 days from any rotation experience
(professional leave/personal/vacation).
o Requests for vacation days should be submitted to the Residency Director via electronic mail at least 4
weeks in advance for priority consideration. Requests made after the 4 week cut-off will be handled on
a case-by-case basis in order to ensure appropriate staffing. All requests will receive a response within 2
business days. If for some reason the Residency Director is not available, the responsibility for
reviewed vacation requests will be delegated to the Residency Coordinator.
o 12 Sick Days are accrued over the course of the year. Refer to the hospital/department policy for details.
o Seven (7) Holidays (July 4th
, Labor Day, Thanksgiving Day, Christmas Eve, Christmas Day, New
Year’s Day, Memorial Day) and 3 personal days are accrued over the year. These must be taken. If
required to work a holiday, the holiday is to be taken on an alternate day within 30 days of accrual.
Residents will agree with rotation preceptor if the resident is to work the actual holiday or take an
alternate day as the holiday. If the resident is scheduled on the pharmacy staffing schedule for a holiday,
that shift prevails. The department also recognizes the day after Thanksgiving and New Years Eve in
the department staffing rotation and these are handled and scheduled per department policy.
8
LICENSURE VERIFICATION
Pharmacy licensure in Tennessee is a requirement for pharmacy practice residents at VUMC. The residency
program director will confirm that each resident has taken the NABPLEX and the Tennessee pharmacy law
exam, or will take the Tennessee law exam upon transfer of NABPLEX scores from another state, or already
had a valid Tennessee pharmacy license. Upon notification of successful completion of the NABPLEX and/or
law exam the resident will provide documentation of licensure to the residency program director. The resident
will provide the department the licensure certificate for display during the resident’s year at VUMC. Licensure
must be obtained no later than August 15th of the residency year.
SUPERVISION AND WORK ETHIC
The resident is expected to achieve the objectives of the Residency Program related to both administrative and
professional practice skills. The resident reports to and is supervised by the rotation preceptor and the residency
director. During staffing, the resident is under the supervision of the pharmacist in charge.
Hours of practice vary according to the requirements set forth by the preceptor and director. The resident is
expected to be present in body, mind and spirit at all assigned activities of the service they are currently a part
of, including medical staff rounding, education classes, and administrative activities. It is not uncommon for
the resident to be assigned duties that require work overnight or that may continue during days away from the
hospital. Although these assignments will be frequent, they will not be beyond the expectations of other
pharmacy professionals’ duties. An eight hour day is a minimum requirement for physical presence on site
during assigned work days.
The work of the Department is the resident’s most important commitment. Working outside the residency
program (moonlighting) is strongly discouraged, particularly at the beginning of the residency. Should posted
time be available inside the Department, the resident will be paid at a competitive staff pharmacist rate. To
work overtime, the resident must be trained in the area. Extra work moonlighting and overtime work must be
approved by the Residency Director, and hours worked will be reported on a monthly basis by each resident.
The ACGME duty hour requirements are to be followed at all times.
Additional Policies Applicable to Pharmacy Residents Should
be reviewed at the following websites:
Vanderbilt Human Resources WebSite: http://hr.vanderbilt.edu/
VUMC Website: http://vumcpolicies.mc.vanderbilt.edu
VUH Pharmacy Residency Policy: http://vumcpolicies.mc.vanderbilt.edu/E-
MANUAL/Hpolicy.nsf/AllDocs/A09FD26D92F6770886257289005AB35F
9
Pharmacy Practice Residency:
Activities/Requirements
Residency Experience Synopses
Tracking Form for requirement completion
Residency Project Requirement Overview and Timeline
Residency Project Description Worksheet
Completed Residency Project List (1999-2009)
Suggested Timeline for Requirements Completion
10
RESIDENCY EXPERIENCE ACTIVITIES
Out-of-State Conferences:
ASHP Midyear: Usually occurs the first week of December. Residents should start registration process for this meeting in
August.
Southeastern Residency Conference:
This is usually in April or May in Athens, Georgia. Registration begins in January/February and Abstract submission deadline is
usually around February 10. Residents are responsible for meeting these registration deadlines. Residents are to confirm these
deadlines and register in early January. Information for this conference can be found at:
http://www.rx.uga.edu/main/home/ce/programs-and-seminars/serc.asp#dates
Hospital Pharmacy Practice:
The residents will practice in a guided hospital practice scheduled every fourth weekend, selected holidays and one evening per week.
The resident will gain experience in the IV room, Central dispensing area, Narcotic Room procedures, and responsibilities of the
pharmacist in charge as well assist with clinical consults and dashboard monitoring.
Journal Club:
This is a longitudinal activity. Residents will sign up to formally present two current pharmacotherapy related studies during the
residency year. This will include a self-evaluation and a formal evaluation. Resident attendance is required at all sessions.
The primary goal of journal club is to exercise skills in critical thinking and literature evaluation.
Case Conference:
This is a longitudinal activity. Residents will sign up to formally present two case presentations during the residency year. The cases
presented should revolve around pharmacotherapy topics and include primary literature and be a case in which the resident was
directly involved. This will include a self-evaluation and a formal evaluation. PowerPoint is used for this presentation. Resident
attendance is required at all sessions.
Seminars:
Two formal presentations by each resident will be conducted during the residency year:
One of these will be a Therapeutic Exchange slot. This presentation should be a pharmacotherapy topic that includes
some controversy and/or is a hot topic in pharmacotherapy. This is a 60 minute CE presentation. This is not just a
review of a disease state. Primary literature is to be used as a guiding force to put this presentation together. This is to
be prepared and presented with MS Power Point. This will include a self-evaluation and a formal evaluation.
Presentation objectives and Title are to be submitted by July 15th to Gayle Lane. Self-assessment questions (~5
questions for the audience) will are due by August 1st to Gayle Lane.
The second formal presentation will be a 10-15 minute presentation of the resident’s residency project. This includes
several practice sessions then the formal presentation with feedback/evaluation from preceptors and residents during
practice and attendees at SERC.
These presentations will be presented to the pharmacy department and other guests. Resident attendance is required at all sessions.
Pharmacy and Therapeutics Committee:
Each resident will attend one P&T committee meeting and related subcommittees during the residency year. A drug monograph will
be written and presented during this experience. This will be assigned by the P&T Pharmacist. Drug monographs require review and
presentation of primary literature. A 10 minute power point presentation will be prepared that focuses on the drug’s place in therapy,
with a literature supported comparison and analysis of efficacy, safety and cost of the drug and its competitors. An opinion should be
outlined with recommendation for formulary status. This will be presented to the P&T Committee. As new agents are constantly be
approved by the FDA, monographs will be assigned as they come to the attention of the P&T Committee. A resident will have
approximately 30 days to prepare the monograph once assigned.
Newsletter/Fast Facts:
Each resident will make 2 fast fact contributions to the newsletter.
Research Project:
Each resident will conduct a research project over the course of the residency year. This project will include idea development,
literature review, study design, IRB submission, data collection, data analysis, data interpretation, oral presentation and a written
manuscript. The written manuscript is to include identification of an appropriate journal for potential submission and the following of
the instruction to authors for that journal. The manuscript must be written and submitted in final form prior to completion of
residency. The manuscript must be reviewed by the project mentor(s) and approved by the residency director.
11
MUE: Each resident will complete one medication use evaluation during the residency year. These are assigned in the first or second quarter
of the year and depending on the scope of the MUE chosen may be conducted individually or in pairs. Findings are to be summarized
in a 10 minute power point presentation with recommendations of the most appropriate course of action based on the findings to the
P&T Committee and/or appropriate committee.
Recruitment:
Residents will assist in the resident recruitment and candidate selection process.
Therapeutic Exchange:
This is a weekly conference held at noon on Thursdays by the pharmacy department for pharmacists and technicians to obtain
continuing education hours. Attendance by residents is strongly encouraged throughout the year.
Block Rotations:
There are seven block rotation periods during the PGY1 residency year. Each block rotation period is approximately six weeks in
duration. A minimum of five of the seven rotation periods must be completed in clinical patient care rotations. All residents must
complete the following three required rotations: administration, internal medicine and either surgical or trauma intensive care.
During block rotations, residents will fulfill many of the clinical core requirements of the residency as well as develop interest areas
through selected rotations. Rotation requirements may vary based on preceptor. Criteria based assessments should be reviewed at the
outset of each rotation by resident and preceptor to assure completion of all requirements by the end of the residency year.
Medical Center Educational Programs:
Noon conferences, departmental grand rounds, and other educational conferences are offered throughout VUMC. These are posted in
the Vanderbilt publications. Residents are encouraged to attend various conferences related to specific rotations.
12
RESIDENCY EVALUATION TRACKING FORM RESIDENT: ____________
(Indicate date of completion in box)
SUMMATIVE EVLAUATIONS
Rotation Period Rotation 1 Rotation 2 Rotation 3 Rotation 4 Rotation 5 Rotation 6 Rotation 7
Preceptor’s Evaluation
Resident Self Assessment
Preceptor/Rotation Eval
LONGITUDINAL EVALUATIONS
Hospital Practice Quarter 1 Quarter 2 Quarter 3 Quarter 4
Preceptor’s Evaluation
Resident Self Assessment
Preceptor/Rotation Eval.
Residency Project
Preceptor’s Evaluation
Resident Self Assessment
Preceptor/Rotation Eval
Training Plan Progress
Residency Council Report
Resident Training Plan Self Assess
PRESENTATIONS
Case Presentations #1 #2
Preceptor’s Evaluation
Resident Self Assessment
Formal Presentations #1 #2
Therapeutic Exchange/Seminar SERC
Therapeutic Exchange/Seminar Self-Assessment
JOURNAL CLUB/DRUG INFORMATION
Journal Club #1 #2
Preceptor’s Evaluation
Resident Self Assessment
DI Questions #1 #2 #3 #4 #5 #6
DI Researched Question Eval
Resident Self Assessment ***Turn in to corresponding preceptor during rotation
13
PHARMACEUTICAL CARE/FOUNDATION SKILLS
Care Plan #1 #2 #3 #4
Preceptor’s Evaluation
Resident Self Assessment
Drug Therapy or Practice Related Problem Solving #1 #2
Preceptor’s Evaluation
Resident Self Assessment
Patient Counseling #1 #2
Preceptor’s Evaluation
Resident Self Assessment
Documentation #1 #2
Preceptor’s Evaluation
Resident Self Assessment
PROJECTS
Title Proposal IRB Data Collection Presentation Manuscript
MEDICATION USE EVALUATION
Topic Proposal Data Collection Report Presentation
P&T MONOGRAPH
Topic Written Presented Evaluated
Newsletter/Fast Fact
#1 #2
Direct Patient Care
#1
Sterile Product Preparation*
*Per Dept. Competency Procedures
14
RESIDENCY PROJECT
A project, administered by the resident and mentored by a primary preceptor, is
required of all residents. The project is to be of benefit to the individual, the
Department, and to the institution. There is to be a significant amount of literature
review, project design, data gathering, statistical evaluation, writing, and reporting
done by the resident. The end product is a presentation at the Southeastern
Residency Conference and a written manuscript suitable for publication in the
pharmacy refereed journal, written in according to the Instructions for Authors of
the American Journal of Health-System Pharmacists or selected journal
requirements. Residency project ideas will be submitted by the Department to the
residents early in the year. Deadlines are set for initial submission of project plans.
Projects must be evaluated for feasibility and approved by the residency director /
research committee before performing the project. One preceptor will be selected
for each project who will act to facilitate the project, mentor the resident, and who
shares responsibility for meeting deadlines, submission of applications for research
(IRB, etc.), presentations and manuscript development and submission. The project
plan submitted should be binding to the resident and to the preceptor(s) involved.
Project designs will be reviewed by the research committee. The committee will
serve as a consultant and advisor for the residency project.
Project Deadline Schedule: Project topic/title August 31
Study Protocol and data collection form October 31
IRB submission completed November 30
Project data collection complete February 28
Data analysis March 30
First manuscript draft May 15
Final revisions completed June 1
15
Residency Project Description
Worksheet
2011
_________________________________________________________________
Resident: Project Advisor:
Date of Initiation: Date of Completion:
Responsible Investigators:
Department(s) Involved:
Key Personnel to Obtain Approval From:
Question to be Answered:
Expected Outcomes of the Study:
Rationale for the Study:
Defining Measurements:
Data that will be Collected:
Databases to Study or Create:
Data Analysis:
Description of Results:
Benefit to the Resident:
Benefit to the Department:
Likelihood of Publication:
Commitments: ___________ _________ __________
Resident Preceptor Other
16
Past Residency Projects 1999 – 2011
Year Resident Title Comment
1998 - 1999 Darryl McGuire, Jr. Evaluation of Empiric Treatment of Community Acquired Pneumonia
*
1999 - 2000 Leigh Black Assessment of Pharmacists Knowledge and Attitudes Regarding Pain Management
* Submitted for publication
D’Andrea Forbish-Skipwith
Study of Dietary Supplement Use Among Medicine Patients
*
2000 2001 Amy Maulsby Preparing and Modeling Pharmacy Analysis Techniques in a Managed Care Plan Physician Order Entry - Vanderbilt Health Systems
* ◊
2001 – 2002 Carly Feldott Pharmacist Involvement in a Managed Care Clinic Setting – A Focus on Asthma Disease Management, Cost Management, and Practitioner Prescribing Patterns
*
Lisa Izlar The Usage of Prophylactic Antibiotics in Coronary Artery Bypass Surgery
*
Kimberly Moyers Pharmaceutical Care in an Epilepsy Clinic *
Jill VonDielingen The Role of Pharmacists in Disease State Management (Diabetes Focus) in a Managed Care Setting
*
2002 – 2003 Marty Baker Reestablishment of an Institutional Antibiogram Phase I: Identifying Trends in Resistance
*◊
Christie Buchanan Pharmaceutical Intervention Improves Efficiency for High Risk Dyslipidemic Patients Compared to Usual Care – Part I
*◊
Lindy Taylor Factors and Issues to Consider in the Assessment of Adverse Drug Events among Hospitalized Patients
*◊ To be published in AJHP
November 2006
Karen Wilson Preventing Medication Errors with Smart Infusion Technology
*◊ Published in AJHP Jan
2004
2003 – 2004 James A. Carr Pharmaceutical Intervention Improves Efficiency for High Risk Dyslipidemic Patients Compared to Usual Care – Part II
*◊☼ To be submitted
Brian Fontenot Development and Implementation of a Pharmacy Discharge Counseling Service for the Patients of Vanderbilt Children’s Hospital
*◊☼
Brandy Greene Vancomycin Utilization Following Computerized Prescriber Order Entry (CPOE) Intervention
*◊☼
Natalie Kittrell Protocol for Diagnosing and Treating Relative Adrenal Insufficiency
*◊☼
2004 - 2005 Paige Fuller Validation of an Innovative Computerized Vancomycin Dosing Nomogram Utilized by a Tertiary Care Teaching Hospital
◊☼
Shivani Patel Complications of Corticosteroid Therapy for Adrenal Insufficiency in Critically Ill Trauma Patients
◊☼*
Hayley Rector Assessment of an Alcohol Withdrawal Prevention Protocol
◊☼*
Katie Smith Appropriate Use of Patient-Controlled Analgesia Infusion Devices
◊☼*
2005-2006 Jennifer Fosnot Effect of Bisphosphonates on Fracture Rates in Renal Transplant Patients
*
Matt Conley Impact of Pharmacist Interventions on the Medication Use Process
*
17
Kim Kelly Effects of Sympathetic Blockade on Outcomes in the Acutely Injured Patient
**
Stacie Soja Implementation and Reliability Testing of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) in Trauma Patients
**
2006-2007 Lindsay Dyer High Dose Antioxidant Therapy in Acutely Injured Trauma Patients
**
Nikki Lokker Parents and OTC Medications: Do Literacy and Numeracy Impact Product Use?
**
Mindy Mann Vasopressin Use in Trauma Patients with Severe SIRS **
Kanan Shah Out-of-hospital medication errors: A six-year analysis of the poison control national database
*
2007-2008 Erin Bedard Improvement of an Automated ADE Surveillance Tool for Warfarin
*
Aylson Gibson Effect Of Subcutaneous Administration Of Insulin Glargine On Insulin Infusion Requirements In Critically Ill Burn Patients
*
Erika Hunt The Pharmacokinetics of Gamma Glutamyl Cysteine in Rats
*
Jon Aston Vancomycin Failure in Patients with Methicillin-Resistant S. aureus Nosocomial Pneumonia
**
2008-2009 Zac Cox Effects of a CPOE Clinical Decision Support Tool on the empiric Dosing and Monitoring of Tobramycin and Amikacin
**
Chris Peryam Antibiotic Administration Timing: Impact of Clinical Decision Support and Barcode Technology
*
Ashley Quintili Pain Control in the Postoperative Patient Population *
Darby Siler Impact of Extended Infusion Piperacillin/tazobactam on susceptibility patterns of gram negative organisms
**
2009-2010 Travis Fleming The Effect of Pre-operative Clopidogrel Use on Bleeding Outcomes in Cardiovascular Surgery Patients
*
Monica Hanson Reliability of Preliminary BAL Culture Results in Critically Ill Surgical and Trauma Patients
*
Amy Pennington Developing a Warfarin Training Program *
Kelli Rumbaugh Acid suppression medications and the risk of hospital acquired pneumonia in ICU patients
*
2010-2011 Jon Pouliot The Role of a Computerized Epidural Ordering Advisor in Reducing Administration of Concomitant Inappropriate Medications
*
Allison Palmer Evaluation of a Modified Cefepime Dosing Regimen in ICU Patients
*
Christi Parker The Incidence of Adrenal Insufficiency in Cardiac Surgery Patients Induced with Etomidate
*
Angela Loo Analysis of C. difficile Infection Management at a Tertiary Care Academic Medical Center
*☼◊
*Presented at the Southeastern Residents Conference in Athens, GA
**Published in a medical journal ◊ Presented at the ASHP Residency Poster Presentation ☼ Presented at the UHC Poster Presentation
18
RESIDENT REQUIREMENT/ACTIVITY TIMELINE** (For Guidance Purposes Only; Dates are subject to change based on individual resident goals/assigned tasks) **This may not be all inclusive – watch your residency requirements tracking form!**
July Baseline self-assessment (Entering resident interest and preference information)
Select and Develop 60 minute CE Presentation
Dates for Journal Club, Case Presentation Selected, CE Presentation
August Project topic/preceptor confirmed
Project literature review and bibliography.
MUE topic selected and timeline for completion established.
Register for ASHP Midyear Meeting
September Project design/Methods write-up complete
Project Proposal Presentation –IRB submissions
If taking a poster to MYCM, investigate deadlines for abstract submission
How many Criteria Based Assessments have you completed? Pace yourself!
Evaluate where you stand with longitudinal assignments (P&T Monograph, MUE)
If you have not started your MUE – start now!
October Project Proposal completion and submitting to IRB, establish timeline for project data collection
and analysis etc.
Are you working on your MUE? Just checking!!!
Recruitment Showcases
Case Presentations and Journal Clubs
November MUE timeline established and confirmed.
If taking a poster to MYCM need to complete slide by mid November.
Recruitment Showcases
How many Criteria Based Assessments have you completed? Pace yourself!
Résumé preparation and interview skills
December ASHP Midyear – UHC Posters, showcase
January Register for SERC and Prepare SERC abstract
February Complete and submit SERC abstract
Wind up data collection for project
Case presentations and journal clubs
How many Criteria Based Assessments have you completed? Pace yourself!
Are you on track with your MUE?
March Project: begin organizing data – analyze data - results
April Pre-SERC project presentation I, II, III, IV, SERC
How many Criteria Based Assessments have you completed? Pace yourself!
May Project manuscript – first draft completed May 15th
June Final Project manuscript due June 1
All Criteria Based Assessment Requirements completed by Jun 15.
All requirements fulfilled no later than June 20.
19
Pharmacy Practice Residency:
Evaluation Process and Requirements
Evaluation Process Description
Resident Documentation Requirements
20
EVALUATIONS
An essential component of developing the skills of a resident is frequent two-way feedback between residents
and preceptors. The preceptors, program director, and residents will frequently provide feedback to one another via formal
evaluation. Evaluation will occur as described below:
a. Rotation Summative Evaluations: Due no later than 5 days after the end of the previous rotation period (5
business days). This is a written evaluation of the resident’s performances in meeting the objectives of each
rotation. The resident and preceptor will review these evaluations together. The resident will also complete a
preceptor and rotation evaluation and a self-evaluation. Additionally, the resident will complete selected
criteria assessment instrument’s as a self-evaluation to be discussed with appropriate preceptor and/or
program director.
b. Pharmacy Practice Quarterly Evaluation (Staffing/Project): PP is a longitudinal evaluation where a written
evaluation of the resident’s progress is completed. Rotation and preceptor evaluations must also be
completed on a quarterly basis for these experiences.
c. Criteria Based Assessments: evaluations of selected activities will be completed as a self-evaluation as well as
a designated preceptor will evaluate the resident.
Counseling (evaluation preceptor=primary preceptor during that experience)
Documentation (evaluation preceptor=primary preceptor during that experience)
Problem solving (evaluation preceptor=primary preceptor during that experience)
Researched DI Questions (evaluation preceptor=primary preceptor during that experience)
Case Conferences (evaluation preceptor will be assigned)
Journal Club (evaluation preceptor will be assigned)
Therapeutic Exchange (evaluation preceptor will be assigned)
Monograph (evaluation preceptor will be assigned)
d. Residency Council Reports – a written evaluation based on period review by the residency council. This
evaluation examines overall progress, including integration of skills learned in separate rotations, non-rotation
objectives/experiences, progress on longitudinal requirements/rotations (residency project, criteria
assessments etc.) and any pertinent trends or information found in evaluations to that date. This report will
track resident progress by goal quarterly using the 5 point scale established in this programs residency
evaluation system. Progress of the resident’s strengths, weaknesses and career goals will be documented. To
satisfactorily complete the residency, the resident must have shown improvement over the course of the year
in both resident and preceptor scoring. For any goals in which less than a score of 3 is averaged, the resident
and program director will work together to develop individualized plans to assist in making progress in those
areas by residency end. If the resident does not work towards those plans and progress improvement,
residency completion with certificate may be compromised. On a quarterly basis, goals in which the resident
has scored an average of 5 for two consecutive quarters will be removed from further evaluation.
a. Progress on yearly goals/objectives
b. Acute Care progress (rotations)
c. Staffing
d. CBAs
e. Practice Mgmt: Inter-professional communications/relations
f. Practice Mgmt: Professional presentation (verbal communication, dress, style, content)
g. Practice Mgmt: Planning and Organizing/meeting deadlines
h. Enthusiasm/initiative/disposition
i. Status of: scheduled presentations, residency project, MUE, Performance Improvement, drug
information, criteria based assessments, time worked, time off
All evaluations are to be discussed personally between resident and preceptor. All evaluations (rotation summative on
resident, resident on preceptor and resident on rotation overall), CBAs, and self-assessments, should be forwarded to the
resident program director or designee in electronic format. A hard copy should be printed and signed by resident and
evaluator and maintained in the resident’s residency portfolio binder. The electronic database will document the
review by the residency program director.
21
RESIDENT DOCUMENTATION
Each resident will maintain/submit the following documentation:
1. Summative Self-Evaluation (Final Comments section): Required for each rotation, concentrated
experience, longitudinal experience. Due 5 business days after the completion of the previous
Rotation period.
Self -Assessment on progress of goals and objectives assigned to the learning experience.
Summary of how your residency goals and objectives were met/unmet during the rotation period.
Summary of your professional strengths and weaknesses during the rotation period.
As the year progresses, compare to previous time periods and always include what is a focus for
improvement for the next time period as well as what has been achieved.
2. Rotation and Preceptor evaluations will be submitted to the preceptor and then program director or designee
5 business days following the completion of the rotation or designated quarterly evaluation completion
dates. This should be presented to the preceptor the same day that the preceptor presents the block or
longitudinal evaluation to the resident. The preceptor must sign off on this in the evaluation database as
reviewed.
3. Many Criteria Based Assessments (CBAs) are to be initiated by the resident as opportunities are
encountered then evaluated with corresponding preceptor and then forwarded to the program director or
designee. Resident initiated CBAs:
Care plans
Counseling
Documentation
Problem solving
Drug Information Researched Questions
Case Conferences (evaluation preceptor will be assigned)
Journal Club (evaluation preceptor will be assigned)
Therapeutic Exchange (evaluation preceptor will be assigned)
4. A record of interventions is to be compiled on an ongoing basis. Many preceptors request a list of these
pertaining to the rotation as part of the rotation summative evaluation.
5. Each resident will compile a residency notebook for the year to include: The contents is to include
suggestions/edits/drafts/final copies as worked on between resident and preceptor(s) as well.
1. Documents described above
2. All evaluations
3. Inservices presented (handouts and outlines, slides)
4. Cases presented
5. Any education programs presented
6. MUEs, monographs, reports etc.
7. Written projects or proposals
*The contents of the residency notebook serve as documentation of activities completed during the residency
year. The residency yearbook is a permanent record which is the property of Vanderbilt University Medical
Center.*
22
Pharmacy Practice Residency:
Longitudinal Rotation Experience Descriptions
Hospital Pharmacy Practice (Staffing)
23
HOSPITAL PHARMACY PRACTICE (STAFFING)
(This is a guideline and will be dependent on staffing location assignment)
Expectations for Residents in First Quarter – Staffing Assignment
Orient to the Central Pharmacy and learn the procedures of both the unit dose area and the sterile
products preparation areas.
Adjust to the scheduling assignments and focus on being present and ready to work in the assigned area
at the assigned time. Stay in the work area during your entire shift and be available to focus on the work
at hand. Observe appropriate break time such as 30 minutes for lunch breaks. Learn to indicate any
scheduling adjustments on the posted pharmacist schedule such as swaps in assignments
Develop an understanding of the systems and processes and develop skills such as with CPOE order
processing (“VOP”).
Develop relationships with the Central Area team. Be careful to ask a more senior pharmacist before
making changes to work processes. Follow the established dress code and other workplace policies. Be
sensitive to the needs of the other staff in the area and do not routinely ask to leave early. Make sure
that work is caught up prior to leaving your assignment.
Begin to develop a broader view of the work place and rotate among the various stations (Pyxis check or
cart check, labels on PR16, extemp prep, packaging machine, phones, tube station, IV Room, etc.) in
order to maintain and effective work flow and efficiency level.
Learn to collaborate with other staff members shift regarding work flow issues or whenever time may
become available to work on projects but remain available to return your focus to the work at hand
whenever workload increases.
Remain flexible and ask questions.
Work on Clinical Dashboards.
Once initial training is complete, primary assignment will be in the Unit Dose area.
Resident will check in with the pharmacist and technician mentors at the end of each weekend shift to
see if there are suggestions for improvement. If mentors are not working on the same weekend, resident
will check in with their mentors at the next available opportunity to discuss any questions.
Expectations for Residents in Second Quarter – Staffing Assignment
Demonstrate proficiency in all areas of the Central Pharmacy.
Demonstrate proficiency with systems and processes and manage the established levels of efficiency.
Demonstrate a broad view of the work place and rotate among the various stations maintaining effective
work flow and efficiency.
Primary assignment will be to float between the IV Room and Unit Dose areas
Work on Clinical Dashboards
Resident will check in with the pharmacist and technician mentors at the end of each weekend shift to
see if there are suggestions for improvement. If mentors are not working on the same weekend, resident
will check in with their mentors at the next available opportunity to discuss any questions.
Expectations for Residents in Third Quarter – Staffing Assignment
As above with more autonomy
Responsible for Clinical Dashboards
Expectations for Residents in Fourth Quarter – Staffing Assignment
Begin training in the Junior Pharmacist in Charge (PIC) role
The resident (junior) and the normal (senior) management person on the weekend will both be
designated as PIC. These two persons will work together to manage the personnel and workflow. The
normal management person can help teach the resident how to solve problems that arise during a shift.
24
The resident will not be in the float position unless scheduling dictates this as a need. However, part of
being PIC includes assessing both the unit dose and IV areas and helping in all areas.
The resident has an increased responsibility to keep in touch with the workflow and employees during
the shift. The resident should assure all work has been completed for the shift prior to approving anyone
to leave early (then check with the lead tech and check who is working in an overtime slot to help with
these decisions).
Communicate end of shift issues to the unit dose area evening pharmacist prior to leaving.
Personnel conflicts, staffing problems, catastrophes, occupational health issues will defer to the senior
management person designated for the weekend.
Resident will check in with the pharmacist and technician mentors at the end of each weekend shift to
see if there are suggestions for improvement. If mentors are not working on the same weekend, resident
will check in with their mentors at the next available opportunity to discuss any questions.
Continued responsibility of Clinical Dashboards
Expectations for Mentors
Check in with residents at the end of each weekend workday or as soon as possible after their weekend
to work to discuss their staffing and PIC roles and answer any questions that arise.
Observe the residents during their staffing and PIC roles and offer tips and suggestions for improvement.
Provide feedback to the resident from other staff members as appropriate regarding their work
performance.
Prepare the quarterly evaluations for the residents in regard to their staffing experiences.
Expectation of Residents
Submit a report of activities learned, accomplishments, problems solved etc. as well as areas in need of
clarification or focus for the next weekend by Monday following your weekend worked.
25
Appendix
26
QUARTERLY RESIDENT TRAINING PLAN
SELF ASSESSMENT ASSISTANCE SHEET
If you want to grow personally and/or professionally you have to take an honest look at where you are before you can decide where you want to go. A serious self-evaluation is very helpful if done on a regular interval basis. Prepare a summary of how your residency goals and objectives were met/unmet during the rotation period, what were your professional strengths and weaknesses during the rotation period and the progress you have made on longitudinal requirements (projects, criteria based assessments etc.) and an assessment of personal/professional life balance.
The following questions facilitate a positive self-reflection and make the process more effective. These questions will be fuel for helping you understand how progress is being made and what course corrections are necessary. They also open the door for some serious career mentoring. You may want to discuss the answers you arrive at, or not. Most importantly, the questions may help you discover the skills you need to achieve your goals.
Think about these types of questions when completing your progress review form. Use the Assessment FORM to complete this exercise.
Career 1. What are my desired professional outcomes for the next year? 2. What are the most significant professional challenges for the next year? 3. What are the most significant professional opportunities for the next 3 to 5 years? 4. Who am I not working well with, and how can I make the relationship better? 5. What issues keep me up at night? 6. What have I learned about myself while working at my job? 7. What would I like to see my hospital modify? 8. What have I learned from my staff/co-workers and from working for my hospital? 9. What will I commit to make me better and to make those around me better? Personal 1. What are the most valuable achievements/goals I attained in the past 4 months? 2. How can I improve the way I am dealing with the current challenges in my life? 3. What are my most significant personal goals for the next period? 4. What do I need to keep doing? 5. What would I like to change about myself? 6. What are my most significant personal challenges for the next period? 7. How am I treating the most important people in my life? 8. How could I treat the most important people in my life better? 9. How will I add joy to my life in the next period? 10. What do I wish for the future? Preparing for my next step 1. Would I work better in a large or small organization? 2. Do I prefer working in a team environment or on my own? 3. Am I more comfortable following than leading? 4. Do I prefer to analyze situations and projects over actual implementation of an action plan? 5. Do I prefer to work with people or things? 6. How do I work under pressure? 7. Am I a good planner or idea person? 8. Am I a good listener? 9. Am I able to think quickly and articulate myself “on the spot”? 10. Am I able to make decisions in a timely manner? 11. Do I express myself well verbally and in writing? 12. What characteristics do I admire in others? 13. What do I enjoy most about my major? 14. What aspects of my current job do I enjoy? What do I dislike? 15. In the next five years what would I like to accomplish? 16. What level of responsibility do I hope to reach in the future? 17. How will I achieve my career goals? What skills, knowledge, and experience do I need?
27
Rotation Schedule for 2011-2012 Residents Draft 9 PGY1** Megan
Hames Paul
Moore Michelle Huber
Jenna Faircloth
CC PGY
2
Jon Pouliot
Onc PGY2
Mona Benrashid
TxPlant PGY2 ???
Alexandra
Powderly
Informatic
s
Wing Liu
Orient. Orient. Orient. Orient. Jul Orient/ Nutrition
July Orient 7/6-23
Orientation
Jul Orientation
Rotation 1 Aug 1 to Sep 1
Medicine*@
Trauma*# Cardiology* @
PICU* Aug MICU August
Hematology 7/25-10/21 Liver Transplant
Aug Clinical Systems
Rotation 2 Sep 5 to Oct 13
Hem/Onc*@
Nutrition Trauma *# Gen Peds* Sept MICU Sept BMT 10/24 – 11/25
Transplant ID
Sept Clinical Pharmacy Systems
Rotation 3 Oct 17 to Nov 29
BMT*
SICU* ID#* Medicine*@ Oct Trauma Oct Oncology 11/28 – 3/2
Renal/Pancreas Transplant
Oct Peds Clinical Rotation
ASHP Midyear and Project Nov 30 to Dec 9
Nov Trauma Nov Elective 3/5 – 3/30 Cardiology
Nov AdminRX and Smart Pumps
Nov
Rotation 4 Dec 12 to Feb 2
Transplant*
Medicine*# NICU Admin @ Dec Project Dec Project 4/2 -7/4 Heart/Lung Transplant
Dec Clinical Decision Support
Project Feb 6 to Feb 24
Jan Nutrition Jan ID Jan Project Mgmt Jan
Rotation 5 Feb 27 to Apr 5
Admin ID*# Medicine@*
SICU Feb
Burn Feb
Elective Feb
Technical Concepts and Automation
Mar Transplant
March Pain/HOPA Mar Vendor Operations
Rotation 6 Apr 9 to May 17
ID# Transplant Admin Cardiology @*
Apr CVICU April Clinic Apr Data Mgmt
Rotation 7 May 21 to Jun 29
Trauma# Admin@ Heme/Onc Solid Tumor Oncology
May
PICU May
Elective May
Ambulatory
Jun SICU June Elective Jun Med Safety
28
Evaluation Due Dates
Due Dates Sept 9 Oct 21 Dec 9 Feb 10 April 13 May 25 June 20
Due Dates Sept 30 Dec 31 March 31 June 20
Aug 30 Oct 11 Nov 15 Jan 10/Jan 17 Mar 6 March 13 May 15 June 21
1. Rotation Summative Evaluations
2. Resident Self-Evaluation for Rotation
3. Preceptor/Rotation Evaluations
Period 1 Period 2 Period 3 Period 4 Period 5 Period 6 Period 7
Longitudinal Summative Evaluations: Quarterly Assessment
1. Residency Project Self Evaluation
2. Hospital Pharmacy Practice (Staffing weekends) Self Evaluation
3. Residency Council Quarterly Report: Individual Learning plan update
4. Any CBAs conducted during that quarter and the Self Evaluations
A B C D
Mtg 1 Mtg 2 Mtg 3 Mtg 4 +
Recruiting Mtg
Mtg 5 Mtg 6 Mtg 7
Residency Council Meeting Dates
Mtg 8
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Resident Presentation Series: 2011-2012
Pharmacy Conference Room 12-1 pm
Journal Club 12-1 in PCR Resident Evaluator
August 30 Megan David ?
September 13 Michelle Marcus ?
October 4 Paul Susan
November 1 Mona Mahsa
November 29 Jenna Cori
January 17 Michelle Erin
February 7 Megan Bob
March 6 ----- ----
April 3 Paul Jon Pouliot
May 1 Jenna Alex
May 29 Mona Jon Aston ?
Case Conference 12-1 in PCR
Sept 27 Megan Erin
Sept 27 Mona Jon Aston ?
Oct 18 Jenna Bob
Oct 18 Michelle Cori
Nov 15 Paul Dan ?
Nov 15 Jon Susan
Feb 21 (PGY1 only) Paul Alex
Feb 21 (PGY1 only) Megan Mona
Mar 20 (PGY1 only) Jenna Jon Pouliot
Mar 20 (PGY1 only) Michelle Wing
Apr 10 (PGY2 only) Alex Stefanie Bala
Apr 10 (PGY2 only) ------ -----
March 28 (Weds) All – SERC Practice: Mandatory 11-1 in PCR
April 4 (Weds) All – SERC Practice: Mandatory 12-2 in PCR
April 11 (Weds) All – SERC Practice: Mandatory 10-12 in PCR
April 16 (Mon) All – SERC Practice: Mandatory 11-1 in PCR
April 18 (Weds) All – SERC Practice: Mandatory 12-1:30 in PCR
April 23 (Mon) All – SERC Practice: Mandatory 11:30-1:30 in PCR
Therapeutic Exchange Resident Evaluator
August 18 (PGY1 only) Megan Cori
August 25 (PGY1 only) Michelle Susan
September 1 (PGY1 only) Jenna David
September 8 (PGY1 only) Paul Bob
August 11 (PGY2) Jon Marcus
October 6 (PGY2) Alex Jen Fosnot
Informatics
Oncology
30
Pharmacy Practice Residency Orientation Series: 2011-2012
Date Topic Objective Presenter Time Place
Friday
July 1
Orientation
Department Policies (PPT)
Residency Policies PPT)
Staffing Orientation (PPT)
Biosketch
Orientation Schedule and Checklist
Interest Inventory
David 11-4 PCR
Tuesday
July 5
Orientation Quantifi Clinical Documentation – Bob Lobo
Veritas/Medication Safety – Carly Feldott
Review Rotation Schedules
Distribute Residency Manuals
Therapeutic Exchange Discussion
Library Orientation
IRB Training – On line in Resident Office
David
Carly
Bob
Sandi
8-3:30 PCR and
Library
Monday
July 25
RLS Residency Requirements/Expectations
RLS System; Evaluations (PPT)
Residency Manual and Binder
Rotation Schedules
Follow-up Therapeutic Exchange
Presentation Series Sign-up
David/Cori 1-3:30 PCR
Tuesday
July 26
Project Developing a project idea, Finding a good mentor,
sponsor, and workers, and bringing them along, and,
developing the details of a proposal IRB, and the
steps required for successful completion
David 1-3:30pm PCR
Wednesday
July 27
MUE, P&T, Monograph
Presentations, etc
MUE with examples, a monograph, and examples of
administrative projects. Description of the journal
club, case presentations and therapeutic exchange;
teaching undergraduate students; classroom teaching
Cori 1-3:30pm PCR
Thursday
July 28
Vandy Pearls What you need to know for patient care: protocols,
Wiz and Starpanel,
Cori 1-3:30pm PCR
Friday
July 29
Evaluation Database
Summative evaluations, self evaluations, CBAs,
quarterly evaluations, rotation evaluations, the
residency council’s job in evaluating
Tracking form
How to use evaluation database
David/Cori 1-3:30 PCR
31
Pharmacy Resident
Orientation Checklist
2011-2012
Central Pharmacy
Orientation Checklist Orientation Items Resident Initials Trainer Initials Date Reviewed
General Daily work flow Unit Dose Area Times and associated tasks
Review Pharmacist Shift slots and associated duties Pharmacist in charge IV/Central UD Float Central UD IV/TPN
Review how to read/interpret staffing schedule
Review daily Technician slots and associated responsibilities
Procurement Process Storeroom Staff Storeroom Responsibilities Storage locations: walk in fridge, storeroom, Med Carousels, PakPlus room Over fill cart, IV/TPN room
Med Carousel/Connect Rx Process Log In code given Pull on demand pick Review of Pyxis/Cartfill Process Pharmacist Scan process Acceptance of Pyxis zones
Pyxis Fill Process Pyxis Orientation with Frank Ray Checking Pyxis Doses Pyxis Log-in and Filling Pyxis Machines Narcotic Check in Narcotic Room
Medication Error Recording Process in the Central Area Internal Errors External Errors
Narcotic Room Procedures CII Safe Log-in and orientation with Charity Prater Checking process Discrepancy resolution Narcotic orders attachment in HMM (patient specific)
Cart Fill Process Pull process from Med Carousel Check Process Catch-up Doses Delivery of meds to patient specific med drawers
Look alike – Sound alike medications
Extemp Process Set up/Filling Process Checking Process
Non-Sterile Compounding area Orientation to Area What type of products made Who to ask if questions PCCA
Order Processing (Vopping) in Central Areas Central order processes for What to send to the ED How to Clarify an order (resident pager list/operator)
Resident:________________
32
Crash Carts 6 month expiration Red Locks Charges ED Trays
Specific References: Psych book, IV reference manual etc. Blood Factor book, Clozaril, MSDS, etc.
Borrow/Loan policy and procedures
Unit dose packaging TadPoles Bar coding Responsibilities of Pharmacy Unit Dose Packaging Options How to check items in Pak Plus
Tube system policy and procedures Tube System Competency Check List
*Outpatient prescriptions, Stallworth and Psych Hospital Procedures on weekends (cover on first weekend)
IV/TPN/IDS Room Orientation Checklist Orientation Items Resident Initials Trainer Initials Date Reviewed
General workflow and distribution of responsibilities amongst pharmacists and technicians
How to find things in the IV room
IV preparation policy and procedures Set up of IV Preparations and Batches Reconstitution of vials Preparation of syringes, PB, LVP and checking these Storage of medications prior to delivery Delivery Schedule
Sterile products preparation check off
Call for medications
Review of how we meet USP 797
Latex allergy policy and procedures
Review of IV resources: how to determine compatibilities, expirations, Vandy IV manual, IV room website , latex website
Narcotic Preparation and wastage Log sheets Wastage record Record of RX number in patient maintenance
Standard Time Schedules
Investigational Drug Area
TPN Area
Outpatient Areas Orientation Checklist Orientation Items Resident Initials Trainer Initials Date Reviewed
Review of what and where all outpatient pharmacy services are located, hours, key persons
**Indigent Med Program: policy and procedures – please learn the process of who is eligible, what the policy is, how patients are approved, how much medication can be dispensed.
**Sample pharmacy: policy and procedures, location, products available, how it works, who pays for it, and why we offer this
33
service, how to look up formulary for this
Process for prior authorization etc of high cost drugs and our policy/procedure for handling these (identify main agents etc.)
How we manage the purchase, distribution and charging of medications used in the clinics Medicare/Tenncare issues What are the toughest problems in clinic medication reimbursement
Coumadin Clinic – Tommy and Suzanne **Who is serviced/eligible **How to enroll a patient (Starpanel) – please walk the resident through the Starpanel process How information is communicated/documented Policy and Procedures/Protocol CC follows Staff involved in clinic Standards of care in regards to anticoagulation History of the service at Vanderbilt Credentials involved and structure of providing this service Quality assurance/improvement in this area
Order Processing: Orientation Checklist Orientation Items Resident Initials Trainer Initials Date Reviewed
Orient to satellites Locations Areas serviced by each Hours
Order clarifications
Work flow
Pharmacist and technician responsibilities
Adverse Drug Reaction reporting , Medication Error reporting
Customer Service Focus
Intervention Documentation
Telephone Courtesy/Etiquette
IV medication administration policy and chart
Meds/Devices brought from home
PCA Pump Policy
DI Resources: Micromedex, Lexi-Comp, Kings, Facts&Comp, Up to Date, Trissell’s, Pubmed
Alaris GuardRails for IV pumps
How to use phone and beeper system
Dashboards (Will do with Cori) Orientation Items Resident Initials Trainer Initials Date Reviewed
Warfarin
Aminoglycoside
Heparin
Insulin
Consults
34
Resident Orientation Schedule July 2011
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
1 8-11Gayle Badges,keys, pagers, parking, HR 11-12:30 Lunch 1-4 Review Dept Policies and orientation schedule and checklist and weekend schedule
2
3
4 Holiday - Off 5 8-9 Quantifi 9-11 David – tx exg etc 11-12 Veritas 12-1 Lunch on own 1-2:30 Library Training 2:30- 4:30 IRB Training
6 Computer Training 8-4:30
7 Computer Training 8-4:30
8 Computer Training 8-4:30
9
10 12 Hospital Orientation Work on Tx Exg
12 Hospital Orientation Work on TxExg
13 Paul -IV Jenna - TPN Megan – Central Michelle –Central Work on TxExg
14 Paul -IV Jenna - TPN Megan – Central Michelle –Central Work on TxExg
15 Paul -Central Jenna - Central Megan - TPN Michelle – IV TXExg: Objectives and Test Questions DUE to Gayle TODAY!!!!!!!
67
17 18 Paul -Central Jenna - Central Megan – IV Michelle – IV Work on TxExg
19 Paul -TPN Jenna – IV Megan - Central Michelle – Central Work on TxExg
20 Paul -Central Jenna – Central Megan - TPN Michelle – IV Work on TxExg
21 Clinical Training Dashboards Kinetics Practice Warfarin/Hep Practice Clinical IV Basics Work on TxExg
22 Clinical Training Dashboards Kinetics Practice Warfarin/Hep Practice Clinical IV Basics
23
24
25 9-12 Clinical Training Afternoon: Residency Orientation Paul 3:30 to 7 – Central Jenna 3:30-7 - Central Work on TxExg
26 9-12 Clinical Training Afternoon: Residency Orientation Megan 3:30 – 7 - central Michelle 3:30 to 7 – central Work on TxExg
27 9-12 Clinical Training Afternoon: Residency Orientation Paul 3:30 to 7 – Central Jenna 3:30-7 – Central Work on TxExg
28 9-12 Clinical Training Afternoon: Residency Orientation Megan 3:30 – 7 - central Michelle 3:30 to 7 - central Work on TxExg
29 9-12 Clinical Training Afternoon: Residency Orientation Work on TxExg
30
35