Pharmacy Services

Pharmacy Services Residency

Redwood Clinic I

(PGY1 Rotation - Ambulatory Care)

 
Preceptors:

Macheala Jacquez, PharmD, BCACP
Megan Lowe, PharmD, BCACP
Jenni Buu, PharmD, BCACP

Learning Experience:

Pharmacy Primary Care Services/ Clinic/Patient-Care Activity

 
Site Description:

The Redwood Health Center Pharmacy is a high volume (approximately 700 prescriptions per day) pharmacy that primarily serves a diverse patient population and employees of the University of Utah Health System.

 
Learning Experience Description:

The resident will be oriented to the operations of the pharmacy primary care services at the rotation site. The resident will be involved in the provision of medication management as well as patient-centered services via the use of multiple collaborative practice agreements including, but not limited to, diabetes, hypertension, hyperlipidemia, asthma, and smoking cessation. The resident will actively manage chronic disease states and communicate this care with the patient and the other healthcare providers. Throughout this experience, the resident will be in contact with physicians, nurses, medical assistants and other clinical pharmacists.

 
Educational Goals:

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.
Goal R1.2  Ensure continuity of care during patient transitions between care settings
Goal R3.1  Demonstrate leadership skills
Goal R4.1  Provide effective medication and practice-related education to patients, caregivers, health care professionals, students, and the public (individuals and groups)

 
Activities Evaluated:

Objective Number (Level of Learning Required) & Description Teaching Methods Rotation Activities
OBJ R1.1.1: (Applying) Interact effectively with health care teams to manage patients’ medication therapy. Modeling, Coaching, Facilitation
  • Receive referrals from clinic providers for chronic disease state management, education, medication reconciliation, etc. in order to assist providers and enhance patient care.
  • Attend high risk care conferences for all clinic providers along with nursing, social work and care managers to develop an interdisciplinary plan for high risk patients.
OBJ R1.1.2: (Applying) Interact effectively with patients, family members, and caregivers. Modeling, Coaching, Facilitation
  • Interact with many different types of patients, family members, home health nurses and interpreters through office visits, telephone and electronic follow-up.
OBJ R1.1.3: (Analyzing) Collect information on which to base safe and effective medication therapy. Direct instruction, Modeling, Coaching,
Facilitation
  • Patients scheduled for clinical pharmacy visits will be worked up and presented on a daily basis in clinic. Emphasis will be placed on efficiently and accurately interviewing the patient during the visit in order to ascertain patient-specific information.
OBJ R1.1.5: (Creating) Design or redesign safe and effective patient-centered therapeutic regimens and monitoring plans (care plans). Modeling, Coaching, Facilitation
  • The resident will have multiple opportunities to design care plans for new referrals during initial office visits (avg 2-3 daily) and redesign plans during patient follow up (avg 2-3 in person and 15-20 over the phone daily).
  • Monitor patient’s therapy with each interaction including goals and pertinent labs.
OBJ R1.1.7: (Applying) Document direct patient care activities appropriately in the medical record or where appropriate. Modeling, Coaching,
Facilitation
  • Patient visits will be documented in Epic using the clinical pharmacy ambulatory care smart text note. Follow-up calls will also be documented in Epic as telephone encounters. Documentation will be routed to referring provider in a timely manner. Maintain follow-up schedule on patient task list in Outlook.
OBJ R1.2.1 (Applying) Manage transitions of care effectively   Not addressed
OBJ R3.1.2 (Applying) Apply a process of on-going self-evaluation and personal performance improvement Direct instruction, Modeling, Coaching, Facilitation
  • Daily informal debriefs to guide the resident’s self-evaluation of what went well and what can be improved on going forward.
  • Residents will be given feedback on patient interactions, provider interactions and formal presentations throughout the rotation.
OBJ R4.1.2 (Applying) Use effective presentation and teaching skills to deliver education Direct instruction, Modeling, Coaching, Facilitation
  • Develop the ability to create individualized patient education taking into account diverse cultural factors. Education will include goals of therapy, basic pathophysiology, therapeutic life style changes, understanding medications, compliance and any other disease state specific information.
  • Resident will be assigned a presentation (in-service, patient case, journal club, etc.) to give to pharmacy staff.

 
Preparatory Work/Resources:

Be familiar with the common disease states found in primary care. These include, but are not limited to, diabetes, hyperlipidemia, hypertension, asthma and smoking cessation.

Typical Daily Activities:

The resident will average 4 days per week in clinical patient-care activities and 1 day per week devoted to didactic activities. The resident is expected to work toward developing autonomy in managing this service and will be viewed as a team member from the start of the residency. While in clinic, the resident will be responsible for all of the duties associated with the Pharmacy Primary Care Services including preparing for patient visits, seeing patients, documenting patient encounters, patient follow-ups and participation in high risk care conferences.

 
Evaluations:

The resident will receive informal face-to-face evaluations on almost a daily basis. This will ensure that progress is made each day in clinic. Formal evaluations will be documented in PharmAcademic™. The resident will complete a mid-point and final self-evaluation as well as evaluations of both the preceptor and the learning experience. The preceptor will also complete a mid-point and final evaluation of the resident.

Updated November 2016