The residency is built on the philosophy that our purpose as an organization and as preceptors is to guide residents toward their future career goals. In our Mentorship Program, residents have the opportunity to learn about the qualifications and style of all preceptors and will select a preceptor to serve as their mentor for the duration of the program to guide the resident on areas such as time management, career planning, and approaching complex situations.

Operations Requirement

  • Every third weekend
  • One evening every third week
  • Additional hours not exceeding 4 hours in a one month period

Major Research Project

Upon arrival at Lancaster General Health, residents will receive detailed summaries of numerous research projects available and will have the option of selecting one that meets his/her clinical/professional interests. The major research project will be on a topic suitable for publication and will be presented at the following events:

  • ASHP Mid-Year Clinical Meeting
  • Eastern States Residency Conference
  • Lancaster General Annual Health Sciences Poster Session

Medication Usage Evaluation (MUE)

The purpose of performing an MUE is to promote optimal medication therapy and ensure that such therapy meets current standards of care. The resident will have the opportunity to select a particular MUE that is of interest to him/her and aligns with the needs of the organization.

Teaching Opportunities

Residents will have ample opportunities to provide medication and practice-related education to patients, caregivers, healthcare professionals, and students. Residents with a strong interest in teaching may have additional teaching opportunities in precepting P4 pharmacy students.

Learning Experience

Pharmacy residents receive abbreviated rotation experiences in pharmacy operations, anticoagulation, and pharmacokinetics upon first starting and will move on to six core rotations.

In addition, residents will be given the opportunity to choose two elective rotations, and an additional elective rotation consisting of a special patient population (oncology, pediatrics, decentralized or transitions of care).

There are 5 longitudinal learning experiences required which include Medication Information/Drug Use Policy, Ambulatory Patient Care, Research Project, Education & Professional Development and Pharmacy Services.

Required Learning Experiences

Cardiology Learning Experience

The Cardiology Learning Experience will provide exposure to the many subspecialties that make up cardiovascular care at Lancaster General Health. This includes working with Multidisciplinary teams made up of physicians, nurses and pharmacists in order to provide comprehensive, valuable care to our critically ill cardiac and heart failure and heart failure population.

Critical Care - Trauma Learning Experience

The Critical Care - Trauma Learning Experience will provide residents with the exposer to the functions of pharmacy on the Trauma Neurosurgical unit. They will also participate in trauma journal clubs, research meetings and grand rounds. The pharmacists participate in Intensivists model multidisciplinary trauma rounds that include propofol monitoring, haloperidol QTc monitoring, pharmacy to dose vancomycin and aminoglycosides and ICU transfer medication reconciliation.

Infectious Disease Learning Experience

The Infection Disease (ID) rotation will allow the resident to develop a solid understanding of microbiology, pharmacokinetics and pharmacodynamics of antimicrobials and antimicrobial stewardship. The resident will have the opportunity to interact with various departments, such as infection control and microbiology, and be part of the Infectious Diseases and Antimicrobial Stewardship Program rounding services. Resident responsibilities include but are not limited to: daily rounds, PK dosing, weekly topic discussions, in-servicing infection control nurses, ID journal club, 45-minute patient case presentation, and adherence counseling.

Internal Medicine Learning Experience & Medication Safety Learning Experience

The Internal Medicine learning experience involves rounding with physicians from the Internal Medicine Hospital Specialist Group, providing drug information, therapeutic recommendations and detailed medication reconciliation for each patient. Family Practice Residents are also involved in this rounding experience and provide additional opportunities for learning and teaching.

The Medication Safety learning experience will introduce the resident to patient safety initiatives, National Patient Safety Goals, medication safety resources, automated technologies, medication error reporting and adverse drug reaction surveillance. The resident will be involved with providing bedside patient care by lessening the potential for harm and optimizing medication management strategies with high-risk medication therapies, such as anticoagulants.

Management Learning Experience

Lancaster General’s management/leadership learning experience is intended to expose the resident to issues affecting overall pharmacy practice and operations, including specific current initiatives across the health-system. Financial performance, human resource management, organizational systems, current topics in pharmacy practice, regulatory compliance, leadership development, and practice model considerations are among the topics covered. During this time, the resident will also gain an understanding of the role of other members of the department’s management team, actively participating as a member of the management team during the learning experience.

Orientation / Pharmacy Operations (Part 1)

Lancaster General’s Orientation / Pharmacy Operations (Part 1) learning experience is a 3 week Learning Experience for PGY-1 residents.  During this Learning Experience, the resident will receive a comprehensive orientation to the pharmacy department, gain knowledge and experience of the department of pharmacy and become familiar with pertinent policies and procedures as well as obtain hands-on experience. This learning experiences requires residents to have a workable knowledge of the electronic health record for which the resident will complete approximately 24 hours of training and related competencies. 

Pharmacy Operations (Part 2)

Lancaster General’s Pharmacy Operations (Part 2) learning experience is a 2 week Learning Experience for PGY-1 residents.  During this Learning Experience, the resident will build upon their previous 2 learning experiences (Orientation/Pharmacy Operations – Part 1 and Clinical Monitoring).  This learning experiences requires residents to begin to have more autonomy and learn the daily activities for the areas of operation that the resident will staff throughout the residency program.

Elective Learning Experiences

Ambulatory Care (Longitudinal) Learning Experience–The Heart Group

The elective learning experience in ambulatory care 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.

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.

Care Connections

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 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.

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.

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. 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.

Ambulatory Care (Longitudinal) Learning Experience–Downtown Family Medicine

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 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. 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 rotation will also provide the resident with the experience to evaluate complex chemotherapy regimens and provide chemo teaching to patients.

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. This includes 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*

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. Lancaster General Health is dedicated to the safe and successful transition of our recently discharged patients back into the community. 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.

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

Required Longitudinal Experiences

Ambulatory Care Learning Experience

This rotation focuses on the provision of pharmaceutical care to patients at our ambulatory practices with a pharmacist embedded in the practice site. 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. However, the resident will develop familiarity with many of the common chronic disease states that are seen in the outpatient setting (i.e.: diabetes, hypertension, dyslipidemia, venous thromboembolism, atrial fibrillation, asthma, COPD).

Drug Information/Medication Use Policy Learning Experience

This yearlong longitudinal rotation exposes the resident to all aspects of the development of medication related policies and procedures and the evaluation of medications for Formulary reviews. The resident will be actively involved in performing a Medication Use Evaluation and in providing ongoing drug information. Opportunities will be provided for the resident to make formal presentations at Formulary and Pharmacy and Therapeutics committee meetings.

Pharmacy Services/Operations

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.

Research Project

The research project learning experience is intended to expose the resident to learn the essential points of research design and develop the resident’s skills in research techniques. Throughout the longitudinal rotation the resident will work to design, develop and implement a research project.

Education and Professional Development

The Education and Professional Development learning experience is a 12-month, longitudinal Learning Experience for PGY-1 residents. The purpose of this learning experience is to ensure that the resident is effectively employing the appropriate preceptor roles when engaged in teaching the appropriate stakeholder, providing effective medication (practice-related) education to patients, HCP, students and the public as well as developing the necessary skill of self-evaluation and personal performance improvement. This learning experience will encompass (but is not limited to): formal/informal presentations, journal clubs, pharmacotherapy grand rounds, morning report, in-services, case presentations, layered learning models with other healthcare professionals, including students.

Contact Information

Amanda Prusch, Pharm.D., BCPS
Clinical Pharmacy Specialist - Medication Safety
PGY-1 Residency Program Director
Lancaster General Health
Department of Pharmacy Services
555 N. Duke Street
Lancaster, PA 17604

Email: amanda.prusch@pennmedicine.upenn.edu
 

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