Pharmacy Services

Pharmacy Services Residency

Cardiology

 (PGY1 Rotation - Ambulatory Care)

 
Preceptor:

Adam Smith, PharmD

 
Site Description:

The University of Utah Cardiovascular Center provides comprehensive cardiac care with the latest innovations and clinical therapies. The clinic is composed of general, interventional, and congenital cardiology, heart failure and transplant, electrophysiology, cardiothoracic surgery, and vascular surgery. The pharmacist provides clinical pharmacy services including patient education, medication review and adjustments, drug information, and provider education to all subspecialties. The interprofessional team includes attending cardiologists and subspecialists, cardiology fellows, nurse practitioners, physician assistants, nurses, study coordinators, and medical assistants.

 
Rotation Description:

The clinical pharmacist is responsible for providing drug information to both patients and the practitioners working the cardiovascular clinic. The pharmacist will complete medication reconciliation on selected patients, identify and resolve problems, and provide recommendations through communication with the interprofessional team. You will have extensive one-on-one interaction with patients, providers, and ancillary staff. You will also have the opportunity to attend cardiology grand rounds and cardiology clinical conferences and view diagnostic and/or interventional studies related to cardiology.

Case presentations, journal clubs, drug therapy updates, in-service presentations, facilitating the heart failure education class, and precepting pharmacy students may all be a part of the rotation. The resident will discuss with the preceptor a variety of cardiology related topics.

Upon completion of the rotation, the resident will have increased knowledge of the pathophysiology, diagnosis, and pharmacological treatment of cardiovascular disease states including heart failure, hypertension, dyslipidemia, coronary artery disease, vascular disease, pulmonary hypertension, arrhythmias, and anticoagulation.

 
Activities Evaluated and Taught:

Goals and Objectives

Teaching Method(s)

Related Rotation Activities

Goal R  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 R1.1.1:  Interact effectively with health care teams to manage patients’ medication therapy. (Am Care I)

Modeling
Coaching
Facilitation

  • Learner will effectively collaborate with the various cardiology subspecialty teams to provide patient care.

OBJ R1.1.2:  Interact effectively with patients, family members, and caregivers. (Am Care I and II)

Customized based on resident’s baseline skills and progression

Direct instruction
Modeling
Coaching
Facilitation

  • Learner will conduct at least 5 patient interviews daily to determine adherence to and issues with current medication therapy.
  • Learner will communicate (face-to-face, by phone, or written) with patients, providers, health care facilities, and pharmacies as needed to facilitate therapeutic plans.
  • Learner will assist in teaching the Heart Failure Education Class if it occurs during the course of the rotation.

OBJ R1.1.3:  Collect information on which to base safe and effective medication therapy. (Am Care I)

Customized based on resident’s baseline skills and progression

Direct instruction
Modeling
Coaching
Facilitation

  • Learner will review at least 5 patient charts prior to daily visit.
  • Learner will conduct at least 5 patient interviews daily to determine adherence to and issues with current medication therapy.
  • Learner will review charts and the medical literature as needed to answer medication therapy questions.

OBJ R1.1.4:  Analyze and assess information on which to base safe and effective medication therapy. (Am Care II)

Customized based on resident’s baseline skills and progression

Direct instruction
Modeling
Coaching
Facilitation

  • Learner will analyze and assess information collected during chart review, patient interviews, and literature review to guide medication therapy.

OBJ R1.1.5:  Design or redesign safe and effective patient-centered therapeutic regimens and monitoring plans (care plans). (Am Care I and II)

Customized based on resident’s baseline skills and progression

Direct instruction
Modeling
Coaching
Facilitation

  • Learner will formulate therapeutic plans for patients seen in clinic and as needed in response to questions by the patients or providers.
  • Learner will discuss plans with the preceptor as needed.
  • Learner will appropriately document patient encounters in the electronic health record.

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

Modeling
Coaching
Facilitation

  • Learner will communicate (face-to-face, by phone, or written) with patients, providers, health care facilities, and pharmacies as needed to facilitate therapeutic plans.
  • Learner will appropriately document patient encounters in the electronic health record.

OBJ R1.1.7:  Document direct patient care activities appropriately in the medical record or where appropriate. (Am Care I)

Direct instruction
Modeling
Coaching
Facilitation

  • Learner will appropriately document patient encounters in the electronic health record which may include writing notes and updating patient information.

OBJ R1.1.8:  Demonstrate responsibility to patients. (Am Care II)

Modeling
Coaching
Facilitation

  • Learner will ensure all activities are performed with patient-centered values.
  • If all needs cannot be met for a patient, learner will take initiative to pass along information needed to take care of the patient.
  • Learner will appropriately document patient encounters in the electronic health record.

Goal R1.2:  Ensure continuity of care during patient transitions between care settings

OBJ R1.2.1:  Manage transitions of care effectively. (Am Care I)

Modeling
Coaching
Facilitation

  • When selecting patients to interview, learner will make those with a recent transition a priority.
  • Learner will contact patients, providers, health care facilities, and pharmacies as needed to manage transitions.

Goal R3.1:  Demonstrate leadership skills.

OBJ R3.1.2:  Apply a process of on-going self-evaluation and personal performance improvement. (Am Care I and II)

Coaching
Facilitation

  • Learner will self-assess baseline cardiology knowledge and ambulatory care experience prior to beginning rotation and communicate gaps to the preceptor.
  • Learner will apply feedback to future patient and provider encounters.
  • Learner will self-assess progress at the end of the rotation experience.

Goal R3.2:  Demonstrate management skills.

OBJ R3.2.4:  Manages one’s own practice effectively. (Am Care II)

Modeling
Coaching
Facilitation

  • Goal will be for learner to independently run the Heart Failure, General Cardiology, and/or Dyspnea Clinic by the last week of rotation.

Goal R4.1:  Provide effective medication and practice-related education to patients, caregivers, health care professionals, students, and the public.

OBJ R4.1.2:  Use effective presentation and teaching skills to deliver education. (Am Care I and II)

Coaching
Facilitation

  • Learner will prepare and present a journal club, case, or in-service as needed to health care professionals.
  • Learner will provide medication or other education as needed to patients and providers.
  • Learner will assist in teaching the Heart Failure Education Class if it occurs during the course of the rotation.

 
Possible Readings/Topics/References:

Project or Presentation Description:

The resident will complete one journal club, in-service presentation, case presentation, or other assignment depending on resident and/or preceptor preference.

 
Typical Daily/Weekly/Monthly Activities:

Monday – General Cardiology 0800-1200, Heart Failure 1230-1700
Tuesday – General Cardiology 0800-1200, Heart Failure 1230-1700 (or all day Dyspnea Clinic)
Wednesday – General Cardiology 0800-1200, Heart Failure 1230-1700
Thursday – General Cardiology 0800-1200, Heart Failure 1230-1700 (or all day Dyspnea Clinic)
Friday – Heart Failure 0830-1200, General Cardiology 1300-1700
Monthly meetings – attend meetings with preceptor as needed

 
Evaluation:

The resident will receive regular formative feedback related to patient care activities, patient education, and other activities. A midpoint evaluation will be scheduled after 2 weeks of rotation and a final summative evaluation will be completed at the end of the rotation in PharmAcademic.

Updated March 2016