Located northeast of Los Angeles in Lancaster, California, Antelope Valley Hospital (AVH) is a healthcare district owned, 420 bed facility that serves the Antelope Valley and surrounding areas including parts of Kern County and Edwards Air Force base. The non-profit community hospital was founded in 1955 and provides general acute care services.
Antelope Valley Hospital is fully accredited by the Joint Commission and offers comprehensive health care services in the following areas:
Medical/Surgical Intensive Care Neurology/ Primary Stroke Center
Neonatal Intensive Care (Level 2) Emergency Medicine/Trauma Services (Level 2)
Labor and Delivery/Post-Partum Oncology
Mental Health Unit Home Health Services
General Medicine/Surgery Cardiology/Open Heart Surgery/STEMI I Receiving Ctr
The Pharmacy at AVH is fast-paced, highly functioning department that provides 24 hour care and a full range of clinical services including antimicrobial stewardship, anticoagulant and pharmacokinetic dosing and monitoring by protocol utilizing a decentralized staffing model. The Pharmacy Department also provides extensive pharmacy student clerkship rotations for students from all of the United States but mostly from California Schools of Pharmacy, such as USC, UOP, and Loma Linda.
DEFINITIONS AND SCOPE
Purpose of the ASHP Standard: the ASHP Accreditation Standard for Postgraduate Year One (PGY1) Pharmacy Residency Programs establishes criteria for training pharmacists to achieve professional competence in the delivery of patient-centered care and pharmacy services. A PGY1 pharmacy residency is a prerequisite for postgraduate year two (PGY2) pharmacy residencies.
ASHP PGY1 Program Purpose: PGY1 pharmacy residency programs build on Doctor of Pharmacy (Pharm.D.) education and outcomes to contribute to the development of clinical pharmacists responsible for medication-related care of patients with a wide range of conditions, eligible for board certification, and eligible for postgraduate year two (PGY2) pharmacy residency training.
AVH EDUCATION STANDARDS
The PGY1 Pharmacy Residency Program at Antelope Valley Hospital has been designed in accordance with the American Society of Health-System Pharmacists (ASHP) accreditation standards, and is routinely updated to include the most recent Summary of Changes as noted in the Guidance Document posted on the ASHP website.
PROGRAM GOALS AND OBJECTIVES:
Our residency concept is described in the introduction of the ASHP Accreditation Standard for Postgraduate Year One (PGY1) Pharmacy Residency Programs.
The pharmacy practice residency program at Antelope Valley Hospital is designed to develop self-directed community hospital practitioners prepared to assume an advanced practice as an active member of a comprehensive interdisciplinary healthcare team partnering to improve the health of the Antelope Valley. By the time pharmacy residents complete the program, they will be competent, confident and recognized by our community for their heartfelt, compassionate care and medical excellence.
The programs core rotations include the following areas:
Orientation & Practice Internal Medicine
Critical Care Emergency Medicine
Longitudinal Experiences in Drug Information and Education/Teaching, Clinical Research Project, and Staffing and Professional Development
Elective rotations include the following offerings*:
Infectious Disease Pediatrics/NICU
Advanced Infectious Disease** Ambulatory Care**
*Other elective rotations may be offered based on resident’s interest.
**Advanced Infectious Disease and Ambulatory Care will take place at another offsite facility 80 miles away
Educational goals are broad statements of the residency graduates’ abilities. The objectives required to achieve the goals that follow are listed on ASHP’s website “under “Postgraduate Year One Pharmacy Residencies - Competency Areas, Goals, and Objectives (CAGO) and Guidance” The objectives are observable, measurable statements describing what residents will be able to do as a result of participating in the residency program. Criteria are examples that are intended to help preceptors and residents identify specific areas of successful skill development or needed improvement in residents’ work.
Upon successful completion of the program, the resident will at a minimum have achieved for the residency (ACHR) the following:
Four competency areas (required)
Competency Area R1: Patient Care
In collaboration with the health care team, provide safe and effective patient care to a diverse range of patients, including those with multiple co-morbidities, high-risk medication regimens, and multiple medications following a consistent patient care process.
Ensure continuity of care during patient transitions between care settings.
Prepare, dispense, and manage medications to support safe and effective drug therapy for patients.
Competency Area R2: Advancing Practice and Improving Patient Care
Demonstrate ability to manage formulary and medication-use processes, as applicable to the organization.
Demonstrate ability to evaluate and investigate practice, review data, and assimilate scientific evidence to improve patient care and/or the medication use system.
Competency Area R3: Leadership and Management
Demonstrate leadership skills
Demonstrate management skills
Competency Area R4: Teaching, Education, and Dissemination of Knowledge
Provide effective medication and practice-related education to patients, caregivers, health care professionals, students, and the public (individuals and groups).
Effectively employ appropriate preceptors’ roles when engaged in teaching (e.g. students, pharmacy technicians, or other health care professionals).
Objectives have been selected to assure the above outcomes and goals are achieved through structured learning experiences. Flexibility has been designed into the program to permit individualization of the program to meet the personal interests and goals of the resident while directing attention to areas identified for improvement.
Residency Advisory Committee (RAC)
The RAC governs the residency program. The Committee is comprised of preceptors and select members of the Pharmacy Leadership Group. The Committee is chaired by the Residency Program Director (RPD) and meets routinely to review and discuss the progress of the residents. Interactive feedback within the committee is utilized to direct the resident’s current and upcoming residency activities and to provide mentoring and guidance in the resident’s pharmacy practice. The group will recommend modifications to the resident’s schedule as necessary.
PGY1 Pharmacy Resident Advisor (Preceptor)
Mentoring and advising are key elements of the PGY1 Pharmacy Residency Program. Following the orientation period, each resident will select an individual from among the Residency preceptors as their personal Resident Advisor. This selection should take into account shared career goals, work ethic, general attitude and disposition. It should also be the person that should be considered the mentor of their research project. The advisor to resident ratio cannot exceed 1:1. The Resident Advisor will collaborate with the RPD to complete the resident’s quarterly assessments which are reviewed and updated at the RAC meeting, then shared electronically via PharmAcademic.. If circumstances arise during the residency year that warrant reevaluation of the Resident Advisor selection, discussion with and approval from the RPD will be required before any changes are made.
The Resident Advisor will act as a personal contact in all matters related to the successful completion of the PGY1 pharmacy residency program and will supplement and augment the activities of the RPD.
The Resident Advisor will collaborate with the resident to develop their residency plan and monitor the plan’s progress. The resident advisor will determine the degree of contact and involvement necessary to meet these objectives (generally meeting at least monthly). Key areas that will be focused on include: advice on projects (initiation, completion, deadlines, etc.), elective rotation selection, time management, professional interpersonal relationships and conflict, licensing, career opportunities after residency and any residency-related or other issues that may arise.
The goal in providing a residency advisor is to give the resident a specific contact, of their choosing, with whom they will be comfortable discussing any matters related to the successful completion of the residency. Residents are involved in many different projects, in many different aspects of hospital operations, interacting with many different individuals. The pharmacy practice resident may become overwhelmed at some time during the program and may benefit from discussions, direction and counsel from their selected contact person. The Resident Advisor may also act as an impartial third party should issues or conflict arise between the resident and the director/managers of the pharmacy department or residency program.
PGY1 Pharmacy Resident Advisor - As related to preceptor of the research:
All research proposals will include designation of a qualified research preceptor for each project. The selected research preceptor for each resident will assist the resident who is the primary investigator in the research process. The research preceptor responsibilities include:
Assist the resident in defining a project that will be completed within the residency allotted time.
Assist the resident in developing the research protocol including study hypothesis, study design, methodology, and analysis.
Coordinate research resources for statistician review and advice in the protocol design, analysis, and power determination if necessary.
Assist the resident in obtaining any approvals (i.e. IRB)
Ensure that the resident maintains progress on the project according to the research timetable.
Helps the resident on data collection, data analysis, and summary of results.
Assist the resident in preparation of their presentation at Western States Conference.
Ensure that the resident’s research project is written in manuscript form suitable for publication as required by the residency requirements.
Residency Program Director
The Residency Program Director (RPD) is appointed by the Director of Pharmacy Services to be the organizationally authorized leader of the residency program; however the Director of Pharmacy has ultimate responsibility for the program. The Residency Program Director has demonstrated sustained contribution and commitment to pharmacy practice, maintained high professional ideals, has distinguished herself or himself in practice, and has the desire and aptitude to teach. In addition to holding and advanced pharmacy credential, the Residency Program Director will also have at least 5 years of clinical pharmacy practice experience if without an ASHP-accredited residency; or have completed an ASHP-accredited PGY1 residency followed by a minimum of three years of pharmacy practice experience; or have completed an ASHP-accredited PGY1 and PGY2 residency with one or more years of pharmacy practice experience. The RPD maintains compliance with the provisions of the current version of the ASHP Regulations on Accreditation of Pharmacy Residencies throughout the accreditation cycle.
The RPD serves as a role model for pharmacy practice, as evidenced by:
Leadership within the pharmacy department or within the organization, through a documented record of improvements in and contributions to pharmacy practice;
Demonstrating ongoing professionalism and contribution to the profession;
Representing pharmacy on appropriate drug policy and other committees of the pharmacy department or within the organization; and
The RPD serves as the organizationally authorized leader of the residency program and has responsibility for:
Organization and leadership of a RAC that provides guidance for residency program conduct and related issues;
Oversight of the progression of residents within the program and documentation of completed requirements;
Implementing use of criteria for appointment and reappointment of preceptors;
Evaluation, skills assessment, and development of preceptors in the program;
Creating and implementing a preceptor development plan for the residency program;
Continuous residency program improvement in conjunction with the RAC; and,
Working with pharmacy administration
Appointment or Selection of Residency Program Preceptors:
The organization allows the residency program director to appoint and develop pharmacy staff to become preceptors for the program.
The RPD develops and applies criteria for preceptors consistent with those required by the accreditation standard.
In the absence of the RPD, the Residency Coordinator may be utilized to assist the Program in carrying on regularly scheduled RAC meetings. The Coordinator also assists in the residency interview process by coordinating or working alongside the RPD in assigning application packet review to the preceptors as well as other interview needs.
Director of Pharmacy
The Director of Pharmacy has ultimate responsibility for the residency program and has appointed the Residency Program Director who provides the coordination and oversight for the residency program.
Residents are adequately oriented to the residency and Pharmacy Services.
Neither the educational outcomes of the program nor the welfare of the resident or the welfare of the patients are compromised by excessive reliance on residents to fulfill service obligations.
The program is compliant with ASHP Pharmacy Specific Duty Hours posted on the ASHP website under Accreditation Standards for PGY1 Pharmacy Residencies.
Overall program goals and specific learning objectives are met.
Training schedules are maintained.
Resident evaluations based on the pre-established learning objectives are routinely conducted.
The residency program meets all standards set by the ASHP.
Communication with residents is maintained throughout the program to ensure an optimal experience and to resolve any problems or difficulties.
All resident requirements are completed prior to recommendation for certification.
Selection of residency preceptors based on ASHP Standard 4.5: Appointment or Selection of Residency Preceptors.
Evaluation of potential preceptors and re-evaluation of current preceptors based on ASHP Accreditation Standard for PGY1 Pharmacy Practice Residency Programs established in Standard 4 based on completed Preceptor Academic and Professional Record.
Pharmacist Preceptors’ Eligibility for PGY1 program Pharmacist preceptors must be licensed pharmacists who:
Have completed as ASHP-accredited PGY1 residency followed by a minimum of one year of pharmacy practice experience; or
Have completed an ASHP-accredited PGY1 residency followed by an ASHP-accredited PGY2
Without completion of an ASHP-accredited residency, have three or more years of pharmacy practice experience.
Preceptor’s Qualifications: Preceptors must demonstrate the ability to precept residents’ learning experiences as described in sections 4.8a-f, at least one of the examples is demonstrated within the last five years unless otherwise noted.
Demonstrating the ability to precept residents’ learning experiences by use of clinical teaching roles (i.e., instructing, modeling, coaching, facilitating) at the level required by residents:
The ability to assess resident’s performance;
Recognition in the area of pharmacy practice for which they serve as preceptors;
An established, active practice in the area for which they serve as preceptor;
Maintenance of continuity of practice during the time of residents’ learning experiences; and,
Ongoing professionalism, including a personal commitment to advancing the profession.
Preceptor desire and aptitude for teaching
Evaluate the current preceptor at least annually.
Desire will be determined based on subjective information (i.e., Conversations with the preceptors and information from current or past residents, as well as observation when opportunities present).
Aptitude is based on preceptor’s current status and ability to practice within the hospital (i.e., active license, clinical privileges, etc.), along with participation in preceptor development.
Adequate preceptor development programs are provided to and completed by the residency preceptors.
RPD acts as chair of the RAC which meets regularly.
The residency program provides qualified preceptors to ensure appropriate training, supervision, and guidance to all residents to fulfill the requirements of the accreditation standard.
Each rotational experience is directed by a pharmacy preceptor who serves as a role model for learning experiences. They must:
Contribute to the success of residents and the program
Completing evaluations on the last day of a rotation optimally, and not later than 7 days, discussing it with the resident as noted in the learning experience description.
Completing Preceptor Development requirements (those offered or additional ones sought to meet requirement).
Provide learning experiences in accordance with Standard 3.3. Learning experiences:
3.c(1) Learning experience descriptions must be documented and include:
3.c(1)(a) a general description, including the practice area and the roles of pharmacists in the practice area;
3.c(1)(b) expectations of residents
3.c(1)(c) educational goals and objectives assigned to the learning experience
3.c.(1)(d) for each objective, a list of learning activities that will facilitate its achievement;and
3.c(1)(e) a description of evaluations that must be completed by preceptors and residents
3.c(2) Preceptors must orient residents to their learning experiences using the learning experience description.
3.c(3) During learning experiences, preceptors will use the four preceptor roles as needed based on residents’ needs.
3.c(4) Residents must progress over the course of the residency to be more efficient, effective, and able to work independently in providing direct patient care.
Participate actively in the residency program’s continuous quality improvement processes.
Demonstrate practice expertise, preceptor skills, and strive to continuously improve.
Adhere to residency program and department policies pertaining to residents and services.
Demonstrate commitment to advancing the residency program and pharmacy services.
Pharmacists new to precepting or who do not meet the qualifications for residency preceptors:
Are assigned an advisor or coach who is a qualified preceptor; and,
Have a documented preceptor development plan to meet the qualifications for becoming a residency preceptor within two years.
When non-pharmacists (e.g. physicians, physician assistants, certified nurse practitioners) are utilized as preceptors:
The learning experience is scheduled after the RPD and preceptors agree that residents are ready for independent practice; and
A pharmacist preceptor works closely with the non-pharmacist preceptor to select the educational goals and objectives for the learning experience.
Evaluation and Feedback
The residents’ progression toward achievement of the program’s required educational goals and objectives is evaluated via both an initial assessment, then through formative (on-going, regular) assessment. This helps to guide not only the resident, but to reveal to the preceptor their effectiveness of training. Verbal and written feedback is essential for skill development, and the frequency of it is dependent upon progress and time of year. It may be written, such as comments on SOAP notes or on evaluations of presentations, projects, etc. If progress is not meeting expectations, more frequent feedback should be given. Oral formative feedback is required; and documentation may be necessary if progress is not sufficient. Specific recommendations for improvement and achievement of objectives are documented if not progressing satisfactorily; while preceptors ensure activities and responsibilities align with the progress in the experience. All evaluations are based upon the Residency Program Goals and Objectives. Written evaluations are managed via the ASHP Resident Tracking System (PharmAcademic).
Informal, Verbal Feedback
Resident and rotation preceptor are to meet at a frequency determined by the preceptor based on resident experience, timing of rotation in the residency year and support needs of the resident, to review and discuss patients and issues.
Residents and Program Director meet at least monthly to discuss and review overall program success.
Mid-rotation Evaluation Up to the preceptor’s discretion to complete a midpoint evaluation. Written or verbal communication can be utilized.
Summative Evaluation (as described below)
Resident Self-Evaluation (as assigned, at least three times per year)
The resident completes a formal, written self-evaluation using the summative self-evaluation form and reviews this with the rotation preceptor. All evaluations are reviewed by the Program Director and highlights shared with the RAC.
Formal, written Preceptor Evaluations are completed at the conclusion of each rotation, shared with the preceptor at the end-of-rotation evaluation session and reviewed by the Program Director. For longitudinal experiences, evaluations are completed quarterly.
Learning Experience Evaluation
Formal, written Learning Experience Evaluations are completed at the conclusion of each rotation, shared with the preceptor at the end-of–rotation evaluation session and reviewed by the Program Director. For longitudinal experiences, evaluations are completed quarterly.
Routine Progress Report
The resident’s progress on goals and objectives as well as their program plan are discussed routinely at RAC meetings. The summative evaluations and criteria based checklists will provide the basis for the progress report.
At the beginning of the residency, the RPD in conjunction with preceptors, assess each resident’s entering knowledge and skills related to the educational goals and objectives.
The results of the residents’ initial assessments is documented by the program director or designee in each resident’s development plan by the end of the orientation period and taken into consideration when determining residents’ learning experiences, learning activities, evaluations, and other changes to the program’s overall plan.
Formative (on-going, regular) assessment
Preceptors provide on-going feedback to residents about how they are progressing and how they can improve that is frequent, immediate, specific, and constructive.
Preceptors make appropriate adjustments to residents’ learning activities in response to information obtained through day-to-day informal observations, interactions, and assessments.
At the end of each learning experience, residents receive, and discuss with preceptors, verbal and written assessment on the extent of their progress toward achievement of assigned educational goals and objectives, with reference to specific criteria
Evaluation ratings are defined (see table)
Comments are qualitative: specific and actionable, related to objectives, recognize skill development, focus on how to improve performance, and are completed by the end of the rotation or within 7 days.
Summative evaluation is completed at least every three months if experience is 12 weeks or more in length.
If more than one preceptor is assigned to a learning experience, all preceptors must provide input into residents’ evaluations.
One preceptor should be identified as the primary preceptor.
Preceptors will provide input to the primary preceptor who will document the joint evaluation.
The primary preceptor will seek consensus of preceptors to determine final ratings and co-sign evaluations.
Co-preceptors are encouraged to provide documentation in written evaluations.
For preceptors-in-training, evaluations will be routed to the advisor assigned in PharmAcademic for review, feedback as necessary , and approval prior to signatures.
Residents must complete and discuss at least one evaluation of each preceptor at the end of the learning experience.
Residents must complete and discuss an evaluation of each learning experience at the end of the learning experience.
The preceptor for the resident’s upcoming experience may be invited to the evaluation session to identify areas of focus for the upcoming experience if desired.
Evaluations are reviewed by the RPD and highlights are shared with the RAC when deemed appropriate and as they pertain to the creation of future development plans.
Table 1: Performance Indicators for Learning Experience Evaluation
Needs Improvement (NI)
§ Deficient in knowledge/skills in this area
§ Requires assistance to complete the goal/objective in >30% of instances
§ Unable to ask appropriate questions to supplement learning
Satisfactory Progress (SP)
§ Adequate knowledge/skills in this area
§ Requires assistance to complete the goal/objective in 10-30% of instances
§ Able to ask appropriate questions to supplement learning
§ Requires skill development over more than one rotation
§ Fully accomplished the ability to perform the goal/objective
§ Requires assistance to complete the goal/objective in <10% of instances; minimum supervision required
§ No further developmental work needed
Achieved for Rotation
§ A goal may be achieved for a given rotation if ≥85% of its objectives are “Achieved”
Achieved for Residency (ACHR)
§ A goal may be achieved for the residency if ≥85% of its objectives are “Achieved” over the course of the year
The development plan is used to modify the design and conduct of the program to address unique learning needs and interests. It also acts a tool for monitoring, tracking, and communicating about overall progress and adjustments made to meet learning needs. With resident input and RAC participation (specifically including the resident’s advisor), meetings are held at least quarterly to discuss overall resident progress and agree on development plan adjustments needed, which are reflected in the quarterly updates to the plan.
Each resident must have a resident development plan documented by the RPD or designee.Initial assessment by the resident, RPD and/or designee and/or preceptor(s).
Initial assessment by the resident, RPD and/or designee and/or preceptor(s).
Completion of initial assessment is to be done before, or more ideally during the beginning of the residency, with analysis during the orientation.
May use AVH assessment methods such as self-assessment checklists, case discussions, other checklists, interviews, observation, or other methods and tools including those in PharmAcademic.
Short- and long-term career goals (optional)
Incoming strengths (required)
Knowledge, skills, and abilities related to the goals and objectives
Personal strengths related to being a professional
Incoming areas for improvement (required)
Professional areas in terms of knowledge, skills and abilities related to goals and objectives
Personal areas related to being a professional.
Incoming learning interests related to required or elective learning opportunities (optional)
An initial development plan is created for the resident (by the end of the orientation period, generally within the first 30 days of the residency by the RPD (and/or designee), discussed with the resident, and may be reviewed by the RAC to determine the resident’s learning experiences, learning activities, evaluations and other changes to the program overall. If the RAC suggests changes or additions they are incorporated and the document is updated. Adjustments to the initial plan include the following as appropriate, and summaries of initial plans are shared with preceptors:
Modification of residents’ schedules
Preliminary determination of elective learning experiences
Educational goals and objectives to be emphasized in required and elective learning experiences
Addition of goals and objectives to required or elective learning experiences
Changing and/or increasing summative self-evaluations, formative self-evaluations, and preceptors’ feedback related to areas of improvement
Modification of preceptors’ use of modeling, coaching, and facilitation
1st, 2nd, 3rd quarter updates
Completed, discussed with resident, and documented approximately every 90 days from the start of the residency (e.g. October, January, and April).
Adjustments are made based upon review of the performance relevant to the previous quarter’s plan with input from preceptor(s) and residents; the identification of new strengths or areas for improvement and, optionally, changes in short- or long-term career goals and interests.
Quarterly review of the residents’ progress in achieving the competencies, goals, and objectives of the program and the resident professional development plans.
A system (PharmAcademic use along with RAC/RPD/Advisor and resident input/review/discussion) is used to track goals and objectives achieved, areas for improvement, and expected progress relative to the time of year.
A system (PharmAcademic use along with RAC/RPD/Advisor and resident input/review/discussion) is used to track adjustments to and the effectiveness of adjustments documented in development plans.
On a quarterly basis, the RPD or designee must assess resident’s progress and determine if the development plan needs to be adjusted.
The development plan and any adjustments must be documented and shared with all preceptors. It is shared initially with the RAC before it is finalized and shared with them via PharmAcademic.
Continuous Residency Program Improvement
A process for quality improvement of the program includes RAC meeting discussion during the bi-weekly meetings to not only assess program strengths, opportunities and strategies to improve the residency program at the end of the year, but throughout as change allows (content of residency program must be maintained throughout the year and any significant changes must occur at a time to make them known prior to the interview for the following residency year, and to be incorporated into policy for that next year). Retreats or on/off-site meetings may be a part of the process, as well as focused meetings, meetings including residents whereby their feedback is incorporated (including, but not limited to the exit-interview), and survey instruments (both with staff and current residents as needed). Instruments employed may be for preceptor self-assessment, resident evaluations of the RPD, as well as those for prospective residents post-match regarding the survey process (Survey Monkey).
Annual Program Evaluation
The RPD, RAC, and Director of Pharmacy must engage in an on-going assessment of the residency program including a formal annual program evaluation.
The RPD or designee must develop and implement program improvement activities to response to the results of the assessment of the residency program.
The residency program’s continuous quality improvement process must evaluate whether residents fulfill the purpose of a PGY1 pharmacy residency program through graduate tracking
Information tracked in PharmAcademic must include initial employment and environment if known, and may include changes in employment, board certification, surveys of past graduates, or other applicable information.
COMPENSATION AND BENEFITS:
Compensation for the 12-month residency is $50,000. Benefits include medical, dental, and vision coverage as well as paid vacation time. Personal days, sick days, extended illness, and leaves of absence are covered in the agreement/contract and policy. Residents also receive travel and registration reimbursement for residency related conferences such as the ASHP Midyear Clinical Meeting and Western States. Moonlighting is regulated and monitored. Details are in the contract agreement and policy.
THE EDUCATIONAL PROGRAM
Successful candidates are asked to complete the on-line Residency Entering Interests form and Entering Objective-Based Self-Evaluation that are in PharmAcademic in the Resident Portfolio under Education and in the Evaluations section. It may be best to complete during the first 30 days on-site once the resident has a feel for their abilities and interests at the hospital. This will serve to aid residents in identifying their areas of strength, weakness, and interest. These forms are also utilized in developing the residents’ training schedule and the residency plan for each resident.
Prior to the start of the residency, the Resident will be asked to familiarize oneself with the systems-based evaluation software (PharmAcademic). Residents will be directed to the ASHP and PharmAcademic web sites to access the material. The RPD will assess the progress of the resident’s knowledge of PharmAcademic during the orientation period.
Required and Elective Learning Experiences:
Structured learning experiences spread throughout a 12 month period are utilized to facilitate the achievement of the program outcomes. Within each structured experience, learning activities have been developed which allow the resident to meet the program’s goals and objectives. There are 8 mandatory learning experiences (5 rotation blocks and 3 longitudinal) and 3 elective learning experiences. The program is flexible to meet individual needs of residents. Residents are encouraged to develop areas of interest and become involved in all pharmacy activities. The program’s structure permits residents to gain experience and sufficient practice with diverse patient populations, a variety of disease states, and a range of patient problems, ensuring diversity, variety, and complexity.
Prior to each learning experience, the resident will discuss their goals with the preceptor so as to provide an opportunity for the preceptor to evaluate and, if possible, design specific activities to meet the resident’s goals. Activities and expectations to achieve the goals and objectives identified for each learning experience have been developed by each preceptor and are shared with the resident at the beginning of each experience.
Mandatory rotational learning experiences with minimum lengths:
Orientation to Hospital Practice (3 weeks)
Administration (6 weeks)
Internal Medicine (6 weeks)
Critical Care (6 weeks)
Emergency Medicine (6 weeks)
Elective rotational learning experiences, incorporated according to resident interest and preceptor availability. These may include, but are not limited to:
Ambulatory Care (4-6 weeks)
Geriatrics (4-6 weeks)
Infectious Disease (4-6 weeks)
Infectious Disease Advanced (4-6 weeks)
Pediatrics/NICU (4-6 weeks)
Trauma (4-6 weeks)
Longitudinal learning experiences:
Clinical Research Project
Drug Information and Education/Teaching
Staffing & Professional Development
Residents develop, with guidance from the Residency Director and their advisor, an annual schedule. The schedule includes all required and elective experiences, research projects, staffing requirements, travel, miscellaneous assignments, meetings, and time off.
Participation in Recruitment Efforts
Each resident will assist the department in recruiting new residents to the program. Because each resident is a valuable source of information and advice for the prospective candidates, time will be scheduled during the interview process for interviewees to interact with current residents. Each resident is also required to spend time providing information to potential candidates during the ASHP Midyear Clinical Meeting and at Residency Showcases as appropriate.
Residents who are not performing satisfactorily based on standards and evaluation procedures must be immediately notified, and a written “memo of expectation” describing the deficiencies must be developed and presented in person. Examples of corrective actions include special assignments, direct supervision, or repeating rotation(s) with understanding that this may have an impact on the length of the residency. The Preceptor in conjunction with the Resident Advisor, RPD, and Director of Pharmacy have the authority to initiate corrective actions, and develop and monitor the plan. The plan of action should be specific and include measurable objectives.
Dismissal and/or Voluntary Withdrawal:
Dismissal may be considered for residents who have been unsuccessful in correcting deficiencies. Examples of other actions that may progress toward dismissal which may or may not allow for remediation depending on the severity of the action or the risk to the patient, and in accordance with hospital policy are as follows:
Behavioral misconduct or unethical behavior that may occur on or off hospital premises
More than one unsatisfactory performance evaluation on learning experiences
Theft of hospital property
Mental impairment caused by mental disorder or substance abuse
Violation of AVH policies
Poor performance despite a corrective action plan
Failure to obtain license as per the agreement
A recommendation for dismissal may be made by the Program Director, and requires the support of the RAC.
Prior to dismissing a resident, the RPD must verify that the resident was notified in writing of his or her performance problems, was given the opportunity to remediate his or her deficiencies for those circumstances where remediation is allowable, and was provided feedback on his or her efforts.
ACKNOWLEDGMENT OF MATCH:
Residents matched to Antelope Valley Hospital will receive an acceptance letter within 30 days from the match results that is to be signed and returned acknowledging the Match. Additionally, they will receive the contract agreement with the general terms and conditions of the residency, including the residency policy with a summative list (included in this attachment) of criteria for successful completion of the PGY1 residency at Antelope Valley Hospital, as well as Human Resources policies. Acknowledgement by the resident will constitute acceptance of the match and the agreement to fulfill the duties of the residency position for the upcoming year.
HOW TO APPLY:
Deadline to apply is January 5, 2019
All applicants must be registered for the ASHP Resident Matching Program
Only applications submitted online through PhORCAS will be accepted. Application materials must include a letter of intent stating the reasons for seeking a residency at AVH, a current CV, official college transcripts from your college of pharmacy and three letters of recommendation all submitted electronically via PhORCAS
Requirements and Selection of Residents
The Residency Program Director (RPD) and the Preceptor Panel (RAC) will assess the completeness of the application materials prior to scheduling candidate interviews.
The RPD and Preceptor Panel that participate in the pre-interview process will first complete an initial evaluation score using predetermined criteria and scoring for consideration of interviews. Subsequently, a residency candidate interview assessment, final score, and ranking will be compiled also using predetermined scoring tools and criteria, and the ranking for the ASHP Residency Matching Program will be submitted.
Interviews will be scheduled during January and/or February.
This residency site agrees that no person at this site will solicit, accept, or use any ranking-related information from any residency applicant.
FOR QUESTIONS, PLEASE CONTACT:
Jill Bennett, PharmD, BCPS, APh — Pharmacy Residency Program Director
Criteria for Successful Completion –PGY1 Residency at Antelope Valley Hospital:
Qualify for participation in the Antelope Valley Hospital (AVH) PGY1 Pharmacy Residency Program in accordance with criteria set forth by ASHP.
Residents shall participate in and obey the rules of the Residency Matching Program
Currently be in or have graduated from an Accreditation Council for Pharmacy Education (ACPE)-accredited Doctor of Pharmacy program at the time of application. Residents must have graduated prior to the start of the residency program in July, and have provided an official transcript to AVH.
Resident must meet hospital eligibility requirements for employment, including negative drug testing results, and no criminal record, as in hospital employment requirements.
Resident must start the program with a California pharmacist intern license or active pharmacist licensure.
Eligible for pharmacist licensure in California, with the requirement of passing the California Board Examination for Pharmacists and receiving a license to practice Pharmacy either prior to or within 90 days of the start of the residency, by October 1, of the entering residency year. Failure to meet this deadline shall not be grounds for immediate termination from the program if the delay in licensure is not caused by Resident. The expectation of the ASHP Commission on Credentialing is that the resident should be licensed for at least 2/3 of the residency year or at least 8 months. Residency licensure, therefore, could be no later than the end of October if the residency year begins July 1st, with an understanding that any scheduled staffing shifts missed in October, due to lack of licensure, would need to be accounted for by the end of the residency year. Delays in this time period will be addressed on an individual basis to determine if the delay is beyond the resident’s control and to determine how the resident’s plan will be modified (e.g. dismissal, extension, suspension, or restart when licensed, etc.).
Completion of 12 months (2000 hours) in the program.
In-services – Prepare and conduct a minimum of four as educational opportunities (allow for varied audiences)
Formal Presentations – two
Case Based Presentation
One Medication Safety Newsletter
Community Outreach Activity – one of your choosing
Medication Safety Assessment
ISMP Quarterly Action Agenda assessment and presentation at Medication Error Reduction Program (MERP) meeting
Active participation in the MERP meetings, to better understand the Quality Improvement process and how it impacts pharmacy department functions and patient care at AVH.
Policy creation or revision – one
Journal Clubs – Goal to improve residents’ critical research literature evaluation, biomedical statistics, communication, and presentation skills.
Evaluate, present and lead discussion of published article on at least two occasions
Teaching/Precepting – Each resident is expected to participate in educating students and staff. The goal of this requirement is to improve the resident’s communication skills, literature evaluation and presentation techniques. Each resident is required to perform:
Resident led education topic to students – one as assigned during each APPE medicine block.
Supervision of student topic discussions as assigned and availability permits during each APPE block.
Opportunities will be offered to participate in and conduct staff education internal and external to the department.
Residents will assist and support preceptors to pharmacy students completing their APPE clinical rotations at AVH.
Residents will attend conferences (internal and external) whenever the schedule permits.
Completion of all requirements associated with learning experiences as defined and in accordance with ASHP Accreditation Standard 3.3.c.
Completion of all requirements associated with longitudinal learning experiences
Staffing component of one weekend per month – Shifts will be varied in time and service area. This will allow for development of distribution skills, operations, and comprehension and incorporation of policies and procedures as well as clinical consultation opportunities to provide safe and effective pharmaceutical care. Fifteen medication histories completed on admission will be required each month.
Clinical Research Project
Topic and advisor selection by the resident by July 31st of the residency year. Topics reviewed and approved by the RAC. Residents are provided a list of project ideas during the orientation period, but may propose original project ideas as well. Organizational and Departmental mission, values and strategic plans are taken into account when selecting projects. The project generally includes the following steps:
Presentation of project to the Advisor and RAC including background, hypothesis, methodology and timetable
Full project development
IRB submission and approval, if necessary (contact is Western IRB)
Oral presentation to staff
Oral presentation to San Gabriel Valley California Society of Health-System Pharmacists (CSHP) Chapter as they permit prior to Western States
Completed project presented at Western States
Written manuscript in publishable format
Submission of manuscript to a medical or pharmacy journal for publication
Formal Drug Information Responses – two per month
Medication Utilization Evaluation (MUE) – (if all affiliated work not completed in assigned rotation)
Completed MUE with recommendations and conclusions presented to P&T Committee
Drug Formulary Review/Class Review – (if all affiliated work not completed in assigned rotation)
Prepared and presented with recommendations to P&T Committee for consideration.
Completion of all assigned evaluations
Meet Performance Indicators in Learning Experiences as defined in Table 1:
All requirements of the program must be satisfied within the residency year. Residents will receive a certificate of completion upon fulfillment of the 12 month commitment with submission of all materials noted. The RAC will determine when the resident has met all requirements for successful completion, in accordance with the provisions of the ASHP Regulations on Accreditation of Pharmacy Residencies, and include the ASHP accredited residency logo on the document, along with signatures of the RPD and the CEO
About Antelope Valley Hospital PGY1 Pharmacy Practice Residency Program
Antelope Valley Hospital, a 420-bed district hospital located in the city of Lancaster in northern Los Angeles County, has been serving the community for more than 60 years. The area’s only full-service acute-care hospital, AVH provides a full array of medical/surgical services, pediatric treatment, NICU, mental health, cancer care and more. It is a Level II trauma center, Accredited Chest Pain Center, Advanced Primary Stroke Center and Comprehensive Community Cancer Center.
As the local healthcare leader, Antelope Valley Hospital:
• Provides care to more than 218,000 patients each year.
• Receives over 130,000 Emergency Department visits annually.
• Is the only Level II Trauma Center within 50 miles.
• Has 450 physicians on staff, representing 66 different specialties.
• Serves as a major economic engine in the community with a workforce of 2,800 employees.
• Relies on the time and talent of more than 550 volunteers.
• Delivers more than 5,200 babies a year.
• Offers the area’s only Pediatrics Unit and Neonatal Intensive Care Unit (NICU).
• Its Institute for Heart & Vascular Care, offers advanced cardiovascular care in one location.
• Is a...n Accredited Chest Pain Center, Advanced Primary Stroke Center and STEMI Receiving Center with the expertise and equipment required to treat severe strokes and heart attacks.
• Is recognized as a National Comprehensive Community Cancer Center providing cancer care in conjunction with its community partners.
The pharmacy at AVH is a fast paced, highly functioning department that provides 24 hour care and a full range of clinical services as well as state of the art dispensing technology.
AVH’s PGY1 Pharmacy Residency Program gives motivated, self directed individuals the opportunity to gain the necessary skills to become a clinical pharmacist in a supportive, real world environment. In compliance with accreditation standards set by the American Society of Health System Pharmacists, the pharmacy residency program allows participants to expand their clinical knowledge and gain practical experience in diverse, multi disciplinary settings. The program consists of a one year postgraduate intensive training experience primarily in the area of acute pharmacotherapy.
Residents are given the opportunity to develop and apply their didactic pharmaceutical knowledge in areas of adult and pediatric acute care, practice management, drug use management, communication and education. The program includes core rotations in orientation and practice, administration, critical care, emergency medicine, and internal medicine as well as longitudinal experiences in drug information and education/teaching, clinical research projects, staffing and professional development. The available elective rotations are geriatrics, infectious disease, advanced infectious disease, trauma, pediatrics/NICU and ambulatory care.
Upon completion of the residency, the resident should be able to:
• Manage and improve the medication-use process.
• Provide evidence-based, patient-centered medication therapy management.
• Ensure continuity in transitions of care.
• Exercise leadership and practice management skills.
• Demonstrate project management skills.
• Provide medication and practice-related education/training to varied audiences.
• Conduct pharmacy practice research.
• Participate in the management of medical emergencies.
• Manage formulary and medication-use process decisions.
For more information about AVH’s PGY1 Pharmacy Residency Program, contact Jill Bennett, Pharm.D, BCPS, APh at email@example.com or 661 726 6020