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Department of Pharmacy Services
PGY1 Residency Program
Residency Manual
2014-2015
TABLE OF CONTENTS
I.
Introduction
II.
General Program Goals
III.
Residency Program Purpose Statement
IV.
Program’s Goals
V.
Residency Rotation Schedule
VI.
Required Projects
VII.
Required Meetings
VIII. Staffing responsibilities and Benefits
IX.
Resident Responsibilities
X.
Assessment of Learning Experience
XI.
Requirements for Program Completion
XII.
Phone Numbers
I.
Introduction
The Bayhealth Postgraduate Year (PGY1) One Residency Program is a one-year training
program primarily in an inpatient healthcare practice setting. The PGY1 resident will receive
extensive education and training in treating hospitalized patients through guided practice. The
program is tailored to meet the needs and interests of individual residents.
During the program, residents will participate in all aspects of our comprehensive pharmacy
service. Rotations in acute care practice areas, ambulatory care, pharmacy management,
research, and pharmacy systems are offered. As a vital member of the healthcare team, residents
will have the opportunity to enhance practice skills that are necessary to evaluate a patient’s
medication regimen. Throughout the one year program, residents will have numerous
opportunities to provide education to patients and other health care professionals. In addition,
residents will gain experience in providing written responses to drug information questions. The
knowledge gained over the course of the program will enable residents to competently conduct a
research project. In addition, residents will be expected to conduct a medication utilization
evaluation (MUE) and complete a project that will enhance medication safety. Opportunities for
teaching pharmacy students and earning a teaching certificate are available.
Residents will acquire foundation skills needed to become competent and confident clinical
practitioners and future leaders in pharmacy practice. Also, residents will gain experience in
collaborative working relationships with other health care team members through proactive
recommendations during patient care rounds and while working as a decentralized pharmacy
team member.
Bayhealth pharmacy started its PGY1 residency program in 2003. The program received ASHP
accreditation in March 2005 and was re-accredited in 2010.
II.
General Program Outcomes
At the completion of the Bayhealth PGY1 Residency program the resident will be able
a. To provide quality patient care through collaborative working relationships with
other health care providers
b. To design, recommend, and monitor patient-specific treatment regimens.
c. To provide concise, comprehensive, applicable, and timely response to drug
information requests.
d. To provide effective education to health care professional and patients.
e. To demonstrate professionalism, leadership skills, responsibility, and ethical
conduct.
f. To identify medication safety issues and to improve medication systems to maximize
patient safety.
III.
PGY1 Residency Program Purpose Statement
The purpose of the Bayhealth postgraduate year one residency program is to prepare
pharmacists for clinical acute care positions, adjunct faculty positions, or for postgraduate year
two training in a focused practice area.
IV.
Program’s Goals
1) Outcome R1: Manage and improve the medication-use process.
i) Goal R1.1: Identify opportunities for improvement of the organization’s
medication-use system.
(a) OBJ R1.1.1: Explain the organization’s medication-use system and its
vulnerabilities to adverse drug events (ADEs).
(b) OBJ R1.1.2: Analyze the structure and process and measure outcomes of the
medication-use system.
(c) OBJ R1.1.3: Identify opportunities for improvement in the organization’s
medication-use system by comparing the medication-use system to relevant
best practices.
ii) Goal R1.2: Design and implement quality improvement changes to the
organization’s medication-use system.
(a) OBJ R1.2.1: Explain the process for developing, implementing, and
maintaining a formulary system.
(b) OBJ R1.2.2: Make a medication-use policy recommendation based on a
comparative review (e.g., drug class review, drug monograph).
(c) OBJ R1.2.3: Participate in the identification of need for, development of,
implementation of, and evaluation of an evidence-based treatment
guideline/protocol related to individual and population-based patient care.
(d) OBJ R1.2.4: Design and implement pilot interventions to change problematic
or potentially problematic aspects of the medication-use system with the
objective of improving quality.
iii) Goal R1.3: Prepare and dispense medications following existing standards of
practice and the organization’s policies and procedures.
(a) OBJ R1.3.1: Interpret the appropriateness of a medication order before
preparing or permitting the distribution of the first dose.
(b) OBJ R1.3.2: Follow the organization's policies and procedures to maintain
the accuracy of the patient’s medication profile.
(c) OBJ R1.3.3: Prepare medication using appropriate techniques and following
the organization's policies and procedures.
(d) OBJ R1.3.4: Dispense medication products following the organization's
policies and procedures.
iv) Goal R1.4: Demonstrate ownership of and responsibility for the welfare of the
patient by performing all necessary aspects of the medication-use system.
(a) OBJ R1.4.1: Display initiative in preventing, identifying, and resolving
pharmacy-related patient-care problems.
v) Goal R1.5: Provide concise, applicable, comprehensive, and timely responses to
requests for drug information from patients and health care providers.
(a) OBJ R1.5.1: Discriminate between the requesters' statement of need and the
actual drug information need by asking for appropriate additional
information.
(b) OBJ R1.5.2: Formulate a systematic, efficient, and thorough procedure for
retrieving drug information.
(c) OBJ R1.5.3: Determine from all retrieved biomedical literature the
appropriate information to evaluate.
(d) OBJ R1.5.4: Evaluate the usefulness of biomedical literature gathered.
(e) OBJ R1.5.5: Formulate responses to drug information requests based on
analysis of the literature.
(f) OBJ R1.5.6: Provide appropriate responses to drug information questions that
require the pharmacist to draw upon his or her knowledge base.
(g) OBJ R1.5.7: Assess the effectiveness of drug information recommendations.
2) Outcome R2: Provide evidence-based, patient-centered medication therapy management
with interdisciplinary teams.
i) Goal R2.1: As appropriate, establish collaborative professional relationships
with members of the health care team.
(a) OBJ R2.1.1: Implement a strategy that effectively establishes cooperative,
collaborative, and communicative working relationships with members of
interdisciplinary health care teams.
ii) Goal R2.2: Place practice priority on the delivery of patient-centered care to
patients.
(a) OBJ R2.2.1: Choose and manage daily activities so that they reflect a priority
on the delivery of appropriate patient-centered care to each patient.
iii) Goal R2.3: As appropriate, establish collaborative professional pharmacistpatient relationships.
(a) OBJ R2.3.1: Formulate a strategy that effectively establishes a patientcentered pharmacist-patient relationship.
iv) Goal R2.4: Collect and analyze patient information.
(a) OBJ R2.4.1: Collect and organize all patient-specific information needed by
the pharmacist to prevent, detect, and resolve medication-related problems
and to make appropriate evidence-based, patient-centered medication therapy
recommendations as part of the interdisciplinary team.
(b) OBJ R2.4.2: Determine the presence of any of the following medication
therapy problems in a patient's current medication therapy: (1) Medication
used with no medical indication; (2) Patient has medical conditions for which
there is no medication prescribed; (3) Medication prescribed inappropriately
for a particular medical condition; (4) Immunization regimen is incomplete;
(5) Current medication therapy regimen contains something inappropriate
(dose, dosage form, duration, schedule, route of administration, method of
administration); (6) There is therapeutic duplication; (7) Medication to which
the patient is allergic has been prescribed; (8) There are adverse drug or
device-related events or potential for such events; (9) There are clinically
significant drug-drug, drug-disease, drug-nutrient, or drug-laboratory test
interactions or potential for such interactions; (10) Medical therapy has been
interfered with by social, recreational, nonprescription, or nontraditional drug
use by the patient or others; (11) Patient not receiving full benefit of
prescribed medication therapy; (12) There are problems arising from the
financial impact of medication therapy on the patient; (13) Patient lacks
understanding of medication therapy; (14) Patient not adhering to medication
regimen.
(c) OBJ R2.4.3: Using an organized collection of patient-specific information,
summarize patients’ health care needs.
v) Goal R2.5: When necessary, make and follow up on patient referrals.
(a) OBJ R2.5.1: When presented with a patient with health care needs that
cannot be met by the pharmacist, make a referral to the appropriate health
care provider based on the patient’s acuity and the presenting problem.
(b) OBJ R2.5.2: Devise a plan for follow-up for a referred patient.
vi) Goal R2.6: Design evidence-based therapeutic regimens.
(a) OBJ R2.6.1: Specify therapeutic goals for a patient incorporating the
principles of evidence-based medicine that integrate patient-specific data,
disease and medication-specific information, ethics, and quality-of-life
considerations.
(b) OBJ R2.6.2: Design a patient-centered regimen that meets the evidence-based
therapeutic goals established for a patient; integrates patient-specific
information, disease and drug information, ethical issues and quality-of-life
issues; and considers pharmacoeconomic principles.
vii) Goal R2.7: Design evidence-based monitoring plans.
(a) OBJ R2.7.1: Design a patient-centered, evidence-based monitoring plan for a
therapeutic regimen that effectively evaluates achievement of the patientspecific goals.
viii)
Goal R2.8: Recommend or communicate regimens and monitoring plans.
(a) OBJ R2.8.1: Recommend or communicate a patient-centered, evidence-based
therapeutic regimen and corresponding monitoring plan to other members of
the interdisciplinary team and patients in a way that is systematic, logical,
accurate, timely, and secures consensus from the team and patient.
ix) Goal R2.9: Implement regimens and monitoring plans.
(a) OBJ R2.9.1: When appropriate, initiate the patient-centered, evidence-based
therapeutic regimen and monitoring plan for a patient according to the
organization's policies and procedures.
(b) OBJ R2.9.2: Use effective patient education techniques to provide counseling
to patients and caregivers, including information on medication therapy,
adverse effects, compliance, appropriate use, handling, and medication
administration.
x) Goal R2.10: Evaluate patients’ progress and redesign regimens and monitoring
plans.
(a) OBJ R2.10.1: Accurately assess the patient’s progress toward the therapeutic
goal(s).
(b) OBJ R2.10.2: Redesign a patient-centered, evidence-based therapeutic plan
as necessary based on evaluation of monitoring data and therapeutic
outcomes.
xi) Goal R2.11: Communicate ongoing patient information.
(a) OBJ R2.11.1: When given a patient who is transitioning from one health care
setting to another, communicate pertinent pharmacotherapeutic information
to the receiving health care professionals.
(b) OBJ R2.11.2: Ensure that accurate and timely medication-specific
information regarding a specific patient reaches those who need it at the
appropriate time.
xii) Goal R2.12: Document direct patient care activities appropriately.
(a) OBJ R2.12.1: Appropriately select direct patient-care activities for
documentation.
(b) OBJ R2.12.2: Use effective communication practices when documenting a
direct patient-care activity.
(c) OBJ R2.12.3: Explain the characteristics of exemplary documentation
systems that may be used in the organization’s environment.
3) Outcome R3: Exercise leadership and practice management skills.
i) Goal R3.1: Exhibit essential personal skills of a practice leader.
(a) OBJ R3.1.1: Practice self-managed continuing professional development with
the goal of improving the quality of one’s own performance through selfassessment and personal change.
(b) OBJ R3.1.2: Demonstrate pride in and commitment to the profession through
appearance, personal conduct, and association membership.
(c) OBJ R3.1.3: Act ethically in the conduct of all job-related activities.
ii) Goal R3.2: Contribute to departmental leadership and management activities.
(a) OBJ R3.2.1: Participate in the pharmacy department's planning processes.
(b) OBJ R3.2.2: Explain the effect of accreditation, legal, regulatory, and safety
requirements on practice.
(c) OBJ R3.2.3: Explain the principles of financial management of a pharmacy
department.
(d) OBJ R3.2.4: Prioritize the work load, organize the work flow, and check the
accuracy of the work of pharmacy technical and clerical personnel or others.
iii) Goal R3.3: Exercise practice leadership.
(a) OBJ R3.3.1: Use knowledge of an organization's political and decisionmaking structure to influence accomplishing a practice area goal.
(b) OBJ R3.3.2: Explain various leadership philosophies that effectively support
direct patient care and pharmacy practice excellence.
(c) OBJ R3.3.3: Use group participation skills when leading or working as a
member of a committee or informal work group.
(d) OBJ R3.3.4: Use knowledge of the principles of change management to
achieve organizational, departmental, and/or team goals.
4) Outcome R4: Demonstrate project management skills.
i) Goal R4.1: Conduct a practice-related project using effective project
management skills.
(a) OBJ R4.1.1: Identify a topic for a practice-related project of significance for
pharmacy practice.
(b) OBJ R4.1.2: Formulate a feasible design for a practice-related project.
(c) OBJ R4.1.3: Secure any necessary approvals, including IRB and funding, for
one's design of a practice-related project.
(d) OBJ R4.1.4: Implement a practice-related project as specified in its design.
(e) OBJ R4.1.5: Effectively present the results of a practice-related project.
(f) OBJ R4.1.6: Successfully employ accepted manuscript style to prepare a final
report of a practice-related project.
(g) OBJ R4.1.7: Accurately assess the impact, including sustainability if
applicable, of the residency project.
5) Outcome R5: Provide medication and practice-related education/training.
i) Goal R5.1: Provide effective medication and practice-related education,
training, or counseling to patients, caregivers, health care professionals, and the
public.
(a) OBJ R5.1.1: Use effective educational techniques in the design of all
educational activities.
(b) OBJ R5.1.2: Design an assessment strategy that appropriately measures the
specified objectives for education or training and fits the learning situation.
(c) OBJ R5.1.3: Use skill in the four preceptor roles employed in practice-based
teaching (direct instruction, modeling, coaching, and facilitation).
(d) OBJ R5.1.4: Use skill in case-based teaching.
(e) OBJ R5.1.5: Use public speaking skills to speak effectively in large and small
group situations.
(f) OBJ R5.1.6: Use knowledge of audio-visual aids and handouts to enhance the
effectiveness of communications.
6) Outcome R6: Utilize medical informatics.
i) Goal R6.1: Use information technology to make decisions and reduce error.
(a) OBJ R6.1.1: Explain security and patient protections such as access control,
data security, data encryption, HIPAA privacy regulations, as well as ethical
and legal issues related to the use of information technology in pharmacy
practice.
(b) OBJ R6.1.2: Exercise skill in basic use of databases and data analysis
software.
(c) OBJ R6.1.3: Successfully make decisions using electronic data and
information from internal information databases, external online databases,
and the Internet.
7) Outcome E1: Conduct pharmacy practice research.
i) Goal E1.1: Design, execute, and report results of investigations of pharmacy
practice-related issues.
(a) OBJ E1.1.1: Identify potential practice-related issues that need to be studied.
(b) OBJ E1.1.2: Use a systematic procedure for performing a comprehensive
literature search.
(c) OBJ E1.1.3: Draw appropriate conclusions based on a summary of a
comprehensive literature search.
(d) OBJ E1.1.4: Generate a research question(s) to be answered by an
investigation.
(e) OBJ E1.1.5: Develop specific aims and design study methods that will
answer the question(s) identified.
(f) OBJ E1.1.6: Use a systematic procedure to collect and analyze data.
(g) OBJ E1.1.7: Draw valid conclusions through evaluation of the data.
(h) OBJ E1.1.8: Use effective communication skills to report orally and in
writing the results and recommendations of an investigation into a pharmacy
practice-related issue.
V.
Residency Rotation Schedule (2013-2014)
Core Rotations
General Orientation (1 week)
Pharmacy Systems (6 weeks)
General Medicine/Nutrition (8 weeks)
Oncology (4 weeks)
Pharmacy Management (3 weeks)
Cardiology (4 weeks)
Intensive Care (4 weeks)
Infectious Disease (4 weeks)
Rehabilitation (3 weeks)
Ambulatory Care (4 weeks)
Elective Rotations*
Pharmacy Informatics/Economics (4 weeks)
Emergency Medicine (4 weeks)
Diabetes (4 weeks)
Advanced Oncology (4 weeks)
Pain Management (4 weeks)
*There is the possibility of offsite elective
rotations to meet the resident’s practice interest
areas
If there is a lack of preceptor availability in the rotation practice area, the rotation schedule/
availability is subject to change by the Residency Director.
Longitudinal Experiences:
1.
2.
3.
4.
VI.
Drug Information
Pharmacy Systems (i.e. staffing) II
Pharmacy Practice Management II
Research
Required Projects
1. Clinical research project for presentation at the Eastern States Residency Conference.
The project should be of such quality that the written results may be submitted for
publication in a peer-reviewed journal.
2. Research poster presentation at the ASHP Mid-Year meeting
3.
4.
5.
6.
One inservice (nursing)
One Formulary Monograph and one Therapeutic Drug Class Review
Design, implement, and complete one MUE project
Complete one medication safety project (may be part of or related to MUE or
research project)
7. Update one policy and procedure
8. Two community service projects/lectures
9. Three newsletter articles
10. One Bayhealth pharmacy CE
11. One Christiana grand rounds CE
12. One journal club presentation
13. Two technician PEARL presentations
14. Co-teach outpatient anticoagulation class for pre-op orthopedic patients
Please note that required projects are subject to change by a majority vote from
Residency Steering Committee Members.
VII.
Required Meetings
1.
2.
3.
4.
P&T Committee
Clinical Pharmacy Meeting
Interdisciplinary Rounds
Journal Club
VIII. Staffing Responsibilities and Benefits
1. Staffing Responsibilities
a. The Pharmacy Resident shall perform and demonstrate proficiency as a Staff
Pharmacist during the course of the Program.
b. The normal assignment will be eight hours of evening shift per two-week pay
period.
c. The normal weekend assignment will be every third weekend. This rotation will
include one Saturday and one Sunday for the shift assigned. The weekend
assignment may be scheduled at either Bayhealth campus depending on staffing
needs.
d. The resident will be required to work one (1) Summer Holiday and one (1)
Winter Holiday. The holiday assignment may be scheduled at either Bayhealth
campus depending on staffing needs.
e. In addition to these requirements, the Resident will work one (1) week of night
shift.
f. This schedule is subject to change by the Residency Program Director.
2. Benefits
a. Stipend.
b. 15 days of paid time off which includes sick leave, vacation leave, paid
holidays, and bereavement leave. Please note that Bayhealth has six paid
holidays and any holiday not worked will be subtracted from the 15 days of paid
time off.
c. Financial support to selected professional meetings
d. Payment of professional liability insurance.
IX.
Resident Responsibilities
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
Development of personal goals for the residency following an initial evaluation
of career interests, prior experience, and areas of strength and weakness.
To meet the residency requirements, it is expected that the PGY1 residency will
have to work in excess of 40 hours per week. Thus, moonlighting outside of
Bayhealth Medical Center is strongly discouraged. Any moonlighting must be
approved by the Director of the Residency Program.
Compliance with rotation expectations:
a)
Meeting with the rotation preceptor to discuss individual goals and
objectives for the rotation.
b)
Completing assignments by the end of the rotation.
c)
Informing the Residency Director of difficulties encountered in meeting
goals and objectives or problems with preceptor.
d)
Assuming the responsibilities of the rotation preceptor in his/her absence.
e)
Completing an evaluation of each rotation experience, preceptor, and a
self-evaluation at the conclusion of the rotation that includes
accomplishment of objectives and experiences gained with
recommendations for improvement.
Completion of quarterly evaluations to be reviewed by the Residency Director.
The purpose is to assure that the established residency goals are being achieved.
Provision of pharmacy staffing coverage.
Maintenance of active membership in the American Society of Health-System
Pharmacists.
Completion of a major residency project and medication use evaluation.
Completion of required presentations throughout the residency.
Submission of articles to pharmacy newsletters.
Attendance at the ASHP Midyear Clinical Meeting and Eastern States
Conference for Pharmacy Residents and Preceptors. Attendance at applicable
local pharmaceutical education programs is expected. Residents may attend other
professional meetings if the staffing schedule permits.
Reading and following the Attendance and Dress Code Policies.
Following patient privacy laws and regulations.
X. Assessment of Learning Experiences
a.
b.
c.
d.
e.
f.
There will be summative evaluation by the preceptor which will be reviewed
with the PGY1 resident by the last day of the rotation.
The PGY1 resident will complete a self-evaluation by the last day of the rotation.
It will be submitted and discussed with the preceptor.
The PGY1 resident will complete an evaluation of the preceptor and rotation and
submit it to the Director of the Residency Program by the last day of the
rotation.
The Director of the Residency Program will conduct quarterly evaluations with
the PGY1 resident.
At the end of each week of the rotation, progress will verbally be discussed with
the PGY1 resident.
Completed Resitrak® evaluations will be co-signed by the Director of the
Residency Program.
XI. Requirements for Program Completion
Completion of the PGY1 residency program is attained by:
a.
b.
c.
d.
Achieving 85% or greater of the Pharmacy Systems I and II goals.
Achieving 85% or greater of all other rotation goals.
Submission of the final paper for the residency project to the Director of the
Residency Program.
Completion of 85% of the required projects listed in section VI of this manual.
The official Bayhealth Medical Center Residency Certificate will be withheld until all
requirements are fulfilled.
XII.
Phone Numbers
Alex Zarow, RPh, MBA
Director of Pharmacy Service
Phone:
744-7020 (KGH)
430-5805 (MMH)
Louis Levenson, RPh, MAS, MSITS
Informatics/ Economic Manager
Phone:
744-6921 (KGH)
430-5440 (MMH)
Rita Montone, RPh, MBA
Site Manager KGH
Phone:
744- 6102 (KGH)
Ryan Majchrzak, RPh, MBA
Site Manager MMH
Phone:
430-6753 (KGH)
430-5563 (MMH)
Karen Freid, Pharm.D.
Residency Director
Phone:
430-5973 (MMH)
744-7517 (KGH)
Carl Popelas, Pharm.D.
Clinical Coordinator
Phone:
744-6950 (KGH)
430-5447 (MMH)