Practice experiences and rotations
Pharmacy residents are responsible for collaborating with family medicine physicians to optimize medication regimens and provide patient education on medications and disease states. Patients seen in the clinic range from newborn to elderly and have various conditions. Other opportunities for the resident include teaching group patient education and mentoring pharmacy students.
The goal of the psychiatry rotation is to expose and enhance the resident’s knowledge and skills in the treatment of psychiatric disorders while still incorporating general medicine principles into patient care. This practice environment involves greater patient involvement in terms of continual patient interviewing and assessment as well as interactions with other mental health therapists, physicians and psychiatrists working with the patient. Medication education groups or sessions, when appropriate, are part of the rotation. The resident will be exposed to patients with schizophrenia, schizoaffective disorder, bipolar disorder, brief psychotic disorder, major depressive disorder, anxiety disorders, various personality disorders and substance abuse-related disorders. If desired, the resident will also have an opportunity to work in the area of geropsychiatry or with children and adolescents with disorders such as autism spectrum disorders, conduct disorders, ADHD, and so on. This experience not only reinforces general medical principles and enhances psychiatric medicine principles, but also allows for the development of essential patient communication skills necessary for a pharmacist to be able to communicate effectively during commonly encountered situations in all types of practice.
The cardiovascular pharmacotherapy rotation, based at Community Heart and Vascular Hospital, is designed to immerse the resident in the clinical pharmacist's role as part of a multidisciplinary team caring for a wide range of patients with cardiovascular medical problems. Community Heart and Vascular Hospital is a 100-bed hospital that offers state-of-the-art care with computerized physician order entry for patients with acute coronary syndrome, various dysrhythmias, and heart failure, as well as coronary artery bypass surgery patients. The resident is expected to acquire specialized cardiovascular pharmacotherapy management skills and build on general pharmacy practice skills.
The critical care rotation is a one-month rotation designed to enhance pharmacy practice skills through the monitoring of a complex patient group. The rotation experience could include patients from both the Medical Intensive Care Unit (MICU) and the Coronary Care Unit. Throughout the rotation the resident will play an active role on the multidisciplinary team.
The formalized Drug Information (DI) Center exists to provide accurate and timely information in response to specific drug-related questions for all health care professionals within Community Health Network, including inpatient (i.e., all five hospitals in the network) and outpatient (e.g., MedChecks, Community physician practices) settings. The DI Center responds to a broad scope of drug information requests. During a one-month rotation, the resident will focus on formulating an efficient, systematic method for receiving, documenting and responding to drug information requests while utilizing numerous print and electronic resources. The resident will also be involved in DI Center activities such as contributing to the pharmacy department's newsletter, preparing and presenting a P&T drug class review, reviewing investigational drug and medical device protocols, and evaluating and monitoring adverse drug reaction reports.
General medicine (family medicine)
The goal of the general medicine rotation is to improve clinical skills and clinical competency. The rotation is meant to improve knowledge and skills required to care for general medicine patients and to build self-confidence as a clinical practitioner. The resident will be directly involved in the care of family medicine patients in the inpatient setting. The resident will work with patients and physicians to optimize medication regimens, improve patient compliance and educate patients about their medications and specific disease states. The resident will also make recommendations in areas such as pharmacotherapy, pharmacokinetics and parenteral nutrition. In addition, the goal of this rotation is to provide “hands-on” experience with precepting students and educating medical professionals, including resident physicians. This experience will be gained by observing and then modeling.
During this experience the resident follows patients of the infectious diseases consult services. This is an independent rounding team that addresses all aspects of infectious diseases as they pertain to pharmacy practice. The resident will also participate in antimicrobial stewardship practices. During the experience the resident will co-precept Pharm.D. students from Butler University. The one-month program will be tailored to fit the resident's interests, needs and expectations. The program will include formal discussions as well as day-to-day teaching at the bedside. The resident will be expected to participate in and lead student discussions as well as participate in resident-directed discussions (separate from student discussions). A variety of topics will be discussed throughout the month including, but not limited to, the following: endocarditis, meningitis, HIV/AIDS, fungal infections, nosocomial infections, antimicrobial agents (bacterial, viral and fungal), pharmacokinetics/pharmacodynamics, and resistance. The experience will provide the resident with the knowledge and skills needed to provide pharmaceutical care for patients with infectious diseases; assess and improve anti-infective pharmacotherapy; and provide education to health care professionals regarding the treatment of infectious diseases.
The neurology/rehabilitation rotation is based at Hook Rehabilitation Center at Community Hospital East. The goal of this rotation is to gain exposure and further develop skills needed to provide pharmaceutical care to patients that require physical rehabilitation. These patients are medically stable, but require 24-hour skilled rehabilitation nursing care, daily physician management of their medical issues, and physical and occupational therapy to improve functional deficits. An emphasis is placed on rehabilitation of patients who have experienced traumatic brain injury and stroke as they proceed through the treatment continuum from a minimally conscious state. The continuum includes acute brain injury rehab followed by a neurobehavioral program designed to help patients and families manage issues related to cognition and behavior. As part of the multidisciplinary team, the resident will participate in weekly rounds with the physiatrist and the team providing care for each patient. The pharmacy resident will make recommendations regarding the pharmacotherapy of commonly encountered disease states, pain management, pharmacokinetics and anticoagulation. Additionally, the resident will provide education to patients and their families to optimize drug therapy and enhance their understanding of specific diseases. An opportunity to provide clinical pharmacy services to patients on the neurology unit at Community Hospital East is also available, depending on the resident's practice interests.
Pediatrics/Neonatal intensive care
The pediatric rotation focuses on the direct care of pediatric patients and neonates in an inpatient community hospital setting. The experience will help the resident develop an understanding of the level of pharmaceutical care needed to provide safe and appropriate use of medication within the pediatric population. The resident will actively participate with the multidisciplinary team in both the pediatric and the neonatal intensive care settings. The experience will include participation in rounds with the family practice residency team.
The goal of the practice management experience is to gain a broad overview of the concepts and functions of pharmacy management and leadership. The experience will involve a number of projects designed to enhance the resident's experience through working in teams that consist of hospital and pharmacy staff. The resident will gain experience in areas of medication safety, clinical service development, clinical and budget outcomes and residency recruitment. The experience is coordinated by Bill Malloy, clinical pharmacy coordinator at Community Health Network. The resident will also spend time with other members of the pharmacy and hospital leadership team.