Pharmacy Services

Pharmacy Services Residency

Internal Medicine Academic Faculty

 (PGY1 Rotation - Acute Care)

 
Preceptors:

Jennifer Babin, PharmD
Heather Nyman, PharmD

 
Site Description:

University of Utah Hospital has five acute care internal medicine teams with potential to expand to eight teams in the near future. Three teams are traditional teaching teams comprised of a hospitalist attending, medical resident, interns and students. Two teams are hospitalist led without medical interns or students but may include a medical resident and/or midlevel providers. All internal medicine teams include a clinical pharmacist and each covers up to 20 patients. Common reasons for admission include infection, coagulopathies, pulmonary dysfunction, liver dysfunction, and kidney injury. Patients present with multiple disease states and complicated drug regimens.

 
Rotation Description:

The pharmacist functions as part of a multidisciplinary team. Residents will round with an internal medicine team daily, design medication plans for patients, make recommendations to the medical team to optimize medical treatment, complete admission medication reconciliation, provide patient education and document these activities. Residents will participate in a weekly journal club and one to two topic discussions each week. The preceptors split their time between clinical service at the hospital and an academic appointment at the University of Utah College of Pharmacy. Opportunities are available for interested and motivated residents to be exposed to academic responsibilities of clinical faculty and there are often opportunities to participate in precepting pharmacy students on clinical rotation at the site.

 
RLS Goals for First Acute Care Rotation:

  • Goal R1.1: In collaboration with the health care team, provide safe and effective patient care to a diverse range of patients, including those with multiple co-morbidities, high-risk medication regimens, and multiple medications following a consistent patient care process.
    • OBJ 1.1.1 Interact effectively with health care teams to manage patients’ medication therapy.
    • OBJ 1.1.2 Interact effectively with patients, family members, and caregivers.
    • OBJ 1.1.4 Analyze and assess information on which to base safe and effective medication therapy.
    • OBJ 1.1.5 Design or redesign safe and effective patient-centered therapeutic regimens and monitoring plans.
    • OBJ 1.1.7 Document direct patient care activities appropriately in the medical record or where appropriate.
    • OBJ 1.1.8 Demonstrate responsibility to patients.
  • Goal R1.2: Ensure continuity of care during patient transitions between care settings.
    • OBJ 1.2.1 Manage transitions of care effectively.
  • Goal R3.1: Demonstrate leadership skills.
    • OBJ 3.1.2 Demonstrate personal, interpersonal, and teamwork skills critical for effective leadership.

RLS Goals for Second/Third Acute Care Rotation:

  • Goal R1.1: In collaboration with the health care team, provide safe and effective patient care to a diverse range of patients, including those with multiple co-morbidities, high-risk medication regimens, and multiple medications following a consistent patient care process.
    • OBJ 1.1.1 Interact effectively with health care teams to manage patients’ medication therapy.
    • OBJ 1.1.3 Collect information on which to base safe and effective medication therapy.
    • OBJ 1.1.6 Ensure implementation of therapeutic regimens and monitoring plans (care plans) by taking appropriate follow-up actions.
    • OBJ 1.1.8 Demonstrate responsibility to patients.
  • Goal R1.3: Prepare, dispense, and manage medications to support safe and effective drug therapy for patients.
    • OBJ 1.3.2 Manage aspects of the medication-use process related to formulary management.
  • Goal R3.1 Demonstrate leadership skills.
    • OBJ 3.1.2 Apply a process of on-going self-evaluation and personal performance improvement.
  • Goal R3.2
    • OBJ 3.2.4 Manage one’s own practice effectively.
  • Goal R4.1 Provide effective medication and practice-related education to patients, caregivers, health care professionals, students, and the public.
    • OBJ 4.1.1 Design effective educational activities.

Internal Medicine Rotation Activities and Teaching Methods Linked to Objectives:

Rotation Activity

Teaching Method(s)

Objective

Round daily with an internal medicine team. Make evidence-based recommendations to optimize patients’ medication therapies. Follow-up with medical team and ancillary staff in a timely manner as needed after rounds to assist with optimizing therapeutic plans.

Direct instruction
Modeling
Coaching
Facilitation

R1.1.1 Interact effectively with health care teams to manage patients’ medication therapy.

R1.1.3 Collect information on which to base safe and effective medication therapy.

R1.1.4 Analyze and assess information on which to base safe and effective medication therapy.

R1.1.5 Design or redesign safe and effective patient-centered therapeutic regimens and monitoring plans.

R1.1.6 Ensure implementation of therapeutic regimens and monitoring plans (care plans) by taking appropriate follow-up actions.

R1.1.8 Demonstrate responsibility to patients.

R1.2.1 Manage transitions of care effectively.

R1.3.2 Manage aspects of the medication-use process related to formulary management.

R3.1.2 Demonstrate personal, interpersonal, and teamwork skills critical for effective leadership.

R3.2.4 Manage one’s own practice effectively.

Complete admission medication reconciliation and review discharge medication orders for accuracy.

Modeling
Coaching
Facilitation

R 1.1.2 Interact effectively with patients, family members, and caregivers.

R1.1.8 Demonstrate responsibility to patients.

R1.2.1 Manage of transitions of care effectively.

R3.2.4 Manage one’s own practice effectively.

Document daily activities in the medical record in accordance with site specifications.

Direct instruction
Coaching
Facilitation

R1.1.8 Document direct patient care activities appropriately in the medical record or where appropriate.

R1.2.1 Manage of transitions of care effectively.

R3.2.4 Manage one’s own practice effectively.

Educate patients on oral anticoagulants started or continued in the hospital and other newly initiated medications as appropriate.

Direct instruction
Modeling
Coaching
Facilitation

R1.1.2 Interact effectively with patients, family members, and caregivers.

R4.1.1 Design effective educational activities.

Present and/or facilitate (for residents precepting pharmacy students) journal article and topic discussions.

Coaching
Facilitation

R1.1.4 Analyze and assess information on which to base safe and effective medication therapy.

R4.1.1 Design effective educational activities.

Use and incorporate feedback from preceptors to continuously improve clinical skills.

Coaching
Facilitation

R3.1.2 Apply a process of ongoing self-evaluation and personal performance improvement.

 
Readings and Preparatory Work:

Be familiar with contents of the Medication Management Process https://pulse.utah.edu/site/dirc/Pages/med-mgt-process.aspx

 
Orientation Materials:

Your preceptor will meet with you on the first day of rotation to make an individual orientation plan with you.

 
Typical Daily/Weekly/Monthly Activities:

7:00 – 4:30, Monday through Friday
Topic discussions and journal club will be scheduled during orientation

 
Evaluations:

Evaluations will be documented in PharmAcademic™.

At the midpoint of the rotation, the preceptor will evaluate the resident. At the end of each rotation, the resident will self-evaluate, the preceptor will evaluate the resident, and the resident will evaluate both the preceptor and the learning experience.

Updated March 2016