This five-week rotation orients residents to their home-base practice site as well as Norton Healthcare facilities where learning experiences occur. This rotation serves as an introduction to pharmacy practice as it relates to both health system and hospital-specific operations and delivery of patient care. During the orientation period, residents become familiar with the hospital facility and departmental policies and procedures, and begin the process of integration within the pharmacy staff.

The internal medicine (IM) rotation provides residents with a broad training experience in managing acutely ill internal medicine patients who are admitted to an adult medical/surgical unit for diverse and complex medical management. The goal of this rotation is for the resident to develop knowledge, skills and competencies to provide evidence-based, patient-centered medication therapy management.

This rotation is designed to provide the resident with an introduction to critical care medicine. The goal of this rotation is for the resident to develop knowledge, skills and competencies to provide evidence-based, patient-centered medication therapy management for disease states commonly encountered in critically ill patients. At the conclusion of this learning experience, the resident should be able to recommend appropriate treatment options, perform therapeutic drug monitoring for selected medications and communicate with other health care professionals to ensure optimal drug therapy.

The infectious diseases rotation provides PGY1 residents with a broad training experience in the infectious diseases pharmacotherapy needs of acutely ill inpatients and in the principles of antimicrobial stewardship. Specific daily tasks include prospective audit and feedback, blood culture reporting and recommendation, patient counseling, anti-infective allergy clarification and management, and drug information service. Using Norton Healthcare’s pharmacist-driven rapid response bacteremia protocol will allow residents to be first responders to initiate and adjust antibiotic therapy.

This rotation provides residents with practical experiences related to a clinical pharmacy service in transitions of care. Through this experience, residents will explore unique opportunities and document challenges/barriers that exist for providing medication management during transitions of care. The role of the pharmacist in these areas is to facilitate transitions of care for patients admitted to medical/surgical units and deemed to be at high risk for readmission. This will be accomplished through the collection of accurate admission medication histories, the delivery of comprehensive medication education at admission and discharge, and coordination with the outpatient pharmacy.

This longitudinal experience enhances teaching skills by allowing residents to earn a teaching and learning certificate through Sullivan University College of Pharmacy. The didactic teaching and learning curriculum is complemented by activities facilitated by Norton Healthcare such as educating patients, other pharmacists and healthcare providers, and serving as a preceptor.

Each resident will complete a major project during their residency year, designed to improve pharmacy practice as well as align to Norton Healthcare and the pharmacy department’s strategic goals. A list of potential projects is generated and vetted by pharmacy leadership prior to the beginning of each new resident class. Residents are assigned projects from the list based on interests and alignment with future goals. All projects are facilitated by a project team with the resident and project preceptor serving as the primary investigators/facilitators. All projects must be presented at the Great Lakes Pharmacy Resident Conference. Finally, the project is presented to the residency program director (RPD) in final manuscript format as a criterion for successful completion of the residency program. Publication prior to successful completion of the residency program is encouraged but not required.

This learning experience is conducted across a wide variety of professional situations including but not limited to local, state, regional and national professional meetings, Norton Healthcare pharmacy departments and multidisciplinary committee work (such as pharmacy clinical leadership and Pharmacy and Therapeutics (P&T) Committee meetings), colleges of pharmacy and the community. Opportunities to participate in legal and regulatory situations vary from year to year (i.e., accreditation, residency accreditation survey, etc.). This learning experience emphasizes patient and professional advocacy as leadership skills and a professional obligation. Residents will explore the interrelationship of their personal development on their abilities to lead others and lead the profession.

As part of this learning experience, residents each will have a leadership role for the duration of the year. Available leadership positions include:

• Residency Advisory Council/Continuous Quality Improvement representative (1)
• Longitudinal learning experience coordinator (1)
• Recruitment and technology chair (2)
• Resident engagement coordinator (2)

This learning experience provides the resident with longitudinal exposure to experiences and practice with information systems. This learning experience may occur at any location/facility and will focus on the role of the pharmacist in the integration of technology throughout the pharmacy enterprise and emphasize how pharmacists and technology interface to support delivery of pharmacy services. The resident can expect to participate in specific learning experiences that are coordinated through the core rotations.

This longitudinal learning experience occurs in the home-base practice site for each resident. It serves to develop the skills necessary to practice pharmacy in a hospital setting with emphasis on operational pharmacy practice. In general, this rotation takes place in the central pharmacy with a good amount of interaction with health care team colleagues including pharmacy, nursing and physician staffs. The roles of the pharmacist in the central pharmacy include coordination and oversight for all manufacturing and dispensing of medications, verification of medication orders, managing the work flow with an emphasis on prioritization according to efficiency and safety, and provision of medication-related direct patient care when applicable. Specific areas of emphasis include using department and facility policy and procedure, functioning as a member and leader of the pharmacy team, using various hospital information systems and technology, and participating in the management of medical emergencies.

• Cardiology
• Adult medical/surgical
• Critical care specialty populations
  • Cardiology
  • Neurology
  • Neonatal intensive care unit (NICU)
• Nutrition support
• Ambulatory care oncology clinic
• Ambulatory care disease state management
  • Diabetes management
  • Neurology
  • Primary care
  • Heart failure
• Inpatient oncology and supportive care
• Pediatric medical/surgical
• Pediatric hematology/oncology
• Kentucky Poison Control Center of Norton Children’s Hospital
• Norton Specialty Pharmacy

• Clinical pharmacy management
• Information technology
• Practice management

Martin Brenneman, Pharm.D.

Ohio Northern University Raabe College of Pharmacy, Ada, Ohio; Class of 2020

Project: Evaluation of Urinalysis and Urine Culture Use for Diagnostic Stewardship Within a Community Health-system

Area of interest: Infectious diseases

Emily Followell, Pharm.D.

University of Kentucky College of Pharmacy, Lexington; Class of 2020

Project: Standardizing the Implementation of Pharmacist-Led Patient Care Protocols in the Ambulatory Setting

Area of interest: Cardiology, critical care and ambulatory care

Erin Ottman, Pharm.D.

University of Kentucky College of Pharmacy, Lexington; Class of 2020

Project: Impact of a Pharmacist-Driven Intervention Tool on Adherence to Guidelines Related to the Use of Bone Modifying Agents (BMAs) in Patients with Advanced Solid Tumor Malignancies With Metastatic Disease to the Bone

Area of interest: Ambulatory care, critical care and HIV

Tori Penick, Pharm.D.

University of Kentucky College of Pharmacy, Lexington; Class of 2020

Project: Revision of the Advanced Hospital Practice APPE Rotation: Standardizing Learning Experiences Among Student Pharmacists

Area of interest: Ambulatory care, palliative care, chronic disease state management and geriatrics

Rachel Sowell, Pharm.D., MPH

University of Tennessee Health Science Center College of Pharmacy, Memphis; Class of 2020

Project: Development of Pharmacist Driven Transition of Care Intervention in Acute Ischemic Stroke (AIS) Patient Population

Area of interest: Ambulatory care

Adele Venable, Pharm.D.

University of Mississippi School of Pharmacy, Oxford; Class of 2020

Project: Clinical Impact of an Anticoagulation Protocol Revision for Extracorporeal Membrane Oxygenation (ECMO) Patients

Area of interest: Critical care and cardiology

2019-2020 PGY1 PHARMACY RESIDENCY CLASS

Alex Anderson, Pharm.D.

Research topic: Identifying Opportunities for Optimization of the Use of Continuous Infusion Antihypertensive Therapies in the Emergency Department

Megan Cummins, Pharm.D.

Research topic: The Effect of Dexmedetomidine Use on Concomitant Benzodiazepine Exposure in Mechanically Ventilated Neonates

PGY2: Pediatrics, UK HealthCare, Lexington, Kentucky

Ally Dingess, Pharm.D.

Research topic: Elevating Safety and Efficacy of Anticoagulation Practice: Closing the Gap on National Patient Safety Goals

Ashley Jatczak, Pharm.D.

Research topic: Evaluating Patient Outcomes Associated With the Use of Guideline-directed Supportive Care for Diabetic Ketoacidosis and Hyperglycemic Hyperosmolar Syndrome

James Mitchell, Pharm.D.

Research topic: A Systematic Approach to Improve and Maintain Compliance with Revised USP 797 Guidelines in a Health-System

Lindsay Otis, Pharm.D., MBA

Research topic: Assessment of the Management of Immunotherapy-related Toxicities in Oncology Patients Presenting to Community Hospital System Emergency Departments

PGY2: Ambulatory care, Norton Healthcare

2018-2019 PGY1 PHARMACY RESIDENCY CLASS

Ashley Mullins, Pharm.D.

Research topic: Optimizing Use of the Electronic Medical Record to Improve Transitions of Care for Oncology Services

Emily Hampton, Pharm.D., MPH, BCPS

Research topic: Directed Education and Feedback to Non-physician Providers to Reduce Treatment of Asymptomatic Bacteriuria at a Community Hospital

Evan Bryson, Pharm.D.

Research topic: Therapeutic Enoxaparin in High-Risk Patients: An Evaluation of a Pharmacist-driven Anti-Xa Monitoring and Dose Adjustment Protocol

PGY2: Emory University, Atlanta, Georgia

Joanna Towles, Pharm.D.

Research topic: Burnout Among Pharmacy Technicians: The Impact of Strategic Initiatives

Justin McCann, Pharm.D.

Research topic: Risk Factors for Venous Thromboembolic Events in Patients Following Elective Total Hip and Total Knee Arthroplasty in the Community Hospital Setting

PGY2: Ambulatory care, Norton Healthcare

Kimber Woodrum, Pharm.D., MPH

Research topic: A Systematic Approach to Optimizing Opioid Prescribing by Standardizing Order Sets

PGY2: Ambulatory care, Norton Healthcare

2017-2018 PGY1 PHARMACY RESIDENCY CLASS

Abby Taylor, Pharm.D.

Research topic: A Process for the Development of Clinical Pharmacy Tools within an Electronic Medical Record

Amanda Kuszmaul, Pharm.D.

Research topic: Designing a Tool to Standardize Pharmacist Workflow in an Ambulatory Care Specialty Practice

PGY2: Ambulatory care, University of Louisville

Brittany Wyatt, Pharm.D.

Research topic: Describing the Potential Impact of a Pharmacist-driven Protocol to Prevent Febrile Neutropenia

PGY2: Ambulatory care, Norton Healthcare

Kathleen Gillen, Pharm.D.

Research topic: Evaluation of Facility Specific Risk Factors for Opioid-induced Respiratory Depression

PGY2: Ambulatory care, Samford University, Birmingham, Alabama

Lars Almassalkhi, Pharm.D.

Research topic: Engaging Pharmacist to Effectively Manage Clinical Decision Support Alerts

PGY2: Emergency Medicine, University of Kentucky

2016-2017 PGY1 PHARMACY RESIDENCY CLASS

Danielle Henry, Pharm.D.

Research topic: Implementation of a Process to Ensure the Safe and Efficient Use of Cytotoxic Medications for Non-Oncologic Indications

Haley Willett, Pharm.D.

Research topic: Optimizing a Pharmacy Dashboard to Improve Success at Implementation

PGY2: Ambulatory care, Belmont University, Nashville, Tennessee

Jessica Robinson, Pharm.D., BCPS

Research topic: Evaluation of the Potential Impact of a “Darbepoetin Alfa Indication Restriction and Dosing Guideline” in an Inpatient Setting

Kelli Noel, Pharm.D.

Research topic: A Retrospective Review to Determine the Efficacy of Fecal Microbiota Transplantation via Colonoscopy in a Community Hospital for Recurrent, Refractory, or Severe Clostridium difficile Infection

Lauren Schmitt, Pharm.D.

Research topic: A Standardized Pharmacist-driven Process for Anticoagulation Education: Evaluating the Impact on Patient Outcomes and Opportunities for Optimization

Maryam Yazdanshenas, Pharm.D.

Research topic: Rate of Deviation From Evidence-based Protocols in Neo-adjuvant and Adjuvant Breast Cancer Treatment Regimens

2015-2016 PGY1 PHARMACY RESIDENCY CLASS

Rachel Connors, Pharm.D.

Research topic: Potential Impact of a Pharmacist-Driven Protocol to Improve Staphylococcal Bacteremia Care

Kassandra Fernsler Mohler, Pharm.D., BCACP

Research topic: Defining a Standardized Pharmacist-Driven Process for Inpatient Warfarin Education

PGY2: Ambulatory care, Norton Healthcare

Michael Frazier, Pharm.D., BCPS

Research topic: A Comprehensive, Systematic, And Multidisciplinary Approach to Continuous Optimization of Clinical Decision Support (CDS)

Lindsay Hazelden, Pharm.D.

Research topic: Evaluation of Empiric Direct Thrombin Inhibitor Therapy With Optimization of the Heparin-induced Thrombocytopenia Laboratory Testing Protocol and Pharmacist Intervention

PGY2: Oncology, John Hopkins, Baltimore, Maryland

Jamie Mahan, Pharm.D., BCPS

Research topic: Designing and Implementing a Pharmacist-driven Process for Inpatient Novel Oral Anticoagulant Education

Michael Robinson, Pharm.D., BCPS

Research topic: Optimization of Antibiotic Regimen Selection and Dispensing in the Perioperative Setting

2014-2015 PGY1 PHARMACY RESIDENCY CLASS

Tara Haworth Wright, Pharm.D., BCPPS, BCOP
Research topic: Characterizing Clinical Decision Support Alerts Within an Electronic Health Record System
PGY2: Pediatrics, Texas Children’s Hospital, Houston

John Holston, Pharm.D.
Research topic: Implementing Transitions of Care in a Health Care System – A Pilot Study on Patients Discharged on Anticoagulants

Courtney McDonald, Pharm.D.
Research topic: Impact of a Pharmacist in the Patient-centered Medical Home

Christie Lee Scott, Pharm.D.
Research topic: Identifying Operational Barriers to Initiation of Appropriate Antimicrobial Therapy Following a Positive Blood Culture

PGY-2: Ambulatory Care, Norton Healthcare

Josh Senn, Pharm.D., BCPS
Research topic: Evaluation of Intravenous Immunoglobulin Grams Averted With Implementation of an Inpatient IVIG Restricted Use and Dosing Guideline

2013-2014 PGY1 PHARMACY RESIDENCY CLASS

Jonathan Ptachcinski, Pharm.D.
Research topic: Impact of a Pharmacist-directed Intervention on Duration of Aminoglycoside Empiric Therapy for Health Care Associated Pneumonia
PGY2: Hematology/Oncology, University of North Carolina Healthcare, Chapel Hill

Ashley Stack Bane, Pharm.D., BCPS
Research topic: Evaluation of the Safety and Efficacy of a Colistin Dosing Protocol

Yvonne Umeh, Pharm.D., BCCP
Research topic: The Impact of a Vancomycin Interchange Protocol on Costs and Length of Stay

2012-2013 PGY1 PHARMACY RESIDENCY CLASS

Michael Braun, Pharm.D., BCPS
Research topic: Creating and Implementing a Dosing Protocol for Intravenous Immune Globulin

Khyati Desai, Pharm.D.
Research topic: Utility of Gram Stain to Identify the Pathogen in Methicillin-resistant Staphylococcus aureus (MRSA) Pneumonia

Kelsi Peay, Pharm.D.
Research topic: Expansion of a Generic Medication Pilot Project within an Integrated Delivery Network

2011-2012 PGY1 PHARMACY RESIDENCY CLASS

Jeffrey Bahng, Pharm.D., BCPS
Research topic: Engaging Pharmacists to Become Effective Stewards of the Formulary System Through the Use of Education, Documentation and Communication

Susan Martin, Pharm.D.
Research topic: Maximizing Generic Prescribing in an Integrated Delivery Network: Impact of the Pharmacist

Thomas Stoltz, Pharm.D.
Research topic: Comparison of Individualized Versus Standardized Parenteral Nutrition (PN) for Adult Inpatients in a Healthcare System

2010-2011 PGY1 PHARMACY RESIDENCY CLASS

Julianne Jeffries, Pharm.D.
Research topic: Impact of an Antimicrobial Stewardship Pilot Project for the Treatment of Candidiasis on Prescribing Practices, Patient Outcomes and Cost

Kelly Kampschmidt, Pharm.D.
Research topic: Pharmacist Comfort at Codes: Due to Knowledge or Experience?
PGY2: Oncology at Northwestern University, Chicago, Illinois

Brittany Surface, Pharm.D.
Research topic: Implementation of a Basal-bolus Insulin Order Set as a Test of Change

2009-2010 PGY1 PHARMACY RESIDENCY CLASS

Kimberly Blanton, Pharm.D., BCPS
Research topic: Evaluation of Vancomycin Trough Levels Before and After Implementation of Pharmacist-driven Dosing and Monitoring Guidelines
Current Position: Clinical oncology pharmacist, St. Joseph East Hospital, Lexington, Kentucky

Mary Miracle, Pharm.D., BCPS
Research topic: Pharmacist Medication Reconciliation and Discharge Counseling in a Heart Failure Population