PGY2 Informatics Pharmacy Residency Manual

Transcription

1 PGY2 Informatics Pharmacy Residency Manual

2 Table of Contents Section I Training Manual Page 1. Purpose and philosophy Organization Structure 6 3. Program Goals 7 4. Residency Program Structure 8 5. Benefits 9 6. Verification of licensure Supervision and Work Ethic Policy Access Required experiences and activities Residency Project Residency Project Worksheet Past Residency Project List Project/Activity Timeline Evaluations Documentation Hospital Pharmacy Practice (Staffing) Overview Section II Schedules / Calendars 1. Resident Training Plan Evaluation Due Date Schedule Presentation Calendar Orientation Discussion schedule Orientation Checklist Section III Resident Portfolio 1. Presentations 2. Projects 3. Assignments 4. Evaluations 2

3 PGY2 Informatics Pharmacy Residency Program: Structure - Purpose and Philosophy - Departmental Organization Chart - Program Goals - Program Structure - Benefits 3

4 PURPOSE AND PHILOSOPHY Purpose The purpose of a PGY2 pharmacy informatics residency is to prepare the pharmacist for practice in a pharmacy informatics position. Residency training is designed to provide the resident experience in applying informatics and technology to enhance care of the patient and support healthcare professionals. This is accomplished by staffing responsibilities, clinical rotations (if desirable) and working with a broad range of medication systems, health care professionals, and vendors. Residency training also offers other advantages: A competitive advantage in the job market More and more employers recognize the value of residency training. A pharmacist who has completed a residency will have a clear advantage over applicants who have not. Networking opportunities Many opportunities arise for residents to establish or expand their network of professional acquaintances and contacts including preceptors and other residents, especially in the informatics specialty area. Career planning During the course of training, most residents gain a clearer understanding of the specific informatics setting which best suits him or her. Residency preceptors are committed to providing personal attention to assist each resident in further defining professional goals. Professional vision Many programs also offer the opportunity to see how pharmacy is practiced in different parts of the country, by arranging for residents to visit other residency programs or by allowing residents to complete a portion of the residency at another site (for example, vendor rotation opportunity or didactic teaching or precepting opportunities if available). 4

5 Philosophy The ASHP accreditation standard provides criteria that every program must meet in order to receive and maintain accreditation. This program follows the ASHP - approved PGY2 Informatics Residency Outcomes, Goals, and Objectives. Beginning in December 2007, the requirement for this residency program was altered to be consistent with ASHP to solely consider candidates who have successfully completed a PGY1 residency. While this program follows ASHP standards, a strength of this program is the flexibility to tailor the program to meet the informatics needs and interests of each individual resident. The mission of our program includes developing a core skill set in pharmacy informatics and fully understanding the intersection of technology, patient care and professional practice. The program also offers a unique opportunity to work closely with the primary vendor of the institution to learn about the vendor perspective. 5

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7 PROGRAM GOALS The residency program will provide each resident with specific learning/practice experiences designed to enable the resident to expand the scope of his/her practice skills. Required Goals R1.1 Demonstrate understanding of basic pharmacy informatics principles, standards, and best practices. Evaluate opportunities for improving patient outcomes by improving the safety and quality of the medication- R1.2 use system through the application of informatics principles, standards, and best practices. Evaluate opportunities for improving operational efficiencies in order to better serve patient and health R1.3 professional needs through the application of informatics principles, standards, and best practices. R2.1 Evaluate the validity of information and knowledge in the organization s technology and automation systems. R2.2 R3.1 Assure that all patient-specific, medication-specific, and evidence-based pharmacotherapy information required to support effective medication-related decisions is readily available in a useful format to members of interdisciplinary, patient-centered teams. Assure the accurate and efficient flow of data between the organization s technology and automation systems. Support efforts to assure the interoperability of technology and automation systems that interface with those R3.2 of outside organizations. R3.3 Guard the confidentiality and security of health data stored in the health care organization s database. Assure the implementation of documented, formal testing procedures for data and transactional verification R3.4 and/or validation. Demonstrate a working knowledge of available technology and automation systems for prescribing R4.1 medications. R4.2 Demonstrate a working knowledge of currently available automated technology for order processing. Demonstrate a working knowledge of currently available automated devices for the safe and efficient R4.3 distribution and dispensing of medications. R4.4 Demonstrate a working knowledge of currently available technology or automation for the safe and efficient administration of medications. Demonstrate a working knowledge of currently available automated technology for documenting medication R4.5 administration. Demonstrate a working knowledge of currently available electronic surveillance systems for effects R4.6 monitoring. R4.7 Demonstrate a working knowledge of currently available pharmacy inventory management systems. Demonstrate a working knowledge of emerging technology and automation systems that assist with the R4.8 medication-use system. R4.9 Contribute to resolution of identified operational problems. R5.1 Contribute to planning for acquisition and implementation of significant technology or automation inita R5.2 Participate in the implementation of a technology or automation system. R5.3 Participate in contingency planning. R5.4 Report the findings of a technology or automation system project. R6.1 Demonstrate the personal skills and abilities of a pharmacy informatics leader. Represent the pharmacy informatics perspective in interactions with the information technology staff, other R6.2 health care staff, and/ or technology and automation vendors. R6.3 Demonstrate the technical skills essential to the role of a pharmacy informaticist. R6.4 Represent pharmacy informatics concerns in strategic planning for the implementation, use, and maintenance of technology and automation systems. Elective Goals E1.1 Design, execute, and report results of investigations of pharmacy informatics-related issues. E2.1 Serve as an expert resource for the management of a specific technology or automation system. E3.1* Understand faculty roles and responsibilities. E3.2* Exercise teaching skills essential to pharmacy faculty. *Not selected for 2013 resident* 7

8 STRUCTURE PGY2 Informatics Pharmacy Residency Orientation (Month 1) Core Rotations (in preferred order) typically 4 weeks in length Transitional Elective Informatics Rotations 1. Medical Center Orientation 2. Residency/RLS 3. Computer Training 4. Hospital Practice/Central Pharmacy & Satellites Orientation (Staffing) Longitudinal 1. Clinical Pharmacy Systems Management (CPOE, Pharmacy System, Documentation System, Automated Dispensing Devices) 2. Clinical Decision Support 3. Clinical Rotation 4. AdminRx/Vendor Relations & business strategies 5. Data Management & Smart Pumps 6. Medication Safety 7. Technical Concepts 1. ASHP Midyear 2. Residency Project 1. System Alerts 2. Outpt Pharmacy Automation & e- Prescribing 3. Web based pharmacy applications Med Carousel Technology 4. Pharmacy Interventions 5. Evidence Based Medicine/Order Sets 6. Medication Safety II 7. Clinical Decision Supt II Topic &/or Case Presentation (2) Assistance with PGY1 MUE projects Newsletter Fast Fact (1) optional Hospital Pharmacy Practice (staffing) Residency Project (1) Therapeutic Exchange (1 CE) or equivalent Residency Project Presentation Automation Project *Elective Clinical Rotations Available: Solid Organ Transplant Bone Marrow Transplant Infectious Disease General Pediatrics ICU Pediatrics NICU Pediatrics BMT/Onc Pediatrics Nutrition Critical Care Medicine Trauma Burn Surgical Geriatrics Coumadin Clinic HIV/AIDS Cardiology *At the request of resident to gain experience in a particular clinical area. No more than one 4 week rotation is recommended, however, exceptions may be made. Ideally, informatics will be incorporated into the clinical rotation when possible. 8

9 BENEFITS Educational leave Flex PTO (Paid time off) Travel & relocation expense directly related (moving company, rental, fuel, hotel) to the move up to $1500 Life insurance Professional liability insurance supplied by the Medical Center Health care plan options, including an HMO plan Payment of Tennessee Board of Pharmacy license fee in June license fee and professional tax. We will pay for transfer of NABPLEX scores (payable fees are defined by dept details can be provided) Photocopying directly related to residency Office space & computer workstation Employee Assistance Program Concierge Service Full access to Biomedical Library Lab coats are the responsibility of the resident, but can be purchased through the hospital Selected observed holidays Financial support and professional leave for ASHP MYCM, annual Southeastern Residency Conference in Athens, GA Discounts at local merchants All ACPE approved continuing education provided by the Department of Pharmaceutical Services Immunizations and other health related costs required by the Medical Center House staff & hospital orientation programs Competitive stipend Employee Wellness Program Membership in professional organizations is the responsibility of the resident Explanation of Time Off: Residents (Exempt status) o o o Flexible Paid Time Off (vacation & sick days) are accrued over the course of the year. Vacation days are available for use and must be taken during the year. Each resident is encouraged to sign up for and take no less than one week of vacation time prior to January 15 of the residency year. (Residency Director may approve alterations in certain situations). There could be days accrued that might be paid out to each resident at the completion of the residency (these may be used during the year for extraneous circumstances if deemed appropriate by the Residency Director). Vacation may not be taken during ASHP Midyear Meeting or SERC meeting days, or scheduled holidays/weekends in the staffing component of the residency. Vacation requested for June is discouraged and will be reviewed on a case by case basis by the Residency Director. Residents may not be absent more than 5 days from any rotation experience (professional leave/personal/vacation). 12 Sick Days are accrued over the course of the year. Refer to the hospital/department policy for details. Seven (7) Holidays (July 4 th, Labor Day, Thanksgiving Day, Christmas Eve, Christmas Day, New Year s Day, and Memorial Day) are accrued over the year. These must be taken. If required to work a holiday, the holiday is to be taken on an alternate day within 30 days of accrual. Residents will agree with rotation preceptor if the resident is to work the actual holiday or take an alternate day as the holiday. If the resident is scheduled on the pharmacystaffing schedule for a holiday, that shift prevails. 9

10 LICENSURE VERIFICATION Pharmacy licensure in Tennessee is a requirement for pharmacy residents at VUMC. The residency program director will confirm each resident has taken the NABPLEX and the Tennessee pharmacy law exam, or will take the Tennessee law exam upon transfer of NABPLEX scores from another state, or already had a valid Tennessee pharmacy license. Upon notification of successful completion of the NABPLEX and/or law exam the resident will provide documentation of licensure to the residency program director. The resident will provide the department the licensure certificate for display during the resident s year at VUMC. Licensure must be obtained no later than August 15th of the residency year. SUPERVISION AND WORK ETHIC The resident is expected to achieve the objectives of the Residency Program related to both administrative and professional practice skills. The resident reports to and is supervised by the rotation preceptor and the residency director. During staffing, the resident is under the supervision of the pharmacist in charge. Hours of practice vary according to the requirements set forth by the preceptor and director. The resident is expected to be present in body, mind and spirit at all assigned activities of the service they are currently a part of, including medical staff rounding, education classes, and administrative activities. It is not uncommon for the resident to be assigned duties that require work overnight or that may continue during days away from the hospital. Although these assignments will be frequent, they will not be beyond the expectations of other pharmacy professionals duties. An eight hour day is a minimum requirement for physical presence on site during assigned work days. The work of the Department is the resident s most important commitment. Working outside the residency program (moonlighting) is strongly discouraged, particularly at the beginning of the residency. Should posted time be available inside the Department, the resident will be paid at a competitive staff pharmacist rate. To work overtime, the resident must be trained in the area. Extra work moonlighting and overtime work must be approved by the Residency Director, and hours worked will be reported on a monthly basis by each resident. The ACGME duty hour requirements are to be followed at all times. Additional policies applicable to pharmacy residents should be reviewed at the following websites: Vanderbilt Human Resources Website: VUMC Website: VUH Pharmacy Residency Policy: MANUAL/Hpolicy.nsf/AllDocs/A09FD26D92F AB35F 10

11 PGY2 Informatics Pharmacy Residency: Activities/Requirements - Residency Experience Synopses - Tracking Form for requirement completion - Residency Project Requirement Overview and Timeline - Residency Project Description Worksheet - Completed Residency Project List ( ) - Suggested Timeline for Requirements Completion 11

12 INFORMATICS RESIDENCY EXPERIENCE ACTIVITIES Out-of-State Conferences: ASHP Midyear: Usually occurs the first week of December. Residents should start registration process for this meeting in July/August. Southeastern Residency Conference (TBD) This is usually in April or May in Athens, Georgia. Registration begins in January/February and Abstract submission deadline is usually around February 15. Residents are responsible for meeting these registration deadlines. Residents are to confirm these deadlines and register in early January. Information for this conference can be found at: Hospital Pharmacy Practice: The residents will practice in a guided hospital practice scheduled every fourth weekend and selected holidays. The resident will gain experience in the IV room, Central dispensing area, Narcotic Room procedures, and responsibilities of the pharmacist in charge. Journal Club or Case/ Topic Conference: This is a longitudinal activity. Residents will sign up to formally present two case presentations during the residency year. The cases presented should revolve around an informatics topic relevant to PGY1 residents and pharmacists and be a case in which the resident was directly involved. This will include a self-evaluation and a formal evaluation. PowerPoint is preferred for this presentation. Resident attendance is required at all sessions. Seminars: Two formal presentations by each resident will be conducted during the residency year: One of these will be a Therapeutic Exchange. This presentation should be an informatics-related topic that will benefit pharmacists and residents. This is a 60 minute CE presentation. This is to be prepared and presented with PowerPoint. This will include a self-evaluation and a formal evaluation. Objectives are to be submitted 30 days prior to presentation date. The second formal presentation will be a minute presentation of the resident s residency project. This includes several practice sessions then the formal presentation with feedback/evaluation from preceptors and residents during practice and attendees at SERC. These presentations will be presented to the pharmacy department and other guests. Resident attendance is required at all sessions. Newsletter/Fast Facts: The informatics resident will be required to submit one fast fact for the newsletter (optional). Research Project: The informatics resident will conduct a research project over the course of the residency year. This project will include idea development, literature review, study design, IRB submission, data collection, data analysis, data interpretation, oral presentation and a written manuscript. The written manuscript is to include identification of an appropriate journal for potential submission and the following of the instruction to authors for that journal. The manuscript must be written and submitted in final form prior to completion of residency. The manuscript must be reviewed by the project mentor(s) and approved by the residency director. MUE: The informatics will assist PGY1 residents with medication use evaluation data as requested during the residency year. Recruitment: Residents will assist in the future resident recruitment and candidate selection process. Therapeutic Exchange: This is a weekly conference held at noon on Thursdays by the pharmacy department for pharmacists and technicians to obtain continuing education hours. Attendance by residents is strongly encouraged throughout the year. Medical Center Educational Programs: Noon conferences, departmental grand rounds, and other educational conferences are offered throughout VUMC. These are posted in the Vanderbilt publications. Residents are encouraged to attend various conferences related to specific rotations. 12

13 RESIDENCY PROJECT A project, administered by the resident and mentored by a primary preceptor, is required of informatics resident. The project is to be of benefit to the individual, the Department, and to the institution. It is also beneficial if the project is beneficial to our Vendor, McKesson Corporation. There is to be a significant amount of literature review, project design, data gathering, statistical evaluation, writing, and reporting done by the resident. The end product is a presentation at the Southeastern Residency Conference and a written manuscript suitable for publication in the pharmacy refereed journal, written in according to the Instructions for Authors of the American Journal of Health-System Pharmacists or selected journal requirements. Residency project ideas will be submitted by the Department to the residents early in the year. Deadlines are set for initial submission of project plans. Projects must be evaluated for feasibility and approved by the residency director before performing the project. One preceptor will be selected for each project who will act to facilitate the project, mentor the resident, and who shares responsibility for meeting deadlines, submission of applications for research (IRB, etc.), presentations and manuscript development and submission. The project plan submitted should be binding to the resident and to the preceptor(s) involved. Project designs will be reviewed by the program director. The program director will serve as a consultant and advisor for the residency project. Residents should make every attempt to stick as close to the following suggested schedule as possible: Month Day Progress Point July 31 Project topic and preceptor identified and submitted September 30 Initial literature review completed and bibliography compiled and submitted. October 31 Project protocol and statistical plan proposal due for presentation to the Residency Director/Council November 30 IRB applications submitted (background and materials/methods written as needed) February 28 Project data collection completed February 28 Meeting with statistician complete or established March 30 Data analysis April 1-24 Practice Sessions for SERC May 15 Manuscript submitted to project mentor for review June 1 Final Manuscript due to residency director 13

14 Residency Project Description Worksheet July 2013 Resident: Date of Initiation: Project Advisor: Date of Completion: Responsible Investigators: Department(s) Involved: Key Personnel to Obtain Approval From: Question to be answered: Expected Outcomes of the Study: Rationale for the Study: Defining Measurements: Data that will be collected: Databases to Study or Create: Data Analysis: Description of Results: Benefit to the Resident: Benefit to the Department: Likelihood of Publication: Commitments: 14

15 Resident Preceptor Other 15

16 Past Residency Projects Year Resident Title Comment Alan Chung Evaluation of an Integrated Computerized * Pharmacist Intervention Database Alan Chung Minimizing Alert Fatigue in a Pharmacy Computer System Matt Marshall Traffic Jams in the Medication-Use Superhighway * Wing Liu Reconciliation of Drug-Drug Interaction Alerts Between Customized and Commercial Database Compendia Vanitra Richards Evaluation of Contraindicated Drug-Drug Interaction in a CPOE System, a Pharmacy Information System, and an Electronic Prescribing System * * Presented at the Southeastern Residents Conference (SERC) in Athens, GA Presented at the ASHP Residency Poster Presentation 16

17 RESIDENT REQUIREMENT/ACTIVITY TIMELINE** (For Guidance Purposes Only; Dates are subject to change based on individual resident goals/assigned tasks)**this may not be all inclusive!** July August September October Baseline self-assessment (Entering resident interest and preference information) Project topic/preceptor selected Dates for Journal Club, Case Presentation, CE Presentation Project topic/preceptor confirmed Project literature review and bibliography completed and submitted. Register for ASHP Midyear Meeting Project design/methods write-up complete Project Proposal Presentation follow-up with IRB submissions If taking a poster to MYCM, investigate deadlines for abstract submission Once IRB approved, establish timeline for project data collection and analysis etc. Topics for Therapeutic Exchange selected Assist PGY1 residents with MUE data as requested November If taking a poster to MYCM need to complete slides by Nov 20 Recruitment Showcases December January February ASHP Midyear UHC Posters, showcase Have you taken 5 days of vacation in the first half of the residency? Therapeutic Exchange (TBD) Wind up data collection for project Begin organizing data preliminary results Therapeutic Exchange if not completed in January March Project Final results due March 15 th. Project Results interpreted and slides complete March 30 th. April May Project Manuscript work Project manuscript first draft completed early May June Final Project manuscript due June 15 All requirements fulfilled no later than June

18 PGY2 Informatics Pharmacy Residency: Evaluation Process and Requirements - Evaluation Process Description - Resident Documentation Requirements 18

19 EVALUATIONS An essential component of developing the skills of a resident is frequent two-way feedback between residents and preceptors. The preceptors, program director, and residents will frequently provide feedback to one another via formal evaluation. Evaluation will occur as described below: a. Rotation Summative Evaluations: Due no later than 3 days after the end of the previous rotation period (3 business days). This is a written evaluation of the resident s performances in meeting the objectives of each rotation. The resident and preceptor will review these evaluations together. The resident will also complete a preceptor and rotation evaluation and a self-evaluation. b. Quarterly Evaluation (Staffing): Staffing is a longitudinal evaluation where a written evaluation of the resident s progress is completed. Rotation and preceptor evaluations must also be completed on a quarterly basis for these experiences. c. Criteria Based Assessments: evaluations of selected activities will be completed as a selfevaluation as well as a designated preceptor will evaluate the resident. Case/Topic Conferences (evaluation preceptor will be assigned) Journal Club (evaluation preceptor will be assigned) Therapeutic Exchange (evaluation preceptor will be assigned) Newsletter Fast Fact Others as applicable d. Residency Council Reports a written evaluation based on period review by the residency council. This evaluation examines overall progress, including integration of skills learned in separate rotations, non-rotation objectives/experiences, progress on longitudinal requirements/rotations (residency project, criteria assessments etc.) and any pertinent trends or information found in evaluations to that date. a. Progress on yearly goals/objectives b. Staffing c. Inter-professional communications/relations d. Professional presentation (verbal communication, dress, style, content) e. Planning and Organizing/meeting deadlines f. Enthusiasm/initiative/disposition g. Status of scheduled presentations, residency project, criteria based assessments, time worked, time off All evaluations are to be discussed personally between resident and preceptor. All evaluations (rotation summative on resident, resident on preceptor and resident on rotation overall), CBAs, and self-assessments, should be forwarded to the resident program director or designee in electronic format. A hard copy should be printed and signed by resident, evaluator, and program director. The hard copy should be filed by the resident in the resident s residency notebook. 19

20 RESIDENT DOCUMENTATION Each resident will maintain/submit the following documentation: 1. Summative Self-Evaluation: Required for each rotation, concentrated experience, and longitudinal experience. Due 3 business days after the completion of the previous Rotation period. Self-Assessment on progress of goals and objectives assigned to the learning experience. Summary of how your residency goals and objectives were met/unmet during the rotation period. Summary of your professional strengths and weaknesses during the rotation period. As the year progresses, compare to previous time periods and always include what is a focus for improvement for the next time period as well as what has been achieved. 2. Rotation and Preceptor evaluations will be submitted to the preceptor and then program director or designee 3 business days following the completion of the rotation or designated quarterly evaluation completion dates. 3. Many Criteria Based Assessments (CBAs) are to be initiated by the resident as opportunities are encountered then evaluated with corresponding preceptor and then forwarded to the program director or designee. Resident initiated CBAs: Case Conferences* (evaluation preceptor will be assigned) Journal Club* (evaluation preceptor will be assigned) Therapeutic Exchange* (evaluation preceptor will be assigned) *Require self-assessment 4. Each resident will compile a residency notebook for the year to include: The contents are to include suggestions/edits/drafts/final copies as worked on between resident and preceptor(s) as well. 1. Documents described above 2. All evaluations 3. In-services presented (handouts and outlines, slides) 4. Cases presented 5. Any education programs presented 6. Written projects or proposals *The contents of the residency notebook serve as documentation of activities completed during the residency year. The residency yearbook is a permanent record which is the property of Vanderbilt University Medical Center.* 20

21 PGY2 Informatics Pharmacy Residency: Longitudinal Rotation Experience Descriptions - Hospital Pharmacy Practice (Staffing) 21

22 HOSPITAL PHARMACY PRACTICE (STAFFING) (This is a guideline and will be dependent on staffing location assignment. The PGY2 resident will have a similar staffing experience model as the PGY1 residents, however, depending on the PGY2 prior staffing experience, goals and objectives may be adjusted as needed to ensure staffing competency of the PGY2 resident. It is an expectation that informatics resident will provide oversight to the PGY1 residents in dispensing roles and clinical monitoring roles when PGY1 and PGY2 residents are staffing simultaneously). Expectations for Residents in First Quarter Staffing Assignment Orient to the Central Pharmacy and learn the procedures of both the unit dose area and the sterile products preparation areas. Adjust to the scheduling assignments and focus on being present and ready to work in the assigned area at the assigned time. Stay in the work area during your entire shift and be available to focus on the work at hand. Observe appropriate break time such as 30 minutes for lunch breaks. Learn to indicate any scheduling adjustments on the posted pharmacist schedule such as swaps in assignments Develop an understanding of the systems and processes and develop skills such as with CPOE order processing ( VOP ). Develop relationships with the Central Area team. Be careful to ask a more senior pharmacist before making changes to work processes. Follow the established dress code and other workplace policies. Be sensitive to the needs of the other staff in the area and do not routinely ask to leave early. Make sure that work is caught up prior to leaving your assignment. Begin to develop a broader view of the work place and rotate among the various stations (AcuDose check or cart check, pharmacy labels on Zebra, extemp prep, packaging machine, phones, tube station, IV Room, etc.) in order to maintain and effective work flow and efficiency level. Learn to collaborate with other staff members shift regarding work flow issues or whenever time may become available to work on projects but remain available to return your focus to the work at hand whenever workload increases. Remain flexible and ask questions. Once initial training is complete, primary assignment will be in the Unit Dose area. Resident will check in with the pharmacist and technician mentors at the end of each weekend shift to see if there are suggestions for improvement. If mentors are not working on the same weekend, resident will check in with their mentors at the next available opportunity to discuss any questions. Expectations for Residents in Second Quarter Staffing Assignment Demonstrate proficiency in all areas of the Central Pharmacy. Demonstrate proficiency with systems and processes and manage the established levels of efficiency. Demonstrate a broad view of the work place and rotate among the various stations maintaining effective workflow and efficiency. Primary assignment will be to float between the IV Room and Unit Dose areas Begin to observe the Pharmacist in Charge (PIC) role Resident will check in with the pharmacist and technician mentors at the end of each weekend shift to see if there are suggestions for improvement. If mentors are not working on the same weekend, resident will check in with their mentors at the next available opportunity to discuss any questions. Expectations for Residents in Third Quarter Staffing Assignment Begin training in the Junior Pharmacist in Charge (PIC) role The resident (junior) and the normal (senior) management person on the weekend will both be designated as PIC. These two persons will work together to manage the personnel and workflow. The normal management person can help teach the resident how to solve problems that arise during a shift. The resident will not be in the float position unless scheduling dictates this as a need. However, part of being PIC includes assessing both the unit dose and IV areas and helping in all areas. The resident has an increased responsibility to keep in touch with the workflow and employees during the shift. The resident should assure all work has been completed for the shift prior to approving 22

23 anyone to leave early (then check with the lead tech and check who is working in an overtime slot to help with these decisions). Communicate end of shift issues to the unit dose area evening pharmacist prior to leaving. Personnel conflicts, staffing problems, catastrophes, and occupational health issues will defer to the senior management person designated for the weekend. Resident will check in with the pharmacist and technician mentors at the end of each weekend shift to see if there are suggestions for improvement. If mentors are not working on the same weekend, resident will check in with their mentors at the next available opportunity to discuss any questions. Expectations for Residents in Fourth Quarter Staffing Assignment Resident will be assigned as the PIC and make independent decisions regarding issues that arise with little assistance from the senior pharmacists. Residents should keep track of DI calls, extra tasks and problem solving they are involved with to review with his/her mentor. Expectations for Mentors Check in with residents at the end of each weekend workday or as soon as possible after their weekend to work to discuss their staffing and PIC roles and answer any questions that arise. Observe the residents during their staffing and PIC roles and offer tips and suggestions for improvement. Provide feedback to the resident from other staff members as appropriate regarding their work performance. Prepare the quarterly evaluations for the residents in regard to their staffing experiences. Expectation of Residents Submit a report of activities learned, accomplishments, problems solved etc. as well as areas in need of clarification or focus for the next weekend by Monday following your weekend worked. 23

24 Appendix 24

25 QUARTERLY RESIDENT TRAINING PLAN SELF-ASSESSMENT ASSISTANCE SHEET If you want to grow personally and/or professionally you have to take an honest look at where you are before you can decide where you want to go. A serious self-evaluation is very helpful if done on a regular interval basis. Prepare a summary of how your residency goals and objectives were met/unmet during the rotation period, what were your professional strengths and weaknesses during the rotation period and the progress you have made on longitudinal requirements (projects, criteria based assessments etc.) and an assessment of personal/professional life balance. The following questions facilitate a positive self-reflection and make the process more effective. These questions will be fuel for helping you understand how progress is being made and what course corrections are necessary. They also open the door for some serious career mentoring. You may want to discuss the answers you arrive at, or not. Most importantly, the questions may help you discover the skills you need to achieve your goals. Think about these types of questions when completing your progress review form. Use the Assessment FORM to complete this exercise. Career 1. What are my desired professional outcomes for the next year? 2. What are the most significant professional challenges for the next year? 3. What are the most significant professional opportunities for the next 3 to 5 years? 4. Who am I not working well with, and how can I make the relationship better? 5. What issues keep me up at night? 6. What have I learned about myself while working at my job? 7. What would I like to see my hospital modify? 8. What have I learned from my staff/co-workers and from working for my hospital? 9. What will I commit to make me better and to make those around me better? Personal 1. What are the most valuable achievements/goals I attained in the past 4 months? 2. How can I improve the way I am dealing with the current challenges in my life? 3. What are my most significant personal goals for the next period? 4. What do I need to keep doing? 5. What would I like to change about myself? 6. What are my most significant personal challenges for the next period? 7. How am I treating the most important people in my life? 8. How could I treat the most important people in my life better? 9. How will I add joy to my life in the next period? 10. What do I wish for the future? Preparing for my next step 1. Would I work better in a large or small organization? 2. Do I prefer working in a team environment or on my own? 3. Am I more comfortable following than leading? 4. Do I prefer to analyze situations and projects over actual implementation of an action plan? 5. Do I prefer to work with people or things? 6. How do I work under pressure? 7. Am I a good planner or idea person? 8. Am I a good listener? 9. Am I able to think quickly and articulate myself on the spot? 10. Am I able to make decisions in a timely manner? 11. Do I express myself well verbally and in writing? 25

26 12. What characteristics do I admire in others? 13. What do I enjoy most about my major? 14. What aspects of my current job do I enjoy? What do I dislike? 15. In the next five years what would I like to accomplish? 16. What level of responsibility do I hope to reach in the future? 17. How will I achieve my career goals? What skills, knowledge, and experience do I need? 26

27 Evaluation Due Dates 1. Rotation Summative Evaluations 2. Resident Self Progress Review Reports 3. Preceptor/Rotation Evaluations Clinical System Clinical Pharmacy Sys Clinical Rotation Clinical Decision Support Project & Research Data Management Med Safety CDS II Technical Concepts AdminRx & Vendor Ambulatory Due Dates 8/30/13 9/30/13 10/28/13 11/28/13 1/31/14 2/28/14 3/28/14 4/28/14 5/30/14 6/27/14 Longitudinal Summative Evaluations 1. Residency Project 2. Staffing 3. Automation Project A B C D Due Dates Sept 30 Dec 31 March 31 June 23 27

28 Resident Presentation Series: Pharmacy Conference Room: 12-1P Journal Club Resident Evaluator August 27 Juliana Kyle September 10 Megan Bodge Megan Hames September 24 October 8 October 22 November 5 January 14 February 4 March 4 March 25 April 1 April 15 Jeremy Moretz Dan Johnson May 6 Megan Bodge Mahsa Talbott Case Conference Resident Evaluator September 177 Jeremy Moretz Dan Johnson September 17 October 15 October 15 November 19 November 19 January 21 January 21 February 18 February 18 March 18 March 18 April 8 April 8 May 20 May 20 Megan Bodge Juliana Kyle Susan Hamblin Jon Aston Julian Kyle Stefanie Bala Therapeutic Exchange Resident Evaluator August 22 August 29 September 5 September 12 September 19 September 26 October 3 Juliana Kyle Jennifer Gray October 10 Jeremy Moretz Dan Johnson October 17 Susan Hamlin June 5 Megan Bodge Research Preceptor 28

29 Initial Orientation Days starting after July 1 Day 1 Orientation Department Policies, residency policies, staffing orientation, biosketch, orientations schedule and checklist, interest inventory Day 2 Orientation Quantifi clinical documentation (Bob Lobo), Veritas - medication safety Carly Feldott, general informatics orientation Day 3 Orientation general informatics orientation Day 4 Orientation general informatics orientation Day 5 Orientation general informatics orientation Day 6 Orientation general informatics orientation Day 7 Orientation general informatics orientation 29

30 Resident: Pharmacy Resident Orientation Checklist Central Pharmacy Orientation Checklist Orientation Items Resident Initials Trainer Initials Date Reviewed General Daily work flow Unit Dose Area Times and associated tasks Review Pharmacist Shift slots and associated duties Pharmacist in charge IV/Central UD Float Central UD IV/TPN Review how to read/interpret staffing schedule Review daily Technician slots and associated responsibilities Procurement Process Storeroom Staff Storeroom Responsibilities Storage locations: walk in fridge, storeroom, Med Carousels, PakPlus room, Over fill cart, IV/TPN room Med Carousel/Connect Rx Process Log In code given Pull on demand pick Review of AcuDose/Cartfill Process Pharmacist Scan process Acceptance of AcuDose zones AcuDose Fill Process AcuDose Orientation with Frank Ray Checking AcuDose Doses AcuDose Log-in and Filling AcuDose Machines Narcotic Check in Narcotic Room Medication Error Recording Process in the Central Area Internal Errors External Errors Narcotic Room Procedures CII Safe Log-in and orientation with Jason Broom Checking process Discrepancy resolution Narcotic orders attachment in HMM (patient specific) Cart Fill Process Pull process from Med Carousel Check Process 30

31 Catch-up Doses Delivery of meds to patient specific med drawers Look alike Sound alike medications Extemp Process Set up/filling Process Checking Process Non-Sterile Compounding area Orientation to Area What type of products made Who to ask if questions PCCA Order Processing (Vopping) in Central Areas, Central order processes for service areas What to send to the ED How to Clarify an order (resident pager list/operator) Crash Carts 6 month expiration Red Locks Charges ED Trays Specific References: Psych book, IV reference manual etc. Blood Factor book, Clozaril, MSDS, etc. Borrow/Loan policy and procedures Unit dose packaging TadPoles Bar coding Responsibilities of Pharmacy Unit Dose Packaging Options How to check items in Pak Plus Tube system policy and procedures Tube System Competency Check List *Outpatient prescriptions, Stallworth and Psych Hospital Procedures on weekends (cover on first weekend) 31

32 IV Room Orientation Checklist Orientation Items Resident Initials Trainer Initials Date Reviewed General workflow and distribution of responsibilities amongst pharmacists and technicians How to find things in the IV room IV preparation policy and procedures Set up of IV Preparations and Batches Reconstitution of vials Preparation of syringes, PB, LVP and checking these Storage of medications prior to delivery Delivery Schedule Sterile products preparation check off Call for medications Review of how we meet USP 797 Latex allergy policy and procedures Review of IV resources: how to determine compatibilities, expirations, IV manual, IV room website, latex website Narcotic Preparation and wastage Log sheets Wastage record Record of Rx number in patient maintenance Standard Time Schedules Investigational Drug Area Outpatient Areas Orientation Checklist Orientation Items Resident Initials Trainer Initials Date Reviewed Review of what and where all outpatient pharmacy services are located, hours, key persons Indigent Med Program: policy and procedures Discharge Meds and Counseling Program: policy and procedure Process for prior authorization etc of high cost drugs and our policy/procedure for handling these (identify main agents etc.) Hayley Rector: How we manage the purchase, distribution and charging of medications used in the clinics Medicare/TNCare issues Sample pharmacy: policy and procedures, location, products available, how it works, who pays for it, and why we offer this service What are the toughest problems in clinic medication 32

33 reimbursement Hemophilia Clinic Hours of operation and scope of service Johnna Oleis role in hemophilia patients and how that compares to others with similar roles across the country Best DI reference for this topic What does the clinic service entail on a regular basis Financial issues for patients/clinic/hospital Family/Social issues Product selection How the pharmacy should respond to calls/orders for factors How to keep up to date in this specialized area Coumadin Clinic Tommy Meador Who is serviced/eligible How to enroll a patient (StarPanel) How information is communicated/documented Policy and Procedures/Protocol CC follows Staff involved in clinic Standards of care in regards to anticoagulation History of the service at Vanderbilt Credentials involved and structure of providing this service Quality assurance/improvement in this area Satellite Pharmacies: Terry Bosen 3 rd & 4th Pharmacy Orientation Checklist Orientation Items Resident Initials Trainer Initials Date Reviewed Orient to satellites Locations Areas serviced be each and AcuDose locations Hours Practice in HMM Medication order processing Access patient, med profile, update information, generate missing dose labels/charges, schedule IV fluids Area specific order entry issues: epidural orders, PACU Orders, OB ABX orders, dialysis, Chemo meds, ACLS Dosing sheets Order clarifications Work flow Pharmacist and technician responsibilities Adverse Drug Reaction reporting, Medication Error reporting Customer Service Focus Intervention Documentation Telephone Courtesy/Etiquette 33

34 IV medication administration policy and chart Meds/Devices brought from home PCA Pump Policy DI Resources: Micromedex, Lexi-Comp, Kings, Facts & Comp, Up to Date, Trissell s, Pubmed Alaris GuardRails for IV pumps How to use phone and beeper system Oncology Satellite Orientation Checklist Orientation Items Resident Initials Trainer Initials Date Reviewed Hours of operation and scope of services Staff introduction and their roles Direct patient care responsibilities: clinic, infusion area, inpatient and stem cell Committees and boards oncology works with Staff education in oncology satellite How to handle a chemo spill What situations should the resident call the Onc satellite What type of counseling does the staff provide to patients Proper procedures for reviewing an oncology order Oncology references Proper procedures for preparing chemotherapy Review and demonstration Proper procedures for disposing of chemotherapy Study Protocols/Investigational Drugs 34