Rotations

Research & Education > Education

Pharmacy Rotations Overview

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.

Required Rotations Elective Rotations* Longitudinal Experiences
Orientation Cardiology Addiction Treatment (2018-19)
Ambulatory Care Hematology/Oncology - Inpatient Administration - Clinical
Critical Care Hematology/Oncology - Outpatient Administration - Operations
Emergency Medicine Informatics Community Outreach & Family Wellness
Infectious Diseases Medication Safety Pharmacy Practice/Staffing
Internal Medicine Neonatal Intensive Care Research Project
  Neurovascular Intensive Care

University of Cincinnati Teaching Certificate Program
  Palliative Medicine  
  Psychiatry/Neurologic Medicine  

Required Rotations

Orientation

  • Duration: 5 weeks
  • Location: GSH Central Pharmacy (primary), various inpatient settings (secondary)

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.

Ambulatory Care

  • Duration: 4 weeks
  • Location: GSH Faculty Medical Center

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.

Critical Care

  • Duration: 6 weeks
  • Location: GSH MSICU

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.

Emergency Medicine

  • Duration: 4 weeks
  • Location: GSH Emergency Department

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.

Infectious Diseases

  • Duration: 4 weeks
  • Location: GSH inpatient wards

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.

Internal Medicine

  • Duration: 6 weeks
  • Location: GSH inpatient wards

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.

Elective Rotations

Cardiology

  • Duration: 4 weeks
  • Location: GSH inpatient wards (primary), CVICU & Electrophysiology Lab (secondary)

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.

Hematology/Oncology – Inpatient

  • Duration: 4 weeks
  • Location: GSH inpatient wards

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.

Hematology/Oncology – Outpatient

  • Duration: 4 weeks
  • Location: TriHealth Cancer Institute Infusion Centers

The outpatient hematology/oncology learning experience for the PGY1 program is primarily located at the TriHealth Cancer Institute Infusion Center. While there, residents will practice pharmaceutical care for ambulatory hematology/oncology patients. The resident will gain experience in the provision of evidence-based treatment and supportive care in both the medical oncology and chemotherapy infusion center settings through interaction with the multidisciplinary team. Direct patient care will be provided through patient interactions such as counseling, care plan review, and monitoring for adverse drug reactions.

Pharmacy Informatics

  • Duration: 4 weeks
  • Location: GSH various settings

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.

Medication Safety

  • Duration: 4 weeks
  • Location: GSH (primary), various TriHealth facilities (secondary)

The medication safety learning experience is a dedicated elective rotation of this PGY1 program. The pharmacy department at GSH is committed to ensuring the safe and appropriate use of all medications. As such, residents on this rotation will participate in identifying ways to improve the medication-use system and to minimize the risk of adverse drug events. This rotation will provide residents the opportunity to develop and participate in various initiatives designed to positively impact medication use within our health system. Additionally, projects, presentations, and meetings will be assigned to increase the resident’s knowledge of various strategies utilized in medication safety including surveillance tools, reports, and interdepartmental communications.

Neonatal Intensive Care

  • Duration: 4 weeks
  • Location: GSH Neonatal Intensive Care Unit

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.

Neurovascular Intensive Care

  • Duration: 4 weeks
  • Location: GSH Neurovascular Intensive Care Unit

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.

Palliative Medicine

  • Duration: 4 weeks
  • Location: GSH inpatient wards

This elective learning experience is designed to permit the resident to practice as the sole pharmacy representative on the palliative medicine medical team. As such, it is only offered after residents demonstrate sufficient growth over the course of the residency year to indicate they are ready for independent practice. Many disease states and settings will be observed and managed during this learning experience, including end of life care, cancer, trauma, substance abuse and addiction, chronic pain, and hospice care. Providing education to patients, their caregivers, and clinical staff are crucial elements of the rotation as palliative medicine has meaningful impact on the patient experience during and well after their admission.

Psychiatry & Neurologic Medicine

  • Duration: 4 weeks
  • Location: GSH inpatient psychiatry wards

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.

Longitudinal Learning Experiences

Addiction Treatment

The addiction treatment longitudinal learning experience is currently in development and is anticipated to be offered for the 2018-19 residency year. Incoming residents will be an integral part in establishing the structure of this rotation.

Administration – Clinical Management

  • Duration: 5 months
  • Location: GSH (primary), various TriHealth facilities (secondary)

The clinical management learning experience is designed to give residents opportunities to focus on drug policy development, staff education, and implementing clinical services. Residents will work with members of the pharmacy leadership team and serve on interdisciplinary committees. Residents will be responsible for preparing at least one drug monograph and one medication use evaluation to be presented to the TriHealth Pharmacy & Therapeutics Committee.

Administration – Operations

  • Duration: 5 months
  • Location: GSH (primary), various TriHealth facilities (secondary)

The administrative operations learning experience is designed to give residents insight into management of an inpatient pharmacy department. Residents will work alongside members of the pharmacy leadership team to help optimize and maintain departmental workflow. Additionally, residents will be exposed to elements of personnel and financial management of the department.

Community Outreach & Family Wellness

  • Duration: 6 months
  • Location: TriHealth GE Family Wellness Clinic

The GE Family Wellness Center Pharmacy is a required, 6-month longitudinal ambulatory learning experience. This learning experience includes participation in clinical services offered at the Wellness Center serving General Electric employees, dependents, and retirees. The team consists of primary care physicians, occupational medicine physicians, health coaches, culinary dietitian, physical therapy, massage therapy, and nursing. The clinical resident is responsible for attending patient consultation appointments. The focus of appointments are medication management for chronic diseases like diabetes, dyslipidemia, hypertension, mental health, supplement/vitamin use, prescription cost reduction planning, reduction in side effects and reduction of pill burden. Additionally, residents are responsible for attending Wellness Screenings and provide patient counseling on the screening results. This includes lipid panel, blood glucose, Hemoglobin A1c, blood pressure, body mass index, and waist circumference. This also includes basic dietary and lifestyle suggestions and referrals to appropriate health care provider. Further, residents are responsible for administering vaccinations.

Pharmacy Practice (Staffing)

  • Duration: August-June
  • Location: GSH Inpatient Pharmacy

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 up to every other weekend. 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.

Residency Project

  • Duration: August-June
  • Location: GSH

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.

Teaching Certificate Program

  • Duration: July-June
  • Location: University of Cincinnati College of Pharmacy

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.

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