Rotation Name Description
Internal Medicine/Transitions of Care 1 & 2

During your Internal Medicine (IM) and Transitions of Care (TOC) rotation(s) you will be exposed to multiple essential roles that a pharmacist can, and should, participate in to optimize the care of our patients. During IM and TOC you will be responsible for identifying and resolving medication therapy issues and maximizing medication-related outcomes. This may include, but is not limited to:

  • Therapeutic drug monitoring
  • Education of patients/caregivers, physicians, nursing, ancillary staff and students
  • Drug information requests
  • Multidisciplinary rounding
  • Medication reconciliation upon admission and discharge
  • Patient and caregiver counseling
  • Drug therapy optimization
  • Development, refinement and/or provide feedback on clinical algorithms
  • Medication affordability issues and prior authorizations
Pharmacy Services

During this rotation, the resident will learn how a hospital pharmacy runs and how to perform the duties of a staff pharmacist. The resident will become efficient in order entry, vancomycin and warfarin management, checking IV compounds, answering nurse questions, problem solving and more.

Medication Safety

This rotation is designed to introduce the resident to the important role of pharmacists in medication safety and the hospital’s medication use systems.  The resident will review reported medication errors and safety events during this rotation. 

Community The community rotation is completed through New Choice Pharmacy. The resident will assume responsibility for medication use processes and provide direct medication related patient care. This includes but is not limited to medication counseling, administering immunizations, compounding, processing medication orders, and final verification of prescriptions.  The resident will also have exposure to financial aspects of running a pharmacy business that include inventory management, reimbursement, pricing, and use of discounts and patient assistance programs for high dollar prescriptions. The resident will work closely with medical staff and nursing to provide patient centered pharmacy services.
Infectious Disease/Stewardship

On the infectious disease / stewardship rotation, the resident will participate in the hospital’s antimicrobial stewardship program. We look at regulations and standards that surround stewardship as well as rounding on patients. The resident will get to work alongside the infectious disease team and gain a better understanding of the treatments that surround bacterial, viral, and fungal infections as well as spend time in the microbiology lab.

Research

This rotation is a longitudinal and month long required rotation focused on the resident’s chosen research project and quality improvement project. Throughout the year the resident will meet with the research team to develop a project, progress through the research process, and see the project through to completion. Assistance from the Western Reserve Hospital research committee and a statistician will be available to the resident. Additionally, the resident will work on a quality improvement project throughout the year showcasing an idea to improve an aspect of the medication ordering, verifying, or administration. 

Critical Care/ICU 

The Critical Care rotation is a required rotation where the pharmacy resident is integrated into the multidisciplinary team in the Intensive Care Unit (ICU). The resident has the opportunity to round with the medical team and also participate in multidisciplinary rounds focused on liberating patients from the ICU. The focus of this rotation is providing guidance on optimizing medications for all conditions of the critically ill patient. The resident is available for any medication therapy related questions, optimizing therapy, and evaluating patients that are positive for delirium. The resident will have the opportunity to participate in code situations and observe a variety of bedside procedures.

Pain Pain medicine is a one month required rotation. The Center for Pain Medicine at Western Reserve Hospital utilizes a comprehensive approach to treat patients. Throughout the rotation, residents will have the opportunity to round with the inpatient team, provide medication education to patients and providers, and observe pain procedures.
Administration

Administration is a 4 week required rotation for PGY1 pharmacy residents at Western Reserve Hospital. During this rotation, the resident will work closely with the Director of Pharmacy to develop skills to be an effective leader.  Included in this will be a general understanding of inventory and purchasing philosophies, diversion prevention, billing and reimbursement, scheduling and staff development, safety and quality and the ability to lead staff meetings. 

Emergency Department/Clinical Leadership* New for 2022

The Emergency Department (ED) rotation is a required rotation that will allow the resident to experience the ED and work alongside physicians, midlevel practitioners, and nursing to improve the care in the ED. The resident will get to participate in medication reconciliation, code situations, observe a variety of bedside procedures, follow up on cultures, and educate the ED staff. The resident will work to process ED orders and help with any trauma activations and code strokes.

LONGITUDINAL 

 

Education and Projects (Longitudinal) 

The Education and Projects rotation is a required longitudinal experience extending throughout the entire residency year. This rotation encompasses many different areas of teaching and learning. This rotation evaluates the resident’s experience in precepting pharmacy students (APPE and IPPE), Pharmacy and Therapeutics (P&T) presentations and projects, the teaching certificate through ASHP, and much more. The resident is required to provide lectures to internal medicine residents through our graduate medical education department as part of the teaching certificate. There are opportunities to educate other healthcare providers including nursing staff. The goal of this experience is to have the resident leave proficient and confident in all aspects of teaching.

Ambulatory Care (Longitudinal)  The Ambulatory Care rotation is a required longitudinal experience encompassing both opportunities in a pharmacist run anticoagulation clinic and the hospitals primary care clinic. Western Reserve Hospital has a family medicine medical residency where these residents run a primary care clinic. The resident participates one afternoon a week in an ambulatory care setting. The resident rotates every other week between the anticoagulation clinic and the family medicine clinic. The resident will become proficient in managing anticoagulation therapy and provide patient visits independently. The resident will work alongside the family medicine residents providing pharmacy services to primary care patients. Opportunities include but are not limited to medication education, diabetic education, assisting with medication therapy related questions, and providing recommendations to optimize medication regimens.
ELECTIVES  
Ambulatory Care (Elective) 

The Ambulatory Care rotation is a one month elective rotation focusing time in the primary care clinic. This elective opportunity builds on the time spent at the primary care clinic over the longitudinal year. As noted in the longitudinal description, the resident has the opportunity to work alongside family medicine residents to optimize medication regimens and provide education to patients. During this experience the resident will also provide education to the family medicine residents in a didactic lecture. The resident will assist with medication reconciliations, identifying issues with medication compliance and cost issues. The goal of this elective is to provide additional experiences for those interested in refining their skills in a primary care clinic setting.