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Home Residency Rotations Practice Management - PGY1 Rotation

Residency

Practice Management - PGY1 Rotation

Preceptors:

Linda S. Tyler, PharmD, FASHP
Kavish Choudhary, PharmD, MS

 
Site Description:

University of Utah Hospitals & Clinics (UUHC) is comprised of 4 hospitals, 18 clinics, 15 retail pharmacies, 3 infusion centers, ambulatory clinic services, and a comprehensive drug information service. University Hospital is a 436 bed, level 1 trauma center with strong critical care, emergency medicine, surgical services, obstetrics and gynecology, neonatal, internal medicine and subspecialties, neurosciences, and rehabilitation. University Neuropsychiatric Institute is an 80 bed inpatient psychiatric facility. The Huntsman Cancer Center consists of a 50 bed inpatient service, an ambulatory infusion suite, and extensive ambulatory cancer clinics, including bone marrow transplant. The University Orthopaedic Hospital provides mostly ambulatory care surgery services plus orthopaedic specific clinics. At UUHC, the ambulatory care network includes the Community Clinics, located throughout the Salt Lake Valley, and the specialty clinics and infusion room at University Hospital. While on rotation, the resident will primarily be at University Hospital but will have the opportunity to visit numerous UUHC sites.

 
Rotation Description:

Residents will receive a broad overview of the leadership and management issues in the Pharmacy Department. The resident will attend many of the meetings that the Administrative Director attends including those with senior leadership. The resident will develop a good understanding of pharmacy's important role in the organization. The resident will be introduced to the department's compliance, supply chain, revenue integrity, regulatory and financial issues. Residents will complete several projects to apply key concepts and understand how to justify pharmacy services.

 
RLS Goals:

R1.1 Identify opportunities for improvement of the organization's medication-use system.

  1. Explain the organizations medication use system and its vulnerabilities to ADEs
  2. Analyze the structure and process and measure outcomes of the medication use system.
  3. Identify opportunities for improvement in the organization's medication-use system by comparing the medication-use system to relevant best practices.

R1.2 Design and implement quality improvement changes to the organization's medication-use system.

  1. Explain the process for developing, implementing and maintaining a Formulary system from an administrative perspective
  2. Make a medication-use policy recommendation based on a comparative review
  3. Participate in the identification of need for, development/implementation/evaluation of an evidence-based treatment guideline
  4. Design pilot interventions to change problematic aspects of the medication use system to improve quality.

R3.1 Exhibit essential personal skills of a practice leader.

  1. Practice self-managed continuing professional development with the goal of improving the quality of one's own performance through self-assessment and personal change.
  2. Demonstrate pride in and commitment to the profession through appearance, personal conduct and association membership.
  3. Act ethically in the conduct of all job-related activities.

R3.2 Contribute to department leadership and management activities.

  1. Participate in the pharmacy department's planning processes.
  2. Explain the effect of accreditation, legal, regulatory, and safety requirements on practice.
  3. Explain the principles of financial management of a pharmacy department.
  4. Prioritize the work load, organize the work flow, and check the accuracy of the work of pharmacy technical and clerical personnel or others.

R3.3 Exercise practice leadership

  1. Use knowledge of an organizations political and decision making structure to influence accomplishing a practice area goal.
  2. Explain various leadership philosophies that effectively support direct patient care and pharmacy practice excellence.
  3. Use group participation skills when leading or working as a member of a committee or informal work group.
  4. Use knowledge of the principles of change management to achieve organizational, department and/or team goals.

E7.3 Balance obligations to oneself, relationships, and work in a way that minimizes stress.

  1. Devise an effective plan for minimizing stress while attending to personal needs, maintaining relationships, and meeting professional obligations.

E7.4 Manage time effectively to fulfill practice responsibilities.

  1. Use time management skills effectively to fulfill practice responsibilities.

Activities Evaluated

Rotation Activity RLS Goal Teaching Method
Attend meetings with department leaders. Understand the relationship pharmacy has with other departments. Discuss change management and leadership styles and philosophies, specifically during weekly topic discussion sessions between the resident and preceptor. R3.3 I, M
Read JCAHO medication management and NSPG goals and discuss implications for our organization. Identify opportunities stronger institutional compliance with published regulations during rotation meetings with preceptor. R1.1, R3.2 I, M
Review supply chain management issues. Describe the implications of 340b pricing for the organization. Review 340b splitting software with pharmacy buyers. R3.2 I, M
Review monthly financial statements and evaluate for trends and patterns. Review benchmarking data. If applicable during rotation, assist in the preparation of data submission for institutional benchmarking or presentation of data in staff meetings or department newsletter. R1.1, R3.2 I, M, C
Review revenue cycle. Attend pharmacy compliance meetings. Develop an educational module on a compliance topic. R3.2 I, M, C, F
Attend meetings with vendors. Discuss the ethical issues in vendor relations. R3.1 I, M
Discuss the department organizational structure and strategic plan. R1.1, R3.2 I, M
Discuss stress management and work-life balance issues. R7.3 I, C, M
Conduct a project related to the administrative, quality, safety or management of the department. Examples of projects include: Conduct a gap analysis for a new regulatory standard. Coordinate immunization clinics. Analyze purchasing data for cost savings opportunities. Conduct an ROI analysis for a new service. Write a proposal or justification for services. All I, M, C, F
Analyze data related to medication use policies or guidelines (eg, vaccine audit with Shantel Mullin). R1.2 I, M, C, F
Use time management techniques to juggle rotation responsibilities. E7.3, E7.4 I, M, C, F
Attend State Board of Pharmacy meeting (arrange with Dave Young, 4th Tuesday of each month). R3.2 I, M
Keep a journal during the rotation to capture questions and observations you have during the rotation. Be sure to bring up questions with preceptors for discussion. R3.1 F
Teaching Methods include: I=direct instruction, C=coaching, M=modeling, and F=facilitation

 
Readings and Preparatory Work:

  1. Bush PW, Walesh SG. Managing and Leadership: 44 Lessons Learned for Pharmacists. Bethesda MD: American Society of Health-System Pharmacists. 2008.
  2. JCAHO. 2010 Hospital Accreditation Standards
  3. Readings on H:\Rx Pharmacists\Resident Management Rotation
  4. 340b Tutorial:  https://www.340bpvp.com/public/gps/gps.html

 
Project/Presentation Description:

The resident will have the opportunity to work on a wide range of relevant administrative, quality, safety or management projects during the rotation. Projects will be concentrated on topics and initiatives that will enable to resident to work with different areas within the department of pharmacy as well as departments throughout the entire organization. Projects opportunities will be driven by current events in the department/organization and may require a presentation.

 
Typical Daily/Weekly/Monthly Activities:

Usual time for rotation is 7:45 am to 4:30 pm. However, it is very important to be flexible based on what is going on in the department and meetings: 7 am or late in the afternoon evening are likely to happen several times in the rotation. The schedule will be reviewed every Monday morning to develop a plan for the week.

 
Evaluation:

The resident will have discussions with the preceptor(s) multiple times per week. The weekly planning meeting will serve as a place for providing feedback to the resident. A formal summary evaluation at midpoint and final summative evaluation on the last day of rotation will occur with the preceptor and the resident. A summary of the discussion will be posted in ResiTrak.