PGY1 Pharmacy Practice Residency Manual 2012-2013 Table of Contents Section I Training Manual Page 1. Purpose and philosophy 3 2. Organization Structure 4 3. Program Goals 5 4. Residency Program Structure 6 5. Benefits 7 6. Verification of licensure 8 7. Supervision and Work Ethic 8 8. Policy Access 8 9. Required experiences and activities 10-11 10. Tracking Form 12-13 11. Residency Project 14 12. Residency Project Worksheet 15 13. Past Residency Project List 16-17 14. Project/Activity Timeline 18 15. Evaluations 20 16. Documentation 21 17. Hospital Pharmacy Practice (Staffing) Overview 22 Section II Section III Schedules / Calendars 1. Resident Rotation schedule 27 2. Evaluation Due Date Schedule 28 3. Residency Council Dates 29 4. Presentation Calendar 30 5. Orientation Discussion schedule 31 6. Orientation Checklist 32-35 7. Orientation Schedule 36 Resident Portfolio 1. Presentations 2. Projects 3. Assignments 4. Evaluations 1
Pharmacy Practice Residency Program: Structure Purpose and Philosophy Departmental Organization Chart Program Goals Program Structure Benefits PURPOSE AND PHILOSOPHY The purpose of this residency is to develop a pharmacist with the skills and abilities to successfully practice as an acute care pharmacist, adjunct faculty member and/or be prepared to pursue and complete PGY2 residency training. Philosophy The ASHP accreditation standard provides criteria that every program must meet in order to receive and maintain accreditation. Although the standard requires experiences in certain core areas, there is room for concentration in a practice area and for additional experiences. The mission of our program includes developing a core skill set in drug information and literature evaluation, pharmacotherapy evaluation and management, project based research and team functioning, presentation development and delivery, and direct patient interaction. 2
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PROGRAM GOALS The residency program will provide each resident with specific learning/practice experiences designed to enable the resident to expand the scope of his/her practice skills. Outcomes R1 R2 R3 R4 R5 R6 E2 E6 E7 E8 Patient Care Manage and improve the medication-use process. Provide evidence-based, patient-centered medication therapy management with interdisciplinary teams. Exercise leadership and practice management skills. (Overall Performance and Administration Rotation) Demonstrate project management skills. (Projects) Provide medication and practice-related education/training Utilize medical informatics. Exercise added leadership and practice management skills. Provide drug information to health care professionals and/or the public. Demonstrate additional competencies that contribute to working successfully in the health care environment. Demonstrate additional competencies that contribute to working successfully in the health care environment (additional) R2.10 Evaluate patients progress and redesign regimens and monitoring plans.. R2.11 Communicate ongoing patient information R2.12 Document direct patient care activities appropriately. R2.2 Place practice priority on the delivery of patient-centered care to patients. R2.3 As appropriate, establish collaborative professional pharmacist-patient relationships. R2.4 Collect and analyze patient information. R2.5 When necessary, make and follow up on patient referrals. R2.6 Design evidence-based therapeutic regimens. R2.7 Design evidence-based monitoring plans. R2.8 Recommend or communicate regimens and monitoring plans. R2.9 Implement regimens and monitoring plans. Practice Foundation Skills R1.5 Provide concise, applicable, comprehensive, and timely responses to requests for drug information from patients, health care providers, and the public. E8.1 E8.2/7.2 E8.3/7.3 E8.4/7.4 Use approaches in all communications that display sensitivity to the cultural and personal characteristics of patients, caregivers, and health care colleagues. Communicate effectively. Balance obligations to oneself, relationships, and work in a way that minimizes stress. Manage time effectively to fulfill practice responsibilities. R2.1 As appropriate, establish collaborative professional relationships with members of the health care team. R3.1 Exhibit essential personal skills of a practice leader. R3.3 Exercise practice leadership. Practice Management E1.1 Design, execute, and report results of investigations of pharmacy practice-related issues. E2.2 Understand the pharmacy procurement process. E2.6 Understand the process of managing the practice area's human resources. E6.1 Participate in the organization s formulary process. E7.1 Identify a core library, including electronic media, appropriate for a specific practice setting. E8.5 Make effective use of available software and information systems. R1.1 Identify opportunities for improvement of the organization s medication-use system. R1.2 Design and implement quality improvement changes to the organization s medication-use system. R1.3 Prepare and dispense medications following existing standards of practice and the organization s policies and procedures. Demonstrate ownership of and responsibility for the welfare of the patient by performing all necessary aspects of the medication-use R1.4 system. R3.2 Contribute to departmental leadership and management activities. R4.1 Conduct practice-related investigations using effective project management skills. R5.1 Provide effective medication and practice-related education, training, or counseling to patients, caregivers, health care professionals, and the public. R6.1 Use information technology to make decisions and reduce error. 4
STRUCTURE Orientation (required) Core Rotations (required) Transitional Elective Rotations (choose 4) Hospital Orientation Residency/RLS Computer Training Hospital Practice Hospital Pharmacy Practice Projects ASHP Midyear Administration General Internal Medicine Critical Care (pick one) Surgical ICU Trauma ICU Medical ICU Longitudinal (required) Drug Information P&T MUE Journal Club Case Conference Hospital Pharmacy Practice Staffing (operational and clinical) Residency Project Seminars Tx Exg CE 60min Residency Project 15-30min Criteria Based Skill Assessments (CBAs) Solid Organ Transplant Bone Marrow Transplant General Pediatrics Hematology/Oncology Nutrition Infectious Disease Critical Care Medicine Trauma Burn Surgical Geriatrics Coumadin Clinic HIV/AIDS Cardiology ICU Pediatrics NICU Pediatrics Informatics 5
BENEFITS Educational leave Books directly related to the residency Two weeks paid vacation, select holidays 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 do not pay NABPLEX fees or for reciprocation of license to TN. We will pay for transfer of NABPLEX scores. Photocopying directly related to residency Office space & computer workstation Employee Assistance Program Concierge Service Provision of personal electronic devices will be supplied by the hospital if they are essential to the work of the resident. Full access to Biomedical Library Lab coats are the responsibility of the resident, but can be purchased through the hospital Sick leave Financial support and professional leave for the University of Tennessee Annual Residency Program, the ASHP MYCM and the Annual Southeastern Residency Conference in Athens, GA Discounts at local merchants Limited financial support for presentations at Vanderbilt and outside the campus depends on the residents activities at the meeting (officer, presentation, etc) 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 Purchase of software, books, or other materials must be directly related to the achievement of residency objectives, and must be approved beforehand by the Residency Director. Explanation of Time Off: Residents (Exempt Status) o Fifteen vacation days are accrued over the course of the year. Ten (10) vacation days are available for use and must be taken during the year. Each resident must sign up for and take no less than one week of vacation time prior to January 15 of the residency year. (Residency Director may approve alterations in certain situations). In general, a maximum of five (5) of the 15 days accrued may be paid out to each resident at the completion of the residency (these may be used during the year for extraneous circumstances if deemed appropriate by the Residency Director). Vacation may not be taken during ASHP Midyear Meeting or SERC meeting days, or scheduled holidays/weekends in the staffing component of the residency. Vacation requested for June is discouraged and will be reviewed on a case by case basis by the Residency Director. Residents may not be absent more than 5 days from any rotation experience (professional leave/personal/vacation) unless approved by the Residency Director. o Requests for vacation days should be submitted to the Residency Director via electronic mail at least 4 weeks in advance for priority consideration. Requests made after the 4 week cut-off will be handled on a case-by-case basis in order to ensure appropriate staffing. All requests will receive a response within 2 business days. If for some reason the Residency Director is not available, the responsibility for reviewed vacation requests will be delegated to the Residency Coordinator. o 12 Sick Days are accrued over the course of the year. Refer to the hospital/department policy for details. o Seven (7) Holidays (July 4 th, Labor Day, Thanksgiving Day, Christmas Eve, Christmas Day, New Year s Day, Memorial Day) and 3 personal days are accrued over the course of the residency year. These must be taken. If required to work a holiday, the holiday is to be taken on an alternate day within 30 days of accrual. Residents will agree with rotation preceptor if the resident is to work the actual holiday or take an alternate day as the holiday. If the resident is scheduled on the pharmacy staffing schedule for a holiday, that shift prevails. The department also recognizes the day after Thanksgiving and New Years Eve in the department staffing rotation and these are handled and scheduled per department policy. 6
LICENSURE VERIFICATION Pharmacy licensure in Tennessee is a requirement for pharmacy practice residents at VUMC. The residency program director will confirm that each resident has taken the NABPLEX and the Tennessee pharmacy law exam, or will take the Tennessee law exam upon transfer of NABPLEX scores from another state, or already had a valid Tennessee pharmacy license. Upon notification of successful completion of the NABPLEX and/or law exam the resident will provide documentation of licensure to the residency program director. The resident will provide the department the licensure certificate for display during the resident s year at VUMC. Licensure must be obtained no later than July 31 of the residency year. SUPERVISION AND WORK ETHIC The resident is expected to achieve the objectives of the Residency Program related to both administrative and professional practice skills. The resident reports to and is supervised by the rotation preceptor and the residency director. During staffing, the resident is under the supervision of the pharmacist in charge. Hours of practice vary according to the requirements set forth by the preceptor and director. The resident is expected to be present in body, mind, and spirit at all assigned activities of the service they are currently a part of, including medical staff rounding, education classes, and administrative activities. It is not uncommon for the resident to be assigned duties that require work overnight or that may continue during days away from the hospital. Although these assignments will be frequent, they will not be beyond the expectations of other pharmacy professionals duties. An eight hour day is a minimum requirement for physical presence on site during assigned work days. The work of the Department is the resident s most important commitment. Working outside the residency program (moonlighting) is strongly discouraged, particularly at the beginning of the residency. Should posted time be available inside the Department, the resident will be paid at a competitive staff pharmacist rate. To work overtime, the resident must be trained in the area. Extra work moonlighting and overtime work must be approved by the Residency Director, and hours worked will be reported on a monthly basis by each resident. The ACGME duty hour requirements are to be followed at all times. Additional Policies Applicable to Pharmacy Residents Should be reviewed at the following websites: Vanderbilt Human Resources WebSite: http://hr.vanderbilt.edu/ VUMC Website: http://vumcpolicies.mc.vanderbilt.edu VUH Pharmacy Residency Policy: http://vumcpolicies.mc.vanderbilt.edu/e- MANUAL/Hpolicy.nsf/AllDocs/A09FD26D92F6770886257289005AB35F 7
Pharmacy Practice Residency: Activities/Requirements Residency Experience Synopses Tracking Form for requirement completion Residency Project Requirement Overview and Timeline Residency Project Description Worksheet Completed Residency Project List (1999-2012) Suggested Timeline for Requirements Completion 8
RESIDENCY EXPERIENCE ACTIVITIES Out-of-State Conferences: ASHP Midyear: Usually occurs the first week of December. Residents should start registration process for this meeting in August. Southeastern Residency Conference: This is usually in April or May in Athens, Georgia. Registration begins in January/February and Abstract submission deadline is usually around February 10. Residents are responsible for meeting these registration deadlines. Residents are to confirm these deadlines and register in early January. Information for this conference can be found at: http://www.rx.uga.edu/main/home/ce/programs-and-seminars/serc.asp#dates Hospital Pharmacy Practice: The residents will practice in a guided hospital practice scheduled every fourth weekend, selected holidays and one evening per week. The resident will gain experience in the IV room, Central dispensing area, Narcotic Room procedures, and responsibilities of the pharmacist in charge as well assist with clinical consults and dashboard monitoring. Journal Club: This is a longitudinal activity. Residents will sign up to formally present two current pharmacotherapy related studies during the residency year. This will include a self-evaluation and a formal evaluation. Resident attendance is required at all sessions. The primary goal of journal club is to exercise skills in critical thinking and literature evaluation. Case Conference: This is a longitudinal activity. Residents will sign up to formally present two case presentations during the residency year. The cases presented should revolve around pharmacotherapy topics and include primary literature and be a case in which the resident was directly involved. This will include a self-evaluation and a formal evaluation. PowerPoint is used for this presentation. Resident attendance is required at all sessions. Seminars: Two formal presentations by each resident will be conducted during the residency year: One of these will be a Therapeutic Exchange slot. This presentation should be a pharmacotherapy topic that includes some controversy and/or is a hot topic in pharmacotherapy. This is a 60 minute CE presentation. This is not just a review of a disease state. Primary literature is to be used as a guiding force to put this presentation together. This is to be prepared and presented with MS Power Point. This will include a self-evaluation and a formal evaluation. Presentation objectives and Title are to be submitted by July 15th to Gayle Lane. Self-assessment questions (~5 questions for the audience) will are due by August 1 st to Gayle Lane. The second formal presentation will be a 10-15 minute presentation of the resident s residency project. This includes several practice sessions then the formal presentation with feedback/evaluation from preceptors and residents during practice and attendees at SERC. These presentations will be presented to the pharmacy department and other guests. Resident attendance is required at all sessions. Pharmacy and Therapeutics Committee: Each resident will attend one P&T committee meeting and related subcommittees during the residency year. A drug monograph will be written and presented during this experience. This will be assigned by the P&T Pharmacist. Drug monographs require review and presentation of primary literature. A 10 minute power point presentation will be prepared that focuses on the drug s place in therapy, with a literature supported comparison and analysis of efficacy, safety and cost of the drug and its competitors. An opinion should be outlined with recommendation for formulary status. This will be presented to the P&T Committee. As new agents are constantly be approved by the FDA, monographs will be assigned as they come to the attention of the P&T Committee. A resident will have approximately 30 days to prepare the monograph once assigned. Newsletter/Fast Facts: Each resident will make 2 fast fact contributions to the newsletter. Research Project: Each resident will conduct a research project over the course of the residency year. This project will include idea development, literature review, study design, IRB submission, data collection, data analysis, data interpretation, oral presentation and a written manuscript. The written manuscript is to include identification of an appropriate journal for potential submission and the following of the instruction to authors for that journal. The manuscript must be written and submitted in final form prior to completion of residency. The manuscript must be reviewed by the project mentor(s) and approved by the residency director. 9
MUE: Each resident will complete one medication use evaluation during the residency year. These are assigned in the first or second quarter of the year and depending on the scope of the MUE chosen may be conducted individually or in pairs. Findings are to be summarized in a 10 minute power point presentation with recommendations of the most appropriate course of action based on the findings to the P&T Committee and/or appropriate committee. Recruitment: Residents will assist in the resident recruitment and candidate selection process. Therapeutic Exchange: This is a weekly conference held at noon on Thursdays by the pharmacy department for pharmacists and technicians to obtain continuing education hours. Attendance by residents is strongly encouraged throughout the year. Block Rotations: There are seven block rotation periods during the PGY1 residency year. Each block rotation period is approximately six weeks in duration. A minimum of five of the seven rotation periods must be completed in clinical patient care rotations. All residents must complete the following three required rotations: administration, internal medicine and either surgical or trauma intensive care. During block rotations, residents will fulfill many of the clinical core requirements of the residency as well as develop interest areas through selected rotations. Rotation requirements may vary based on preceptor. Criteria based assessments should be reviewed at the outset of each rotation by resident and preceptor to assure completion of all requirements by the end of the residency year. Medical Center Educational Programs: Noon conferences, departmental grand rounds, and other educational conferences are offered throughout VUMC. These are posted in the Vanderbilt publications. Residents are encouraged to attend various conferences related to specific rotations. 10
RESIDENCY EVALUATION TRACKING FORM RESIDENT: (Indicate date of completion in box) SUMMATIVE EVLAUATIONS Rotation Period Rotation 1 Rotation 2 Rotation 3 Rotation 4 Rotation 5 Rotation 6 Rotation 7 Preceptor s Evaluation Resident Self Assessment Preceptor/Rotation Eval LONGITUDINAL EVALUATIONS Hospital Practice Quarter 1 Quarter 2 Quarter 3 Quarter 4 Preceptor s Evaluation Resident Self Assessment Preceptor/Rotation Eval. Residency Project Preceptor s Evaluation Resident Self Assessment Preceptor/Rotation Eval Training Plan Progress Residency Council Report Resident Training Plan Self Assess PRESENTATIONS Case Presentations #1 #2 Preceptor s Evaluation Resident Self Assessment Formal Presentations #1 #2 Therapeutic Exchange/Seminar SERC Therapeutic Exchange/Seminar Self-Assessment JOURNAL CLUB/DRUG INFORMATION Journal Club #1 #2 Preceptor s Evaluation Resident Self Assessment DI Questions #1 #2 #3 #4 #5 #6 DI Researched Question Eval Resident Self Assessment Turn in to corresponding preceptor during rotation 11
PHARMACEUTICAL CARE/FOUNDATION SKILLS Drug Therapy or Practice Related Problem Solving #1 #2 Preceptor s Evaluation Resident Self Assessment Patient Counseling #1 #2 Preceptor s Evaluation Resident Self Assessment Documentation #1 #2 Preceptor s Evaluation Resident Self Assessment PROJECTS Title Proposal IRB Data Collection Presentation Manuscript MEDICATION USE EVALUATION Topic Proposal Data Collection Report Presentation P&T MONOGRAPH Topic Written Presented Evaluated Newsletter/Fast Fact #1 #2 Direct Patient Care Sterile Product Preparation Per Dept. Competency Procedures #1 12
RESIDENCY PROJECT A project, administered by the resident and mentored by a primary preceptor, is required of all residents. The project is to be of benefit to the individual, the Department, and to the institution. There is to be a significant amount of literature review, project design, data gathering, statistical evaluation, writing, and reporting done by the resident. The end product is a presentation at the Southeastern Residency Conference and a written manuscript suitable for publication in the pharmacy refereed journal, written in according to the Instructions for Authors of the American Journal of Health-System Pharmacists or selected journal requirements. Residency project ideas will be submitted by the Department to the residents early in the year. Deadlines are set for initial submission of project plans. Projects must be evaluated for feasibility and approved by the residency director / research committee before performing the project. One preceptor will be selected for each project who will act to facilitate the project, mentor the resident, and who shares responsibility for meeting deadlines, submission of applications for research (IRB, etc.), presentations and manuscript development and submission. The project plan submitted should be binding to the resident and to the preceptor(s) involved. Project designs will be reviewed by the research committee. The committee will serve as a consultant and advisor for the residency project. Project Deadline Schedule: Preceptor ideas due July 10 Project topic/title selected August 22 Study Protocol and data collection form complete October 12 IRB submission completed November 16 Project data collection complete March 1 Data analysis complete April 5 First manuscript draft May 31 Final revisions completed June 14 13
Residency Project Description Worksheet 2012 Resident: Project Advisor: Date of Initiation: Date of Completion: Responsible Investigators: Department(s) Involved: Key Personnel to Obtain Approval From: Question to be Answered: Expected Outcomes of the Study: Rationale for the Study: Defining Measurements: Data that will be Collected: Databases to Study or Create: Data Analysis: Description of Results: Benefit to the Resident: Benefit to the Department: Likelihood of Publication: Commitments: Resident Preceptor Other 14
Past Residency Projects 1999 2012 Year Resident Title Comment 1998-1999 Darryl McGuire, Jr. Evaluation of Empiric Treatment of Community Acquired Pneumonia 1999-2000 Leigh Black Assessment of Pharmacists Knowledge and Attitudes Regarding Pain Management Submitted for publication D Andrea Forbish- Skipwith Study of Dietary Supplement Use Among Medicine Patients 2000 2001 Amy Maulsby Preparing and Modeling Pharmacy Analysis Techniques in a Managed Care Plan Physician Order Entry - Vanderbilt Health Systems 2001 2002 Carly Feldott Pharmacist Involvement in a Managed Care Clinic Setting A Focus on Asthma Disease Management, Cost Management, and Practitioner Prescribing Patterns Lisa Izlar The Usage of Prophylactic Antibiotics in Coronary Artery Bypass Surgery Kimberly Moyers Pharmaceutical Care in an Epilepsy Clinic Jill VonDielingen The Role of Pharmacists in Disease State Management (Diabetes Focus) in a Managed Care Setting 2002 2003 Marty Baker Reestablishment of an Institutional Antibiogram Phase I: Identifying Trends in Resistance Christie Buchanan Pharmaceutical Intervention Improves Efficiency for High Risk Dyslipidemic Patients Compared to Usual Care Part I Lindy Taylor Factors and Issues to Consider in the Assessment of Adverse Drug Events among Hospitalized Patients To be published in AJHP November 2006 Karen Wilson Preventing Medication Errors with Smart Infusion Technology 2003 2004 James A. Carr Pharmaceutical Intervention Improves Efficiency for High Risk Dyslipidemic Patients Compared to Usual Care Part II Brian Fontenot Development and Implementation of a Pharmacy Discharge Counseling Service for the Patients of Vanderbilt Children s Hospital Brandy Greene Vancomycin Utilization Following Computerized Prescriber Order Entry (CPOE) Intervention Natalie Kittrell Protocol for Diagnosing and Treating Relative Adrenal Insufficiency 2004-2005 Paige Fuller Validation of an Innovative Computerized Vancomycin Dosing Nomogram Utilized by a Tertiary Care Teaching Hospital Shivani Patel Complications of Corticosteroid Therapy for Adrenal Insufficiency in Critically Ill Trauma Patients Hayley Rector Katie Smith Assessment of an Alcohol Withdrawal Prevention Protocol Appropriate Use of Patient-Controlled Analgesia Infusion Devices Published in AJHP Jan 2004 To be submitted 15
2005-2006 Jennifer Fosnot Effect of Bisphosphonates on Fracture Rates in Renal Transplant Patients Matt Conley Impact of Pharmacist Interventions on the Medication Use Process Kim Kelly Effects of Sympathetic Blockade on Outcomes in the Acutely Injured Patient Stacie Soja Implementation and Reliability Testing of the Confusion Assessment Method for the Intensive Care Unit (CAM- ICU) in Trauma Patients 2006-2007 Lindsay Dyer High Dose Antioxidant Therapy in Acutely Injured Trauma Patients Nikki Lokker Parents and OTC Medications: Do Literacy and Numeracy Impact Product Use? Mindy Mann Vasopressin Use in Trauma Patients with Severe SIRS Kanan Shah Out-of-hospital medication errors: A six-year analysis of the poison control national database 2007-2008 Erin Bedard Improvement of an Automated ADE Surveillance Tool for Warfarin Aylson Gibson Effect Of Subcutaneous Administration Of Insulin Glargine On Insulin Infusion Requirements In Critically Ill Burn Patients Erika Hunt The Pharmacokinetics of Gamma Glutamyl Cysteine in Rats Jon Aston Vancomycin Failure in Patients with Methicillin- Resistant S. aureus Nosocomial Pneumonia 2008-2009 Zac Cox Effects of a CPOE Clinical Decision Support Tool on the empiric Dosing and Monitoring of Tobramycin and Amikacin Chris Peryam Antibiotic Administration Timing: Impact of Clinical Decision Support and Barcode Technology Ashley Quintili Pain Control in the Postoperative Patient Population Darby Siler Impact of Extended Infusion Piperacillin/tazobactam on susceptibility patterns of gram negative organisms 2009-2010 Travis Fleming The Effect of Pre-operative Clopidogrel Use on Bleeding Outcomes in Cardiovascular Surgery Patients Monica Hanson Reliability of Preliminary BAL Culture Results in Critically Ill Surgical and Trauma Patients Amy Pennington Developing a Warfarin Training Program Kelli Rumbaugh Acid suppression medications and the risk of hospital acquired pneumonia in ICU patients 2010-2011 Jonathan Pouliot The Role of a Computerized Epidural Ordering Advisor in Reducing Administration of Concomitant Inappropriate Medications Allison Palmer Evaluation of a Modified Cefepime Dosing Regimen in ICU Patients Christi Parker The Incidence of Adrenal Insufficiency in Cardiac Surgery Patients Induced with Etomidate Angela Loo Analysis of C. difficile Infection Management at a Tertiary Care Academic Medical Center 16
2011-2012 Paul Moore Effects of antioxidant supplementation on the incidence of atrial arrhythmias in trauma patients at a level I trauma center Megan Hames Analysis of empiric antibiotic coverage in neutropenic leukemia patients at a tertiary care, academic medical center Michelle Huber Delirium and pain in the post operative cardiac surgery patient: a retrospective review Jenna Faircloth Evaluation of the efficacy of management for occluded enteral access Presented at the Southeastern Residents Conference in Athens, GA Published in a medical journal Presented at the ASHP Residency Poster Presentation Presented at the UHC Poster Presentation 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 watch your residency requirements tracking form! July August September October November December January February March April May Baseline self-assessment (Entering resident interest and preference information) Select and Develop 60 minute CE Presentation Dates for Journal Club, Case Presentation Selected, CE Presentation Project topic/preceptor confirmed Project literature review and bibliography completed and submitted. MUE topic selected and timeline for completion established. Register for ASHP Midyear Meeting Project design/methods write-up complete Project Proposal Presentation IRB submissions If taking a poster to MYCM, investigate deadlines for abstract submission How many Criteria Based Assessments have you completed? Pace yourself! Evaluate where you stand with longitudinal assignments (P&T Monograph, MUE) If you have not started your MUE start now! Project Proposal completion and submitting to IRB, establish timeline for project data collection and analysis etc. Are you working on your MUE? Just checking!!! Recruitment Showcases Case Presentations and Journal Clubs MUE timeline established and confirmed. If taking a poster to MYCM need to complete slide by mid November. Recruitment Showcases How many Criteria Based Assessments have you completed? Pace yourself! Résumé preparation and interview skills ASHP Midyear UHC Posters, showcase Register for SERC and Prepare SERC abstract Complete and submit SERC abstract Wind up data collection for project Case presentations and journal clubs How many Criteria Based Assessments have you completed? Pace yourself! Are you on track with your MUE? Project: begin organizing data analyze data - results Pre-SERC project presentation I, II, III, IV, SERC How many Criteria Based Assessments have you completed? Pace yourself! Project manuscript first draft completed May 15th June Final Project manuscript due June 15 All Criteria Based Assessment Requirements completed by Jun 15. All requirements fulfilled no later than June 20. 18
Pharmacy Practice Residency: Evaluation Process and Requirements Evaluation Process Description Resident Documentation Requirements 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 5 days after the end of the previous rotation period (5 business days). This is a written evaluation of the resident s performances in meeting the objectives of each rotation. The resident and preceptor will review these evaluations together. The resident will also complete a preceptor and rotation evaluation and a self-evaluation. Additionally, the resident will complete selected criteria assessment instrument s as a self-evaluation to be discussed with appropriate preceptor and/or program director. b. Pharmacy Practice Quarterly Evaluation (Staffing/Project): PP is a longitudinal evaluation where a written evaluation of the resident s progress is completed. Rotation and preceptor evaluations must also be completed on a quarterly basis for these experiences. c. Criteria Based Assessments: evaluations of selected activities will be completed as a self-evaluation as well as a designated preceptor will evaluate the resident. Counseling (evaluation preceptor=primary preceptor during that experience) Documentation (evaluation preceptor=primary preceptor during that experience) Problem solving (evaluation preceptor=primary preceptor during that experience) Researched DI Questions (evaluation preceptor=primary preceptor during that experience) Case Conferences (evaluation preceptor will be assigned) Journal Club (evaluation preceptor will be assigned) Therapeutic Exchange (evaluation preceptor will be assigned) Monograph (evaluation preceptor will be assigned) d. Residency Council Reports a written evaluation based on period review by the residency council. This evaluation examines overall progress, including integration of skills learned in separate rotations, non-rotation objectives/experiences, progress on longitudinal requirements/rotations (residency project, criteria assessments etc.) and any pertinent trends or information found in evaluations to that date. This report will track resident progress by goal quarterly using the 5 point scale established in this programs residency evaluation system. Progress of the resident s strengths, weaknesses and career goals will be documented. To satisfactorily complete the residency, the resident must have shown improvement over the course of the year in both resident and preceptor scoring. For any goals in which less than a score of 3 is averaged, the resident and program director will work together to develop individualized plans to assist in making progress in those areas by residency end. If the resident does not work towards those plans and progress improvement, residency completion with certificate may be compromised. On a quarterly basis, goals in which the resident has scored an average of 5 for two consecutive quarters will be removed from further evaluation. a. Progress on yearly goals/objectives b. Acute Care progress (rotations) c. Staffing d. CBAs e. Practice Mgmt: Inter-professional communications/relations f. Practice Mgmt: Professional presentation (verbal communication, dress, style, content) g. Practice Mgmt: Planning and Organizing/meeting deadlines h. Enthusiasm/initiative/disposition i. Status of: scheduled presentations, residency project, MUE, Performance Improvement, drug information, criteria based assessments, time worked, time off All evaluations are to be discussed personally between resident and preceptor. All evaluations (rotation summative on resident, resident on preceptor and resident on rotation overall), CBAs, and self-assessments, should be forwarded to the resident program director or designee in electronic format. A hard copy should be printed and signed by resident and evaluator and maintained in the resident s residency portfolio binder. The electronic database will document the review by the residency program director. 20
RESIDENT DOCUMENTATION Each resident will maintain/submit the following documentation: 1. Summative Self-Evaluation (Final Comments section): Required for each rotation, concentrated experience, longitudinal experience. Due 5 business days after the completion of the previous Rotation period. Self -Assessment on progress of goals and objectives assigned to the learning experience. Summary of how your residency goals and objectives were met/unmet during the rotation period. Summary of your professional strengths and weaknesses during the rotation period. As the year progresses, compare to previous time periods and always include what is a focus for improvement for the next time period as well as what has been achieved. 2. Rotation and Preceptor evaluations will be submitted to the preceptor and then program director or designee 5 business days following the completion of the rotation or designated quarterly evaluation completion dates. This should be presented to the preceptor the same day that the preceptor presents the block or longitudinal evaluation to the resident. The preceptor must sign off on this in the evaluation database as reviewed. 3. Many Criteria Based Assessments (CBAs) are to be initiated by the resident as opportunities are encountered then evaluated with corresponding preceptor and then forwarded to the program director or designee. Resident initiated CBAs: Counseling Documentation Problem solving Drug Information Researched Questions Case Conferences (evaluation preceptor will be assigned) Journal Club (evaluation preceptor will be assigned) Therapeutic Exchange (evaluation preceptor will be assigned) 4. A record of interventions is to be compiled on an ongoing basis. Many preceptors request a list of these pertaining to the rotation as part of the rotation summative evaluation. 5. Each resident will compile a residency notebook for the year to include: The contents is to include suggestions/edits/drafts/final copies as worked on between resident and preceptor(s) as well. 1. Documents described above 2. All evaluations 3. Inservices presented (handouts and outlines, slides) 4. Cases presented 5. Any education programs presented 6. MUEs, monographs, reports etc. 7. Written projects or proposals The contents of the residency notebook serve as documentation of activities completed during the residency year. The residency yearbook is a permanent record which is the property of Vanderbilt University Medical Center. 21
Pharmacy Practice Residency: Longitudinal Rotation Experience Descriptions Hospital Pharmacy Practice (Staffing) 22
HOSPITAL PHARMACY PRACTICE (STAFFING) (This is a guideline and will be dependent on staffing location assignment) Expectations for Residents in First Quarter Staffing Assignment Orient to the Central Pharmacy and learn the procedures of both the unit dose area and the sterile products preparation areas. Adjust to the scheduling assignments and focus on being present and ready to work in the assigned area at the assigned time. Stay in the work area during your entire shift and be available to focus on the work at hand. Observe appropriate break time such as 30 minutes for lunch breaks. Learn to indicate any scheduling adjustments on the posted pharmacist schedule such as swaps in assignments Develop an understanding of the systems and processes and develop skills such as with CPOE order processing ( VOP ). Develop relationships with the Central Area team. Be careful to ask a more senior pharmacist before making changes to work processes. Follow the established dress code and other workplace policies. Be sensitive to the needs of the other staff in the area and do not routinely ask to leave early. Make sure that work is caught up prior to leaving your assignment. Begin to develop a broader view of the work place and rotate among the various stations (Pyxis check or cart check, labels on PR16, extemp prep, packaging machine, phones, tube station, IV Room, etc.) in order to maintain and effective work flow and efficiency level. Learn to collaborate with other staff members shift regarding work flow issues or whenever time may become available to work on projects but remain available to return your focus to the work at hand whenever workload increases. Remain flexible and ask questions. Work on Clinical Dashboards. Once initial training is complete, primary assignment will be in the Unit Dose area. Resident will check in with the pharmacist and technician mentors at the end of each weekend shift to see if there are suggestions for improvement. If mentors are not working on the same weekend, resident will check in with their mentors at the next available opportunity to discuss any questions. Expectations for Residents in Second Quarter Staffing Assignment Demonstrate proficiency in all areas of the Central Pharmacy. Demonstrate proficiency with systems and processes and manage the established levels of efficiency. Demonstrate a broad view of the work place and rotate among the various stations maintaining effective work flow and efficiency. Primary assignment will be to float between the IV Room and Unit Dose areas Work on Clinical Dashboards Resident will check in with the pharmacist and technician mentors at the end of each weekend shift to see if there are suggestions for improvement. If mentors are not working on the same weekend, resident will check in with their mentors at the next available opportunity to discuss any questions. Expectations for Residents in Third Quarter Staffing Assignment As above with more autonomy Responsible for Clinical Dashboards Expectations for Residents in Fourth Quarter Staffing Assignment Begin training in the Junior Pharmacist in Charge (PIC) role 23
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 anyone to leave early (then check with the lead tech and check who is working in an overtime slot to help with these decisions). Communicate end of shift issues to the unit dose area evening pharmacist prior to leaving. Personnel conflicts, staffing problems, catastrophes, occupational health issues will defer to the senior management person designated for the weekend. Resident will check in with the pharmacist and technician mentors at the end of each weekend shift to see if there are suggestions for improvement. If mentors are not working on the same weekend, resident will check in with their mentors at the next available opportunity to discuss any questions. Continued responsibility of Clinical Dashboards Expectations for Mentors Check in with residents at the end of each weekend workday or as soon as possible after their weekend to work to discuss their staffing and PIC roles and answer any questions that arise. Observe the residents during their staffing and PIC roles and offer tips and suggestions for improvement. Provide feedback to the resident from other staff members as appropriate regarding their work performance. Prepare the quarterly evaluations for the residents in regard to their staffing experiences. Expectation of Residents Submit a report of activities learned, accomplishments, problems solved etc. as well as areas in need of clarification or focus for the next weekend by Monday following your weekend worked. 24
Appendix 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? 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
Rotation Schedule for 2012-2013 Draft PGY1 Amory Cox Emily Bullington Jeremy Moretz Juliana Kyle CC PGY 2 Paul Moore Onc PGY2 Megan Hames Tx Plant PGY2 Alexa Informa tics Rotation 1 Aug 1 to Sep 7 Orient. Orient. Orient. Orient. Jul CV/ Orientati on Gen Peds/PICU MICU TICU # Intern Med @ July Orient 7/6-23 Orient Jul Orientation Aug CVICU Aug 7/23-10/26 Liver Transplant Aug Clinical Systems Overview Rotation 2 Sep 10 to Oct 19 Admin # TICU Internal Med # Cardiology @ Sept Nutrition Sept 10/28 2/1 Renal/ Pancreas Sept Clinical Pharmacy Systems Rotation 3 Oct 17 to Nov 30 Heme/Onc Nutrition Cardiology @ Admin # Oct MICU Oct 2/4 3/1 Transplant ID Oct Clinical Rotation Rotation 4 Dec 12 to Feb 1 ASHP Midyear December 3 to December 7 Intern Med Cardiology @ Nov TICU Nov 3/4 6/7 Heart/Lung Txplant Heme/Onc ID # Dec Project Dec 6/10-7/4 Elective - TBA Nov Dec Clinical Decision Support Vendor & Project Mngt Rotation 5 Feb 27 to Apr 5 Rotation 6 Apr 8 to May 17 Project Feb 4 to Feb 22 Jan Jan Jan AdminRx and Smart Pumps ID Admin @ MICU # Gen peds Feb Burn Feb Feb Clinical Decision Support II Mar TICU March Mar Data Management Cardiology @ ID # TxPlant MICU Apr SICU April Apr Technical Concepts Rotation 7 May 21 to Jun 29 MICU # Intern Med Admin @ BMT May Heme/ Onc May May Ambulatory Care Jun PICU June Jun Medication Safety @ Warfarin Sentri 7 back-up only for anticoag pharmacist; # Aminoglycoside Sentri 7 daily check at 2:30to wrap-up non non-covered patients when TDM pharmacist unavailable. Vancomycin Sentri 7 daily check at 2:30to wrap-up non non-covered patients when TDM pharmacist unavailable. The @, #, and residents will work together if necessary to complete the dashboards. If one of the residents is off, the other will check both dashboards. On-call resident and Backup On Call Pharmacist covers when both preceptors and both residents are out. 27
PGY1 Project Days: Feb 4-22 Evaluation Due Dates 1. Rotation Summative Evaluations 2. Resident Self-Evaluation for Rotation 3. Preceptor/Rotation Evaluations Period 1 Period 2 Period 3 Period 4 Period 5 Period 6 Period 7 Due Dates Sept 14 Oct 26 Dec 7 Feb 8 April 12 May 24 June 24 Longitudinal Summative Evaluations: Quarterly Assessment 1. Residency Project Self Evaluation 2. Hospital Pharmacy Practice (Staffing weekends) Self Evaluation 3. Residency Council Quarterly Report: Individual Learning plan update 4. Any CBAs conducted during that quarter and the Self Evaluations A B C D Due Dates October 1 January 7 April 1 June 24 Residency Council Meeting Dates Mtg 1 Mtg 2 Mtg 3 + Recruiting Mtg Mtg 4 Mtg 5 Mtg 6 Mtg 7 Aug 21 Oct 9 Jan 15/Jan 29 Feb 26 March 26 May 14 June 20 28
Resident Presentation Series 2012-2013 Draft PCR 12-1:00 Journal Club Resident Evaluator August 28 Juliana September 11 Amory Susan October 2 Jeremy October 30 Megan Hames Mahsa November 27 Emily February 5 Jeremy Alexa March 5 Emily Paul April 2 Amory April 30 Megan Hames May 14 Juliana Case Conference Resident Evaluator September 18 Jeremy Susan September 18 October 16 Juliana October 16 Emily November 13 Paul Moore November 13 Amory Alexa February 19 Megan Hames Jon Aston February 19 Juliana March 19 Amory March 19 Jeremy April 16 Alexa Jen April 16 Emily Paul Therapeutic Exchange Resident Evaluator August 23 Megan Scott August 30 Amory Amy September 6 Jeremy Zac September 13 Juliana Kelli September 20 Emily Kristy September 27 Paul October 4 Alexa Christie October 11 Vanitra Richards P Stewart June 6 Megan Project Advisor 29