Elective Learning Experiences
Ambulatory Care (Longitudinal) Learning Experience – The Heart Group
The elective learning experience in ambulatory care based at The Heart Group of Lancaster General Health will provide the resident exposure to cardiovascular management within a physician office. The multidisciplinary office cares for patients in general cardiology, heart failure, electrophysiology, peripheral vascular disease, and cardiovascular risk reduction clinics. In addition, the office contains an outpatient center for laboratory and cardiovascular testing. The resident will manage anticoagulation patients under a collaborative drug therapy management agreement with multiple opportunities to meet directly with patients in the office for new visits as well those with medication-related problems. The resident will also have exposure to cardiovascular drug therapy monitoring and management of other cardiovascular diseases. Opportunities for providing educational sessions to office staff will be available.
Adult Family Medicine Learning Experience
The Family Medicine inpatient learning experience focuses on the provision of pharmaceutical care to patients admitted to our Family Community Medicine service. There will be active involvement and teaching responsibilities to the Family Medicine Medical Residents. The emphasis of this learning experience will be on the management of drug therapy in patients with multiple medical problems and viewing the patient as a “whole” versus focusing on one problem. The spectrum of pharmaceutical care services experienced during the rotation includes daily review of patient medication profiles, resolution of patient medication problems, completing medication reconciliation, providing pharmacokinetic consults, providing patient education and counseling, teaching during daily team rounds and providing drug information services to the health care team.
This rotation focuses on the provision of pharmaceutical care to patients at the Care Connections Office (high utilizer patients). The resident will have the opportunity to work collaboratively with the Care Connections team members (patient care navigators, social workers, case managers, nurses, nurse practitioners and physicians) to enhance medication management in this high risk population. The resident will have the opportunity to shadow various team members to get a good understanding of how the high intensity team model impacts patient care. The resident will have the opportunity to meet with patients face to face in the office and at home. A majority of the time will be spent on medication reconciliation and medication education, however warfarin management and chronic disease state management through use of collaborative practice agreements will also be activities the resident will be involved with. The resident will also have the opportunity to educate Care Connections team members on various pharmacy related topics.
Chronic Care Disease Clinic at Norlanco
Lancaster General’s Ambulatory Care Clinical learning experience is intended to expose the resident to an area of direct patient interaction and to provide opportunities to practice evidence-based medication. Residents will work under collaborative drug therapy management agreements to care for hypertension patients in Norlanco Family Medicine. The residents will work with staff physicians to manage current uncontrolled hypertension patients and create a personalized prevention plan for each patient based on patient interview, various risk assessments and patient histories. The resident will be a part of a medication adherence program designed specifically for patients who are not reaching their health outcome goal and will be discussing the patients concerns with their current therapy. In addition, the resident will gain experience as a member of the transition of care team, responsible for the safe and successful transition from the inpatient to outpatient setting for our high risk patient population.
Critical Care – MICU/SICU Learning Experience
Lancaster General’s advanced critical care learning experience is intended to expose the resident to an additional focus on ICU patients. The resident will continue to expand the knowledge gained during the critical care rotation on management of trauma/neurosurgical patients. Residents will also gain additional knowledge of medication management and disease states involving medical/surgical ICU patients. The pharmacy resident will serve as the primary pharmacy resource for the trauma service. In addition, the resident will serve as the primary preceptor for any pharmacy students during their critical care rotation. Learning opportunities will be determined based on the resident’s activities completed in the required critical care rotation.
Ambulatory Care (Longitudinal) Learning Experience – Downtown Family Medicine
This rotation focuses on the provision of pharmaceutical care to patients, at the Downtown Family Medicine Office. The resident will have the opportunity to meet with patients face to face for medication education and chronic disease state management through use of collaborative practice agreements. A majority of the time will be spent on anticoagulation management and hypertension management. However, the resident will develop familiarity with many of the common chronic disease states that are seen in the outpatient setting (i.e.: diabetes, dyslipidemia, venous thromboembolism, atrial fibrillation, asthma, COPD). The resident will assist with expanding the role of the clinical pharmacist in the Patient Centered Medical Home (PCMH) setting. The resident will also have the opportunity to interact with medical residents and attending physicians as well as educate other health care professionals (Family Community Medicine residents and nursing staff) and most importantly patients.
Pediatric Learning Experience*
Lancaster General Health, in collaboration with Penn State Hershey Children’s Hospital offers a 19-bed general pediatric unit. The primary focus of this rotation is to strengthen the residents’ knowledge and skills necessary to become proficient in providing pharmaceutical care for the general pediatric patient. The resident will be an active member of the pediatric hospitalist team which includes family practice residents who are on their pediatric rotation by participating in daily rounds. Topic discussions and patient care experiences will be utilized to enhance the resident’s understanding of common pediatric disease states and the management of those disease states. Additional experiences include journal club, experience at Lancaster General Health’s Women & Babies Hospital and attendance of pediatric-related meetings.
Oncology Learning Experience*
Lancaster General’s Adult Hematology/Oncology learning experience is a 4-week rotation consisting of both inpatient and outpatient exposure. The rotation will provide a balance of rounding with an oncologist on the inpatient oncology unit and providing pharmaceutical care to outpatients at the brand new Ann B. Barshinger Cancer Institute. The resident will have the opportunity to strengthen their knowledge and understanding of prevalent topics in hematology/oncology, including principles of chemotherapy, and treatment of solid tumors and hematologic cancers. The resident will also participate in oncology supportive care, including counseling patients as part of our pharmacy managed epoetin program. The rotation will also provide the resident with the experience to evaluate complex chemotherapy regimens and provide chemo teaching to patients. The pharmacy at the Cancer Institute will enable the resident to gain practical experience in the prevention of chemotherapy medication errors and chemotherapy preparation using safe handling practices.
Pain Management Learning Experience
The pain management learning experience is a four week rotation focusing on pain management and palliative care. Pharmacy practice residents will optimize pain management therapy in chronic and acute on chronic pain patients admitted to the palliative medicine consultant service. An active role will be taken in the management of medication therapy during this rotation with involvement and participation in rounding with the pain service, review of patient’s medications, laboratory values and test results, optimizing patient’s medication management and resolving any problems identified, providing drug information to healthcare professionals, and patient medication counseling.
Research Learning Experience
This four-week learning experience is offered to the resident as an elective for which the resident can choose to dedicate a concentrated period of time, in addition to their year-long longitudinal commitment, toward their longitudinal research project.
Transition of Care Learning Experience*
Lancaster General Health is dedicated to the safe and successful transition of our recently discharged patients back into the community. The Transition of Care Learning experience will empower the resident to develop the skills necessary to participate as a collaborative member of the healthcare team, working closely with nurses and physicians to improve outcomes for our complicated transition patients. Opportunities to improve high-risk medication management for multiple disease states and the provision of direct patient care are at the heart of the transition of care opportunity. The resident will develop the skills necessary to educate providers, as well as other members of the interdisciplinary healthcare team to improve the overall quality of the transition process.
Trauma Learning Experience
The Trauma learning experience is a 4 week rotation focusing on trauma patients from the time of admission to the intensive care unit until discharge from the hospital. Residents will participate in daily rounds with the trauma intensivists. Residents will learn about various topics including but not limited to stress ulcer prophylaxis, DVT prophylaxis, seizure prophylaxis, sedation, pain management, de-escalation of antibiotic therapy, pharmacokinetics and ICU transfer medication reconciliation.
* Resident’s choice of 1 of the 4 noted above to fulfill special populations elective