Mission: To extend the presence and healing ministry of Christ in all we do.

Residency Manual 2018-2019 UPDATED 7/18 Mission: To extend the presence and healing ministry of Christ in all we do. https://www.saintfrancis.com/careers/pages/careers%20in%20healthcare/pharmacy-careers.aspx

MIS The PGY2 Infectious Diseases Pharmacy Residency conducted by Saint Francis Hospital in Tulsa, Oklahoma, has an accreditation candidate status by ASHP. MISSION, VISION, AND VALUES Saint Francis Health System operates according to the Ethical and Religious Directives for Catholic Health Care Services and continually strives to integrate the values put forward in those directives. Mission Vision Values To extend the presence and healing ministry of Christ in all we do. Saint Francis Health System will be the leading integrated Catholic healthcare system providing high quality, comprehensive and innovative care across our regional continuum of services. Excellence: Promoting high standards of service and performance Dignity: Respecting each person as an inherently valuable member of the human community and as a unique expression of life Justice: Advocating for systems and structures that are attuned to the needs of the vulnerable and disadvantaged and that promote a sense of community among all persons Integrity: Encouraging honesty, consistency, and predictability in all relationships Stewardship: Ensuring prudent use of talents and resources in a collaborative manner SAINT FRANCIS HOSPITAL Saint Francis Hospital, a Catholic, not-for-profit healthcare organization affiliated with the Religious Sisters of Mercy, was founded in 1960 by William and Natalie Warren. Saint Francis Health System was formed in 1997 and now includes Saint Francis Hospital, The Children s Hospital at Saint Francis, Heart Hospital at Saint Francis, Saint Francis Hospital South, Laureate Psychiatric Clinic and Hospital, Saint Francis Hospital Muskogee, Saint Francis Hospital Vinita, Saint Francis Broken Arrow, Saint Francis Cancer Center, and Warren Clinic. Saint Francis Glenpool will be the region s first free-standing emergency room when it opens in 2018. Over 9,500 employees make Saint Francis Health System one of Tulsa s largest employers. More than 25 percent of employees have been with the health system longer than 10 years. More than 750 volunteers clocked more than 139,000 hours of service in fiscal year 2017. Saint Francis Hospital is the largest in Oklahoma. The health system provides services for more than 250,000 emergency room visits and more than 56,000 admissions annually. With more than 5,000 births, the health system leads the state in the number of deliveries performed annually at our facilities. The health system is licensed for more than 1,000 beds, including more than 200 critical care beds. The largest expansion in the hospital s history was completed in 2014 when an eight-story, 150-bed, 500,000 square foot patient tower and Trauma Emergency Center opened that includes acute and critical care capacity; new chapel and convent; clinical education rooms; and administrative and physician office space. Construction is currently underway on a surgery renovation that will add more than 15,000 square feet and 7 new operating rooms. An electronic medical record system was implemented in 2014 in order to provide safer, higher quality and costefficient outcomes. The system created a seamless, integrated electronic health record and replaced 18 separate systems previously in use. In fiscal year 2017, Saint Francis Health System provided $108,492,088 in community benefit, including nearly

$50,000,000 in charity care. HealthGrades, the nation s leading independent healthcare ratings organization, has named Saint Francis Hospital a Distinguished Hospital for Clinical Excellence and ranks Saint Francis Hospital among the top 5% of hospitals nationwide for clinical performance. In 2016, The Children s Hospital at Saint Francis became the eighth affiliate clinic of St. Jude Children s Research Hospital. Saint Francis Hospital is recognized with National Research Corporation s (NRC) Consumer Choice Award for providing outstanding healthcare to the Tulsa community. MRTMENT SAINT FRANCIS HOSPITAL PHARMACY DEPARTMENT The Saint Francis Health System Department of Pharmacy provides services for Saint Francis Hospital, The Children s Hospital at Saint Francis, Saint Francis Hospital South, Laureate Psychiatric Clinic and Hospital, Saint Francis Hospital Muskogee, Saint Francis Hospital Vinita, and Saint Francis Cancer Center. The pharmacy provides services for more than 45,000 inpatient admissions and 147,000 emergency department visits annually. The mission of the Saint Francis Hospital Pharmacy is to provide accurate, safe, effective, and timely pharmaceutical care. The department strives to be recognized as a regional and national innovator and leader in medication safety. The hospital's affiliations with two state colleges of pharmacy provide opportunities for interaction with pharmacy students. Complete renovation of the Saint Francis Hospital Pharmacy was completed in 2013. The pharmacy features a state-ofthe-art sterile compounding lab with a pass-through inventory carousel and pass-through refrigerators. Pharmacy inventory management systems have been expanded to include four inventory carousels. The pharmacy utilizes automated dispensing cabinet technology housewide for safe drug storage and distribution. The pharmacy utilizes a decentralized practice model that incorporates clinical pharmacists and clinical pharmacy specialists. SAINT FRANCIS HOSPITAL PGY2 INFECTIOUS DISEASES PHARMACY RESIDENCY PROGRAM HISTORY Saint Francis Hospital accepted the first PGY2 infectious diseases pharmacy resident for the 2017-2018 residency term. The first graduate entered practice as a clinical specialist in infectious diseases. The program is currently in candidate status for ASHP accreditation. PROGRAM PURPOSE The purpose of this twelve-month program is to develop competent, confident practitioners with expert knowledge, skills, attitudes, and abilities in infectious diseases pharmacotherapy and pharmacy practice. The Saint Francis Hospital Infectious Diseases PGY2 residency builds upon Doctor of Pharmacy (Pharm.D.) education and PGY1 pharmacy residency programs to contribute to the development of clinical pharmacists in advanced or specialized practice. PGY2 residencies provide residents with opportunities to function independently as practitioners by conceptualizing and integrating accumulated experience and knowledge and incorporating both into the provision of patient care that improves medication therapy. Residents who successfully complete an accredited PGY2 pharmacy residency should possess competencies that qualify them for clinical pharmacist and/or faculty positions and position them to be eligible for attainment of board certification in the specialized practice area (when board certification for the practice area exists). The program provides experiences in all aspects of infectious diseases pharmacy practice. The resident will develop advanced skills in pharmacokinetics, drug selection and dosing, and formulary management. Residents will have a leadership role in institutional dosing and monitoring services as well as antimicrobial stewardship initiatives. The program features opportunities for interprofessional collaboration and for the resident to serve as a subject matter expert in infectious diseases. Other leadership opportunities include mentoring PGY1 residents and pharmacy students, as well as participating in the health system s Antimicrobial Stewardship, Infection Control, and Pharmacy and Therapeutics Committees. Education opportunities include didactic lectures at a local university and teaching patients, students, and other health care providers. Major research projects provide exposure to developing study methods, collecting and analyzing data, and presenting findings.

Residents who successfully complete the PGY2 pharmacy residency are well-suited for advanced patient care, academic, or specialized positions, as well as specialty board certification. The residency program is designed and conducted in a manner that supports residents in achieving the following purpose and the required educational competency areas, goals, and objectives described in the ASHP Accreditation Standards for Postgraduate Year Two (PGY2) Pharmacy Residency Programs The following competency areas are taught and evaluated throughout the residency term: (1) Patient care (2) Advancing practice and improving patient care (3) Leadership and management (4) Teaching, education, and dissemination of knowledge SALARY & BENEFITS Pharmacy residents are eligible for full employee benefits. The Saint Francis Health System PGY2 resident will receive a salary of approximately $47,476 and earn up to 21 PTO days during the 12-month program. A travel stipend is provided for one major national meeting and a regional residency conference. Visit this site for additional details about employee benefits: https://www.saintfrancis.com/careers/pages/benefits.aspx CANDIDATE ELIGIBILITY To be eligible for residency training, candidates must be graduates or candidates for graduation of an Accreditation Council for Pharmacy Education (ACPE) accredited degree program (or one in process of pursuing accreditation) or have a Foreign Pharmacy Graduate Equivalency Committee (FPGEC) certificate from the National Association of Boards of Pharmacy (NABP). Applicants must be participating in, or have successfully completed, an ASHP-accredited PGY1 pharmacy residency program, or a program in the accreditation process. Applicants must also be licensed or eligible for licensure in Oklahoma. Proof of degree must be provided immediately upon conferral. Applicants with a Bachelor of Science degree from an accredited college of pharmacy are eligible if graduate coursework is supplemented with sufficient practical pharmacy experience to demonstrate the knowledge, skills, attitudes, and abilities essential to fulfill the educational goals and objectives of the program. APPLICATION Interested candidates should submit the following materials through Pharmacy Online Residency Centralized Application Service (PhORCAS) via WebAdmit: letter of intent college transcripts curriculum vitae three recommendations All application materials should be submitted to the Residency Program Director (RPD) by the program deadline specified on PhORCAS/WebAdmit. SFHS residency programs adhere to the Rules for the ASHP Pharmacy Resident Matching Program. Residency program applicants are evaluated and ranked according to the applicant's ability to meet the educational goals and objectives of the program. This residency site agrees that no person at this site will solicit, accept, or use any ranking-related information from any residency applicant. All program applicants are initially evaluated by telephone interview and review of submitted application materials. The initial evaluation

of written communication, transcript, references, graduate degree(s), pharmacy work experience, professional presentations, research experience, publications, leadership experience, professional organization membership, community service, awards, and telephone interview (program understanding, career goals, strengths and weaknesses, interest in clinical practice, and verbal communication) are utilized to select applicants for on-site interview. The following predetermined criteria are used in the evaluation and ranking of applicants invited for on-site interview: written communication, references, professional behavior and appearance, initiative, program understanding, career goals, strengths and weaknesses, interest in clinical practice, and verbal communication. In addition, applicants participating in an on-site interview are asked to provide a clinical presentation that will be evaluated by program preceptors. RPC (if applicable), residency preceptors, pharmacy management, and current residents participate in candidate evaluations and provide feedback to the RPD who is responsible for final candidate evaluation and match rankings as directed by the rules of the national Resident Matching Program (RMP). Candidates applying for unmatched residency positions are evaluated and selected during RMP Phase II using the same criteria as candidates selected via the RMP Phase I. The RPD issues a letter to matched residents outlining acceptance to the program after results of the match are received. The letter includes Information on the pre-employment requirements and other relevant information. Acceptance by residents of these terms and conditions, requirements for successful completion, and expectations of the residency program must be documented prior to the beginning of the residency. Early Commitment to PGY2 Infectious Diseases Pharmacy Residency Program Under certain circumstances a PGY2 residency program may commit a position to a current PGY1 resident in advance of the matching process, through the Early Commitment Process. The process will adhere to the guidelines set forth by the American Society of Health-System Pharmacists (ASHP) and NMS. During orientation, all PGY1 residents will be informed of the PGY2 residency available and the early commitment process. Only PGY1 residents in good standing will be considered for Early Commitment. Good standing is indicated by the following: the majority of the resident s preceptor evaluations demonstrate that the PGY1 resident is making Satisfactory Progress (SP) and is anticipated to be able to successfully complete the PGY1 residency program requirements by the conclusion of the training program and there are no violations of the Code of Conduct of the Health System. Procedure for Application/Selection for Early Commitment Based on each year s ASHP Midyear deadlines, a date in October will be selected by which residents who are interested in early committing to the PGY2 residency must submit a letter of intent to the PGY2 RPD. This letter states that the resident will accept the PGY2 residency if offered; however, it does not commit Saint Francis Hospital to offer the PGY2 residency to the resident. The PGY2 RPD will use direct observation, discussion with the resident, rotation evaluations, and inquiries of other preceptors to assess the resident s appropriateness for the PGY2 residency. The PGY2 RPD may choose to offer an interview. Residents will be evaluated on the following: written communication, professionalism and appearance, initiative, program understanding, career goals, strengths and weaknesses, interest in clinical practice, and verbal communication. Prior to the deadline for early commitment established by ASHP and NMS, the PGY2 RPD will decide whether or not an interested resident is selected for early commitment to the PGY2 residency. All residents applying to the PGY2 residency will be notified of the decision by the RPD prior to the deadline for submission to the Match. The exact date when the selection is made is at the discretion of the individual RPD. Based on the timing of this decision, it may be in the resident s best interest to participate in the ASHP Personnel Placement Service (PPS). The PGY2 RPD will notify NMS of the early commitment decision according to NMS policy.

LICENSURE REQUIREMENTS Oklahoma intern license is required prior to program start date, unless the resident is already a pharmacist licensed in Oklahoma. Residents must become a licensed pharmacist by the Oklahoma State Board of Pharmacy. Failure to obtain appropriate licensure by September 30 will result in dismissal from the residency program. ASSESSMENT Initial assessment At the beginning of the residency, the RPD in conjunction with preceptors, assess each resident s entering knowledge and skills related to the educational goals and objectives. The results of residents initial assessments are documented by the RPD or RPC (if applicable) in each resident s development plan by the end of the orientation period and taken into consideration when determining residents learning experiences, learning activities, evaluations, and other changes to the program s overall plan. Formative (on-going, regular) assessment Preceptors provide on-going feedback to residents about how they are progressing and how they can improve that is frequent, immediate, specific, and constructive. Preceptors make appropriate adjustments to residents learning activities in response to information obtained through day-to-day informal observations, interactions, and assessments. Summative evaluation At the end of each learning experience, residents receive, and discuss with preceptors, verbal and written assessment on the extent of their progress toward achievement of assigned educational goals and objectives, with reference to specific criteria. Written assessment is documented in PharmAcademic. Evaluations are completed by the due date or within 7 days. Ratings used for evaluation of goals and objectives during summative evaluation are: Achieved for the Residency (ACHR). The resident has fully mastered the goal for this learning experience. No further instruction or evaluation is required in subsequent learning experiences. Achieved (ACH). The resident can perform associated activities independently for this learning experience. Satisfactory Progress (SP). This applies to a goal whose mastery requires skill development in more than one learning experience. The goal will be taught in future learning experiences. In this current experience the resident has progressed at the required rate to attain full mastery by the end of the program. Needs Improvement (NI). The resident's level of skill on the goal does not meet the preceptor's standards of either "Achieved" or "Satisfactory Progress. For learning experiences greater than or equal to 12 weeks in length, summative evaluation is completed at least quarterly. Individual preceptors may designate that a resident has achieved a goal for the residency during the summative evaluation process, or the RPD/RPC may determine that a resident has achieved a goal for the residency based on collective feedback. Preceptor and learning experience evaluation Residents must complete and discuss an evaluation of each preceptor and learning experience at the end of the learning experience. Evaluations are completed by the due date or within 7 days.

DUTY HOUR REQUIREMENTS Residents, program directors, and preceptors have the professional responsibility to ensure they are fit to provide services that promote patient safety. SFHS residency programs comply with ASHP duty-hour standards. Refer to ASHP Duty-Hour Requirements for Pharmacy Residencies (also available at http://www.ashp.org/doclibrary/residents/pharmacy-specific-duty-hours.pdf). Moonlighting is permitted only with approval from the RPD. Failure to obtain RPD approval for moonlighting may result in dismissal from the program. CERTIFICATION Certificates of residency are awarded upon meeting the following requirements: achievement of at least 80% of required program goals during twelve months of active residency experience; fulfillment of required research elements, including submission of formal residency project manuscript suitable for publication; and fulfillment of all rotation requirements, quarterly progress requirements, required drug information activities, service commitments as defined by the residency program director, and ability to function independently as a hospital pharmacist. If a resident takes a leave of absence, time away is not counted towards twelve months of active residency experience. With approval of the residency program director, residents may choose to participate in an optional teaching certificate elearning program available as an independent learning experience through ASHP and the University of Kentucky College of Pharmacy. Residents who successfully complete the program by June 1st of the residency term will be reimbursed for the activity fee. Overall progress toward achievement of residency certificate must be prioritized above this optional activity. Additional program information is available at the following website: http://elearning.ashp.org/products/5169 MAJOR RESEARCH PROJECT Conducting pharmacy practice research exposes the resident to the following important skills: Identify practice-related issues for study Comprehensive literature search Generate research question(s) Design study methods that will answer question(s) identified Institutional Research and Ethics Board application process Systematic data collection and analysis Draw valid conclusions Use effective communication skills to report recommendations RESIDENT RESEARCH PROJECTS Year Resident Topic 2018-2018 Elizabeth Sandmann, PharmD 2017-2018 Molly Grasberger, PharmD Evaluation of a pharmacy intervention to improve beta-lactam allergy documentation Evaluation of culture review and follow-up to improve antimicrobial stewardship and prescribing practices in the emergency department

ROTATIONS & LONGITUDINAL EXPERIENCES Core Rotations REQUIRED Duration Preceptor Orientation & Introduction to Infectious Diseases, Stewardship & Microbiology 3-6 weeks Ann Lloyd, PharmD, BCPS AQ ID Pediatric Infectious Diseases Consult Service Ann Lloyd, PharmD, BCPS-AQ ID Hematology/Oncology & Bone Marrow Transplant Teresa Cooper, PharmD Emergency Medicine Kaili Melton, PharmD, BCPS Solid Organ Transplant Vivian Carson, PharmD, BCPS Adult Infectious Diseases Consult Service 3-6 weeks Ann Lloyd, PharmD, BCPS-AQ ID Antimicrobial Stewardship 6 weeks Ann Lloyd, PharmD, BCPS-AQ ID Management/Leadership Ann Lloyd, PharmD, BCPS-AQ ID Elective Rotations Duration Preceptor Advanced Critical Care Vivian Carson, PharmD, BCPS Advanced Independent Practice 4-6 weeks Ann Lloyd, PharmD, BCPS AQ ID Adult Infectious Diseases Consult Service II 4-6 weeks Ann Lloyd, PharmD, BCPS AQ ID Research Data Collection and Analysis Ann Lloyd, PharmD, BCPS AQ ID Longitudinal Rotations REQUIRED Duration Preceptor HIV/AIDS Ambulatory Care Clinic 9 months Christina Connel, PharmD, BCPS, AAHIVP Research 12 months Jacyntha Sterling, PharmD

SAINT FRANCIS HOSPITAL PGY2 INFECTIOUS DISEASES PHARMACY RESIDENCY PROGRAM STRUCTURE Q1 Q2 Q3 Q4 Rotations Orientation & Introduction to Infectious Diseases, Stewardship, and Microbiology 3-6 weeks Adult ID Consult Service 3-6 weeks Antimicrobial Stewardship 6 weeks Core I Elective Research Data Collection and Analysis Core II Core III Elective Core IV Elective Management Leadership Research HIV/AIDS Ambulatory Care Clinic Research CITI IREB Data collection Analysis Presentation and Poster Presentation Manuscript Develop topic, design, methods

REQUIRED COMPETENCY AREAS, GOALS, & OBJECTIVES All program goals and objectives are assigned to be taught and evaluated at least once in required learning experiences. Most goals are taught and evaluated several times during the residency program year to enable residents to achieve competency. Goals & Objectives Skill Competency Area R1: Patient Care Goal R1.1 R1.1.1 In collaboration with the health care team, provide comprehensive medication management to patients with infectious diseases following a consistent patient care process Interact effectively with health care teams, including microbiologists and infection control preventionists, to manage medication therapy for patients with infectious diseases R1.1.2 Interact effectively with infectious diseases patients, family members, and caregivers R1.1.3 R1.1.4 R1.1.5 R1.1.6 R1.1.7 Collect information on which to base safe and effective medication therapy for infectious diseases patients Analyze and assess information on which to base safe and effective medication therapy for infectious diseases patients Design or redesign safe and effective patient-centered therapeutic regimens and monitoring plans (care plans) for infectious diseases patients Ensure implementation of therapeutic regimens and monitoring plans (care plans) for infectious diseases patients by taking appropriate follow-up actions For infectious diseases patients, document direct patient care activities appropriately in the medical record or where appropriate Analyzing Analyzing Creating R1.1.8 Demonstrate responsibility to infectious diseases patients Goal R1.2 Ensure continuity of care during infectious diseases patient transitions between care settings R1.2.1 Manage transitions of care effectively for patients with infectious diseases Goal R1.3 R1.3.1 Manage antimicrobial stewardship activities Demonstrate an understanding of the integral members of the stewardship team, their roles, and the antimicrobial stewardship strategies used by organizations Analyzing R1.3.2 Participate in the institution s antimicrobial stewardship program R1.3.3 Evaluate stewardship program processes and outcomes Evaluating Competency Area R2: Advancing Practice and Improving Patient Care Goal R2.1 R2.1.1 R2.1.2 R2.1.3 Goal R2.2 Demonstrate ability to manage formulary and medication-use processes for infectious diseases patients, as applicable to the organization and antimicrobial stewardship program Prepare or revise a drug class review or monograph, and treatment guideline or protocol related to care of infectious diseases patients Participate in the review of medication event reporting and monitoring related to care of infectious diseases patients Identify opportunities for improvement of the medication-use system related to care for patients with infectious diseases Demonstrate ability to conduct a quality improvement or research project Creating Analyzing

R2.2.1 R2.2.2 Identify and/or demonstrate understanding of a specific project topic to improve patient care related to care of patients with infectious diseases or topics related to advancing the pharmacy profession or infectious diseases pharmacy Develop a plan or research protocol for a practice quality improvement or research project related to the care of patients with infectious diseases or topics related to advancing the pharmacy profession or infectious diseases pharmacy Analyzing Creating Goals & Objectives Skill R2.2.3 R2.2.4 R2.2.5 R2.2.6 Goal R2.3 Collect and evaluate data for a practice quality improvement or research project related to the care of patients with infectious diseases or topics related to advancing the pharmacy profession or infectious diseases pharmacy Implement quality improvement or research project to improve patient care related to care for patients with infectious diseases or topics related to advancing the pharmacy profession or infectious diseases pharmacy Assess changes or need to make changes to improve patient care related to care for patients with infectious diseases or topics related to advancing the pharmacy profession or infectious diseases pharmacy Effectively develop and present, orally and in writing, a final project report suitable for publication related to care for patients with infectious diseases or topics related to advancing the pharmacy profession or infectious diseases pharmacy at a local, regional, or national conference Manage and improve anti-infective-use processes Evaluating Evaluating Creating R2.3.1 R2.3.2 Make recommendations for additions or deletions to the organization s anti-infective formulary based on literature and/or comparative reviews Contribute to the activities of the P&T committee, specifically the anti-infective subcommittee, when applicable Competency Area R3: Leadership and Management Evaluating Creating Goal R3.1 R3.1.1 Goal R3.2 R3.2.1 R3.2.2 Goal R3.3 Establish oneself as an organizational expert for infectious diseases pharmacy-related information and resources Implement a successful strategy for earning credibility with the organization to be an authoritative resource on the pharmaceutical care of individuals with an infectious disease Demonstrate leadership skills for successful self-development in the provision of care for infectious diseases patients Demonstrate personal, interpersonal, and teamwork skills critical for effective leadership in the provision of care for infectious diseases patients Apply a process of ongoing self-evaluation and personal performance improvement in the provision of care for infectious diseases patients Demonstrate management skills in the provision of care for infectious diseases patients R3.3.1 Contribute to management of infectious diseases-related policies and issues R3.3.2 Manage one s own infectious diseases practice effectively Competency Area R4: Teaching, Education, and Dissemination of Knowledge Goal R4.1 Provide effective medication and practice-related education to infectious diseases patients, caregivers, health care professionals, students, and the public (individuals and groups)

R4.1.1 Design effective educational activities related to care of patients with infectious diseases R4.1.2 R4.1.3 R4.1.4 Use effective presentation and teaching skills to deliver education related to care of patients with infectious diseases Use effective written communication to disseminate knowledge related to care of patients with infectious diseases Appropriately assess effectiveness of education related to care of patients with infectious diseases Goals & Objectives Skill Goal R4.2 Effectively employ appropriate preceptor roles when engaged in teaching students, pharmacy technicians, or fellow health care professionals) about care of patients with infectious diseases R4.2.1 R4.2.2 When engaged in teaching related to care of patients with infectious diseases, select a preceptor role that meets learners educational needs Effectively employ preceptor roles, as appropriate, when instructing, modeling, coaching, or facilitating skills related to care of patients with infectious diseases Analyzing Resident Name Molly Grasberger, PharmD, BCPS Year Completed 2018 College of Pharmacy Manchester University RESIDENTS SINCE 2017 AND PRACTICE SITES PGY1 Residency Saint Francis Hospital Tulsa, OK Practice Site Clinical Specialist in Infectious Diseases St Anthony s (Mercy) Medical Center, St Louis, MO