Rotation requirements and descriptions

• Critical Care
• Infectious Disease
• Internal Medicine
• Oncology
• Orientation
• Administration

• Ambulatory Care — Solid Organ Transplant
• Outpatient Cardiopulmonary Rehabilitation
• Residency Project
• Staffing
• Trauma Transitions of Care

• Cardiology
• Neonatology
• Precepting
• Other elective learning experiences may be developed based on resident interest and preceptor availability.

Block Rotations are generally five weeks in length with the exception of Orientation which is about eight weeks. Ambulatory Care – Solid Organ Transplant, Outpatient Cardiopulmonary Rehabilitation, and Trauma Transitions of Care meet twice monthly about five months each.

Ambulatory Care — Solid Organ Transplant is a required longitudinal rotation precepted by Christina Olmsted, PharmD, BCPS. During this rotation, the resident will follow outpatients at the Virginia Transplant Center for approximately one half day every other week for either the fall or spring semester. Appointments with patients involve medication reconciliation, monitoring for side effects, recommending adjustments to therapy based off of patient interview, and assisting patients in the development of independence and compliance with complicated regimens status post transplantation.

Cardiology an elective rotation which is precepted by Daniel Miller, PharmD, BCPS, BCCP. During this rotation, the resident will interact with members of the interdisciplinary team, patients, and caregivers to provide pharmacy care to patients in the cardiac intensive care unit, cardiac stepdown unit, and interventional cardiology unit. Residents will gain exposure to a variety of acute cardiovascular conditions through direct patient care, patient case presentations, drug information responses, and clinical staff in services.

Critical Care is a required rotation precepted by Amy Cook, PharmD, BCPS which focuses on the treatment of patients requiring intensive medical, general surgical care, and trauma surgery care. The rotation encompasses the Surgical ICU, Progressive Surgery Unit, and Trauma rounds. The critical care service heavily involves the monitoring of and intervening upon the pharmacotherapy of severely ill patients. Profiles of ICU patients are reviewed daily, as well as specific reports which detail attributes of interest in providing pharmaceutical care. Disease state and critical care literature are routinely reviewed with the preceptor and applied to clinical practice.

Internal Medicine is a required rotation precepted by Sydney Omohundro, PharmD, BCPS. The patients of focus will primarily be attended by the hospitalist service and located on medical surgery units. Patients may be included from general medical, neurovascular, or surgical units or from hospitalist rounding lists as deemed appropriate for the learning experience.

Infectious Disease is a required rotation precepted by Rachel Perry, PharmD. This rotation is a required rotation and focuses on effective use of antimicrobials within the acute care setting for the treatment of patients with bacterial, fungal, and viral illnesses. Antimicrobial coverage and antibiotic selection are discussed in-depth. The resident is able to actively participate in provision of pharmaceutical care and integrate pharmacodynamic principles into a multidisciplinary approach. Patients span all service lines of each HDH campus. Core content of this rotation will include disease state topic readings/discussion, antimicrobial mechanisms of action/resistance, and evidence-based management of common pathogens and infectious processes. Streamlining activity involving antibiotic selection, dosing and duration will be paramount for this rotation.

Neonatology is a required rotation of the residency precepted by Christina Fox, PharmD. Rotations will teach the fundamentals of caring for neonatal patients, including unique drug dosing, disease states, and treatment modalities involved in these patients. HDH has a very busy Neonatal Intensive Care Unit (NICU) and there is ample opportunity for a resident to become competent in a large variety of disease states unique to this population. The resident will review patient cases, provide drug information services, confer with physicians, nurses, respiratory, and our dietitian. Parental interaction and teaching may be required for medication management at patient discharge.

Outpatient Cardiopulmonary Rehabilitation is a required rotation precepted by Sydney Omohundro PharmD, BCPS, that meets twice monthly. Cardiac patients and pulmonary patients have the opportunity to attend a monthly medication class highlighting common cardiac and pulmonary medications, their uses, and their adverse effects. Residents may work with patients to update their medication profiles and to answer patient questions. Residents will also provide staffing education for Cardiac Rehab personnel.

Oncology is an elective rotation precepted by Emily Chambers, PharmD, BCOP. This rotation focuses on the treatment of patients with oncologic and hematologic diseases, as well as supportive care and complications. The resident will be an active participant and take lead in the care of patients on the service, which includes both inpatient oncology and the outpatient infusion center. Proficiency with the use of chemotherapeutic, biotherapeutic, and immunologic agents is attained while on this rotation. The resident will leave the rotation being competent with the oncology patient and chemotherapy order evaluation and processing.

Orientation is designed to develop an understanding of the various tasks required to staff a complex hospital pharmacy department. The resident will learn how to perform as a pharmacist including the interpretation, compounding, and dispensing of medications. The resident will also develop competency at interpreting and applying drug information to clinical programs. A considerable amount of literature is reviewed with the preceptor over the course of the rotation. Additionally, the resident will learn and participate in formulary management, medication utilization evaluation, competency design and follow-through, and application of clinical knowledge into clinical programs. The preceptor will also mentor the resident in designing a clinically relevant continuing education program. The resident will learn the importance of integrating pharmacists into hospital performance improvement activities and will understand the role the pharmacist must play in the medication-use process in improving core measure performance.

Administration is a required rotation precepted by Rebeccah Collins, PharmD, BCPS. This rotation develops proficiency in the many aspects of managing a complex hospital pharmacy department. Skills such as human resource management, evaluation review and delivery, regulatory compliance, policy development, and patient safety systems enforcement, are taught. The resident will serve on collaborative interdisciplinary committees as an expectation of this rotation. Projects are typically assigned to the resident under the guidance of the preceptor.

Staffing is a required longitudinal rotation. During this rotation, the resident will develop competency working independently as a staff pharmacist. The resident will gain exposure to a wide variety of responsibilities, including compounded sterile product preparation processes, total parenteral nutrition entry and review, high risk medication dosing and preparation, medication order entry and verification, point-of-use automation technology, electronic record documentation, and pharmacokinetic dosing and monitoring. The resident will also become proficient with regulatory compliance and adverse event reporting. This rotation offers numerous opportunities to interact with other disciplines allowing the resident to have active understanding of the pharmacist's role within an institution committed to a multidisciplinary approach to patient care.

Trauma Transitions of care is a required longitudinal rotation precepted by Amy Cook, PharmD, BCPS, that meets one day every other week.  Residents will complete admission medication reconciliation for patients on the trauma service as well as discharge medication reconciliation with counseling for patients being discharged home.  Residents will have the opportunity to work with the trauma team to correct medication errors and complete appropriate changes to the medication list in the electronic health record.