AMBULATORY CARE Post-Graduate Year 2 Pharmacy Residency

AMBULATORY CARE PHARMACY RESIDENCY PROGRAM OVERVIEW

Residency Focus ambulatory care

Residency Focus

The focus of the ASHP-accredited ambulatory care pharmacy specialty residency at St. Vincent Indianapolis and the St. Vincent Joshua Max Simon Primary Care Center is to provide the resident with the opportunity to expand his/her knowledge and skills to provide comprehensive pharmaceutical care to ambulatory patients. This opportunity will be provided through active participation in evidence-based disease state management, patient/family and medical staff education, medication safety, primary and preventive care, outcomes-based research, educational and scholarly activities, and collaborative drug therapy management. Experiences will provide the resident the ability to function independently as a specialist by conceptualizing, integrating and transforming accumulated experience and knowledge into optimal drug therapy for patients.

Program Site Description

The Ambulatory Care Pharmacy Residency at St Vincent Indianapolis focuses on providing compassionate person-centered care to all patients, regardless of income and insurance status. The Joshua Max Simon Primary Care Center (PCC) is designed to serve the uninsured, underinsured, and otherwise underserved populations, while Ascension Medical Group (AMG) provides care to all those in the surrounding community. In addition, the Primary Care Center is the site of the outpatient-based training component for the St. Vincent medical residency programs and a diverse representation of learners from many different disciplines.

Purpose Statement

PGY2 residency programs build upon Doctor of Pharmacy (PharmD) education and PGY1 pharmacy residency training to develop pharmacist practitioners with knowledge, skills, and abilities as defined in the educational competency areas, goals, and objectives for advanced practice areas. Residents who successfully complete PGY2 residency programs are prepared for advanced patient care or other specialized positions, and board certification in the advanced practice area, if available.

AMBULATORY CARE PRACTICE SITES 

The PGY-2 ambulatory care resident will have the opportunity to practice at a variety of ambulatory care practice sites. The two primary patient care sites for required longitudinal learning experiences are the St. Vincent Joshua Max Simon Primary Care Center and St. Vincent Medical Group patient-centered medical home sites. Information about the required and elective practice sites are listed below.

St. Vincent Joshua Max Simon Primary Care Center (PCC): The PCC is a medical residency training facility where physicians provide optimal outpatient care to a diverse patient population including multiple patient languages and varying degrees of health literacy. This facility includes Internal Medicine, Family Medicine, OB/GYN, and Pediatric clinics as well as a variety of sub-specialty clinics. The pharmacists provide collaborative drug therapy management to adult patients for a variety of disease states and have direct patient care coverage responsibilities for the Internal Medicine and Family Medicine clinics. An on-site pharmacy provides unique services to this uninsured and underinsured patient population. The Primary Care Center is located on the St. Vincent Indianapolis campus.

Ascension Medical Group of Indiana (AMG): The Ascension Medical Group of Indiana includes over 500 medical providers located throughout the state, many of whom are working to practice in the patient-centered medical home model. Pharmacy services expanded into the patient-centered medical home sites in 2016, providing collaborative drug therapy management and population health initiatives. The goal is to continue to expand pharmacy services to additional SVMG sites over the next several years with the hope of implementing telehealth services for more rural locations.

St. Vincent Medication Management Services Anticoagulation Clinic (MMS): MMS is a hospital-based outpatient clinic providing pharmacist-driven anticoagulation services. In addition to providing anticoagulation management, MMS provides medication management services, post-discharge diabetes education, and immunizations to enrolled patients. MMS has also provided immunization services to a variety of organizations and corporations within central Indiana. MMS has 3 locations in Central Indiana- Indianapolis, Carmel and Fishers hospital campuses. 

Program at a glance

The ambulatory care pharmacy resident will actively participate in both longitudinal and rotational learning experiences. The residency preceptors will provide written learning objectives for each learning experience. These objectives specify the skills and knowledge the resident will gain upon successful completion of each experience. The resident will be provided a training plan to help guide performance and expectations, and track achievements and progress in obtaining individualized and program goals. These training plans will be updated quarterly and will coincide with quarterly resident evaluations. In addition, the resident will be expected to evaluate themselves, preceptors, and the strengths and weaknesses of each aspect of the residency program.

Longitudinal Learning Experiences

Medicine Experience:

The Medicine Experience will incorporate the resident Family Medicine (FM) and Internal Medicine (IM) clinics, and is designed to provide the resident with the foundational knowledge about common acute/chronic disease state management of adults and children through direct instruction, observation and modeling by the preceptors. Residents will have the opportunity to apply this knowledge through participation in multidisciplinary patient care at the St. Vincent Joshua Max Simon Primary Care Center (PCC), working with various healthcare providers in managing social and medical aspects of total patient care.

Activities include:

  • Daily patient chart review and care plan development
  • Adherence evaluations and medication histories
  • Provide drug information resources and pharmacotherapy
  • Participate in transitions of care medication treatment recommendations to medical residents and staff reconciliation
  • Patient/provider education and optimal medication management

Collaborative Drug Therapy Management:

The longitudinal Disease State Management experience is designed to provide the resident with the foundational knowledge of pharmacy-driven clinics for the following disease states (adult focus): anticoagulation, asthma, COPD, diabetes/pre-diabetes, heart failure, hyperlipidemia, hypertension, immunizations, medication therapy management, and tobacco cessation. The resident will be responsible for providing care to patients per the Collaborative Drug Therapy Management (CDTM) practice agreement two half days per week throughout the year and will document all activities within the electronic health record. The resident will participate in ongoing outcomes-based research by evaluating the outcomes of these pharmacy-driven disease-state management of clinics, as well as participating in the annual review and revision of the CDTM individualized disease state protocols.


Practice Management: 

The Practice Management longitudinal experience is designed to provide the resident with the foundational knowledge about the medication use process, practice management skills, medication safety, and medical informatics through participation in hospital and clinical committees. The resident will be given dedicated administrative time to fulfill practice management expectations throughout the residency. Activities include, but are not limited to:

  • Publication preparation and submission
  • Quality improvement/ benchmarking projects; drug class reviews
  • Prior authorization approvals
  • Wellness initiatives
  • Formal drug information questions
  • Professional development activities
  • Development of new service or evaluation of an existing service

Population Health, Quality Management, and Medication Safety:

These experiences is designed to provide the resident with the knowledge and experience to participate in improving patients’ care using population data and quality metrics. The resident will participate in and design a variety of initiatives aimed at improving the overall quality and cost-effectiveness of the care of patients at specified practice sites. In addition, the resident will participate in activities and initiatives designed to improve the culture of medication safety, to evaluate and respond to medication safety reports, and to evaluate and decrease risk prospectively.  As part of the teaching component, the resident will work with preceptors and the Community-based PGY1 pharmacy residents to develop the 6th annual medication safety escape room for the medical residents.

Teaching / Education Experiences

Residents will have the opportunity to provide a variety of teaching/lecture experiences at St. Vincent Indianapolis as well as other ambulatory care practice sites. They will have the opportunity to mentor PGY-1 pharmacy residents and pharmacy students, and participate in elective academia based teaching experiences at Butler University College of Pharmacy and Health Sciences (COPHS), Manchester University College of Pharmacy and Purdue College of Pharmacy. Additionally, the resident will participate in the Indiana Pharmacy Resident Teaching Certificate (IPTeC) Program through Purdue and Butler universities, if not already completed.

Residents have the option of participating in teaching experiences for many different audiences and groups of learners, both in the classroom and in practice.  Alternatively, residents may choose to select a teaching track, enabling them to focus on provision of teaching to a more focused group of learners.  Track options include pharmacy academia, inter-professional education, and pharmacy practitioners and experiential learners. 

Teaching activities may include:

  • One-hour didactic lectures. Audience may include pharmacy staff, medical providers, pharmacy students, or other healthcare professional students.
  • One didactic lecture must be an Outpatient Pharmacy Grand Rounds for the statewide outpatient pharmacy team, regardless of chosen track.
  • Inter-professional education opportunities geared toward support staff – Formal presentation or written (i.e. newsletter)
  • Serving as co-preceptor for pharmacy students during clinic activities and primary preceptor for one pharmacy student rotation during the second six months of the residency experience.
  • Facilitating monthly student standing topic discussions
  • Providing monthly PGY-2 topic discussion from prespecified topic list
  • Completing a minimum of three preceptor development activities as made available by the preceptor development committee
  • Providing a pharmacy-focused quarterly newsletter for primary care providers
  • Electronic medication safety communications (social media, interactive games)
  • Interactive didactic presentation (the medication safety escape room)

Residency Project 

The resident will have the opportunity to complete and present a residency project to a local, regional or national meeting. The project will be tailored around the interests of the resident as well as the organization 

Staffing Commitment 

The Anticoagulation clinic staffing experience is designed to provide the resident an opportunity to develop skills in a retail setting while working with a closed formulary and qualifying patient population. The resident will have the opportunity to problem-solve with patients and providers, dispense prescriptions, provide patient education, utilize patient assistance programs, participate in formulary decisions, and complete a biannual staffing-related project. 

PGY-2 AMBULATORY CARE PAST RESIDENTS – WHERE ARE THEY NOW? 

Lauren Turner, PharmD, is an ambulatory care clinical pharmacist at Community Health Network in Indianapolis. Her resident project evaluated safe prescribing of DOACs in an outpatient population.

Nicole Jasperson, PharmD, is an ambulatory care clinical pharmacist with Community Health Network in Indianapolis and an adjunct faculty with Purdue University. Her resident project involved evaluation of prescribing practices in poorly controlled hypertensive patients.

Stephanie O’Brien, PharmD, is a co-funded ambulatory care pharmacist with the University of St. Joseph School of Pharmacy, West Hartford, CT. Her resident project investigated unmeasurable doses prescribed to pediatric patients who are discharged from the NICU to the outpatient setting.

Jessica McKinney, PharmD is an ambulatory care clinical pharmacist at Community Health Network in Indianapolis. Her research project evaluated clinical outcomes in a pharmacist-run disease state management clinic.

Alana Juodvalkis, PharmD, BCACP is an ambulatory care clinical pharmacist at ___.  Her resident project evaluated patient satisfaction and clinical outcomes with drive-up anticoagulation pharmacy visits.

Olivia Craker, PharmD is an ambulatory care clinical pharmacist with Ascension St. Vincent in Indianapolis. Her research project assessed prescriber understanding and usage of pharmacogenomic testing in the primary care setting.

PRIMARY PRECEPTORS FOR THE SPECIALTY RESIDENCY IN AMBULATORY CARE

Kameron Baker, PharmD, BCPS, is an Ambulatory Care Clinical Pharmacist. He received his Doctor of Pharmacy from Butler University. He went on to complete a PGY-1 residency at Franciscan Health Lafayette in Lafayette, Indiana and a PGY-2 residency in ambulatory care at Whiteriver Indian Hospital in Whiteriver, AZ. He is interested in chronic disease state management. 
Brad Bentfield, PharmD, is an ambulatory care pharmacist at St Vincent Medication Management Services. Brad received his PharmD degree from Butler University in 2006. Brad’s previous experience was in community pharmacy. Brad’s current interests include anticoagulation, tobacco cessation and medication therapy management. 
Olivia Craker, PharmD, is an Ambulatory Care Clinical Pharmacist at Ascension St. Vincent. Olivia received her Doctor of Pharmacy degree from Purdue University in 2020 and completed her community-based PGY1 residency and ambulatory care PGY2 residency at Ascension St. Vincent Indianapolis. Her current practice areas of interest are chronic disease state management, geriatrics, and medication safety.

Kacey West, PharmD, BCACP, BCGP, is an Ambulatory Care Clinical Pharmacist and an Assistant Professor of Pharmacy Practice at Butler University College of Pharmacy and Health Sciences. She received her Doctor of Pharmacy from Butler University. She went on to complete a PGY-1 residency at Community Health Network in Indianapolis and a PGY-2 residency in geriatrics and academia at Midwestern University College of Pharmacy-Glendale in Glendale, AZ. Her interests include geriatrics, chronic disease state management, and academia, and is passionate about working with learners in all settings.
Toni Eash, PharmD, is a board-certified ambulatory care pharmacist who serves as a primary care clinical pharmacist at the St. Vincent Joshua Max Simon Primary Care Center in a part-time role. Toni completed her bachelor's degree in Pharmacy and Doctor of Pharmacy degree at Butler University in 2000 and 2001, respectively. She went on to complete a PGY-1 pharmacy practice residency at St. Vincent Hospital and a PGY-2 Ambulatory Care residency at the St. Vincent Primary Care Center. Toni’s current areas of interest include anticoagulation and diabetes education and management. 
Amanda Place, PharmD, is a board-certified Ambulatory Care Clinical Pharmacy specialist. She received her PharmD degree in 2000 from Butler University. Following graduation, she practiced in a Family Practice clinic, providing lipid and asthma management, and managing the onsite outpatient pharmacies. She then transitioned to co-owner and pharmacist of an independent pharmacy, before moving to the join the ambulatory care clinical team at St. Vincent in 2009. She is the residency program director for the Community-based (PGY-1) Pharmacy Residency Program and the Ambulatory Care (PGY-2) Pharmacy Residency Program at St. Vincent Indianapolis. Her areas of focus include medication safety, quality improvement, developing adherence, and transitions of care programs.

Deborah Zeitlin, PharmD, is an Ambulatory Care Clinical Pharmacist and an Associate Professor of Pharmacy Practice at Butler University College of Pharmacy and Health Sciences.  She received her Doctor of Pharmacy from Butler University.  She went on to complete a PGY-1 residency at Medical College of Virginia Hospital in Richmond, Virginia and a PGY-2 residency in Ambulatory Care at University of Illinois at Chicago in Chicago, Illinois.  Her interests include anticoagulation, chronic disease state management, self-care management, and academia.  She enjoys working with learners in all settings.

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