This rotation focuses on the provision of pharmaceutical care to patients at our ambulatory practices with a pharmacist embedded in the practice site. The longitudinal experience gives residents experience with anticoagulation and chronic disease state management and opportunities to educate patients other health-care professionals. Residents have the opportunity to meet with patients for medication education and chronic disease state management through use of collaborative practice agreements.
Ambulatory Care (Longitudinal) Offerings
The Heart Group
Based at The Heart Group of Lancaster General Health, residents are exposed to anticoagulation management within a cardiology practice. This practice site is an option for the three to four-month required longitudinal anticoagulation experience.
The multidisciplinary office cares for patients in general cardiology, heart failure, electrophysiology, peripheral vascular disease, valvular heart disease, and cardiovascular risk reduction clinics. The office has an outpatient center for laboratory and cardiovascular testing.
Residents manage anticoagulation patients under a collaborative drug therapy management agreement, and have opportunities to meet directly with patients in the office for new visits and medication-related problems. Residents are also exposed to cardiovascular drug therapy monitoring and have opportunities to provide educational sessions to office staff.
Crooked Oak & Norlanco Regional Anticoagulation Clinic
This anticoagulation longitudinal learning experience option focuses on the care of patients on anticoagulation for the treatment or prevention of thrombosis. Residents spend approximately eight weeks at one site and then transition to the regional anticoagulation clinic for the remainder of the learning experience.
Residents develop the skills necessary to participate as an effective anticoagulation management services provider, providing direct patient education, point of care INR testing, and laboratory study evaluation. They will also adjust warfarin dosing using a collaborative drug therapy management agreement and monitor for adverse events.
As a collaborative member of the health care team, residents also work with providers to transition patients to and from the direct oral anticoagulants. They create care plans for periprocedural disruptions in anticoagulation therapy and present these plans for provider approval. Residents communicate with other ambulatory care providers, nursing, retail pharmacies, and family to disseminate information to ensure the safe and effective use of these high-risk anticoagulants during transitions in care. Residents educate providers, and other members of the interdisciplinary health care team, as called upon to improve the overall quality of care for our anticoagulated patients.
Chronic Disease State Management Locations
Downtown Family Medicine
This rotation focuses on the provision of pharmaceutical care to patients at a downtown Lancaster practice site with an embedded clinical pharmacist. The practice is an academic site run by family medicine residents and attending physicians, allowing for significant collaboration and education. The patient population is varied and includes underserved and Spanish-speaking patients.
Residents have the opportunity to meet with patients for medication education and chronic disease state management through use of collaborative drug therapy management agreements. A majority of time is spent on diabetes management. However, residents become familiar with many common chronic and acute disease states seen in the outpatient setting (i.e. hypertension, dyslipidemia, venous thromboembolism, atrial fibrillation, asthma, COPD).
Drug Information / Medication Use Policy
This yearlong longitudinal rotation exposes residents to all aspects of the development of medication-related policies and procedures and the evaluation of medications for formulary reviews. Residents are actively involved in performing a medication use evaluation and in providing ongoing drug information. Residents have opportunities to make formal presentations at Formulary and Pharmacy and Therapeutics committee meetings.
This learning experience covers the provision of pharmaceutical services to all patients at LG Health. The focus is on the medication use process including, but not limited to: computerized provider order entry, order verification, preparation, distribution, and monitoring of medications.
Following orientation, residents are responsible for all duties assigned to the position, verifying, preparing and dispensing medications following existing standards of practice as well as LG Health’s policies and procedures. Each resident fulfills this requirement by completing the following hour requirement: one evening shift every third week; one weekend every third week (or its equivalent); and a four-hour IV room staffing requirement each month.
This yearlong learning experience has two major areas of focus: Medication Therapy Management (MTM) and Rapid Administration of Antimicrobials by Infectious Diseases Specialist (RAIDS).
The rotation exposes residents to active medication therapy management (MTM) programs through our partnership with various payers. Residents conduct comprehensive medication reviews (CMRs) and targeted medication reviews (TMR) through patient interviews, and communicate recommendations to the appropriate provider for review. The RAIDS initiative targets streamlining appropriate antibiotic therapy for positive S. aureus blood cultures in a timely manner.
Major Research Project
The research project learning experience exposes residents to the essential points of research design and develops research technique skills. Residents work to design, develop and implement a research project.
Education & Professional Development
This 12-month learning experience ensures residents are using the appropriate preceptor roles when engaged in teaching stakeholders, providing effective medication (practice-related) education to patients, HCP, students and the public, as well as developing self-evaluation and personal performance improvement skills.
This yearlong longitudinal rotation, for pharmacy PGY-1 residents, will cover the provision of pharmaceutical services to all patients at LG Health. The focus is on the medication use process including, but not limited to: computerized provider order entry, order verification, preparation, distribution, and monitoring of medications. The resident will verify, prepare and dispense medications following existing standards of practice as well as LG Health’s policies and procedures.
This learning experience encompasses (but is not limited to): formal/informal presentations, journal clubs, pharmacotherapy grand rounds, morning report, in-services, case presentations, layered learning models with other health care professionals, including students. While some of these may be associated with activities on other learning experiences, residents will be evaluated longitudinally on specific goals/objectives.