Elective Rotations

Elective Rotations

Elective Rotations

Ambulatory Care (6 weeks)

Preceptor: Sharjeel Khan, PharmD

The Ambulatory Care rotation is an elective, 6-week learning experience focused toward developing the skills necessary to work in an ambulatory care environment.  The resident will gain experience caring for patients with a variety of disease states. Primary focuses will be anticoagulation, asthma, COPD, diabetes, and heart failure. Most activities will take place in the Heart Function Clinic, Diabetes Education area, and the Pulmonary Rehabilitation Clinic. The resident may also be required to make contact with patients and other professionals in any given area of the Winter Haven Hospital campus. The resident is expected to identify opportunities to improve patient outcome via a thorough assessment of medication therapy and addressing identified barriers to compliance.  Residents are expected to interact regularly with other members of the healthcare team, including dieticians, nurses, pharmacists, physicians, social workers and other members of our the team.

Cardiology (4 weeks)

Preceptor: Sharjeel Khan, PharmD

Co-Preceptor: Laura Johnson, PharmD, BCPS

The cardiology rotation is a 4-week elective experience designed to allow the resident to gain expertise in providing pharmaceutical care to cardiovascular patients. Goals of this rotation include learning to extract information from a patient's medical record, clinically monitoring patients and their drug therapy, providing patient-specific therapy recommendations, providing useful and accurate drug information to cardiology practitioners, rounding on CHF patients, dosing/monitoring antibiotics and cardiovascular medications, counseling patients, responding to cardiopulmonary arrests (Code Blues), and developing effective communication skills.

Patient Care Units covered during the cardiology rotation include cardiac telemetry, cardiac step-down unit, and a heart failure floor. Typical duties of the cardiology pharmacist include addressing and documenting on any pharmacy consults (i.e. warfarin dosing, anticoagulant monitoring, antibiotic kinetics), answering drug information questions from physicians and other allied healthcare providers, actively participating during daily CHF rounds, providing discharge counseling for CHF patients, assisting with the completion of discharge medication reconciliations for covered patients, and precepting APPE students when applicable.

The resident will participate and often lead daily CHF rounds each afternoon.  The resident is expected to identify and work-up all CHF patients prior to rounds and be prepared with any evidence-based therapy recommendations. The rounding team usually consists of a cardiologist, a cardiology ARNP, a clinical pharmacist, care management, and the nurse(s) caring for the patients discussed. The resident also attends weekly “Cath Lab Conference,” a multi-disciplinary sitting rounds designed to evaluate complex and interesting cases.

Hospitalist (4 weeks)

Preceptor: Jovino Hernandez, PharmD, BCPS

Co-Preceptor: Steven Nelson, PharmD, BCPS

The Hospitalist Rotation is a 4-week elective learning experience conducted in conjunction with the hospital medical staff. During this learning experience, the resident will participate with make rounds with hospitalist and specialist physicians and mid-level practitioners. Residents will be responsible for ensuring safe and effective medication use for patients reviewed during rounds. Duties will include active participation during rounds, collaboration with decentralized clinical pharmacists on any relevant consults, education of patients and care providers, and providing drug information as requested.

Informatics (4 weeks)

Preceptor: Nishi Ramcharitar, PharmD

Co-Preceptor: Glenn Wysock, RPh

This 4-week elective rotation is intended to provide an introduction to the various facets of health informatics.  Residents will develop a basic understanding of the technologies designed to support the medication management use process and healthy patient outcomes.  These technologies include, but are not limited to, Computerized Prescriber Order Entry (CPOE), Clinical Decision Support (CDS), Pharmacy Information Systems (PIS), Automated Dispensing Cabinets (ADC), Bar-Code Medication Administration (BCMA), and Smart Infusion Devices.  Resident will also be exposed to the concepts of system databases, automation, project management, data analytics, and population health.  Over the course of the rotation, the resident may have the opportunity to collaborate with members of the Information Systems Clinical Applications team to design and implement innovative solutions to electronic health record (EHR) system issues.

Oncology (4 weeks)

Preceptors: Erika J. Rugay-Buchanan, PharmD, BCOP and Natoya Muirhead, PharmD

During this 4-week elective learning experience, the resident will become familiar with the multidisciplinary inpatient and outpatient hematologic and oncologic services at Winter Haven Hospital. A majority of the pharmaceutical care during the learning experience will be provided to adult outpatients in the hospital’s Cassidy Cancer Center. In addition to chemotherapy, the resident will have the opportunity to become familiar with IVIG, IV iron formulations, injections for growth factor support, common pre-medications, and other IV infusions used for conditions such as osteoporosis and inflammatory bowel disease.

Typical duties of oncology pharmacists at WHH include reviewing paper medication orders faxed to the pharmacy, verifying the appropriateness of chemotherapy regimens, confirmation of dose accuracy based on current weight and labs, supervision of pharmacy technicians who mix chemotherapy, checking all medications covered by the oncology/hematology service, and preparing for the next day's Cassidy Cancer Center patients. Oncology pharmacists also provide drug information when requested, help manage charging accuracy for high-cost medications, and help manage inventory and waste for relevant oncology/hematology medications.

The rotation will focus on chemotherapeutic medications and supportive care for the cancer patient. The resident will be responsible for developing knowledge pertaining to etiology, pathogenesis, clinical presentation, diagnostic criteria, prognosis, common treatment regimens, therapeutic goals, and monitoring parameters associated with each disease state and treatment discussed.

Therapeutic Policy and Management (4 weeks)

Preceptor: Glenn Wysock, RPh

Co-Preceptor: Jovino Hernandez, PharmD, BCPS

The Practice Management / Therapeutic Policy elective rotation is a 4-week experience to further develop leadership, financial, strategic planning, and project management skills beyond those obtained during the required longitudinal experience. Additional skills related to formulary management, drug information, and medication safety can also be obtained.

Residents will work from the offices of the Pharmacy Manager and Clinical Coordinator during the experience. Residents should expect to interact with other members of hospital management including those for the Medical Staff, Nursing, Pharmacy, and other disciplines. Management interactions will not be limited to Winter Haven Hospital but will also include other facilities within the BayCare Health System.

Transitions of Care (4 weeks)

Preceptor: Lacey Charbonneau, PharmD

The transitions of care program at Winter Haven Hospital focuses on inpatients that have Medicare insurance, are age 65 years and older, and are admitted with a core measure disease state. The main goal of the transitions of care program is to reduce 30-day readmissions. The program involves patient introduction to the service prior to discharge, an initial follow up call 3-7 days post-discharge, and a second follow up call 21 days post-discharge.

The resident will begin each day of the rotation reviewing potential patients for enrollment in the transitions of care program, introducing the transitions of care program to new patients during admission, and providing follow up calls as described previously. As the rotation progresses, the resident will assume complete responsibility for ensuring optimal evidence-based drug therapy outcomes for all patients in their assigned units.