Abbott Northwestern Hospital
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Pharmacy Residency Program rotations
During each rotation, the resident is responsible for collaborating with that area’s pharmacists, nurses and physicians to identify, prevent and resolve medication therapy issues. The resident must devise efficient strategies for accomplishing all required activities in a limited time frame. The focus of each rotation will be specific to the area, but may include other medication use issues as needed to care for the patients. Emphasis will be placed on the resident’s ability to improvetheir clinical skills in the selected area; however, the total care of the patient will also be taught. This includes the ability to multi-task and perform necessary dispensing functions. By the end of the rotation, the resident should be competent to work independently as a novice pharmacist in the particular area, including:
The preceptor will be accountable for evaluating and providing feedback to the resident. The resident may work with several pharmacists during each rotation.
The cardiology rotation is designed to give the resident an opportunity to interact with various types of cardiology patients: CHF, arrhythmia, acute coronary syndrome (ACS), primary pulmonary hypertension (PPH), interventional, cardiac surgery patients and critically ill patients with a cardiology-related primary diagnosis. The resident will work with a patient-centered care team composed of physicians, pharmacists, nurses, dieticians, speech therapists, social workers, chaplains and respiratory therapists. Residents are expected to interact with each member as appropriate and gain experience and confidence as a member of the team.
The Infectious Diseases experience is an elective rotation of the Residency at Abbott Northwestern. The resident is provides pharmaceutical care to patients with infectious diseases as part of that department’s consultation service. The resident will be rounding with three private infectious diseases consult groups. Each team will include a physician and may include an infectious diseases fellow and/or a medical resident. During this rotation the resident will identify and resolve medication therapy issues for patients as it pertains to infectious diseases. The resident will utilize current treatment guidelines to develop patient-specific pharmacotherapy regimens and monitoring plans. The resident will perform pharmacokinetic calculations to design drug regimens and modify regimens based on drug levels obtained.
The critical care rotation allows the resident to identify patient-specific problems in critically ill patients and apply clinical therapeutic knowledge to provide patient care. In addition, the resident will monitor therapeutic drug regimens for efficacy and toxicity and become familiar with disease states common to critically ill patients. Interaction with other members of the care team is crucial to gain experience and confidence.
The Internal Medicine rotation occurs in the last four months of the residency. A semi-autonomous rotation, the resident is assigned to the Internal Medicine team working and rounding with internal medicine residents and faculty. A pharmacy preceptor serves to consult twice a week (more often if needed).
This patient population includes those with acute kidney injury, hemodialysis, peritoneal dialysis, CRRT, and heart/kidney transplant. Residents identify patient specific problems in renal disease and heart/kidney transplantation and develop skills related to the identification, resolution and prevention of drug therapy problems in these patients. Rotation activities include: rounding with nephrology group, seeing and responding to patient consults and reviewing outpatient medication regiments and meeting with heart transplant patients in clinic twice weekly.
During this rotation, the resident will initiate, follow and document anticoagulation/kinetics/TPN for assigned patients and establish collaborative professional relationships with members of the health care team. This is achieved through effective medication and practice-related education, training, and counseling to patients, caregivers, healthcare professionals and the public.
The hematology/oncology clinical rotation is an elective rotation for residents interested in the oncology specialty with an emphasis on supportive care. The resident will provide hematology/oncology pharmaceutical care for inpatients on the oncology station and outpatients in the Infusion Center. During this rotation the pharmacy resident will identify and resolve medication therapy issues for patients as it pertains to oncology or hematology care. The resident will use current treatment guidelines to develop, monitor, and adjust patient-specific pharmacotherapy regimens and monitoring plans. The resident will be involved in patient education for patients initiating chemotherapy, antibiotics, iron therapy or other treatments as they come up. The resident will follow all patients admitted for chemotherapy, and other patients identified by either the resident or preceptor.
The purpose of the Practice Management rotation is to enhance the resident’s understanding of the role of pharmacy management and leadership in meeting the goals of the organization. Through assigned readings, focused discussions, projects, and observational and participative experiences, the resident will gain knowledge and skills related to financial operations, purchasing, medication safety, medication distribution, regulatory compliance, and collaboration with other disciplines. The resident will be challenged to evaluate and express insight related to their ongoing experiences, and the manifestations of leadership.
The resident will work routinely with the Pharmacy Operations Manager(s), nursing participants in multidisciplinary committees and projects, Allina Health pharmacy leaders and other leaders on an ad-hoc basis. The resident will attend department staff meetings, director-manager meetings and other department meetings as assigned by the preceptor.
The resident will follow a decentralized pharmacist in the inpatient psychiatry wards and round with an inpatient psychiatrist and be available for questions and recommendations. Additionally, residents will round with a psych-specialty certified nurse practitioner during inpatient psychiatry consultations on the medical units and be available for questions and recommendations. Other activities include teaching a medication education class to outpatient mental health patients, working with a chemical dependency counselor to gain experience with the chemical dependency programs and learning about the legal processes involved in inpatient psychiatry by spending time with a social worker.
The Renal-Medical/Surgical experience is a five-week elective rotation and introductory experience. The resident is responsible for providing pharmaceutical care to patients admitted to stations E4000 and E4100, predominantly post-surgical and a variety of medicine and renal patients. Residents gain invaluable experience in patient monitoring, pain management, parenteral nutrition, bariatric services, acute/chronic renal failure, pharmacy managed anticoagulation and pharmacy to dose antibiotics. The resident will also have the opportunity to round with the nephrology consult group which sees all acute/chronic renal failure and kidney transplant patients in the hospital.
This rotation is directed through the Allina Health Center for Drug Policy (CDP). The primary functions of the CDP are to coordinate the activities of the Allina Health System Formulary Committee and to coordinate system-wide responses to medication safety alerts. CDP staff also participate in educational and policy initiatives regarding medications and medication use.
Each resident will be assigned at least one new drug monograph or therapeutic class review, which should be completed during the time they are on the rotation. The resident may need to make arrangements to attend the System Formulary Committee meeting to present his/her work at a later date, if the SFC meeting dates do not coincide with the rotation dates. Additionally, the resident may be assigned work on an additional formulary-related project and/or may be asked to contribute to the monthly Ambulatory Medication News newsletter. Each resident will participate in weekly topic discussions with the preceptor and also a single discussion with the senior buyer for Allina Health pharmacy. The resident may also attend and participate in various meetings related to CDP activities, as directed by the preceptor.