Core Rotations

This longitudinal rotation is a broad ambulatory care which provides pharmacy services within primary care environment with a focus of chronic care management. Catholic Health Systems seeks to meet quality measures while reducing the total cost of care for our patient population and this pharmacy service addresses all aspects of the Triple/Quadruple Aim. Additionally, these services will align with Catholic Health Systems values; reverence, compassion, justice and excellence. The pharmacist-led ambulatory care service within the Catholic Health System serves as an outpatient practice which focuses on medication safety and efficacy/outcomes, as well as cost management as they relate to transitions of care and chronic disease management.

Residents will develop and utilize necessary knowledge and skills to provide quality, direct patient care, through pharmacist-led relationships and within a collaborative practice agreement within an adult medicine clinic. Residents will assess needs for patient education, lifestyle modification reinforcement, appropriate device use and technique, insulin titration or instruction and adherence with drug therapy plans. In addition they will utilize Collaborative Drug Therapy Management protocols for cardiovascular risk reduction, diabetes management, hypertension management, coagulopathy, and COPD/Asthma management. They will gain experience as a resource to clinicians by providing drug information, monitoring drug therapy, assessing adherence, considering cost comparisons, and making recommendations for to achieve optimal patient outcomes.

Catholic Health offers outpatient medication-assisted treatment for substance-use disorders with an enrollment of approximately 1,200 patients. The department of pharmacy has established a clinical pharmacist-led chronic hepatitis C virus (HCV) clinic at two treatment center locations in the city of Buffalo and Amherst. The clinical pharmacist is responsible for HCV monitoring and care under a Collaborative Drug Therapy Management (CDTM) protocol. The multidisciplinary team includes the infectious disease providers, substance use disorder providers, counselors and ancillary staff. Clinical pharmacists are integral members of the multidisciplinary team and provide a valuable role in HCV care. The HCV clinical pharmacists serve an integral role in screening, assessing readiness for treatment, medication selection, prior authorization, medication procurement, identification and management of drug-drug interactions, assessing for appropriateness of vaccine administration and continued assessment of medication adherence.

This longitudinal experience is designed to provide residents an opportunity to develop their professionalism and to learn about and participate in important pharmacy-related functions of the health system beyond direct patient care. PGY-2 residents will utilize this experience to further enhance time management skills, communication skills, and enhance their personal leadership and advocacy which is necessary within the practice of ambulatory care. The resident will demonstrate and eventually lead in dissemination knowledge and apply skills in the area of leadership and ethics.

Preparing the resident for a future career involving academia or precepting student pharmacists on experiential rotations is a vital skill to be an advanced practitioner. Being involved in different types of teaching and learning experiences also allows the resident to grow as a professional. The PGY-2 ambulatory care resident will focus on precepting ambulatory care pharmacy learners including IPPE or APPE students and/or PGY-1 pharmacy residents. Educational teaching and learning opportunities will exist in other settings throughout the residency year, including didactic teaching or facilitation opportunities at D’Youville School of Pharmacy. The resident may also be called upon to develop educational programs for medical/pharmacy staff. Completion of such activities, among others, allows the resident an opportunity to obtain the basic or advanced academic teaching certificate offered through D’Youville School of Pharmacy.

Elective rotations are an area that allows for customization of our program to fit the interests of the residents. While we have several elective rotations that have been developed based on strengths of our institution, one of the requirements for this program is for the resident to create their own elective. Creation of an elective provides ownership for the resident in their experiences as well as develops a skill set and understanding of the regulations set forth by our accrediting organization, ASHP. Some examples of created electives include:

• Transitions of Care
• Cardiology
• Hepatitis C
• Research
• Management