PGY1 Pharmacy Residency Program Overview

Learning Experiences and Preceptors

Required Longitudinal Direct Patient Care Learning Experiences

Ambulatory Care with Jason Dent, PharmD, BCPS

This experience is designed to develop the pharmacy resident's skills in operating under collaborative practice agreements to provide pharmacotherapy initiation, monitoring, dosing, education, documentation, and physician communication for outpatients at the Ambulatory Care Clinic associated with Renown Health Institute for Heart & Vascular Health. Diseases states managed at the outpatient Ambulatory Care Clinic at Renown Health Institute for Heart & Vascular Health included anticoagulation, hypertension, dyslipidemia, smoking cessation, pharmacotherapy and heart failure. Residents will primarily practice at Renown Regional Medical Center but are expected to gain experience at each community practice site at least once/site during the residency year.

Renown's Pharmacy Department is a leader in parenteral nutrition management with pharmacist run protocols for optimal outcomes for patients. During this rotation, the resident will have the opportunity to perform nutritional assessments as well as formulate and adjust parenteral nutrition solutions for different patient populations including the elderly and critically ill.

The staffing service commitment is designed to ensure the resident gains experience and is able to function as an independent clinical pharmacist. The resident will become competent in daily pharmacy operations, distributive functions, and clinical shifts by staffing in the central pharmacy for the first part of the residency year and then transitioning to clinical shifts after successful completion of training for anticoagulation, TPN, kinetics and the internal medicine and infectious diseases learning experiences.

Required Longitudinal Non-Direct Patient Care Learning Experiences

This learning experience is designed to develop the resident's ability to provide accurate, unbiased, and relevant drug information to patients, nurses, pharmacists, physicians, and other allied health professionals.  The experience provides an opportunity for residents to use developing problem solving and critical thinking skills to design effective educational activities, improve medication use systems, develop and maintain pharmacy driven protocols, maintain the medication formulary, and perform drug use evaluations and other reviews as needed. Residents actively participate in meetings including the Pharmacy and Therapeutics Committee and Medication Safety Committee.

Residents are required to develop and complete a major research project.  Residents will select a research topic based on their clinical interests and needs of the department.  Faculty and clinical staff will present project ideas during orientation. An appropriate associated preceptor will guide and supervise the resident throughout the year.  Following approval of the research topic and preceptor by the Residency Advisory Research Committee (RAC Research), residents will develop a formal research proposal.  The resident will submit the protocol for IRB approval. A completed research project form, formal proposal, completed IRB, poster presentation at Midyear, an oral presentation at the Western States Pharmacy Residents Conference and final written manuscript are required for successful completion of this longitudinal experience.

Required Concentrated Direct Patient Care Learning Experiences (6 weeks each)

During orientation the resident is comprehensively trained and oriented to the hospital, the pharmacy, and the residency program. Subsequent to satisfactory completion of Renown New Employee orientation and electronic medical record (Epic) training, the resident begins staffing. The staffing training will include central pharmacy staffing orientation/training and IV room staffing orientation. Full functioning as a pharmacist does not begin until the resident attains Nevada pharmacist licensure.

The Internal Medicine learning experience is designed to introduce the resident to all aspects of inpatient care through topic discussions, patient presentations, patient counseling, and active participation on daily internal medicine rounds.  The resident will learn to effectively communicate with other healthcare professionals and patients. The pharmacy resident is responsible for ensuring safe medication use for their patients by preventing, identifying, and resolving pharmacy related patient specific problems. The resident will monitor drug dosages to make sure they are appropriate for patient-specific data (drug allergies, drug-drug and drug-disease state interactions, adverse drug reactions, etc.).

This experience is designed to provide the resident with an understanding of core infectious diseases principles. The resident will learn how to integrate knowledge of disease states and antibiotics in order to formulate evidence-based antimicrobial regimens for patients with active infections. There are two major practice components to this rotation: antimicrobial stewardship and the infectious diseases consult service.  In addition, the resident will gain the skills needed to manage the pharmacokinetics service. The overall goal of the resident is to learn how to provide timely, safe, appropriate, and cost-effective antimicrobial therapy while optimizing patient outcomes.

A pharmacist is present in the emergency department at Renown Regional Medical Center 24 hours a day, 7 days per week and are heavily involved in direct patient care and a vital component to the multidisciplinary team.  The resident will be exposed to the diverse patient population that presents to the emergency department and the unique role the ED pharmacist has in this practice setting. Residents will be challenged by patient cases that span the entire continuum of care from ambulatory care, pediatric and geriatric care, to critical care.  The practice environment will require daily interactions with patients, ED physicians, medical attendings, surgeons, nurses, social workers, respiratory therapists, pharmacy staff, and other healthcare professionals as necessary to optimize pharmacotherapy.

The objective of this learning experience is to train the resident to be a resource for the multidisciplinary team concerning medications and their appropriate uses, therapeutic alternatives, adverse reaction profiles and to perform in medical emergencies.  The rounding team on this experience is comprised of the Critical Care Intensivist/Trauma Surgeon, dietary, social services, respiratory therapy and the bedside nurse for each patient.  The resident is responsible for pre-rounding and developing a plan for any therapeutic deviations, lab abnormalities, medication interactions, therapeutic duplications, IV to po opportunities, or educational opportunities that may exist.

Required Concentrated Non-Direct Patient Care Learning Experiences (4 weeks)

Practice Management with Kate Ward, PharmD, BCPS

This rotation is intended to expose the resident to a variety of administrative activities including committee work, the departmental budget, inventory control, formulary management, and inpatient pharmacy regulations. The practice management rotation will help the resident become familiar with the key principles utilized in hospitals and health systems for leadership.

Elective Learning Experiences* (Select 2, 6 weeks each)

Medical/Cardiac ICU with Mike Thuyns, PharmD, BCPS, BCCP, BCCCP and Nikki Noroian, PharmD, BCPS, BCCCP

This learning experience is based on the experiences of the cardiac and medical intensive care patient.  The resident will continue to gain experience and confidence within the realm of medical and cardiology, including appropriate response to emergencies, cardiac surgery protocols, and management of acute on chronic disease states. As proficiency is demonstrated more responsibilities will be given/required until the resident is able to effectively staff as a clinical pharmacist in this area.

Oncology with Lauren Zion, PharmD, BCPS, BCOP

The Oncology rotation is designed to introduce the resident to chemotherapeutic medications and supportive care for the cancer patient in both the inpatient and ambulatory settings.  The goal of this rotation is to develop the resident's knowledge base and skill set in optimizing the treatment for various disease states in oncology patients.  During this rotation, the resident is expected to be able to become an integral member of the interdisciplinary team by providing pharmaceutical recommendations, drug information, patient counseling and pharmacy support.

Pediatrics with Carol Vollmer-Johnson, PharmD, BCPPS

This experience will provide exposure to a diverse pediatric population, and the unique role that the pharmacist has in medication safety and dosing for pediatrics.  The resident will be integrated as a key member of the pediatric hospitalist team making drug therapy recommendations and monitoring patients for both positive and negative outcomes.  They will be an advocate for optimal patient care while showing care and compassion towards this unique yet varied patient population.  The resident will be responsible for order verification, drug information, and pharmacokinetic monitoring while present. The resident is expected to spend one day in the Cystic Fibrosis Clinic.

Pharmacy Informatics with Greta Upton, PharmD, BCPS

Though specific projects will vary based on the organization's priorities at the time of rotation, the resident will be proficient in the core fundamentals of healthcare informatics by the end of their time with the informatics team.  The resident will begin the rotation learning the history of electronic health records in medicine and how informatics roles became imperative to the success of these systems. From there, residents will get to practice workflow optimization and design as well as utilizing EHR functionality to support evidence-based practice for the healthcare system.  With that foundation in place, the resident will be expected to work independently and take more of a leadership role with informatics tasks that are brought to the team during rotation. Residents will come up with and present EHR and non-EHR solutions for current organizational issues. 

*Other elective learning experiences may be developed based on resident interest and preceptor availability.