PGY2 Infectious Disease Pharmacy Residency

Infectious Diseases Services at Renown

Renown Health cares for a wide variety of common and rare infections due to its large catchment area, extensive trauma and oncology services, and Reno-Tahoe being an international tourist destination. The infectious diseases pharmacy team consists of three infectious diseases pharmacists and a PGY2 pharmacy resident. Together they provide pharmacotherapy expertise for infectious diseases consulting physicians and Renown Health Infection Control and Prevention. They also work in partnership with the Antimicrobial Stewardship Medical Director to provide antimicrobial stewardship services for the health-system. The infectious diseases pharmacy team at Renown has developed extensive protocols and collaborative practice agreements that allow pharmacists to practice at the top of their licenses.

Four infectious diseases physician groups provide consulting services for Renown Health. They range from private practice to healthcare system-employed to university-based with medical residents and students. The consulting groups rely heavily on Renown’s infectious diseases pharmacists and residents to provide optimal care to patients.

The primary focus of the antimicrobial stewardship program at Renown Health is Renown Regional Medical Center; however, the program extends to Renown South Meadows Medical Center, Rehabilitation Hospital, Medical Group, and Home Care. An antimicrobial stewardship and infection prevention module in the electronic medical record helps prioritize daily stewardship activities such as bug-drug mismatch, duplicate therapy, drug-lab mismatch, etc. Handshake stewardship occurs three days a week with the Medical Director. These rounds are unique because they not only include chart review, but also physical examine and patient interview prior to making recommendations to providers in person. The team works to educate, empower, and provide pharmacists tools to incorporate antimicrobial stewardship into their daily activities. Additionally, they collaborate with Infection Control and Prevention and Laboratory to align goals and initiatives throughout the organization.

Learning Experiences

Required Learning Experiences:

• Orientation (4 weeks)
• Introduction to Infectious Diseases (6 weeks)
• ID Consults I & II (4 weeks each)
• Antimicrobial Stewardship I, II, III, IV (4 weeks each)
• Pharmacy Clinical Specialist
• Longitudinal experiences
  • South Meadows & Rehab AMS (one day per week, every other month)
  • Ambulatory Care (two hours per week)
  • Outpatient Infusion Center (30 minutes daily)
  • Emergency Medicine Culture Follow-up (30 minutes daily)
  • Infectious Diseases On-Call (every other weekend)
  • Infection Prevention (1 hour per week)
  • Infectious Diseases Practice Management
  • Project

Elective Learning Experiences (select 3, 4 weeks each):

• Critical Care
• Emergency Medicine Antimicrobial Stewardship
• Pediatric Infectious Diseases
• Internal Medicine
• Oncology
• Leadership
  
  

Learning Experiences and Preceptors

Required Concentrated Direct Patient Care Learning Experiences 

• Orientation with Jessica Thompson, PharmD, BCPS, BCIDP
  The goal of the rotation is to become familiar with the residency program and the organization's policies, procedures, work environment, and coworkers. During this time the resident will also be oriented to all longitudinal learning experiences. It is expected that the resident enters the residency with a solid foundation of general clinical pharmacy skills due to successful completion of a PGY1 pharmacy residency program.
• Introduction to Infectious Diseases with Kiya Mohadjer, PharmD, BCPS, BCIDP
  As the first learning experience specific to infectious diseases, the resident is expected to develop a foundation of common pathogens, antimicrobials, and infectious diseases. The resident will also be introduced to antimicrobial stewardship activities and operations at Renown Regional and South Meadows Medical Centers. In addition, the resident will spend a week in microbiology.
• Consults I & II with Kiya Mohadjer, PharmD, BCPS, BCIDP
  The resident will round with the Renown and UNR Infectious Diseases Consulting groups and gain experience and knowledge of more advanced infectious diseases topics and cases. The preceptor will model and coach the resident on this experience during ID Consults I and progress to independent rounding by ID Consults II.  The goal is for the resident to build and develop relationships with the infectious diseases consulting physicians and gain experience providing care to more complicated infectious disease states.
• Antimicrobial Stewardship I, II, III, IV with Kiya Mohadjer, PharmD, BCPS, BCIDP
  These learning experiences are designed to provide residents with a comprehensive inpatient antimicrobial stewardship direct patient care experience. The resident will participate and contribute to the antimicrobial stewardship throughout the year, ultimately progressing to complete independence and responsibility of the service. There are two major components to this learning experience: pharmacist-driven antimicrobial stewardship and physician-assisted antimicrobial stewardship. The resident will become proficient in both aspects.
• Pharmacy Clinical Specialist with Kiya Mohadjer, PharmD, BCPS, BCIDP
  The Pharmacy Clinical Specialist learning experience is the capstone of the year.  The resident will be responsible for all ID-pharmacist related activities at Renown Regional Medical Center, including but not limited to antimicrobial stewardship activities and rounds, drug information requests, and precepting.

Required Longitudinal Direct Patient Care Learning Experiences

• South Meadows and Rehab Antimicrobial Stewardship with Adrienne Desens, PharmD, BCPS
  The resident will attend and participate in antimicrobial stewardship rounds at South Meadows Medical Center one-half day each week, every other month.  During this time the resident will also perform antimicrobial stewardship activities remotely for Renown Rehabilitation Hospital.  The goal of this learning experience is for the resident to gain experience managing an antimicrobial stewardship service at a smaller, community hospital that has more limited resources and in the post-acute setting. 
• Emergency Department Culture Follow-Up with Heather Townsend, PharmD, BCPS, BCCCP
  The resident, through a collaborative practice agreement with the ED Medical Director, will follow-up on patients discharged from the ED with positive cultures.  The collaborative practice agreement allows the resident to continue, discontinue, or modify therapy as needed. The resident will also contact, counsel, and obtain additional information from the patient as needed.  
• Infectious Diseases On Call with Kiya Mohadjer, PharmD, BCPS, BCIDP
  The Infectious Diseases On-Call learning experience is a longitudinal learning experience that serves as the resident's "staffing" component of the residency. Instead of staffing a standard clinical pharmacist shift, the resident will serve as the at-home on-call Infectious Diseases Pharmacist every other weekend.
• Ambulatory Care with Adrienne Desens, PharmD, BCPS
  During ambulatory care the resident will operate under a collaborative practice agreement with the Infectious Diseases providers to provide Hepatitis C treatment.  Additionally, the resident will serve as a drug information resource for the primary and urgent care providers in the Renown Health network which includes compiling an antimicrobial stewardship dashboard quarterly. 
• Outpatient Infusion Center with Ian Ferrari, PharmD, BCPS
  Outpatient Infusion Center is a required longitudinal learning experience and is designed to provide the residents with a clinical and operational experience of an outpatient infusion center and transitions of care. The resident will be responsible for reviewing referrals to the infusion center for antimicrobial therapy and ensuring indication, treatment, and lab monitoring are appropriate. 

Required Longitudinal Non-Direct Patient Care Learning Experiences

• Infection Prevention with Adrienne Desens, PharmD, BCPS 
  Infection Prevention is a longitudinal learning experience designed to focus on preventing and stopping the spread of infections in the healthcare setting. The resident will become proficient in risk factors, prevention, ongoing process improvement, and education of healthcare associated infections. The resident is expected to participate as an integral member of the multi-disciplinary Infection Prevention team by providing evidence-based information, drug information services, and clinical insight to healthcare associated infection cases.
• Infectious Diseases Practice Management with Jessica Thompson PharmD, BCPS, BCIDP
  The primary goal of the learning experience is to become recognized as a leader in infectious diseases pharmacy at Renown Health and the community.  The resident will gain experience with the administrative (non-patient care) responsibilities of an infectious diseases pharmacist and learn to contribute to healthcare team.  Major components of the learning experience include formulary review; utilization evaluations; journal club and case presentations; protocol, policy, procedure, and order set development and maintenance; multidisciplinary meetings; and education and inservices.
• Project (preceptor is dependent upon project selection)
  The resident is expected to conduct an infectious diseases related research project that is relevant to patient care at Renown Health. The preceptor must approve any documents prior to them being submitted for approval or publication (i.e. institutional review board, poster presentation, Western States Conference, etc.). The pharmacy resident is responsible for developing a hypothesis, designing, and implementing the project. Additionally, the resident will analyze any data collected, present the results, and submit a manuscript for publication.