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The following is a brief overview of required, elective, and longitudinal learning experiences offered to residents of Good Samaritan TriHealth Hospital. Residents are scheduled for six required and four elective learning experiences over the course of the residency year. All longitudinal experiences are required and are completed over the course of the residency year.
| Required Rotations | Elective Rotations | Longitudinal Experiences |
|---|---|---|
| Orientation | Ambulatory Endocrinology | Administration |
| Accute Inpatient Care | Bone Marrow Transplant |
Emergency Code Response |
| Ambulatory Care | Cardiology | Pharmacy Practice/Staffing |
| Critical Care | Hematology/Oncology | Research Project |
| Emergency Medicine | Informatics | Teaching and Education |
| Infectious Diseases | Neonatal Intensive Care | |
| Internal Medicine | Neurovascular Intensive Care | |
| Population Health |
||
| Psychiatry/Neurologic Medicine |
A formal orientation program for all incoming residents is scheduled for the first four weeks of the residency year. New residents attend two corporate orientation programs prior to beginning training within the department of pharmacy. The orientation rotation is designed to introduce residents to the Good Samaritan TriHealth Hospital (GSH) Department of Pharmacy policies and procedures and various practice settings throughout the hospital. During this time residents meet with the program director to establish the individual resident development plan. Additionally, residents will become proficient in use of all pharmacy department software and gain a baseline functional knowledge of the medication-use and distribution systems. A fifth week of the orientation rotation is dedicated to development of the residency project.
The inpatient acute care learning experience is a 2-week rotation involving complete management of pharmaceutical care for patients admitted to telemetry or medical-surgical units. This rotation is a supplemental experience to the orientation period. Inpatient acute care will allow the resident to gain useful experience in all aspects of inpatient acute care including order verification, consult management, chart review, and transitions of care activities for a wide variety of patients. The goal of this learning experience is for the resident to demonstrate competency in typical inpatient clinical pharmacist duties, through the support and guidance of the rotation preceptor.
Unlike many area programs, the ambulatory care experience at GSH is a dedicated rotation at an individual practice site. Residents will spend four weeks in this required rotation at the Faculty Medical Center on the 5th floor of the hospital. The goal of this rotation is to provide the resident the opportunity to develop expertise in the medication therapy management of chronic diseases such as hypertension, hyperlipidemia, diabetes, and coagulopathy. Residents will interact with patients daily to assess the need for education, lifestyle modifications, self-medication administration, and adjustments to therapeutic care plans. The resident will serve as a drug information resource to the many medical resident services who utilize this clinic (family medicine, internal medicine, OB/GYN, etc.). Advanced knowledge of disease states will be garnered through assigned discussions and projects by the preceptor. The resident is also responsible for co-precepting any student pharmacists on the service.
The critical care rotation is a 6-week required learning experience which focuses on providing pharmaceutical care to critically ill medical and surgical patients. The resident’s primary responsibility during this learning experience is to provide pharmaceutical knowledge to the interdisciplinary team through daily rounds. The resident will assess each patient before and after rounds to ensure appropriate care is provided so as to promote the best possible patient outcomes. Through this residents will develop clinical knowledge necessary to gain confidence in recommending appropriate drug therapy in the critical care setting. Advanced understanding of disease states and treatment modalities will be gained through discussions and projects assigned by the rotation preceptor. Additionally, residents will gain familiarity with the management of medical emergencies through participation on the code response team.
Located in the hospital district of downtown Cincinnati, the Emergency Department at GSH receives approximately 62,000 patient visits per year. While on this learning experience, the resident will focus on emergency medicine and transitions of care. Residents will work with all disciplines present in the ED to ensure appropriate intake of admitted patients. Direct patient care will be provided by way of patient interactions including interviews for medication histories, reconciliations, and education. Residents will work with prescribers to ensure appropriateness of empiric therapies started within the ED. Residents will be ACLS certified and respond to all medical emergencies. Additionally, residents will participate in ED discharge antibiotic surveillance. Projects, presentations, and topic discussions are to be completed as assigned by the rotation preceptor.
The infectious diseases rotation is a 4-week required rotation with three aspects of practice. The resident will spend multiple days a week providing direct patient care through rounding with the infectious diseases medical team. Through this, the resident will refine his/her approach to collaborative practice. Residents will proactively review patients for response to treatment and learn to make adjustments to care plans based on culture data and other patient factors. Other days of the week the resident will participate on the Antimicrobial Advisory Team providing antimicrobial stewardship services. Finally, the resident will spend one day per week in the microbiology lab learning basic functionality of its services and how it relates to pharmacy practice. Additional opportunities exist to advance therapeutic knowledge through topic discussions and case presentations.
The internal medicine rotation is a 6-week required learning experience, focusing on medical care of adult inpatients. The primary responsibility of the resident during this learning experience is to provide pharmaceutical services to the medical team through interdisciplinary rounds. This rotation stresses the importance of accurate application of therapeutics in patient care, and requires the resident to develop skills in proper drug therapy selection, patient monitoring, pharmacokinetics, patient education, drug administration, and delivery of pharmaceutical care. Core content will be covered by way of patient interactions, discussion of reading material and guidelines, and case presentations. Additional responsibilities include ensuring continuation of appropriate care through transitions of patients through the healthcare system.
The Ambulatory Care-Endocrinology rotation is a 4-week elective rotation offered for PGY1/PGY2 residents at Good SamaritanTriHealth Hospital. The resident will work closely with TriHealth Clinical Pharmacist Specialists working in Endocrinology and pharmacy leadership to advance and expand clinical pharmacy services. The resident will serve as the Clinical Pharmacist Specialist that works collaboratively with the Endocrinology team to manage unnecessary and avoidable health care costs while focusing on preventive care and disease management.
This rotation is a four-week elective learning experience at Good Samaritan TriHealth Hospital. This experience is designed to provide the resident with clinical experience in managing patients undergoing a bone marrow transplant or cellular therapy. This includes understanding certain hematologic conditions, chemotherapy preparative regimens and their side effects, supportive care considerations, infectious disease implications, and oncologic emergencies.
During the Inpatient/Outpatient Bone Marrow Transplant & Cellular Therapy elective rotation at Good Samaritan TriHealth Hospital, the PGY2 Internal Medicine Pharmacy Resident will provide clinical pharmacy support to providers caring for inpatients and outpatients with a hematologic disease requiring bone marrow transplant or cellular therapy. This experience will encompass intensive, direct patient care of those on the consultation service with a focus on malignant hematology. The service is comprised of an oncologist, mid-level practitioner, pharmacist, registered nurse(s), social worker, dietician, and may include medical residents.
The elective cardiology rotation at Good Samaritan TriHealth Hospital is a relatively new extension of the pharmacy service line. This learning experience focuses on direct patient care as part of the cardiac medical team as they provide care to inpatients on telemetry units and the Cardiovascular Intensive Care Unit. Additional time may be dedicated for the resident to attend and observe procedures in the electrophysiology lab while learning of the clinical application of cardiac medications in procedural environments.
The focus of the inpatient oncology experience will be on adult hematologic malignancies (acute and chronic leukemia, myelodysplastic syndrome, Hodgkin’s and Non-Hodgkin’s Lymphoma, and myeloma) and the comorbid conditions affecting admitted patients. Residents on the inpatient oncology service line will provide direct patient care while rounding one on one with consultant oncologists. Enhanced knowledge about certain disease states will be gained through topic discussions with the preceptor and completion of assigned projects.
The goal of this learning experience is to introduce the resident to the medication-use system of TriHealth and its constant evolution by applying pharmacy informatics principles, standards, and best practices. Further, residents will gain basic understanding of the language and concepts of information technology (IT), thereby equipping them to function in the interdisciplinary environment of informatics project teams. Residents will gain insight to the system-level applicability of all pharmacy software and hardware employed at TriHealth. The resident will have the opportunity to explore common practice areas under the scope of an informatics pharmacist such as CPOE background and maintenance, clinical decision support tools, information systems that allow electronic validation of medication orders in real time, automated dispensing cabinets and robotics integrated and/or interfaced with pharmacy information systems, among many other facets of informatics practice.
Good Samaritan TriHealth Hospital’s Neonatal Intensive Care Unit is one of the few Level III establishments in the region. As such, the pharmacy resident will be exposed to the provision of complete pharmaceutical care to this patient population. The resident will work closely with neonatal pharmacists, pediatric residents and fellows, neonatal nurse practitioners, and neonatologists to provide care for pre-term infants born as early as 23 weeks of gestation and up to term newborns requiring intensive care. In addition to learning best practices in this setting, the resident will also participate in process improvement for the medication-use system as well as medication error reporting and root cause analyses. The resident will participate with the interdisciplinary team for daily rounds and attend meetings as scheduled by the preceptor. Topic discussions, journal clubs, and case presentations are to be completed as assigned by the preceptor.
This elective learning experience is designed to promote resident growth of skill and comfort in critically ill neurology patients. As a member of the interdisciplinary rounding team, the resident will be responsible for providing appropriate pharmaceutical care to patients with a range of neurovascular disease states & complications including, but not limited to intracranial hemorrhage, acute ischemic stroke, management of elevated intracranial pressure, complex neurologic orthopedic procedures, and solid tumors. Solidification of disease state understanding and management will be done so through preceptor interaction, topic discussions, and project assignments.
The population health service line is one of the newest endeavors of TriHealth Pharmacy. Residents on this experience will work with the pharmacy manager of population health to address gaps within continuity of care as patients transition from the inpatient to outpatient setting. Residents will spend the majority of their time conducting direct patient outreach to ensure patient accessibility to care, understanding of care, and adherence to medications. Further, residents will analyze provider performance in their management of targeted disease states so as to identify and correct deficiencies of provided care.
The psychiatry and neurologic medicine elective rotation will provide the resident the opportunity to explore medical management of mental illnesses. The resident will participate with the interdisciplinary team in the inpatient psychiatry ward at GSH. The resident will participate in rounds and psychiatric consultative services throughout the hospital. Additionally, the resident may get the opportunity to observe cognitive behavioral therapy (CBT) groups and/or electroconvulsive (ECT) therapy. The resident’s primary responsibility is the optimization of drug therapy in adult patients with mental illnesses, particularly focusing maintaining balance between efficacy and side effects. The resident will discuss patients and/or therapeutic topics with the pharmacist preceptor daily so as to garner better insight into pharmacy practice in this patient setting.
The clinical & operations administration learning experience is a ten-month, required, longitudinal rotation designed to give the resident focused experience in drug policy development, medication utilization evaluation and outcomes, creation and dissemination of education, and implementation and assessment of clinical and operational initiatives. Inherent to the nature of the work, this rotation helps the resident build analytical and research skills, and promotes the fostering of interdisciplinary collaboration. Further, residents will gain insight into personnel and departmental management principles so as to equip them with baseline knowledge regarding oversight of central pharmacy operations and the drug distribution system. Residents will gain the skills necessary to appropriately balance the competing obligations of a clinical and departmental leader.
The emergency code response longitudinal rotation is the resident's introduction to code management. The resident will be responsible for attending all emergency response situations while on-site at Good Samaritan hospital and work closely with the preceptor to anticipate needs and ensure the proper use of medications in acute situations. The resident will also attend a simulation lab with interdisciplinary team members to get a better understanding of their roles and responsibilities during code response. Residents will rotate every other month to take responsibility for signing on to the code pager during rotation and attending emergency responses as they happen.
The pharmacy practice/staffing learning experience is a requirement of the PGY1 program. After the orientation process and once competent in the use of pharmacy software systems, the resident will provide staffing services in the central pharmacy every third weekend plus one weekday evening shift every three weeks. The resident will perform all duties expected of staff pharmacists, as well as build upon the knowledge and experience gained during other learning experiences throughout the year. The staffing experience will focus on the drug distribution system and consultative pharmacy services. The rotation will aid the resident in refining skills required of an independent practitioner, such as communication, collaboration, and therapeutic applications. Hours worked in the central pharmacy are in addition to those required for the current rotation the resident is on, but the ASHP Duty Hours policy must be adhered to.
Each resident is required to conduct a year-long project. The project can be in any subject of particular interest to the resident, but it must be submitted to the Institutional Review Board (IRB) for approval. Examples of projects include original research or expansion of pharmacy service lines. The resident will be assigned a preceptor based on the subject matter of the project. Residents will choose their research topic during the orientation month and submit it for review by the IRB no later than September. Data collection will begin as soon as IRB approval is gained. If adequate progress has been made, the resident is encouraged to submit his/her poster and current findings for presentation at the ASHP Midyear Clinical Meeting. The resident is required to formally present the conclusions from the research project at the Great Lakes Pharmacy Residency Conference in the spring. The resident is required to write a manuscript of the research project suitable for publication to graduate from the residency program.
The Teaching Certificate Program hosted by the University of Cincinnati College of Pharmacy provides the resident a broad understanding of issues in pharmacy education and opportunities to enhance his/her teaching skills. The resident will attend seminars on the University of Cincinnati campus to review theories in education and develop his/her own teaching philosophy. The resident will provide instruction in Pharmacy Practice Skills Development and/or recitations at the College of Pharmacy. Additionally, course rubrics will be met by giving formal continuing education presentations at GSH. Further, the resident will apply what is learned to the real world setting by precepting pharmacy students throughout the residency year. The resident will learn the four preceptor roles (direct instruction, modeling, coaching, and facilitation), and how to best employ them based on the current level of the student he/she is precepting. Creation and maintenance of a teaching portfolio is required to earn the teaching certificate.