post graduate year two (pgy2) pharmacy informatics · orientation (4 weeks) core rotations (4...

1 | P a g e

Post Graduate Year Two (PGY2) Pharmacy Informatics

Residency Manual

2 | P a g e

Table of Contents Purpose and Philosophy................................................................................................................................ 3

Program Outcomes, Goals, and Objectives .................................................................................................. 4

Structure of Residency Experiences .............................................................................................................. 6

Residency Activities and Requirements ........................................................................................................ 7

Evaluation Process and Requirements........................................................................................................ 12

Evaluations .............................................................................................................................................. 12

Documentation ....................................................................................................................................... 12

Requirements for Receiving a Certificate ................................................................................................... 14

Appendices .................................................................................................................................................. 17

Appendix A: Requirements Tracking Form ............................................................................................. 18

Appendix B: Requirement Timeline ........................................................................................................ 20

Appendix C: Unique Learning Experiences ............................................................................................. 21

Appendix E: PTO Request Procedures .................................................................................................... 28

3 | P a g e

Purpose and Philosophy

Purpose The purpose of a PGY2 pharmacy informatics residency is to prepare thepharmacist for practice in a pharmacy informatics position. Residencytraining is designed to provide the resident experience in applyinginformatics and technology to enhance care of the patient and supporthealthcare professionals. This is accomplished by staffing responsibilities,appropriate clinical rotations and working with a broad range of medicationsystems, health care professionals, and vendors.

Philosophy The ASHP accreditation standard provides criteria that every program mustmeet in order to receive and maintain accreditation. This program followsthe ASHP - approved PGY2 Informatics Residency Outcomes, Goals, andObjectives. The requirement for this residency program is consistent withASHP to solely consider candidates who have successfully completed a PGY1residency. While this program follows ASHP standards, one of its strenths isthe flexibility to tailor the learning experience to meet the informatics needsand interests of each individual resident. The mission of our programincludes developing a core skill set in pharmacy informatics and fullyunderstanding the intersection of technology, patient care and professionalpractice. The program also offers a unique opportunity to work closely withthe primary vendor of the institution to learn about the vendor perspective.

4 | P a g e

Program Outcomes, Goals, and Objectives

The residency program will provide each resident with specific learning experiences designed to enable

the resident to expand the scope of his/her practice skills.

Required Goals

R1.1 Demonstrate understanding of basic pharmacy informatics principles, standards and

best practices.

R1.2 Evaluate opportunities for improving patient outcomes, clinical and operational efficiencies, safety and quality of the medication-use process through the application of Continuous Quality Improvement (CQI) strategies.

R1.3 Assure the interoperability and integration of health information systems.

R1.4 Ensure security of data stored in health information systems.

R1.5 Assure the interoperability and integration of health information systems.

R2.1 Maintain and support technology and automation systems.

R2.2 Demonstrate a working knowledge of technology and automation systems for

prescribing medications.

R2.3 Demonstrate a working knowledge of technology and automation systems for order processing and verification.

R2.4 Demonstrate a working knowledge of technology and automation systems for the safe and efficient preparations, distribution, and dispensing of medications.

R2.5 Demonstrate a working knowledge of technology and automation systems for safe and accurate medication administration and documentation.

R2.6 Demonstrate a working knowledge of technology and automation systems for safe and accurate medication administration and documentation.

R2.7 Demonstrate a working knowledge of technology and automation solutions for managing pharmacy inventory.

R2.8 Demonstrate a working knowledge of technology and automation systems that assist with transitions of care.

R2.9 Demonstrate a working knowledge of unique needs of stakeholders in various technology or automations systems in diverse practice settings and how are those areas supported by informatics.

R2.10 Demonstrate a working knowledge of emerging technology and automation systems that assist with the medication-use process.

R3.1 Analyze Clinical Decision Support (CDS) to ensure support of effective medication-related decisions and ensure it is available in a useful format to members of interprofessional teams.

R3.2 Evaluate the usefulness/effectiveness of CDS.

R3.3 Create and maintain decision support that allows for efficient and appropriate monitoring of patients by members of interdisciplinary, patient-centered teams, particular pharmacists.

5 | P a g e

R4.1 Learn the fundamental concepts of data analytics and data driven patient care.

R4.2 Participate throughout the entire life cycle of report creation.

R5.1 Demonstrate ability to effectively plan and conduct an informatics project.

R5.2 Participate in the contingency planning for an implementation of a medication management technology or an automation system.

R5.3 Contribute to the development of a plan for testing a technology or automation system.

R5.4 Implement the project, technology or automation system, or supplemental upgrades or build outs. (Project Execution)

R5.5 Assess project results and the need to make changes, if applicable (Performance/ Monitoring and Closure).

R5.6 Become proficient at planning ongoing medication-use technology and automation system maintenance or optimization projects.

R6.1 Provide effective education to patients, caregivers, healthcare professional, students and other interested stakeholders (individuals and groups).

R6.2 Effectively employ appropriate preceptor roles when engaged in teaching students, pharmacy technicians, or fellow healthcare professionals.

R7.1 Demonstrate the technical skills essential to the role of a pharmacy informaticist.

R7.2 Represent pharmacy informatics concerns in strategic planning for the implementation, use, and maintenance of technology and automation systems.

R7.3 Represent the pharmacy informatics perspective in interactions with interprofessional teams.

R7.4 Represent pharmacy informatics concerns in strategic planning for the implementation, use and maintenance of technology and automation systems.

R7.5 Demonstrate the personal leadership pharmacy qualities, commitments, business and political skills necessary to advance the profession of pharmacy and informatics.

E1.1 Design, execute, and report results of investigations of pharmacy informatics-related issues.

E2.1 Demonstrate understanding of various areas of informatics practice other than the residency's primary practice setting.

E2.2 Describe the interaction and exchange of data between the alternate site and the primary organization site.

E3.1 Understand faculty roles and responsibilities.

E3.2 Exercise teaching skills essential to pharmacy faculty.

6 | P a g e

Structure of Residency Experiences Orientation (4 weeks) Core Rotations (4 weeks) Transitional Elective Rotations

1. Medical Center

Orientation

2. Residency/RLS

3. Computer Training

4. Hospital Practice/

Central Pharmacy &

Satellites

5. Staffing Orientation

1. Clinical Pharmacy Systems Management (CPOE, Pharmacy System, Documentation System, Automated Dispensing Devices)

2. Clinical Decision Support

3. Clinical Rotation

4. Data Analytics Management

5. Medication Safety

6. Technical Concepts

7. Ambulatory

1. ASHP Midyear

2. Residency Project

3. ASHP Summer

Meeting or

SERC/MSRC

4. TSHP (optional)

1. Advanced Clinical Decision Support

2. EHR/Vendor Relations

3. Advanced Medication Safety

4. Evidence Based Medicine/Order Sets

5. System Alerts

6. Outpatient Pharmacy Automation & e-Prescribing

7. Web-based pharmacy application

8. Med Carousel Technology

9. Advanced Ambulatory

10. Advanced Data Analytics Management

Longitudinal Elective Clinical Rotations:

Topic and/or Case Presentation (2)

Assistance with PGY1 MUE projects

Newsletter Fast Fact (1)

Hospital Pharmacy Practice (staffing)

Residency Project (1)

Therapeutic Exchange (1 CE) or equivalent

Residency Project Presentation

Automation Project

Solid Organ Transplant

Bone Marrow Transplant

Infectious Disease

General Pediatrics

ICU Pediatrics

NICU Pediatrics

BMT/Onc Pediatrics

Nutrition

Critical Care

Medicine

Trauma

Burn

Surgical

Cardiology

*At the request of a resident to gain experience in a particular clinical area. No more than one 4 week rotation is

recommended, however, exceptions may be made. Ideally, informatics will be incorporated into the clinical rotation when

possible.

7 | P a g e

Residency Activities and Requirements

Rotations

There are 11 rotations during the PGY2 residency year. Each rotation period is approximately 4 weeks in

duration. All residents must complete the following required rotations: orientation, pharmacy systems,

clinical systems, clinical rotation, CDS, data management, medication safety, technical concepts, and a

clinical rotation. Rotation requirements may vary based on preceptor. Criteria based assessments should

be reviewed at the outset of each rotation by resident and preceptor to assure completion of all

requirements by the end of the residency year.

Informatics On-Call

The On-Call person provides a resource to help with pharmacy informatics issues 24/7. The resident will

be on-call usually 4-6 days per month depending on the rotation roster and calendar month.

Out-of-State Conferences

• ASHP Midyear

o Registration begins in July/August; residents are responsible for meeting these

registration deadlines.

o Residents must also register for the Vizient meeting and present a poster at the Vizient

resident poster session.

o It is required that all residents attend a minimum of 10 hours of lectures/seminars.

• ASHP Summer Meeting

o Residents are responsible for meeting registration deadlines.

o Residents must also present a poster at the resident poster session.

o SERC or MSRC – if not attending ASHP Summer Meeting

Journal Club

The purpose of the Journal Club assignment is for the resident to present or assist the pharmacy student

or resident in creating an optimal journal club experience of a current informatics related study to

targeted members of the Health IT team, including, but not limited to, other residents, students, and

clinical preceptors. The Journal Club experience will be a discussion between the pharmacy

resident/student and the members of the audience, with full audience participation expected. Residents

are expected to lead Journal Club for the department once in their residency year. All residents are

required to attend.

8 | P a g e

Topic Presentation

The purpose of topic presentation is for the resident to present an interesting topic in which they directly

participated. They are to present members of the Health IT team or Pharmacy Portfolio, including, but not

limited to, other residents, students, and clinical preceptors. All residents are required to attend.

Presentation should be focused on informatics topics and include primary literature in reference to the

case.

Continuing Education Presentations

Two formal presentations by each resident will be conducted during the residency year:

• Therapeutic Exchange: This is a 60 minute CE presentation that includes some controversy

and/or is a hot topic in informatics or pharmacotherapy. Primary literature is to be used as a

guiding force to put this presentation together. Presentation objectives and title are to be

submitted one month prior to your assigned presentation date.

• Residency Project: This is a 10-15 minute presentation of the resident’s research project. This

includes several practice sessions and then a formal presentation with feedback/evaluation

from preceptors and residents during practice and attendees at. This will also be presented

in conjunction with the other residents ASHP Summer Meeting to be a complete 60 minute

CE presentation for the department.

9 | P a g e

Newsletter/Fast Facts

The purpose of the Fast Fact assignment is for the resident to provide information about a pharmacy-

related topic that could be of use and educational value to the Department of Pharmaceutical Services.

The Fact Fast should highlight a new topic and provide practical information to pharmacists and/or

pharmacy technicians. The Fast Fact will be published in the InPharmation newsletter, which is published

at the end of each month. Each resident will provide one Fast Facts during the year, typically one in the

fall and one in the spring.

Research Project

Each resident will conduct a research project over the course of the residency year. This project will

include idea development, literature review, study design, IRB submission, data collection, data analysis,

data interpretation, oral presentation and a written manuscript. The written manuscript is to include

identification of an appropriate journal for potential submission and the following of the instruction to

authors for that journal. The manuscript must be written and submitted in final form prior to completion

of residency. The manuscript must be reviewed by the project mentor(s) and approved by the residency

director. The resident will have a mentor identified for interactions and guidance during the year.

Recruitment

Residents will assist in the resident recruitment and candidate selection process at Midyear and during

on-site interview of candidates during the first part of the calendar year.

MUE

Each informatics resident will assist with a medication use evaluation during the residency year. These are

assigned the first month of the residency. Findings are to be summarized in a 10 minute power point

presentation with recommendations of the most appropriate course of action based on the findings to

the P&T Committee and/or appropriate committee.

Medical Center Education Programs

Noon conferences, DBMI lectures, and other education conferences are offered throughout VUMC. These

are posted in Vanderbilt publications and via email notifications. The resident is strongly encouraged to

attend these whenever possible.

10 | P a g e

Hospital Pharmacy Practice

The resident will practice in a guided hospital practice scheduled for every fourth weekend and selected holidays. The

resident will gain experience in IV Room & Sterile Products, Central dispensing, narcotic room, and responsibilities

associated with Pharmacist in Charge.

(This is a guideline and will be dependent on staffing location assignment. The PGY2 resident will have a similar staffing

experience model as the PGY1 residents, however, depending on the PGY2 prior staffing experience, goals and objectives

may be adjusted as needed to ensure staffing competency of the PGY2 resident. It is an expectation that informatics

resident will provide oversight to the PGY1 residents in dispensing roles and clinical monitoring roles when PGY1 and PGY2

residents are staffing simultaneously).

Expectations for Residents in First Quarter – Staffing Assignment

• Orient to the Central Pharmacy and learn the procedures of both the unit dose area and the sterile products preparation areas.

• Adjust to the scheduling assignments and focus on being present and ready to work in the assigned area at the assigned time. Stay in the work area during your entire shift and be available to focus on the work at hand. Observe appropriate break time such as 30 minutes for lunch breaks. Learn to indicate any scheduling adjustments on the posted pharmacist schedule such as swaps in assignments

• Develop an understanding of the systems and processes and develop skills such as with CPOE order processing (“VOP”).

• Develop relationships with the Central Area team. Be careful to ask a more senior pharmacist before making changes to work processes. Follow the established dress code and other workplace policies. Be sensitive to the needs of the other staff in the area and do not routinely ask to leave early. Make sure that work is caught up prior to leaving your assignment.

• Begin to develop a broader view of the work place and rotate among the various stations (AcuDose check or cart check, pharmacy labels on Zebra, extemp prep, packaging machine, phones, tube station, IV Room, etc.) in order to maintain and effective work flow and efficiency level.

• Learn to collaborate with other staff members shift regarding work flow issues or whenever time may become available to work on projects but remain available to return your focus to the work at hand whenever workload increases.

• Remain flexible and ask questions.

• Once initial training is complete, primary assignment will be in the IV Room/Sterile Products or the Unit Dose area – may flex depending on staffing requirements.

• Resident will check in with the pharmacist and technician mentors at the end of each weekend shift to see if there are suggestions for improvement. If mentors are not working on the same weekend, resident will check in with their mentors at the next available opportunity to discuss any questions.

Expectations for Residents in Second Quarter – Staffing Assignment

• Demonstrate proficiency in all areas of the Central Pharmacy.

• Demonstrate proficiency with systems and processes and manage the established levels of efficiency.

• Demonstrate a broad view of the work place and rotate among the various stations maintaining effective workflow and efficiency.

• Primary assignment will be to float between the IV Room and Unit Dose areas

• Begin to observe the Pharmacist in Charge (PIC) role

11 | P a g e


Expectations for Residents in Third Quarter – Staffing Assignment

• Begin training in the Junior Pharmacist in Charge (PIC) role

• The resident (junior) and the normal (senior) management person on the weekend will both be designated as PIC. These two persons will work together to manage the personnel and workflow. The normal management person can help teach the resident how to solve problems that arise during a shift.

• The resident will not be in the float position unless scheduling dictates this as a need. However, part of being PIC includes assessing both the unit dose and IV areas and helping in all areas.

• The resident has an increased responsibility to keep in touch with the workflow and employees during the shift. The resident should assure all work has been completed for the shift prior to approving anyone to leave early (then check with the lead tech and check who is working in an overtime slot to help with these decisions).

• Communicate end of shift issues to the unit dose area evening pharmacist prior to leaving.

• Personnel conflicts, staffing problems, catastrophes, and occupational health issues will defer to the senior management person designated for the weekend.


Expectations for Residents in Fourth Quarter – Staffing Assignment

• Resident will be assigned as the PIC and make independent decisions regarding issues that arise with little assistance from the senior pharmacists. Residents should keep track of DI calls, extra tasks and problem solving they are involved with to review with his/her mentor.

Expectations for Mentors

• Check in with residents at the end of each weekend workday or as soon as possible after their weekend to work to discuss their staffing and PIC roles and answer any questions that arise.

• Observe the residents during their staffing and PIC roles and offer tips and suggestions for improvement.

• Provide feedback to the resident from other staff members as appropriate regarding their work performance.

• Prepare the quarterly evaluations for the residents in regard to their staffing experiences.

Expectation of Residents

• Submit a report of activities learned, accomplishments, problems solved etc. as well as areas in need of clarification or focus for the next weekend by Monday following your weekend worked.

12 | P a g e

Evaluation Process and Requirements

Evaluations

In addition to the core requirements of the evaluation process:

a. Criteria-Based Assessments: Evaluations of selected activities will be completed by both a preceptor and the

resident.

Case Conferences

Journal Club

Therapeutic Exchange

b. Residency Council Reports: A written evaluation based on period review by the residency council. This

evaluation examines overall progress, including integration of skills learned in separate rotations, non-rotation

objectives/experiences, progress on longitudinal requirements/rotations (residency project, criteria

assessments, etc.) and any pertinent trends or information found in evaluations to that date. Progress of the

resident’s strengths, weaknesses and career goals will be documented. To satisfactorily complete the

residency, the resident must have shown improvement over the course of the year in both resident and

preceptor scoring. For any goals in which less than a score of 3 is averaged, the resident and program director

will work together to develop individualized plans to assist in making progress in those areas by residency end.

If the resident does not work towards those plans and progress improvement, residency completion with

certificate may be compromised. On a quarterly basis, goals in which the resident has scored an average of 5

for two consecutive quarters will be removed from further evaluation.

Documentation

Each resident will maintain/submit the following documentation in addition to core RLS evaluations:

1. Residency Notebook: The resident will maintain both a hardcopy and an electronic residency notebook which shall be

a complete record of the resident’s program activities. The notebook should include the following:

• Orientation Checklist

• All residency-based evaluations including: o Entering Interest form o Goal-based evaluations o Summative (by preceptor and self-evaluations) o Preceptor evaluations o Learning experience evaluations o Custom evaluations o Customized training plans

• A record of all educational in-services and seminars presented o Outlines and/or lecture slides o Evaluation of in-service or seminar where applicable o Any edits that you received

• Residency Project Materials o Proposal o IRB submission o Data collection & analysis o Final manuscript

13 | P a g e

o Any edits that you received

• Any formulary reviews, written drug information responses or other completed assignments

*The contents of the residency notebook serve as documentation of activities completed during the residency year. The

residency yearbook is a permanent record which is the property of Vanderbilt University Medical Center. *

14 | P a g e

Requirements for Receiving a Certificate

Upon successful completion of all program requirements and compliance with all conditions of the residency program,

Vanderbilt University Medical Center will award the resident a certificate indicating successful completion of the residency

program. The purpose of the PGY2 pharmacy informatics residents is to prepare the pharmacist for practice in a pharmacy

informatics position. Residency training is designed to provide the resident experience in applying informatics and

technology to enhance care of the patient and support healthcare professionals. This is accomplished by staffing

responsibilities, clinical rotations (if desirable) and working with a broad range of medication systems, health care

professionals, and vendors.

This one year specialty residency and training program is designed to prepare and provide pharmacy informatics

experiences so that the resident will have the core skills to pursue pharmacy informatics as a career. Through a varied list

of potential activities including clinical systems, automation, robotics, and pharmacy workflow management systems, the

resident can have a robust learning environment.

All of the following criteria must be satisfied to successfully complete the program:

Completion of a residency research project that is approved by the program director and submission of a formal write-up in manuscript format by June 1 of the academic year.

Completion of the required number of formal presentations (Journal Club, Therapeutic Exchange and Topic Presentation).

Satisfactory completion of all rotations as determined by the primary preceptor for the rotation

Completion of the required number of Competency-Based Assessments.

A minimum of 80% of all residency objectives marked as “Achieved for Residency” by preceptors or residency program director.

Completion of the residency notebook.

Residents who fail to complete all program requirements and/or do not comply with all conditions of the residency

program shall not be awarded a certificate of completion.

Submission of a completed notebook to the program director (at the conclusion of the program) that includes evaluations,

self-evaluations, and preceptor and learning experience evaluations for all concentrated and longitudinal experiences.

Poster presentation of the research project at the ASHP MYM or other comparable scientific meeting.

Submission of project abstract for the annual Southeastern Residency Conference or comparable meeting.

The resident reports to and is supervised by the rotation preceptor and the residency director/ coordinator.

15 | P a g e

Responsibilities of the resident include:

Development of personal goals for the residency following an initial evaluation of career interests, prior experience, and

areas of strength and weakness.

Compliance with rotation expectations.

Meeting with the rotation preceptor to define individual goals and objectives for the rotation completing assignments by

the end of the rotation.

Scheduling routine meetings with rotation preceptor.

Informing the residency director of difficulties encountered in meeting goals and objectives or problems with preceptors

assuming responsibility of the rotation preceptor in his/her absence.

Preparing a written self-evaluation, preceptor and learning experience evaluation at the conclusion of each rotation and

quarterly for longitudinal requirements.

Timely communication regarding absences and requested leave; failure to inform the program director of an

absence/illness will result in disciplinary action.

Completion of quarterly reports to be reviewed by the residency director; the purpose of these reports will be to assure

that the established residency goals and objectives are being achieved.

Provision of pharmacy staffing coverage as indicated on the Pharmacy Staffing Schedule.

Completion of a major residency project

PGY2 projects will be presented at platforms at the Southeastern Residency Conference (ASHP Summer Meeting) for

Pharmacy Residents and Preceptors.

Submissions of articles to departmental newsletters.

Attendance at the ASHP Midyear Clinical Meeting and Southeastern Residency Conference for Pharmacy Residents and

Preceptors. Residents may attend other professional meetings if the staffing schedule permits.

Submission of a completed notebook to the program director upon completion of the program. Specific details regarding

“Notebook Requirements” can be found in the program specific residency manual.

16 | P a g e

Sample Resident Rotation Schedule

Learning Experience Type Duration Designation

Orientation Rotation 4 weeks Required

Clinical Pharmacy Systems Management Rotation 4 weeks Required

Clinical Decision Support Rotation 4 weeks Required

Clinical Rotation Rotation 4 weeks Required

Medication Safety Rotation 4 weeks Required

Analytics - Data Management Rotation 4 weeks Required

Ambulatory Rotation 4 weeks Required

Technical Concepts Rotation 4 weeks Required

Advanced CDS Rotation 4 weeks Elective

Advanced Ambulatory Rotation 4 weeks Elective

Advanced Data Analytics Management Rotation 4 weeks Elective

Staffing Longitudinal 12 months Required

Automation Project Longitudinal 12 months Required

Research Project Longitudinal 12 months Required

17 | P a g e

Appendices

A: Requirements Tracking Form

B: Requirement Timeline

C: Unique Learning Experience

D: PTO Request Procedures

18 | P a g e

Appendix A: Requirements Tracking Form SUMMATIVE EVALUATIONS

Rotation Rotation 1

Rotation 2 Rotation 3 Rotation 4 Rotation 5

Preceptor’s Evaluation

Resident Self-Assessment

Learning Experience

Rotation Rotation 6

Rotation 7 Rotation 8 Rotation 9 Rotation 10 Rotation 11



Learning Experience

LONGITUDINAL EVALUATIONS

Quarter 1 Quarter 2 Quarter 3 Quarter 4

Hospital Practice (Staffing)



Learning Experience

Residency Project



Learning Experience

Automation Project



Learning Experience

Training Plan Progress

Residency Council Report

Resident Training Plan Self-Assess

TOPIC PRESENTATIONS

#1 #2



Learning Experience

JOURNAL CLUB

#1 #2



Learning Experience

THERAPEUTIC EXCHANGE


19 | P a g e


Learning Experience

OTHER REQUIREMENTS (WITHOUT FORMAL EVAUALTIONS)

ASHP Summer Meeting Presentation

Manuscript

Project Requirements

Proposal IRB Data Collection Presentation

Report/ Manuscript

Research Project

20 | P a g e

Appendix B: Requirement Timeline (For Guidance Purposes Only; Dates are subject to change based on individual resident goals/assigned tasks) **This may not be all inclusive – watch your residency requirements tracking form!**

July Baseline self-assessment (Entering resident interest and preference information) Select and develop 60 minute CE Presentation Dates for Journal Club, Case Presentation Selected, CE Presentation August Project topic/preceptor confirmed

Project literature review and bibliography completed and submitted. MUE topic selected and timeline for completion established.

Register for ASHP Midyear Meeting September Project design/Methods write-up complete Project Proposal Presentation –IRB submissions If taking a poster to MYCM, investigate deadlines for abstract submission

How many Criteria Based Assessments have you completed? Pace yourself! Evaluate where you stand with longitudinal assignments (P&T Monograph, MUE) October Project Proposal completion and submitting to IRB, establish timeline for project data collection

and analysis etc. Recruitment Showcases

Case Presentations and Journal Clubs November If taking a poster to MYCM need to complete slide by mid November.

Recruitment Showcases How many Criteria Based Assessments have you completed? Pace yourself! Résumé preparation and interview skills

December ASHP Midyear – Vizient Posters, showcase January Register for ASHP Summer Meeting and Prepare ASHP Summer Meeting abstract February Complete and submit ASHP Summer Meeting abstract Wind up data collection for project Case presentations and journal clubs

How many Criteria Based Assessments have you completed? Pace yourself! March Project: begin organizing data – analyze data - results April Pre-ASHP Summer Meeting project presentation I, II, III, IV, ASHP Summer Meeting

How many Criteria Based Assessments have you completed? Pace yourself! May Project manuscript – first draft completed May 15th June Final Project manuscript due June 15 All Criteria Based Assessment Requirements completed by Jun 15

21 | P a g e

Appendix C: Unique Learning Experiences

Orientation – Rotation Description

PGY2 Pharmacy Informatics

Phillip W. Stewart, DPh

Pharmacy Portfolio, HealthIT @VUMC

Office: 615.936.2930 Cell: 615.829.1347

[email protected]

Edward Woo, PharmD

Pharmacy Portfolio, HealthIT @VUMC, Outpatient IT, Associate Director

Office: 615.875.9308 Cell: 662.801.1841

[email protected]

Learning Experience Description

This is the initial orientation to VUMC and core systems where the resident learns the daily operational aspects of the

pharmacy including dispensing, administration, policies and procedures, and skills needed for staffing and general

orientation to pharmacy informatics. Training focuses on organizational and department structure, workflow, resident

and pharmacist responsibilities and requirements, and appropriately using technology for patient care, research, and

other residency requirements. The Resident will attend core computer systems training primarily comprised of CPOE,

Pharmacy system, BCMA, EHR. The resident will also rotate through the various work areas of the Central Pharmacy;

preparing exempts, cartfill, automated dispensing machines, prepackaging process area, AcuDose replenishment, IV

room processing including IV preparation, checking, validation, limited exposure to TPN process, order processing and

general workflow that prepares the resident for staffing duties. The rotation will include office setup, any orientation

and learning for On-Call duties during the upcoming year.

Resident Expectations

Residents are expected to be an active participant during their orientation experience. Residents will take an active role

in learning about the enterprise culture and informatics team structure and team roles.

The core components of the rotation include:

• Attend core computer systems training

• Rotate through various work areas in Central Pharmacy

• Shadow with analysts for preparation of On-Call duties

• Document interactions with team members to understand their unique roles

mailto:[email protected]

mailto:[email protected]

22 | P a g e

Communication

The preceptor will be available to the resident via phone (cell is above), text, and email during the rotation. The

preceptor will meet with the resident for daily work review and ad hoc questions. The resident will gain broad

experience in understanding the function of the pharmacy informatics group by both independent observations and

structured learning experiences.

Tentative Didactic Teaching and Readings

Common resources for review and discussion might include:

• ASHP Goals – Pharmacy Informatics & Technology section related to principles of Informatics

• Competencies in Pharmacy Informatics – Fox, Thrower, Felkey

• Pharmacy Informatics Primer - Dumitru

• Local archive (Evernote) of informatics related articles, papers, references.

General Schedule

The hours of this month long rotation is typically Monday through Friday, 7:30 am -4:30 pm. This can vary depending on

the time of year and department requirements, thus the resident should remain flexible as much as possible. Meeting

will be limited due to staffing orientation. The resident will be encouraged when possible to attend the weekly Pharmacy

Informatics meeting when possible. The Resident will report to 3401 West End Avenue & Central Pharmacy as needed.

• 7:30 am Check-in with preceptor

• 8:00 am Daily Willow Meeting

• Completion of rotation tasks

Resident Progression

A calendar template for a typical rotation month is listed for reference activities during the rotation. Guidelines for

progression would include:

Week 1 – Orient to work areas, teams and essential spaces for resident interaction.

Week 2 – Attend computer system training for pharmacists and understand how orders are entered and verified, how to

use chart search, view MAR, and basic functions taught in training class.

Week 3 – Learn to function in a staff pharmacist role during the orientation provided by VUH Pharmacy operations in

preparation for staffing.

Week 4 – Shadow on call team members and develop supplemental reference documentation to facilitate on call

responsibilities.

23 | P a g e

Residency Orientation Template (general schedule that will vary annually):

** Co-resident schedule will be coordinated through the RPD for that program.

ASHP Goals and Objectives

The grid lists specific goals and objectives, which are evaluated during the rotation month. Please refer to the Learning

Experience evaluation grid to determine which objectives will be formally evaluated during the assigned month.

Goals and Objectives

Activities

Goal R1.1 Demonstrate understanding of basic pharmacy informatics principles, standards, and best

practices.

R1.1.1 (Understanding) Identify standards and

standard-setting bodies governing the use of

data, information and knowledge in healthcare.

- Observe, participate and comprehend critical

and basic steps for order entry such as order

evaluation and appropriateness.

- Observe and comprehend the role of

pharmacist processing including dosage form

July 2018SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY

1 2 3 4 5 6 7

PGY2 Res

Michael Wisner - MW

Bridget Lynch - BL

VUMC Orientation@ 8a-

1p Langford Auditorium;

BL 1P @ 3401 WE

Breakfast in Pharmacy,

8:30a-3:30p Pharmacy

9:30a Clin Intro - Lobo

1p-3:30 Meet/Greet

HolidayRes Photos 8a-10a

10a TJC Preparedness

LU Teaching Certificate 9a-

10a; Residency Welcome

celebration B130 2-3:30P

8 9 10 11 12 13 14

3401 West End

10:30 - 11:30 TE

expectations

1p-4 MSS tour

Michael & Bridget -

Computer Training - CCT-

Rm 2, 8a - 5p

Michael & Bridget -

Computer Training - CCT-

Rm 2, 8a - 5p

3401 West End

8a Project Mngt

BL @ 3401 till 12N

3401 West End

11a - Med Rec

BL @ LU all day

15 16 17 18 19 20 21

3401 West End

11a - 12N Veritas

BL - LU Capstone?

9a - 10a Red Cap

1p-2p Med Rec

BL @ LU all day

3401 West End

8a - 9:30 Tip/Tricks

3401 West End

10a Alaris

3401 West End

2p -4p Joe's Excel

22 23 24 25 26 27 28

Central Pharmacy

Training @ 7 :00AM

Central Pharmacy IV

Training @ 7 :00AM

(Media Challenge -

scrubs)

MW - Central Pharmacy

Training at 7:00AM

BL @ LU all day

MW - Central Pharmacy

Training

BL @ LU all day

Res Welcome BBQ - Bob

Lobo's Clubhouse - TBD

3401 West End MW - Central Staffing

29 30 31 1 2 3 4

MW - Central Staffing 3401 West End 3401 West End

24 | P a g e

selection, dose range, allergy interactions, timing

of medications and dispense choices.

R1.1.2 (Understanding) Identify influences for

best practices in pharmacy informatics.

- Participate and shadow individual members of

the Pharmacy Informatics group to learn how

each member contributes to the larger group,

identify duties, while learning and documenting

activities and skill sets required for ongoing

support of systems, on call and end users.

Goal R1.4 Ensure security of data stored in health information systems.

R1.4.1 (Applying) Implement measures to

ensure data security in the context of supporting,

maintaining and/or implementing technology and

automation systems.

- Understand and articulate organizational and

regulatory policies for managing and securing

patient information, including ethical

considerations for PPI, steps to guard patient

data, criteria for security and assessments,

HIPAA regulations.

-Articulate differences for terms such as HIPAA,

PHI, de-identification, encryption, and

understanding proper approvals for secured

information.

Goal R2.2 Demonstrate a working knowledge of technology and automation systems for prescribing

medications.

R2.2.1 (Understanding) Explain critical factors

for assessing the functions, benefits, and

constraints relative to safety and effectiveness of

available technology and automation systems for

prescribing medications.

- Observe and comprehend underlying principles

and decision process for actual dispensing

whether via automation devices or manual

product dispense.

R2.2.2 (Analyzing) Make optimization

recommendations to and/or perform requisite

build in available technology and automation

systems for prescribing medications.







Goal 2.3 Demonstrate a working knowledge of technology and automation systems for order

processing and verification.





order processing and verification.

-Observe and comprehend medication

management of controlled substances, automated

dispensing devices activities, vendor packaging

activities, carousel technology, inventory

receiving, barcode scan for inventory verification

and other miscellaneous preparations for

RapidFill, TPN, etc.




systems for order processing and verifications.





25 | P a g e



Goal 2.4 Demonstrate a working knowledge of technology and automation systems for the safe and

efficient preparations, distribution, and dispensing of medications.





preparation, distribution, and dispensing of

medications.


management of controlled substances, automated

dispensing devices activities, vendor packaging

activities, carousel technology, inventory

receiving, barcode scan for inventory verification

and other miscellaneous preparations for

RapidFill, TPN, etc.




systems for order processing and verifications.







Goal 2.5 Demonstrate a working knowledge of technology and automation systems for safe and

accurate medication administration and documentation.





medication administration and documentation.


management of the documentation and nursing

perspective of medication administration.




systems for administering medication and

documentation.

- Participate and shadow analysts for problem

solving Pegasus tickets for issues being reported

by Pharmacy Operations.

Goal 7.2 Demonstrate management skills.

R7.2.1 (Applying) Contribute to pharmacy

departmental management.

- Observe and comprehend medication



- During onsite orientation ask for details of how

the business works and how informatics is

currently supporting that work.

R7.2.2 (Applying) Manage one’s practice

effectively.

- Participate and shadow analysts during team

meetings or with other disciplines to understand

the need for process and communication. During

onsite orientation, ask staff how informatics

support the work done in a given area and

understand the interactive process with

Informatics staff.

Goal 7.3 Represent the pharmacy informatics perspective in interactions with interprofessional

teams.

26 | P a g e

R7.3.1 (Applying) Demonstrate commitment to

optimizing use of informatics to improve patient

outcomes by achieving pharmacy informatics

goals.




-During onsite orientation ask for details of how

the business works and how informatics is

currently supporting that work.

R7.3.2 (Understanding) Explain effective

strategies for establishing openly

communicative, collaborative working

relationships between pharmacy and the

information technology staff of an organization.

- Participate and shadow analysts during team

meetings or with other disciplines to understand

the need for process and communication. During

onsite orientation, ask staff how informatics

support the work done in a given area and

understand the interactive process with

Informatics staff.

R7.3.3 (Applying) Use knowledge of

organizational dynamics to effectively achieve

pharmacy informatics goals.

- Participate and shadow Pharmacy Informatics

leadership when meeting with Pharmacy

Operations to understand an issue and how it

supports the department and organizational

goals. Participate in mid-week PIPS meeting to

capture notes to supplement meeting agendas

understanding requests and process needed for

follow to those requests.

R7.3.4 (Applying) Participate in the

development of budget estimates and financial

projections of the acquisition, implementation,

and maintenance of technology and automation

systems.

Participate and shadow Pharmacy Informatics




goals. Understand what the financial impacts are

for new technology and maintaining existing

technology used between Pharmacy and PI.

R7.3.5 (Evaluating) Engage in effective and

creative issue management and resolution when

problems are encountered in pharmacy

technology and automation systems.

- Participate and shadow analysts for problem

solving Pegasus tickets for issues being reported

by Pharmacy Operations.

R7.3.6 (Applying) Use assertive skills to

successfully represent pharmacy informatics

concerns and positions to internal and external

audiences.





goals.

Goal 7.4 Represent pharmacy informatics concerns in strategic planning for the implementation, use

and maintenance of technology and automation systems.

R7.4.1 (Analyzing) Participate in constructing or

updating strategic plans for technology and

automation systems for the medication -use

process.

-Observe and comprehend the major systems

used to support the medication use process, ex.

Epic, carousels, TPN compounder, and any other

systems that are key to pharmacy operations.

Goal 7.5 Demonstrate the personal leadership pharmacy qualities, commitments, business and

political skills necessary to advance the profession of pharmacy and informatics.

27 | P a g e

R7.5.1 (Understanding) Capitalize on personal

skills, and interests to offer professional service.





goals. Map out the process followed for

identification of issues, identifying solutions, and

implementation of a short or long-term fix.

Evaluation Strategy

The specific goals and objectives, on which the resident will be evaluated are summarized in the grid. Evaluations are

completed in the evaluation database (PharmAcademic or RLS system). All work to be evaluated on rotation must be

turned in for review no later than the last day of the rotation.

Type Required Who When Where

Formative MidPoint

Evaluation

Yes Preceptor End of week 2 N/A

Summative Final

Evaluation

Yes Preceptor End of rotation PharmAcademic Summative

Eval

Summative Self-Eval Yes Preceptor Prior to Summative

Evaluation

PharmAcademic Summative

Self Eval

Preceptor Eval Yes Resident End of rotation PharmAcademic Preceptor Eval

Learning Experience

Eval

Yes Resident End of rotation PharmAcademic Learning

Experience Eval

28 | P a g e

Appendix D: PTO Request Procedures

Purpose: To ensure that pharmacy services are provided 365 days per year by Clinical Pharmacists or Residents

in order to prevent service disruptions that could impact patient safety.

1. PTO Request Process

a. Email RPD by the 10th of the month to request time off for the following month. Earlier

notification is preferred. The RPD will check with the assigned preceptor regarding any time off

requests.

b. RPD will communicate PTO to the appropriate staff if approved.

2. Holidays

a. Vanderbilt recognizes 7 holidays: New Year’s Day, Memorial Day, July 4th, Labor Day, Thanksgiving

Day, Christmas Eve and Christmas day. It is assumed that PTO will be used on these holidays. If

you wish to or are assigned to work one of these holidays, advance notification is required

b. Holiday work is scheduled in advance by Molly Knostman

c. When a holiday is worked on a regular work day (M-F), no Off Day is taken and no PTO is

deducted. If you work a holiday on a weekend, an Off Day will be taken, and no PTO deducted.

d. Holidays may be traded with other residents, but must be approved by Molly and the RPD.

e. Off Days during the week of Christmas and Thanksgiving are not scheduled without approval in

order to ensure appropriate coverage.

3. Sick Call Process

a. Email or call either Phillip Stewart, Edward Woo or Jon Jackson.

b. Email your current preceptor.

29 | P a g e

Residency Project Description Worksheet

Resident: Project Advisor:

Date of Initiation: Date of Completion:

Responsible Investigators:

Department(s) Involved:

Key Personnel to Obtain Approval From:

Question to be answered:

Expected Outcomes of the Study:

Rationale for the Study:

Defining Measurements:

Data that will be collected:

Databases to Study or Create:

Data Analysis:

Description of Results:

Benefit to the Resident:

Benefit to the Department:

Likelihood of Publication:

Commitments: ______________ _________________ __________

Resident Preceptor Other

30 | P a g e

Past Residency Projects

2006 – 2017

Year Resident Title Comment

2006 - 2007 Alan Chung

Evaluation of an Integrated Computerized Pharmacist Intervention Database

*

2007 - 2008

Alan Chung Minimizing Alert Fatigue in a Pharmacy Computer System

2008 - 2009

Matt Marshall

Traffic Jams in the Medication-Use Superhighway * ◊

2011 - 2012 Wing Liu

Reconciliation of Drug-Drug Interaction Alerts Between Customized and Commercial Database Compendia

◊

2012 - 2013 Vanitra Richards

Evaluation of Contraindicated Drug-Drug Interaction in a CPOE System, a Pharmacy Information System,

and an Electronic Prescribing System

*

2013 - 2014 Anuj Thirwani

Implementation of Clinical Decision Support to enhance Antimicrobial Stewardship-guided novel Laboratory

Test Ordering

*

2014 - 2015 Seth Strawbridge

Using Smart Pump Technology to Improve Charge Capture of Outpatient Infusions

* ◊

2015 - 2016 Taylor Woodroof

Comparing Medications Lists to Problem Lists Using a Medication-Indication Matching Resource

◊

2016 - 2017 Hamilton Wen

Searching for a single source of truth using knowledge management of immunization information

◊

2017 - 2018 Joseph Huenecke

Instance-based optimization of order groups following electronic health record (HER) implementation

◊ ^

2018 - 2019

* Presented at the Southeastern Residents Conference (SERC) in Athens, GA ◊ Presented at the ASHP MidYear Clinical Meeting ^ Presented at ASHP Summer Meeting

31 | P a g e

Staffing Guidance and Expectations

First Quarter

• Orient to the Central Pharmacy and learn the procedures of both the unit dose area and the sterile products preparation areas.

• Adjust to the scheduling assignments and focus on being present and ready to work in the assigned area at the assigned time. Stay in the work area during your entire shift and be available to focus on the work at hand. Observe appropriate break time such as 30 minutes for lunch breaks. Learn to indicate any scheduling adjustments on the posted pharmacist schedule such as swaps in assignments

• Develop an understanding of the systems and processes and develop skills such as with CPOE order processing (“VOP”).

• Develop relationships with the Central Area team.

• Follow the established dress code and other workplace policies. Be sensitive to the needs of the other staff in the area and do not routinely ask to leave early. Make sure that work is caught up prior to leaving your assignment.

• Begin to develop a broader view of the work place and rotate among the various stations (AcuDose check or cart check, extemp prep, packaging machine, phones, tube station, IV Room, etc.) in order to maintain and effective work flow and efficiency level.

• Learn to collaborate with other staff members shift regarding work flow issues or whenever time may become available to work on projects but remain available to return your focus to the work at hand whenever workload increases.

• Remain flexible and ask questions.

• Resident will check in with the pharmacist and technician mentors at the end of each weekend shift to see if there are suggestions for improvement are areas that they would like more exposure and complete The Weekend Staffing Report. This report will include activities learned, accomplishments, problems solved etc. as well as areas in need of clarification or focus for the next weekend.

Second Quarter

• Demonstrate proficiency in all areas of the Central Pharmacy.

• Demonstrate proficiency with systems and processes and manage the established levels of efficiency.

• Demonstrate a broad view of the work place and rotate among the various stations maintaining effective work flow and efficiency.

• Primary assignment will be to float between the IV Room and Unit Dose areas

• Resident will check in with the pharmacist and technician mentors at the end of each weekend shift to see if there are suggestions for improvement are areas that they would like more exposure and complete The Weekend Staffing Report.

Third Quarter

• As above with more autonomy

• Begin floating to 6th Floor Satellite to obtain broader vision of pharmacy services Fourth Quarter

• Begin to practice some skills related to the (PIC) role such as having an increased responsibility and awareness of the workflow and employees during the shift. The resident should assure all work has been completed for the shift prior to approving anyone to leave early (then check with the lead tech and check who is working in an overtime slot to help with these decisions).

• Communicate end of shift issues to the unit dose area evening pharmacist prior to leaving.

32 | P a g e

Staffing Form

Pharmacist Resident

Staffing Report

Name:

Date:

Location for staffing:

Pharmacist in charge:

What did I do this weekend? (check all that apply)

Answered at least 5 phone calls

Checked/Filled Extemps

Identified and resolved a medication error and

documented in Veritas

Prepared indigent meds

Clozapine registry

IDS dispense

Sent missing dose

Helped resolve an AcuDose issue

Documented my interventions/DI Questions

Checked Pak Plus

Psych Orders

Regenerated or rescheduled an order

Process at least 20 orders

Helped resolve staffing issue (i.e. sick call)

Checked crash cart, ED, FEL trays

Prepared and checked out event box

Borrow and Loan

Checked or prepared compounding item

Verified and dispensed Factor order

Checked TPN

Checked or dispensed narcotic with CDR

Connect Rx (stock outs, inventory, event report)

Med Carousel

Other_____________________________

What did I learn this weekend?

__________________________________________________________________________________________________

______________________________________________________________________

Next weekend, I want to learn or try to:

__________________________________________________________________________________________________

__________________________________________________________________________________________________

________________________________________________________

Comments from pharmacist in charge: Initials__________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

________________________________________________________

post graduate year two (pgy2) pharmacy informatics · orientation (4 weeks) core rotations (4...

Documents