Core Rotations

Our core rotations represent the strengths of the hospital services where clinical pharmacy specialists have been incorporated into the multidisciplinary teams. The broad reach of our pharmacy department will allow for ample learning opportunities with the goal of identifying or reinforcing areas of interest and future direction for our residents.

Additionally, our philosophy is to tailor the learning experiences to the learner, which includes

  • Flexible scheduling of core rotations
  • Multiple elective opportunities
  • Mandatory creation of at least one elective rotation by the resident, to truly make the learning experience their own.

Ambulatory Care

This longitudinal rotation is a broad ambulatory care which provides medication therapy management (MTM) services, management of chronic disease and care transitions within an inter-professional healthcare environment. Catholic Health Systems seeks to meet quality measures while reducing the total cost of care for our patient population and this pharmacy service addresses all aspects of the Triple/Quadruple Aim. Additionally, these services will align with Catholic Health Systems values; reverence, compassion, justice and excellence. The pharmacist-led ambulatory care service within the Catholic Health System serves as an outpatient practice which focuses on medication safety and efficacy/outcomes, as well as cost management as they relate to transitions of care and disease management.

Neonatal Intensive Care Unit

The rotation will consist of providing clinical pharmacy services to the Level III Neonatal Intensive Care Unit (NICU) at Sisters of Charity Hospital, under the guidance of the rotation preceptor, for patients born premature and/or having other acute illness requiring intensive monitoring. The resident will have daily interactions with the neonatal intensivists, nurse practitioners, physician’s assistants, nursing staff, pharmacy personnel, and other healthcare professionals as required to optimize the therapeutic management of these patients. In addition to the pharmacotherapeutic consultative services, the resident will also be expected to provide drug information services, patient education (as needed), discharge counseling, and educational presentations to the pharmacy, providers, and nursing staff. The resident will meet frequently with the preceptor to discuss patient care issues and pharmacotherapeutic topics specific to neonatology.

Critical Care

Critical Care Pharmacy is a required, four week learning experience at Sisters of Charity Hospital (SOC). This rotation will be comprised of both the intensive care unit (ICU) and the cardiology teaching service. The ICU is a 16 bed unit that cares for critically ill patients. The cardiology teaching service provides care to a maximum of 18 patients. Members of both the ICU and cardiology teaching service consist of an attending physician, PGY-2 senior medical resident, 2 PGY-1 medical interns, and medical students.

Emergency Medicine

The Emergency Department rotation is a required, one month learning experience at Sisters Hospital. In this rotation, the resident will learn the skills necessary to become a competent clinical pharmacist that can work independently and provide direct patient care to patients in the emergency department (ED). The ED at Sisters Hospital is a 29-bed unit equipped with two code rooms and a 5-bed fast track. Clinical pharmacy services are provided in the ED, at minimum, from 0900-2200 Monday through Friday. Pharmacist responsibilities in the ED include responding to cardiac arrests and stroke emergencies, answering drug information questions from ED and Sister Hospital caregivers, patients, and families, antibiotic stewardship (including the daily outpatient microbiology report), collaborating with the centralized pharmacists to assure timely medication availability, and medication reconciliation. During this rotation, the pharmacy resident will work collaboratively with several disciplines including the ED physicians, ED mid-level providers, hospitalists, medical residents and ED nurses to optimize pharmaceutical care for the ED patients. The resident will be required use evidence-based medicine to provide pharmaceutical care to a range of ED patients, from the ambulatory to the critically ill. A typical day in the ED does not exist and the resident will be required to "work on the fly".

Internal Medicine #1

3 North (3N) Clinical Pharmacy Services is a required, five week learning experience at Sisters of Charity (SOC) hospital. There are 22 general medicine beds on 3N. The resident will have an opportunity to interact with a variety providers, including hospitalist groups, specialists, consultants and mid-level providers. There are also a number of other ancillary staff on 3N involved in the care of the patient, including nurses, nursing students, respiratory therapists, case managers, clinical dieticians, and physical therapists.

The resident will also establish collaborative relationships with other healthcare professionals by providing at least one pharmacy education presentation to nursing students each semester (topics to be determined based on discussion with nursing). This teaching/educational component will be a longitudinal assignment, to be completed over the course of the residency year. Good communication and interpersonal skills are vital to success in this experience.

Internal Medicine #2

Internal Medicine - 3 Teaching / 3N. This service provides care to diverse patient populations. It’s a combined service that includes step down ICU patients, complicated patients that are stable enough to be on the floor (Teaching) and general medicine patients. We provide care to around 35 patients in total, including 10 patients being taken care of by the teaching team, which consists of the attending physician, PGY2 senior resident, PGY1 medical intern, and medical students, and 25 patients being taken care of by independent hospitalists, specialists, consultants, and mid-level providers. The pharmacy resident will actively participate in the development of patient treatment plans, identify patient problems, ensure the safe and effective use of medications through gathering past medical histories of patients, make recommendations pertaining to medication regimens, communicate these recommendations to the healthcare team during multidisciplinary rounds, and monitor the patient treatment plans to evaluate the patient outcomes. We have many rounds that the resident will attend in our service. This includes a round with the medical residents to go through updates in the teaching patients followed by a round with the attending physician. We also have a multidisciplinary rounds for 3N patients with two different hospitalists and mid -level providers. The resident will therefore be also exposed to and interact with healthcare providers from diverse specialties.

Internal Medicine #3

Internal Medicine III (Precepting) is a core learning experience at Sisters Hospital PGY1 pharmacy residency program. The primary goal of this rotation is for residents to develop the skills and competencies in pharmaceutical care to effectively participate in therapeutic decision making, drug therapy selection, clinical monitoring, and patient counseling. The pharmacy resident will be responsible for medication reconciliation, identification and resolution of DRPs, and patient counseling, and will work toward assuming a case load similar in size to the pharmacist’s throughout the learning experience. Pharmacy residents will also be responsible for the co-precepting of IPPE and APPE pharmacy students.

Pharmacy Research Project

This longitudinal rotation will cover the dispensing and distributive operations of Sisters of Charity Hospital. Within this rotation, an initial 5 week period will be incorporated to give residents a chance to orient to the physical layout of the department and hospital, read and understand Catholic Health, Sisters Hospital, and pharmacy department specific policies and procedures, as well as software programs pertinent to pharmacy operations. Staffing requirements include an average of 2 weekend shifts every other week and coverage of major holidays (max of 3 holiday shifts per resident) as needed by the department.

Residency Orientation

The resident will be required to complete a longitudinal pharmacy research project. This research project may be of a clinical, economic, research, administrative, or quality/process improvement design. A list of possible projects will be provided to the resident at the beginning of the residency year. Additionally, the resident may elect to conduct an unlisted project, only with the approval of the research committee and residency advisory committee. The resident will work with their assigned preceptor(s) to create a study design proposal which will be presented to the CH IRB, conduct a literature search, conduct the actual study, interpret the study data, and present the results. The resident will work on their research project longitudinally during the residency year with extra time devoted to research in December.

Operations Orientation

This longitudinal experience is designed to give residents a chance to develop their professionalism and to learn about and participate in important pharmacy-related functions of the health system that are not necessarily associated with direct patient care. The resident will demonstrate knowledge and application skills in the pharmacy services that are critical to safe, effective, and cost-conscious medication use in a hospital and ambulatory care pharmacy departments, including (1) practice management; (2) medication-use policy development; (3) optimizing medication therapy; (4) drug product procurement and inventory management; (5) monitoring medication use; and (6) evaluating the effectiveness of the medication-use system.

Pharmacy Operations/Staffing Services

Preparing the resident for a future career involving academia or precepting student pharmacists on experiential rotations is a vital skill to be an advanced practitioner. Being involved in different types of teaching and learning experiences also allows the resident to grow as a professional. Educational opportunities exist in multiple settings throughout the residency year, including small group teaching (in-services, drug info, topic discussions), mentoring APPE pharmacy students, and grand rounds. Additionally, the resident may be called upon to develop educational programs for medical/pharmacy staff.

Practice Management

Elective rotations are an area that allows for customization of our program to fit the interests of the residents. While we have several elective rotations that have been developed based on strengths of our institution, one of the requirements for this program is for the resident to create their own elective. Creation of an elective provides ownership for the resident in their experiences as well as develops a skill set and understanding of the regulations set forth by our accrediting organization, ASHP. Some examples of created electives include:

  • Infectious Diseases
  • Ambulatory Care
  • Cardiology Clinic
  • Retail/Community Pharmacy

Leadership Series

This longitudinal experience is designed to give residents a chance to develop their professionalism and to learn about and participate in important pharmacy-related functions of the health system that are not necessarily associated with direct patient care. The resident will demonstrate knowledge and application skills in the area of leadership and ethics. It is recommended that the residents utilize the Catholic Health University to attend classes related to leadership, teamwork, and ethics so long as they do not interfere with scheduled rotations.

Leadership series will be a longitudinal experience consisting of 1 hour meetings related to a myriad of topics. Please refer to the Leadership Dashboard for the minimum areas to be covered.

Teach and Learn

Preparing the resident for a future career involving academia or precepting student pharmacists on experiential rotations is a vital skill to be an advanced practitioner. Being involved in different types of teaching and learning experiences also allows the resident to grow as a professional. Educational opportunities exist in multiple settings throughout the residency year, including small group teaching (in-services, drug info, topic discussions), mentoring APPE pharmacy students, and grand rounds. Additionally, the resident may be called upon to develop educational programs for medical/pharmacy staff.

Transition Month

This rotation module will occur for approximately 4 weeks around the month of December. During this module the residents will be spending most of their time on their longitudinal research poster project to be presented at the national ASHP Midyear Conference, generally during the 1st half of December. The goals of this rotation are for the residents to appropriately manage their time in order to successfully complete a mid-term point of their yearlong research project, coordinate a business trip to the Midyear Conference and manage the finances associated. In addition, this will be the time to complete all mid-year evaluations on PharmAcademic and follow through with any outstanding work from the first half of the resident year.

Elective Rotations

Elective rotations are an area that allows for customization of our program to fit the interests of the residents. While we have several elective rotations that have been developed based on strengths of our institution, one of the requirements for this program is for the resident to create their own elective. Creation of an elective provides ownership for the resident in their experiences as well as develops a skill set and understanding of the regulations set forth by our accrediting organization, ASHP. Some examples of created electives include:

  • Ambulatory Care
  • Cardiology Clinic
  • Critical Care- Kenmore Mercy
  • Cardiovascular ICU
  • Obstetrics/Maternal Child