Description of Available Rotations
Required Block Learning Experiences
Clinical Pharmacy Services
In a series of two 3-week rotations, the resident will play a crucial role in the clinical pharmacy services provided by the Adventist Health Glendale. The series includes experiences in nutrition support, oral anticoagulation and pharmacokinetic monitoring. The goal of the nutrition support rotation is to maximize patient benefit from parenteral nutrition, minimize potential complications from these therapies and to ensure a cost-effective approach to nutrition.
The anticoagulation portion will provide the resident with exposure and training on the use and monitoring of all formulary anticoagulants. During this time, the resident will become proficient in the use of all anticoagulant medications in hospitalized patients. The resident will, on a daily basis, follow all inpatients receiving warfarin to become comfortable with the dosing, monitoring and education associated with the drug. The resident will also complete one nursing or staff in-service on anticoagulation.
The pharmacokinetic portion is designed to develop the resident's knowledge and skills in drug dosing, interpreting serum concentrations, calculating pharmacokinetic parameters, identifying and making appropriate adjustments to regimens and monitoring patients for drug toxicity. Significant time will be spent on vancomycin and aminoglycoside monitoring, in addition to other medications that warrant appropriate PK/PD targets.
Critical Care
This six-week rotation is designed to provide residents with broad training in managing acutely ill internal medicine patients admitted for diverse and complex medical management. Pharmacy residents assume the responsibilities of staff clinical pharmacists, including attending rounds, monitoring patients, providing inservice education to nurses and medical staff, documenting clinical activities and precepting pharmacy students.
Infectious Disease
This six-week rotation will expose residents to interesting and complex infectious diseases. Residents will follow select patients and critically analyze their therapy plan. Residents and preceptors will play a major role within our Antibiotic Stewardship Program, rounding daily with the ID physician. The resident and preceptor will spend time reviewing and making recommendations regarding patients' antibiotic regimens. All pending and completed interventions will be logged into our clinical performance dashboard, "Quality Compass."
Transition of Care (3 components for a total of 6 weeks)
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Emergency room
- This rotation aims to expose residents to different emergency disease states management. During this two-week rotation, residents will provide pharmacist support to the fast-paced emergency department and be involved in direct patient care as they interact, interview and update home medication profiles.
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Discharge pharmacy
- This two-week rotation aims to expose residents to working with other healthcare professionals to collaboratively verify the completeness of the discharge medication reconciliation and provide medication to ensure optimal patient care.
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Satellite dispensing pharmacy
- This two-week rotation will train the residents to complete continuity of care by providing medication to patients' rooms, providing medication consultation to patients prior to leaving the hospital and following up with a 48-hours post-discharge phone call.
Family Medicine Services
During this six-week learning experience, residents will work closely with our family medicine residents in the inpatient setting as the main pharmacist rounding and helping them handle their patient case load. This rotation comes later in the year when the resident has gained enough experience and confidence to work independently. The resident will be expected to work up patients, attend rounds, make interventions, educate the medical residents on drug topics, and be the main source of pharmacy drug information to the medical residents.
Basal Bolus Insulin Program
This is a five-week rotation where pharacists are responsible for the insulin management of all patients flagged with elevated blood glucose readings. Residents will manage the insulin regimen based on the patient's medical history, dietary status, corticosteroid use, etc., and monitor patients on a daily basis to ensure they are within goal range.
Outpatient Anticoagulation Clinic
In this new program, pharmacists are responsible for managing the anticoagulation of outpatients referred to Coumadin clinic. Residents will be able to adjust dosing, monitor for safety, educate patients and follow up on their progress on a weekly basis.
Longitudinal Learning Experiences (year-long)
Pharmacy Operations
The primary purpose of the Pharmacy Operations rotation is to gain experience in various aspects inpatient hospital pharmacy practice. Once licensed and trained, the resident will be capable of acting as an independent pharmacy practitioner. Residents will gain experience working as a staff pharmacist to evaluate and screen physician's orders, dispense medications, and provide clinical services in accordance with state and federal pharmacy law by working one weekend per month.
Pharmacy Education Services
Residents will develop a working knowledge the current healthcare environment. Through completion of projects, residents will be exposed to several aspects of drug information and hospital policy. Residents will work with preceptors to accomplish projects such as: medication use evaluations, formulary management, disease state management guidelines, medication error reduction, proposal development, and cost containment strategies.
Pharmacy Management
During the Pharmacy Management learning experience, residents will have the opportunity to learn about the unique challenges facing hospital pharmacy management in today's complex healthcare environment. Residents will carry out focused projects under the guidance of the department director and other members of the leadership team. These projects include but are not limited to: policy determination, medication safety, budget and expense planning, coordinating department meetings, implementing and refining services, and managing department employees. There will also be opportunities to attend hospital administrative meetings and present reports related to the above mentioned projects.
Project Management
All residents are required to participate in completing a longitudinal research project. The objective is to provide residents with the experience of developing, implementing, and presenting original research. Residents will meet regularly with their designated preceptors to fine tune the project and ensure adherence to deadlines. Residents must prepare an abstract for the Western States Residents Conference, as well as a final manuscript intended for potential publication. The completed project will be presented at the Western States Residents Conference and at a campus poster session sponsored annually by the department of clinical pharmacy. Additional information is available in the Residency Manual.