Residency Manual 2020-2021 - Cleveland Clinic Indian River Hospital Department of Pharmacy Services - Cleveland Clinic Indian River ...
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Residency Manual
2020-2021
Cleveland Clinic Indian River Hospital
Department of Pharmacy Services
1TABLE OF CONTENTS
1.0 General
1.1 Definition
1.2 Philosophy and Purpose
1.3 ASHP Accreditation
1.4 Qualifications of Resident
1.5 Residency Faculty Structure
1.6 Acceptance Into the PGY-1 Pharmacy Residency Program
1.7 Resident Statement of Agreement
2.0 General Information
2.1 Residency Overview
2.2 Residency Benefits
2.3 Pharmacist Licensure
2.4 Required Meetings
2.5 Staffing Requirements
2.6 CCIRH Policies and Procedures
2.7 Resident Holidays
2.8 Duty Hours
2.9 Resources
3.0 PGY-1 Pharmacy Residency Required and Elective Experiences
3.1 Syllabus with Learning Experiences and Required Readings
3.2 Required Clinical Rotations
3.3 Elective Rotations
3.4 Longitudinal Experiences
3.5 Teaching Requirements
3.6 Resident Schedule
4.0 PGY-1 Pharmacy Residency Expectations and Residency Requirements
4.1 Professional Practice
4.2 Residency Requirements
4.3 Determination of Graduation
5.0 Presentations
5.1 Continuing Education Presentations
5.2 Pharmacy Presentations
5.2.1 Department Presentations
5.2.2 Topic Discussions
5.2.3 Journal Club
6.0 Residency Project
6.1 Purpose
6.2 Selection of Residency Project
6.2.1 Project Advisor
6.2.2 Project Time Line
26.2.3 Project Presentation
7.0 Faculty
7.1 Department of Pharmacy Administration
7.2 Residency Advisory Committee (RAC)
7.3 Rotation Preceptors
8.0 Evaluations
9.0 Appendixes
3March 22, 2019
Dear Residents,
On behalf of the CCIRH Department of Pharmacy, I would like to welcome you to your post-
graduate training program. We are committed to the provision of an outstanding residency
training program. As a community hospital, we offer a variety of experiences designed to prepare
you for the various roles in pharmacy practice.
The goal of this residency program will be the development of practical clinical and operational
skills that will prepare you for future employment or a PGY-2 Residency. We will delegate to
you both clinical and operational responsibilities under the guidance of our experienced
pharmacy staff. You will refine your teaching and leadership skills by working in a
multidisciplinary environment with patients, caregivers, nurses, physicians, as well as students
from colleges of medicine, pharmacy and nursing. You will participate in multi-disciplinary
patient care activities to further develop your problem-solving skills and the ability to work with
other healthcare providers.
Preceptors will establish minimum expectations as laid out in the syllabi for your performance
during rotations. However, you should strive to surpass these minimum expectations. You will
be encouraged to work with as much independence as desired and achievable.
The year ahead of you will be busy and challenging, but I am confident that benefit from our
residency program and achieve great success. I am excited to work with you over the next year.
Best Regards,
Nicole Brooks, PharmD, BCACP, CACP
Residency Program Director
4Ralph Turner, DBA, MSHA,
MPA, FACHE
Chief Operating Officer
Paul DiPasquale, PharmD
Director Of Pharmacy
Nicole Brooks, PharmD, Serenity Ford, PharmD
BCACP, CACP
Pharmacy Operations
Director of PGY1 Pharmacy Manager
Residency Program
Medication Management
Clinic Coordinator
IT Pharmacist
Medication Management Clinical Pharmacists
Clinic Pharmacists/LPN
Sterile Products Pharmacist
PGY1 Pharmacy Residents
Pharmacy Buyer
Senior Technician
Technicians
51.0 General
1.1 Definition
Cleveland Clinic Indian River Hospital (CCIRH) Postgraduate Year One training (PGY-1) Pharmacy
Residency Program is a 12-month program developed to meet and exceed all pharmacy practice
standards established by the American Society of Health-System Pharmacists. This residency training
program is designed to develop the resident’s clinical expertise and education in a variety of pharmacy
practice areas.
1.2 Philosophy and Purpose
The growth of pharmacy practice and the utilities of a pharmacist are substantially increasing
throughout many institutions. Many more physicians rely on the expertise of a pharmacist for
therapeutic and pharmacologic decisions. Therefore, in order to provide the most comprehensive
pharmaceutical care in all areas of pharmacy practice, it is essential for pharmacy graduates to have
formal training. Pharmacy residencies serve as one of the best modalities for pharmacy graduates to
obtain practical pharmacy skills. Under the guidance from preceptors, residents will have the
opportunity to apply and integrate pharmaceutical care principles in the care of patients.
PGY1 Program Purpose: PGY1 pharmacy residency programs build on Doctor of Pharmacy
(Pharm.D.) education and outcomes to contribute to the development of clinical pharmacists
responsible for medication-related care of patients with a wide range of conditions, eligible for board
certification, and eligible for postgraduate year two (PGY2) pharmacy residency training.
1.3 ASHP Residency Accreditation
In order to provide universal post-graduate training and to ensure complete competency on
pharmaceutical practice, ASHP has set standards for residency programs. The residency must pursue
compliance with these standards in order to maintain accreditation. CCIRH PGY-1 Pharmacy Practice
Residency Program became an accredited program by ASHP in October 2008.
1.4 Qualifications of Resident
As per ASHP requirements for pharmacy residents, the resident must be a graduate of a college or
school of pharmacy accredited by the Accreditation Council for Pharmacy Education (ACPE) or
otherwise approved to participate in the ASHP match program through PhORCAS.
1.5 Residency Faculty Structure
Residency Program Director (RPD)
The purpose of the Residency Program Director is to:
• Act as the direct supervisor to the residents
• Organize recruitment of new residents
• Oversee continual quality assessment and improvement of the residency
• Ensure program goals and specific learning objectives are met
• Ensure training schedules are maintained
• Ensure appropriate preceptorship is provided for each learning experience
• Ensure resident evaluations are routinely conducted
• Oversee Residency Advisory Committee (RAC)
Residency Program Coordinator (RPC)
6The purpose of the Residency Program Coordinator is to:
• Assist in recruitment of new residents
• Manage updating of syllabi and evaluation materials
• Ensure program goals and specific learning objectives are assigned to appropriate learning
experiences
• Ensure appropriate preceptor is assigned to each learning experience
• Ensure each resident is provided the opportunity to be taught and evaluated on each ASHP
required outcome, goal, and objective
• Create and update training schedules
• Create and update forms, templates, and files, as needed
• Prepare and maintain Preceptor Records Binder
• Prepare resident onsite binder prior to start of each residency year
• Organize materials for RAC meetings
• Assist RPD in various residency-related projects
Residency Advisory Committee (RAC)
The RAC is comprised of the Director of Pharmacy, Clinical Pharmacy Manager, Residency Program
Director, Resident Advisors, Residency Preceptors and various staff members of the CCIRH
Department of Pharmacy. The purpose of the RAC is to:
• Participate in the selection of residency candidates
• Facilitate the education of the residency program by contributing to the development of
residency guidelines
• Aid in the evaluation process of each resident
The advisory committee will assist the RPD in significant decision-making processes in the residency
program. RAC meetings will be called by the RPD a minimum of four times per residency year.
Members will be appointed to the RAC annually.
1.6 Acceptance Into the PGY-1 Pharmacy Residency Program
Application Requirements:
Interested applicants must be PharmD graduates of accredited college of pharmacy, be eligible for
licensure in the State of Florida, and submit the standard application materials through PhORCAS (i.e.
Letter of Intent, CV, the 3 standard reference forms in PhORCAS, official college transcripts), along
with:
1. We request a minimum of one (two is preferred) of your three references
should come from a preceptor who you have worked with in a clinical
setting, related to an APPE in acute or ambulatory care. The clinical
preceptor should be able to comment on your scope of responsibility, total
patient load, level of autonomy, clinical abilities, and organizational and
time management skills. All 3 reference writers should use the standard
PhORCAS template to submit their candidate recommendation and
comment on a minimum of 7 of the 13 listed candidate characteristics.
2. A response to the following essay statement is required for acceptance.
The essay response should be no longer than one page in length. An
application will not be reviewed if this statement is missing. Please note
that the essay is separate from your letter of intent. Reflecting on your
APPE rotations, please provide a piece of critical feedback you have
received from one of your preceptors on a direct patient care rotation.
Explain how you have incorporated this feedback into your practice and/
or worked to improve in this area.
7NOTE:
1. Residency applicants must currently be authorized to work in the United States. Cleveland Clinic
Pharmacy does not sponsor applicants for work Visas.
2. Appointments of applicants to residency positions may be contingent upon the applicants satisfying
certain eligibility requirements [e.g., graduating from accredited college of pharmacy, obtaining
pharmacist license in Ohio (for Ohio sites) or Florida (for Florida sites) within 90 days of start date,
and successful completion of a pre-employment physical and drug screen, including testing for
cotinine].
3. Unfortunately, we cannot accommodate OPT (Optional Practical Training) Visas for the Cleveland
Clinic Pharmacy Residency Program as the program extends beyond 12 months.
4. The Cleveland Clinic Pharmacy Residency Program does not meet the qualifications of an OPT
STEM employer because Cleveland Clinic is not enrolled in E-Verify.
Program will not consider applicants with GPA less than _____3.25_________
Program will not consider applicants from pass/fail schools
Candidate Interview process:
Selected Residency applicants will be interviewed as per ASHP standards on a formal, criteria-based
process. Candidates will be evaluated and ranked on their academic performance, professional
activities, skills, attitudes, ability to obtain outcome goals, references, on-site interview, and case
review. Resident candidates should be prepared to participate in a patient case review.
The selection of candidates to be ranked will be made based on the consensus of the RAC. The
National Matching Service finalizes candidate selection.
1.7 Resident Statement of Agreement
Prior to start of the residency program, the resident will be asked to sign a Resident Statement of
Agreement which outlines expectations of the resident during the year as well as benefits the resident
will receive. Please refer to Appendix A of this manual for a copy of the Residency Agreement.
2.0 General Information
2.1 Residency Overview
PGY -1Pharmacy Residencies are formal training programs that focus on the development of practice
skills in a variety of pharmacy practice areas. All residents are involved in service, education, and
research activities. The residency will be tailored to the individual needs of the resident.
Education and Training- Residency programs allow time for residents to pursue and achieve defined
educational outcomes set by ASHP. In addition, residents will be involved in teaching healthcare
students, pharmacy staff, nurses, and medical practitioners.
Pharmacy Operations- Residents will partake in pharmacy services. Residents will be held responsible
and accountable for the provision of various clinical services and/or distributive services provided in
practice areas of the pharmacy.
2.2 Residency Benefits
Resident Stipend: $ 40,000
Paid-Time-Off (PTO)- Refer to Appendix I. Twelve (12) days may be used by the resident at their
discretion for vacation, holidays, interviews, and short term illness. No more than 20% of a given
rotation may be taken off unless prior approval is given by the RPD. A maximum six (6) approved
conference days are not considered personal days and are in addition to these twelve (12) days.
8Resident is encouraged to maximize their amount of time on their particular rotation. Missing 20% or
more of a rotation will require either make-up time at the end of the residency or a repeat of the
rotation as an elective. Residents taking leave greater than paid leave allowed (i.e, “time-off” days)
cannot be awarded a residency certificate unless additional leave is made up.
i For example, if a resident needs to take a leave of absence and they have 12 days of “time off,”
they can use the 12 days and then will need to make up the remaining days taken on the leave of
absence [i.e., a resident takes 4 weeks leave or 20 work calendar days leave of absence, they will
be required to make-up 8 days for the residency at the end of the year].
If a resident taking a leave of absence exhausts all of their permitted days off (i.e., 12 days “time off”),
they will need to take unpaid leave, unless eligible for Short Term Disability pay, per Human
Resources Benefits eligibility guidelines.
Make-up Time for Absences
1. Leave of absence(s) may extend the training period to reach an acceptable level of performance in
order to graduate from the program. The resident must complete 12 months of residency.
2. Any leave greater than or equal to 7 calendar days will require the resident to make-up missed time.
a. Leave of absence time must be completed within 6 months of the date the program was scheduled to
be completed, or the resident forfeits the privilege of receiving the Certificate of Completion of the
program.
Upon returning from leave, hours will be paid and must be: worked under the guidance of a preceptor,
equal to the hours missed, and used to complete the requirements not yet achieved.
All requests for time-off must be submitted in writing to the rotation preceptor, RPD, and Director of
Pharmacy 4 weeks prior to and are subject to their approval. The resident is required to arrange
coverage of any activities missed as a result of the request.
Extended Leave of Absence
Refer to Appendix H. In the event that a resident requires an extended leave of absence for personal
leave, extended sick leave or medical leave, it is the resident’s responsibility to ensure that all
paperwork is completed and turned into Human Resources. The time away from the residency
program due to a leave of absence must be completed at the end of the residency. Each case will be
reviewed by the Residency Advisory Committee for evaluation. The resident will be able to return and
complete the residency off cycle as long as the leave of absence is approved through Human Resources
and does not exceed six months.
Health Insurance- The resident will receive health care benefits according to the CCIRH employee
policy as entitled for a full-time employee of the Department of Pharmacy.
Professional Meetings- Residents will receive reimbursement pursuant to Human Resources policy
(Appendix L) for expenses incurred during attendance at the following conferences:
1.) ASHP Clinical Midyear Meeting
2.) Florida Residency Conference
Procedures for submitting reimbursement for professional meetings:
1.) Prior to Travel (no less than 2 weeks prior) obtain “Request for Travel” form
a. Gather program materials, sample flights, hotel reservations, etc. and attach to form.
b. Submit form to RPD for review and further instructions
2.) After travel has occurred:
a. Obtain “Travel Expense Form” and complete all necessary information.
b. Receipts of events must be organized by day and taped to a 8” X 11” paper.
c. Forms are to be submitted to the RPD and Director of Pharmacy.
d. Forms must be signed by the Administrator or Vice President over Pharmacy
9Each resident will assist with the recruitment efforts of the department at the residency showcases.
Residents are expected to prepare and staff the residency showcase or any other function that
involves recruitment, unless given permission otherwise.
Affiliated College of Pharmacy Online References- See Residency Director and/or Preceptor
2.3 Pharmacist Licensure
The resident must obtain Florida pharmacist licensure within 90 days of the start day of the residency
program. Failure to obtain licensure within the first 90 days will result in dismissal from the program.
2.4 Required Meetings
The resident will be required to attend a number of meetings throughout the year. Other meetings may
be required by specific rotations. These meetings must be coordinated with each preceptor. Exceptions
to this are if the resident is staffing or if there is a patient care issue which takes precedence and must
be addressed immediately.
1. Pharmacy & Therapeutics Committee
2. Department Meetings
3. Continuous Quality Improvement
2.5 Staffing Requirements
The resident will be required to work a minimum of 40 hours per week for at least 52 weeks. However,
it is understood that the resident will likely need to work greater than 40 hours to facilitate all patient
care responsibilities. Specific hours will depend upon the individual needs of the rotation and will be
determined by each preceptor at the beginning of the rotation. Unless otherwise specified by the
preceptor, the resident will be expected to report to the main pharmacy by 0700. Residents are
expected to punch in at the beginning of every shift and punch out prior to leaving for the day. While
on the Ambulatory Care rotation residents are expected to punch in and report to the clinic by 0745.
The residents are responsible for their assigned staffing service, and are responsible for assuring that
these service commitments are met in the event of an unforeseen absence. Paid time off cannot be used
in place of staffing requirements. If a resident requests PTO on a scheduled staffing weekend, it is
his/her responsibility to make arrangements with the other resident(s).
In order to ensure competence in this role, residents will work under the supervision of another
pharmacist during the orientation/training period. Residents are responsible for reviewing every
pharmacotherapy consult with the assigned clinical pharmacist at completion of the initial consult and
before any notes are placed in the chart or any verbal recommendations are made. All notes must be
co-signed by a clinical staff pharmacist during the training period. After the training period, as the
resident displays the necessary clinical skills and provided that licensure was obtained, the resident
will transition to practice as an independent pharmacist.
Residents will participate in every other weekend staffing during the required operational pharmacy
practice I & II experiences for a total of at least 20 weekends worked over the program year. Residents
are expected to arrive no later than 0700 and work until at least 1530. The resident may have a project
day on the Monday after staffing the weekend. In order to minimize time away from the residency
rotation, this day will not be offered in lieu of another residency obligation which will take the resident
away from their rotation during the pay period week. The resident may choose to work at home on
these project days provided there is not another event scheduled that week which will take the resident
away from their assigned rotation. The resident will coordinate with the rotation preceptor and RPD
prior to each staffing weekend to ensure there are no conflicts which would preclude the resident from
working from home.
102.6 CCIRH Policies and Procedures
The CCIRH Employee Policies and Procedures will be reviewed by the resident during the orientation
period. Residents are subject to all of CCIRH Policies and Procedures. Electronic documentation of
Policies and Procedures are available on the CCIRH intranet. Important policies to be reviewed prior to
starting the residency are included in the appendixes.
2.7 Resident Holidays
One resident will be assigned to work on each designated holiday. Resident will provide pharmacy
service coverage on holidays similar to weekend coverage.
a. New Year's Day
b. Memorial Day
c. Labor Day
d. Thanksgiving Day
e. December 25th (Christmas Day)
2.8 Duty Hours
Duty hours must be limited to 80 hours per week averaged over a four-week period as to comply with
ASHP Accreditation Standards for Pharmacy Residents. Residents will be instructed in and required to
electronically log all hours worked at the facility.
The RPD and/or the Director of Pharmacy must approve all outside employment. External employment
or “Moonlighting” should be carefully chosen as to not interfere with the ability of the resident to
achieve the educational goals and objectives of the residency program. The residency program
schedule will not be modified to accommodate moonlighting.
Any hours worked moonlighting will be reported to the RPD on a weekly basis. Duty hours including
external employment must be limited to 80 hours per week.
2.9 Resources
1. Lexi-comp®
Available on the intranet under applications
2. UpToDate®
Available on the intranet dropdown box
3. University of Florida Health Science Center Library
Access available through preceptors
3.0 PGY-1 Pharmacy Residency Program Design
3.1 Syllabus with Learning Experiences and Required Readings
Prior to beginning each rotation or learning experience residents are to obtain a copy of the syllabus. It
is the responsibility of the resident to coordinate and fulfill the objectives set forth by the syllabus.
Residents are required to make arrangements to meet and discuss an upcoming rotation with the
preceptor at least 1 week prior to starting any new rotation. The purpose is for resident and preceptor to
discuss expectations, syllabus, readings, schedule, etc. The resident is also required to make
11arrangements with preceptor within 7 days of end of the previous month to discuss evaluations for that
particular experience.
The resident and preceptor should complete a pre-rotation checklist prior to the start of each rotation.
The resident will discuss their personal goals for the rotation as well as any feedback received from the
previous rotation. The resident and preceptor will customize the rotation plan and activities for the new
rotation to account for the resident’s interests, strengths, and weaknesses. At the end of the rotation, an
end-rotation checklist will be completed where the resident and preceptor will exchange feedback
regarding the rotation and identify strengths and areas for improvement to be carried over to the next
rotation.
3.2 Required Clinical Rotations
ASHP Residency Accreditation Standards (Appendix F) require PGY-1 residents to achieve
satisfactory remarks in four (4) competency areas and all associated educational goals and objectives.
(Standard 3.2 of the ASHP Accreditation Standard for Postgraduate Year One Pharmacy Residency
Programs):
1. Patient care
2. Advancing practice and improving patient care
3. Leadership and management
4. Teaching, education, and dissemination of knowledge
See Appendix G for the PGY-1 Pharmacy Residency Competency Areas, Goals, and Objectives
The following experiences are designated by CCIRH as required for successful completion of this
residency:
Core Rotational
1.) Orientation
2.) Cardiology
3.) Internal Medicine
4.) Advanced Internal Medicine
5.) Critical Care
6.) Ambulatory Care
7) Advanced Ambulatory Care
8.) Infectious Disease
9.) Sterile Preparations
10.) Emergency Medicine
A list of pre-requisites for each experience is included in Appendix U: Program Structure.
3.3 Elective Rotations
The residency program will be tailored to the individual resident. It is one of the goals of the
residency program to work with the interests of the resident and to promote other areas of interest for
the resident. Residents are to select two electives and one concentrated (2 week) elective. Any
elective experience may be modified to a concentrated elective. Other elective options may be
available with RPD discussion.
Elective Experiences:
1.) Administration
2.) Hematology/Oncology
3.) Nutrition Support
4.) Primary Care Medication Management
5.) Advanced Critical Care
126.) Advanced Infectious Disease
7.) Advanced Emergency Medicine
If a specific area of interest of the resident is not listed as an elective rotation and the hospital has
the opportunity in providing that experience, the RPD will attempt to facilitate the learning
experience. Each residency elective must be decided by the resident and confirmed by the
preceptor and RPD at least 8 weeks prior to the assigned elective month.
3.4 Longitudinal Experiences
In conjunction with core learning experiences, residents are required to complete experiences in a
longitudinal format. These experiences will occur throughout the program. See program structure grid
for details.
Longitudinal Experiences:
1.) Leadership in Pharmacy
2.) Education in Pharmacy
3.) Longitudinal Research Project
4.) Operational Pharmacy Practice
5.) Advanced Operational Pharmacy Practice
Operational Pharmacy Practice and Advanced Operational Pharmacy Practice
In order to provide continuity of clinical pharmacy services, residents are each required to cover
clinical services for their assigned rotation and all clinical services on weekends and holidays.
Examples of current pharmacy services include order entry, anticoagulation dosing and
monitoring, pharmacokinetic consults, antibiotic dosing and monitoring, and parenteral nutrition
consults.
Each weekend will have one resident covering. The resident will be responsible for assisting
with order entry and other distributive processes, operations and management of the pharmacy,
supervising pharmacy technicians, and maintaining clinical services.
3.5 Teaching Requirements
CCIRH has affiliations with several Colleges of Pharmacy, including Nova Southeastern University,
Ohio Northern University, Palm Beach Atlantic University, Creighton University, and the University
of Florida. These affiliations include accepting Advanced Pharmacy Practice Experience students
from these schools. The resident will be actively involved in teaching/precepting students throughout
the year. Towards the end of the residency, the resident will be the primary preceptor for at least one
student and will be responsible for orientation, evaluation, and grading of that student. The resident
will work with their preceptor in facilitating experiences for the student.
3.6 Resident Schedule
The RPD and Residency Program Coordinator are responsible for scheduling the required experiences
and dates. They will develop resident schedules at the beginning of the residency year, except for
elective rotations. The schedule will be posted online via PharmAcademicTM.
4.0 PGY-1 Pharmacy Residency Expectations and Residency Requirements
4.1 Professional Practice
13Professional Conduct - It is the responsibility of all residents to uphold the highest degree of
professional conduct. The resident will display an attitude of professionalism in all aspects of daily
practice. Professional conduct is expected to be maintained at off campus functions that are
representing CCIRH, including meetings (i.e. ASHP Midyear and the FRC).
Professional Dress - Residents are expected to dress in an appropriate professional manner whenever
they are in the institution or attending any function as a representative of CCIRH. Clean, pressed white
lab coats of full length will be worn at all times in patient-care areas and when presenting on hospital
grounds. If problems exist with the dress code, the RPD or preceptor will address these issues.
Patient Confidentiality - Residents are responsible for maintaining strict patient confidentiality. Any
consultations concerning patients will be held in privacy with the utmost concern for the patients’ and
families’ emotional and physical well-being. Issues will not be discussed unless medically pertinent.
Further information regarding patient confidentiality can be found in the CCIRH Employee handbook.
Laptops assigned to residents must be stored in the pharmacy at the end of the day. Residents should
not bring laptops home.
Attendance - Residents are expected to attend all functions as required by the Residency Advisory
Committee, RPD, and rotation preceptors. Residents are responsible for weekend/weekday coverage of
clinical pharmacy services. The resident must make up days that are missed if not approved by the
RPD. All leave requests should be discussed in advance with the involved preceptor to assure that
service responsibilities can be fulfilled. Residents must attend required meetings unless on an approved
leave of absence. This also includes punctuality. It is important to be on time to all scheduled rotations,
residency program, and other professional activities.
Corrective Action- The RPD and Director of Pharmacy will follow the Human Resources Corrective
Action policy to address issues with work performance. (Appendix J)
4.2 Residency Requirements
Residents will be required to perform or participate in a number of activities throughout the year.
These requirements must be completed within one year of the beginning of the residency program
(unless a leave of absence has been approved) in order to obtain a CCIRH PGY-1 Pharmacy Residency
Certificate. The certificate acknowledges a resident’s successful completion of all requirements in
accordance with the residency guidelines and recognizes a minimum level of competency in the area of
pharmacy practice. See section 4.3 Determination of Graduation for details.
PharmAcademicTM Performance Indicator Definitions:
See Appendix V: Residency Program 3-Part Assessment Strategy
1. Needs Improvement (NI)
a. The resident is deficient in skills/knowledge in this area and requires assistance to
successfully complete the learning activities associated with the objective in more than 30%
of instances.
b. Resident is unable to ask appropriate questions to supplement limitations and/or has a general
deficit in this area.
c. The resident’s level of skill on the objective does not meet the preceptor’s standards of either
“Achieved” or “Satisfactory Progress,” whichever applies.
2. Satisfactory Progress (SP)
a. The resident has adequate skills/knowledge in this area and requires assistance to successfully
complete the learning activities associated with the objective in 10-30% of instances. The
resident performs associated tasks at an acceptable level, and in a consistent manner.
b. This applies to an objective whose achievement requires skill development during more than
one learning experience. In the current learning experience, the resident has progressed at the
14required rate to attain full and independent ability to perform the objective by the end of the
program.
c. Resident is able to ask questions to acknowledge limitations and/or judgment is not refined.
3. Achieved (ACH)
a. The resident has the skill/abilities in this area and requires assistance to successfully complete
the learning activities associated with the objective in less than 10% of the instances. The
resident requires no further developmental work in this area and requires minimal supervision,
or
b. The resident has fully accomplished the ability to independently perform the learning
activities associated with the objective in a consistent manner.
4. Achieved (ACH-R) for Residency:
a. An objective may be “Achieved for Residency” (ACH-R) when the resident:
i. Has “Achieved” the objective at least once during the residency (or at the discretion
of the RPD/Advisor).
b. A goal may be “Achieved for the Residency” (ACH-R) when the resident:
i. Has “Achieved for Residency” all the objectives for the specific goal (done
automatically by Pharmacademic when all the objectives have been achieved).
Please see Attachment G for the ASHP Outcomes, Goals, and Objectives.
The following activities are designed to achieve the ASHP Residency Outcomes and Standards:
1.) Rotational and Longitudinal Experiences
2.) Complete a residency project (Major) of either a service or research project designed to improve
the services of the department or achieve a specific research objective.
3.) Prepare and present one topic for each learning experience. These presentations are to include at
least
4.) four journal clubs and
5.) at least four formal presentations
6.) Fulfill all clinical pharmacy services
7.) Complete all pharmacy staffing obligations
8.) Attend required residency meetings (detailed in section 2.4)
9.) Actively participate in didactic teaching sessions including journal club, topic discussions, and
case presentations.
10.) Complete as least one Medication Use Evaluation (MUE)
11.) Present longitudinal project to society meeting or conference
12.) Participate in pharmacy resident recruitment
13.) Prepare written manuscript of publishable quality. Publication is recommended but not a
requirement.
14.) Present 1 hour of continuing education credit
15.) Prepare and present at least one Drug Monograph to Pharmacy and Therapeutics Committee
16.) Precept at least one APPE pharmacy student
17.) Take personal responsibility and accountability for providing ethical and quality pharmaceutical
care to enhance patient outcomes
18.) Participate in community involvement events
19.) Lead a formal or informal meeting
20.) Attend and take minutes at P&T meetings
21.) Complete at least one SOAPE note for each direct patient care rotation
22.) Other assigned duties, projects, and activities
4.3 Determination of Graduation
A resident must meet the following in order to successfully complete the residency and be awarded a
residency certificate. A resident:
151. Must obtain pharmacist licensure in the State of Florida within 90 days of residency program start
date.
2. Must complete all required residency rotations as outlined by the specific residency program (as
outlined in Acceptance Letter).
3. Must have all resident evaluations (in PharmAcademic) completed.
4. Must meet the following:
a. PGY1 Pharmacy: A resident must achieve all goals in R1, R2, R3, R4. By the end of the
residency, there can be no objectives that are rated as Needs Improvement.
5. Must complete research or project(s) and present at Florida Residency Conference. Manuscript
must be turned in by end of program.
6. Must complete all presentation requirements (e.g., case presentations, seminar, continuing
education topics, and research project/DUE proposal and findings).
Each Resident’s Quarterly Evaluations will be reviewed by the Residency Advisory Committee to
determine if the resident is on schedule to successfully complete the residency.
5.0 Presentations
5.1 Continuing Education Presentations
The residents are required to provide 1 hour of continuing education credit to either pharmacists,
pharmacy technicians, or to members of the medical or nursing staff. ACPE certification of continuing
education may be obtained through the Treasure Coast Society of Health-System Pharmacists
(TCSHP). Certification of CME or CEU credits may be obtained through affiliations provided by
CCIRH.
The presentation should include an effective delivery method using PowerPoint, handouts, or other
material. The formal presentation should last 45 minutes. An outline should be completed at least 4
weeks prior to the presentation and reviewed by the RPD.
5.2 Pharmacy Presentations
5.2.1 Department Presentations
The resident will present a monthly to department staff focused on a clinical issue related
to the month’s learning experience. Residents shall ensure no fewer than four of the twelve
presentations are in journal club format and at least four in disease state/therapeutic agent
presentation format. The remaining four presentations may be in whichever format
(journal club or disease state/therapeutic agent) selected by either resident or preceptor.
Disease State/Therapeutic Agent Presentations
The resident will work with their preceptor to identify a topic based on their interest and
will prepare a 30-40 minute presentation and handout. The topic of the presentation and 3
learning objectives should be determined and discussed with the preceptor 7 days prior to
the presentation. The resident will include at least 3 learning objectives at the beginning of
each presentation. The presentation may include the following:
Disease State Presentation
A. Anatomy/pathophysiology
B. Epidemiology
C. Risk Factors
D. Presentation/Clinical Manifestation
16E. Screening/Diagnosis Criteria
F. Treatment (emphasis of presentation)
a. Non-pharmacologic
b. Organizational guidelines
c. Primary literature review
d. New/investigational agents
e. Surgery
G. Conclusion
H. References
Therapeutic Agent/Class Presentation
A. Introduction/History
B. Chemical Structure
C. Mechanism(s) of Action
D. Pharmacokinetics
E. Dosage and Administration
F. Preparation
G. Adverse Effects
H. Special Populations
I. Clinical Applications
J. Areas of Research
K. Conclusions
L. References
Competency Evaluation: the resident will present a minimum 3 question quiz during each
presentation. The quiz may be presented either verbally during the presentation or in
writing.
Residents will be evaluated on their presentations using the form Appendix D. Areas to
be evaluated include material presented, appropriateness of handouts, presentation style,
and the ability to answer questions regarding the topic. The preceptor and RPD will
collect evaluation forms and give feedback to the resident after the presentation.
Evaluation forms are to be included in the resident binder.
5.2.2 Topic Discussions
The purpose of the topic discussion is to provide the residents with a forum focused on
various disease states, evidence based medicine, and treatment related issues pertaining to
pharmaceutical care of CCIRH patients. These discussions will supplement the practical
and clinical education the residents will receive during their rotations.
Topic discussions are to be held at the discretion of the rotation preceptor and will be
discussed and scheduled at the pre-rotation meeting in advance of the rotation. Either the
resident or preceptor may lead the topic discussion. Pharmacy students can participate. If
the topic discussion is led by the resident, the resident should include documentation in the
form of meeting minutes in their residency binder.
5.2.3 Journal Club
Competence in medical literature review is an important skill for clinical pharmacists to
have in order to provide appropriate interpretations of the data.
Pharmacy residents are required to present an article to the pharmacy at least four times
per residency year. General dates will be placed on the residency calendar. Journal club
provides the resident with opportunity to present a current article that addresses drug or
17disease related problems. The presentation should be no longer than 30 minutes including
discussion.
The format should include the following:
a. Study or article objective
b. Study Design
c. Methods
d. Biostatical appropriateness
e. Results
f. Application to practice
Resident is encouraged to explain the biostatistics
The presentation should be informal. The article chosen by the resident must be given to
the RPD at least one week prior to the presentation.
6.0 Residency Project
6.1 Purpose
One of the required outcomes of the ASHP Residency Standards is that the resident demonstrates
project management skills. A residency project helps the resident develop and justify new services or
build upon existing ones. The resident is afforded the opportunity to develop research, project
management, and writing skills. The residency project may vary depending on the needs of the hospital
and the interest(s) of the individual resident.
6.2 Selection of Residency Project
During the month of orientation & training, the resident must select their project from a list generated
by the RPD, Director of Pharmacy, and/or preceptors. The RPD will make every effort to provide
opportunity for research projects that align with each resident’s individual interests and that will be
sustainable, feasible, and beneficial to the facility.
Towards the end of the residency and prior to the Florida Residency Conference (FRC), residents are
required to give formal presentations to the pharmacy staff on their residency project.
6.2.1 Project Advisor
The RPD and resident will select a member of the staff to act as a Project Advisor. The
Project Advisor will act as a resource and help to facilitate the project.
6.2.2 Project Time Line
After a project has been selected and approved, the resident, Project Advisor, and RPD
will develop a time line outlining key deadlines. The time line will include the following:
a. Title
b. Purpose
c. Date to complete writing the proposal or outline of project
d. Date of submission to IRB, if applicable
e. Date of implementation or start
f. Target date of completion
g. Target dates for presentation
h. Target date for submission for publication (not required, but encouraged)
6.2.3 Project Presentation
18It is expected that residents will present their project in a poster format at the ASHP
Midyear Clinical Meeting. Resident must identify appropriate deadlines for submission.
A formal PowerPoint presentation is generally made at the Florida Residency
Conference. If the resident is unable to attend either of these meetings, then the resident
will discuss alternative forums for presentation with the RPD.
7.0 Faculty
7.1 Department of Pharmacy Administration
Director of Pharmacy Paul Dipasquale, Pharm.D.
Clinical Manager Serenity Ford, Pharm.D., C.Ph.
7.2 Residency Advisory Committee
Residency Program Director Nicole Brooks, PharmD, BCACP, CACP
Residency Program Coordinator Jessica LaFosse, PharmD, CPh,
Residency Advisory Committee
Members (RAC):
Jinal Andrade, PharmD, BCGP
Ravi Bacchus, PharmD, BCCCP
Cleon-Paul Blake, PharmD
Nicole Brooks, PharmD, BCACP, CACP
Daniel Carp, PharmD.,BCNSP
John Comunale, B.S., RPh
Paul Dipasquale, PharmD
Cecile Kelly, PharmD, BCPS
Milena Kelly, PharmD
Jessica LaFosse, PharmD, CPh
Julian Mattes, PharmD
Jeni McGuire, RPh, BCPS, BCCCP
Mary Mullinary, RPh
Alex Siragusa, PharmD
Karen Speed, Pharm.D, BCPS
Andrew Stoessel, Pharm.D., BCIDP
Preceptor in Training:
Julian Mattes, PharmD
Paul Dipasquale, PharmD
Karen Speed, Pharm.D, BCPS
Cleon-Paul Blake, PharmD
7.3 Rotation Preceptors
Administration: Paul Dispasquale, PharmD
19Ambulatory Care: Milena Kelly, Pharm.D.,
Advanced Ambulatory Care: Nicole Brooks, Pharm.D., BCACP, CACP
Hematology/Oncology Donald Weiss, B.S., RPh
Julian Mattes, PharmD
Critical Care & Ravi Bacchus, PharmD, BCCCP
Advanced Critical Care:
Education in Pharmacy: Nicole Brooks, PharmD, BCACP, CACP
Emergency Medicine & John Comunale, B.S., RPh &
Advanced Emergency Medicine: Jeni McGuire, RPh, BCPS, BCCCP
Infectious Disease & Andrew Stoessel, Pharm.D., BCIDP
Advanced Infectious Disease:
Internal Medicine: Cecile Kelly, PharmD, BCPS
Advanced Internal Medicine: Cecile Kelly, PharmD, BCPS
Cardiology: Karen Speed, Pharm.D., BCPS
Leadership in Pharmacy: Nicole Brooks, PharmD, BCACP, CACP
Longitudinal Research Project: Nicole Brooks, PharmD, BCACP, CACP
Orientation & Training: Nicole Brooks, PharmD, BCACP, CACP
Operational Pharmacy Practice & Mary Mullinary, RPh &
Advanced Operational Pharmacy Practice Alex Siragusa, PharmD
Sterile Preparation: Daniel Carp, Pharm.D., BCNSP
Nutrition Support: Daniel Carp, Pharm.D., BCNSP
Primary Care Medication Management: Jinal Andrade, PharmD, BCGP
8.0 Evaluations
The evaluation process is an important component to residency programs. The feedback the resident receives
during these evaluations is meant to assist and develop the resident in achieving the goals of the residency
program but also it aids in completing the resident’s personal goals. Prior to completing any online evaluation,
the preceptor and resident will meet to discuss the end rotation checklist which will include verbal feedback
reflected in the evaluation. Also, it is important that the resident complete an evaluation on the preceptor and
rotation in order for the residency program to grow. Evaluations will be made based on the
Outcomes/Goals/Objectives set forth in each of the rotational or longitudinal experiences. In addition, the
resident will be evaluated on all presentations and small projects.
Residents will be required to use PharmAcademic™ for the evaluation process.
Resident Evaluation- The resident will be evaluated by the preceptor(s) for a particular learning
experience based on the learning goals and objectives set forth prior to the learning experience.
20Resident Self-Evaluation: The Rresident will evaluate him/herself for a particular learning
experience based on the learning goals and objectives set forth prior to the learning experience.
Learning Experience Evaluation- This is an opportunity for the resident to evaluate and to provide
feedback to the preceptor(s) and the residency director on the learning experience provided.
Information that is given will be used for upcoming rotations or other residency classes.
Preceptor Evaluation- The resident is to provide a written evaluation for the assigned preceptor.
This will aid in the preceptor to identify strengths and weaknesses in order for them to improve
later in the residency year or other residency classes.
.
It is the resident’s Responsibility to ensure ALL evaluations are completed within 7 days of the end of the
learning experience. It is the resident’s responsibility to set up a meeting with preceptor to discuss
evaluations. Evaluations should not be submitted until resident and Preceptor have meeting one on one to
discuss all evaluations.
Evaluation Responsibilities and Deadlines
Resident Evaluations Due Date:
Pre-Residency Self Evaluation Prior to start - PharmAcademic™
Pre-Residency Assessment & goals During Orientation - PharmAcademic™
Pre-rotation checklist Seven days prior to new rotation
End rotation checklist Last day of rotation
Rotation Evaluation Within 7 days of completing rotation
Preceptor Evaluation Within 7 days of completing rotation
Training Plans Quarterly
Evaluations must be forwarded to residency advisor and RPD.
Residency Director Evaluations Due Date:
Training Plans Quarterly
Longitudinal Rotations Quarterly
Formal Presentations Within 24 hours of presentation
Preceptor Evaluations Due Date:
Rotation Evaluation Within 7 days of completing rotation
Topic Discussion Evaluations Within 24 hours of presentation
219.0 Appendixes
Appendix A Resident Statement of Agreement
Appendix B Pre-rotation Checklist
Appendix C End Rotation Checklist
Appendix D Presentation Evaluation Form
Appendix E Topic Discussion Evaluation Form
Appendix F ASHP Accreditation Standard for Postgraduate Year One (PGY-1) Pharmacy
Residency Programs
Appendix G ASHP Guidance Document for Required Competency Areas, Goals, and
Objectives for Postgraduate Year One (PGY-1) Pharmacy Residency Programs
Appendix H Pharmacy Residency Procedure: Leave of Absence
Appendix J Paid Time Off (PTO) Policy
Appendix K Corrective Action Policy
Appendix L Pharmacy Residency Dismissal Policy
Appendix M Tobacco Free Campus Policy
Appendix N Employee Travel/Professional Development Policy
Appendix O Mandatory Influenza Vaccination Policy
Appendix P Pharmacy Residency SOP – Resident Duty Hours
Appendix Q Pharmacy Residency Policy – Licensure
Appendix R Journal Club Evaluation Form
Appendix S Successful Completion of Residency Policy
Appendix T Preceptor Manual
Appendix U Program Structure Table
Appendix V Residency Program 3-Part Assessment Strategy
Appendix W Preceptor Appointment and Reappointment
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