Program Description and Requirements Providence Alaska Medical Center (PAMC) in Anchorage consists of 401 acute care beds and is part of the integrated Providence St. Joseph Health system across seven states. The Alaska region includes Providence Kodiak, Valdez and Seward Medical Centers; Providence Extended Care and Transitional Care Centers; Family Practice, General Medical and Senior Clinics; assisted living and drug abuse rehabilitation facilities and Outpatient Infusion Center. The health system supports a Family Practice Physician Residency program and provides training sites for the University of Alaska at Anchorage Nursing and UAA/Idaho State University pharmacy programs. Major service lines include Medicine, Oncology, Surgery, Emergency, Rehab/Neuro, Cardiovascular/Critical Care, Behavioral Health and the Children’s Hospital. Pharmacy services are supported by an electronic medical record with physician order entry and bedside barcoding. Formulary, clinical and operational systems and services are integrated with the other Providence Saint Joseph Health ministries.
PAMC Pharmaceutical Care Services Department The Pharmaceutical Care Services Department employs over 70 FTEs of pharmacists, technicians and support personnel with 24 hour per day services including:
•Centralized unit dose distribution, order verification and IV Admixture service •Decentralized Clinical Services including an Antimicrobial Stewardship Program •ICU Satellite pharmacy and order verification •Emergency Department •Outpatient IV Infusion and Cancer Therapy Center
The department is committed to providing and expanding the pharmacy’s role in the delivery of quality pharmaceutical care. This includes:
Routine Focused Medication Use Review – Routine order screening and medication use trouble shooting, patient profile review, dosing and monitoring of aminoglycosides, warfarin, digoxin, anticonvulsants, pain medications, parenteral nutrition, drugs in renal impairment, and other target drugs; antibiotic use review, adverse drug reaction monitoring, therapeutic exchange program, medication reconciliation, transition of care services. All vancomycin dosing is done by pharmacists
Interdisciplinary Rounds – Family Practice, Hospitalist, Critical Care, Coronary Care, Pediatrics, Pediatric Intensive Care, Neonatal Intensive Care, Oncology, Tumor Board
Medication Use Quality Improvement Activities– Medication Use Guidelines and Policy Development, Drug Use Evaluation and Benchmarking, Newsletters, Core Measure and National Patient Safety Goal Initiatives, Providence Saint Joseph Health Quality Initiatives
Drug Formulary Management – Providence Saint Joseph Health Pharmacy and Therapeutics Committee class reviews and monograph development
Investigational Drug Program in Oncology
Staff Education – Staff Meetings, Weekly Clinical Meetings, Invited Speakers, Nursing In-services, Competency Program Teaching – Pharmacists, Pharmacy Interns, Medical Residents, Nurses, Public and Pharmacy Association Presentations
Residency Program Mission The PGY1 Pharmacy Residency Program builds on the Doctor of Pharmacy (PharmD) 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 post graduate year two (PGY2) pharmacy residency training.
Program Goals and Objectives The Providence Alaska Medical Center Residency Goals are as follows: •Serve as an authoritative resource on the optimal use of medications used to treat a wide variety of medical conditions. •Optimize the outcomes by providing evidence-based, patient-centered medication therapy as an integral part of an interdisciplinary team. •Manage and improve the medication-use process •Demonstrate excellence in the training and education of health care professionals •Sustain ongoing personal development of expertise and professionalism in pharmacy practice •Conduct practice assessments and investigations •Work independently in various areas of pharmacy services •Demonstrate competency in medication order review and central pharmacy operations •Supervise and coordinate pharmacy technical staff
The resident will demonstrate competencies in four core areas: •Patient Care •Advancing Practice and Improving Patient Care •Leadership and Management •Teaching, Education and Dissemination of Knowledge
Successful completion of the residency program involves meeting the required Residency Program Goals and Objectives as defined by ASHP for PGY1 residencies and identified at the beginning of the residency year. An assessment of the resident’s knowledge, skills, experiences and interests will be performed prior to the beginning of the residency. Preceptorships, elective rotations and activities will be individualized based on their skills and interests. Resident Evaluation Two-way verbal exchange regarding progress will occur regularly, at minimum weekly, during rotations. Formative evaluation will occur during experiences and summative at the end of each block learning experience or quarterly for longitudinal experiences. Residents will self-evaluate periodically throughout the residency and their self-evaluation skills will be assessed. Residents will evaluate preceptors and learning experiences formally at the end of each learning experience.
Project The resident is required to complete a major project during the 12-month program. The project shall be on some aspect of pharmacy practice. The project may involve: •Program Development •Evaluation of a Service •Interdisciplinary Medication Use •Quality Improvement •Original Clinical or Administrative Investigations •Another aspect of pharmacy practice approved by the residency program director
The project will be presented at the ASHP Clinical Midyear Meeting, UAA/ISU School of Pharmacy Grand Rounds and the North Western States Residency Conference and must be submitted in written manuscript form by the completion of the residency year.
Residency Learning Experiences Learning Experiences are subject to change from year to year depending on preceptor and resident suggestions, as well as department and organizational needs (services provided by Pharmacy). The following are learning experiences offered in the PAMC Residency. Descriptions of each experience and the corresponding preceptors are found at the end of this document.
Required Learning Experiences •Orientation •Internal Medicine/Surgery •Inpatient Family Practice •Progressive Care •Critical Care •Pediatrics •Infectious Disease
Longitudinal Learning Experiences •Practice Management •Medication and Practice Related Teaching •Operational and Clinical Staffing •Teaching Certificate
Elective Learning Experiences •Oncology •Neonatal Intensive Care •Pharmacy Operational or Clinical Management •Emergency Department •Electives may also include extension of required rotations
Residency Hours A minimum of 2000 hours (one year), are required for completion of the residency program. The expectation of the residency program is that residents will expend the time and effort necessary to effectively complete the program objectives. More than a 40-hour workweek is required to obtain the maximum benefits of the program and accomplish all goals. Preceptors are responsible for ensuring that the residents understand the time requirements for each learning experience. Resident positions are considered “exempt” (salaried) positions by PAMC and not paid per hour. Presentation of the resident’s certificate is contingent upon completion of all program objectives.
Staffing Responsibilities In order for the resident to adequately gain the understanding and confidence necessary to provide pharmaceutical care, it is necessary that the resident spend some time staffing. This consists of every other weekend in clinical or operational areas, 4 weeks of central pharmacy or critical care satellite, and the final week of the patient care learning experiences. A resident should be competent to staff independently in clinical areas by October 1 and in Central Pharmacy by October 31. Staffing responsibilities should not detract from the resident’s learning experience. Residents may be asked to staff a pharmacist shift during the last half of a specific learning experience when the pharmacist is unexpectedly absent, no more than five times during the residency year and two days in the same learning experience.
Licensure The resident must become licensed as a pharmacist in the state of Alaska by August 31 of the residency year and for a minimum of 2/3 of the residency one-year program. The Board requires 1500 intern hours for licensure. Questions regarding licensing should be directed to BoardofPharmacy@alaska.gov website https://www.commerce.alaska.gov/web/cbpl/ProfessionalLicensing/BoardofPharmacy.aspx or emailing email@example.com. Contact phone numbers are listed on the Alaska Board of Pharmacy home page: https://www.commerce.alaska.gov/web/cbpl/ProfessionalLicensing/BoardofPharmacy.aspx. An Alaska intern license is required by the first day of orientation (this means the process must be started early after receiving your acceptance letter) if you do not already have an AK pharmacist license by then. You may not start without it. Delays sometimes occur in the process for the intern license and the pharmacist license, so start ASAP! The State Board recommends that applications be submitted a minimum three months in advance of the need for licensure.
Competency Programs Completion of several basic competency programs and self-instructional modules is required prior to completion of orientation. The programs include: •Aminoglycoside and Vancomycin Pharmacokinetics •Warfarin Management – Monitoring, documenting and reversal agents •Parenteral Nutrition Management •Pharmacy and Therapeutics Committee approved clinical services •Computer System •Aseptic Technique and Hazardous Materials Handling •Basic Life Support, Advanced Cardiac Life Support •Adult and Pediatric Code Attendance •Policy Review •Staffing Unit Dose and Orientation to IV Admixtures
Miscellaneous Requirements The following are additional requirements of the residency program: •Pharmacy and Therapeutics Committee – attend all, present at two minimum (1 System) •Medication Safety Committee: Attend meeting x 6 months, project (1) Safety Alert Reports (3) •Department projects/activities (2) •Case Presentations (2) •Journal Club Presentations (3) •Medication Use Evaluation (QA,QI): minimum one •System P&T Monograph/Class Review (1) •Protocol,/Guideline identification, development, implementation, evaluation (optional) •ADR Report One quarter including presentation to P&T •Drug Information Questions (2) •Other small projects related to department management role •Annual Project with written and verbal presentation •Student preceptorship •Pulmonary and Cardiac Rehab Teaching •Pharmacy staff and interdisciplinary education •Leadership and management skill development •Presentation at the Alaska Pharmacist Association Annual Meeting
Many of these activities enable achievement of the following specific required objectives:
Identification of opportunities and changes needed for improvement of patient care and/or the medication use system.
Planning Implementation and assessment of the impact of changes to improve patient care and/or the medication use system.
Health Screening Health screening, including a urine drug/nicotine screen, is required by the Human Resources department prior to the beginning of the residency program. This is arranged through Human Resources prior to starting the position. Providence does not hire nicotine users (any source including nicotine replacement/cessation products).
Employee Benefits Pharmacy Residents qualify for employee benefits consistent with staff level positions at PAMC. Vacation: 10 working days. Work one major holiday and two minor. Thirteen paid leave days are available for interviews and ASHP Mid-Year and North Western States Residency Conference meeting attendance. Residents may work as staff pharmacists for pharmacist wages outside of residency requirements, once licensed as a pharmacist, competent in all pharmacist duties, and meeting other residency requirements, as long as this does not detract from the residency experience. The department must have a need to fill a budgeted position.
Contact Information Elaine O. Reale, PharmD Clinical Manager, Pharmaceutical Care Services Residency Program Director Providence Alaska Medical Center 3200 Providence Drive Anchorage, AK 99508 907-212-3646 firstname.lastname@example.org
About Providence Alaska Medical Center
Providence is committed to excellence in patient-centered, clinical pharmacy practice and dedicated to developing clinical pharmacists with a set of rich foundational experiences. We offer robust pharmacy residency programs throughout our network of hospitals in California, Oregon, Washington, Alaska and Montana.
Providence Health & Services joined with St. Joseph Health in 2016 to form Providence St. Joseph Health, a unique not-for-profit health and social services system focused on a mission to serve all. As a combined organization, our 119,000-plus caregivers/employees serve in 51 hospitals, more than 800 clinics and a comprehensive range of health and social services.