PGY2 Emergency Medicine Pharmacy Residency

Residents will serve as a preceptor for PGY1 pharmacy residents and PharmD students during Emergency Medicine rotations. Research and leadership skills will be developed through the completion of a longitudinal research project and through an Emergency Department leadership experience. The resident will also gain experience in developing pharmacy services in an Emergency Department and to develop and monitor quality and stewardship initiatives.

Graduates of the residency program are prepared for competitive Emergency Medicine clinical pharmacist and Emergency Medicine clinical pharmacy specialist positions in Emergency Departments of all sizes and with various levels of pharmacy services.

Learning Experiences

Required Learning Experiences

• Orientation
• Emergency Medicine I
• Emergency Medicine II
• Emergency Medicine III Graveyard
• Emergency Medicine South Meadows
• Medical Critical Care
• Pediatric Emergency Medicine
• Pediatric/Pediatric Critical Care
• Toxicology
• Longitudinal experiences
• Staffing
• Pharmacy Emergency Medicine Leadership
• Prehospital/Emergency Preparedness
• Major Research Project

Elective Learning Experiences

• Cardiac Critical Care
• Antimicrobial Stewardship/Infectious Diseases
• Ambulatory Care
• Surgical/Trauma Critical Care

Learning Experiences and Preceptors

The learning experiences at Renown Regional Medical Center will immerse the PGY1 resident in all areas of patient care, providing exposure to many aspects of pharmacy practice. The resident’s schedule will be personalized according to their areas of interest.

 

Required Longitudinal Direct Patient Care Learning Experiences

Staffing with Heather Townsend, PharmD, BCEMP, BCPS 

PGY2 residents are required to fulfill the service commitment (traditional staffing) designed to ensure that residents gain experience and can function as a competent Emergency Medicine practitioner.  The goal of the staffing component of the residency is to provide experiences to ensure that the resident can function autonomously as an EM clinical pharmacist.  This is a longitudinal experience designed to provide residents with exposure focusing on direct patient care, pharmacy operations, and medication distribution within the Emergency Department. It will serve to enhance their ability to triage care and respond to drug information requests.  Staffing responsibilities encompass clinical functions in both the surgical/trauma intensive care unit and Emergency Department.  Prior to staffing basic clinical shifts, the resident must have successfully completed training in anticoagulation and kinetics and had orientation and demonstrated competence in the designated area to be staffed (Q1 – central pharmacy/internal medicine clinical pharmacist, Q2 – ERAM, Q3/Q4 – ERAM/ERPM/ERSM). Competence to be determined for the central pharmacy/internal medicine clinical pharmacist shifts by the clinical pharmacy specialist and operations team and for the EM clinical shifts through satisfactory progress on the EM-I, EM-II, and EM-South Meadows learning experiences.  The resident must be certified in BLS and ACLS.   

Required Longitudinal Non-Direct Patient Care Learning Experiences

Pharmacy Emergency Medicine Leadership with Heather Townsend, PharmD, BCEMP, BCPS  

Emergency Medicine Leadership is a required longitudinal learning experience. The primary goal of the learning experience is to become recognized as a leader in emergency medicine pharmacy related issues at Renown Health and prepare for a role as a clinical specialist in emergency medicine. Major components of this learning experience include: drug information, contributions to multi-disciplinary meetings, ED discharge culture review, teaching, staffing every other weekend in the ICU or ED (after competency is demonstrated).

Prehospital/Emergency Preparedness with Heather Townsend, PharmD, BCEMP, BCPS and Zack Marcus, PharmD, BCCCP

The purpose of this learning experience is to provide the resident with a detailed, patient-centered and regulatory experience in Emergency Medical Services (EMS) and Emergency Preparedness. The resident will acquire an understanding of legislative environment around these services as well as the logistics and planning efforts. Additionally, the resident will become proficient in providing pharmaceutical care support for EMS and emergency preparedness scenarios.

Major Research Project with Heather Townsend, PharmD, BCEMP, BCPS 

Resident are required to develop and complete a major research project.  The resident is expected to conduct an Emergency Medicine related research project that is relevant to patient care at Renown Health.  Faculty and clinical staff will present project ideas during orientation. The resident will develop a formal research proposal.  The pharmacy resident is responsible for developing a hypothesis, designing, and implementing the project. The preceptor must approve any documents prior to them being submitted for approval or publication (i.e. institutional review board application, poster presentation, western states conference presentation).  A completed research project form, formal proposal, completed IRB, poster presentation, an oral presentation at the Western States Pharmacy Residents Conference and final written manuscript are required for successful completion of this longitudinal experience.

Required Concentrated Direct Patient Care Learning Experiences

Orientation with Heather Townsend, PharmD, BCEMP, BCPS  

Orientation is a required learning experience that is 5-6 weeks in length (Residents that are not new to the organization and pharmacy department will have a shortened orientation of 5 weeks, residents new to the organization will have a 6 week orientation).   The goal of the rotation is to become familiar with the residency program and organization's policy and procedures, work environment, and coworkers.  It is expected that the resident already has a solid foundation of general clinical pharmacy skills as evidenced by completion of an ASHP accredited PGY1 residency. The resident will be expected to begin staffing initially in central pharmacy or clinical pharmacist internal medicine shifts until completion of the first ED experience. Independent staffing is expected to begin at the end of the orientation learning experience. 

Emergency Medicine I with Laura Milner, PharmD, BCPS, MS 

This experience will provide exposure to the diverse patient population that presents to the Emergency Department (ED), and the unique role the ED pharmacist has in this practice setting. Residents will be challenged in direct patient care activities and in the busy environment to make decisions quickly and utilize drug information resources efficiently. The practice environment will require daily interactions with patients, ED physicians, medical attendings, surgeons, nurses, social workers, respiratory therapists, pharmacy staff, and other healthcare professionals as necessary to optimize pharmacotherapy.

Emergency Medicine II with Maili Nelson, PharmD, BCCCP 

This experience will provide the resident additional exposure to the Emergency Department allowing them to focus on individual shifts and objectives where they may need additional exposure. It will also allow the resident to practice more independently and ready themselves to staff the busier ERPM shift more independently. In addition, this learning experience will have trauma and surgery topic discussions to better understand the trauma/surgical role of the pharmacist.  The resident will start the first week of rotation with orientation to the emergency department and topic discussion on the direct patient care activities that they are expected to attend. Topic discussions will be tailored to previous experiences that the resident has encountered during their PGY1 year. The preceptor will model the patient care activities being discussed in order to get the resident familiar with the scenarios. The resident will also learn and become competent in obtaining a complete and accurate medication history during the first week of the rotation.

Emergency Medicine III Graveyard with Parker Webster, PharmD

This experience will provide exposure to the diverse critical care and ER patient population during hours when there is different levels of support from management than daytime hours.  The practice environment will require daily interactions with patients, ICU and ED physicians and nursing staff. Topic discussions will be determined based on patients evaluated and direct patient care experiences.

Emergency Medicine South Meadows with Kathy Weekes-Plante, PharmD, BCPS 

The resident will be charged with acting as the ED pharmacist while on duty in the ED.  The pharmacist will be required to provide drug information quickly and accurately, enhance medication therapy decision making and delivery during emergencies and codes, and both prospectively review medication orders through order verification and retrospectively review medication orders through review of the patient.  The resident will also be responsible for helping with medication reconciliation for patients being admitted when the medication reconciliation technician is not available.   The resident will contact the preceptor and/or the SM on-call pharmacist for support.

Medical Critical Care with Tiffany Kliewer, PharmD, BCCCP

The objective of this learning experience is to train the resident to be a resource for the multidisciplinary team concerning medications and their appropriate uses, therapeutic alternatives, adverse reaction profiles and to perform in medical emergencies.  The rounding cadre on this experience is comprised of the Critical Care Intensivist/Trauma Surgeon, dietary, social services, respiratory therapy and the bedside nurse for each patient.  The resident is responsible for pre-rounding and developing a plan for any therapeutic deviations, lab abnormalities, medication interactions, therapeutic duplications, iv to po opportunities, or educational opportunities that may exist.

Pediatric Emergency Medicine with Heather Townsend, PharmD, BCEMP, BCPS and Carol Vollmer-Johnson, PharmD, BCPPS

This experience will provide exposure to a diverse pediatric population that presents to the Children's ED, and the unique role that the pharmacist has in medication safety and dosing for pediatrics. The resident will be scheduled to round along-side a certified pediatric ED provider for 2 days per week where they will be challenged with evaluating a child alongside the physician and providing medication information and recommendations. The resident will also be challenged with following a patient admitted through the ED during their hospital stay in order to better understand the management of their disease states and social care. These cases will be discussed with the pediatric pharmacy clinical specialist once per week. Lastly, the resident will be responsible for pediatric code response, emergency care, order verification and drug information while present in the Children's ED.  The resident is expected to be on duty in the ED four days per week for approximately 8-10 hours a day, shifts may vary in time based on physician availability and are to be determined.

Pediatric / Pediatric Critical Care with Carol Vollmer-Johnson, PharmD, BCPPS

This experience will provide exposure to a diverse pediatric population, and the unique role that the pharmacist has in medication safety and dosing for pediatrics. The resident will have exposure rounding with both the PICU and Pediatric teams on a daily basis, and will be responsible for pediatric code response, order verification, drug information, and pharmacokinetic monitoring while present. The resident is expected to be on rotation four days per week for approximately 8-10 hours a day which may vary in time based on needs and learning experiences. The resident will be expected to complete one project during the rotation that includes teaching staff.

Toxicology with Zach Stewart, PharmD, BCPS

During this experience the resident will become the primary consultant for all toxicology cases that arrive through the ED. The resident will alert the pharmacist and ED teams when starting the rotation that they are available for toxicology cases and will take all calls. From then the resident will begin to follow the toxicology cases that present to the ED. The resident will continue to follow the cases through their hospital stay to assure the proper pharmaceutical management and to have the opportunity to learn how a patient responds to various treatments. The resident will begin the rotation by discussing cases with the preceptor and then acting, and by the end of the rotation will be independently making toxicology recommendations and acting as a pharmacy clinical specialist. The resident will also be responsible for two formal case presentations to the pharmacy staff on toxicities and naloxone dispensing during the learning experience.

Elective Learning Experiences*

Cardiac Critical Care with Mike Thuyns, PharmD, BCPS, BCCP, BCCCP and Nikki Noroian, PharmD, BCPS, BCCCP

This learning experience is based on the experiences of the cardiac intensive care patient.  The resident must continue to gain experience and confidence within the realm of cardiac emergencies, cardiac surgeries, and management of other acute and chronic disease states.  As the resident progresses through the rotation they will be required to show proficiency in the management of these different disease states and the overall care of the critically ill cardiac patient.  As proficiency is demonstrated more responsibilities will be given/required until the resident is able to effectively function as a clinical pharmacist in this arena.

Antimicrobial Stewardship/Infectious Diseases with Jessica Thompson, PharmD, BCPS, BCIDP

Designed to provide the PGY2 Emergency Medicine Resident with an understanding of core ID principles with an emphasis in infections commonly seen in the emergency department (ED).  The resident will learn how to integrate knowledge of disease states and antibiotics in order to formulate evidence-based antimicrobial regimens for patients with active infections.  The resident will actively participate in infectious diseases consult and antimicrobial stewardship rounds.  The overall goal of the resident is to learn how to provide timely, safe, appropriate, and cost effective antimicrobial therapy while optimizing outcomes in patients with infections.

Ambulatory Care with Adam Porath, PharmD, BCPS, BCACP, FASHP

This learning experience is primarily designed to develop the resident's skills in ambulatory care through pharmacotherapy consults at the Renown Institute for Heart and Vascular Health. Residents will be involved in medication initiation, modification, and monitoring. Effective documentation and communication with other healthcare providers are required. Residents will gain experience in consults for: anticoagulation, anemia, diabetes, hypertension, hyperlipidemia, polypharmacy, and smoking cessation. Residents will primarily practice at Renown Regional but may choose to gain experience at other community practice sites.

Surgical/Trauma Critical Care with Zack Marcus, PharmD, BCPS, BCCCP

This 4 week rotation is designed for the resident to become familiarized with the topics and rounding expectations that will pervade their training in the trauma intensive care unit.  This training will center around large groups of penetrating and blunt force trauma, and the subsequent pharmacologic and medical issues that arise from these injuries.  The resident will work toward assuming the role of the pharmacist and provide the services that the staffing pharmacist would normally including: being a resource for the multidisciplinary team concerning medications and their appropriate uses, therapeutic and formulary alternatives, order entry and processing, pharmacokinetic monitoring and adjustment, pharmacy driven anticoagulation, and parenteral nutrition monitoring and adjustment. 

*Other elective learning experiences may be developed based on resident interest and preceptor availability.