Infectious Diseases Consult Service
(PGY1 Elective Rotation)
Russell Benefield, PharmD, BCPS (AQ-ID)
The Infectious Diseases (ID) Consult Services are responsible for all inpatient consults for University Hospital (488 beds) and Huntsman Cancer Institute (100 beds). There are 2 teams consisting of a General ID Consult Service and an Immunocompromised ID Consult Service. The Immunocompromised ID Consult Service is responsible for all inpatient consults for the Huntsman Cancer Institute, as well as inpatient consults for immunocompromised patients (largely solid organ transplant recipients) and patients with ventricular assist device-related infections at University Hospital. The General ID Consult Service is responsible for the remainder of patients at University Hospital, including some patients with immunocompromising conditions such as HIV/AIDS. Each consult team carries an average patient load of 8-10 patients, with considerable variance at times. The teams consist of an attending physician, fellow, and occasionally 1 medical resident. An ID pharmacist (i.e. the preceptor) rounds regularly with the Immunocompromised ID service.
Role of Pharmacist:
The ID pharmacist is an integral member of the consult teams and is responsible for optimizing anti-infective therapy for all patients of his team.
The resident is expected to serve the team in the role of the ID pharmacist to the best of his/her ability by participating actively in daily patient-care rounds, literature evaluation, patient presentations, and disease and drug analyses and discussions. The rotation will consist of two, two-week blocks spent with each consult service to maximize the breadth of learning experiences available. The resident will round independently with the General ID team (with preceptor support), and with the preceptor on the Immunocompromised ID team. The resident is challenged to develop individualized therapeutic recommendations and monitoring plans daily. Development of critical thinking skills is paramount in this rotation. Each team has daily rounds in the afternoons, usually 1-6 pm. The resident will be responsible to round for the entire period the team is rounding.
|Outcomes, Goals, Objective Number (Level of Learning Required) & Description||Methods||Rotation Activities|
|Outcome R1: Patient Care|
|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||Modeling, Coaching, Facilitation||
|OBJ R1.1.4 Analyze and assess information on which to base safe and effective medication therapy||Direct Instruction, Modeling, Coaching, Facilitation||
|OBJ R1.1.5 Design or redesign safe and effective patient-centered therapeutic regimens and monitoring plans (care plans)||Modeling, Coaching||
|OBJ R1.1.6 Ensure implementation of therapeutic regimens and monitoring plans (care plans) by taking appropriate follow-up actions||Direct Instruction, Modeling, Coaching, Facilitation||
|Goal R1.3 Prepare, dispense, and manage medications to support safe and effective drug therapy for patients|
|OBJ R1.3.2 Manage aspects of the medication-use process related to formulary management||Direct Instruction, Modeling, Coaching||
|Outcome R3: Leadership and Management|
|Goal R3.2 Demonstrate management skills|
|R3.2.4 Manages one’s own practice effectively||Modeling, Coaching, Facilitation||
Readings and Preparatory Work:
The resident is expected to identify his or her own search strategy to retrieve relevant readings and literature with general guidance and supplementation from the preceptor.
The resident will prepare and lead topic discussions on specific topics related to infectious diseases with emphasis on medical microbiology and antimicrobial pharmacotherapy. Operational and antimicrobial stewardship issues will also be presented and discussed with the preceptor. Patient care plans will be presented multiple times daily to the preceptor. Additionally, in-services on a range of infectious diseases topics may be presented to the ID teams.
Typical Daily/Weekly/Monthly Activities:
Hours vary depending on the patient load and rounding schedule of the consult services as well as the level of preparation of the resident. In general the rotation hours will be from 9:00 am to 6:30 pm Monday through Friday. Residents may need to come in earlier or stay later to meet patient care needs. Supplemental reading and preparation for topic discussions will require an additional time commitment outside of the rotation.
Morning topic discussions will be held Monday through Friday from 9:00 to 11:00 AM barring exceptional circumstances. This time is intended for daily presentations of patient care plans, disease and drug reviews, and operational/stewardship issues. Additionally, the residents are expected to attend the weekly Infectious Diseases Core Curriculum Conferences (Monday mornings from 8:00-9:00 am), Fellows Case Conference or Journal Club (Wednesday afternoons from 12:00-1:00 pm), and Case Conferences (Thursday afternoons from 4:00-5:00 pm)
Residents are expected to work to care for patients, read, and discuss patients for as long as it takes to ensure best patient care.
The resident will receive regular oral feedback regarding his or her thought processes, therapeutic plans, and follow-up. The resident will have formative snapshot self and preceptor evaluations at the midpoint and summative self and preceptor evaluations of all goals at the end of the rotation. The resident will complete preceptor and learning experience evaluations at the end of the rotation. The evaluations will be documented in PharmAcademic within 7 days after completion of the learning experience.
Updated September 2017