1 Pharmacy Practice Residency Manual (2011-2012) 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 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 Section III Resident Portfolio 1. Presentations 2. Projects 3. Assignments 4. Evaluations
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1
Pharmacy Practice Residency Manual (2011-2012)
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 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
Section III Resident Portfolio
1. Presentations
2. Projects
3. Assignments
4. Evaluations
2
Pharmacy Practice Residency Program:
Structure
Purpose and Philosophy
Departmental Organization Chart
Program Goals
Program Structure
Benefits
3
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.
4
5
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 Manage and improve the medication-use process.
R2 Provide evidence-based, patient-centered medication therapy management with interdisciplinary teams.
R3 Exercise leadership and practice management skills. (Overall Performance and Administration Rotation)
R5 Provide medication and practice-related education/training
R6 Utilize medical informatics.
E2 Exercise added leadership and practice management skills.
E6 Provide drug information to health care professionals and/or the public.
E7 Demonstrate additional competencies that contribute to working successfully in the health care environment.
E8 Demonstrate additional competencies that contribute to working successfully in the health care environment (additional)
Patient Care
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 Use approaches in all communications that display sensitivity to the cultural and personal characteristics of patients, caregivers, and health care colleagues.
E8.2/7.2 Communicate effectively.
E8.3/7.3 Balance obligations to oneself, relationships, and work in a way that minimizes stress.
E8.4/7.4 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.
R1.4 Demonstrate ownership of and responsibility for the welfare of the patient by performing all necessary aspects of the medication-use 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.
(choose 4) Hospital Orientation Residency/RLS Computer Training Hospital Practice
Administration General Internal Medicine Critical Care (pick one) Surgical ICU Trauma ICU
Hospital Pharmacy Practice Projects ASHP Midyear
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
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)
7
BENEFITS
Educational leave Full access to Biomedical Library
Books directly related to the residency Lab coats are the responsibility of the resident, but
can be purchased through the hospital
Two weeks paid vacation, select holidays Sick leave
Travel & relocation expense directly related (moving company, rental, fuel, hotel) to the move –
up to $1500
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
Life insurance Discounts at local merchants
Professional liability insurance supplied by the Medical Center
Limited financial support for presentations at Vanderbilt and outside the campus – depends on the residents activities at the
meeting (officer, presentation, etc)
Health care plan options, including an HMO plan All ACPE approved continuing education provided by the
Department of Pharmaceutical Services
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.
Immunizations and other health related costs required by the Medical Center
Photocopying directly related to residency House staff & hospital orientation programs
Office space & computer workstation Competitive stipend
Employee Assistance Program Employee Wellness Program
Concierge Service
Provision of personal electronic devices will be supplied by the hospital if they are essential to the work of the resident.
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). 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).
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 4th
, Labor Day, Thanksgiving Day, Christmas Eve, Christmas Day, New
Year’s Day, Memorial Day) and 3 personal days 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 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.
8
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 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: http://hr.vanderbilt.edu/
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
*◊ Published in AJHP Jan
2004
2003 – 2004 James A. Carr Pharmaceutical Intervention Improves Efficiency for High Risk Dyslipidemic Patients Compared to Usual Care – Part II
*◊☼ To be submitted
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 Assessment of an Alcohol Withdrawal Prevention Protocol
◊☼*
Katie Smith Appropriate Use of Patient-Controlled Analgesia Infusion Devices
◊☼*
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
*
17
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 Jon 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
*☼◊
*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
18
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 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
August Project topic/preceptor confirmed
Project literature review and bibliography.
MUE topic selected and timeline for completion established.
Register for ASHP Midyear Meeting
September 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!
October 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
November 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
December ASHP Midyear – UHC Posters, showcase
January Register for SERC and Prepare SERC abstract
February 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?
March Project: begin organizing data – analyze data - results
April Pre-SERC project presentation I, II, III, IV, SERC
How many Criteria Based Assessments have you completed? Pace yourself!
May Project manuscript – first draft completed May 15th
June Final Project manuscript due June 1
All Criteria Based Assessment Requirements completed by Jun 15.
All requirements fulfilled no later than June 20.
19
Pharmacy Practice Residency:
Evaluation Process and Requirements
Evaluation Process Description
Resident Documentation Requirements
20
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.
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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:
Care plans
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.*
22
Pharmacy Practice Residency:
Longitudinal Rotation Experience Descriptions
Hospital Pharmacy Practice (Staffing)
23
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
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.
24
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.
25
Appendix
26
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?
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Rotation Schedule for 2011-2012 Residents Draft 9 PGY1** Megan
Vandy Pearls What you need to know for patient care: protocols,
Wiz and Starpanel,
Cori 1-3:30pm PCR
Friday
July 29
Evaluation Database
Summative evaluations, self evaluations, CBAs,
quarterly evaluations, rotation evaluations, the
residency council’s job in evaluating
Tracking form
How to use evaluation database
David/Cori 1-3:30 PCR
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Pharmacy Resident
Orientation Checklist
2011-2012
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 Pyxis/Cartfill Process Pharmacist Scan process Acceptance of Pyxis zones
Pyxis Fill Process Pyxis Orientation with Frank Ray Checking Pyxis Doses Pyxis Log-in and Filling Pyxis 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 Charity Prater Checking process Discrepancy resolution Narcotic orders attachment in HMM (patient specific)
Cart Fill Process Pull process from Med Carousel Check Process 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 What to send to the ED How to Clarify an order (resident pager list/operator)
Resident:________________
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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)
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, Vandy 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
TPN 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 – please learn the process of who is eligible, what the policy is, how patients are approved, how much medication can be dispensed.
**Sample pharmacy: policy and procedures, location, products available, how it works, who pays for it, and why we offer this
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service, how to look up formulary for this
Process for prior authorization etc of high cost drugs and our policy/procedure for handling these (identify main agents etc.)
How we manage the purchase, distribution and charging of medications used in the clinics Medicare/Tenncare issues What are the toughest problems in clinic medication reimbursement
Coumadin Clinic – Tommy and Suzanne **Who is serviced/eligible **How to enroll a patient (Starpanel) – please walk the resident through the Starpanel process 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
Order Processing: Orientation Checklist Orientation Items Resident Initials Trainer Initials Date Reviewed
Orient to satellites Locations Areas serviced by each Hours
Order clarifications
Work flow
Pharmacist and technician responsibilities
Adverse Drug Reaction reporting , Medication Error reporting
Customer Service Focus
Intervention Documentation
Telephone Courtesy/Etiquette
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
Dashboards (Will do with Cori) Orientation Items Resident Initials Trainer Initials Date Reviewed