Pharmacy

PGY2 Pharmacy Medication- Use Safety Residency Program

The PGY2 pharmacy residency programs build on Doctor of Pharmacy (Pharm.D.) education and PGY1 pharmacy residency programs to contribute to the development of clinical pharmacists in advanced or specialized practice. PGY2 medication safety residencies provide residents with opportunities to function independently as practitioners in medication safety or informatics by conceptualizing and integrating accumulated experience and knowledge and incorporating both into the provision of patient care or coordinating and implementing improvements that advance medication therapy or medication safety. Residents who successfully complete an accredited PGY2 pharmacy residency should possess competencies that qualify them for clinical pharmacist, faculty positions, leadership roles in medication safety, policy development, or informatics, and position them to be eligible for attainment of board certification in the specialized practice area (when board certification for the practice area exists).

Program Overview:

The PGY2 Medication Use Safety Residency Program at Cincinnati Children's Hospital Medical Center is a 12 month post-graduate curriculum that offers opportunities to develop the skills required to become an organizational leader in medication safety.

Core Rotations: All rotations are required.

Learning Experience	Duration
Orientation	1 month
Central Operations	1 month
Hospital System Administration	1 month
Informatics	1 month
Clinical Automation	12 months
Oncology Operations	1 month
Leadership-Scholarship-Education	12 months
Antimicrobial Stewardship	1 month
Patient Care I - Selective	1 month
Patient Care II - Selective	1 month
Research Project	1 month

Detailed Rotation Descriptions

Orientation

Includes orientation and training to the PGY2 residency program as well as the inpatient pharmacy and staffing experience. The inpatient pharmacy provides medications to all areas of Cincinnati Children's.

The pharmacy consists of a unit dose and clean IV room, where the pharmacist reviews, verifies, and dispenses all medications. These include oral medications, TPNS, compounded IV fluids, and all IV medications. The inpatient pharmacy operates 24 hours a day, 7 days a week. Training modules will be completed during the orientation learning experience, including pharmacokinetics, code response, pediatric dosing, various research learning sessions, TPN, dialysis, electronic medication record system (Epic), risk evaluation mitigation strategies (REMS), safety reporting system, and other competency areas as determined on an annual basis.

Central Operations

This rotation focuses on: Operational Systems, Analysis of workflows, Optimizing processes for Safety, Utilization of technology to increase safety and key tools for implementation. The resident will be expected to review of each pharmacy dispensing process in each of Cincinnati Children's pharmacies, discuss key failure modes, and develop tangible, measurable mitigation strategies. Implementation of desired changes is not required.

Hospital System Administration

Provides exposure to the structure and function of hospital system administration and its integration with quality improvement and risk management. The resident will be exposed to regulatory affairs and compliance with organizations including: DEA, FDA, State Board of Pharmacy, and Joint Commission on Accreditation of Healthcare Organization (TJC).

The resident will be interviewing key leaders from hospital, nursing, and medical staff administration, quality improvement, and risk management in order to appreciate the role and function of each as it relates to patient and medication safety. The resident will accompany the director at meetings and committee meetings as appropriate.

Informatics

Provides exposure to the role of pharmacists in the ongoing development and implementation of electronic health information systems related to the delivery of patient care. Project management responsibilities involve the development, management and execution of projects related to health IT. Build, configuration and release management responsibilities involve the provision of medication and related system expertise to the development, analysis and implementation of enterprise-wide clinical system projects.

Clinical Automation

Designed to create expertise with two major clinical automation systems that are designed to prevent patient harm by human error. The design and maintenance of a drug library in an IV delivery pump and safe storage options in an automated dispensing cabinet system. Additionally how the use of data that these systems provide can help detect system/human issues and influence future behaviors.

Oncology Operations

Provides exposure to inpatient and outpatient chemotherapy order entry, preparation, and administration of the medication. There will also be exposure to outpatient oncology / BMT clinic, oncology chemotherapy safety meetings, and Beacon build meetings. Oncology clinic responsibilities include entering chemotherapy orders into Beacon, review of chemotherapy orders, composing chemotherapy admission orders, preparing chemotherapy, and counseling outpatients on their medications.

Leadership-Scholarship and Education

Designed to build confidence in the medication-use safety resident as a knowledgeable safety leader. Emphasis will be placed on science of safety and improvement and new developments in patient safety. The resident will be working with hospital leaders and staff of various disciplines, leading improvement changes, and training other health care workers, residents, and students in medication safety. The skills that will be developed will include guideline and policy development, regulatory readiness, event analysis, leadership, and influence. He/she will coordinate system improvements through the use of rapid cycle improvements tools, root cause analysis (RCA), and Failure Mode and Effects Analysis (FMEA). The resident will be given various projects and attend assigned meetings to gain experience in safe medication use. During the rotation, the resident will regularly interact with nurses, medical staff, other prescribers, risk managers, quality improvement staff, and other health care providers. He/she may also be involved in precepting students and coordinating their activities.

Antimicrobial Stewardship

The PGY2 resident will experience how the use of technology for the collection and utilization of patient data impacts the safe use of medications.

Patient Care I and II

Patient Care I and II are clinical learning experiences and the experience areas are selective. Choices include; Heme/Onc, BMT, PICU, NICU, Cardiovascular Critical Care, Ambulatory Care - Cardiology, Ambulatory Care – Pediatric Epilepsy, Solid Organ Transplant, Pulmonary Medicine, or Emergency Medicine. The clinical pharmacy specialist on the team is responsible for ensuring safe and effective medication use for all patients admitted to the team.

Research Project

Designed to familiarize the medication-use safety resident with activities and responsibilities of conducting improvement research. The experience is designed to assure that the resident is educated about topics such as identifying research questions, securing appropriate institutional approvals, designing a study, retrieving literature, collecting and interpreting data, writing an abstract and manuscript, and presenting the findings of a project relevant to medication safety.

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