Pharmacy Services

Pharmacy Services Residency

Westridge Clinic

(PGY1 Rotation - Ambulatory Care)

 
Learning Experience:

Pharmacy Primary Care Services/ Clinic/Patient-Care Activity

 
Preceptors:

Kyle Turner, PharmD
Hannah Fudin, PharmD, BCACP

 
Site Description:

The Westridge Health Center is a primary care clinic in the University of Utah Health community clinic group. Medical specialties include pediatrics, family medicine, internal medicine, OBGYN and urgent care. Additional team members include social work, nursing, care management and others. Westridge serves a diverse patient population including a significant portion of patient on Medicaid. A University of Utah pharmacy is located on site.

 
Learning Experience Description:

The resident will be oriented to the operations of Pharmacy Primary Care Services (PPCS) at the rotation site. The resident will be involved in the provision of comprehensive 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 and participate in clinic meetings and operations as able.

 
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 Methods Rotation Activities
OBJ R1.1.1: (Applying) Interact effectively with health care teams to manage patients’ medication therapy.

Modeling
Coaching
Facilitation

Accomplished during each patient encounter in clinic.
  • Provide patient care to patients presenting for CMM. This includes Pre‐Visit Planning, education on preventative health, lifestyle and medication management and referrals from providers.
  • The resident will utilize the collaborative practice agreements in place for diabetes, hypertension, hyperlipidemia, asthma, smoking cessation, immunizations and refills
  • Explain strategies for convincing patients of the importance of adhering to their therapeutic plans.
  • Develop a therapeutic plan, document in the patient’s chart and then communicate it electronically to the provider.
  • Develop follow-up strategy for communication (in-person, electronic, telephone) based on best practice and patient preference.
  • Utilize patient education to help the patient reach his or her therapeutic goals.
  • The resident will refer a patient to the appropriate healthcare professional as needed.
  • The resident will be actively involved in ordering and assessing lab tests to ensure safety and efficacy through the collaborative practice agreement
  • Appropriate use of primary literature and tertiary resources to determine appropriate drug therapy.
OBJ R1.1.2: (Applying) Interact effectively with patients, family members, and caregivers. Modeling
Coaching
Facilitation
OBJ R1.1.3: (Analyzing) Collect information on which to base safe and effective medication therapy. Modeling
Coaching
Facilitation
OBJ R1.1.5: (Creating) Design or redesign safe and effective patient-centered therapeutic regimens and monitoring plans (care plans). Modeling
Coaching
Facilitation
OBJ R1.1.7: (Applying) Document direct patient care activities appropriately in the medical record or where appropriate. Modeling
Coaching
Facilitation
OBJ R1.2.1 (Applying) Manage transitions of care effectively Modeling
Coaching
Facilitation
OBJ R3.1.2 (Applying) Apply a process of on-going self-evaluation and personal performance improvement Modeling
Coaching
Facilitation
  • Use and incorporate feedback from preceptors to continuously improve clinical knowledge and performance.
OBJ R4.1.2 (Applying) Use effective presentation and teaching skills to deliver education Modeling
Coaching
Facilitation
  • Explain strategies for convincing patients of the importance of adhering to their therapeutic plans.
  • Utilize patient education to help the patient reach his or her therapeutic goals.
  • Participate in care coordination team meetings with all members of the collaborative team for high risk patients, provide pharmacy-specific recommendations and follow-up with patients and care team
  • The resident will choose ONE topic of their interest and in the interest of advancing knowledge within Westridge Health Center. The resident is required to obtain topic approval by their primary preceptor to facilitate an in-service to the clinical healthcare team
  • The resident will participate in therapeutic discussions with the preceptor on a weekly basis on topics in each of the following areas: diabetes, asthma, hypertension, and hyperlipidemia. Other topic discussions may be introduced as time permits. Preparation prior to these discussions is expected of the resident
Note: Direct patient care activities include office visit, telephone calls and electronic communication via EHR

 
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.

  • 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014; 311(5):507-520. doi:10.1001/jama.2013.284427. . On the web at: http://jama.jamanetwork.com/article.aspx?articleid=1791497
  • National Asthma Education and Prevention Program Expert Panel Report 3: guidelines for the diagnosis and management of asthma. NIH Publication Number 08-5846. October 2007. On the web at: http://www.nhlbi.nih.gov/guidelines/asthma/asthsumm.htm
  • Standards of Medical Care in Diabetes—2016. Diabetes Care. January 2016 38:S1-S93; doi: 10.2337/dc15-S003. On the web at http://care.diabetesjournals.org/content/suppl/2016/12/23/38.Supplement_1.S4.DC1/January_Supplement_Combined_Final.6-99.pdf
  • 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. On the web at: https://circ.ahajournals.org/content/early/2013/11/11/01.cir.0000437738.63853.7a.full.pdf

Role of the Pharmacist:

The pharmacist will work to provide comprehensive medication management for patient seen within the clinic which involved the identification and resolution of medication-related problems as a member of the health care team. The pharmacist takes responsibility for medication-related outcomes of the patients we serve.

 
Typical Daily Activities/Resident Expectations:

The resident will average 5 days per week in clinical patient-care 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 patient identification, patient scheduling, preparing for patient visits, seeing patients, documenting patient encounters, patient follow-ups and responding to drug information questions from providers and clinic team members.

 
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 August 2017