Pharmacy Residency Training Update 2006 ASHP Midyear Clinical Meeting

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					PGY1 & 2 Pharmacy Residency Programs in the ASHP Accreditation Process
        December 2006 ( N=853 Programs offering 1,900 positions)

                                     PGY1 - Managed Care     (23)
                                             3%
                                         PGY1 - Community     (38)
                                                4%

           (289)   PGY2
                    34%




                                                PGY1 Pharmacy Residency   (503)
                                                         59%
                         PGY1*   PGY2 Remaining
Primary Care               23       43
Geriatrics                  5        9
Pediatrics                  3      20
Managed Care Health System 1         5

PGY2 programs have until December 31, 2006 to convert
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                                                                                                                                   289 Programs offering 448 positions




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                                                                                                                      PGY2 Programs in the ASHP Accreditation Process December 2006




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          Potential positions in 2006-07
Residency Programs in ASHP Accreditation Process
                     (n=1,900)


            PGY2
             22%




                             PGY1
                              78%
   Pharmacy School and Residency
        Graduation Trends




Source: AACP & ASHP Data
Residency Programs in the Accreditation Process                      Pharmacy Practice programs

        Growth Over Time 1990 - 2006                                 Specialized programs
         853 Programs November 2006                                  totals


900
                                      CMS funding removed for Specialized            2006

800                                                Oct 2003
                                                                              2005

700
                                           2000
600

500
                       1995

400
      1990
300

200

100

 0
        Matching numbers for Accredited Pharmacy Practice Programs
                                1990 - 2006
1600


1400


1200
         More Applicants than Positions
1000


800                                                                        # applicants
                                                                           # positions
                                                                           # matched
600


400


200


  0

       1990               1995             2000              2005    200
PGY1 Pharmacy Residency
PGY1 Community Pharmacy Residency
PGY2 Pharmacy Residency
  PharmD
  Graduat        Broad                 Patient/Practice FOCUS               Narrow
  e

             A           PGY1                                PGY1                      B

                          Generalist                             Generalist
  Basic
             Wide variety of patients &           Wide variety of diseases may be in a
             diseases                             unique setting or population (e.g.,
                                                  pediatrics, geriatrics, ambulatory,
                                                  managed care)
DEPTH of
knowledge,   C           PGY2                                PGY2                          D
skills,
abilities,
experience         Advanced Practitioner                   Advanced Practitioner

             More experience, skill and ability   More experience, skill, and ability
             developed in a broad set of          developed in a focused area of
             patients (e.g., pharma-cotherapy)    practice (e.g., oncology, critical care)
Advanced
PGY1
PGY1 Community
PGY2 Ambulatory ( previously Primary Care)
Frank Briggs- WV
Mary Hess - SC
Carolyn Kowalchik - UT
Bruce Nelson – ASHP
Christine Nimmo - ASHP
Marialice Bennett – OH
Jeffrey Goad - CA
Pamala Marquess
Matthew Osterhaus – IA
James Owen – DE
Sarah Ray – WI
Kushal Shah – Resident
Anne Burns – APhA
Christine Nimmo – ASHP
Jeffrey Brewer - MD
Douglas Covey – FL
Laura Hansen - CO
Art Schuna – WI
Kelly Ragucci – SC
Joseph Saseen - CO
Bruce Nelson – ASHP
Christine Nimmo - ASHP
PGY2 - Pharmacy Informatics
Michael Baron - TheraDoc
Scott McCreadie – MI
Sandi Mitchell – MD
Craig Herzog – UT
Bruce Nelson – ASHP
Christine Nimmo - ASHP
PGY1 Managed Care Standard
    Outcomes, goals and objectives
PGY2 Health System Pharmacy Administration
    (previously Pharmacy Management)
PGY2 Critical Care



                                    Send us comments!
Carey Cotterell – CA
Raulo Frear - MN
Lydia Nesemann – AZ
Mark Brueckl – AMCP
Marissa Schlaeffer – AMCP
Bruce Nelson – ASHP
Christine Nimmo - ASHP
Alison Apple - TN
Steven Rough -WI
Jerry Siegel – OH
Thomas Woller – WI
Janet Teeters – ASHP
Christine Nimmo - ASHP
Jill Rebuck – VT
Brian Erstad – AZ
Lisa Hall – MI
Bruce Nelson – ASHP
Christine Nimmo - ASHP
NEW – PGY2 Transplant
PGY2 Medication Safety
PGY2 Oncology
PGY2 Drug Information
PGY2 Infectious Diseases
PGY2 Internal Medicine
PGY2 Pharmacotherapy
PGY2 Psychiatry
PGY1
PGY2
Community
Managed Care
New Pre-Candidates
November – Early Commitment PGY1 to PGY2
             (If not in at NMS, you are in the match)
            - Listings Posted
February 9 – Instructions for Rank Order Lists
            - Reversion of Unfilled Positions

March 9, 2007 – Rank Order Lists due !

March 21, 2007 – Match Results Released
35/ 289 (8%) programs have contacted NMS
               to fill PGY2 for 2007 year
Reversion of Unfilled Positions
   Can donate up to ALL unfilled positions to another
    program or site that is part of your organization
    PGY2                     PGY1
    PGY1                     PGY2
    PGY1 one site            PGY1 another site same program
   Donor & Receiver – both must sign form from National
    Matching Service http://www.natmatch.com/ashprmp/
   Can donate to multiple programs
   Can not loop positions back to original donor program
   Early Commit one position &
   Revert open Onc positions to PGY1
PGY 1          PGY2-Crit Care         PGY2-DI         PGY2-Onc
List with Match in August:
   4               1                  1                       2
Fill through Matching process in March:
      1            1 Early Commit     1                       1
      1
      1                                                        1
      1
                                                           Does not fill one
                                                           position
     1
           Gains One position & additional placement of a resident
   Interview all eligible candidates to find the best
    fit with your organization
   Only Rank candidates you would accept
   Rank in the same order as you would make an
    offer
   Do NOT try to consider how a candidate would
    rank your program
   If you have multiple programs discuss the
    possibilities of “reverting” unfilled positions to
    maximize the matching process
   Understand - Post match information & how to
    use it if necessary
   Remember “Early Commitment” for PGY1 to
    PGY2 positions at the same site – occurs in
    November
Join us on Wednesday, December 6, 2006
Matching Information
Room 210A/B
11am – 12noon
New Accreditation Status Terms:
 Pre-Candidate
 Candidate
 Preliminary Accreditation 
 Conditional Accreditation 
Resident must be:
  Enrolled in ASHP accredited program
  Plan to enter a PGY2 accredited residency
  Submit CV & letter of intent
  Letter of support from Program Director
1 Year appointment
Please contact asd@ashp.org if you know of
  interested candidates by December 31, 2006
PGY2 – Board Certification Requirement (5.1)
          Pharmacotherapy + added Qualifications
                    Infectious Diseases
                    Cardiology
          Nuclear
          Psychiatry
          Nutrition Support
          Oncology
       Amnesty until December 31, 2008
PGY1 – Drug information requirement (7.6b)
New Pre-Survey materials & grids
AMBULATORY CARE SERVICES                                                         Medicine   Transplant   Oncology   Bone Marrow
                                                                                                         Infusion   Transplant Clinic
Directions: INDICATE ALL THAT APPLY BY RECORDING                                                         Center
THE INFORMATION REQUESTED IN THE BOX
CORRESPONDING TO THE PATIENT CARE SERVICES
PROVIDED AT THE RESIDENCY SITE
Hours of clinic per week (all clinics)                                           40         32           40         40
Hours of pharmacy clinic per week (all clinics)                                  32         12           0          0
Number of patient encounters per week (all clinics)                              185        150          100


Number of pharmacist - patient encounters per week                               35         15


Percentage of total patient visits at facility have encounters with pharmacist   25         10
DIRECTIONS: Indicate the % of time the following services are   Medicine   Transplant   Oncology          Bone Marrow
provided for services listed at your site:                                              Infusion Center   Transplant
                                                                                                          Clinic


Medication history                                              100        100          100               100


Profile review                                                  100        100          100               100


Medication reconciliation                                       100        100          N/A               N/A
New medication order review                                     N/A        100          100               100
Conduct physical assessment appropriate for drug therapy        100        100          N/A               N/A


Provide point-of-care testing                                   100        N/A          N/A               N/A
Order drug therapy-related laboratory tests                     100        100          100               100
Prospective medication regimen design                           100        100          100               100
Initiate medication regimens                                    100        100          100               100
Consultation services: nutrition, pain, other                   N/A        100          100               100
Document recommendations in patient’s medical record            100        100          100               100
ACUTE CARE SERVICES                                       Med/Surg   Med/Surg   Med/     MICU        SICU   Neuro/   Neuro   Neuro
                                                          – Wing 1   – Wing 2   Surg –                      Ortho    Step    ICU
Directions: INDICATE ALL THAT APPLY BY RECORDING                                Wing                                 Down
THE REQUESTED INFORMATION IN THE BOX                                            3
CORRESPONDING TO THE PATIENT CARE UNITS
SERVICED AT
THE RESIDENCY SITE
                                                          120 BEDS   80         40       16          24     48       8       16
Pharmacy Practice Model: (Provide % of patient                       BEDS       BEDS     BEDS        BEDS   BEDS     BEDS    BEDS
beds covered by the following services)
Centralized Operations                                    100        100        100      100         100    100      100     100
                                                          24/7       24/7       24/7     24/7        24/7   24/7     24/7    24/7
Hours/Days   (e.g., 24/7 for 24 hours 7 days per week)
Dispensing Pharmacy Satellites



                                                          NA         NA         NA       NA          16/7   NA       NA      16/7
Hours/Days

                                                          NA         NA         NA       NA          36     NA               16
Average   patient load
Decentralized Clinical Pharmacist



                                                          8/7        8/7        8/7      8/7         8/7    8/7      X       X
Hours/Days                                               Day        Day        Day      Day                Day

                                                          110        70         30       16          X      48       X       16
Average   patient load
Clinical Pharmacist/Clinical Pharmacy Specialist



                                                          8/5        8/5        8/5      8/5         8/5    8/5      8/5     8/5
Hours/Days                                               24/7       24/7       24/7     24/7 call   24/7   24/7     24/7    24/7
                                                          call       call       call                 call   call     call    call

                                                          110        70         30       16                 48               16
Average   patient load
Pharmacy Services –                          Med-     Med/     Med/     MICU   SICU   Neuro/   Neuro   Neuro ICU
                                             Surg-    Surg –   Surg –                 Ortho    Step
Distribution: (Provide %                     Wing 1   Wing 2   Wing 3                          Down
of patient beds covered by
the following services)




Unit-dose oral drug products (indicate %)    99       99       99       99     99     99       99      99


Comprehensive sterile product admixture      100      100      100      100    100    100      100     100
service, including IV push, IVPB, LVP,
chemotherapy, TPN, IM, SQ (indicate %)




24-hour cart fill (indicate %)               100      100      100      100    100    100      100     100


Investigational drug product controlled by   100      100      100      100    100    100      100     100
pharmacy (indicate %)



Extemporaneous compounding services          100      100      100      100    100    100      100     100
Pharmacy Services – Clinical                    Med/     Med/     Med/     MICU   SICU   Neuro/   Neuro   Neuro ICU
DIRECTIONS: Indicate the % of                   Surg –   Surg –   Surg –                 Ortho    Step
the time patient care areas receive             Wing 1   Wing 2   Wing 3                          Down
the following pharmacy services
(e.g., 50%, 75%, 100%):

Medication history                              100      100      100      67     67     67       67      67
Profile review                                  100      100      100      100    100    100      100     100
MAR reconciliation                              NA       NA       NA       NA     NA     NA       NA      NA
Medication reconciliation                       100      100      100      100    100    100      100     100
Prospective identification of medication-       33       33       33       90     90     33       33      100
related problems.

Prospective medication regimen design           33       33       33       90     90     33       33      100
New medication order review                     100      100      100      100    100    100      100     100
Initiate medication regimens                    33       33       33       33     33     33       33      33
Prospective patient monitoring                  33       33       33       100    100    33       33      100
Recommend/implement therapeutic changes         67       67       67       67     67     67       67      67
Pharmacokinetic monitoring                      100      100      100      100    100    100      100     100
Consultation services: nutrition, pain, other   33       33       33       33     33     33       33      33
Pharmacy Services – Clinical                          Med/     Med/     Med/     MICU   SICU   Neuro/   Neuro   Neuro
DIRECTIONS: Indicate the % of the time                Surg –   Surg –   Surg –                 Ortho    Step    ICU
patient care areas receive the following              Wing 1   Wing 2   Wing 3                          Down
pharmacy services (e.g., 50%, 75%,
100%):


Clinical outcomes documentation                       YES      YES      YES      YES    YES    YES      YES     YES



Patient education and discharge counseling            33       33       33       33     33     33       33      33


Clinical intervention documentation                   YES      YES      YES      YES    YES    YES      YES     YES



Support/conduct research                              100      100      100      100    100    100      100     100

Participate in multidisciplinary rounds (Teaching     100      100      100      100    100    100      100     100
Rounds)


Medication order-entry                                100      100      100      100    100    100      100     100

Medication Use Evaluation participation               YES      YES      YES      YES    YES    YES      YES     YES



Create and implement treatment guidelines/protocols   YES      YES      YES      YES    YES    YES      YES     YES



Participate in multidisciplinary committees           YES      YES      YES      YES    YES    YES      YES     YES     Y
                                                                                                                        E
                                                                                                                        S
Outcomes, goals and objectives
     - Required vs Elective
     - Evaluation
Increase search capabilities on web page
Ability for you to enter data
Web-based tool
Currently in Development
Will be available to all accredited programs



McCreadie Group/ASHP
Further questions you can contact us at:
asd@ashp.org

				
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