Drug Information @ EUHM Learning Activities: Preceptor: Collin E. Lee, PharmD Office: EUH Ground Floor, Room EG 22 Hours: ~ 8:00 am 5:00 pm Desk: 404 712 4487 Pager: 12627 General Description Drug Information (DI) is a four week learning experience at Emory University Hospital. The rotation location is in the central pharmacy Drug Information Center. Residents will be responsible for answering questions presented to the Drug Information Center using a variety of Drug Information resources and references available to them. The resident will take a quiz to demonstrate the ability to utilize these resources in answering a variety of drug information questions. The residents will communicate directly with the requestors in order to gain experience in both written and oral professional communication. The resident will be responsible for selecting articles from reputable journals to discuss with the preceptor at least three times a week. The resident will be responsible for using a systematic approach to critically evaluating the literature. On multiple occasions, the resident will take quizzes and tests on these principles in order to demonstrate understanding. In addition, the resident will participate in monthly Resident Journal Club and Atlanta Area Journal Club every other month as part of a longitudinal aspect of their rotation. Using evidence based medicine, the resident will develop several drug monographs, therapeutic interchanges and class reviews as dictated by the needs of the institution. Many of these projects may correlate with practice management projects which occur throughout the year. These assignments items will be presented to the Pharmacy and Therapeutics committee and the resident will be responsible to follow through with the Department of Pharmacy for implementation of the committee decisions. The resident will also be required to conduct at least one medication usage evaluation (MUE). The resident will be required to develop the data collection form and to collect data on patients during their rotation month (this may be extended depending on the MUE). The resident will analyze the results, write a summary, suggest areas for improvement/change and present their results to the Pharmacy and Therapeutics committee and/or other committees who have a vested interest in the results. Through participation in the Formulary Implementation Group, the resident will witness how formulary decisions are implemented and how they affect all aspects of the pharmacy department. Additionally, the resident will also assist the preceptor in dealing with the various medication crises that occur during their rotation (drug shortages, recalls, lack of adequate inventory, borrowing medications, FDA alerts).
The preceptor will discuss the importance of ADR reporting and will be an active participant in ADR analysis. The resident will be responsible for identifying and reporting a minimum of 2 adverse drug reactions and 2 medication errors during their residency. The resident will be responsible for following the patients for outcomes and doing an analysis of the steps which led to the medication error. The resident will accompany the preceptor when she is meeting with Pharmaceutical Drug Representatives. Key issues presented and discussed will be conflict of interest and setting boundaries. Topics 1. Identification and use of Drug Information resources (e.g. Micromedex, OVID, Pubmed, EMBASE, FDA website, UptoDate) to answer healthcare provider questions 2. Critical appraisal of the literature (study design, bias, power, RRR, ARR, NNT, NNH, OR, HR, correlation, regression) 3. Formulary management (recalls, shortages, discontinuations, deletion, additions, automatic dispensing machines, storage, administration, CPOE order development, risk minimization) 4. Pharmacy and Therapeutics Committee responsibilities 5. Formulary Implementation Group responsibilities (CPOE and computer issues, guidelines, policy and protocol development, Omnicell, Inventory) 6. Development of monographs, therapeutic interchanges, and class reviews 7. Medication Usage Evaluation (MUE) 8. Adverse Drug Reaction reporting 9. Drug Representative/Institutional/Drug Information relationships and medication contracts Goals Selected Goals selected to be taught and evaluated during this learning experience include: R1.1 Identify opportunities for improvement of the organizations medication use system. R1.2 Design and implement quality improvement changes to the organizations medication use system. R1.4 Demonstrate ownership of and responsibility for the welfare of the patient by performing all necessary aspects of the medication use system. R1.5 Provide concise, applicable, comprehensive and timely responses to requests for drug information from patients and health care providers R2.1 As appropriate, establish collaborative professional relationships with members of the health care team. R2.4 Collect and analyze patient information R3.1 Exhibit essential personal skills of a practice leader R3.3 Exercise practice leadership R4.1 Conduct a practice related project 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 reduce error
Activities Activity Accurately gather, organize, and analyze patient specific information related to a drug information question. Use DI resources to locate information. Use critical evaluation skills to analyze the information and make sound decisions. Use communication skills to educate healthcare providers. R 1.4 R 1.5 R 2.1 R 2.4 Goal R 3.1 Conduct MUE R 1.1 R 2.4 R 4.1 Participate in the formulary process through development of drug monographs, therapeutic interchanges, class reviews, drug shortages/recalls, and other formulary projects as indicated. These will be presented to both FIG and P&T committees in written and oral format. R 1.1 R 1.5 R 4.1 R 6.1 ADR reporting and evaluation R 1.1 R 6.1 Participate in formulary implementation group (FIG) and Pharmacy and Therapeutics Committees R 1.1 R 2.1 R 3.1 Take tests and quizzes on Drug Information resources, study design, and literature evaluation. R 1.5
R 3.1 Preceptor Interaction Daily: Preceptor available from 0800 to 1300 at least 4 days a week. Preceptor available after that time via pager. Resident will spend mornings side by side with the DI preceptor answering DI questions, analyzing articles, reviewing statistical concepts and working on any pertinent formulary issues. Afternoons will be spent working independently on monographs, interchanges, class reviews, collecting MUE data and staffing the DI center. Meetings: Resident will attend P&T committee meetings (EUH and MID), and the monthly FIG meeting. Resident will meet with drug represenatives on the 2 nd and 4 th Thursday mornings. Evaluation Strategy ResiTrak will be used for documentation of formal evaluations. Preceptor will provide daily feedback regarding strengths and weaknesses. A formal midpoint evaluation will occur at the end of the second week. The resident will be evaluated on a continual basis for the ability to work more independently and given responsibilities accordingly. Final evaluation will occur verbally with the resident on the last day of the rotation; however, final written evaluation will not occur until all projects are completed and presented to the appropriate committee. Due to P&T committee meeting dates, this could be up to 2 months after the completion of the rotation. What Snapshot Who When Midpoint Summative Self Evaluation Midpoint Summative Evaluation Resident End of week 2 Preceptor End of week 2 Summative Self Evaluation Resident End of learning experience deadline to be signed and submitted by 1300 the day following rotation completion. Summative Evaluation Preceptor End of learning experience deadline 7 days post final day of rotation to meet with resident to discuss. Preceptor & Learning Experience Evaluation Resident End of learning experience deadline 7 days post final day of rotation.