Acute Care/Neurosciences

• Preceptor: Veronica Timmons, PharmD, BCPS
• Patient Population:
  • Average number of beds: 60 (maximum: 64)
  • Common diseases encountered: stroke, epilepsy, infectious diseases, venous thromboembolism, atrial fibrillation, acute and chronic pain.
• Student Responsibilities:
  • Rounding with a multidisciplinary team
  • Patient education
  • Antimicrobial stewardship
• Examples of commonly assigned projects:
  • Topic discussions e.g., Stroke, CHEST, IDSA guidelines
  • Drug information questions
  • Case presentation and/or in-service

Acute Care/Surgery

Acute Care Cardiology Rotation

• Preceptor: Jessica Chasler, PharmD BCPS
• Patient Population:
  • Patients are admitted to the PCCU through the ED, other units or floors within the hospital, or an outside hospital transfer.
  • Commonly encountered patient populations in the PCCU include: heart failure, arrhythmias, acute coronary syndromes, and pericarditis.
• Student Responsibilities:
  • The student will thoroughly evaluate medication related issues and present recommendations to the team, with follow-up for unresolved issues.
  • After rounds, the student will follow up on unresolved issues from rounds, review patient records and evaluate new admissions to the PCCU, and meet with the preceptor for patient and literature review.
  • The student will be required to counsel 2 patients daily on new medicines.
• Schedule for a Typical Day:
  • The rotation lasts for 4-6 weeks as specified by the school of pharmacy and is a full time rotation.
  • Daily patient care activities include pre-rounding on all assigned patients and participating in daily rounds with the interdisciplinary team at 8:30 a.m.
• Examples of commonly assigned projects:
  • Attend weekly discussions provided by heart failure attendings
  • Conduct patient and literature reviews to the preceptor

Hematology Anticoagulation Clinic

• Preceptor: Peggy Kraus, PharmD
• Patient Population:
  • Outpatient clinic with approximately 7-18 patient scheduled in the half-day clinic. The number of patients will depend on if there is a pharmacy resident in clinic.
  • You may encounter patients who have hypercoagulable states, pulmonary embolism, deep vein thrombosis, May-Thurner syndrome, Thoracic outlet syndrome, antiphospholipid syndrome, LVAD’s, Afib and unusual locations for venous thromboembolism (VTE) such as portal or hepatic vein.
• Student Responsibilities:
  • You will be seeing patients initially with the preceptor and learning the logistics of the clinic flow. This will include performing the point of care INR. As you progress, you may be seeing patients on your own then reporting to the preceptor the plan prior to sending the patient on the way.
  • You will be writing the note on the patient then routing it to the preceptor prior to it being signed by preceptor or routed to the medical director for signature. You will need a lab coat and a stethoscope to re-check blood pressure in the event of encountering a hypertensive patient.
• Schedule for a typical day:
  • For morning clinic, the first patient is scheduled for 8:00 am. You should arrive around 7:45 with having worked up all the patients scheduled.
  • Appointments for return patients are 20 minutes. If a new patient is scheduled, they are given a 60 minute slot so that education and orientation to the clinic may be done.
  • Afternoon clinics start at 1:00 pm until 4:00 pm with the last hour being reserved for a new patient.
• Examples of commonly assigned projects:
  • When encountering a patient with a more unusual indication for developing a VTE you will be asked to look up information regarding how they are associated with VTE and what may be done to treat or prevent reoccurrence.
  • You may be asked to prepare patient education for our bulletin board.

Neurosciences Critical Care

• Preceptors: Salia Farrokh
• Patient Population:
  • The neurosciences critical care unit (NCCU) is a 22 bed intensive care unit consisting of approximately 70% neurosurgical and 30% neurological critical care patients.
• Student Responsibilities:
  • The student will join the interdisciplinary team on daily rounds and be intimately involved with the optimization of drug therapy in this specialized patient population.
  • In addition, students are expected to provide educational services to the team through a variety of forums.
• Schedule for a Typical Day:
  • Daily attendance on rounds
    • Rounds begin at 6:00am daily
  • Attendance at afternoon daily education session in the NCCU provided by the attending physicians, fellows, and clinical pharmacy specialist
• Examples of Commonly Assigned Projects:
  • Daily meeting with preceptor for patient review or topic discussion
  • Communication (verbal and written) with Critical Care team regarding pharmacotherapy issues

Adult Emergency Medicine

• Preceptors:
  • Melinda J. Ortmann, PharmD, BCPS
  • Umbreen Murtaza, PharmD, BCPS
  • Juliana Zschoche, PharmD, BCPS
• Patient Population:
  • 67 Adult treatment beds
  • The Adult Emergency Medicine Rotation is a 1 month experience in a level I trauma center at The Johns Hopkins Hospital (JHH).
  • The rotation allows students to provide pharmaceutical care patients presenting with acute and chronic illnesses as well as actively participate in the resuscitation of medical and trauma patients.
• Student Responsibilities:
  • Expand student’s knowledge base in disease states and complications that patients routinely present with to the ED.
  • Enhance student’s clinical skills in collecting and evaluating patient data in order to identify pharmacotherapy related issues.
  • Provide recommendations clearly and concisely to other members of the multidisciplinary team in the ED environment.
• Schedule for a typical day:
  • Rotation activities will typically begin daily (Monday through Friday) at 11:00AM and end at 7:00PM, during this block based on preceptor scheduling. Hours may be adjusted to a full evening shift (1:00PM-9:00PM) if needed to accommodate multiple learner schedules.
    • NOTE: Rotation hours may vary slightly as educational opportunities pertinent to the learning experience becomes available. Activities outside of the regular rotation hours will not be required but may be made available to the student.
• Examples of commonly assigned projects:
  • Emergency Medicine blog post
  • Clinical pearls for pharmacy staff
  • Formal drug information response for providers/ staff

Adult HIV/AIDS Outpatient Service

• Preceptor: Fidelia Bernice
• Patient Population:
  • Census for the service ranges between 15 and 20 patients per day.
  • The Polk service is a mixture of well-controlled HIV-positive patients presenting with acute care issues, advanced HIV patients presenting with opportunistic infections and non-HIV patients with complex infectious diseases.
• Student Responsibilities:
  • The student will gain experience in antiretroviral therapy, opportunistic infection prophylaxis and treatment as well as management of general infectious disease (e.g. pneumonia, meningitis).
• Schedule for a typical day:
  • A typical day may look like the following:
    • 7:00-7:30 AM Student Pre-Rounding Period
    • 7:30-8:00 AM Patient Discussion with Preceptor
    • 8:00-12:00 PM Patient Care Rounds/Follow-up
    • 12:00-1:00 PM Noon Conference
    • 1:00-5:00 PM Follow-up on Patient Care/Topic Discussion/Project Time
• Examples of commonly assigned projects:
  • Patient care discussions will be held daily and topic discussions led by the student will be completed at least twice weekly

Antimicrobial Stewardship

• Preceptor: Kate Dzintars, PharmD, BCPS, AQ-ID
• Patient Population:
  • Three to 5 patients will be assigned at any given time.
  • The Antimicrobial Stewardship Service assists with determining the appropriate therapy management in terms of the “right antimicrobial at the right dose for the right duration.”
  • At times during the rotation, the student may also interact and work with infection control preventionists (ICPs) and (CCPs).
• Student Responsibilities:
  • The student will be responsible for all pertinent information related to floors and/or services they are assigned. This includes indication for antibiotics, antibiotic allergies, microbiology information, radiology data, and signs/symptoms of infection.
  • Pertinent antimicrobial data would include drug, indication, dose, frequency/route of administration, need for adjustment based on organ function and therapeutic drug monitoring.
• Schedule for a typical day:
  • 8:30-11:00 AM Student Pre-Rounding/Follow-up on Patient Care/Topic Discussion/Project Time
  • 11:00 AM-12:00 PM Patient Discussion with Preceptor/ID resident
  • 12:00-1:00 PM Noon Conference/Lunch Time
  • 1:00-2:00 PM Daily Stewardship Rounds
  • 2:00 – 5:00 PM Follow-up/Project Time
• Examples of commonly assigned projects:
  • Drug information questions, journal clubs
  • Patient case presentations

General Adult Infectious Disease Consult Service

• Preceptor: Kate Dzintars, PharmD, BCPS, AQ-ID
• Patient Population:
  • The average daily census of the Consults list is 15 – 20 patients. Three to 5 patients will be assigned at any given time.
  • The General Adult Infectious Disease (ID) Consult Service is referred to as the "Mann" service and consists of two services: "teaching" and "solo attending".
  • Patients on service are generated through formalized consults from adult primary services (e.g. medicine, surgery, neurology, etc.). The patient care area is distributed throughout the hospital and not confined to a specific area.
• Student Responsibilities:
  • The student will be responsible for all pertinent information related to patients they are assigned. This includes reason for consult, antibiotic allergies, microbiology information, radiology data, and signs/symptoms of infection.
  • Pertinent antimicrobial data would include drug, indication, dose, frequency/route of administration, need for adjustment based on organ function and therapeutic drug monitoring.
• Schedule for a typical day:
  • 8:30-11:00 AM Student Pre-Rounding/Follow-up on Patient Care/Topic Discussion/Project Time
  • 11:00-12:00 AM Patient Discussion with Preceptor/ID resident
  • 12:00-1:00 PM Noon Conference/Lunch Time
  • 1:00-5:00 PM Patient Care Rounds
• Examples of commonly assigned projects:
  • Drug information questions, journal clubs, patient case presentations

Bone Marrow Transplant, Myeloma, and Lymphoma

• Preceptor: Jamie Elsner Ziggas, PharmD
• Patient Population:
  • The average team census consists of 8 to 15 patients.
  • This service is primarily responsible for providing care to patients that are in the process of receiving or who have received an autologous or allogeneic hematopoietic stem cell transplant. Patients with multiple myeloma or lymphoma are also admitted to this service.
• Student Responsibilities:
  • Students will have the opportunity to participate in direct patient care through rounding with the medical team and providing pharmacy-related recommendations, completing therapeutic drug monitoring, and providing patient education on immunosuppression and prophylactic antimicrobial agent.
  • Students will also be expected to attend daily interdisciplinary discharge rounds, a variety of weekly oncology-related conferences, and topic discussions throughout this rotation.
• Schedule for a Typical Day:
  • Work-up patients prior to rounds in the morning
  • Round with assigned service
  • Touch base with preceptor about the plan for the day.
  • After rounds and scheduled meetings, counsel patients while waiting for levels to return.
• Examples of Commonly Assigned Projects:
  • Inservices to either the nursing or pharmacy staff
  • Journal Clubs with preceptor and other learners on rotation

Oncology Pain and Palliative Care

• Preceptor: Julie Waldfogel, PharmD, CPE
• Patient Population:
  • The Oncology Pain and Palliative Care Consult Service assists with providing pharmaceutical care and appropriate pain and symptom management to both inpatients and outpatients at the Sidney Kimmel Comprehensive Cancer Center.
  • The service consists of an attending physician, nurse, social worker and clinical pharmacy specialist.
• Student Responsibilities:
  • Students will be expected to participate in daily team rounds and be involved in the daily evaluation of both inpatient and outpatient consults.
  • Conduct a patient interview and comprehensive pain assessment
• Schedule for a typical day:
  • Daily team rounds start at 9:00am Monday through Friday. Students will also participate in the Pain and Palliative Care Clinic on Monday, Wednesday and Friday mornings.
• Examples of commonly assigned projects:
  • Topic discussions
  • Patient care discussions

Pediatrics

• Preceptor: Carlton K.K. Lee, Pharm.D., MPH, FASHP, FPPAG
• Patient Population:
  • The inpatient Pediatrics service typically carries a total of 10-15 patients.
  • General Pediatric patient population ages ranging from newborn infants to adolescents. Common diseases encountered include asthma, diabetes, seizures, community acquired pneumonia and other childhood infections, GE reflux, Kawasaki’s Disease and cases of pending diagnoses.
• Student Responsibilities:
  • Participate in daily inpatient rounds with multidisciplinary medical team by reviewing the appropriateness of pharmacotherapy and answering drug information questions. Provides patient/caregiver counseling via the pharmacy department patient education program.
  • Establish one’s own Pediatric Pharmacotherapy database by preparing and presenting topic discussions with preceptor.
  • Prepare and present a case presentation to the Pediatric Pharmacy staff at the end of the rotation.
• Schedule for a typical day: Pre-round review of the pharmacotherapy of patients on service.
  • Participate in daily morning work rounds with medical team (2-2.5 hours)
  • Follow up on drug information questions, prepare for topic discussion and or preceptor patient presentation.
  • Attend applicable education sessions (e.g. Pharmacotherapy rounds, Pediatric Grand Rounds, Pediatric Pharmacy Education Sessions, and Pediatric Case Conferences).
  • Meeting with preceptor for a minimum of 3 days per week.
• Examples of commonly assigned projects:
  • Patient presentations to the preceptor.
  • Topic discussion of Common Pediatric Disease states which require Pharmacotherapy by organ systems.
  • End of rotation case presentation.

Psychiatry

• Preceptor: Sujin Lee Weinstein, PharmD, BCPP
• Patient Population:
  • The Osler satellite provides care to 88 inpatient beds and several outpatient day programs. The student will participate in a variety of hospital related activities focusing on the development of clinical skills.
• Student responsibilities:
  • Students will be expected to perform as an entry level clinical pharmacist, not as a student.
  • Meet at least once a week with preceptor to discuss assigned topics and readings
  • Meet at least once a week with preceptor to discuss assigned patients.
• Schedule for a typical day:
  • The hours for this clerkship are from 8:00 am to 4:30 pm Monday through Friday. You may need to be here earlier and/or stay longer, depending on your responsibilities and daily activities.
• Examples of commonly assigned projects:
  • Present at least one formal in-service on a drug therapy related topic to the medical, nursing, and/or pharmacy personnel
  • Complete a newsletter item for the hospital’s newsletter

Kidney/Pancreas Transplantation Surgery Service

• Preceptor: Laura M. Lees Pharm D. BCPS
• Patient population:
  • There are generally 10-12 patients admitted to the renal transplant surgery service.
  • This rotation provides experience in taking care of patients who are admitted to receive a kidney or pancreas transplant patients. Common disease states encountered include, hypertension, diabetes, coronary artery disease, hypothyroidism, infection, and a variety of renal diseases that are the etiology of renal failure.
• Student responsibilities:
  • The student will prepare for rounds, attend transplant rounds, as well as care coordination rounds. The student will also reconcile medications for all patients admitted to the team, provide documentation in the patient chart as needed, address the need for non-formulary drug requests, and provide drug information and education to healthcare professionals, patients and caregivers.
  • The student will attend transplant related meetings with the preceptor including weekly listing meetings every Tuesday and Wednesday. Students will also be expected to attend journal clubs, transplant topic discussions, and renal grand rounds.
• Schedule for a typical day:
  • Rotation hours are from approximately 7:30-4pm Monday through Friday.
    • Pre-rounding 7:30-8, rounds 8-9 am, care coordination rounds 11-12, daily meetings with preceptor. Transplant related meetings are at various days and times throughout the rotation.
• Examples of commonly assigned projects:
  • Transplant related topic discussion, journal club review, literature review
  • Respond to drug information questions regarding outpatients from transplant coordinators.

Pharmacy Informatics

• Preceptors:
  • Kim Pietropola
  • Alix Dabb
  • Ian Watt
• Patient Population: The experience involves planning, implementing, maintaining, and improving processes using the electronic medical record and non-direct patient interaction.
• Student responsibilities:
  • The student will seek to understand the efforts and resources required for the maintenance of applications and hardware of existing systems.
• Schedule for a typical day:
  • The student will work with a multi-disciplinary team to plan and implement new systems and review and measure the performance of existing systems.
• Examples of Commonly Assigned Projects:
  • Rotation content may vary depending upon Departmental and Organizational needs. Project management will be emphasized.

Investigational Drug Services

• Preceptors
  • Aleksandra Beselman, Pharm.D.
  • Hye Kim, Pharm.D.
  • Manisha Hong, Pharm.D
  • Laura Wachter, Pharm.D.
• Student responsibilities:
  • This rotation is designed to introduce students to the operations of an Investigational Drug Service and give them the foundation to assess financial, operational, and regulatory issues involved in supporting research.
  • Students will gain an understanding of the new drug development process and research terms, learn the regulations and processes concerning the dispensing of investigational drugs, the pharmacist's role on the IRB, and become familiar with the daily operations of a pharmacy-based investigational drug service.
  • Students will have a chance to attend an IRB meeting and other study-related meetings as well as management and administrative meetings.
• Schedule for a typical day:
  • Daily tasks include reviewing protocols, communicating with study personnel, developing dispensing instructions, assisting with inventory management, and dispensing study products to study participants.
  • Other responsibilities include completing audits of drug accountability records, establishing budget estimates for pharmacy services for new studies, answering drug information questions related to research issues, counseling study participants, and monitoring study medication adherence.
• Examples of commonly assigned projects:
  • Inservice/Presentation
  • Designing dispensing instructions
  • Internal/external audits

Pediatric Medication-Use Safety

• Preceptor: Meghan M. Rowcliffe, PharmD, BCPS, BCPPS
• Patient population:
  • Johns Hopkins Hospital Children’s Center (205 beds), various patient populations: ICU, oncology, general pediatrics
• Student responsibilities:
  • During this rotation, the student will learn about medication error prevention through exploration of:
    • Literature regarding medication safety
    • Pharmacy operations and workflow
    • ISMP ‘Key Elements’ of the medication-use process
    • Use of technology to reduce errors (“Best Practice” and JHH practice)
    • Reported medication errors
• Schedule for a typical day:
  • Review medication errors reported in the past 24 hours and follow up as appropriate, shadowing of pharmacist/technician/nurse as appropriate, attendance at various patient and medication safety meetings, attendance at topic discussions/education sessions
• Examples of commonly assigned projects:
  • Medication error investigation and review
  • Prepare and present one journal club on a relevant medication safety topic.
  • Actively participate in bi-monthly medication safety discussion lectures.
  • Read necessary/assigned materials and be prepared to discuss with the preceptor during topic discussions. Formal topic discussion will be held once weekly.

Pharmacy Leadership and Management

Leadership and Management

• Preceptor: Meghan Davlin Swarthout, PharmD, MBA
• Patient population:
  • The Ambulatory and Care Transitions Pharmacy oversees the drug distribution and clinical pharmacy services for the ambulatory clinics, operating rooms, and procedure areas at The Johns Hopkins Hospital.
• Student responsibilities:
  • The student will participate in pharmacy leadership activities related to clinical program development, human resource management, financial oversight and planning, clinical information systems administration, quality improvement, and medication safety.
• Schedule for a typical day:
  • Working with multidisciplinary teams on transitions of care initiatives
  • Participating in quality improvement and medication safety activities
  • Attending daily meetings with preceptor for topic discussion
• Examples of commonly assigned projects:
  • Completing at least one administration project based on the student’s interests
  • Lead at least one meeting using effective meeting management techniques

Hospital/ Health System Pharmacy

• Preceptor: Matthew Walbrown, Pharm.D., BCPS
• Patient population:
  • The Weinberg pharmacy services inpatient oncology (approximately 80 beds), inpatient surgery (approximately 50 beds), and outpatient oncology clinic services (approximately 150 – 200 patients/day)
• Student responsibilities:
  • The student will spend time in the various roles seen in the Weinberg pharmacy. This will include distributive roles with pharmacy technicians and pharmacists, clinical rounds with decentralized staff, and time with the oncology investigational drug staff.
  • The student will also perform patient education several times per week.
• Schedule for a typical day:
  • Depends on the student’s role for the day. If shadowing decentralized staff, the student will work up patients and be prepared to participate on multidisciplinary rounds.
  • If the student is shadowing someone in a distributive role, the student will observe the pharmacist or technician as well as help fill/compound products.
• Examples of commonly assigned projects:
  • Work on Pyxis optimization and assisting with data collection related to missing doses.