Implementing a PGY-2 Residency ProgramCritical Care Pharmacy Practice Case Study

Kimberly Zammit, PharmD, BCPS

Advantages of PGY2 Residency Program•Program Recognition

▫PGY1 Recruitment ▫Publication

•Leadership /Preceptor Development▫Clinical and Mentoring skills

•Departmental Goals▫Projects▫Expand clinical programs and increase

pharmacy visibility▫Recruit clinical practitioners

ASHP Recognized PGY-2 Programs• Ambulatory care• Cardiology • Critical care • Drug information • Emergency medicine• Geriatrics• Infectious diseases• Informatics• Internal medicine• Managed care pharmacy

systems

• Medication safety• Nuclear pharmacy• Nutrition support• Oncology• Pediatrics• Pharmacotherapy• Health-system pharmacy

administration practice management

• Psychiatric pharmacy• Solid organ transplant

Kaleida Health Overview

•Largest not-for-profit health care provider in Western New York

•Sites for Critical Care Residency▫Primary Site:

Buffalo General Hospital▫Secondary Sites:

Millard Fillmore Gates Hospital Millard Fillmore Suburban Hospital Women and Children’s Hospital of Buffalo

Buffalo General Hospital

Buffalo General Hospital

Internal & Family Medicine

Intensive Care MedicineCardiacSurgical Cardiac SurgeryStep-down

Cardiology Chest Pain CenterCardiac Catheterization Lab

NeurologyPsychiatry

Gastroenterology/ UrologySurgery

GeneralCardiacOrthopedicVascular

Interventional RadiologyNephrology / DialysisSolid Organ

TransplantationRehabilitation medicine

Hospice

Largest hospital within Kaleida Health•Founded in 1855 •511-bed acute care medical center

Patient Care Services

Program Goal

•Successful completion of this program will produce an individual with the knowledge, skills and confidence necessary for a challenging and rewarding career as a critical care pharmacy practitioner

Program Design

Residency Program Overview Clinical Practice Experiences

•Core Rotations▫ Medical ICU (16 weeks)▫ Surgical ICU (8 weeks)

•Elective Rotations (20 weeks)▫ Neurosurgical ICU▫ Coronary Care▫ Toxicology▫ Emergency Medicine▫ Pediatric ICU▫ Neonatal ICU▫ Cardio-thoracic ICU

Residency Program Overview Longitudinal Requirements

•Committee Participation▫Critical Care ▫Code Blue

•Drug Information▫MUE ▫P&T: Selected critical care topics

•Project•Process implementation

Residency Program Overview Responsibilities• Hospital Practice Responsibilities

▫ Every 3rd weekend (PK/ MAS)▫ Code Blue response

• Educational Responsibilities▫ Critical Care Pharmacotherapeutics (UB)▫ PGY1 Residents▫ Students (Multiple schools)▫ Pharmacist competencies▫ Nursing Grand Rounds

• Research Responsibilities▫ Process evaluation / MUE▫ Therapeutic intervention evaluation

Resources

•ASHP:▫ http://www.ashp.org/Import/

ACCREDITATION/ResidencyAccreditation/RegulationsStandards.aspx

•Accredited programs•Consultants

http://www.ashp.org/Import/ACCREDITATION/ResidencyAccreditation/RegulationsStandards.aspx

Recruiting

•Residency Showcase•Pre-accreditation

▫Recruit from local programs/ graduates▫Guarantee spot to qualified candidates

prior to the match▫Contact unmatched candidates

•Matching Program ▫ASHP-accredited, provisionally-accredited,

and application-submitted residency programs only

Self-Assessment Questions

1. Which of the following are considered benefits of a PGY-2 Residency program?

a. Increase PGY-1 program recruitmentb. Increase project development and

implementationc. Expand professional staff developmentd. Improve clinical pharmacy servicese. All of the above

2. Important resources to consult when considering development of

a PGY-2 program include all of the following except:

a. ASHP Websiteb. Established PGY-2 program directorsc. Paid Consultantsd. CMS websitee. None of the above

3. Which of the following is not currently an ASHP recognized PGY-2 residency program?

a. Neurologyb. Medication Safetyc. Pharmacotherapyd. Critical Caree. Infectious Disease

Answers to self assessment questions1. E2. D3. A