The primary goals of the residency on-call program are to enhance the resident's practice responsibilities and experiences as well as to assist the second shift pharmacy staff with clinical/operational support.
An on-call survival guide has been developed to help assist the resident perform routine activities. In an attempt to provide additional support to the second shift, the following activities will be provided by the on-call resident:
- Code Pager Coverage
- respond to code pager and provide the required assistance
- Drug Information
- provide answers to drug information questions that require in-depth research
- Pharmacokinetic Coverage
- provide initial dosing checks for medications requiring therapeutic drug monitoring or the potential for renal/hepatic toxicity
- provide drug level interpretations
- Administrative/Operational Support
- assist in obtaining medications from other area hospitals
- serve as the second shift "supervisor" and assist in the solution of patient care needs/issues.
- other administrative/operational procedures that require assistance
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The on-call resident shift will be 4:00 PM to 11:00 PM weekdays, and 11:00 AM to 11:00 PM on weekends and holidays. The on call rotation will provide 7 day/week coverage (approximately one shift every 2 weeks).
Areas being serviced include the medical/surgical units, the pediatric units and the oncology units.
It is the responsibility of the resident to arrange for coverage if he/she cannot work the designated on-call shift. The weekend and holiday on-call shifts will be assigned to residents that are staffing on those days. Residents that opt to work extra shifts on weekday evenings will not be allowed be on-call simultaneously.
The resident will be available by pager and will round twice during the shift through each satellite to assist with any issues.
- Residents will be on-call approximately every three weeks with shifts rotating between residents so that weekend shifts are divided equally.
- Following the staffing or on call weekend PGY-1’s will have a compensatory day off.
- PGY-2’s new to the Johns Hopkins Hospital will have the same weekend on-call schedule as PGY-1’s for their first 3 months.
- After 3 months the PGY-2 residents will transition to working every third weekend.
- clinical specialists
- administrator on call
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The resident will serve as the in-house clinical specialist during his/her on-call shift. This additional responsibility will:
- Assist in the resident's development of his/her clinical autonomy.
- Meet the following residency learning system (RLS) goals:
a. Take personal responsibility for attaining excellence in one's own ability to provide pharmaceutical care.
b. Demonstrate ethical conduct in all activities related to pharmacy practice.
c. Communicate clearly when speaking or writing.
d. Work harmoniously with others in the health system.
e. Accept responsibility for accurate evaluation of one's own work.
f. Manage time effectively to fulfill practice responsibilities.
g. Conduct direct patient-care activities using a consistent approach that reflects the philosophy of pharmaceutical care and that is performed with the efficiency and depth of experience characteristic of an experienced pharmacist.
h. Recommend pharmacotherapeutic regimens and corresponding monitoring plans.
i. Document pharmaceutical care activities appropriately.
j. Participate in the management of medical emergencies.
k. Provide concise, applicable, and timely responses to requests for drug information from health care providers and patients.
- Provide the resident with the experience of being the primary clinical reference.
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The resident will be responsible for documenting his/her activities for the shift and providing a sign out note that will be kept in both a central filing location and as an electronic file.
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Evaluation will be performed by the resident's facilitator based on combination of staff (pharmacist, nursing and physician) comments and resident activity documentation. Individualized feedback will also be provided to the resident by a clinical specialist assigned to review the on-call signouts.