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Winning Strategies for Developing Dynamic Residency Programs
DisclosureIn accordance with the ACPE’s and ACCME’s Standards for Commercial Support, anyone in a position to control the content of an educational activity is required to disclose their relevant financial relationships. In accordance with these Standards, ASHP is required to resolve potential conflicts of interest and disclose relevant financial relationships of presenters.
• In this session:
All planners, presenters, reviewers, and ASHP staff report nofinancial relationships relevant to this activity.
Objectives Describe innovative techniques used in resident practice
management, clinical development, and professional development
Identify resident projects that will contribute to the achievement of organizational goals
Summarize quality improvement processes for continuousdevelopment of overall program operations.
List strategies for maintaining an engaging precepting environment for learners, preceptors, and RPDs.
2018 National Pharmacy Preceptors ConferenceWinning Strategies for Developing Dynamic Residency Program
Resident projects and organizational goals Quality improvement processes
• Preceptor and resident evaluation• Self‐evaluation
Learning environment• Residency committee structure• Professional involvement• Core curriculum
I am familiar with the ASHP Foundation Pharmacy Residency Excellence
Awards Program.
YesNo
ASHP Foundation Pharmacy Residency Excellence Awards (PREA)
Recognizes excellence and leadership of residency programs and practitioners that/who have excelled in the training and mentoring of pharmacy residents.
Honors leading practice facilities and mentors. Widely disseminates the accomplishments in order
to foster innovations in pharmacy residency training.
2018 National Pharmacy Preceptors Conference Winning Strategies for Developing Dynamic Residency Program
Annual awards for:• Preceptor• New Preceptor• Program
ASHP Foundation PREA Extensive application assesses:
• Innovation• Quality improvement• Resident training environment• Preceptor engagement and development• Service Excellence• Achievement record• Letters of support
ASHP Foundation PREA Timelines:
• Application released in spring• Due in early summer
Panel review by select past recipients and ASHP staff Award presented at ASHP Midyear meeting Stay tuned to ASHP Foundation for details/ deadlines
2018 National Pharmacy Preceptors Conference Winning Strategies for Developing Dynamic Residency Program
Resident projects and organizational goals Quality improvement processes
• Preceptor and resident evaluation• Self‐evaluation
Learning environment• Residency committee structure• Professional involvement• Core curriculum
UVA Program Background
PGY1 pharmacy residency begin in 1991 with 1 resident; 9 in 2018 PGY1 community‐based pharmacy (n=1) Nine PGY2 programs
• Ambulatory care, cardiology, critical care, infectious diseases, oncology, pediatrics, transplant, pharmacy informatics, health system pharmacy administration
• Consistent history of early committing many positions from PGY1 class
2018 National Pharmacy Preceptors Conference Winning Strategies for Developing Dynamic Residency Program
Late November ‐ Early January If used as a rotation
• Resulted in fewer than 17 rotation days• Three or four rotation starts
If used as a research block• Resulted in more research days than we
purposefully schedule into the program• Questions arose about efficient use of research
days
Mini‐rotations Mini‐rotations were “born”
• Abbreviated experiences (2‐10 days in duration)• Total time commitment varies each residency year
(10‐17 days)• Initially provided lots of opportunities within
pharmacy and the medical center• Currently, primarily scheduled with pharmacy team
members
Mini‐rotationsProvide residents with exposure: No current scheduled rotation Repeat exposure beyond current scheduled rotations Varied experience beyond scheduled rotations
• Peds ED vs. adult ED• Ambulatory heme/onc vs. inpatient heme/onc
Services/ departments outside of the pharmacy• Nutrition services• Toxicology• Pharmacogenomics research lab
2018 National Pharmacy Preceptors Conference Winning Strategies for Developing Dynamic Residency Program
Pharmacist‐accredited Seminar• 2 live sessions (7 AM for night shift, 2 PM
for day and evening shift)• Encore session is recorded
Tech Talk• Recorded only
Multimedia CE
Recorded presentations are posted to a private YouTube channel Additional CE requirements• Active learning • Post‐activity questions + response rationale
Multimedia CE Feedback
• Requires adjustment to presenting without a live audience
• Provides exposure to technology‐intense presentation/ prepares for distance learning
• Offers additional data to future employers (electronic CE hyperlinked in CVs and letters of recommendation)
2018 National Pharmacy Preceptors Conference Winning Strategies for Developing Dynamic Residency Program
• Antimicrobial selection for surgical prophylaxis for in‐unit open chest procedures in our thoracic cardiovascular surgical intensive care unit • Initial project identified broach spectrum antimicrobial
agents were used more than narrow spectrum agents• Narrow spectrum agent designated as standard of care• Follow‐up evalua. on iden� f ed ↑ adherence to
standard of care (narrow spectrum agent), ↓ Clostridium difficile infection rate, positive impact on antibiogram
Project ExamplesOrganizational priority
• Sepsis‐related mortality• Initial project evaluated timing of antibiotic initiation in
emergency department (ED) in septic patients before and after implementation of evening ED clinical pharmacy services
• Results: signif cant ↓ me to f rst dose and order to administra� on me, signif cant ↑ in receipt of f rst dose within one hour
• Improvements resulted in expanded pharmacy coverage in ED• Subsequent resident projects focused on improving sepsis
alerts within the electronic health record for patients
Project Feedback Quality Project
• Project completion and presentation early in the year• Opportunity to implement solution to a problem/issue• Able to see impact of the work within our patient
population Research Project
• Impact on patient care • Opportunity to share findings external to organization
Overall• Gained greater understanding of healthcare costs• Grew in project management skills• Had opportunity to lead groups to consensus
2018 National Pharmacy Preceptors Conference Winning Strategies for Developing Dynamic Residency Program
My organization has involved residents in supporting organization technology
initiatives.
YesNo
Resident Involvement in InitiativesElectronic health record (EHR) conversion Go‐live(s)
• Trained as end‐users• Residents worked alongside clinical pharmacists and coordinators
to support order “cutover” between systems
Smart pump conversions• Phase 1: Implementation of smart pumps• Phase 2: Integration of smart pumps and EHR• Trained as super‐users• Residents worked alongside pharmacists/nurses/biomedical
engineering staff to support smart pump conversions (order and medication changes, library support)
Resident Involvement in Initiatives Feedback
• Residents: gained full understanding of magnitude of changes, acquired new skills, able to serve as expert resource to the teams
• Patient care team: appreciated having support and expertise of medication expert and someone with whom they were already familiar/ comfortable
• Senior leadership: highly complimentary, observed firsthand the impact of resident involvement in our priorities
2018 National Pharmacy Preceptors Conference Winning Strategies for Developing Dynamic Residency Program
Resident projects and organizational goals Quality improvement processes
• Preceptor and resident evaluation• Self‐evaluation
Learning environment• Residency committee structure• Professional involvement• Core curriculum
Quality Improvement ProcessesProgram design in Pharmacademic™ RPD co‐signs all evaluations & feedback RPD designates “achieved for residency (ACHR)” Many rotations are team taught
• Primary preceptor used for summative evaluations Timelines (in accordance with accreditation standard)
• Emphasis on:• Preceptor roles most frequently utilized • Preceptor’s strengths• What did I learn from this preceptor? • What could the preceptor do to make future
Resident self‐evaluation required elements:• What did I do? (little emphasis)• How well did I do it? • What did I learn? • What will I do differently next time?
Quality Improvement Processes
Administrative support personnel downloads overdue evaluations report from Pharmacademic™ weekly to every other week Reports submitted via e‐mail to those with
overdue evaluations with CC to RPD and supervisor (if necessary)
Quality Improvement Processes
Collation and distribution of resident feedback• RPD/ administrative support personnel queries
all evaluations • Emphasis on: strengths, weaknesses,
suggestions for improving the learning experience
• Distributed via email to preceptor team and others, as necessary
2018 National Pharmacy Preceptors Conference Winning Strategies for Developing Dynamic Residency Program
Residency Oversight Committee (ROC)• All program directors/ assistant directors• Responsible for overall planning,
coordination, and evaluation of all residency programs offered by the Pharmacy Department
Residency Committee StructureResidency Advisory Committee (RAC) RAC per program; combined meetings Current and next rotation preceptors, annual advisors,
longitudinal preceptors (staffing, projects) Purpose: share current resident progress/plans/
strengths and areas for improvement Conduct periodic evaluations of program, accreditation
standards, goals, and objectives
Residency Research Committee Charge: oversight of residency research initiatives Evaluates projects for all residents from design to final
presentation Led by 3 departmental coordinators Membership includes pharmacists and data analyst Significant commitment of time Continuously seeking strategies to gain efficiencies
• Project design workshops in spring • Research orientation at beginning of residency year• Required resident attendance at presentations
2018 National Pharmacy Preceptors Conference Winning Strategies for Developing Dynamic Residency Program