PRE-SURVEY QUESTIONNAIRE AND SELF-ASSESSMENT CHECKLIST · PDF filepre-survey questionnaire and self-assessment checklist . for the accreditation of a . postgraduate year one (pgy1)

PRE-SURVEY QUESTIONNAIRE AND SELF-ASSESSMENT CHECKLIST

FOR THE ACCREDITATION OF A

POSTGRADUATE YEAR ONE (PGY1) PHARMACY RESIDENCY PROGRAM

Name of Program:__Stellar Hospital

City, State, Zip Code:_

Chief of Pharmacy:_William Fairfax_ Telephone Number:__

E-mail Address:____

Telephone Number:___ Program Director:__Benjamin Franklin

Date Submitted: ___March 1, 2013 E-mail Address:___

FC PC NC NA

Principle 1: Qualifications of the Resident

1.1a Residency applicant qualifications are evaluated by the residency program director (RPD)

through an established, formal procedure that includes an assessment of the applicant’s

ability to achieve the educational goals and objectives selected for the program.

X

1.1b Criteria used to evaluate applicants are documented and understood by all involved in the

evaluation and ranking process. X

1.2 Residents are graduates of an Accreditation Council for Pharmacy Education (ACPE)-

accredited Doctor of Pharmacy degree program. X

1.3 Applicants are licensed, or are eligible for licensure in the state or jurisdiction in which

the residency program is conducted. Consequences of failure to obtain appropriate

licensure are addressed in policy of the organization.

X

1.4 Residents have participated in and adhered to the rules of the Resident Matching Program

process. X

Comments:

FC PC NC N A

Principle 2: Obligations of the Program to the Resident

2.1 Program is a minimum of twelve months and is a full-time practice commitment or

equivalent. X

2.2a RPD assures that the educational outcomes of the program, the welfare of the resident,

and the welfare of patients are not compromised by excessive reliance on residents to

fulfill service obligations.

X

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2.2b RPD assures residency complies with the current duty hour standards of the Accreditation

Council for Graduate Medical Education (ACGME). X

2.3 Program adheres to the rules of the Resident Matching Program process. X

2.4a RPD provides residents who are accepted into the program with a letter outlining their

acceptance to the program. X

2.4b RPD provides information on the terms and conditions of the appointment and

information is consistent with that provided to pharmacists within the organization. X

2.4c Acceptance by residents of these terms and conditions is documented prior to beginning

of the residency. X

2.5 Program provides sufficient professional and technical pharmacy staff complement

to ensure appropriate supervision and preceptor guidance to all residents. X

2.6 Program provides residents with an area in which to work, access to appropriate

technology, access to extramural educational opportunities, and sufficient financial

support to fulfill the responsibilities of the program.

X

2.7 Policies concerning professional, family, and sick leaves and the effect such leaves would

have on the resident’s ability to complete the residency program are documented. X

2.8 RPD awards a certificate of residency only to those who complete the program’s

requirements. Certificate states program is accredited by ASHP and, if appropriate,

its corresponding partner; is issued in accordance with the provisions of the ASHP

Regulations on Accreditation of Pharmacy Residencies; and is signed by the RPD and

the CEO of the organization.

X

2.9 Program is compliant with the provisions of the current version of the ASHP

Regulations on Accreditation of Pharmacy Residencies. X

Comments: 2.8 The program is in its first year thus a certificate of residency only to those who complete

the program’s requirements first iteration is planned for end of June 2013. A proposed certificate is

available for review on site that is in compliance the provisions of the ASHP Regulations on

Accreditation of Pharmacy Residencies; and is signed by the RPD and the CEO of the organization.

FC PC NC N A

Principle 3: Obligations of the Resident to the Program

3.1 Residents’ primary professional commitment is to the residency program. X

3.2 Residents adhere to the values and mission of the training organization. X

3.3 Residents complete the educational goals and objectives established for the program. X

3.4 Residents ask for verbal and written feedback from preceptors. X

3.5 Residents make active use of constructive feedback from preceptors. X

Comments: 3.3: RTP has not graduated or had any residents complete our program at this time. 3.4:

The RPD has coached, modeled and instructed Residents to ask for verbal and written feedback from

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preceptors with good results but not grade as 100% FC. The RPD innovated our custom evaluation in

ResiTrak for this purpose. 3.5: The RPD has coached, modeled and instructed Residents to make active

use of constructive feedback from preceptors with good results but not 100% FC, in fact I have no

example to base this other than handful of observations. An example would be the resident’s and our

preceptor’s (CF and AE) frustration after the feedback on medical grand rounds presentation in fall

2012. Application of preceptor feedback was partially observed but needed close attention and repeating

in subsequent. Recently the RPD coached the resident AE with hour case presentation on “MRSA and

Cellulitis” resident AE has successfully applied said skills in the subsequent opportunity. RPD has

worked with preceptor’s who stated the residents’ “should just do it” or “they should know this coming

into the program” at the level of the Clinical Pharmacy Supervisor and in preceptor training meetings.

FC PC NC N A

Principle 4: Requirements for the Design and Conduct of the Residency Program

4.1 RPD and, when applicable, program preceptors collaborate to design the residency

program. X

a. Program design includes documentation of the program’s:

(1) Purpose X

(2) Outcomes that reflect the program’s purpose X

(3) Educational goals for each outcome X

(4) Educational objectives for each goal, the sum of which assure goal

achievement X

b. Program includes all six outcomes required by the accreditation standard and

all of the associated educational goals listed with the required outcomes as

follows:

(1) Manage and improve the medication-use process. X

(2) Provide evidence-based, patient-centered medication therapy

management with interdisciplinary teams. X

(3) Exercise leadership and practice management skills. X

(4) Demonstrate project management skills. X

(5) Provide medication and practice-related education/training. X

(6) Utilize medical informatics. X

c. The design of program structure has the following characteristics:

(1) Facilitates achievement of the program’s educational goals and objectives. X

(2) Allows resident experience in diverse patient populations, a variety of

disease states, and a range of complexity of patient problems as

characterized by a generalist’s practice.

X

(3) No more than four months of the program deals with a specific patient

population or practice area. X

(4) Program’s educational goals and objectives, including those for the project,

are assigned to a single learning experience or a sequence of learning

experiences that allows sufficient practice for their achievement.

X

d. Preceptors have a description of their learning experience and a list of activities

to be performed by residents. Learning activities demonstrate adequate

opportunity to learn the educational goals and objectives assigned to the

learning experience.

X

e. Program design for competency-based evaluation includes the following

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requirements:

(1) Regarding preceptor evaluation of resident performance:

(a) Each preceptor conducts and documents a criteria-based, summative

assessment of each resident’s performance of each of the respective

program-selected educational goals and objectives assigned to the

learning experience.

X

(b) Preceptor summative resident evaluations are conducted at the

conclusion of the learning experience (or at least quarterly for

longitudinal learning experiences) and reflect the resident’s performance

at that time.

X

(c) Each resident evaluation is discussed by the preceptor with the resident

and RPD, and the reviews are documented by each. X

(2) Regarding resident self-evaluations:

(a) Each preceptor provides periodic opportunities for the resident to

practice and document criteria-based, formative self-evaluation of

aspects of their routine performance.

X

(b) Each preceptor provides an opportunity for the resident to document a

criteria-based, summative self-assessment of achievement of the

educational goals and objectives assigned to the learning experience,

completed on the same schedule as required of the preceptor by the

assessment strategy.

X

(c) Residents complete end-of-the-year self-assessments. X

(3) Residents complete an evaluation of the preceptor and of the learning

experience at the completion of each learning experience (or at least quarterly

in longitudinal learning experiences) and provide their evaluations to the RPD.

X

4.2 Documentation of the program’s ongoing attention to fulfillment of both preceptor and

resident roles and responsibilities shows that:

a. Regarding orientation activities:

(1) Residents are oriented to the program to include its purpose, applicable

accreditation regulations and standards, designated learning experiences, and

the evaluation strategy.

X

(2) RPD orients staff to the residency program (when necessary). X

(3) Preceptors orient their residents to their learning experiences, including

reviewing and providing written copies of the learning experience educational

goals and objectives, associated learning activities, and evaluation strategies.

X

b. Regarding customization of resident training programs:

(1) The RPD and, when applicable, preceptors customize the training

program for the resident based upon an assessment of the resident’s

entering knowledge, skills, attitudes, and abilities and the resident’s

interests including accounting for discrepancies in assumed entering

capabilities.

X

(2) Residents’ customized plans maintain consistency with the program’s stated

purpose and outcomes. X

(3) Customization of resident’s plans does not interfere with achievement of the

program’s educational goals and objectives. X

(4) Customized plans and modifications to them, including the resident schedules,

are shared with the resident and all preceptors. X

c. Preceptors provide ongoing, criteria-based verbal and, when needed, written

feedback. Written feedback is used if there is limited direct contact with the

preceptor or verbal feedback alone is not effective in improving performance.

X

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d. Preceptors complete all aspects of the program’s plan for assessment of:

(1) Resident performance X

(2) Preceptor performance X

(3) Resident self-evaluation X

e. Regarding monitoring of resident progress:

(1) RPD and, when applicable, preceptors track residents’ overall progress

toward achievement of their educational goals and objectives at least

quarterly.

X

(2) Any necessary adjustments to residents’ customized plans, including

remedial action(s), are documented and implemented. X

4.3 Regarding quality assurance of training program:

a. RPD evaluates potential preceptors based on their desire to teach and their aptitude

for teaching (as differentiated from formal didactic instruction).X

b. RPD provides preceptors with opportunities to enhance their teaching skills. X

c. RPD utilizes a plan for improving the quality of preceptor instruction based on an

assessment of residents’ written evaluations of preceptor performance and other

sources.

X

d. At least annually RPD and when applicable, preceptors, consider overall program

changes based on evaluations, observations, and other information.X

4.4 RPD evaluates, through employment and other career information of residency graduates,

whether the residency produces the type of practitioner described in the program’s

purpose statement.

X

Comments: 4.1 c (2) Patient care units with on-demand services for clinical pharmacy include pediatrics, neonates, and off-site

ambulatory care are generally not available or structured into resident training at this time but our treatment

population is a diverse and strongly supports pharmacy generalist training services.

4.1 c (3) Infectious Disease core and Family Practice elective may overlap in-patient type with any of the other

direct patient care rotations.

4.1 d The DPC Oncology elective was developed by a current resident, with the support of the RPD, RPC and

approved by the RAC, as a major practice based project. It represents an focus area where the pharmacy

department and RPD desire to expand patient care beyond medication order review order review and preparation.

Preceptors are co-developing the Pharmacy Practice Management longitudinal experience which has taken on the

persona of the prototypical LE “work in progress”. Collaboration and a longer list of T/TEs than other rotations

make this a challenging RTP LE.

With the DPC LE’s where R2.6, 2.7,2.9 are T and TE, the partial compliance answer is rooted in a perception that

our practice model must have 100% prospective care plan design and implementation where actually we have not

achieved this. As a group of pharmacists, we are not clear with the fundamental consensus to achieve prospective

review as an overarching change and organizational decision. Pharmacy practice is being molded by the RTP but

my view is this will take some time and a large loading dose of leadership.

4.3 a.b.c.d. As a young, new program this is difficult criteria to mark FC as there more plans to conduct said

activities than actual outcomes and time dedicated to each task.

4.4: We have yet to complete our first year.

FC PC NC N8

A

Principle 5: Qualifications of the Residency Program Director (RPD) and

Preceptors

5.1 RPD is a licensed pharmacist, has completed an ASHP-accredited residency, and has

a minimum of three years of pharmacy practice experience. Alternatively, RPD is a

licensed pharmacist; has five or more years of practice experience; and has

demonstrated mastery of the knowledge, skills, attitudes, and abilities expected of

one who has completed a residency.

X

5.2 RPD has documented evidence of his or her ability to teach effectively in the clinical

practice environment. X

5.3 The program has a single RPD who is a pharmacist from a practice site involved in the

program or from a sponsoring organization. X

5.4 For multiple site residencies or for a residency offered by a sponsoring organization in

cooperation with one or more practice sites:

a. There is one RPD. X

b. RPD’s responsibilities are defined clearly. X

c. RPD designation is agreed to in writing by responsible representatives of each

participating organization.X

5.5 RPD has documentation of ability to direct and manage a pharmacy residency. X

5.6 RPD has a sustained record of contribution and commitment to pharmacy practice

that is characterized by a minimum of four of the following. Please check those that

apply:

X

X Documented record of improvements in and contributions to pharmacy practice.

X Appointments to appropriate drug policy and other committees of the organization.

X Formal recognition by peers as a model practitioner.

X A sustained record of contributing to the total body of knowledge in pharmacy

practice through publications in professional journals and/or presentations at

professional meetings.

X Serving regularly as a reviewer of contributed papers or manuscripts submitted for

publication.

X Demonstrated leadership in advancing the profession of pharmacy through active

service in professional organizations at the local, state, and national levels.

X Demonstrated effectiveness in teaching.

5.7 Preceptors are licensed pharmacists, have completed an ASHP-accredited residency,

and have a minimum of one year of pharmacy practice experience. Alternatively,

preceptors who are licensed pharmacists but have not completed an ASHP-

accredited PGY1 residency are able to demonstrate mastery of the knowledge, skills,

attitudes, and abilities expected of one who has completed a PGY1 residency and

have a minimum of three years of pharmacy practice experience.

X

5.8 Preceptors have training and experience in the area of pharmacy practice for which

they serve as preceptors, maintain continuity-of-practice in that area, and practice in

that area at the time residents are being trained.

X

5.9 Each preceptor has a record of contribution and commitment to pharmacy practice X

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characterized by a minimum of four of the following. Please check those that apply:

● Record of improvements in and contributions to the respective area of advanced

pharmacy practice.

● Appointments to appropriate drug policy and other committees of the

department/organization.X

● Formal recognition by peers as a model. X

● A sustained record of contributing to the total body of knowledge in pharmacy

practice through publications in professional journals and/or presentations at

professional meetings.

X

● Serves regularly as a reviewer of contributed papers or manuscripts submitted for

publication.X

● Demonstrated leadership in advancing the profession of pharmacy through active

participation in professional organizations at the local, state, and national levels.X

● Demonstrated effectiveness in teaching. X

5.10 Preceptors demonstrate desire and aptitude for teaching that includes all of the

following. Please check those that apply: X

● Mastery of the four preceptor roles fulfilled when teaching clinical problem

solving (instructing, modeling, coaching, and facilitating).

● The ability to provide criteria-based feedback and evaluation of resident

performance.

● Pursuit of continued refinement of their teaching skills.

5.11 If non-pharmacist preceptors are utilized, all of the following conditions are met.

Please check those that apply: X

X The learning experiences in which they are utilized occur in later stages of the

residency when evaluations conducted at the end of previous learning experiences

reflect readiness to practice independently, the RPD and preceptors agree that the

resident is ready for independent practice, and the main role of the preceptor is to

facilitate resident learning experiences.

X A pharmacist works closely with the non-pharmacist preceptor to select the

educational goals and objectives and participates actively in the criteria-based

evaluation of the resident’s performance.

Comments: 5.4 RTP is not a multiple site residency.

5.8: For Stellar Family Practice Rounding (SFP -direct patient care elective) the preceptors (Dr. Lafayette and Dr.

Franklin) have training and experience in the practice area but this learning experience is a stretching of existing

practice to include rounding with this medical team for the benefit of the PGY1 residents as well as patients. SFP

is seeing about 15 SH inpatients similar to the hospitalist service acting as a PCP to the inpatient. The SFP is

essentially a collaboration project justified because SFP conducts a medical residency-training program with 18

medical PGY1,2,3 residents. The SFP DPC rotation is an elective and as such offered late in the final stages when

evaluations conducted at the end of previous learning experiences reflect readiness to practice independently. The

pharmacist preceptors understand how to maintain the preceptor continuity-of-practice in that area as well as the

physician faculty but this is a new endeavor driven by the concept and willingness to explore a different PPMI

like model discussed in early stages of our RAC. The RAC and key preceptor Dr. Lafayette agreed to trial and

consider changing the Internal Medicine rotation structure in 2013-2014 in order to incorporate team rounding

and prospective review by the pharmacist potentially changing practice toward the ASHP PPMI model.

5.9: The program identifies and trains new faculty in order to encourage professional development for satisfaction

of PGY1 record of contribution and commitment. The program has a plan for preceptor development aimed at

the prototypical “new” preceptor found to be lacking required 4/7 criteria.

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A preceptor self-scoring survey has been initiated by the RAC to stimulate interest and concern among our

preceptors. Preceptor development training by the RPD and RPC is evidenced by the RTP meetings and feedback

by RPD and RPC. This requirement is expected to a receive concentrated focus in the years ahead with

development tied to the annual performance appraisal process.

FC PC NC N A

Principle 6: Minimum Requirements of the Site Conducting the Residency Program

6.1 The residency program is conducted only in practice settings that have sought and

accepted outside appraisal of facilities and patient care practice by a recognized

organization appropriate to the practice setting.

a. A health-system (inclusive of all components of the system that provide patient care)

that offers or that participates in offering a pharmacy residency is accredited by

applicable organizations [e.g., Joint Commission on Accreditation of Healthcare

Organizations (JCAHO), American Osteopathic Association (AOA), National

Committee for Quality Assurance (NCQA)].

Please specify which: _JCAHO

X

b. A college of pharmacy that participates in offering a pharmacy residency is accredited

by the Accreditation Council for Pharmacy Education (ACPE).

Name of college: _Midtown College of Pharmacy and Health Sciences (MCPHS)

X

c. Other practice settings that offer a pharmacy residency demonstrate substantial

compliance with applicable professionally developed and nationally applied

standards.

X

6.2 The residency program is conducted only in those practice settings where management

and professional staff have committed to seek excellence in patient care, have

demonstrated substantial compliance with professionally developed and nationally applied

practice and operational standards, and have sufficient resources to achieve the

educational goals and objectives selected for the residency program.

X

6.3 Where two or more practice sites, or a sponsoring organization (e.g., college of pharmacy,

health system) and one or more practice sites collaborate to provide a pharmacy

residency:

a. Patient population base and professional practice experience satisfy residency

requirements.X

b. Sponsoring organizations maintain authority and responsibility for the quality of

residency training.X

c. An individual is designated and empowered to direct program and achieve consensus

on evaluation and ranking of residency applicants.X

d. Sponsoring organizations and practice sites contractual arrangement(s) or signed

agreement(s) define clearly responsibilities for all program aspects.X

e. Each practice site providing residency training meets Requirement 6.2 and all of

Principle 7 of the standard.X

Comments:

6.2 The possible exception to FC is the new Oncology LE. The experience itself was developed as a major

practice based project by resident Dr. Knox and preceptor development and overall scope of the LE is under review and finalization by the lead preceptor and by the RAC. In addition we are exploring the potential to

attract a qualified MCPHS faculty member to the service for both APPE and Resident training which may be the best idea yet for the endeavor.

6.3e We have an affiliation agreement with MCPHS and have chosen to allow two rotations: Scholarship of11

Teaching and Learning (longitudinal) and Ambulatory Care / Rheumatology (elective DPC rotation).

Application of Principle 7 to the MCPHS (college of pharmacy) is an area for investigation with the ASHP survey

team however the two faculty members are SH RTP preceptors approved by SH RAC and are listed in the SH

RTP roster of preceptors.

FC PC NC N A

Principle 7: Qualifications of the Pharmacy

7.1 The pharmacy is led and managed by a professionally competent, legally qualified

pharmacist. X

7.2 The pharmacy is an integral part of the health-care delivery system at the practice site in

which the residency program is offered, as evidenced by the following:

a. The scope of patient pharmacy services is based upon assessment of pharmacy

functions needed to provide care to all patients served.X

b. Services are of a scope and quality commensurate with identified patient needs. X

c. Pharmacy is involved in the overall planning of patient care services for the practice

setting.X

d. Pharmacy services extend to all areas of the practice site in which medications are

prescribed, dispensed, administered, and monitoredX

e. Pharmacists are responsible around-the-clock for procurement, preparation,

distribution, and control of all medications used, including investigational drugs.X

7.3 The chief pharmacist provides effective leadership and management for the

achievement of short- and long-term goals of the pharmacy and the organization

relating to medication use and medication-use policies by assuring that the following

elements associated with a well-managed pharmacy are in place (as appropriate to

the practice setting):

a. A pharmacy mission statement. X

b. A written document describing the scope and depth of pharmacy services. X

c. A well-defined pharmacy organizational structure. X

d. A description of pharmacy services provided. X

e. Documented short- and long-term pharmacy goals. X

f. Current policies and procedures that are readily available to staff participating in

service provision.X

g. Position descriptions for all categories of pharmacy personnel. X

h. Systems to document pharmacy: X

(1) Workload X

(2) Financial performance X

(3) Patient care outcomes data X

i. Pharmacy involvement with key committees involving medications and patient care. X

j. A quality improvement plan. X

7.4 The pharmacy:

a. Complies with all applicable federal, state, and local laws, codes, statutes, and

regulations governing pharmacy practice.X

b. Demonstrates substantial compliance with national practice standards and guidelines. X

c. Regularly reviews and develops plans to conform to new practice standards or

guidelines.X

d. Has sought and accepted outside appraisals of its facilities and patient care practices. X

7.5 The pharmacy provides a safe and effective drug distribution system for all

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medications used within the practice site by including the following components in

its drug distribution system/service (as applicable to the practice setting):

a. A unit-dose drug distribution service. X

b. An intravenous admixture and sterile product service. X

c. An investigational drug service. X

d. An extemporaneous compounding service. X

e. A system for the safe use of drug samples. X

f. A system for the safe use of emergency medications. X

g. A controlled substance floor-stock system. X

h. A controlled floor-stock system. X

i. An outpatient drug distribution service. X

7.6 The pharmacy provides the necessary patient care services in a manner consistent

with practice site and patient needs.

a. The following patient care services or activities are provided in collaboration

with other health-care professionals:

(1) Membership on interdisciplinary teams in the patient care areas

associated with the residency program. X

(2) Development of treatment protocols, critical pathways, order sets, and

other systems approaches involving medications for patients on involved

services.

X

(3) Participation in collaborative practice agreements with other providers and

management of patients following collaborative practice agreements,

treatment protocols, critical pathways, etc.

X

(4) Prospective participation in the development of individualized treatment

plans for patients of involved services. X

(5) Identification of medication-related problems. X

(6) Review of appropriateness and safety of medication orders. X

(7) Design and implementation of medication-therapy monitoring plans. X

(8) Documentation of all significant patient care recommendations and

resulting actions, treatment plans, and/or progress notes in the

appropriate section of the patient’s medical record or the organization’s

clinical information system.

X

(9) Written and oral consultations regarding medication-therapy selection and

management. X

(10) Patient disease and/or medication management consistent with laws,

regulations, and practice site policy. X

(11) Medication administration consistent with laws, regulations, and practice site

policy. X

(12) Preventive and wellness programs. X

(13) A system to ensure and support continuity-of-care.

b. Drug information activities provided by pharmacy staff and the residents include, but

are not limited to, the following (as applicable to the practice setting):

(1) Developing and maintaining a formulary. X

(2) Publishing periodic newsletters or bulletins for health-care providers on

timely medication-related matters and medication policies. X

(3) Preparing medication therapy monographs based on an analytical review of

pertinent biomedical literature, including a safety assessment and a

comparative therapeutic and economic assessment of each new agent for

formulary addition or deletion.

X

(4) Establishing and maintaining a system for retrieving drug information from X

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the literature.

(5) Responding to drug information inquiries from health-care providers. X

(6) Conducting educational programs about medications, medication therapy, and

other medication-related matters for health-care providers. X

(7) Participating in the development or modification of policies related to:

(a) medications X

(b) medication-use evaluation X

(c) adverse drug event prevention, monitoring, and reporting X

(d) appropriate methods to assess ongoing compliance with such policies. X

7.7 The pharmacy provides leadership and participates with other health professionals

in the following systems (as applicable to the practice setting):

a. A system to support and actively participate in decision-making concerning the

pharmacy and therapeutics function, including the preparation and

presentation of drug-therapy monographs.

X

b. A system to review medication-use evaluations and to implement new policies or

procedures to improve the safe and effective use of medications.X

c. A system to review adverse drug event reports and to implement new policies

and procedures to improve medication safety.X

d. A system to evaluate routinely the quality of pharmacy services provided. X

7.8 The pharmacy has personnel, facilities, and other resources to carry out a broad

scope of pharmacy services (as applicable to the practice setting). X

a. Facilities are constructed, arranged, and equipped to promote safe and efficient

work.X

b. Adequate packaging equipment is used to prepare medications for unit-dose

dispensing or compliance packaging.X

c. Automated medication systems and software support a safe medication-use

system.X

d. Computerized systems support a safe medication-use system. X

e. Professional and technical staff is sufficient in number and of the diversity to

ensure that the department can provide the level of service required by all

patients served.

X

f. Professional staff members seek professional enrichment and demonstrate their

interest in continuing competence.X

g. Technical and clerical staff complement is sufficient to handle all functions that can

be assigned appropriately to them.X

Comments. 7.3 h (3) Patient care outcomes data can always be improved to be more comprehensive and the residency

program is one way to achieve the objective to document pharmacist outcomes.

7.6 a (4) We are not always prospective in all practice setting associated with resident training, but we do have

reactive coverage with services to requested consults in all patient care areas of the health care facility. This

restriction to reactive services in some cases is necessary do to limitations of pharmacist resources and is also

complicated by the definition and interpretation of pharmacy services posed by the statement. Progress is

reflected in potentially changing the Internal Medicine rotation structure in 2013-2014 in order to incorporate

team rounding and prospective review by the pharmacist potentially changing practice toward the ASHP PPMI

model.

7.6 a (12) We rarely provide this. One bright spot is we have a 2012 resident project (Dr. J. Adams) aimed at feasibility of smoking cessation services in the inpatient care areas associated with high-level quality improvement

target in the SH organization. The PC reflects the exploratory and incomplete stage of the project as well a weak

presence in this area of service.

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7.6 b (2) The score of PC is based on the lack of a department newsletter but certainly not a lack of publication

within other media in the organization. As matter of periodic publication at SH we do not maintain an

institutional Pharmacy Department newsletter but choose to contribute to medical staff and staff newsletters on a

routine and as needed basis. The pharmacy department participates in medical staff direct mailings and other

informational media.

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Stellar Hospital PGY1 Pharmacy Residency

Purpose Statement

The purpose f the PGY1 Pharmacy Residency at Quality Hospital is to prepare pharmacist clinicians for health-system pharmacy practice, adjunct faculty positions or to pursue PGY2 training in a focused area of practice.

Intended outcomes of the PGY1 Pharmacy Residency

At the end of the PGY1 Pharmacy Residency at Stellar Hospital, the resident is expected to achieve the following outcomes. The educational outcomes, as well as the goals, and objectives below are to be used in conjunction with the ASHP Accreditation Standard for Postgraduate Year One (PGY1) Pharmacy Residency Programs

Outcome R1: Manage and improve the medication-use process.

Outcome R2: Provide evidence-based, patient-centered medication therapy management with interdisciplinary teams.

Outcome R3: Exercise leadership and practice management skills.

Outcome R4: Demonstrate project management skills.

Outcomes R5: Provide medication and practice-related education/training.

Outcome R6: Utilize medical informatics.

Outcome E5: Participate in the management of medical emergencies.

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Stellar Hospital PGY 1 Pharmacy Residency Program – Structure for 2012-2013

Learning Experience Type 1 Primary Preceptor 2

General Orientation to Pharmacy Practice Rotation John Quincy, R.Ph.

Infectious Disease Rotation Benjamin Franklin, R.Ph., PharmD., FASHP

Internal Medicine Rotation Carolyn Taylor, R.Ph., Pharm.D.

Surgery/Pain Management Rotation Emma Adams, R.Ph., Pharm.D.

Critical Care Rotation Joseph Munster, R.Ph., Pharm.D., BCPS

Transitional (December) Rotation Benjamin Franklin, R.Ph., PharmD., FASHP

Emergency Medicine Rotation Florence Nightingale R.Ph., Pharm.D., BCPS

Cardiology Rotation Stephen Stone, R.Ph., Pharm.D., BCPS

CO

RE

Pharmacy Practice Management Longitudinal James Monroe, R.Ph., Pharm.D., FASHP

Staffing In-Patient Pharmacy Longitudinal John Quincy, R.Ph.

Major Research/Project Longitudinal Assigned

ELEC

TIV

E3

Family Practice Service Rotation Carolyn Taylor, R.Ph., Pharm.D.

Palliative Care Rotation Carolyn Taylor, R.Ph., Pharm.D.

Ambulatory – Rheumatology (Off-Site) in collaboration with MCPHS

Rotation Jane Doe, R.Ph., PharmD., MCPHS Assistant Professor

Internal Medicine Hospitalist Service4 Rotation Carolyn Taylor, R.Ph., Pharm.D.

Oncology Chemotherapy Rotation James Monroe, R.Ph., Pharm.D., FASHP

Teaching & Learning Scholarship in collaboration with Some College of Pharmacy (MCPHS)

Longitudinal John Jay, R.Ph., Pharm.D., BCACP, MCPHS Associate Professor

1. Rotation - 3 to 8 weeks, Longitudinal – 9 to 12 months2. Stellar Hospital Pharmacy Staff unless other wise indicated3. Elective rotations, when available, are structured in the training year after several months of successful progress in core- longtitudinal and rotation learning experiences, electives

rotations availability may be limited4. Under development – not available 2012-2013

James Madison, R.Ph., MS James Monroe, R.Ph., Pharm.D., FASHPDirector, Pharmacy Services Supervisor, Clinical Pharmacy Services

Benjamin Franklin, R.Ph., PharmD., FASHPDirector, Residency Program

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http://www.sphcs.org/prp

mailto:[email protected]

Direct Patient Care - Cardiology

Direct Patient Care - Critical Care

Direct Patient Care - Emergency Medicine

Direct Patient Care - Internal Medicine

Direct Patient Care - Surgery/Pain Management

Elective - Ambulatory Care/Rheumatology

Elective - Internal Medicine Family Practice Service

Elective - Oncology/Chemotherapy

Elective - Palliative Care

PROJECT - Longtitudinal

ORIENTATION PRACTICE MANAGEMENT - Longtitudinal

STAFFING - Longtitudinal

Teaching and Learning Certificate Program -

Midtown College of Pharmacyand Health Sciences

Transitional

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T T T T T T TE T TE TE

T T T T T T T T TE TE

T T T TE T T T TE T T T

TE TE T T T T T T TE T T

T TE T T T T T T TE TE

TE T T T TE TE T T TE T T

T T TE TE T T T T T T T

T T T T TE T T T T T T

T T T TE T T TE T T T

T T T T TE T TE T T T

TE TE T T T TE T T T T

T T T TE T T T TE T TE

TE T T T T T TE T T

T T TE T T T TE T T

T T T T TE TE T T T

TE TE

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T T T T T T T T TE

TE

T T T T T T T T TE T TE

TE TE T

TE TE T T

Elective - Hospitalist Rounding Service

TE

T

T

T

TE

T

T

T

T

TE

TE

T

T

TE

T

T

E5.1 - Participate in the management of medical emergencies.

TR5.1 - Provide effective medication and practice-related education, training, or counseling to patients, caregivers, health care professionals, and the public.

T

R6.1 - Use information technology to make decisions and reduce error.

R3.3 - Exercise practice leadership. T

R4.1 - Conduct a practice-related project using effective project management skills.

R3.1 - Exhibit essential personal skills of a practice leader.

R3.2 - Contribute to departmental leadership and management activities.

R2.11 - Communicate ongoing patient information. T

R2.12 - Document direct patient care activities appropriately. TE

R2.9 - Implement regimens and monitoring plans. TE

R2.10 - Evaluate patients’ progress and redesign regimens and monitoring plans. T

R2.7 - Design evidence-based monitoring plans. T

R2.8 - Recommend or communicate regimens and monitoring plans. TE

R2.5 - When necessary, make and follow up on patient referrals. T

R2.6 - Design evidence-based therapeutic regimens. T

R2.3 - As appropriate, establish collaborative professional pharmacist-patient relationships. T

R2.4 - Collect and analyze patient information. T

R2.1 - As appropriate, establish collaborative professional relationships with members of the health care team.

T

R2.2 - Place practice priority on the delivery of patient-centered care to patients. TE

R1.4 - Demonstrate ownership of and responsibility for the welfare of the patient by performing all necessary aspects of the medication-use system.

T

R1.5 - Provide concise, applicable, comprehensive, and timely responses to requests for drug information from patients and health care providers.

T

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.

T

Direct Patient Care -Infectious Disease

R1.1 - Identify opportunities for improvement of the organization’s medication-use system.

Active Learning Experiences for PGY1 - Pharmacy (22037)Stellar HospitalReport Generated: 1/11/2013 15:12

20

B2_SCHEDULE FOUR RESIDENT 2013-14 .doc

1

R1 R2 R3 R4 Week 1 ORIENT ORIENT ORIENT ORIENT

Week 2 ORIENT ORIENT ORIENT ORIENT

Week 3 INTRO TO PRACTICE INTRO TO PRACTICE INTRO TO PRACTICE INTRO TO PRACTICE





Week 8 Critical Care Surgery & Pain Mgt. EMERGENCY MEDICINE CARDIOLOGY





Week 13 INTERNAL MEDICINE INFECTIOUS DISEASE Surgery & Pain Mgt. EMERGENCY MEDICINE





Week 18 Surgery & Pain Mgt. Critical Care ELECTIVE INFECTIOUS DISEASE





Week 23 TRANSITIONAL TRANSITIONAL TRANSITIONAL TRANSITIONAL




21

B2_SCHEDULE FOUR RESIDENT 2013-14 .doc

2

1 2 3 4 Week 27 TRANSITIONAL TRANSITIONAL TRANSITIONAL TRANSITIONAL

Week 28 EMERGENCY MEDICINE INTERNAL MEDICINE Critical Care Surgery & Pain Mgt.





Week 33 ELECTIVE CARDIOLOGY INFECTIOUS DISEASE INTERNAL MEDICINE





Week 38 INFECTIOUS DISEASE ELECTIVE CARDIOLOGY ELECTIVE





Week 43 CARDIOLOGY ELECTIVE ELECTIVE Critical Care





Week 48 ELECTIVE EMERGENCY MEDICINE INTERNAL MEDICINE ELECTIVE





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Stellar Hospital PGY-1 Pharmacy Residency

Internal Medicine (Required Rotation)

Learning Experience Description Xxxx xxxx, Pharm.D., BCPS xxxxx xxxxx, Pharm.D., BCPS Pager: xxx-xxx-xxxx, #xxxx Pager: xxx-xxx-xxxx, #xxxx Office: xxx-xxx-xxxx Office: xxx-xxx-xxxx [email protected] [email protected] xxxx xxxxx, PharmD, BCPS Pager: xxx-xxx-xxxx, #xxxx Office: xxx-xxx-xxxx [email protected] I. General Description:

Internal Medicine (IM) is a five week learning experience at Stellar Hospital developed to provide the opportunity for residents to manage acutely ill patients with a variety of disease states.

The pharmacy resident is responsible for identifying and resolving medication therapy issues for patients and will work towards assuming care of all patients on the team prior to the completion of the learning experience. The resident will participate in and provide clinical pharmacy activities including but not limited to:

• Therapeutic drug monitoring services (ie aminoglycosides, anticoagulants, nutrition, and vancomycin)

• Education of patients, providers, ancillary staff, or pharmacy students • Patient case discussions, topic discussions and journal clubs • Drug information requests • The resident should ensure safe and effective use of all medications including medication

and/or dose adjustment when needed (based on culture results, renal function, weight, monitoring parameters)

Excellent communication skills and interpersonal skills are essential for success in this experience. The resident must develop and implement time management skills to efficiently accomplish the required activities during this experience. At the end of the rotation, the resident should be able to efficiently review a patient and identify pharmacotherapeutic problems, implement medication regimens, develop a plan with measurable endpoints and subsequently monitor the regimens for effectiveness and adverse effects.

II. Disease States:

Common disease states to be covered via patient experiences, topic discussions, and/or literature review may include, but are not limited to:

• Anemia • Asthma/COPD • Catheter-related Infections • Common Infectious Diseases • Chronic Kidney Disease • Diabetes Mellitus • Acute Coronary Syndromes (ACS)

• Hypertension • Acute Renal Failure • Heart Failure • Pneumonia • Renal Replacement Therapy • Hyperlipidemia • Cerebrovascular Accidents (CVA)

Internal Medicine Page 1 of 5





III. Required Readings

The resident is expected to read background information and current primary literature to be familiar with all disease states and medications related to the patients on the medical team. The resident is responsible for selecting reading materials for topic discussion and journal club, but the resident should have reading material approved by the preceptor in a timely manner.

IV. Goals Selected:

Goals selected to be taught and evaluated during this learning experience include: R1.4 Demonstrate ownership of and responsibility for the welfare of the patient by performing

all necessary aspects of the medication-use system. R2.1 As appropriate, establish collaborative professional relationships with members of the

health care team. R2.2 Place practice priority on the delivery of patient-centered care to patients. R2.7 Design evidence-based monitoring plans R2.8 Recommend or communicate regimens and monitoring plans R2.9 Implement regimens and monitoring plans. R2.10 Evaluate patients’ progress and redesign regimens and monitoring plans.

V. Activities

Goals and Objectives Activities to Facilitate Professional Growth

Outcome R1: Manage and improve the medication-use process Goal R1.4 Demonstrate ownership of and responsibility for the welfare of the patient by

performing all necessary aspects of the medication-use system. OBJ R1.4.1 (Characterization) Display initiative in

preventing, identifying, and resolving pharmacy-related patient-care problems.

Explain the role of the pharmacist in preventing, identifying, and resolving pharmacy-related patient-care problems. Explain the importance of assertiveness in presenting pharmacy concerns, solutions, and interests. Explain and understand the interdependent relationship between operational tasks and clinical activities. Perform follow-through for any interventions implemented.

Outcome R2: Provide evidence-based, patient centered medication therapy management with interdisciplinary teams Goal R2.1 As appropriate, establish collaborative professional relationships with members

of the health care team. OBJ R2.1.1 (Synthesis) Implement a strategy that

effectively establishes cooperative, collaborative, and communicative working relationships with members of interdisciplinary health care teams.

Actively participate in multidisciplinary rounds on a daily basis and communicate while on rounds or prior to rounds recommendations for therapeutic regimen changes or monitoring plan changes with the appropriate members of the health care team.

Goal R2.2 Place practice priority on the delivery of patient-centered care to patients. OBJ R2.2.1 (Organization) Choose and manage daily

activities so that they reflect a priority on the delivery of appropriate patient-centered care to each patient.

Organize schedule efficiently so that the resident has adequate time to pre-round daily and is fully prepared for rounds. Follow up within a timely manner



on all patient care issues in the afternoon while meeting other required responsibilities of the residency program.

Goal R2.7 Design evidence-based monitoring plans. OBJ R2.7.1 (Synthesis) Design a patient-centered,

evidenced-based monitoring plan for a therapeutic regimen that effectively evaluates achievement of the patient-specific goals.

Construct patient specific monitoring plans that incorporate objective data and subjective patient progress to assess response to regimens while limiting adverse events. Rewrite monitoring plans based on a response to plans that were unanticipated.

Goal R2.8 Recommend or communicate regimens and monitoring plans. OBJ R2.8.1 (Application) Recommend or communicate

a patient-centered, evidence-based therapeutic regimen and corresponding monitoring plan to other members of the interdisciplinary team and patients in a way that is systematic, logical, accurate, timely, and secures consensus from the team and patient.

Prepare complete and appropriate recommendations for changes to the therapeutic plan for a specific patient and communicate this to the preceptor and interdisciplinary team members concisely. Select appropriate laboratory monitoring follow-ups based on the changes to the therapeutic regimen. Schedule these labs and document as appropriate.

Goal R2.9 Implement regimens and monitoring plans. OBJ R2.9.1 (Application) When appropriate, initiate the

patient-centered, evidence-based therapeutic regimen and monitoring plan for a patient according to the organization's policies and procedures.

After orders have been written by the physicians, check orders to ensure accuracy of what was discussed and ensure appropriate monitoring has also been ordered. Ensure that any required communication is made to the appropriate person-nurse, physician, patient, or operational pharmacist. For patients without insurance or who require medication authorizations, assist clinical social workers in ensuring that patients receive discharge medications.

OBJ R2.9.2 (Application) Use effective patient education techniques to provide counseling to patients and caregivers, including information on medication therapy, adverse effects, compliance, appropriate use, handling, and medication administration.

Observe clinicians (RN, PharmD, MD) while they counsel patients. Counsel patients before discharge while preceptor observes. Practice counseling with preceptor and students.

Goal R2.10 Evaluate patients’ progress and redesign regimens and monitoring plans. OBJ R2.10.1 (Evaluation) Accurately assess the

patient’s progress toward the therapeutic goal(s).

Assess patient’s improvement towards expected therapeutic goals using the resident prepared patient profile, subjective information from the patient, and objective data from the electronic medical record and other documentation sources. Understand what the goals of therapy are and how to define them.



Discuss patient’s therapeutic regimen and plan daily with preceptor.

OBJ R2.10.2 (Synthesis) Redesign a patient-centered, evidence-based therapeutic plan as necessary based on evaluation of monitoring data and therapeutic outcomes.

Compose a reconstructed therapeutic regimen and monitoring plan based on patients known objective and subjective developments during the admission. Discuss changes to therapeutic regimen and plan daily with preceptor. For each patient, develop an alternative treatment plan and discuss when to implement it.

VI. Preceptor Interaction and Typical Daily/Weekly/Monthly Activities

Daily: • Pre-rounding should occur on all patients on the medical team prior to rounds. There is no

formal data collection tool required, but the resident should be able to provide all pertinent information, including laboratory and medication data, to the rounding team and/or preceptor.

• Rounds typically begin at 0830, locations vary throughout the hospital. Contact your team in the morning to find out where and when they are meeting.

• Review of patients/patient related issues with preceptor • Patient counseling/medication histories • Communicating and providing education to medical staff, nurses, or staff pharmacists as

needed Weekly:

• At least one topic discussion to be prepared and led by the resident (may be assigned topic, or residents choice depending on progression of the rotation); Preceptor may assign or lead discussions.

• End of the week informal feedback session with preceptor. Cumulative:

• Literature review will be expected, encouraged, and presented as part of daily patient presentations, formal topic discussions, and rounds with the medical team

• Attendance at P4 student presentations and other meetings as assigned by the preceptor • Projects or in-services may be required or assigned during the course of the learning

experience. Examples include: o Provide nursing education for policies and procedures pertinent to the floor o Protocol development relevant to the unit o Pharmacy education

Expected progression of resident responsibility on this learning experience: Day 1: 0800 Preceptor to review rotation learning objectives and expectations with

resident 0830 – 1000 Attend medicine rounds. 1000 – 1100 Medical residents/students morning report. The pharmacy resident is not

expected to attend, unless specifically requested by the medical team or



preceptor. During this time the resident will follow-up on drug information requests or patient care issues.

1100 – 1245 Attendance at medicine rounds. 1400 – 1600 Table rounds with preceptor to review and discuss patient update, formal

consults, topic discussions, etc Weeks 1-2 Resident will work up assigned patients and discuss in “rounding”

fashion with preceptor each day. Resident will resolve any concerns with team while on the rounds or via other verbal communication. Preceptor will be available for questions and will monitor patients independently to monitor residents’ development of skills. Preceptor will determine presence on round based on resident development.

Weeks 3-5 Resident will work towards and achieve the goal of taking responsibility

for the review of all patients on the team daily. Preceptor will be available for review and discussion, and presence on rounds will be based on the resident’s development.

(The length of time the preceptor spends in each of the phases of learning will depend BOTH on the resident’s progression in the current rotation and where the rotation occurs in the residency program).

VII. Evaluation Strategy ResiTrak will be used for documentation of formal evaluations. At the beginning of the rotation, the resident will develop three personal goals for the rotation, which should be achievable in five weeks. For formal evaluation, the resident will be evaluated based on the Resident Learning System (RLS) during the rotation. Goals and objectives are listed above. Regular feedback will be given and solicited by the preceptor throughout the rotation. An informal midpoint evaluation will be performed in addition to a formal final evaluation. The resident is expected to provide feedback about their own performance and progress towards person goals/objective at each evaluation. What Who When Custom – 3 Personal Goals for Rotation Resident/Preceptor Start of Rotation Informal Feedback Session Resident/Preceptor Weekly (Fridays) Custom – 3 Personal Goals for Rotation Resident/Preceptor End of Rotation Summative Preceptor End of Rotation Summative Self Evaluation Resident End of Rotation Preceptor/Learning Experience Evaluation Resident End of Rotation


1 B5_Overall Residency Program Assessment Strategy.docx

Assessment Strategy: Overall Residency Program

Stellar Hospital will use the ResiTrack™ and the Stellar Hospital Evaluations to organize and provide high quality

evaluations of the PGY1 residents, preceptor’s and program learning experiences.

An essential component of developing the skills of a resident and continuous improvement to the residency program is frequent two-way feedback between residents and preceptors utilizing the ASHP RLS system. The goal of such discussion and interaction is to:

Discuss the resident's achievements in terms of achieving purpose, outcomes, goals and objectives established for the rotation

Provide feedback that may assist the resident with how to improve performance in current rotation or future rotations or practice

Provide feedback on how well the resident self-evaluates

Provide feedback to the preceptors for continuous improvement of preceptor skills, that may strengthen mentoring during future rotations

Provide feedback to the RPD, RPD and RAC, in order to improve the residency program

The preceptors, residents, RPC and RPD will frequently provide feedback to one another during individual rotations, RSM, RAC and in general throughout the residency program. Specific program and rotation feedback may be given via different formats depending upon the learning experience.

DEFINITIONS RAC – Residency Advisory Committee RLS – Residency Learning System RPC - Residency Program Coordinator RPD – Residency Program Director RSM – Residency Staff Committee (Meeting)

Competency-based evaluation/assessment tools for the pharmacy residency:

1. Formative Evaluation: Formative evaluations can be both verbal and written and maybe formal orinformal. Often this type is represented as criteria-based snapshot, performed throughout the rotationbut prior to the final summative evaluation.

2. Summative Evaluation: Written criteria based summative assessment to evaluate the resident’sachievement of objectives at the end of a learning experience.

3. Quarterly Formative and Summative Evaluations: Longitudinal learning experiences written criteria basedsummative assessments are completed quarterly to evaluate the resident’s achievement of objectivesperformed.

4. Learning Experience Evaluation and Preceptor Evaluation: Each is performed by the resident at the end ofthe rotation. Also longitudinal learning experiences require these evaluations are completed quarterly inaddition to end of the rotation.

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5. Self-evaluation: Resident self-assessment and evaluation is an important component of the learningexperience and the RLS system is utilized in most formative and all quarterly and summative evaluationsto compare preceptor rated performance with resident’s self-evaluation of performance.

The residency assessment procedure incorporates the structure and use of the system provided by ASHP, ResiTrak™. Preceptors and residents are oriented and trained in the use of ResiTrak™ by the RPD and RAC.

Summary of Learning Experience Evaluations

Type How Evaluator(s) When

Formative Verbal Preceptor + Resident

Daily

Formative Care Plan Preceptor + Resident

Weekly

Formative Snapshot TBD ResiTrak™

Preceptor + Resident

Weekly

Quarterly Formative and Summative

Summative ResiTrak™


Quarterly for longitudinal rotation

Summative Summative ResiTrak™


End of Rotation

Preceptor Standard ResiTrak™

Resident End of Rotation + Quarterly if longitudinal rotation

Learning Evaluation Standard ResiTrak™

Resident End of Rotation + Quarterly if longitudinal rotation

The residency assessment documentation of outcomes, goals and objectives incorporates the ResiTrak™ system. Every effort is made to sign and date then warehouse all evaluations and associated documentation using the ResiTrak™ system. The size and magnitude of documentation for projects and manuscripts is however limited and currently beyond the operating capacity of ResiTrak™. To circumvent this limitation the program utilizes a linked, shared drive via file ResiTrak™ file manager function to access document files relevant to resident's progress on a network shared drive. This link and access point ensures access for preceptors and residents to important residency materials. Document storage and link orientation training is provided to preceptors and resident’s in order ensure effective portfolio and residency program documentation, security and allowed access.

Preceptor Evaluation of Resident’s Attainment of Goals and Objectives

Only those goals listed in the program design and those that might be added for an individual resident will be included in the written summative evaluation.

For each rotation, at the beginning, the resident will complete the written pre-rotation assessment form (appendix), identify pre-rotation goals and submit these to the preceptor prior to the start of the learning experience. It is the expectation that these goals will provide a focus for self-directed learning for the resident and will assist the preceptor in preparing an individualized plan for the resident. The preceptor will provide appropriate orientation to the learning experience, rotation’s goals and objectives, rotation schedule, resident’s and preceptor’s current major and minor project involvement, resident's specific interests and needs and devise a plan where by the specific learning objectives can be achieved. It is expected that each resident complete the required learning activities in an effort to achieve the rotation’s goals and objectives. Overall, the Resident will be encouraged to pursue additional learning objectives in specific areas of interest or need. Thus, the learning experience assures minimum competency and allows sufficient flexibility to maximize the learning potential of each individual.

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Formative - Preceptor Evaluation of Resident/Self evaluation of Resident: o On-going written formative evaluation is encouraged but can be verbal. Informal or formal

interaction is expected.o During the learning experience, the residency assessment procedure incorporates the use of

ResiTrak™ system and encourages the formative RLS-snapshots and/or mid-point summativeassessments (see above for details). Snapshots are important in assessing ongoingimprovements in a particular area of a resident’s training.

o Narrative comments and scores are criteria-based and shape the resident’s performance to comecloser to the ideal (E.G. what’s expected as a PGY1 graduate of the residency program) and areprovided prior to the final summative evaluation.

o Program snapshot evaluation scale is ASHP Snapshot scale (adequate/ not adequate/ notapplicable).

Definitions:A: Adequate- resident’s performance is expected to result in achievement of objectiveby the end of the rotation

NA: Not Adequate- resident’s performance is expected to result in not achievingobjectives and needs to corrected and improved during the current rotation.

Criteria scored “NA- Not Adequate” must include narrative comment specificallyaddressing concern and a goal attainment strategy going forward

o Formal Criteria-Based Evaluations: The Resident will present a number of formal clinical and casepresentations throughout the Residency year. These presentations are evaluated by thePreceptors attending the presentation and/or self-evaluation by the resident. This formativeevaluation tool and process is designed to provide the Resident with input on presentationcontent, style, and improvement. Narrative comments and scores are criteria-based and shapethe resident’s performance to come closer to the ideal (E.G. what’s expected as a PGY1 graduateof the residency program) and are provided prior to summative evaluation. These will includebut are not limited to:

Case Discussion (primary preceptor during that experience/ assigned preceptor/RPD/RPC)

Intervention Documentation (primary preceptor during that experience/ assignedpreceptor /RPD/RPC)

Researched DI Questions (primary preceptor during that experience/ assigned preceptor/RPD/RPC)

Journal Club (RPD/RPC) Other project assignments (evaluation preceptor will be assigned)

Summative - Preceptor Evaluation of Resident/Self-evaluation of Resident: o Written summative evaluation forms for the learning experience in ResiTrak™ will be utilized.o Narrative comments are to be criteria-based and comments aimed at what the resident can do

to improve performance of the task.o Summative evaluation scale utilized by the program is ASHP Summative Scale ASHP (NI/SP/ACH).

Definitions: NI= Needs Improvement- resident’s progress won’t result in achievement of objectives SP= Satisfactory Progress- resident’s progress is expected to result in achievement of

objectives ACH = Achieved - resident’s performance is ideal and meet’s what’s expected as a PGY1

graduate of the residency program NA = Not Applicable

o Criteria scored “NI- Needs Improvement” must include narrative comment specifically addressingconcern and a goal attainment strategy going forward.

o Criteria scored “SP= Satisfactory Progress” must include narrative comment specificallyaddressing what the resident might do to improve to successful achievement of the criteria.

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o Criteria scored “ACH = Achieved” must include narrative comment specifically addressing whythe goal attainment criteria are scored as achieved.

o The resident self-evaluates his/her performance during the rotation. Self –SummativeEvaluations are to be completed by the resident before the last day of the learning experience.And like wise a Resident’s Summative Evaluation by Preceptor is to be completed by thePreceptor before the last day of the learning experience. This information will ideally besubmitted to the preceptor at the completion of each learning experience and quarterly forlongitudinal experiences. A meeting time and place should be predetermined by this point. Thisprocess sets up the discussion meeting where the resident self-evaluation form is compared tothe completed preceptor summative evaluation form; the Resident and Preceptor will meet toreview the two summative evaluations of the resident’s performance, prior to the end of therotation. In addition, a 15-minute Resident Progress and Handoff meeting will be scheduled bythe RPD with handoff preceptor, new preceptor, RPD and Resident in the first week of thesucceeding rotation in order to list and encapsulate resident’s success and improvement goalsfor the following preceptor’s learning experience rotation.

Overall Program Score for the Goals and Objectives: o The score Achieved for the Residency Program (ACH-R) is determined by the RPD and based on

the evaluations submitted to the RPD upon completion of each rotation.o ACH-R indicates resident’s performance is ideal and meet’s what’s expected of a PGY1 graduate

of the residency program.o A resident may be scored ACH-R for specific evaluated goals and objectives any anytime during

the course residency based on criteria-based evaluations submitted.o Standards and criteria to complete the residency and receive a graduation certificate are listed

and available. Please refer to Policy and Procedure Title: Successful Program Completion andResidency Certificate. LINK

o The RPD will review and co-sign evaluation documents. The RPD will review and discussevaluations quarterly with the RAC. The RPD and/or RAC will meet with the preceptor’s andresident’s in order to develop teaching methods or make changes to his/her training plan whenappropriate. Over the course of the program, the RPD will update the RAC each month onresident scores and progress toward attainment of goals and objectives. The RPD will obtainfrom and provide feedback to the resident’s, preceptors, RAC and RPC when resident’sperformance is scored suboptimal.

Resident’s Self-evaluation of Their Attainment of Goals and Objectives

Self-assessment and evaluation is an important component of the learning experience for the resident. Flexibility has been built into the program to allow the resident to adapt the program to meet their interests and focus on identified areas for improvement. Initially a customized residency plan will be designed for each resident based upon these criteria. After notification of the ASHP match and prior to beginning the Residency on July 1, each prospective Resident completes an Entering Resident Interests and Self-evaluation to critically evaluate his/her self both professionally and personally to determine career direction and purpose. This self-assessment identifies areas of strength and weakness for the Resident and helps the Resident, Resident Advisor and Preceptors develop action plans for learning experiences throughout the Residency year.

Tools: 1. Entering Resident Interests and Self-evaluation: is completed by the resident at program entry point is

used to develop a customized training plan that provides the Resident with a tool for continual self-assessment and benchmarks to measure personal and professional success.

2. Customized Training Plan: is created by the RPD in conjunction with the preceptors and/or RAC and theresident. The Customized Training Plan is then updated in conjunction with preceptors and/or RAC andthen discussed with the resident by RPD or RPC at least quarterly.

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3. Residency Portfolio: is completed by the resident and shall be a complete record and inventory of theresident's program activities. Each Resident is required, on a monthly basis to submit a Resident Portfolioand Progress Tracking Record document (Appendix). The resident will maintain shared, linked filesassociated with the portfolio document. Resident’s must complete the portfolio document update by thelast day of each month. Email notification to the RPD and RPC that the document is prepared and ready isrequired. The RPD and RPC will review and sign the document monthly. The Resident Portfolio andProgress Tracking Record document shall be made available to preceptors throughout the residency year.The document lists or summarizes and/or links to shared drive the resident’s completed, planned and in-progress activities include:

i. Documentation of learning experiences completedii. Documentation of all other activities, Research and QI projects

Lectures, drug information questions, Adverse drug reaction reports, Professionalmeetings attended, Duty hour documentation and days off

iii. Major project - proposal, abstract and written manuscriptiv. Curriculum vitaev. Autobiography

For each rotation, at the beginning of each learning experience, the resident will complete the written pre-rotation assessment form, identify pre-rotation goals and submit these to the preceptor prior to the start of the learning experience. It is the expectation that these goals will provide a focus for self-directed learning for the resident and will assist the preceptor in preparing an individualized plan for the resident. It is expected that each resident complete the required learning activities in an effort to achieve the rotation’s goals and objectives.

Formative: During the early stages of rotation the resident will complete formative self-evaluations whendirected by the preceptor or when desired by the resident using ResiTrak™ system where indicated.

o On-going written formative evaluation is encouraged. Informal or formal interaction isemployed.

o During the learning experience, the residency assessment procedure incorporates the use ofResiTrak™ system and encourages the formative RLS-snapshots and/or mid-point summativeassessments. Snapshots are important in assessing ongoing improvements in a particular area ofa resident’s training.

o Narrative comments and scores are criteria-based and shape the resident’s performance to comecloser to the ideal (E.G. what’s expected as a PGY1 graduate of the residency program) and areprovided prior to the final summative evaluation.

o Program snapshot evaluation scale is ASHP Snapshot scale (adequate/ not adequate/ notapplicable).

Definitions:

A: Adequate- resident’s performance is expected to result in achievement of objective by the end of the rotation

NA: Not Adequate- resident’s performance is expected to result in not achieving objectives and needs to corrected and improved during the current rotation.

Criteria scored “NA- Not Adequate” must include narrative comment specifically addressing concern and a goal attainment strategy going forward

o Formal Criteria-Based Evaluations: The Resident will present a number of formal clinical and casepresentations throughout the Residency year. These presentations are evaluated by thePreceptors attending the presentation and/or self-evaluation by the resident. This formativeevaluation tool and process is designed to provide the Resident with input on presentationcontent, style, and improvement. Narrative comments and scores are criteria-based and shapethe resident’s performance to come closer to the ideal (E.G. what’s expected as a PGY1 graduateof the residency program) and are provided prior to summative evaluation. These will includebut are not limited to:

34


Case Discussion (primary preceptor during that experience/ assigned preceptor/RPD/RPC)

Intervention Documentation (primary preceptor during that experience/ assignedpreceptor /RPD/RPC)

Researched DI Questions (primary preceptor during that experience/ assigned preceptor/RPD/RPC)

Journal Club (RPD/RPC) Other project assignments (evaluation preceptor will be assigned)

Summative: At the end of the rotation, the resident will complete a self-evaluation summative evaluationusing ResiTrak™ system for achievement of all learning experience goals and objectives.

o Written summative evaluation forms for the learning experience in ResiTrak™ will be utilized.o Narrative comments are to be criteria-based and comments aimed at what the resident can do

to improve performance of the task.o Summative evaluation scale utilized by the program is ASHP Summative Scale ASHP (NI/SP/ACH).




o Criteria scored “NI- Needs Improvement” must include narrative comment specifically addressingconcern and a goal attainment strategy going forward.

o Criteria scored “SP= Satisfactory Progress” must include narrative comment specificallyaddressing what the resident might do to improve to successful achievement of the criteria.

o Criteria scored “ACH = Achieved” must include narrative comment specifically addressing goalattainment criteria.

o Evaluations are to be completed before the last day of the learning experience. At thecompletion of each learning experience and quarterly for longitudinal experiences, the Residentand Preceptor will meet to review, sign and date the Resident's summative evaluation. Again,the resident also self-evaluates his/her performance during the rotation. Prior to rotationcompletion, the resident will complete a self-evaluation of the learning experience. Thisinformation will be submitted to the preceptor for that rotation within last week of theconclusion of the rotation/learning experience. The self-evaluation form is compared to thecompleted evaluation of the preceptor. Quarterly self-evaluations should be submitted to theRPD one week prior to the scheduled review date with the RPD.

o The RPD will review and co-sign evaluation documents. The RPD will review and discussevaluations quarterly with the RAC. The RPD and/or RAC will meet with the preceptor’s andresident’s in order to develop teaching methods or make changes to his/her training plan whenappropriate.

Resident’s Evaluation of the Learning Experience and the Preceptor

Residents will complete the program’s evaluation form no later than the last day of each learning experience or quarterly for longitudinal learning experiences using the standard ResiTrak™ Learning Experience and Preceptor evaluation tools.

Completed evaluations will be discussed with preceptors, signed, and dated by each. Preceptors and will consider making appropriate changes to his/her learning experience and teaching methods as necessary based on this critique.

Completed evaluations will be forwarded to the RPD for review on the day of their completion.

35


The RPD will review and co-sign evaluation documents. The RPD will review and discuss evaluations by the resident’s quarterly with the RAC. The RPD and/or RAC will meet with the preceptor’s to discuss their LE and Preceptor evaluations by the resident in order to develop teaching methods or make changes to his/her learning experience and when appropriate.

Summary:

Summative - Preceptor Evaluation of Resident AND Self-evaluation by the Resident: o Written summative evaluation forms for the learning experience in ResiTrak™ will be utilized.o Summative evaluation scale utilized by the program is ASHP Summative Scale ASHP (NI/SP/ACH).




o Narrative comments are to be criteria-based aimed at what the resident can do to improveperformance. This applies to objectives scored with either NI/SP/ACH.

Criteria scored “NI- Needs Improvement” must include narrative comment specificallyaddressing concern and a goal attainment strategy going forward.

Criteria scored “SP= Satisfactory Progress” must include narrative commentspecifically addressing what the resident might do to improve to successfulachievement of the criteria.

Criteria scored “ACH = Achieved” must include narrative comment specificallyaddressing why the goal attainment criteria are scored as achieved.

o The resident self-evaluates his/her performance during the rotation. Self –SummativeEvaluations are to be completed by the resident before the last day of the learning experience.And like wise a Resident’s Summative Evaluation by Preceptor is to be completed by thePreceptor before the last day of the learning experience. This information will ideally besubmitted to the preceptor at the completion of each learning experience and quarterly forlongitudinal experiences. A meeting time and place should be predetermined by this point. Thisprocess sets up the discussion meeting where the resident self-evaluation form is compared tothe completed preceptor summative evaluation form; the Resident and Preceptor will meet toreview the two summative evaluations of the resident’s performance, prior to the end of therotation. In addition, a 15-minute Resident Progress and Handoff meeting will be scheduled bythe RPD with handoff preceptor, new preceptor, RPD and Resident in the first week of thesucceeding rotation in order to list and encapsulate resident’s success and improvement goalsfor the following preceptor’s learning experience rotation.

36

Department of Pharmacy

Address

ph

Fax:

May 2, 2012

George Washington1642 Wellness Blvd. Bountiful, NC

Dear Mr.Washington:

Please complete the following “Entering Resident Interest and Self-Evaluation”.

This information will be used as a baseline in the development of individual objectives prior to beginning

the residency program. Your responses will assist the Residency Advisory Committee in planning a

customized plan to meet your interests and needs for your upcoming year in the PGY1 Pharmacy

Residency. Please sign below and return the completed document to me no later than May 30, 2012.

1. Describe your career goals, both short term (5 years) and long-term (10 to 15 years).

After completing a PGY1 Pharmacy Practice residency, I would like to pursue opportunities that are available for a pharmacist to participate in clinical research/clinical trials in a hospital setting in the short term. As for long-term career goals, I would like to continue doing clinical research either in a hospital setting or an industry setting.

2. List your current practice interests in order of interest.

Clinical Research/Trials Internal Medicine Infectious Disease Labor & Delivery Psychology

3. What are your strengths? This should include direct patient care skills as well as personal

strengths.

I believe that I am somebody who has a strong work ethic and is passionate in my personal life as well as professional life. I like to talk with patients and believe that I am able to empathize with them as well as teach them in terms that they can understand.

37

4. List areas of weakness that you would like to improve on during the residency.

I would like to improve my communication skills. I have learned that communicating with medical professionals is different depending on who you are talking to, and I would like to practice speaking to doctors, pharmacists, nurses, and patients in ways that optimize patient care.

I would also like to improve on my knowledge of pharmacology generally, however with a particular emphasis in the area of infectious disease.

I do not have any experience in pediatrics or pregnancy and would like to become familiar with pharmacy practice pertaining to these patient populations. Also, I would like to become more familiar with treating the geriatric population.

Supervisory skills and/or leadership skills are something that I would like to develop during my PGY1 residency as well.

5. Describe activities or experiences that have contributed to your skills in the following areas.

Written Communication- I have completed a 6-week rotation through pharmacy school where a main task of mine was to answer drug information questions in an ambulatory care/rheumatology setting. These answers were in the form of scientific/medical writing. I received much practice doing this and was given a lot of positive feedback.

Verbal Communication- I have given short “in-services” at Stellar Hospital and elsewherewhich involved communicating medical information to doctors, pharmacists, nurses, and respiratory therapists during patient-care rounds.

Public Speaking- Public speaking is something that I’d like to have more practice doing, however it is something that I am relatively comfortable with. I am experienced in presenting my pharmacy school seminar as well as various presentations during rotations and have been told that I am a good public speaker.

Time Management- This is something I would certainly like to have more practice in. Some of the feedback I have received during rotations had to do with the need to manage time more effectively.

38

Supervisory Skills- I have a little experience supervising and directing technicians during a rotation I had at a drug company. The task was to sort through products that were used in clinical trials and were sent back to the drug company to be destroyed. My task was to decipher and document the technical/scientific material while the technician’s task was to organize the product and destroy it after I had everything documented. Although the outcomes were positive (over 3000 products destroyed), I would certainly like more experience with this.

The items listed below pertain to required or elective outcomes and goals for our residency program. In

each area, please evaluate your current level of ability according to the following scale.

5- I can demonstrate the traits or perform the tasks at the level of an advanced level practitioner

4- I can demonstrate the traits or perform the tasks at greater skill level than most Pharm.D. graduates

at the time of graduation

3- I can demonstrate the traits or perform the tasks at the skill level of a competent Pharm.D.

2- My training and experience in this area has been limited.

1- I have had no training or experience in this area.

Outcome R1: Manage and improve the medication-use process. 5 4 3 2 1

Goal R1.1: Identify opportunities for improvement of the organization’s

medication-use system. 2

Goal R1.2: Design and implement quality improvement changes to the

organization’s medication-use system. 2

Goal R1.3: Prepare and dispense medications following existing

standards of practice and the organization’s policies and

procedures.

3

Goal R1.4: Demonstrate ownership of and responsibility for the welfare

of the patient by performing all necessary aspects of the

medication-use system.

4

Goal R1.5: Provide concise, applicable, comprehensive, and timely

responses to requests for drug information from patients and

health care providers.

4

Comments: Consider for example experiences with: Quality Improvement initiatives, Drug Information

requests and Dispensing experience

Outcome R2: Provide evidence-based, patient-centered medication

therapy management with interdisciplinary teams.

5 4 3 2 1

Goal R2.1: As appropriate, establish collaborative professional relationships

with members of the health care team. 4

Goal R2.2: Place practice priority on the delivery of patient-centered care 4

Goal R2.3: As appropriate, establish collaborative professional pharmacist-

patient relationships. 4

39

Goal R2.4: Collect and analyze patient information. 4

Goal R2.5: When necessary, make and follow up on patient referrals. 3

Goal R2.6 De Goal R2.6: Design evidence-based therapeutic regimens. 3

Goal R2.7: Design evidence-based monitoring plans. 2

Goal R2.8: Recommend or communicate regimens and monitoring plans. 3

Goal R2.9: Implement regimens and monitoring plans. 2

Goal R2.10: Evaluate patients’ progress and redesign regimens and

monitoring plans. 2

Goal R2.11: Communicate ongoing patient information. 3

Goal R2.12: Document direct patient care activities appropriately. 2

Comments: Consider experiences classroom, clerkship or work experiences related to these abilities.

Outcome R3: Exercise leadership and practice management skills. 5 4 3 2 1

Goal R3.1: Exhibit essential personal skills of a practice leader. 4

Goal R3.2: Contribute to departmental leadership and management

activities. 2

Goal R3.3: Exercise practice leadership. 2

Comments: Consider professional and social leadership positions held.

Outcome R4: Demonstrate project management skills. 5 4 3 2 1

Goal R4.1:Conduct a practice-related project using effective project

management skills. 3

Comments: Consider experiences with patient care projects or programs.

Outcome R5: Provide medication and practice-related

education/training.

5 4 3 2 1

Goal R5.1 Provide effective medication and practice-related education,

training, or counseling to patients, caregivers, health care

professionals, and the public.

4

Comments: Consider previous teaching experience and personal goals related to teaching and scholarship.

Outcome R6: Utilize medical informatics. 5 4 3 2 1

Goal R6.1: Use information technology to make decisions and reduce error. 3

40

Comments:

Outcome E1: Conduct pharmacy practice research. 5 4 3 2 1

Goal E1.1: Design, execute and report results of investigations of pharmacy

practice related issues. 2

Goal E1.2: Participate in clinical, humanistic and economic outcomes

analysis 3

Comments:

Certainly the start of our residency year together is coming up quickly and I look forward to a

productive and satisfying year-long experience. Please have an enjoyable and relaxing next few months!

Sincerely,

Benjamin Franklin, PharmD, FASHP

Director, PGY-1 Pharmacy

______Resident Name: _George Washington Date Completed: 05/23/2012

Residency

Stellar Hospital - Pharmacy Department

Resident Signature

City, State [email protected]

41


Customized Training Plan for George Washington, Pharm.D.

Date Submitted/Cosigned Name Comments

7/27/201216:01 Benjamin Franklin,

PharmD, FASHP

<Saved initial version of training plan entry>

7/31/201221:57 Benjamin Franklin,

PharmD, FASHP

Resident: George Washington

Evaluator: Benjamin Franklin, Pharm.D, FASHP

Date: 7/27/2012

Career Goals

After completing a PGY1 Pharmacy Practice residency, I would like to pursue opportunities that are available for a pharmacist to participate in clinical research/clinical trials in a hospital setting in the short term.

As for long-term career goals, I would like to continue doing clinical research either in a hospital setting or an industry setting.

Strengths include direct patient care skills as well as personal strengths

Personal and Patient Care Strengths

1. Strong work ethic

2. Passionate

3. Verbal communication and teaching with respect to patients with diverse levels of medicaleducation

4. Empathetic


1/26/2013 2:35:43 PM Stellar Hospital Page 1 of 5

42

Weaknesses

1. Communication skills with all medical professionals

2. Pharmacology generally

3. Antimicrobial pharmacology specifically

4. Patient populations: Pediatrics, Pregnancy L+D, Geriatrics

5. Supervisory skills

6. Leadership skills

Interests

1. Clinical Research/Trials

2. Internal Medicine

3. Infectious Disease

4. Labor & Delivery

5. Psychology

Initial Customized Plan

Flexibility has been built into the program to allow the resident to adapt the program to meet their interests and focus on identified areas for improvement based on their entering knowledge, skills, attitudes and abilities. As a starting point the resident will submit to the RPD the goal-based self-evaluation using the SH Entering Resident Interests and Self-Evaluation by the 2nd week of July. A customized residency plan will be designed for each resident based upon these criteria. Progress toward achievement of the program's outcomes is assessed at least quarterly.

The PGY1 program is designed to advance resident’s development in pharmacotherapy, leadership and administrative skills. The program has numerous required opportunities to present educational information and dialog patient care assessment, goals and recommendations all medical professionals. Special focus on weak patient populations will be managed when you take



43

responsibility for identifying them with all your DPC core rotation preceptors. Your stated career goals are very reasonable with respect to timeline and the PGY1 major project and minor projects should involve clinical research. You have at your disposal the opportunity to elect an additional longitudinal IRB rotation, please speak to the preceptor directly as soon as possible. To achieve your career goal of employment in Pharmacist clinical research further training should be pursued as you are aware. Please be looking ahead to applications in fellowship or PGY2 and potentially PhD programs to gain what is often required. You have made a great beginning on this life long career path in pharmacy, I am sure your sincere effort in this PGY1 program will be highly rewarding and satisfying.

7/31/201214:35

Dr. George Washington, Pharm.D.Dr. Franklin and I had a helpful meeting. I had many questions answered and it was beneficial to have a one-on-one meeting. I look forward to the next meeting.

11/9/201212:26



11/16/201214:05

Benjamin Franklin, PharmD, FASHP <?xml:namespace prefix = o ns = "urn:schemas-microsoft-com:office:office" />

<?xml:namespace prefix = v />

11/9/2012

Meeting was held and plan was reviewed with George in a face to face meeting . His elective desire for proposed and planned for IRB has been changed as the rotation is not ready at this time. However Dr. Thomas Paine will assure George is introduced to the IRB process in the practice management core longtitudinal as will all residents. This experience will not be as extensive obviously but that is the situation.

Benjamin Franklin, Pharm.D. , RPD

11/16/201215:19

Dr. George Washington, Pharm.D.Thank you.



44

12/18/201209:47



1/7/201315:43


=====================================================================================

12/18/12

Career Goals

After completing a PGY1 Pharmacy Practice residency, I would like to pursue opportunities that are available for a pharmacist to participate in clinical research/clinical trials in a hospital setting in the short term.

New Career Goal: Complete a PGY2 Pain Specialty Residency.

New Interest: Pain Management

The following Customized Training Plan update describes required goals which have recently been marked by the residency program director (RPD) as Achieved for the Residency (ACHR) in ResiTrak which means your performance of a specific goal meets the expected performance by a recent PGY1 graduate. Please note that the Stellar Hospital's PGY1 Residency Program standard requires the the RPD to determine whether or not the resident has met the goals of the program and not all goals necessarily have to be achieved.

Goals Achieved for Resident

COMMENT: The evidence reviewed includes completed ResiTrak evaluations and items in your Resident Portfolio and Tracking Document. There is concordance with preceptor and self summative evaluations at the following evaluation points: ROTATION(S)- Orientation, ED, Surgery/ Pain Management, Internal Medicine; LONGTITUDINAL(S) -Staffing, Practice Management. In addition, the written and verbal comments reviewed support achieved for the residency program. Congratulations on the achievement of the goal and please contact me if there are any concerns or questions.

Marked as achieved Goal R1.3: Prepare and dispense medications following existing

standards of Customized Training Plan for Dr. George Washington, Pharm.D.


45

practice and the organization's policies and procedures.

Marked as achieved Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the patient by performing all necessary aspects of the medication-use system.

Marked as achieved Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.

Marked as achieved Goal R2.3: As appropriate, establish collaborative professional pharmacist-patient relationships.

Marked as achieved Goal R2.5 When necessary, make and follow up on patient referrals.

Marked as achieved Goal R2.12: Document direct patient care activities appropriately.

Congratulations on the achievement of the goals marked ACHR and please contact me if there are any concerns or questions. Please continue as

we previously discussed with your new goal and pursuit of PGY2 in pain management.

Benjamin Franklin, RPh, BS, PharmD, FASHP Director,

Pharmacy Residency Program

=====================================================================================

Marked as achieved Goal R2.5: When necessary, make and follow up on patient referrals.

1/24/201316:46

Dr. George Washington, Pharm.D.Thank you for spending the time and discussing these with me. The feedback is much appreciated.

Customized Training Plan for Dr. George Washington, Pharm.D.


46

EVALUATION CRITERIA: Preceptor Score Code Resident Score Code Comments

The patient receives the medication(s) as ordered A ( Adequate) A ( Adequate) Preceptor: Accurate in drug selection, completion of order entryacross of variety of order types

Resident: levaquin renal dosing needed for patients with low creatinine clearances. called physician to change to make sure patient still recived therapy that was appropraite

Ensures the integrity of medication dispensed A ( Adequate) A ( Adequate) Preceptor: Checking P+L without problems. checking pyxis run, first doses, emergency kits and narcotics

Resident:

Provides any necessary written and/or verbal counseling A ( Adequate) A ( Adequate) Preceptor: Handles phone conversations with prescribers and nurses professionally. Good example is anticipating problems with sliding scale insulin order for hospitalist.

Resident: filled out verbal database to alert nurses of changes

Patient receives medication on time A ( Adequate) A ( Adequate) Preceptor: Stays on top of the queue.

Resident:

Documentation of dispensing follows the organization’s policies and procedures

A ( Adequate) A ( Adequate) Preceptor:

Resident:

Resident: Dr. Emily Baker, Pharm.D.Preceptor: Ms. Margaret Smith, R.Ph.

Snapshot - Side By Side for Dr. Emily Baker, Pharm.D. in ORIENTATION (7/2/2012 - 8/31/2012)

R1.3.4) Application) Dispense medication products following the organization's policies and procedures.

Observation of dispensing process and review of documentation for dispensing of a specific medication

Objective:

Assessment Activity:


Snapshot - Side By Side for Dr. Emily Baker, Pharm.D. in ORIENTATION (7/2/2012 - 8/31/2012)

47

Adequate performance for this learning experience? Y ( Yes) Y ( Yes) Preceptor: Emily is in the groove as a staff- order entry pharmacist. During her last week of orientation, the holes in the pharmacist staffing were not noticed because of Emily's order entry and telephone skills.

Resident:

From Resident's Self-evaluation

From Evaluation Completed by Preceptor

Cosigned 8/28/2012 3:00:34 PM by Ms. Margaret Smith, R.Ph.. Comments: Staff are recognizing the value of the residents for staffing shortfalls It

is a pleasure to precept and work with EmilyRPD Cosigned 9/4/2012 2:00:29 PM by Dr. Benjamin Franklin, PharmD, FASHP. Comments: Thank you.

Cosigned 8/29/2012 8:03:26 AM by Dr. Emily Baker, Pharm.D..

Cosigned 9/4/2012 2:01:46 PM by Dr. Benjamin Franklin, PharmD, FASHP. Comments: Thank you.

Final submission: 8/28/2012 2:36:24 PM



48

Summative Side By Side for Dr. Emily Baker, Pharm.D. in Direct Patient Care -Infectious Disease (10/15/2012-11/30/2012)

Direct Patient Care -Infectious DiseaseLearning Experience:

Outcome/Goal/Objective Preceptor Score Resident Score

Outcome R2: Provide evidence-based, patient-centered medication therapy management with interdisciplinary teams.

Goal R2.2: Place practice priority on the delivery of patient-centered care to patients.

ACH ACH

Preceptor Comments: Based on the activities performed during this 6-week rotation the following goals are achieved and thus performed at the level of a PGY1 residency graduate.

Resident Comments: With managing my time appropriately in the morning before rounds I was able to completely and successfully present patients on rounds to effectively deliver patient-centered care. This met one of the objectives of the rotation of prioritizing assigned tasks, patients and consults to manage all documentation and daily priorities associated with the ASP service.

Obj R2.2.1 (Organization) Choose and manage daily activities so that they reflect a priority on the delivery of appropriate patient-centered care to each patient.

ACH ACH

Preceptor Comments: Dr. Emily Baker reviewed all patients for rounding with ID prescriber / antimicrobial stewardship team and made recommendations to Assigned Care Unit Clinical or Decentralized Pharmacist or ASP Team as appropriate. Daily activities consistently show a priority placed on the delivery of patient-centered care. This was assessed by evaluation of patient care assignments at the pre-day meeting and then periodically throughout the day and week. Dr. Baker successfully arranged the work activities below so that the patient-centered care needs of patients were met. 1. Monitor restricted antibiotic orders.2. Review and address with prescriber antimicrobials for suitability, options, monitoring and interactions directing problems with questions to the Antimicrobial Management /Infectious Disease Clinical Pharmacy Specialist3. Review all patients report of tube feed patients for interacting oral antimicrobial drug interactions (Quinolones) and report such to nutritionists.4. Review and address patient’s antimicrobial orders relevant to renal dosing suitability, options and changes5. Review daily culture and susceptibility report for suitability, options, monitoring and interactions6. Review and contact patient’s physician relevant to IV to PO protocol when appropriate7. Review and address with prescriber antibiotic assays for suitability, options, monitoring and interactions8. Review and address with prescriber antiretroviral agents for drug interactions and dosing concerns

Resident Comments: With the list of all the patients in the hospital on antibiotics for the day to review, as well as other clinical reports to review, plus attending meetings and managing other assignments a lot of prioritization needed to occur to make sure the patients received the appropriate care. I would make sure first thing in the morning, I was able to take care of the quick reports that I could manage so they were not lingering come afternoon time just in case some other issue arose. I would then spend the rest of my morning working up the patients for rounds. This allowed me to allot the proper amount of time needed in order to complete the whole list of patients with the appropriate amount of time needed for each patient.

Goal R2.8: Recommend or communicate regimens and monitoring plans.

ACH ACH


Resident: Dr. Emily Baker, Pharm.D.Preceptor: Dr. Benjamin Franklin, PharmD, FASHP

Page 1 of 5


Stellar Hospital1/25/2013 12:2649

Resident Comments: By using the same pattern of working up a patient, and then the same delivery of each patient to the physician, I was able to develop a quick effective way to deliever a patient regimen to the physician. This also met the objective of working with other healthcare professionals within the ASP service.

Obj R2.8.1 (Application) Recommend or communicate a patient-centered, evidence-based therapeutic regimen and corresponding monitoring plan to other members of the interdisciplinary team and patients in a way that is systematic, logical, accurate, timely, and secures consensus from the team and patient.

ACH ACH

Preceptor Comments: Dr. Baker generated recommendations for ASP team patient cases that were clinically appropriate and supported by clinical test and evidence based medicine. Over time the resident’s missed case candidates were periodically assessed. Frivolous cases and non-physician cases were not brought to ASP. Recommendations generated on rounds in verbal face to face interactions with preceptor and ID Physician faculty and interdisciplinary team and patients were offered in a way that is systematic, logical, accurate, timely, and secures consensus from the team and patient. When talking to prescribers Dr. Baker was able to skillfully defuse negative reactions. On clinical pharmacy consults where the patient has been directly involved in the design of the plans, communication appropriately reflects previous collaboration on the plan for the patient.

Resident Comments: With a little bit of experience speaking with physicians, I felt a little comfortable talking with the doctors on rounds, but I was out of my comfort zone when it came to talking about antibiotics and regimens that patients were on. With some reading and working up patients daily, I was able to become more comfortable with the information I was speaking about, and therefore more confident in my delivery to the physicians I was rounding with. I was able to gather the information needed about the patient to develop a full story that would be presented logically with the physician as well, so that an appropriate suggestion could be made to the provider that was taking care of the patient. I learned to only provide the pertinent information in a logical manner that would allow rounds to be kept to a short amount of time, and also to prioritize which patients could wait until the next rounding time, and which needed to be spoken about that day.

Goal R2.9: Implement regimens and monitoring plans.

ACH ACH


Resident Comments: Through out this rotation I have had many chance to implement regimens according to Stellar's policies as well as monitoring the antibiotics that patients are ordered. By using hospital policies as well, I have been able to convert patients to oral medications as well. This met the rotations objective of being able to effectively use communication skills through ASP memos and progress notes. Also, I met the objective of being able to relay important ASP recommendations to the providers.

Obj R2.9.1 (Application) When appropriate, initiate the patient-centered, evidence-based therapeutic regimen and monitoring plan for a patient according to the organization's policies and procedures.

ACH ACH

Preceptor Comments: Dr. Baker demonstrated the ability to complete daily tasks required including IV to PO, HIV monitoring, enteral feeding drug interaction monitoring, Vancomycin pK and dosing consults , general patient consults and restricted antimicrobial assessments performed at the ability level expected of a PGY1 graduate resident.

Resident Comments: When evaluating patients for their antibiotic therapies, it was important to check the patients that were administered restricted antibiotics in the hospital. This was to ensure resistance to the "heavy hitting" antibiotics doesn't develop as well as for cost savings. Also it was important to look for patients that were eligible for IV to PO changes. This was to facilitate patients changing to oral medications sooner to be discharged and also to decrease costs. Lastly, monitoring the patients that were on vancomycin was very important. Making sure they were being treated at effective troughs for their infection we were treating as well as appropriate dosing based of patient lab values, such as creatinine clearance or even cultures that reported vancomycin was not necessary. The hospital does not have a pharmacy based monitoring plan for vancomycin, but knowing what was necessary to monitor the patient, such as a trough before the 4th dose, was important in order to make sure the physicians order what was necessary.

Obj R2.9.2 (Application) Use effective patient education techniques to provide counseling to patients and caregivers, including information on medication therapy, adverse effects, compliance, appropriate use, handling, and medication administration.

ACH ACH

Preceptor Comments: Recommendations generated on rounds in verbal face to face interactions with preceptor and ID Physician faculty and interdisciplinary team and patients were offered in a way that is systematic, logical, accurate, timely, and secures consensus from the team and patient. When talking to prescribers Dr. Baker was able to skillfully defuse negative reactions. On clinical pharmacy consults where the patient has been directly involved in the design of the plans, communication appropriately reflects previous collaboration on the plan for the patient.

Page 2 of 5



Resident Comments: While on rotation, I had the responsibility of answering questions that came from nurses, including which medications should be given over others for antibiotic prophylaxis with surgery, if a patient was being treated for another infection. Also, physicians would call to ask questions about if a medication therapy would treat an infection given certain disease states, such as treating a UTI in a patient with end stage renal disease. By looking up answers, and using references available to me, I was able to have discussions to provide the appropriate information to caregivers. Another method of providing information to providers was by using the hospitals specific antibiogram to determine which antibiotics would be most effective. Many of these activities achieved the objective of being able to demonstrate in-depth knowedge of antimicrobial agents and classes, as I had to look at mechanism of action, spectrum of activity, dosage, side effects or resistance to give recommendations to physicians and nurses.

Goal R2.12: Document direct patient care activities appropriately.

ACH ACH


Resident Comments: With daily monitoring a specific clinical reports, I was able to follow my own notes for the following days, or hand off my patients to another pharmacist to continue patient care appropriately. This also demonstrated acomplishment of the objective for demonstrating effective written communications.

Obj R2.12.1 (Analysis) Appropriately select direct patient-care activities for documentation. ACH ACH

Preceptor Comments: The patient consultation activity selected for documentation ensured positive patient care outcomes. By the end of the rotation no evidence was observed or discovered regarding any missed responsibility to document patient care activities that must be documented.

Resident Comments: Using the clinical reports that printed out about each patient that was on an antibiotic, I was able to add pertinent patient information that I would need in order to effectively talk about a patient on rounds. This would include different cultures, how many days a patient had received antibiotic, or what the physician was considering that they were treating.

Obj R2.12.2 (Application) Use effective communication practices when documenting a direct patient-care activity.

ACH ACH

Preceptor Comments: Chart documentation problems caused by Dr. Baker were not observed and chart documentation exhibits the following characteristics: (1) Warrants documentation; (2) Written in time to be useful; (3) Follows the health system's policies and procedures, including that entries are signed, dated, timed, legible, and concise; (4) Content includes pertinent subjective and objective data; (5) Assessment reflects accurate interpretation of the objective and subjective data; (6) Recommended plans are clearly presented and relate to the conclusionReports of medication-related problems (e.g., ADRs, medication errors, drug interactions) developed during the rotation adhered to Stellar Hospital’s policies and procedures including appropriate practitioner contacts and written documentation. Occasionally Dr. Baker would need to be reminded that and ADR report or similar issue should be documented and she would complete them as needed after a reminder.

Resident Comments: By following the same, clear concise data for each patient, I would be able to hand off my worksheet to another pharmacist, who could either present my patient to the physicians on rounds or follow up on the patient the following day.

Obj R2.12.3 (Comprehension) Explain the characteristics of exemplary documentation systems that may be used in the organization’s environment.

ACH ACH

Preceptor Comments: Our “Curb side” discussions reflect Dr. Baker ’s grasp of the significance of documentation in the medical and legal arenas. Dr. Baker understands the place for pharmacy documentation and handoff as well as chart documentation.

Resident Comments: One of the best documentation systems at the hospital includes the patient's chart. By writing notes in the progress section to the physician, it is possible to communicate effectively about questions they might have. Documentation can be explained if conversations were had with the patient, or recommendations can be made as well. If the documentation is there, other providers that may be taking care of the patient as well can see what is going on. I have learned it is important to be clear, concise as well as accurate when writing to a physician.

From Resident's Self-evaluation

Final submission: 12/7/2012 4:19:33 PM; Initial submission: 11/28/2012

Page 3 of 5



Resident's Overall Comments: Throughout this rotation I have had many experiences and chances to learn and develop my skills as a infectious disease pharmacist. I have learned many communication skills, documentation skills, how to use the hospital's policies and procedures to affect patient regimens and also many different things about the bacteria that cause infection and what the appropriate therapies are to treat those infectious, as well as their side effects. Two objectives that were focused on and were very important to this rotation included identifying an infection, which organism could be causing the infection and being able to discuss which treatment options were available related to our formlary, as well as following any guidelines or protocols as appropriate. Also learning about specific infections suchs as UTIs, community aquired pneumonia, and following surgical patients for their pre- and post-operation prophylaxis doses were important to successfully completing this rotation. I feel that I successfully achieved these objectives.

Preceptor's Overall Comments: Based on the activities performed during this 6-week rotation the following goals are achieved and thus performed at the level of a PGY1 residency graduate. Goal R2.2: Place practice priority on the delivery of patient-centered care to patients. Goal R2.8: Recommend or communicate regimens and monitoring plans. Goal R2.9: Implement regimens and monitoring plans.Goal R2.12: Document direct patient care activities appropriately.Thank you for completing all paper work and projects on time during this experience. Many specific comments are written in the preceptor's evaluation. To improve the quality of your self-evaluation I would match up what disease states (start with those listed in the ID Learning Experience Description) you were not able to learn about in sufficient detail during the course of this ID experience and try to approach them in subsequent rotations. Please remember to review these on line #4 "topics you want to cover" on the pre-rotation assessment form. Thank you and congratulations on your successful completion of you ID rotation experience.

From Evaluation Completed by Preceptor

Cosigned 12/16/2012 1:46:37 PM by Dr. Benjamin Franklin, PharmD, FASHP. Comments: Thank you for completing all paper work and projects on time during this experience. Many specific comments are written in the preceptor's evaluation. To improve the quality of your self-evaluation I would match up what disease states (start with those listed in the ID Learning Experience Description)you were not able to learn about in sufficient detail during the course of this ID experience and try to approach them in subsequent rotations. Please remember to review these on line #4 "topics you want to cover" on the pre-rotation assessment form. Thank you and congratulations on your successful completion of you ID rotation experience.

RPD Cosigned 12/16/2012 1:46:37 PM by Dr. Benjamin Franklin, PharmD, FASHP: Comments: Thank you for completing all paper work and projects on time during this experience. Many specific comments are written in the preceptor's evaluation. To improve the quality of your self-evaluation I would match up what disease states (start with those listed in the ID Learning Experience Description)you were not able to learn about in sufficient detail during the course of this ID experience and try to approach them in subsequent rotations. Please remember to review these on line #4 "topics you want to cover" on the pre-rotation assessment form. Thank you and congratulations on your successful completion of you ID rotation experience.

Cosigned 11/28/2012 7:09:50 PM by Dr. Emily Baker, Pharm.D..

Cosigned 11/29/2012 2:27:46 PM by Dr. Benjamin Franklin, PharmD,

FASHP: Information about the evaluation(s) sent back for edit:


Page 4 of 552

Evaluator Date sent back Sent back to Who sent the eval back for edit

Comments when sent back

Emily Baker Pharm.D., 11/29/2012 Emily Baker, Pharm.D., Benjamin Franklin PharmD, FASHP

Page 5 of 553

Learning Experience Evaluation in ORIENTATION 7/2/2012-7/29/2012

Preceptor:

Evaluator:

Final submission: 7/31/2012 17:57Mr. Thomas Jefferson, RPh.

Dr. Martha Washington, Pharm.D.

Question Narrative Commentary Score

1 I understood the objectives for this learning experience prior to beginning.

During my second week, I realized my understanding of my specific learning objectives, in the setting of having previous experience as a proficient staff pharmacist, were somewhat different from my preceptor's expecations of my learning experience. Once we identified our expectations were different, we reconciled and came up with a new plan, tailoring my needs with the preceptor's needs for evaluation.

2 (Partially True)

2 The learning opportunities afforded me during this learning experience matched the objectives specified for this experience.

I was given access to review, demonstrate proficiency, or gain a working level of understanding in all objectified learning experiences.

1 (Consistently True)

3 Resources I needed were available to me. Resources are plentiful at Stellar Hospital in terms of identifying drug related information to facilitate safe and effective medication dispensing and pharmacotherapy. The only barrier I ran into was when researching anything on PubMed, our library subscribes to very few journals and therefore I did not have access to about 75-80% of the journal articles I desired access to when researching the Oxaliplatin Desensitization protocol. I later learned I can specifically request these articles from the librarian, however this is an additional step that involves a time delay and when 75-80% of the articles you need require this process, it can be cumbersome.


4 I feel that the preceptor's assessment of my performance on the objectives was fair.

Thomas assessed my performance objectively based on standardized goals. He also was able to tailor my assessment to include additional items that were relevant to the experience.


5 I was encouraged to further develop my ability to self-assess during this learning experience.

I was asked to complete multiple snap shot self evaluations. 1 (Consistently True)

Page 1 of 2

Learning Experience Evaluation

Stellar Hospital1/26/2013 1:54:22 PM54

6 This learning experience provided me opportunities to provide patient-centered care in a responsible way to my patients.

Opportunities occurred each day to provide responsible patient-centered care. Opportunities included IV Admixture Certification, NICU order transcription emphasis and rounding service, med safety process improvement, OR Satellite Pharmacy training, ICU rounding service, and access to staffing services.


7 What were the strengths of this learning experience? Ability to customize my orientation plan to fit my specific needs.Dedication of residency key players in supporting my transition from staff pharmacist to pharmacy resident.

8 What were the weaknesses of this learning experience? Inappropriate time allotment for training needs/activities on the schedule.Inconsistent expectations (my expectation and my preceptor's expectation did not match) at the start of the orientation process (and we did not realize it).

9 What suggestions can you make to improve this learning experience?

I would suggest discussing orientation expectations (resident and preceptor) on day 1 instead of stumbling upon differences as they arise. I would also suggest facilitating logons/Lawson Access in advance to the start of the residency as the lack of access, in my case to Lawson, proved to be a substantial delay in the orinetation process.

Preceptor Cosign: Mr. Thomas Jefferson, RPh., 7/31/2012 18:47

RPD Cosign: Dr. Benjamin Franklin, PharmD, FASHP, 8/3/2012 11:09

RPD Comments: Thank you, your feedback has been very useful. We have in our residency program place a "what works and what doesn't QI process for resident's and preceptor. This document and feedback will be included in the QI process of RAC. Stay tuned for emails already sent and future soliciting your LE and preceptor feedback and invitation to discuss with members of the RAC.

Preceptor Comments: Thank you for the excellent feedback. Because of our experiences I had come to similar conclusions as regards weaknesses / opportunities to improve the learning experience. I will definitely take these comments into consideration for next year's orientation. As for log on issues, I too share your concern regarding the delay this issue caused. Since control of this issue is somewhat removed from the Pharmacy Dept. we may not be able to directly improve things in that regard but may, instead, need to re-organize the order of specific learning activities to accomodate this delay so that it does not contribute to a less than desirable learning outcome. Thank you again!

Page 2 of 2

Learning Experience Evaluation


Preceptor Evaluation for Thomas Jefferson, RPh. in ORIENTATION 7/2/2012- 7/29/2012

Preceptor:

Evaluator:

Final submission: 7/31/2012 17:38Thomas Jefferson, RPh.

George Washington, Pharm.D.

Question Narrative Commentary Score

1 The preceptor was a pharmacy practice role model. Thomas is extremely organized, articulate, and well versed in the practice of pharmacy. This combination makes him an ideal resource and role model.

1 (Always)

2 The preceptor gave me feedback on a regular basis. Thomas provided both formal and informal feedback throughout this orienation month. We had many informal discussions of varying length as we saw eachother throughout each day, as well as objective based feedback at the midpoint in a formalized discussion.

1 (Always)

3 The preceptor's feedback helped me improve my performance.

Thomas facilitated my recognition and understanding of areas where I was achieving prespecified objectives, as well as areas where I was free to go beyond the limitations of practice involvement objectives and move my practice forward in additional, new directions.

1 (Always)

4 The preceptor was available when I needed him or her. Thomas made it a point to be very available anytime I approached him. This is specifically relevent in the setting of his commitment to resident education during his staffing obligations. He also came in multiple hours early on multiple occassions to ensure comprehensive feedback was provided to and discussed with me.

1 (Always)

5 When possible, the preceptor arranged the necessary learning opportunities to meet my objectives.

Thomas went out of his way to both ask for and facilitate the fullfilment of my self-identifed learning objectives for orientation. The flexibility of and detailed attention to customizing my training plan has been expemplary due to Thomas's commitment to creating a successful and productive learning experience reaching beyond the extent of my previous staff pharmacy training.

1 (Always)

6 The preceptor displayed enthusiasm for teaching. Thomas's thoughtfully reflected on the order and content of each experience he lined up for resident training, and was happy to explain the background of importance/relevance of each component to pharmacy practice when necessary.

1 (Always)

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Preceptor Evaluation


7 The preceptor gave clear explanations. Thomas is always articulate and thorough in each explanation offered.

1 (Always)

8 The preceptor asked questions that caused me to do my own thinking.

Thomas asked questions that caused me to introspectively assess my residency experience and contrast it to my previous role as a staff pharmacist. His recognition of and appreciation for this transitional process was helpful to me as I dug deeper to figure out how to work through it.

1 (Always)

9 The preceptor answered my questions clearly. Thomas is always articulate and thorough in answering each question asked of him.

1 (Always)

10 The preceptor modeled for me, coached my performance, or facilitated my independent work as appropriate.

As previously described, Thomas successfully facilitated both independent work and work related to achieving rotation objectives.

1 (Always)

11 The preceptor displayed interest in me as a resident. As previously described, Thomas has specifically address my needs throughout this rotation. This is the utmost demonstration of his interest in me as a resident.

1 (Always)

12 The preceptor displayed dedication to teaching. Thomas is always willing to stop what he is doing to listen to my concerns, answer my questions, bounce ideas off of, and help facilitate a reasonable approach to patient care.

1 (Always)

Preceptor Comments: Thank you for the generous complements and for the collaboration in making this orientation experience valuable for both yourself and also, hopefully, for your co-residents. Your feedback has been very useful and is welcome at any time in the future. Much luck in your future rotations!Preceptor Cosign: Thomas Jefferson, RPh., 7/31/2012 17:50

RPD Comments: Thank you, your feedback has been very useful.

RPD Cosign: Dr. Benjamin Franklin, PharmD, FASHP, 8/3/2012 11:04

Page 2 of 2

Preceptor Evaluation


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Strategic Planning - Department of Pharmacy

Pillar and Strategy Goals & Objectives Year

Pharmacy Strategic Plan 2013.docx

SERVICE

Active participant in the New Care Delivery

Model

Improve OP Pharmacy service access and

efficiency

Partnering for Excellence [March 2013 operational go live]

Relocate OP Pharmacy.

2013

2013

QUALITY

Advance medication safety improvements

as opportunities are identified.

Advance staff understanding and

involvement with patient care outcome

initiatives

Assess Sterile Compound Practices in light

of national regulatory focus on practice

Actively participant in technology

deployment that improves patient safety

and operational efficiency.

Joint Commission

Work with Anesthesia on the Med Related RFIs: complete follow up / monitor compliance.

Value Based Purchasing (VBP): Quality Improvement Initiatives with financial metrics

Strengthen pharmacy participation in med related aspect of VBP to support improved outcomes i.e.

VTE, CHF, SCIP, readmissions

Sterile Compound Preparation:

Review Guidelines for SAFE Preparation of Sterile Compounds from ISMP Safety Summit

Perform gap analysis and implement identified practice changes

Smart Infusion Pumps / Syringes

Pumps: Complete reports workshop, revise drug library and develop plan for 2014 roll out of Symbiq

pumps across partners

Syringes: Implement a Hard Upper Stop for all drugs in the library

2013

2013-14

2013

2013-14

2013

66




PEOPLE

Restructure Pharmacy services across

Partner hospitals

Maintain and advance an effective

Pharmacy work force

Expand dedicated medication

reconciliation resources to meet identified

needs

Improve employee satisfaction

Stellar's Health Partners

Finalize/Implement the Pharmacy Organizational Structure.

Standardize Pharmacy Competency Assessment across partners

Pharmacy Residency Program: Completion year 1 of the Pharmacy program.

Successful survey [April 2013]

Recruitment of candidates for the 2nd

year of the program.

Actively plan for the succession of key management and technical roles.

Work with Midtown College of Pharmacy and Health Sciences regarding additional clinical

affiliation agreements within Health Partners

Implement the Med Rec. position to support improved Hospitalist work flow

Associate Engagement: assess and follow up on survey results

2013

2013

2013-15

2013-14

2013

2013

FINANCE

Meet Pharmacy related merger targets

Assure compliance with changing billing

requirements.

Meet Supply Chain targets

Meet Labor Management targets

Stellar’s Health Partners

Implement changes to achieve pharmacy synergy saving across SHP

Implement Pharmacy billing code changes requested by payers

J code waste documentation (pharmacy/CHE Siemens project)

Implement CHE 2013 Medication ACT Initiatives

Monitor and adjust staffing levels to comly with Premier Outlook Benchmarking metrics set quarterly

throughout 2013.

2013

2013

2013

2013

67




GROWTH

Meet the implementation time line tasks for

CPOE

Provide the Pharmacy related support for

the Facility construction and turnover of

patient care units

Standardize and streamline committee

structures and processes.

Carelink Project

Soarian MED|IVs module / Siemens Pharmacy: complete building and testing across both systems to

support CPOE Go Live. [June 2013]

CHE P&T Council: incorporate system standardization initiatives into site specific built.

Phase 3 Master Facility Plan

Implement the Medication Distribution/Storage model within renovated patient care areas [Pyxis

Equipment].

Implement Stellar’s Health Partners Consolidation

System wide P&T Committee

Campus wide Medication Safety Committee (each campus)

Shared Antimicrobial Stewardship (ASP) activities

2013

2013-14

2013

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O_PHARMACY QUALITY IMPROVMENT PLAN.DOCX

Department of Pharmacy

QUALITY PLAN

QUALITY COMMITMENTS

Aligned with Stellar Hospital Patient Safety and Quality Improvement Plan, the Pharmacy Quality

Improvement Process will consistently reflect Stellar Hospital commitment to:

Create a patient and family centered healing experience through the provision of excellent

care, quality service, and partnership among physicians and caregivers.

Encourage patients and families involvement in quality improvement activities.

Promote and maintain a values-based organizational culture committed to caring through

excellence that supports continuous quality improvement.

Enhance operational excellence including clinical outcomes, financial outcomes and patient

satisfaction.

Systematically identify and prioritize quality improvement opportunities.

Create a “just” environment that supports the identification and reporting of adverse events

and/or near misses.

Apply external standards and/or references for benchmarking performance.

Utilize assessment activities as the basis for developing and implementing action plans

responsive to findings.

Communicate results of quality improvement activities to and across all levels of the

organization.

Provide resources required for performance improvement and change management including

access to information and training.

Leadership evaluating of the effectiveness of staff to promote safety and quality

through Stellar Hospital's Performance Planning and Evaluation

AUTHORITY / RESPONSIBILITY

A. The vice-president of operations is responsible for the development and provision of a

coordinated system for evaluating the overall quality of departments, nursing care, and patient

care programs which are integrated with the hospital/system. The vice-president receives reviews

and acts upon a summary quarterly report regarding the effectiveness of operations’ quality

improvement activities. In so doing, the vice-president empowers appropriate cross-functional

teams, and supports and fosters a commitment to continuous quality improvement throughout the

division.

B. The leadership of the operations division is accountable for the effective implementation of an

integrated, comprehensive, quality improvement effort specific to their department / division/unit.

69


They provide feedback via the report to Patient Safety & Quality Improvement Council on the

implementation of recommendations. Directors/managers ensure participation of staff members

who are most appropriate to the specific quality improvement efforts, and oversee the quality

improvement processes including data collection and analysis, problem identification, plan of

action development, monitoring methodology and activities, and communications to staff.

establishment of indicators aligned with CHE key performance indicators and Stellar Hospital’s operations annual goals, as necessary;

implementation of plans of action to improve the quality of care/service;

communication of results of qi efforts to staff;

review of all patient adverse events;

recognition of excellence & successes in patient care/operations

C. It is the expectation that Stellar Hospital's operations division staff members will providequality care/service in accordance with established policies and procedures; identify and report

problems or issues of safety which impede the delivery of quality patient care and service;

participate in problem solving and improvement efforts individually or as a member of a quality

improvement team; assist with documentation of area specific quality improvement activities as

necessary; and support all aspects of Stellar Hospital operations division’s quality improvement

efforts.

DEPARTMENT LEVEL PLAN

The Pharmacy Department Director is responsible for establishing and implementing a Pharmacy

Department performance improvement plan. The plan shall integrate Pharmacy Department quality

assessment/improvement, continuous quality improvement (CQI) and quality control activities into a

system that will foster improvement in patient care. The Pharmacy Department Director also shall

delegate responsibilities for monitoring, action, evaluation and reporting.

PURPOSE/OBJECTIVE:

The Pharmacy Department participates in a hospital wide performance improvement (PI) program

designed to monitor, evaluate and improve the quality, appropriateness and outcomes of clinical services

by:

Planning, designing, measuring, assessing, improving new or revised processes of patient care

and service,

Identifying opportunities through continuous assessment of systems and processes of care

through a collaborative, interdisciplinary focus,

Implementing solutions and actions which will bring about the desired changed, to

Facilitate a positive patient outcome, while

Maintaining a safe environment of personnel, patients and visitors.

PERFORMANCE ACTIVITIES:

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The performance improvement program for the Pharmacy Department shall monitor priority focus areas

and processes of care which are felt to be high risk, high volume, have demonstrated a trend toward

potential negative patient outcome (problem prone) and/or that involve risks that may result in sentinel

events or have been identified through the continuous quality improvement (CQI) process as an area

where a system or process of patient care may be improved.

Additional indicators will be identified and chosen for monitoring through a collaborative effort utilizing

information obtained from all areas of Nursing Services, administration, medical staff evaluation,

regulatory body reports, patient care questionnaires and other clinical services throughout the facility, as

appropriate.

Proposed processes for assessment include, but are not limited to:

Medication errors - wrong drug, dosage, time, route or rate of administration; wrong patient;

omission, duplication or administration without an order

Adverse reaction to medication

Medication order filled incorrectly

STAT medication not sent within time frames established by department

Controlled substance diversion

Occurrences that have an adverse result on a patient

Equipment breakage/failure that has an adverse result on a patient

Equipment not available

Security incident

Expired, recalled or otherwise unusable drug dispensed

Formulary management

Labeling of drugs

Patient/family education

Drug recall measures

Research investigational drugs

Surveillance, prevention and control of infection

Instrument preventive maintenance and safety assessments

Patient confidentiality

Sentinel event reduction and elimination

Patient satisfaction

Technical quality control activities

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Performance monitoring of identified processes are subject to change due to the collaborative process

outlined above.

RESPONSIBILITY:

The Pharmacy Department Director reports Pharmacy Department performance improvement activities to

the hospital wide Patient Safety & Quality Improvement Council for review and recommendations.

Topic Identified by Improvement Opportunity

Smart Infusion

Pumps

Smart Pump

Implementation Project

Team

Complete reports workshop, revise drug library and

develop plan for 2014 roll out of Symbiq pumps

across partner hospitals.

Smart Infusion

Pumps

NICU / Pharmacy PI

work group

Implement a Hard Upper Stop for all drugs in the

Medfusion drug library. Develop a process, to work

with the regional NICU to improve the functionality

of the pumps and standardize across the region.

Sterile Compound

Preparation

Literature reports of

Compounding Pharmacy

prectices

Review the Guidelines for Safe Preparation of Sterile

Compounds from ISMP Safety Summit: perform gap

analysis and implement identified practice changes

Med Related

Requirements for

Improvement

Joint Commission Survey

Report

Complete follow up / monitor compliance.

Value Based

Purchasing (VBP)

Hospital wide strategic

initiative

Strengthen pharmacy involvement in med related

aspect of VBP to support improved outcomes i.e.

VTE, CHF, SCIP, readmissions

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General Organizational Data Collection Form.doc

General Organizational Data Collection Form

Name of organization: Stellar Hospital

ASHP program number: xxxx

PATIENT VOLUME

If acute care setting: # Licensed beds (total) 442

% Occupancy (average) 375

# ICU beds 37 + 15 NICU

# Emergency dept. visits /day 160

% ER visits = admissions 30%

If ambulatory clinic setting: # Patient visits/month (for all clinics

operated by the organization)

If community setting: Average # prescriptions/day # of patient care

services offered

If managed care setting: # Covered lives

BUDGET

Personnel $ 5,750,900

Drugs $ 17,185,000

Other $ 540,500

Total Budget $ 23,470,400

Current/planned capital expenditures/leases in next three years (e.g., automated

medication dispensing machines, CPOE, robotics, facility renovations related

to pharmacy)

$ 17,440,000

Please list:

AMDM = $ 780,000/year CPOE/MU

= $ 5M/year

OP Pharmacy relocation = $100,000 for

2013

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General Organizational Data Collection Form.doc

PHARMACY PERSONNEL COMPLEMENT

Manager/administrative pharmacists 4.0 FTEs

Acute care centralized pharmacists 19.2 FTEs

Acute care decentralized pharmacists 7.47 FTEs

Acute care specialized pharmacists 5.0 FTEs

Ambulatory outpatient pharmacists 3.37 FTEs

Ambulatory pharmacists in clinics Infusion center 1.93 FTEs

Community care pharmacists --- FTEs

Managed care pharmacists --- FTEs

PGY1 residents 4.0 FTEs

PGY2 residents --- FTEs

College of pharmacy faculty (separate from those above) ---

FTEs

Other: Informatics 1.0 FTEs

Total Pharmacists: 45.97 FTEs

Technicians 32.6 FTEs

Clerks Depart Sec. 1.0 FTEs

Other Informatics 2.0 FTEs

Total Non-Pharmacists: 35.6 FTEs

Total Pharmacy Personnel Complement:

(Budgeted, includes vacancies)

81.57

FTEs

Vacant pharmacist positions 0 FTEs

Vacant non-pharmacist positions 1.0 FTEs

PHARMACY STUDENTS

# Pharmacy student introductory pharmacy practice experiences offered/year

# Pharmacy student advanced pharmacy practice experiences offered/year

RESIDENCY PROGRAM FUNDING SOURCES

Organization

CMS

VA

College

Other. Please explain: ________________________________________________

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TJC1.docx

Joint Commission Survey 2012

MEDICATION Related RFI Findings

MM 03.01.01 The hospital safely stores medications.

EP3: The hospital stores all medications and biological, including controlled (scheduled) medications in a

secured area to prevent diversion, and locked when necessary in accordance with law and regulation.

Findings:

Crash cart in Endo not properly secured. Drawer containing medications could be accesses without disrupting the plastic lock.

L&D area, Anesth. Cart was found unlocked and vials of epinephrine located in top drawer

Evidence of Standards Compliance (ESC): Final draft from xxxxxx. Submitted

online to TJC

MM.03.01.01 EP 3

WHAT:

The following corrective actions were taken to address the element of performance:

The policy Medication Storage was reviewed and determined to meet the element of performance.

The anesthesia cart was locked immediately at the time it was identified as unlocked with a medication in it.

The contents of the code cart in Endoscopy was checked immediately and the lock was replaced to ensure the

security of drawers.

All staff in Endoscopy was educated on code cart check process including check locking mechanism and security of

plastic lock and security of drawers when performing daily code cart checks as well as document lock is secure on

code cart checklist.

All anesthesiologists and certified registered nurse anesthetists were educated on the requirement that any

unattended anesthesia cart with medication must be locked.

All endoscopy, respiratory therapy, pharmacy and clinical technology management staff were educated on the

code cart check to assure locking mechanisms are working as intended when code carts are put back into service

after use.

WHO:

The Director of Surgical Services and the Chief of Anesthesiology are directly responsible for corrective action and

ongoing compliance with the standard. In addition, the Patient Safety and Quality Improvement Council of the

Medical Staff are responsible for compliance with the standards.

The policy was reviewed by the Director of Pharmacy, Director of Clinical Transformation.

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TJC1.docx

The anesthesia cart was locked by the certified registered nurse anesthetist.

The code cart was in Endoscopy was checked by the Operations Manager who replaced the lock to assure the

drawers were secure.

The Chief of Anesthesiology completed the education of the anesthesiologists and certified registered nurse

anesthetists on the need to keep anesthesia carts locked.

The staffs in endoscopy, respiratory therapy, pharmacy and clinical technology management were educated by

their respective managers.

The titles of those who were trained are anesthesiologists, certified registered nurse anesthetists, anesthesia

technicians, registered professional nurses, respiratory therapists, pharmacists, pharmacy technicians, clinical

technologist.

WHEN:

The policy review was completed by 11/13/12.

The anesthesia cart was locked on 11/8/12.

The code cart in Endoscopy was checked and lock replaced on 11/8/12.

The education by the chief of anesthesiology was completed by 12/21/12.

The education of staff in endoscopy, respiratory therapy, pharmacy and clinical technology was completed by

12/29/12.

HOW:

The policy was reviewed in relation to the joint commission standards on medication management.

The education by chief of anesthesiology was completed by face to face dialogue and written correspondence.

The education of staff in endoscopy, respiratory therapy, pharmacy and clinical technology management was

completed by face to face dialogue and written correspondence.

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TJC2.docx

Joint Commission Survey 2012

MEDICATION Related RFI Findings

NPSG 03.04.01 Label all medications, medication containers, and solutions on and off the sterile field

EP3: In perioperative and other procedural settings both on and off the sterile field, medication or

solution labels include the following:

Medication Name

Medication Strength

Quantity

Diluent and volume (if not apparent from the container)

Expiration date when not used within 24 hours

Expiration time when expiration occurs in less than 24 hours

Finding:

CRNA in the OR had prefilled syringes of Propofol, Succinylcholine and Decadron and placed the

syringes on top of the anesthesia work station during induction. The labels applied to the syringes

did not include the quantity or strength of the drugs and diluent and volume of diluent used

Evidence of Standards Compliance (ESC): Final draft from xxxxxx. Submitted online to TJC

NPSG .03.04.01

EP 3

WHAT: Describe the action(s) taken and how the element of performance was addressed. The

organization must indicate what action(s) has already occurred, not the plan for correcting the issue

The policy Medication Administration was reviewed and determined to address the element of

performance.

The Chief of Anesthesia educated all anesthesiologists, Certified Registered Nurse Anesthetists on the

proper and complete labeling of medication and solution removed from original container on and off the

sterile field emphasizing complete labeling must include medication name, strength, quantity, diluent and

volume (if not apparent from container).

WHO: Identify the title of the person responsible for the corrective action and ongoing compliance and

describe the responsibility each person has in correcting the action. Describe who was trained (titles). If

a policy or procedure was developed or revised, include the title of the person responsible, and the title

of the person who has approved the policy or procedure. If a committee is indicated, the title of the

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TJC2.docx

person on the committee who is responsible must be indicated, e.g. Chair, Performance Improvement

Committee

The chief of anesthesia is directly responsible for corrective action and ongoing compliance with the

standard. In addition, the Patient Safety and Quality Improvement Council of the Medical Staff is

responsible for ongoing compliance with the standards.

The Director of Clinical Transformation and the Director of Pharmacy completed the review of the policy

Medication Administration.

The titles of those who were trained are anesthesiologists, certified registered nurse anesthetists.

WHEN: Indicate a date when each action (policy, procedure, process, and/or training) was completed. If

multiple actions are noted, specific dates must correlate to the specific action

The policy review was completed on 11/20/12.

The education of anesthesiologists and certified registered nurse anesthetists was completed by

12/29/12.

HOW: Describe how the actions described in the “WHAT” section were implemented and the process for

sustaining compliance. Describe how the staff was trained

The Director of Clinical Transformation and the Director of Pharmacy reviewed the hospital policy on

medication administration and compared its content to the National Patient Safety Goal to validate that

the policy is compliant with the standard. No revision was needed.

The education of each anesthesiologist and certified registered nurse anesthetist was implemented by

written correspondence from the chief of anesthesia with the expectation that all medication and

solutions will be labeled completely and the specific information required on labels.

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Page 1 of 5

Affiliation with Midtown College of Pharmacy and Health Sciences

Stellar Hospital has two affiliation agreements with Midtown College of Pharmacy and

Health Sciences (MCPHS).

1. Experiential Education

2. Pharmacy Residency Program

1. Experiential Education

This affiliation agreement outlines the relationship between MCPHS and Stellar Hospital. It defines requirements provided by both organizations, including clauses for FERPA and HIPAA.

Also included are clauses regarding student conduct, incidents, insurance and other standard

terminology. The affiliation agreement complies with the Student Rotations policy as defined by

Stellar Hospital's Human Resources Department.

Experiential Education Rotations Offered at Stellar Hospital

Rotation # students/

rotation

Primary Preceptor PGY1 Residency

Rotation

IPPE –

Institutional

(3 week)

1 xxxxx xxxx, RPh Introduction to

Pharmacy Practice

APPE –

Institutional

(6 week)

1 xxxxx xxxx, RPh All Core Rotations and

Longitudinal

APPE –

Drug Information

(6 weeks)

1 xxxxx xxxx, PharmD, FASHP Pharmacy Practice

Management

APPE –

Cardiology

(6 weeks)

1 xxxxx xxxx, PharmD, BCPS Cardiology

APPE –

Critical Care

(6 weeks)

1 xxxxx xxxx, PharmD,

BCPS

Critical Care

APPE –

Infectious Diseases

(6 weeks)

1 xxxxx xxxx, PharmD,

FASHP

Infectious Diseases

APPE –

Emergency Medicine

(6 weeks)1

1-3 xxxxx xxxx, PharmD, BCPS

xxxxx xxxx, PharmD, BCPS

Emergency Medicine

APPE –

Administration

(6 weeks)2

1 xxxxx xxxx, MS Pharmacy Practice

Management

1

2Positions partially funded by MCPHS

Restricted to students co-enrolled in MCPHS PharmD and Another University MBA

programs

Resident Responsibilities

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Residents develop a relationship with the primary residency preceptor and therefore a

relationship with the student. Residents mentor the student in the area of the rotation and serve

as a secondary preceptor for the rotation. Residents do not serve as primary student preceptor.

The students use the resident as first contact for rounds, patient review and other related

activities. In addition, residents coordinate the student journal club, cases and other

presentations. The resident(s) facilitate the presentations evaluate and provide feedback to the

students. They train and utilize the students for educational programs and other related residency

activities. The resident provides feedback to the primary student preceptor for the student mid-

point and final evaluation.

2. Pharmacy Residency Program

This affiliation agreement outlines the relationship between the MCPHS and the PGY1

Pharmacy Residency Program at Stellar Hospital. The agreement outlines the description of the

affiliation and the responsibilities of both parties.

MCPHS Teaching & Learning Scholarship Program 2012-2013

Resident MCPHS Faculty Mentor

xxxx xxxx, PharmD xxxxx xxxx, PharmD, BCACP Assistant Professor, Department of Pharmacy Practice,

Midtown Campus

xxxx xxxx, PharmD xxxxx xxxx, PharmD

Assistant Professor, Department of Pharmacy

Practice, Midtown Campus

xxxx xxxx, PharmD xxxxx xxxx, PharmD

Associate Professor, Department of Pharmacy

Practice, Midtown Campus

xxxx xxxx, PharmD xxxxx xxxx, Pharm.D., BCACP Associate Professor, Department of Pharmacy Practice,

Midtown Campus

The MCPHS and Stellar Hospital, establish the Program in compliance with the accreditation standards of the American Society of Health-System Pharmacists, which requires facilities,

equipment, services and personnel appropriate for resident(s) to obtain the necessary teaching,

educational, clinical and administrative experiences and training. The Residency Program

Director (RPD), hired by Stellar Hospital, will assign to the Resident(s) a range of activities at the College and at SH designed to develop leadership and teaching (both didactic and

experiential) skills in accordance with the accreditation standards set forth by ASHP.

Joint Responsibilities

MCPHS and SH will each identify a person or persons responsible for liaison during the course

of the affiliation. The appointment of liaisons shall be subject to mutual approval of both

MCPHS and SH. The liaison appointed by SH will be the RPD or other person designated by the

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Director of Pharmacy and the liaison appointed by MCPHS will be the Chair of the

Residency and Fellowship Committee or such other person designated by the Dean of

Pharmacy. The liaisons appointed will jointly plan for:

Recruitment and selection, assignment and orientation of residents. The primary recruitment

of the PGY1 Pharmacy residents lies with SH;

Work towards mutually agreed upon marketing brochures and diplomas that accurately

represent all parties for the program offered through the affiliation agreement; and

Periodic review and preparation of objectives, residency learning system (RLS) forms, and

the residency training manual for the residency program to ensure compliance with the

ASHP Accreditation Standards

Periodic preparation for and participation in all accreditation reviews and site visits ,

necessary to achieve and to maintain accreditation.

SH has authority to suspend or terminate a resident in accordance with applicable policies. In

cases where a resident’s performance or conduct threatens the safety or welfare of students,

visitors or staff of MCPHS, MCPHS may suspend the resident’s participation as a resident in accordance with College policies, subject to SH’s right in its discretion to continue the individual

as an employee of SH. The MCPHS liaison will consult the RPD before suspending a resident, except where consultation is not reasonably possible under the circumstances.

Both parties agree to comply with the Title 45, Section 160-164 of the Code of Federal

Regulations (“HIPAA”). Both parties agree that when protected health information (“PHI”), as

defined by HIPAA, is provided or made available to the other party for any purpose, the

receiving party, and its agents or representatives will not use or disclose the PHI other than as

permitted or required by this Agreement or state and federal law. Both parties shall take

reasonable steps to prevent unauthorized disclosures by its employees, officers, directors, agents,

contractors or consultants.

SH and MCPHS agree to meet at least two (2) times per year to review the operations and effectiveness of the relationship and agreement.

SH Responsibilities

SH assumes the overall responsibility for the general educational experience of residents in the

Program, including:

Determination of core educational goals for residents. Educational goals and objectives for

the residents;

Establishing prerequisite criteria for placement of residents with MCPHS;

Determination of completion of the assignment;

Provision of information regarding dates for instruction;

Certification that the residents have been instructed on the confidentiality of medical and

personal information related to patients and/or students.

Final evaluation of resident performance as outlined in the assessment strategy of the RLS

documents; and

Oversee the accreditation process through the American Society of Health-Systems

Pharmacists.

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MCPHS Responsibilities

MCPHS agrees to provide precepting and teaching opportunities for residents in large and small classroom and other selected areas. In this regard, MCPHS will provide the equipment,

facilities, supplies and services for residents and faculty assigned to Residents necessary to meet

the teaching objectives of the program.

MCPHS liaison agrees to meet with Stellar Residency Advisory Committee or designee as needed.

Assigned MCPHS faculty members, have responsibility for teaching, supervising and evaluating the performance of Residents in the Program. Assigned College faculty agrees to

provide SH with written evaluations of the performance of the resident as outlined in the

assessment strategy of the RLS documents.

MCPHS agrees to identify and provide SH with current copies of any policies and

procedures at MCPHS that apply to the educational experience of the residents.

Financial Terms

Residents in the SH PGY1 Pharmacy Residency Program shall be deemed employees of SH,

and SH shall be responsible for all salary and benefits due the Resident. Each party shall bear

any other costs incurred by them in the performance of their obligations pursuant to this

Agreement.

Liability Insurance and Indemnity

Insurance

SH and MCPHS shall take out and maintain or cause to be maintained, without interruption throughout the life of the Agreement, and unless said policy insures for occurrences during the

policy period, notwithstanding that a claim may be filed after termination of coverage, for a

period of three years after the termination of this agreement, unless an endorsement is obtained

covering occurrences during the policy period for claims made after the termination of the policy:

Comprehensive General Liability Insurance, as will protect the said party, and its agents,

students, servants, employees, directors and trustees from claims for personal injury and/or

property damage which may arise from the performance of the activities contemplated by this

Agreement. For all major divisions of coverage, including: Premises-Operations, Broad Form

Property Damage; Contractual Liability; Colleges and Schools Health Care Students.

Professional Liability Insurance for itself and its agents, servants and employees, and students

and interns.

Worker’s Compensation Insurance, as required by law.

Employer’s Liability Insurance.

All other insurance which it may be required to provide pursuant to law.

Such insurance shall be written for not less than the following limits of liability:

Comprehensive General Liability Insurance; $1,000,000 each occurrence and $2,000,000

in the aggregate Premises-Operations, Broad Form Property Damage; $1,000,000 each

occurrence and $2,000,000 in the aggregate Products Liability/Completed Operations;

$1,000,000 each occurrence and $2,000,000 in the aggregate Contractual Liability;

$1,000,000 each occurrence and $2,000,000 in the aggregate

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Indemnification

Notwithstanding that joint or concurrent liability is imposed on the Parties hereto by statute, law,

ordinance, rule, order or regulation, each party hereto shall defend and indemnify the other, and

their agents, students, servants, employees, directors and trustees against any claim, judgment,

liability or expense of any nature caused by the negligence, act or omission of said party, its

agents, students, servants, employees, directors or trustees in the performance of said party’s

obligations under this agreement, to the fullest extent permitted by law, except to the extent

caused by the indemnified party’s negligence, or the negligence of the indemnified party’s

agents, students, servants, employees, directors or trustees.

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PGY1 Pharmacy Residency Program

The PGYI Pharmacy Residency at Stellar Hospital seeks to develop apharmacist into a more highly trained, competent and confident health-system pharmacy practitioner. The resident will exhibit commitment to the advancement of the profession all the while building a solid foundation for further development of advanced clinical pharmacy practice skills.

Modeled after medical training, each resident will undergo 12 month-long learning experiences rotating thru re-quired, elective, and longitudinal experi-ences.

Stellar Hospital is affiliated with the Midtown College of Pharmacy and Health Sciences. The affiliation gives the resident the opportunity to obtain a teaching and learning certificate upon completion of the program.

Department of

Pharmacy

PGY1 Pharmacy Residency Program

James Madison, MS,RPh Director of

Pharmacy

James Monroe,PharmD, FASHP, RPh

Supervisor, Clinical Pharmacy Services

Benjamin Franklin,PharmD, FASHP, RPh

Director, PGY1 Residency

Application Requirements

Minimum entrance requirement are:

Doctor of Pharmacy degree from

an accredited college of pharma-

cy, and

Applicant must be eligible for USPharmacy Licensure.

http://www.op.nysed.gov/pro/pharm/pharmlic.htm

Applicants are accepted through the ASHP Matching Program only.

Applications will only be accepted through PhORCAS

Application Deadline: January 15, 2013

To apply to the Matching Program contact:

National Matching Services, Inc. http://www.natmatch.com/ashprmp/

National Match Services, Inc. P.O. Box 1208

Lewiston, NY 14092-8208 Phone: (716) 282-4013

FAX: (716) 282-0611 Or

20 Holly Street, Suite #301 Toronto, Ontario, Canada M4S 3B1

Phone: (416) 977-3431 FAX: (416) 977-5020

[email protected]

Application requests to:

James Monroe, PharmD, FASHPDepartment of Pharmacy

Stellar HospitalSomewhere, US

Office:

FAX:

86

http://www.op.nysed.gov/prof/pharm/pharmlic.htm

http://www.op.nysed.gov/prof/pharm/pharmlic.htm

http://www.natmatch.com/ashprmp/



Stellar Hospital

Since 1869, Stellar Hospital, hasbeen a transforming, healing presence to patients and families in the area.Acting in the Catholic tradition of the Religious Sisters of Mercy, Stellar isdedicated to caring for the whole individual: from before birth until the last days of life.

Stellar Hospital is a 442 bed acute facility with services in Cardiology, Car-diovascular Surgery, Hematology/ On-cology, Women’s & Children Services and others. With 4,500 employees and a budget of more than $500 million, Stellar is one of the Capital Region's largest employers and one of the largest health care organizations in xxxxx. Each year it brings an economic benefit of nearly $700 million to the Capital Region.

Stellar Hospital is a member of Stellar Health Partners, a multi-dimensional health system servicing the state atover 125 different locations with over 12,000 employees. Stellar Healthpartners encompasses all levels of care and is comprised of 4 acute care hospitals, an integrated home care program, rehabili-tation program, long-term care, Community Hospice, Inc. and much more. Stellar HealthPartners is a member of Catholic Health East, a multi-institutional system of hospitals, nursing homes and other facilities. Co-sponsored by ten religious congregations and Hope Ministries, Catholic Health East has approximately 50,000 employees in 11 eastern states from Maine to Florida.

Visit: xxxxx.org/prp formore information.

The Surroundings The Pharmacy Department

The Pharmacy Department provides a wide range of pharmaceutical services to the hospital, ambulatory network and associated programs.

These services include:

PGY1 Pharmacy Residency Pro-gram

Satellite pharmacies in Critical Care, OR, Oncology, Ambulatory Care & Hospice Homecare

Decentralized Pharmacy Services

Emergency Medicine Pharmacy Ser-vices

Clinical Pharmacy Specialist/Consultation Services

Sterile and non-sterile production

Investigational Drug Service

The Pharmacy Department is composed of 27 centralized/satellite/decentralized pharmacists, 5 clinical pharmacy special-ists, 2 pharmacy specialists in materials and informatics, 32 centralized /satellite/decentralized technicians and support staff, 4 management staff ,4 pharmacy residents and part-time pharmacists, technicians and students.

Benefits

Competitive Stipend-$40,000 Medical, Dental, and Life Insurance 16 Paid Leave Days Contribution to Tax-Deferred Retire-ment Program Educational Allowance Travel Allowance Cafeteria Discount

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http://www.sphcs.org/prp

Documents

PRE-SURVEY QUESTIONNAIRE AND SELF-ASSESSMENT CHECKLIST · PDF filepre-survey questionnaire and self-assessment checklist . for the accreditation of a . postgraduate year one (pgy1)