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Pharmaceutical Care Division

King Faisal Specialist Hospital & Research Centre (KFSH&RC)-Riyadh 2017

Postgraduate Year One (PGY1) Pharmacy Residency Program

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Table of Contents

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Introduction - About KFSH&RC

- About the Pharmaceutical Care Division

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Section I. - Residency Program Overview

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Section II. - Mission Statement

- Program Purpose

- Program Administration

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Section III. - Program Description

- Program Structure

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Section IV. - Competency Area

- Selected Educational Goals and Objectives to Specific Learning Experiences

- Assessment Strategy for the Learning Experience

- Individualized Development Plan

- Quality Improvement Activities

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Section IV. - Orientation to the Program

- Requirements for Successful Completion of PGY1 Residency Program

- Sick Leave and Leave of Absence for PGY1 Residents

- Pharmacy Resident Probation/Dismissal and/or Withdrawal

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Introduction

King Faisal Specialist Hospital & Research Centre P.O. Box 3354 Riyadh 11211 (MBC # 11) Kingdom of Saudi Arabia Website: http://www.kfshrc.edu.sa/wps/portal/En

About KFSH&RC:

King Faisal Specialist Hospital and Research Centre (KFSH&RC) is a 1086-bed tertiary/quaternary care hospital with

the most modern and technologically advanced medical and research facilities in Riyadh, Saudi Arabia. It is reputed

as one of the leading hospitals in the Middle East. The hospital is based on North American Standards of practice,

and has been accredited by the Joint Commission since 2000.

About the Pharmaceutical Care Division The Pharmaceutical Care Division is committed to providing the highest quality of pharmaceutical care that meets

the needs of all patients. It is the place of the first ASHP accredited PGY1 and PGY2 solid organ transplant residency

outside the US.

The Pharmaceutical Care Division is composed of three departments: Ambulatory Care Pharmacy, Medical/Critical Care Pharmacy, and Medication Safety/Clinical Pharmacy Support Services. The Division provides comprehensive, 24-hour computerized services to both inpatients and outpatients, with patient-focused and integrated model of pharmaceutical care. Its exceptional multinational staff, state-of-the-art informatics resources, technology/automation, and facilities have undoubtedly made it one of the leading hospital pharmacies in the Middle East. Its staff clinical pharmacy consultants, clinical pharmacy specialists and clinical pharmacists work in different clinical practice areas such as infectious diseases, anticoagulation, internal medicine, solid organ transplantation, nephrology, cardiology, oncology, surgery, pediatrics, critical care, hematology/oncology, drug information and total parenteral nutrition.

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Section I.

Residency Program Overview:

ASHP Program Code: 02000

Accreditation Status: Accredited

Director of Pharmacy:

Ahmed Al-jedai, Pharm.D., M.B.A., BCPS, FCCP Phone: +966-1-442-7601 Fax: +966-1-442-7608

Program Director:

Sakra S. Balhareth, Pharm.D, BCPS, BCACP Phone: +966-1-442-7604 Fax: +966-1-442-7608

Residency Program: Duration/type Starting date Interview

24 months PGY1 Pharmacy Residency October, 1st Yes

Special Requirements for Acceptance:

1. For graduates from the Ministry of Education and National Commission for Academic Accreditation and Assessment: Refer to the Saudi Commission for health Spatiality (SCFHS) website for more details in the application process.

2. For graduates from ACPE accredited college of pharmacy in the United States: Apply through the PhoRCAS https://portal.phorcas.org/

3. Completion of all required material by the deadline

Salary and Benefits:

Negotiable. Please refer to the Employee Relation Manual (ERM) in the link below http://www2.kfshrc.edu.sa/o&m/Guidelines/ERM_Ram-1435-2015feb26.pdf

Fringe Benefits: A tax-free stipend

Medical insurance

Free housing or a housing allowance

Professional meetings: The resident will receive educational leave and partial travel reimbursement in order to attend professional meetings and other national meetings in Saudi Arabia as deemed necessary by the RPD.

Licensure:

The resident should be licensed or eligible for pharmacy professional licensure within a 3-month period of starting the program.

If the resident fails to get licensed within the allotted time, he/she will receive a warning for dismissal and a one-month extension period for licensure. If the resident fails to achieve licensure after the extension period; then he/she will be expelled from the program.

Duty Hours:

Regular work hours from 7:30-17:00; some rotations might require different working hours. No moonlighting allowed in the program

The preceptors will set specific hours of attendance required at the beginning of each learning experience.

Activities and Meeting Attendance:

The Residents should attend all activities required by the preceptors, RPD, and the Residency Advisory Committee.

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Section II. Mission Statement:

Individuals who complete a pharmacy practice residency shall be qualified independent practitioners who are able to provide pharmaceutical care in various environments. They shall be responsible for drug therapy outcomes as an integral member of the multi-disciplinary health care team. Such pharmacists shall be able to develop their own personal plan for professional development. They shall be able to educate other professionals and patients about medications. Pharmacists completing this program will be capable of conducting their practice with a high level of maturity and leadership. Purpose: PGY1 pharmacy residency programs build on pharmacy education and outcomes to contribute to the development of clinical pharmacists responsible for medication-related care of patients with a wide range of conditions, eligible for board certification, and eligible for postgraduate year two (PGY2) pharmacy residency training. Program Administration: Consistent with the commitment of the hospital and the pharmacy services division a number of individuals play key

roles in the administration of the pharmacy practice residency program. The individuals and their respective roles

are as the following:

Residency Program Director: The Residency Program Director (RPD) has the primary responsibility for running and

administering the residency program. This includes responsibility for ensuring that the overall program goals and

specific learning objectives are met, training schedules are maintained, appropriate preceptorship for each

rotation or training period is provided and that resident evaluations are conducted routinely and based on pre-

established learning objectives. The RPD reports directly to head, Medical/Critical Care pharmacy services who

over sees all pharmacy training programs according to the hospital’s training bylaws.

Training Coordinator: The Training Coordinator works with the RPD to assure that the overall program goals and specific learning objectives are met, training schedules are maintained, appropriate preceptorship for each rotation or training period is provided and that resident evaluations are conducted routinely and based on pre-established learning objectives. Preceptors: Each rotation has a pharmacist preceptor who develops and guides the learning experiences to meet

the residency program’s goals and objectives, and with consideration of the resident’s goals, interests and skills.

The preceptor periodically reviews the resident’s performance, with a final written evaluation at the conclusion of

the learning experience. Refer to Preceptor Selection Criteria & Development Strategy for PGY1 and PGY2

Pharmacy Residency Program policy [MCO-CS-PHA-02-017] for details.

Project Advisor: The Project Advisor, selected by the resident and RPD, assumes primary responsibility to guide the

resident in completing the required research project. The project advisor assists the resident in selecting a project,

defining the scope of the project to assure completion within the time schedule of the residency year and planning

and implementing the project design. Residents are invited to submit their projects for publication at the ASHP

Summer, ASHP Midyear Clinical or other meetings as deemed appropriate by the Project Advisor and the RPD. The

project advisor provides guidance concerning the suitability for publication of the research work. Decisions

concerning submission should be reviewed for final approval with the program director.

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Residency Advisory Committee

The Residency Advisory Committee (RAC) is a standing committee of the Pharmaceutical Care Division. It is

composed of selected residency preceptors, invited to serve by the Director of Pharmacy and RPD. The Committee

aims to maintain the quality and consistency of the residency program. The committee provides a forum for

preceptors to discuss common concerns, to develop additional learning experiences, and to promote new and

innovative areas of practice. The RPD serves as the Chairperson of the Committee.

The committee meets on a quarterly basis. The specific responsibilities of the committee include:

1. Continuous evaluation of the curriculum, goals and objectives 2. Quarterly evaluation of residents’ progress 3. The evaluation and support of residency projects 4. Recruitment and selection of residents 5. Conflict resolution 6. Evaluation of preceptor and preceptor growth 7. Monitor the overall residency’s program and services

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Section III. Program Description:

The program is a twenty four-month, postgraduate training experience composed of four major elements:

1. Pharmacy Practice Management 2. Drug Information and Medication Use Policy 3. Clinical Services and Practice Management 4. Research Project

The specific program for each resident may vary based upon the residents’ interests and previous experience.

However, all residents are required to complete rotations in core subject areas considered to be essential to the

pharmacy practitioner. A broad range of elective rotations is available to permit the resident flexibility in pursuing

individual goals.

Additional learning experiences aimed at producing an advanced practitioner pharmacist include the development

and completion of a major research project of publishable quality related to pharmacy practice. Development of

excellent oral and written communication skills, patient education, participation in various departmental

administrative committees, and practice in various pharmacy areas throughout the institution are fundamental

components of each learning experience. Upon successful completion of the program, residents are awarded a

residency certificate.

Program Structure:

First year structure: The first year (12-month) of the residency program is a systematic approach that will provide the resident with opportunity and stimulus to develop skills, competencies, and professional expertise in all aspects of pharmacy practice. It incorporates all practice areas into different modules. See table below for the required learning experiences for the first year (12-month) of the residency program.

Learning Experiences Duration

Orientation 1 Week

Ambulatory Care 5 Weeks

Inpatient Care I 5 Weeks

Inpatient Care II 5 Weeks

Intravenous Admixture 5 Weeks

Introduction to Clinical Practice 5 Weeks

Clinical rotation (internal medicine) 5 Weeks

Medication Safety/Automation 5 Weeks

Administration Rotation 5 Weeks

Drug Information Rotation 5 Weeks

Longitudinal: Medication Use Evaluation, Research Project, Presentations/Journal club), patient awareness days)

NA

Vacation 4 Weeks

Holidays and Emergency Leave 2 Weeks

Total 52 Weeks

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Second year structure: The second year (12-month) of the residency program will be conducted in such a manner that will provide the resident with the opportunity to develop skills, competencies, and professional expertise in hospital pharmacy practice, with special emphasis on pharmaceutical care. See table below.

Core rotations ( 4 x 5 weeks)

Elective rotations ( 10 x 5 weeks)

Longitudinal

Adult Critical Care Cardiology Infectious Diseases Internal medicine

Adult hematology Cardiac Surgery Medical Oncology Nephrology Pediatrics Pediatrics Hematology Oncology Surgery Total Parenteral Nutrition Transplantation

Research Project Presentations /Journal Club

10 days holidays and emergency leave FTC*: Formulary & Therapeutics Committee

Presentations and research project requirements:

First year:

- Four presentations are required for successful completion of the first year of the residency program

- Research project is to be initiated during the first year: a. The residents will have a research day in the second month of the second quarter in the

presence of the research advisors to present their research to the RAC members. The followings are requested

1. The research folder (containing all the needed documents) 2. The research presented in Power Point slides that is reviewed by the research advisor 3. The resident will present the research in 10-15 minutes and then it will be open for

discussion

Second year:

- Six topic review/case presentations, two of which can be a drug monograph to be presented to the Formulary & Therapeutics Committee (FTC) and journal club to be presented to the pharmacy staff

- Research a. The residents will have a research day in the last month of the first quarter in the presence of

the research advisors to present their research to the RAC members The followings are requested

1. The research folder (containing all the needed documents) 2. The research presented in Power Point slides that is reviewed by the research advisor 3. The resident will present the research in 10-15 minutes and then it will be open for

discussion

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Section IV. Competency Areas:

Pharmacists completing this residency shall be competent and confident practitioners as evidenced by their ability to meet the educational competency areas required by ASHP as well as elective and additional competency areas: R.1: Patient Care R.2: Advancing Practice and Improving Patient Care R.3: Leadership and Management R.4: Teaching, Education, and Dissemination of Knowledge E.1: Pharmacy Research (Elective) A.1: Pharmacokinetics (Additional)

Selected Educational Goals to Specific Learning Experiences

Note: all goals and objectives will be taught and evaluated

I. Pharmacy Practice Management

Goal R1.1: In collaboration with the health care team, provide safe and effective patient care to a diverse range of patients, including those with multiple co-morbidities, high-risk medication regimens, and multiple medications following a consistent patient care process.

Goal R1.3: Prepare, dispense, and manage medications to support safe and effective drug therapy for patients.

Goal R2.1: Demonstrate ability to manage formulary and medication-use processes, as applicable to the organization.

Goal R2.2: Demonstrate ability to evaluate and investigate practice, review data, and assimilate scientific evidence to improve patient care and/or the medication use system.

Goal R3.1: Demonstrate leadership skills.

Goal R3.2: Demonstrate management skills.

Goal R4.1: Provide effective medication and practice-related education to patients, caregivers, health care professionals, students, and the public (individuals and groups).

II. Drug Information and Medication Use Policy

Goal R1.1: In collaboration with the health care team, provide safe and effective patient care to a diverse range of patients, including those with multiple co-morbidities, high-risk medication regimens, and multiple medications following a consistent patient care process.

Goal R2.1: Demonstrate ability to manage formulary and medication-use processes, as applicable to the organization.

Goal R3.1: Demonstrate leadership skills.

Goal R3.2: Demonstrate management skills.

Goal R4.1: Provide effective medication and practice-related education to patients, caregivers, health care professionals, students, and the public (individuals and groups).

Goal R4.2: Effectively employ appropriate preceptors’ roles when engaged in teaching (e.g., students, pharmacy technicians, or other health care professionals).

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III. Clinical Services and Practice Management

Goal R1.1: In collaboration with the health care team, provide safe and effective patient care to a diverse range of patients, including those with multiple co-morbidities, high-risk medication regimens, and multiple medications following a consistent patient care process.

Goal R1.2: Ensure continuity of care during patient transitions between care settings.

Goal R2.1: Demonstrate ability to manage formulary and medication-use processes, as applicable to the organization.

Goal R3.1: Demonstrate leadership skills.

Goal R3.2: Demonstrate management skills.

Goal R4.1: Provide effective medication and practice-related education to patients, caregivers, health care professionals, students, and the public (individuals and groups).

Goal R4.2: Effectively employ appropriate preceptors’ roles when engaged in teaching (e.g., students, pharmacy technicians, or other health care professionals).

Goal A1.1: Demonstrate ability to use drug concentrations to manage a patient's medication regimen and optimize outcome.

IV. Research Project

Goal E1.1: Conduct and analyze results of pharmacy research.

Goal R3.2: Demonstrate management skills.

Assessment Strategy for the Learning Experience:

Initial assessment: At the beginning of the residency, the RPD in conjunction with RAC and/or preceptors will assess each resident’s entering knowledge and skills related to the educational goals and objectives. The results of residents’ initial assessments will be documented by the program director or designee in each resident’s development plan by the end of the orientation period and taken into consideration when determining residents’ learning experiences, learning activities, evaluations, and other changes to the program’s overall plan.

4. Formative (on-going, regular) Assessment: Preceptors must provide on-going feedback to residents about how they are progressing and how they can improve that is frequent, immediate, specific, and constructive.

5. Summative evaluation: The preceptor will utilize the summative evaluation form used

for the residency program for all learning experiences. The form will be completed no later than the seven days after the completion learning experience. The preceptor will discuss the summative evaluation with the resident at that time.

Interpretation of the ratings:

- Achieved: The resident has fully accomplished the ability to perform the goal or the objective. No further instruction or evaluation is required.

- Satisfactory Progress: This applies to a goal or objective whose achievement requires skill development during more than one quarter.

- Needs Improvement: The resident's level of skill on the goal or objective does not meet the preceptor's standards of either "Achieved" or "Satisfactory Progress," whichever applies.

6. Resident evaluation of the preceptor and learning experience: Resident will complete the residency program form for this purpose no later than the seven days after the completion of the learning experience. Discussion of this form will be part of the summative evaluation debriefing session. Residents are responsible for forwarding the form to the preceptor on the day it is discussed.

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Residents Development Plan

- During the first week of the residency, each resident is required to complete an initial self-assessment form (Experience, Skills, and Interest).

- The Residency Program Director (RPD) and resident will review the form together and create a customized residency plan based on the needs and interests of the resident. The plan will be completed by the end of orientation.

- The RPD, RAC and/or preceptors analyze overall resident performance (formative and summative evaluations, projects, presentations, etc) for areas needing improvement or that have been achieved.

- The RPD, RAC and/or preceptors determine the effectiveness of first quarter customized plan.

- The RPD and/or preceptors, with input from the resident, determine second quarter plan and document the follow-up plan for the second quarter.

- May include alterations in the goals and objectives, activities, learning experiences, structure, and/or assessment strategy.

On-call Requirements: The resident is required to shadow the clinical pharmacist on-call at least twice as a second on-call during the first year. In the second year, the resident will be first on- call at least three times. Throughout the on-call experience, you will have a preceptor for any complications that you might not be able to handle on your own. The program will abide by the duty hour standards set by ASHP Accreditation Standards for Pharmacy Residencies. The on-call schedule will satisfy having one free day out of seven averaged over 4 weeks in which the resident will not partake in being on-call. Plan for Quality Improvement Activities:

Overall responsibility for quality improvement is with the RPD, the RAC, and pharmacy director. We will have an annual retreat off-site to assess the program. All preceptors and residents will be invited and encouraged to attend to determine if the program outcomes were achieved and if changes should be made in rotation requirements, preceptors, and general program requirements. Then, during the last month of the program, the RPD and residents will meet individually and together to review the information collected from the retreat to discuss individual input and implementation feasibility. Also, the program director and residents will discuss future professional goals. Plan for preceptor Development The RPD and RAC are responsible to put preceptor development plans including an assessment of needs, a schedule of activities to address identified needs, and a review of effectiveness of development plan. Plan for Tracking Residency Graduates: RPD will request and record contact information for resident when he/she leaves the program.

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Section V. Orientation to the Program:

Residents will complete the 7-day health-system orientation and then general pharmacist orientation. During that time, the following will be covered.

- The residency’s purpose and practice environment

- The appropriate accreditation standards, competencies, goals and objectives

- Design of the residency program including all program requirements

- Description of required and elective learning experiences

- Evaluation strategy

- Residency manual

- Residency policies, terms and conditions, e.g., requirements for completion, duty hours, dismissal

- Each resident will be given the RLS Guide for Residents to review and it will be discussed with the RPD before the end of the orientation.

- Pharmacy system training

- Each resident will complete BCLS training if not already completed

- The resident, preceptors, and the RPD will work to identify resident projects and work will begin during orientation.

- All scheduled meetings and specific responsibilities will be outlined. Requirements for Successful Completion of PGY1 Residency Program

1. Residents shall successfully complete all rotations assigned for their first and second year 2. Complete four presentations on their first year and six topic review/case presentations on their second

year, two of which can be a drug monograph to be presented to the Formulary & Therapeutics Committee (FTC) and journal club to be presented to the pharmacy staff

3. Residents shall obtain “achieved” on a minimum of 80% of the program’s goals and have no more than 1 goal rated as “needs improvement” by the end of the second year

4. Residents shall successfully complete a research project. Successful completion will be indicated by:

a. A final evaluation by the research project advisor b. As instructed by the Program Director, a written manuscript that meets guidelines for submission

to a journal or a poster and written summary c. Manuscript or poster with summary submitted to the Program Director by November of the

second year

5. Residents under the auspice of Saudi Commission for Health Specialties (SCFHS ) and American Society of Health-System Pharmacists (ASHP) shall comply with the examination policy as outlined in the SCFHS manual

6. Complete the exit interview Annual leave, official holidays, sick leave, and Leave of absence:

All leave requests including; annual, professional, and sick leaves should be approved by the RPD and the

preceptor of the rotation that the leave falls in. Annual leave requests should be planned and requested in

advance. The leave should not hinder the completion of the goals and objectives of any rotation. The resident will

be eligible for 4 weeks of annual leave in addition to official holidays. Leaves exceeding ninety days shall be

compensated for with an equivalent period of days before the trainee is awarded the certificate of training

completion.

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- Refer to KFSH&RC Employee Relation Manual http://www2.kfshrc.edu.sa/o&m/Guidelines/ERM_Ram-1435-2015feb26.pdf

- Refer to SCFHS rules and regulations http://www.scfhs.org.sa/MESPS/TrainingProgs/RegulationBoard/Documents/tadreeb.pdf Pharmacy Resident Probation/Dismissal and/or Withdrawal: A pharmacy resident may be placed on probation, dismissed, or voluntarily withdraw from the program should there be evidence of their inability to function effectively or putting patients at risk. Examples which would require action are listed, but are not limited to the following:

Behavioral misconduct or unethical behavior that may occur on hospital premises

Unsatisfactory attendance

More than one unsatisfactory performance evaluation by the end of the program

Theft of government property

- Refer to KFSH&RC Employee Relation Manual for termination of employment policy http://www2.kfshrc.edu.sa/o&m/Guidelines/ERM_Ram-1435-2015feb26.pdf

- For candidates under the auspice of both Saudi Commission for Health Specialties (SCFHS) and American Society of Health-System Pharmacists (ASHP): Refer to SCFHS rules and regulations for detailed process (http://www.scfhs.org.sa/en/Reglations/Documents/Rules%20of%20Procedure%20for%20Training%20of%20Saudi%20Board%20Specialties.pdf