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Practice experiences

Ambulatory care

The resident will spend four weeks in outpatient clinics during the residency year. For the advanced ambulatory care rotation, the resident will spend another four weeks in outpatient clinics. Clinic experiences may change based on patients scheduled for that day. Residents will have the opportunity to work with all members of the multidisciplinary team (nurse practitioner, clinical nurse, nutritionist, respiratory therapist, exercise physiologist, family practice medical residents) as well as teaching pharmacy students.

Behavioral care

The goal of the psychiatry rotation is to expose and then enhance the resident's knowledge and skills in the treatment of psychiatric disorders. This practice environment entails more patient involvement in terms of continual patient interviewing and assessment, and interactions with other mental health therapists, physicians and psychiatrists working with the patient. Education classes or sessions, when appropriate, will be a part of the rotation. The resident will be exposed to patients with schizophrenia, schizoaffective disorder, bipolar disorder, brief psychotic disorder, major depressive disorder, generalized anxiety disorder, borderline personality disorders, and substance abuse-related disorders.

Cardiology

The cardiovascular pharmacotherapy rotation, based at The Indiana Heart 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. The Indiana Heart Hospital is a 100-bed hospital that offers state-of-the-art care for a population that includes patients with acute coronary syndrome, coronary artery bypass surgery patients as well as patients with various dysrhythmias. The resident is expected to acquire specialized cardiovascular pharmacotherapy management skills and build on general pharmacy practice skills.

Drug information

The formalized Drug Information Center (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

The goal of the general medicine resident rotation is to improve clinical skills and clinical competency. The rotation is meant to challenge the mind and to build self-confidence as a clinical practitioner. The resident will be directly involved in the care of family practice patients in the inpatient and outpatient setting and will provide continuity of care. 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. The goal is to provide the resident with direct student contact and direct precepting responsibilities to enable the resident to become an experienced preceptor upon finishing this rotation. This experience will be gained by observing and then modeling.

Practice management

The goal of the practice management experience is to gain a broad overview of the concepts and functions involved with pharmacy management and leadership. The experience will involve a number of projects designed to enhance the resident's experience working in teams consisting 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 for Community Health Network. The resident will also spend time with other members of the pharmacy and hospital leadership team.

Critical care (elective)

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 and the Coronary Care Unit. Throughout the rotation the resident will play an active role in the multidisciplinary team.

Hematology/oncology (elective)

The adult hematology/oncology rotation is designed to develop an appreciation of the role of the pharmacist in total patient care, emphasizing collaboration with other disciplines, and to refine the resident's skills as a medication therapy consultant. Hematology/oncology therapeutics and oncology supportive care strategies will be emphasized. The resident will have exposure to patients with Non-Hodgkin's/Hodgkin's Lymphoma, leukemia (myeloid and lymphocytic), breast cancer, lung cancer (small-cell and non-small cell), ovarian cancer, prostate cancer and colorectal cancer.

Infectious diseases (elective)

During the experience the resident will follow the patients on the infectious diseases consult services. This will be an independent rounding team that will address 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 month will be tailored to fit the resident's interests, needs, and expectations. We will have formal discussions as well as day-to-day teaching at the bedside. The resident will be expected to participate 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: endocarditis, meningitis, HIV/AIDS, fungal infections, nosocomial infections, antimicrobial agents (bacteria, viral and fungal), pharmacokinetics/pharmacodynamics, and resistance. The experience provides 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.

Neurology/rehabilitation (elective)

The neurology/rehabilitation rotation will be based at Hook Rehabilitation Center in Community Hospital East. The goal of this rotation is to gain exposure and then further develop skills needed to provide pharmaceutical care to patients requiring 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 will be placed on rehabilitation of patients experiencing traumatic brain injury and stroke as they proceed through the treatment continuum from a minimally conscious state, acute brain injury rehab, then through a neurobehavioral program designed to help patients and families manage issues with 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 in order 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.