Pharmacy Services

Pharmacy Services Residency

Gastroenterology

(PGY1 Rotation - Ambulatory Care)

 
Preceptor:

Anthony Dalpiaz, PharmD

 
Site Description:

The Gastroenterology clinic is located within the University of Utah Health Hospital. The clinic is adjacent to many specialty clinics, infusion center, laboratory, and outpatient pharmacy. Clinical pharmacy services include patient education and consultation in hepatitis C, inflammatory bowel disease, GERD, eosinophilic esophagitis, and other general GI issues.

 
Rotation Description:

You will review and reconcile patient medications in clinic. Provide patient education on disease state management and new medications, evaluate drug therapy regimens, provide recommendations for optimizing drug therapy, monitoring, and patient adherence. You will also be involved in the triage process of medication-related problems of clinic patients. You will lead a topic discussion every week and may present 1 inservice for nursing staff AND may do one major clinic project (i.e., patient education handout). You will be interacting extensively with patients, providers, and ancillary personnel. The fellow’s clinic will have many opportunities to provide provider education and drug information. You will also be required to attend Internal Medicine Grand Rounds on a weekly basis, Gastroenterology clinical conference on a weekly basis if applicable, and attend Utah Medicaid Drug Utilization Review Board meetings on a monthly basis.

 
RLS Goals

RLS Goals Evaluated

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.

R1.1.1 Interact effectively with health care teams to manage patients’ medication therapy*
R1.1.2 Interact effectively with patients, family members, and caregivers
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 (care plans)
R1.1.6 Ensure implementation of therapeutic regimens and monitoring plans (care plans) by taking appropriate follow-up actions**
R1.1.7 Document direct patient care activities appropriately in the medical record or where appropriate*
R1.1.8 Demonstrate responsibility to patients**

R1.2

Ensure continuity of care during patient transitions between care settings.*

R1.2.1 Manage transitions of care effectively*

R3.1

Demonstrate leadership skills

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

R3.2

Demonstrate management skills**

R3.2.4 Manages one’s own practice effectively**

R4.1

Provide effective medication and practice-related education to patients, caregivers, health care professionals, students, and the public (individuals and groups)

R4.1.2 Use effective presentation and teaching skills to deliver education

*Amb Care-1 only; **Amb Care-2 only

 
Rotation Activities and Teaching Methods Linked to Objectives:

Rotation Activity

Teaching Methods

Objective

Conduct 3-10 patient interviews per day to determine current drug therapy and relevant medication history.

Modeling
Coaching
Facilitating

R1.1.3
R1.1.8

Evaluate medication therapy and identify medication-related problems on all patients interviewed in the clinic.  Communicate recommendations for modifying drug therapy directly to the provider.

Instruction
Modeling
Coaching
Facilitating

R1.1.4
R1.1.5
R1.2.1

Respond to drug information questions from providers and patients in the gastroenterology and inflammatory bowel disease clinic.

Instruction
Modeling
Coaching
Facilitating

R1.1.2
R1.1.8

Participate in the IBD Clinic team by providing medication information and education to the patients and providers and to ensure patient has access to drug therapy.

Modeling
Coaching
Facilitating

R1.1.1
R1.1.2
R1.1.6

Document all patient interventions and medication reviews.

Coaching
Facilitating

R1.1.7

Provide patient education on the various drug treatments and design patient education handouts as needed.

Modeling
Coaching
Facilitating

R1.1.2
R4.1.2
R1.1.8

Lead topic discussion and journal club

Coaching
Facilitating

R4.1.2

Attend weekly GI conferences and Internal Medicine Grand Rounds if applicable

Coaching
Facilitating

R3.1.2

Complete a GI-related in service and relevant clinic project as needed

Coaching
Facilitating

R4.1.2

Use and incorporate feedback from preceptors to continuously improve patient care activities (communication, documentation)

Coaching

R3.1.2

 
Core Topics to be Covered During Rotation:

  • GERD
  • Eosinophilic esophagitis
  • Inflammatory bowel disease
  • Irritable bowel syndrome
  • Gastroparesis
  • End-stage liver disease/hepatitis
  • Hepatitis C
  • NASH/fatty liver disease

Readings and Preparatory Work:

  • GERD/EoE guidelines
  • AASLD hepatology guidelines for hepatitis C and management of end-stage liver disease
  • Inflammatory bowel disease guidelines

Project/Presentation Description (as needed):

You will give a 15-25 minute inservice to either the clinic ancillary personnel or providers AND you will create a 1-2 page patient education handout on a given topic such as a disease state, commonly prescribed new medications, or pertinent issues that arise.

 
Typical Daily Activities:

Anticipated schedule:
Monday— GI clinic 0800-1500 in Clinic 3; topic discussion AM?
Tuesday— General GI Clinic 0800-1600 in Clinic 3
Wednesday— General GI/IBD 0800-1600 in Clinic 3; topic discussion PM?
Thursday— Hepatitis C clinic 0830-1300 in Liver Clinic; Project time PM

Friday—IBD Clinic 0800-1130 in Clinic 3; ECHO HCV clinic 1130-1300, HCV education PM in Liver Clinic, topic discussion PM

 
Evaluations:

Evaluations will be documented in PharmAcademicTM.

At the midpoint of the rotation, the preceptor will evaluate the resident. At the end of the rotation, the resident will self-evaluate, the preceptor will evaluate the resident, and the resident will evaluate both the preceptor and the learning experience. A final summative evaluation will be completed at the end of the rotation.

The resident will receive regular formative feedback related to patient care activities, patient education, and inservice.

Updated March 2016