Core Rotations

This longitudinal rotation is a broad ambulatory care which provides medication therapy management (MTM) services, management of chronic disease and care transitions within an inter-professional healthcare environment. 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 disease management.

The rotation will consist of providing clinical pharmacy services to the Level III Neonatal Intensive Care Unit (NICU) at Sisters of Charity Hospital, under the guidance of the rotation preceptor, for patients born premature and/or having other acute illness requiring intensive monitoring. The resident will have daily interactions with the neonatal intensivists, nurse practitioners, physician’s assistants, nursing staff, pharmacy personnel, and other healthcare professionals as required to optimize the therapeutic management of these patients. In addition to the pharmacotherapeutic consultative services, the resident will also be expected to provide drug information services, patient education (as needed), discharge counseling, and educational presentations to the pharmacy, providers, and nursing staff. The resident will meet frequently with the preceptor to discuss patient care issues and pharmacotherapeutic topics specific to neonatology.

Critical Care Pharmacy is a required, four week learning experience at Sisters of Charity Hospital (SOC). This rotation will be comprised of both the intensive care unit (ICU) and the cardiology teaching service. The ICU is a 16 bed unit that cares for critically ill patients. The cardiology teaching service provides care to a maximum of 18 patients. Members of both the ICU and cardiology teaching service consist of an attending physician, PGY-2 senior medical resident, 2 PGY-1 medical interns, and medical students.

The Emergency Department rotation is a required, one month learning experience at Sisters Hospital. In this rotation, the resident will learn the skills necessary to become a competent clinical pharmacist that can work independently and provide direct patient care to patients in the emergency department (ED). The ED at Sisters Hospital is a 29-bed unit equipped with two code rooms and a 5-bed fast track. Clinical pharmacy services are provided in the ED, at minimum, from 0900-2200 Monday through Friday. Pharmacist responsibilities in the ED include responding to cardiac arrests and stroke emergencies, answering drug information questions from ED and Sister Hospital caregivers, patients, and families, antibiotic stewardship (including the daily outpatient microbiology report), collaborating with the centralized pharmacists to assure timely medication availability, and medication reconciliation. During this rotation, the pharmacy resident will work collaboratively with several disciplines including the ED physicians, ED mid-level providers, hospitalists, medical residents and ED nurses to optimize pharmaceutical care for the ED patients. The resident will be required use evidence-based medicine to provide pharmaceutical care to a range of ED patients, from the ambulatory to the critically ill. A typical day in the ED does not exist and the resident will be required to "work on the fly".

Internal Medicine 1– 4 South (4S) Clinical Pharmacy Services is a required, five week learning experience at Sisters of Charity (SOC) hospital. There are 32 general medicine beds on 4S. The resident will have an opportunity to interact with a variety providers, including hospitalist groups, specialists, consultants and mid-level providers. There are also a number of other ancillary staff on 4S involved in the care of the patient, including nurses, nursing students, respiratory therapists, case managers, clinical dieticians, and physical therapists.

Internal Medicine II is a core learning experience at Sisters Hospital PGY1 pharmacy residency program. The primary goal of this rotation is for residents to develop the skills and competencies in pharmaceutical care to effectively participate in therapeutic decision making, drug therapy selection, clinical monitoring, and patient counseling.

Good communication and interpersonal skills are fundamental to success in this experience as the resident will be interacting with an extensive interdisciplinary team, including physicians, physician assistants, medical residents, nurses, discharge planners, and pharmacy students. These skills are especially vital in your most important role of counseling and educating patients on safe and effective medication management leading to the best possible health outcomes.

A team based learning approach with a layered learning model will be incorporated into the resident's experience during this rotation. This will give the resident an opportunity to work with and lead IPPE and APPE pharmacy students to maximize learning through direct instruction, modeling, coaching, facilitating and providing feedback. The ultimate goal will be to have the resident assume the responsibility of precepting students during the final 2-3 weeks, or sooner as deemed appropriate by the preceptor and resident.

Internal Medicine 2 (IM2) is a required, one-month learning experience at Sisters of Charity Hospital. The University at Buffalo residency program staffs one medicine teaching teams (General Medicine). The general medicine (3S) teaching team provides care to a maximum of 10 general medicine patients. Members of the teaching team include an attending physician, a PGY3 senior medical resident, 2 PGY1 medical interns, and medical students. In addition, the resident will be responsible for both management and care of 3N/3S patients, including but not limited to, attendance and participation in multi-disciplinary rounds

The Antimicrobial Stewardship/Infectious Diseases rotation at Sisters of Charity Hospital will give the resident opportunity to provide clinical pharmacy services under the guidance of the rotation preceptor in order to best optimize the use of antimicrobial agents. The goal of this rotation is to provide inpatient pharmacy services to acutely ill patients being treated for infectious diseases, as well as patients being transitioned out of the hospital on antimicrobial therapy. The resident will have daily interactions with providers including nurse practitioners, physician's assistants, nursing staff, pharmacy personnel, and other healthcare professionals. In addition to the pharmacotherapeutic consultative services, the resident will also be expected to provide drug information services, patient education (as needed), discharge counseling, culture review, and educational in-services. The resident will meet frequently with the preceptor to discuss patient care issues and pharmacotherapeutic topics specific to infectious diseases. Good communication with team members and strong interpersonal skills are vital to success in this experience

The resident will be required to complete a longitudinal pharmacy research project. This research project may be of a clinical, economic, research, administrative, or quality/process improvement design. A list of possible projects will be provided to the resident at the beginning of the residency year. Additionally, the resident may elect to conduct an unlisted project, only with the approval of the research committee and residency advisory committee. The resident will work with their assigned preceptor(s) to create a study design proposal which will be presented to the CH IRB, conduct a literature search, conduct the actual study, interpret the study data, and present the results. The resident will work on their research project longitudinally during the residency year with extra time devoted to research in December.

This 1-week orientation rotation will include orientation to the organization, hospital site, pharmacy department, and residency programs. We will discuss the residency manual and ensure all expectations are understood during this initial week.

This 5 week rotation will cover the dispensing and distributive operations of Sisters of Charity Hospital (SOC). This rotation will be incorporated to give residents a chance to orient to the physical layout of the department and hospital, read and understand Catholic Health, SOC, and pharmacy department specific policies and procedures, as well as software programs pertinent to pharmacy operations. Distributive services has been one of the foundations of pharmacy practice, therefore a competent advanced generalist practitioner should be proficient in their knowledge of the skill-set associated with these functions, including but not limited to: state and federal laws, CHS and SOC policies and procedures, sterile preparation, and a multitude of other skills listed in the operations checklist. During the learning experience, the resident will focus on the goals and objectives outlined below by performing the activities that are associated with each objective. The resident will gradually assume responsibility for all the patients within the assigned unit. The PGY1 resident must devise efficient strategies for accomplishing the required activities in a limited time frame.

This longitudinal rotation will cover the dispensing and distributive operations of Sisters of Charity (SOC). Staffing requirements are average of 1 shift per week, which generally will be every other weekend, and coverage of major holidays, as needed by the department. Distributive services has been one of the foundations of pharmacy practice, therefore a competent advanced generalist practitioner should be proficient in their knowledge of the skill-set associated with these functions, including but not limited to: state and federal laws, CHS and SOC policies and procedures, sterile preparation, and a multitude of other skills listed in the operations checklist.

This one month experience is designed to give residents a chance to develop their professionalism and to learn about and participate in important pharmacy-related functions of the health system that are not necessarily associated with direct patient care. The resident will demonstrate knowledge and application skills in the pharmacy services that are critical to safe, effective, and cost-conscious medication use in a pharmacy department and health system, including (1) practice management; (2) medication-use policy development; (3) optimizing medication therapy; (4) drug product procurement and inventory management; (5) monitoring medication use; and (6) evaluating the effectiveness of the medication-use system.

This longitudinal experience is designed to give residents a chance to develop their professionalism and to learn about and participate in important pharmacy-related functions of the health system that are not necessarily associated with direct patient care. The resident will demonstrate knowledge and application skills in the area of leadership and ethics. It is recommended that the residents utilize the Catholic Health University to attend classes related to leadership, teamwork, and ethics so long as they do not interfere with scheduled rotations.

Leadership series will be a longitudinal experience consisting of 1 hour meetings related to a myriad of topics. Please refer to the Leadership Dashboard for the minimum areas to be covered.

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. Educational opportunities exist in multiple settings throughout the residency year, including small group teaching (in-services, drug info, topic discussions), mentoring APPE pharmacy students, and grand rounds. Additionally, the resident may be called upon to develop educational programs for medical/pharmacy staff.

This rotation module will occur for approximately 4 weeks around the month of December. During this module the residents will be spending most of their time on their longitudinal research poster project to be presented at the national ASHP Midyear Conference, generally during the 1st half of December. The goals of this rotation are for the residents to appropriately manage their time in order to successfully complete a mid-term point of their yearlong research project, coordinate a business trip to the Midyear Conference and manage the finances associated. In addition, this will be the time to complete all mid-year evaluations on PharmAcademic and follow through with any outstanding work from the first half of the resident year.

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:

• Ambulatory Care
• Cardiology Clinic
• Critical Care- Kenmore Mercy
• Cardiovascular ICU
• Obstetrics/Maternal Child