PGY1 Pharmacy Residency

The purpose of the 5-6 week required orientation rotation is to familiarize the new residents with the responsibilities of the residents within Mercy Hospital’s PGY1 residency program. Components of Orientation will include the organization’s new employee orientation (8 hours of live and asynchronous online learning modules), electronic medical record training (1/2 day), residency program orientation (2 days), and pharmacy department orientation (remainder of Orientation month). 

The Critical Care rotation is a required 5-week rotation that takes place on both the Mercy and Unity Campuses. The Mercy Campus ICU is licensed for 25 critical care beds with a patient population including a mix of medical and surgical ICU patients, while the Unity Campus SCU is licensed for 18 specialty care beds with patients who have care needs that are less than an ICU but more than a medical/surgical unit. The purpose of the rotation is to offer an opportunity for the resident to provide pharmacist patient care to critically ill patients. The resident will design, recommend, monitor, and evaluate patient-specific therapeutic regimens for selected critically ill patients and be a resource for the team when attending daily rounds and answering drug information questions.

This 52-week longitudinal experience prepares PGY1 residents to competently respond to inpatient medical emergencies (primarily Code Blue cardiac arrests) as part of the hospital’s interprofessional code team at Mercy Hospital, Mercy Campus. Mercy Hospital is a full-service community hospital, a level II Trauma Center, and Comprehensive Stroke Center.

All residents participate, while on rotation at Mercy Campus. Residents rotate regularly as the on-call code responder (rotation frequency will vary based on each year’s residency schedule, but residents can expect to rotate every four weeks). During their assigned weeks, the resident carries the code pager and responds immediately to all adult “Code Blue” alerts hospital-wide alongside the responding staff pharmacist (hereafter referred to as the “supervising preceptor”). Residents will be exempt from rotation if they are concurrently on their Emergency Medicine rotation.

The resident’s role is to manage all medication-related needs during the resuscitation (under supervision), in order to gain confidence and competence in emergency pharmacotherapy. By the end of the year, residents will be proficient in providing pharmaceutical care during codes and will have improved self‐confidence in emergency response, preparing them to serve as independent pharmacists at future codes.

Internal Medicine (IM) is a required, five to six week learning experience at Mercy Hospital (on both Mercy and Unity campuses). Pharmacy residents will participate, when assigned, to direct patient care activities as well as interdisciplinary instructional activities (in-services). Pharmacy residents will not participate in formal patient care rounds however will have the opportunity to collaborate with physicians and other health care providers during the rotation. The IM rotation patient census will be determined by the preceptor and will typically involve 10-20 patients/day. The preceptor will round with the resident daily to assess ongoing patient care needs.

Infectious Disease (ID) is a required, two-week learning experience at Mercy Hospital-Mercy Campus. The rotation will give an opportunity for the resident to provide patient care to selected infectious disease patients while working closely with other health professionals. One week of the rotation, the resident will complete several topic discussions on pertinent infectious disease topics, reviewing the most recent guidelines and applicable system and site policies. The other week of the rotation, the resident will round with infectious disease providers, shadow in the Allina Central Laboratory, and spend time off-site in a clinic setting, as available. The patient population will include a mix of medical, intensive care, and surgical patients.

The Leadership rotation is a one-week required rotation taking place at Mercy Hospital. Mercy Hospital is one hospital on two campuses in Coon Rapids and Fridley Minnesota; it is licensed for 546 beds between the two campuses. Mercy hospital is part of Allina Health, which is a not-for-profit health system comprised of 12 hospitals, 90+ clinics, and 15 retail pharmacy sites throughout Minnesota and western Wisconsin. While the Leadership Rotation will be conducted at Mercy Hospital, the resident will be involved in meetings that include work across additional Allina Health facilities. The learning experience will help the resident to gain an understanding of the intricacies of providing pharmacy services in an institutional setting and how pharmacy services fit into the larger sphere of the health system. Time will be spent attending meetings and having high-level topic discussions. The resident will also develop or update an applicable policy or procedure under the direction of the pharmacy coordinator to further their learning and present this to key stakeholders.

Medication Safety is a required, 12-month, longitudinal learning experience. This rotation is aimed at providing the resident with a solid foundation and equipping them with the knowledge and tools to identify, develop, and implement safe medication practices, as these are responsibilities of every pharmacist. The resident will gain knowledge through reading medication safety literature, evaluating medication error data, assessing compliance with technology related safety features and policies, and participate in medication safety committee meetings and discussions. The knowledge will then be applied to develop and implement initiatives to improve the medication use system.

The required 2-week precepting rotation is designed to give the resident hands-on precepting and teaching experience by coordinating two, one-week Introductory Pharmacy Practice Experience (IPPE) rotations for University of Minnesota College of Pharmacy students.  This experience will help residents develop skills to be an effective preceptor by allowing them to coordinate student schedules, develop topic discussions, and demonstrate thorough literature evaluation. The resident engages in developing the IPPE students' experience with guidelines provided by the college of pharmacy. The resident will closely collaborate with the pharmacy student coordinator to develop the first IPPE rotation. During the second IPPE rotation, the resident will be the student's main contact with the student coordinator available as a resource.

The Practice Management I rotation is a 4-week required learning experience primarily taking place at Mercy Hospital-Unity campus; this campus is a level IV trauma center licensed for 207 beds located in Fridley Minnesota. Unique services include Mental Health and Addiction Treatment. Mercy Hospital- Unity campus is a part of Allina Health, which is a not-for-profit health system comprised of 12 hospitals, 90+ clinics, and 15 retail pharmacy sites throughout Minnesota and western Wisconsin. The purpose of the Practice Management I rotation is to enhance the resident's understanding of the health system organization and the role of pharmacy in meeting the goals of the organization at a detailed level.  The resident will gain knowledge and skills in the management of the medication use process, clinical programs, personnel, and financial operations. The resident will be involved in administrative activities and projects throughout the course of the rotation.  The resident will be expected to develop independent problem-solving skills related to assessing the impact of pharmacy services on the medication use process and developing and implementing recommendations for improvement.

Practice Management II is a required one-week rotation at Mercy Hospital-Mercy Campus. The resident will attend meetings and work on projects with the manager of home infusion services, who operates out of the inpatient pharmacy at Mercy Campus. Mercy Hospital is one hospital on two campuses in Coon Rapids and Fridley Minnesota; it is licensed for 546 beds between the two campuses. Mercy hospital is part of Allina Health, which is a not-for-profit health system comprised of 12 hospitals, 90+ clinics, and 15 retail pharmacy sites throughout Minnesota and western Wisconsin.  The purpose of this rotation is to enhance the resident's understanding of the health system organization and the role of home infusion in meeting the goals of the organization at a detailed level.  The resident will gain knowledge and skills in the management of the medication use process, clinical programs, personnel, and financial operations. The resident will be involved in administrative activities and projects, as assigned by the preceptor.  The resident will be expected to develop independent problem-solving skills related to assessing the impact of home infusion pharmacy services on the medication use process and developing and implementing recommendations for improvement.

The longitudinal staffing rotation is a required year-long experience designed to give the residents exposure to a variety of staffing locations throughout Mercy Hospital, Mercy and Unity Campuses. This includes experiences staffing in the central pharmacy, medication history, and decentral/clinical areas. Residents will staff approximately 3 of every 8 weekends and 1 weekday evening per month. Residents will also staff 3 holidays during the residency year on both Mercy and Unity campuses.

The System Formulary learning experience is a required, 8-week, longitudinal rotation for all PGY1 Pharmacy Residency Programs in Allina Health, which is a not-for-profit health system comprised of 12 hospitals, 90+ clinics, and 15 retail pharmacy sites throughout Minnesota and western Wisconsin. The purpose of the learning experience is for the resident to coordinate the activities of a quality improvement change for the Allina Health System Formulary Committee based on ASHP Principles of a Sound Formulary System assessment of efficacy, safety, use, cost/reimbursement as requested. The learning experience allows for 1 week concentrated on projects and time with the System Formulary Program Manager at the project site as directed. The learning experience will consist of focused discussions about literature interpretation and assessment during the concentrated week of the rotation, creation of at least one written in-depth drug monograph or drug class review and presentation of that work to the System Formulary Committee and appropriate committees by the end of the 8-week experience.

This is a 52-week longitudinal rotation pertaining to the formal residency capstone project, taking place at Mercy Hospital.  Mercy Hospital is one hospital on two campuses in Coon Rapids and Fridley Minnesota; it is licensed for 546 beds between the two campuses. Mercy hospital is part of Allina Health, which is a not-for-profit health system comprised of 12 hospitals, 90+ clinics, and 15 retail pharmacy sites throughout Minnesota and western Wisconsin. While the Project Rotation will be conducted at Mercy Hospital, depending on the project, the resident may will be involved in meetings or other work across additional Allina Health facilities.

The resident's project will ultimately be of benefit to optimizing pharmaceutical patient care at the institution or within the Allina Health System. The resident will present their project at a formal pharmacy conference in the spring of each year. The project must be approved by the pharmacy management team prior to implementation.

Cardiology is a 5-week selective required rotation that takes place on the Mercy Campus, primarily on the 4 Heart unit. The 4 Heart unit has 24 beds and a patient population that consists of post-operative CABG patients and critically ill patients needing interventional or non-interventional specialized cardiac care. The purpose of cardiology PGY-1 rotation is to assist the resident in becoming proficient in cardiovascular pharmacotherapy. At the conclusion of the rotation, the resident should be able to demonstrate the ability to identify patient specific problems in cardiovascular patients and utilize clinical therapeutic knowledge to resolve medication therapy problems. The aim is that the resident will be competent to successfully cover the cardiology units as the decentralized pharmacist by the end of the rotation.

The Emergency Medicine rotation is a 4-5 week selective required rotation at both Mercy hospital-Unity campus (1-2 weeks) and Mercy hospital-Mercy campus (3-4 weeks). This rotation is a supervised clinical pharmacy experience in an emergency care setting. There are 39 beds on the Unity campus and 58 beds on the Mercy campus and it is staffed by board-certified emergency physicians with approximately 120,000 emergency department visits per year between the two campuses. The Unity campus is a level IV trauma center, and the Mercy campus is a level II trauma center. As a level II trauma center, the Mercy campus is also staffed by trauma surgeons and it has trauma stabilization rooms as well as specialized rooms to care for pediatric patients and patients with cardiac, orthopedic, and gynecology emergencies. Most of the resident time will be spent in direct interaction with the ED pharmacist. The remaining time will be spent shadowing other disciplines, attending meetings, answering drug information questions, or completing projects. Residents can expect to interact with all members of the healthcare team including physicians, physician assistants, nurses, respiratory therapists, social workers, ED technicians, and spiritual care providers. Residents will also assist in the culture call-back service that allows emergency medicine pharmacists to start, change, or stop therapy as directed by culture results per a collaborate practice agreement.

The Mental Health rotation is a selective required 4 to 5-week learning experience at Mercy Hospital-Unity Campus. Residents will have the opportunity to provide pharmaceutical care for patients admitted to the Adult Mental Health, Substance Abuse, and Geriatric Psych units. There are currently 56 adult mental health beds, 24 Substance Abuse beds, and 15 geriatric psych beds. Residents will work alongside one dedicated mental health pharmacist daily. They will collaborate with psychiatrists and internal medicine providers to ensure ordered medications are appropriate, and they will participate in formal rounds daily with psychiatry, social work, nurses, psychology, and occupational therapy staff. Typical responsibilities will include medication therapy review, therapeutic drug monitoring, formal pharmacy consults as ordered by the physician, reconciling home medications as needed, providing drug information to staff and patients, and presenting staff education.

The AHCI Mercy Campus Oncology Infusion rotation is an elective 3-5-week operations directed learning experience that takes place on the Mercy Campus in the Allina Health Cancer Institute (AHCI) pharmacy. The resident will provide clinical review and comprehensive disease state management for patients receiving outpatient infusion therapy. The resident will also learn the complete process of order verification, coordination of compounding, and delivery of hazardous and non-hazardous medications with the goal of being proficient at day-to-day operations by the end of the rotation.

The Home Infusion Rotation at Allina Health Home Infusion Therapy Services (AHHITS) is an elective, 2 to 4 week learning experience at Mercy Hospital-Mercy Campus in the central pharmacy. AHHITs is a full-service home infusion center with a comprehensive nursing license. Therapies provided include antibiotics, total parenteral nutrition, inotropic therapy, chemotherapy/biologics, hydration, and specialty medications (IVIG, Entyvio, etc).  AHHITs staff includes roughly 7 pharmacy technicians, a pharmacy supervisor on site, and 3-4 nursing liaisons. AHHITS works with ProHealth, a third-party healthcare company in Florida, that helps with intake, billing, and pharmacist services, for the delivery of home infusion care to patients in the Twin Cities Metro and surrounding areas of Minnesota.

Pharmacy residents will participate in the home infusion process, which includes patient referral, filling supplies and compounding medications, delivery of products to patients’ homes, and patient medication administration education with the AHHITS nursing team. Residents will participate in direct patient care activities as well as interdisciplinary instructional activities. Residents will work with the AHHITS Lead Pharmacy Technician, the Home Infusion Liaison, and the AHHITS Nurse Manager, as well as nurses who visit patient homes – as available - to understand this process and address drug therapy issues that arise during care transitions.

The Pain Rotation is an elective, 1–3-week rotation taking place on the Mercy Campus. During this rotation, the resident will work up patients who have a pain team consult and round with the pain provider to see patients ranging from 1-10 patients per day. The primary focus of the pain management rotation is to provide the residents with skills to effectively provide pharmaceutical care and make appropriate pain management interventions to hospitalized patients with acute and chronic pain. The resident will work closely with a multidisciplinary consult team during this rotation. In addition to gaining skills in assessing pain, the resident will also develop expertise in designing individual pain regimens and perform opioid equianalgesic conversions.

The Teaching rotation is an elective, longitudinal experience over 52 weeks at Mercy Hospital and the University of Minnesota College of Pharmacy – Twin Cities Campus. Mercy Hospital is one hospital on two campuses in Coon Rapids and Fridley Minnesota; it is licensed for 546 beds between the two campuses. Mercy hospital is part of Allina Health, which is a not-for-profit health system comprised of 12 hospitals, 90+ clinics, and 15 retail pharmacy sites throughout Minnesota and western Wisconsin. The University of Minnesota is a public institution with several campuses through the state, with the primary campus located in Minneapolis (Twin-Cities Campus). There are usually 60-80 students enrolled in the pharmacy program on the Twin Cities Campus each year.

This rotation is designed to provide PGY1 pharmacy residents at Mercy Hospital with the necessary knowledge and skills to obtain a teaching certificate through the University of Minnesota Collaborative Residency Teaching Program. Residents will also complete a 24-hour teaching assistant commitment through the University of Minnesota College of Pharmacy to gain exposure to academic teaching environments. Also, residents will complete 4 online learning modules on foundational content and participate in 4 live scheduled webinars in preparation for designing, delivering, and evaluating two units of instruction.