Residency
Family Medicine, Sugarhouse Clinic Rotation
Preceptor:
Karen Gunning, PharmD, BCPS, FCCP
Site Description:
The family medicine clinical rotation is based at the University of Utah Sugarhouse Clinic, a family medicine residency training site. Sugarhouse clinic provides care to a wide variety of patients, including pediatrics, obstetrics, geriatrics and every type of patient in between. The interdisciplinary team at Sugarhouse Clinic includes attending physicians, family medicine residents, physician assistant students, medical students, pharmacy students, psychologists, dieticians, pharmacists, nurses, medical assistants, and laboratory personnel.
Rotation Description:
The resident will work as an integral participant on the family medicine team at Sugarhouse Clinic. The resident will be responsible for identifying and resolving medication therapy issues for patients referred to the pharmacy team, and will work towards providing independent care of the patients seen in the pharmacy education clinic. Patients are referred to this clinic by their primary care providers to address a variety of drug related issues, including but not limited to smoking cessation, diabetes education and monitoring, hypertension, hyperlipidemia, anticoagulation, pain management, asthma, general medication therapy management, and patient assistance. The resident will also participate as the pharmacist member of the senior clinic team at Sugarhouse clinic, attend home visits with family medicine residents and the senior clinic team, and, if certified, will provide immunization services to clinic patients and members of the community.
Emphasis is placed on the provision of patient drug related care for the entire patient, vs. a solitary view based on a single clinical problem. Further emphasis is also placed on the development and pharmacotherapy education of the other learners in clinic, and on development of drug information skills in the primary care setting.
The resident will be expected to participate in the teaching of pharmacy students, and may, if interested, participate in didactic teaching at the college of pharmacy. A patient education project, patient presentations, journal club, and drug therapy updates to prescribers are all a part of this rotation. Residents may also be involved with clinic quality improvement projects, and didactic presentations at department of family and preventive medicine conferences. Attendance at weekly Family Medicine Grand Rounds is required. Residents may also have the opportunity to attend meetings of the Utah Medicaid Pharmacy and Therapeutics Committee.
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 clinic policies.
Upon completion of the rotation, the resident is expected to have a holistic understanding and increased competence and confidence in the diagnosis and pharmacological treatment of core disease states in primary care, including but not limited to hypertension, diabetes, hyperlipidemia, anticoagulation, core geriatric syndromes, women's health, infectious diseases in ambulatory care, smoking cessation, depression/anxiety, immunizations and wellness, and asthma.
RLS Goals Evaluated
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.
R2.5 — When necessary, make and follow up on patient referrals.
R2.8 — Recommend or communicate regimens and monitoring plans.
R2.9 — Implement regimens and monitoring plans.
R2.11 — Communicate ongoing patient information.
R2.12 — Document direct patient care activities appropriately.
R5.1 — Provide effective medication and practice-related education, training, or counseling to patients, caregivers, health care professionals, and the public.
E7.1 — Use approaches in all communications that display sensitivity to the cultural and personal characteristics of patients, caregivers, and health care colleagues.
E7.2 — Communicate effectively.
E7.3 — Balance obligations to oneself, relationships, and work in a way that minimizes stress.
E7.4 — Manage time effectively to fulfill practice responsibilities.
Rotation Activities and Assignment Summary:
- The resident must prepare adequately for topic discussions of pertinent primary care pharmacotherapy and disease states at least twice per week (R2.9, R5.1, E7.1, E7.3, E7.4; Instruct, Mentor)
- The resident will select, present and lead two journal club activities. (R2.1, R5.1, E7.1, E7.3, E7.4; Coach, Facilitate)
- The resident will provide written or verbal responses to drug information questions as requested by the multidisciplinary team at Sugarhouse Clinic. (R2.1, R2.2, R2.5, R2.8, R5.1, E7.2; Coach, Facilitate)
- The resident will report all adverse drug events according to the University of Utah Hospital protocols. (R2.12; Instruct, Mentor)
- The resident will function within the scope of the collaborative drug therapy management protocols approved by the Pharmacy and Therapeutics Committee for hypertension, dyslipidemia, anticoagulation, refills, immunizations, and diabetes. (R2.2, R2.5, R2.8, R2.12; Mentor, Facilitate)
- The resident will provide medication counseling and instructions as requested, and will document all patient interactions with a progress note entered into EPIC. (R2.12, R5.1,E7.1, E7.3, E7.4; Instruct, Coach)
- The resident may be required to present 1 in-service to nursing staff or residents (20-30 minutes, powerpoint optional, brief handout required) (R5.1, E7.1, E7.2, E7.4Facilitate)
- The resident may be required to complete 1 small project (medication use evaluation, review of policy adherence, etc) (R2.11;E7.3, E7.4; Coach, Facilitate)
- The resident will review their schedule and progress on activities and projects with the preceptor at least weekly to demonstrate adequate progress. (E7.3, E7.4; facilitate)
Readings and Preparatory Work:
Residents are expected to become familiar with the University CDTM protocols for hypertension, dyslipidemia, anticoagulation, refills, immunizations, and diabetes. Readings will be provided to residents on these areas, as well as on the area of smoking cessation. While not required, immunization certificate is desired, particularly for residents seeking rotation opportunities in the late fall and early winter.
Project/Inservice Description:
Journal Club - 1 journal club presentation will be completed during each of the 2nd and 4th weeks of rotation
- The article must be related to primary care, and selected by the resident.
- Published within the last 12 months
- Emphasis is placed on evidence that is likely to have impact on patient care, and change current practice
- A one page written synopsis with clinical questions for discussion is required.
Patient education Project: Poster or handout centered on a specific primary care health issue - audience is clinic patients and caregivers.
Typical Daily/Weekly/Monthly Activities:
The resident is expected to be punctual and to prioritize daily activities. A typical day will be from 830 am - 530 pm, but additional time is expected to complete daily responsibilities and ensure best outcomes for the patient.
Sample weekly schedule:
Monday: SH clinic all day
Tuesday: Pharmacy Clinic am, SH Clinic pm
Wed: DFPM Grand Rounds, Project time/Residency Didactic Presentations.
Thurs: Senior Clinic am, Nursing Home pm
Friday: Home Visit am, SH Clinic pm
Evaluations:
The resident will receive formative evaluations of written work, presentations and patient care plans and recommendations. A midpoint summative evaluation will be documented in ResiTrak, and a full summative evaluation will be recorded in ResiTrak at the conclusion of the rotation.
