ROTATION DESCRIPTION Clinical Management Rotation

Transcription

1 ROTATION DESCRIPTION Clinical Management Rotation PURPOSE The Clinical Management rotation provides the opportunity for PGY1 residents to both improve their knowledge base and pharmacotherapeutic skills as well as expose the PGY1 Resident to the management and leadership of a department of pharmacy services. The intention of this rotation is to mirror the clinical practice of pharmacy leaders in academic medical centers. The focus for the residents is to properly balance competing obligations of a clinical leader. The resident will be exposed to a real life example of how a pharmacist s clinical activities can directly impact the success of the institution through compliance with standards such as CMS Core Measures, The Joint Commission Medication Safety Standards, Hospital Consumer Assessment of Health Plans Survey (HCAHPS) Scores, and other quality and safety metrics. The resident will also gain experience with leadership and practice management, identifying opportunities to improve the medication-use process, develop a plan for a new or enhances pharmacy service, and develop problem solving, communication and critical literature evaluation skills. LEARNING EXPERIENCE DESCRIPTION Management Experience: The resident works directly with the Director of Pharmacy, Pharmacy Management Team and the PGY2 Health System Pharmacy Administration resident throughout the rotation. The primary learning sites include the administrative offices and the MUSC Medical Center. The resident will be provided access to a desk, computer and telephone within the administrative offices. Clinical Experience: This rotation will provide exposure to a broad range of disease states and patient populations. An area of focus for the provision of pharmaceutical care at MUSC is the management of medication therapy upon transitions of care within the hospital. The pharmacy resident s role during this rotation will be to identify patients who have transferred levels of care within the hospital. For patients included in the scope of services to be discussed with the designated preceptor at the beginning of the month, the resident will complete activities in coordination with the pharmacy team (clinical pharmacists, clinical specialists, pharmacy technicians, etc) to include: medication reconciliation upon transfer, identify medication-related problems, provide drug utilization review, make recommendations to the team to improve pharmacotherapy, coordinate pharmaceutical services when needed, review a patient s need for referral for medication management services (such as referral to our Pharmacotherapy Clinic), and any other additional medication-related activities that are required upon transfer from one service to another. The resident will be responsible for following the procedures outlined by their preceptor to complete assigned patient care activities each day. The resident will be expected to

2 interact with pharmacy teams on a daily basis to communicate pertinent patient care related information. They may also interact with medical/surgical teams which may consist of an attending physician, an upper level resident, and interns, a case manager, dietician, nurses, and a clinical pharmacist or clinical specialist. The resident will also need to communicate with pharmacists and nurses who are providing care to the patients to ensure continuity of care. Patients may be located throughout the hospital, and the number of patients to provide services to on a daily basis will vary. The preceptor will meet with the resident routinely but not every day to review the patients the resident evaluated upon transfer. Discussion of recommended interventions, evaluation of documented interventions and/or pharmacotherapy notes, or other methods used to evaluate the resident s competence and performance may be reviewed to assess the resident s progress. However, the role of the preceptor will shift from a model to a coach/facilitator, and the resident is expected to assume the responsibility of providing excellent pharmaceutical care for all patients. The resident is expected to speak with the clinical pharmacists and/or clinical specialists who are covering the patient to make recommendations, and to contact the preceptor with any questions. Once the recommendations are agreed upon, the resident may contact the medical team to relay the recommendation if appropriate. It is expected that the resident document all interventions in the appropriate documentation databases (eg, pharmacokinetics notes, pharmacy information system intervention documentation system). The resident is expected to follow the entire list of transferred patients from the beginning of the rotation, but depending on the census and assessment of the resident s experience and comfort, the preceptor may modify the plan and begin with a portion of the patients and build up to the entire list by a designated point in the month. Clinical activities will be completed throughout the day, and should be incorporated into the day along with management responsibilities. Sometimes a management activity may take priority over a clinical activity, and a scheduling adjustment along with coordination of care for these patients should be arranged by the resident. It is the resident s responsibility to communicate with both the preceptor and the clinical team about their schedule conflicts and prioritize their activities. LEARNING EXPERIENCE ACTIVITIES The following activities are required during the clinical administration rotation for a PGY1 resident. Activities directly related to RLS objectives evaluated on this rotation are noted. Exercise leadership and practice management skills. Prepare a written assessment of management experience, strengths, weaknesses and areas of interest. Provide a curriculum vitae and schedule of non-rotation obligations. Communicate openly with preceptor about scheduling conflicts, requested days off, availability for various activities. Solicit timely feedback. Take ownership of mistakes, and learn from them. Comply with policies and procedures of the university and hospital. Dress professionally at all times, and be an exemplary representative of the Department of Pharmacy Services. Prepare a proposal for a pharmacy program/policy or an improvement of an existing program/policy. The document may include an executive summary, description of organization; description of existing pharmacy services, organizational structure,

3 proposed services including positions, budget justification, job description, recruitment plan, educational rollout plan or job posting as applicable. o PGY1 all programs (HSPA, PCT, Psych, AmbCare) R3.1,3.2, 3.3 Communicate ongoing patient information. When given a patient who is transitioning from one health care setting to another, communicate pertinent pharmacotherapeutic information to the receiving health care professionals. Review pertinent patient information for patients that have transitioned levels of care. Information should include, but is not limited to active medications, allergies, indications for therapy, current labs, nutrition status, vaccine histories, age, weight, compliance with formulary restrictions, etc. Evaluate this information, and identify all important medication-related problems. Present this information to the preceptor to evaluate the resident s ability to analyze and communicate a patient s clinical needs. The resident will complete a medication reconciliation on all recently transferred patients, and document completion of the medication reconciliation as directed. The resident may need to review current literature or review articles to better understand the treatment plans and patient specific information. Once a plan has been created, communicate that plan to all pertinent members of the patient s care team to enact the plan. o PGY1 all programs (HSPA, PCT, Psych, AmbCare) R2.11 Manage and improve the medication-use process. Identify at least one opportunity that would improve the use of medications. Write up the opportunity in the format of an IMPROVE template. Implement the change if applicable, or at minimum present to the preceptor for consideration for a future project. o PGY1 all programs (HSPA, PCT, Psych, AmbCare) R1.1, 1.2 REQUIREMENTS OF LEARNING EXPERIENCE Required Hours Generally the resident will need to be present from 7 am to 5 pm. These hours may vary based on the resident s efficiency, activities occurring that day, and non-rotation activities. The resident shall alert the preceptor if they anticipate they will exceed the resident work hours set forth in the ACGME policy on resident work hours. Required Meetings Journal Club (longitudinal experience) Management Topic Discussion will give a presentation Pharmacy Resident Seminar: Mondays, 1:00-2:00pm Pharmacy Resident RITE presentations: Fridays, 12:00-1:00pm Team Teaching or Topic Discussions per preceptor Any other learning opportunity designated by the RPD or preceptor Clinical Leadership Meeting Departmental Staff Meetings Medical Executive Committee (MEC) Pharmacy Management Team (PMT) Meeting Pharmacy Leadership Team Pharmacy and Therapeutics Committee Pharmacy and Therapeutics Subcommittees (attend at least 2) Anti-infective Subcommittee Coagulation Subcommittee Hematology/Oncology Subcommittee Informatics and Formulary Subcommittee

4 Medication Safety and Improvement Committee Pharmacy Operations (at least once) Pharmacy Practice Committee Resident Discussion Series Service Line Accountability Sessions (SLAS) Optional activities: The resident may present one or more inservices to a pharmacy team, medical team or a nursing group. If a student is on rotation, the resident may co-precept the student s presentation at the primary preceptor s discretion. Pharmacy Grand Rounds: Wednesdays, 12:00-2:00pm ROTATION PRECEPTOR Heather Kokko, PharmD, MBA Director of Pharmacy Services Pager: Phone: kokko@musc.edu This rotation will be co-precepted with a variety of clinical preceptors. METHOD OF EVALUATION Evaluation of resident will be based on the RLS goals assigned by the Residency Program Director (RPD) in Resi-Trak. The preceptor and resident will review the resident s customized plan and the learning experience introduction document on the first day of rotation. Feedback will include, but not be limited to, verbal and written midpoint and end of rotation evaluations. The resident will receive formal written and verbal evaluation approximately two weeks after starting the rotation and within 3 days of completing the rotation, usually on the final day of the rotation. The final evaluation will reflect the goals and objectives identified for the rotation Resi-Trak. Evaluations will incorporate feedback from the interdisciplinary team when available. In addition, the preceptor will make every attempt to provide informal feedback to the resident throughout the month. The resident is encouraged to seek feedback at any time. The resident is expected to provide verbal feedback to the preceptor regarding any areas of the rotation that could be improved to enhance the rotation, both for the month and in the future, at the midpoint and final evaluations. Interim feedback is welcome. To address RLS Goals and Objectives historically achieved during these rotations, the following topics will be covered at the resident discussion series throughout the residency year: ASHP Best Practices Self-Assessment Test Biostatistics Business Plans Documentation

5 Finances and Benchmarking Formulary Management Interviewing Investigational Drug Services Leadership Meeting Effectiveness Outcomes and Reimbursement Staff Development and Training