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URMC / Pharmacy / Residency Program / PGY1 Programs / PGY1 Community / PGY1 Community: Rotations
 

PGY1 Community: Rotations

Core Block Rotations

Orientation

Primary Preceptor: Allison Trawinski, Pharm D, BCACP, MBA

This rotation is designed to orient the resident to UR Medicine and the Department of Pharmacy.

Activities will include hospital orientation, electronic medical record (EMR) orientation, and exposure to the departmental and institutional policies, general functioning of the pharmacy, the daily activities of pharmacy technicians and pharmacists, as well as the hospital environment. The resident will gain experience with the EMR, order verification, checking medications and order entry, Training plans will be modified as required if the resident has completed orientation prior to the current year. Residency related policies, rotation overviews, and resident expectations will also be covered during the orientation period.

The resident will be oriented to the Residency Learning System and will complete a pre-residency questionnaire to help the residency program director and preceptors, along with the residents, begin to develop a Customized Learning Plan. The resident will also be assigned and rotated through various committees within the hospital upon which they will serve throughout the residency year as applicable to the programs. The resident will also be required to complete all hospital and departmental competencies, in addition to any new hire paperwork, required for employment.

This rotation also encompasses an orientation to pharmacy practice, which will give the resident an overview of outpatient pharmacy services at a large teaching hospital. The resident will be paired with a pharmacist for each shift. The resident will have the opportunity to improve skills required to review, prepare, and dispense medications. In addition to dispensing, monitoring, and consulting on medication issues, the resident will also evaluate the work flow in relation to patient safety.

Community Care: Anthony Jordan Health Center

Preceptor: Gabriela Cipriano, Pharm D

The rotation will prepare the resident to provide optimal patient care in the practice of pharmacy through collaboration with other health care professionals. The resident will obtain the skills to build and expand upon medication management pharmacy services in the setting of outpatient clinics (e.g., community health centers). The resident will also have the opportunity to serve as a role model for pharmacy students either in didactic or experiential settings. Some site-specific experiences include, but not limited to: anticoagulation clinic, diabetes education/disease state management, in-service presentations, and clinical staff education.

Ambulatory Psychiatric Disease Clinic

Preceptor: Kerri Klajbor, RPh, MS, BCPP

The rotation will focus on the provision of clinical pharmacy services by the resident in a Psychiatric Ambulatory Care Clinic, under the preceptorship of a board certified psychiatric clinical pharmacy specialist. The clinical pharmacists and pharmacy staff in the Psychiatric Clinic are responsible for providing the following pharmacy services to patients: psychopharmacology consults, diabetes mellitus education, smoking cessation counseling, medication management, clozapine monitoring, and an adherence program. This rotation will occur within the Strong Ties Community Support Program, an ambulatory clinic that provides comprehensive medical, psychiatric, and case management services to severely and persistently mentally ill clients. The goals of this rotation are to comprehend the role of the pharmacist in providing integrated patient care to psychiatrically ill clients in an ambulatory setting, develop competence in the psychopharmacology of and diagnostic criteria for psychiatric disorders, and acquire skills necessary to prevent, identify, and resolve drug-related problems and improve treatment adherence in psychiatrically ill clients.

Specialty Pharmacy

Primary Preceptor: Allison Trawinski, Pharm D, BCACP, MBA

This rotation will focus on providing outpatient clinical pharmacy services to patients that receive specialty medications. Specialty medications are defined by the insurance companies and are typically high cost and or high risk medications. The practice environment will be largely telephonic but will also involve providing clinical pharmacy services in hospital clinics. We currently have programs developed for University of Rochester Employees, Hepatology (Hepatitis C), Multiple Sclerosis and Oncology. We are continually growing and there are many opportunities to learn how to develop new programs. This rotation will include maintaining and developing databases to continually monitor patient outcomes and help optimize therapy. We will provide education on disease states, medication administration, monitoring for adverse events and adherence. The major goal of this rotation is to learn the workflow of a specialty pharmacy and the opportunities for pharmacist involvement.

Transitions of Care

Primary Preceptor: Andrew Smith, Pharm D, BCPS

Transitional care can be defined as a set of actions designed to ensure the coordination and continuity of health care as patients transfer between different locations or different levels of care in the same location. This may involve logistical arrangements for the patient, education of the patient and family to prepare them for their roles in the next setting of care, and coordination among health care professionals involved in the transition to ensure continuity of care. This rotation incorporates advanced pharmacy practice students into transitional care activities in order to contribute meaningfully to patient care specifically for high-risk patients. The practice environment will require daily interactions with patients, providers, nurses, pharmacy staff, and other healthcare professionals as required.

Abdominal Solid Organ Transplant

Primary Preceptor: Jennifer Melaragno,  Pharm D, BCPS

The University of Rochester Medical Center performs approximately 80 – 100 abdominal transplantations per year. This clinical practice site will provide the pharmacy resident with the opportunity to develop the advanced patient-care management skills necessary to care for the complex medical issues associated with adult transplant recipients.

This rotation is a structured, full-time patient care experience with opportunities in both inpatient acute care and an outpatient clinic. The rotation will provide a broad training experience in transplant immunology, internal medicine, and infectious diseases. The resident will develop an interactive role by participating in daily patient clinic/rounds and providing patient-centered & specific pharmaceutical care. The resident will be exposed to a diverse range of disease-states and the associated medication therapies. The resident will be expected to describe the pathophysiology, prognosis, clinical presentation and be familiar with current guidelines of commonly encountered disease states, including acute and chronic renal failure, diabetes, hyperlipidemia, hypertension, infectious disease processes (pneumonia, UTI), gout, osteoporosis/osteopenia, transplant rejection (acute/chronic). The goal of the rotation is for the resident to develop the skills and competencies within the area of adult transplant medicine to effectively integrate themselves into the health care team and participate in drug therapy selection, medication monitoring, and patient education.

The course is designed to build upon general and professional abilities developed in preceding professional curricula.

Longitudinal Rotations

Ambulatory Care: Strong Internal Medicine Resident Clinic (AC-5)

The Strong Internal Medicine (SIM) Clinic is a primary care resident run patient centered medical home (PCMH), located on the 5th floor of the ambulatory care building (AC5). SIM is a safety net clinic which serves primarily the underserved in our community. The majority of patients encountered on this rotation are medically complex with multiple uncontrolled medical comorbidities. Additionally, many patients have psychosocial or mental health issues that play a contributing role in their ability to effectively manage their disease states. The number of patient encounters varies substantially depending on referrals and patient show rate. SIM patients are managed by internal medicine residents, internal medicine attending physicians, and midlevel providers (nurse practitioner/physician assistants). Since patients are followed longitudinally, nearly all medical sub-specialties are encountered.

The team includes internal medicine residents (CCP), internal medicine attending physicians (PCP) midlevel providers (NP’s/PA’s), dietician, clinical pharmacy specialist, patient care technicians, social work, care mangers, team secretaries, and data coordinators. Patients become involved with the pharmacist through several means; self-identification based on pre-specified criteria, provider referral, on the fly consults.

Management

Primary Preceptor: Allison Trawinski, Pharm D, BCACP, MBA

During the resident’s pharmacy management rotation, he/she will work with the Director, Associate Directors, and Supervisors of Pharmacy Services at UR Medicine, Strong Memorial Hospital. The goal of this rotation is to have the resident gain insight into the various intricacies of managing a pharmacy department. The resident will also be involved business development projects. The resident will attend recurring meetings to discuss goals and potential project work under the preceptorship of a pharmacy administrator. In addition, the resident and the preceptor shall identify and assign the resident an administrative project that shall benefit the department and also be of interest to the resident.

Patient Safety/Informatics/Pharmacy Practice

Primary Preceptor: Allison Trawinski, Pharm D, BCACP, MBA

The resident will attend recurring meetings to discuss goals and potential project work under the preceptorship of pharmacy leadership, including administrators on the pharmacy and information technology departments. In addition to minor projects that will be developed throughout the year, the resident and preceptor may identify a major project in patient safety/informatics to develop as part of their residency program (optional).

Current technology and safety projects that will be open for evaluation include electronic medical record systems, pharmacy automation, supply chain management and inventory systems, and bar code medication scanning. All modules for monthly topics will be focused on informatics and/or patient safety, including an overview and direct application of patient safety evaluation and analysis tools.

Presentations

Primary Preceptor: Allison Trawinski, Pharm D, BCACP, MBA

During the pharmacy resident’s presentation longitudinal rotation, he/she will provide several different educational programs (clinical conferences, journal clubs, inter-professional education, continuing education, etc.) to health care professionals and health care professionals in training.

Research

Primary Preceptor: To be determined based on project

The experience should be designed to familiarize the resident with all aspects of the research process from generation of ideas through data analysis and manuscript preparation.