Pharmacy Residency Program: Medication-Use Safety and Policy

Program Type: ASHP Accredited PGY2 Residency

ASHP Match Number: 536377

PGY2 Program Purpose

PGY2 pharmacy residency programs build on Doctor of Pharmacy (Pharm.D.) education and PGY1 pharmacy residency programs to contribute to the development of clinical pharmacists in specialized areas of practice. PGY2 residencies provide residents with opportunities to function independently as practitioners by conceptualizing and integrating accumulated experience and knowledge and incorporating both into the provision of patient care or other advanced practice settings. Residents who successfully complete an accredited PGY2 pharmacy residency are prepared for advanced patient care, academic, or other specialized positions, along with board certification, if available.

Program Overview

The PGY2 Medication-Use Safety and Policy Residency offers advanced training that prepares the resident to assume a leadership role in devising and implementing system changes that improve the safety, efficiency, and appropriateness of the medication-use system.

The resident will work with the medication safety and quality team to investigate medication-related events, assess compliance with regulatory standards and best practice recommendations related to medication-use safety, and develop and implement system changes to ensure safe and efficient use of medications. While the majority of rotations are completed at the hospital, there are also opportunities for away rotations at the Johns Hopkins Bayview Medical Center and The Institute for Safe Medication Practices (ISMP). The resident will also complete a longitudinal educational experience with the Armstrong Institute of Patient Safety and Quality Leadership Academy. Upon completion of this program, the individual will be well positioned to function as a Medication Safety Officer in a health-system setting.

Program Goals

Residents who complete this program will be able to assume a leadership role in devising and implementing system changes that improve the safety, efficiency, and appropriateness of the medication-use system.

Residents will:

• Analyze complex systems to identify and correct system flaws
• Complete a longitudinal educational experience with the Armstrong Institute of Patient Safety and Quality Leadership Academy
• Design and complete a self-directed research project with a focusing on medication-use safety
• Develop effective communication techniques and understand the way human factors that impact the safety of patient care
• Learn and apply methods to promote a culture of safety
• Participate in the application of technologies that improve the medication-use process
• Participate and lead committees promoting medication safety
• Participate in the teaching of medication safety focused lectures at the University of Maryland School of Pharmacy

Orientation

The Pharmacy Residency Orientation experience provides a comprehensive and coordinated training program designed to provide incoming residents with an understanding of policies, procedures, and expectations for the pharmacy residency experience. During orientation, residents will participate in hospital, department, and division orientation, and will be exposed to department policies and resources.

Hospital and pharmacy department orientation is required for all new pharmacist hires at Johns Hopkins Hospital. The resident is expected to interact with members of the pharmacy department throughout orientation and to attend assigned orientation and training sessions.

Prior to the start of the residency program, residents will be given a full, detailed orientation itinerary.

Rotations

Required Rotations

Core block rotations (4-8 weeks each)

• PGY2 MUSP - Orientation (4 weeks)
• PGY2 MUSP - Inpatient Clinical (4 weeks)
• PGY2 MUSP - Medication Safety in Adult Medicine, Critical Care, and Surgery (8 weeks)
• PGY2 MUSP - Formulary and Systems Integration (4 weeks)
• PGY2 MUSP - Medication Safety in Pediatrics (8 weeks)
• PGY2 MUSP - Medication Safety in Oncology (4 weeks)
• PGY2 MUSP - Medication Safety at Bayview Medical Center (4 weeks)
• PGY2 MUSP – Quality Improvement and Regulatory Affairs (4 weeks)

Core longitudinal rotations (9-12 months each)

• PGY2 MUSP – Longitudinal Staffing (12 months)
• PGY2 MUSP – Longitudinal On-Call (12 months)
• PGY2 MUSP - Longitudinal Education and Teaching Experience (12 months)
• PGY2 MUSP – Longitudinal Research Project (12 months)
• PGY2 MUSP – Longitudinal Pharmacy Automation and Technology (9 months)
• PGY2 MUSP – Longitudinal Medication-Use Policy and Formulary Management (9 months)

Elective Rotations

Block Rotations (4 week)

• PGY2 MUSP- Institute for Safe Medication Practices (ISMP) (4 weeks)
• PGY2 MUSP- Central Pharmacy Operations and Automation (4 weeks)

Sample Schedule (monthly basis)

• July - PGY2 MUSP - Orientation
• July – June
  • PGY2 MUSP – Longitudinal Staffing
  • PGY2 MUSP – Longitudinal On-Call
  • PGY2 MUSP - Longitudinal Education and Teaching Experience
  • PGY2 MUSP – Longitudinal Research Project
• August - PGY2 MUSP - Inpatient Clinical
• September - PGY2 MUSP - Medication Safety in Adult Medicine, Critical Care, and Surgery
• October - PGY2 MUSP - Medication Safety in Adult Medicine, Critical Care, and Surgery
• October – June
  • PGY2 MUSP – Longitudinal Pharmacy Automation and Technology
  • PGY2 MUSP – Longitudinal Medication-Use Policy and Formulary Management
• November- PGY2 MUSP - Formulary and Systems Integration
• December - PGY2 MUSP - Medication Safety in Pediatrics
• January - PGY2 MUSP - Medication Safety in Pediatrics
• February - PGY2 MUSP - Medication Safety in Oncology
• March - PGY2 MUSP - Medication Safety at Bayview Medical Center
• April - PGY2 MUSP- Institute for Safe Medication Practices (ISMP)
• May - PGY2 MUSP – Quality Improvement and Regulatory Affairs
• June - PGY2 MUSP- Central Pharmacy Operations and Automation

Education Components

• Pharmacotherapy Rounds
  • All residents will provide a 30-minute presentation that is APCE accredited.
  • Please refer to the “Learning Opportunities” section of the Department of Pharmacy, Johns Hopkins Medicine website.
• Journal Clubs and/or Topic Discussions
  • Example topics:
    • Change Management Principles
    • High Alert Medications & Strategies to Minimize Errors
    • Just Culture and Systems Thinking
    • Safety Implications of Drug Shortages
    • Joint Commission Readiness
• Teaching Requirements
  • Each Hopkins resident is required to provide educational sessions.
  • The resident will provide a 60-minute Medication Safety Continuing Education presentation that is APCE accredited.
  • The resident will provide a medication safety focused lecture for students at the University of Maryland School of Pharmacy
  • Please refer to the “Learning Opportunities” section of the Department of Pharmacy, Johns Hopkins Medicine website

Requirements for Acceptance to the Program

The qualified candidate will have a Doctor of Pharmacy degree from an ACPE accredited school of pharmacy. Prior to the beginning of a PGY2 residency, PGY2 residents must have successfully completed an ASHP-accredited PGY1 pharmacy residency program.

Licensure and Certification Requirements

All residents are required to obtain a Maryland State Pharmacy License by August 1st.

The resident will arrive at the program already ACLS certified, or will complete certification during the residency year.

Program-Specific Experiences

• Armstrong Institute Patient Safety and Quality Leadership Academy
  • This is a 9-month training program that includes didactic and discussion sessions, Lean Sigma training, completion of a patient safety or quality improvement project, and attendance at institutional quality and safety meetings.

Attendance at Professional Meetings

The department will support the resident (expense and leave time) to attend the ASHP Midyear Clinical Meeting and/or the ASHP Summer Meeting. Any additional travel that is to be supported by the department is evaluated on a case-by-case basis.

Please refer to the “Meetings and Conferences” section of the Department of Pharmacy, Johns Hopkins Medicine website.

MUE Project

The resident must complete a self-directed research or quality improvement project. The scope, magnitude, and type of project will vary according to individual interests but must be completed in a manner suitable for presentation and publication.

Please refer to the “Projects” section of the Department of Pharmacy, Johns Hopkins Medicine website.

Drug Class Review (DCR) or Formulary Management Project

The resident will complete a drug class review as part of the formulary management process. This may be achieved through assisting in the determination of formulary additions/deletions by assessing therapeutic merits, safety, redundancies, and the estimated cost impact on the JHHS.

Committee Participation

The resident will be assigned to departmental, hospital, or health-system committee(s) over the course of the year. The resident will serve as the secretary for the Medication Event Review and Intervention Team (MERIT). The resident will help support both the Significant Medication Event (SME) and Pediatric Medication Safety Committees.

Staffing Component

Each resident will practice as a pharmacist in a designated area throughout the residency year.

Please refer to the “Staffing Requirements” section of the Department of Pharmacy, Johns Hopkins Medicine.

On-Call Coverage

The resident will participate in clinical on-call services. On-call duties include adult and pediatric code response, trauma and stroke calls, administrative assistance, and other duties. On-call hours are from 4 PM to 10 PM on weekdays and 8 AM to 8 PM on weekends and holidays. The frequency of on-call coverage depends upon the number of residents in the entire program and averages about 15 shifts per year.

Please refer to the “On Call Program” section of the Department of Pharmacy, Johns Hopkins Medicine website.

Paid Time Off (PTO)

Please refer to the “Benefits” section of the Department of Pharmacy, Johns Hopkins Medicine website.

Residency Program Director

Rosemary J. Duncan, PharmD
Medication Safety Officer
The John Hopkins Hospital
Department of Pharmacy
600 North Wolfe Street, Carnegie 180
Baltimore, MD 21287-6180

Phone: 443-287-6850
Email: rcall1@jhmi.edu

Residency Program Coordinator

Meghan Rowcliffe, PharmD
Pediatric Medication Safety Officer
The John Hopkins Hospital
Department of Pharmacy
600 North Wolfe Street, Carnegie 180
Baltimore, MD 21287-6180

Phone: 410-502-6594
Email: mrowcli1@jhmi.edu

Core Residency Preceptors

Jacob Smith, PharmD, MBA
Assistant Director of Medication Safety and Quality

Emily Pherson, PharmD
Assistant Director of Clinical Informatics and Medication-Use Policy

Program Director

Rosemary Duncan, Pharm.D., BCPS

Title: Medication Safety Officer, Adults
Education: Pharm.D., University of Mississippi

Rosemary Duncan, Pharm.D., BCPS is a Medication Safety Officer at the Johns Hopkins Hospital. Dr. Duncan received her Doctor of Pharmacy degree from the University of Mississippi School of Pharmacy where she also completed her PGY1 in Community and Ambulatory Care Pharmacy. Dr. Duncan completed a PGY2 in Medication-Use Safety at St. Jude Children's Research Hospital in Memphis, Tennessee.

Dr. Duncan is an active member of the Maryland Society of Health System Pharmacists (MSHP) Medication Safety Committee and the ASHP Section of Inpatient Care Practitioners' Group on Medication Safety.

Dr. Duncan's primary responsibility is investigating medication-related events and helping develop system changes that promote the safe use of medications within the hospital and health-system. She is a member of various committees supporting patient and medication quality and safety, and leads and participates in numerous multi-disciplinary initiatives to improve safety, efficiency, therapeutic appropriateness, and compliance with regulatory standards.

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