BETH ISRAEL MEDICAL CENTER PHARMACY DEPARTMENT Hospital Pharmacy Residency Program (PGY1) Inpatient Family Medicine: Service Commitment Rotation Preceptor: Sharon See, Pharm.D., FCCP, BCPS Associate Clinical Professor St.John's University College of Pharmacy and Allied Health Professions Clinical Faculty Beth Israel Residency in Urban Family Practice 212-844-1955 sees@stjohns.edu/ssee@chpnet.org Rotation Website: http://facpub.stjohns.edu/~sees/FMsite/index.shtm Description of Rotation: This is a 4-5 week experiential rotation in inpatient Family Medicine at Beth Israel Medical Center. The family medicine service is primarily located on 8Linsky and on other specialty units throughout the hospital. Our team consists of family medicine interns, residents, Family Medicine physician attendings, a Pharm.D. attending, medical and pharmacy students, pharmacy, psychiatric and OB residents. This experience is intended to expose the pharmacy resident to various aspects of clinical pharmacy practice and principles of family medicine in the inpatient family medicine setting. Under the direct guidance of Dr.See, the resident will help optimize drug therapy in our family medicine patients by conducting patient-specific assessments, evaluating patient drug therapy regimens, identyfying and resolving drug related problems, selecting drug therapy regimens, prospectively monitoring of therapy, and providing patient and health professional education. Disease States: The resident will gain proficiency in the following areas through literature review, topic discussion, and/or direct patient care experience including but not limited to: 1. 2. 3. 4. 5. 6. Cardiovascular-ACS, MI, Atrial Fibrillation, HTN, heart failure Endocrine-Inpatient glycemic control Anticoagulation-DVT/PE ID-osteomyelitis, HIV, HAP, CAP, skin/soft tissue infections, UTI Psych-alcohol withdrawal, depression, bipolar disorder, anxiety Renal-Renal failure SS 8/17/11 1 Resident Learning Goals & Activities: Outcome Manage and improve the medication-use process. R1: R1.4 Demonstrate ownership of and responsibility for the welfare of the patient by performing all necessary aspects of the medication-use system. R1.5 Provide concise, applicable, comprehensive, and timely responses to requests for drug information from patients and health care providers. Outcome Provide evidence-based, patient-centered medication therapy management with R2: interdisciplinary teams. R2.1 As appropriate, establish collaborative professional relationships with members of the health care team R2.2 Place practice priority on the delivery of patient-centered care to patients R2.3 As appropriate, establish collaborative professional pharmacist-patient relationships. R2.4 Collect and analyze patient information. R2.6 Design evidence-based therapeutic regimens. R2.7 Design evidence-based monitoring plans. R2.8 Recommend or communicate regimens and monitoring plans. R2.9 Implement regimens and monitoring plans. R2.10 Evaluate patients’ progress and redesign regimens and monitoring plans. R2.11 Communicate ongoing patient information. R2.12 Document direct patient care activities appropriately. Outcome Provide medication and practice-related education/training R5: R5.1.3 Use skill in the 4 preceptor roles employed in practice based teaching (direct instruction, modeling, coaching, facilitation Activities: 1. Co-precept St. John’s University College of Pharmacy students under supervision of Dr.See (Objective R5.1.3) a. Serve as junior faculty member b. Assess journal clubs, case presentations, student performance 2. Attendance and participation in daily medical rounds with assigned medical teams. (Objective R2.1.1, R.2.2.1, R2.6.2, R2.8.1) 3. Monitor and review patient therapy for efficacy, appropriateness of therapy, and drug related problems for all patients on the family medicine service. Discuss pharmaceutical care plans with preceptor using organized patient monitoring sheets and verbal discussions with preceptor. Communicate recommendations to the team. (Objective R2.4.1, R2.6.2, R2.7.1, R2.8.1, R2.10.1, R2.10.2, R2.11.2, R2.12.3) 4. Obtain drug histories and perform discharge counseling. (Objective R2.3.1, R1.4.1, R2.4.1, R2.4.2, R2.12.1, R2.12.2, R2.9.2) SS 8/17/11 2 a. Documentation: Submit drug histories and patient counseling forms as part of patient management 5. Answer patient-specific drug information questions resulting from rounds, patient contacts or assigned readings. (Objective R1.5.1, R1.5.2, R1.5.3, R1.5.4, R1.5.5, R1.5.6, R.5.7) a. Documentation: Submit drug information responses with references to preceptor or provider when applicable. 6. Review journals and pertinent literature relevant to adult medicine (Objective R1.5.2, R1.5.3, R1.5.4, R1.5.5, R1.5.6, R.5.7) a. Documentation: Journal club presentation and/or conduct discussions with preceptor, students 7. Provide in-service lecture(s) to pharmacy students, nursing staff, or medical team when requested. (Objective R2.11.2, R5.1.5) a. Documentation: Submit outline and lecture handouts. 8. Report cases of adverse drug reactions. (Objective R2.4.1, 2.11.2, 2.12.1) a. Documentation: Submit institution’s ADR reporting form or FDA drug reaction reporting form. 9. Attend all departmental and interdepartmental educational functions including lectures, grand rounds, and journal clubs. a. Documentation: As per preceptor 10. Document all interventions, ADRs, in-services, drug information questions. (Objective R2.12.1, R2.12.2) General Schedule (see website for updated schedule) Time 8-9am 9amnoon M Attending Rounds 9am Noon 1-4pm Pt follow up/Case discussion SS 8/17/11 T W Th Fr Night float rounds/Morning report Attending Attending Rounds/ Attending Attending Rounds Psychosocial Rounds Rounds Rounds Multidisciplin Multidisciplinary ary Rounds-8L Rounds-8L Lunch Pt follow Wed Teaching Pt follow up/Case Pt follow up/Case Afternoon discussion up/Case discussion discussion 3