Residency
Cardiology
Preceptors:
Shannon Ludwig, PharmD
Maureen Ghanem, PharmD
Site Description:
The Cardiology Acute Care rotation is based on CVMU and includes all patients admitted to the cardiology service. This is the primary location for cardiology, cardiothoracic surgery, heart failure, and patient's requiring telemetry monitoring. The Cardiology service may contain a variable number of patients. The rounding cardiology team may include an attending physician, cardiology fellow, medical resident, two medical inters, pharmacist, nurse(s), and student(s).
Rotation Description:
The resident will work as an integral participant on the cardiology team here at the University of Utah. The resident will be responsible for identifying and resolving all medication therapy issues for patients on the cardiology service and will work towards assuming care of all patients on the cardiology and heart failure teams.
The resident will complete all medication histories, medication reconciliations, analyze daily patient data, develop monitoring and therapeutic plans, and document appropriate data on the patients who they are managing. The resident will follow the policy and guidelines of the hospital and pharmacy to ensure best outcomes for their patients. The resident is expected to supplement knowledge gaps by researching those topics via primary literature and/or clinical guidelines.
The resident is expected to be respectful and courteous to the patients, preceptors, other members of the health care team, and others. The resident will need to develop excellent communication skills, both written and verbal. Patient confidentiality should be maintained according to HIPPA and other hospital policies. The resident may help precept students on the cardiology rotation.
Upon completion of the rotation, the resident is expected to have a better understanding and increased competence in the diagnosis and pharmacological treatment of many cardiac disease states.
RLS Goals:
R1.4 — Demonstrate ownership of and responsibility for the welfare of the patient by performing all necessary aspects of the medication-use system.
R2.1 — As appropriate, establish collaborative professional relationships with members of the health care team.
R2.2 — Place practice priority on the delivery of patient-centered care to patients.
R2.4 — Collect and analyze patient information.
R2.6 — Design evidence-based therapeutic regimens.
R2.7 — Design evidence-based monitoring plans.
R2.8 — Recommend or communicate regimens and monitoring plans.
R2.9 — Implement regimens and monitoring plans.
R2.10 — Evaluate patients' progress and redesign regimens and monitoring plans.
R2.12 — Document direct patient care activities appropriately.
R6.1 — Use information technology to make decisions and reduce error.
E7.2 — Communicate effectively.
E7.4 — Manage time effectively to fulfill practice responsibility (applies to all activities).
Activities Evaluated:
| Rotation Activity | RLS Goal | Teaching Methods |
| Collect relevant clinical information on each patient to make thorough clinical decisions. The resident will use efficient techniques to find and assess information in the electronic and paper records. On average, 10 patients per day will be monitored. This data will be documented on the patient monitoring form, complete with a daily plan for treatment and monitoring. | R2.2, R2.4, R2.6, R2.7, R2.10, E7.4 | Instructing, Modeling, Coaching, Facilitation |
| Formulate and design patient specific therapeutic regimens and monitoring plans on each patient. This should be based upon sound evidence from quality sources. Approximately 10 per day. | R1.4, R2.2 R2.4, R2.6, R2.7, R2.10 R2.12, R6.1, E7.4 | Coaching, Facilitation |
| Participate effectively in rounds daily. The resident should answer all pharmacotherapy questions posed in a timely fashion, and the resident should clarify the medical team's pharmacotherapy plan as warranted. | R1.4, R2.1, R2.2, R2.7, R2.8, R2.9, R2.10, E7.2, E7.4 | Modeling, Coaching, Facilitation |
| Patient presentations to preceptor daily (at least 15 per week). A SOAP format should be utilized with the plan supported by evidence-based medicine. The resident will also provide daily pass-off to the swing pharmacist on Cardiology. By the end of the rotation, residents are expected to be able to cover the cardiology patients if asked to staff the floor. | R1.4, R2.2, R2.7, R2.8, R2.9, R2.10, E7.2, E7.4 | Coaching, Facilitation |
| Journal club, Project, Presentation (1 per rotation, description below) | R2.2, R2.7, E7.4 | Facilitation |
| Topic discussions (2-3 per week, one formal discussion per week at a minimum) | R2.2, R2.7, E7.4 | Facilitation |
Readings and Preparatory Work:
Possible topic discussions and readings involve the following topics as provided in document entitled Key Topics in Cardiovascular Medicine. The list of suggested guidelines, articles, and other references is documented here as well. The articles that are required and suggestion readings will be identified. A prerequisite to the rotation is ACLS/BLS certification or actively pursuing certification. All reading and preparatory work should ideally be from guidelines or primary literature only.
Project Description:
Journal Club - 1 journal club presentation will be completed during the 3rd week of rotation
- The article must be related to cardiology
- Published within the last 6 months
- Must be approved by preceptor by Monday of the 2nd week of rotation
- Likely to have impact on patient care
- The article should be distributed to other pharmacists
- No formal presentation or handout material required
MUE/System Improvement Project:
This will be a small research or development project to be completed by the end of the rotation. During orientation the preceptors will give a list of options for this project.
Power Point Presentation:
This will be approximately a 30 minute presentation that is designed to develop a clinical pearl or educate future residents about procedures, disease states, or other cardiovascular topic. Examples of past presentation include discussion on cardiovascular devices and imaging. The preceptors will work with you to help select a topic. This will be presented to clinical pharmacist(s) and/or the cardiology team depending on the topic.
Typical Daily/Weekly/Monthly Activities:
The resident is expected to be punctual and to prioritize daily activities. A typical day will be 8 hours (0700 to 1530), but additional time is expected to complete daily responsibilities and ensure best outcomes for the patient. (This could be replaced with a typical month calendar of daily, weekly and monthly activities.)
- 0730 - 0830 Daily - Pre-rounding (arrival time may need to earlier to complete necessary tasks)
(+ Medical Grand Rounds Thursdays, SOM Classroom A) - 0830 - 0900 Daily - Brief patient discussions with preceptor
- 0900 - 1100 Daily - Cardiology attending rounds
- 1100 - 1230 Daily - Post-rounding (ensure that all orders discussed are entered and verified appropriately)
- 1230 - 1600 Daily - Patient work-up and follow-up, core topic discussions, presentations
- 1400 - 1500 Daily - (+Grand Rounds on Tuesdays and fourth Wednesday)
- 1600 + Daily - The resident is expected to complete all pertinent patient care activities prior to leaving for the day. Outside reading and projects will also be expected.
Evaluation:
The resident will receive verbal feedback (formative evaluation) on a daily basis by the cardiology pharmacist. They will have a short summative evaluation at the midpoint and a full summative evaluation of all goals at the end of the rotation. This evaluation will then be summarized in ResiTrak. The resident self-evaluation is due by the last Wednesday of the rotation. All evaluations must be co-signed within 2 weeks of completion of rotation.
