• 1233 North 30th Street, Billings, MT 59101
  • 406-237-7000

Rotation Descriptions

Orientation
This 8 week core learning experience provides the resident with orientation, training and practical experience in Pharmacy Department and hospital operations. The resident will learn to staff in the central pharmacy and is responsible for ensuring safe and effective medication use for patients throughout the hospital. Routine responsibilities include: order verification and interaction with physicians, nurses, and other health care professionals to ensure medications are appropriately prescribed and monitored to avoid drug allergies, drug interactions, drug contraindications, drug duplications, and drug dosages outside established guidelines; manage orders based on formulary and policies and procedures; preparation of medications for distribution, both scheduled and urgent; processing outpatient prescriptions; compounding intravenous parenteral products, including TPN and chemotherapy; patient care rounds; manage clinical worklists; documentation of interventions; provide drug information to healthcare providers and patients; patient counseling. The resident will train within the central pharmacy to learn medication distribution processes and will have limited exposure to the decentralized pharmacies to get a basic understanding of overall pharmacy operations. This learning experience will provide opportunity for the resident to become comfortable with job descriptions, day to day procedures/workflow, teamwork, and expectations. The resident will develop an understanding and utilize St. Vincent Healthcare policies and procedures, automation and the electronic medical record. The resident’s ability to perform in emergency medical situations will be enhanced.

Service / Staffing
This longitudinal learning experience will provide the resident with training and practice experience in staffing an inpatient pharmacy. Residents will work to increase their proficiency in all areas of the medication use system at St. Vincent Healthcare (SVH), and develop an enhanced understanding of dispensing medications according to all State and Federal laws and SVH policies. The resident will have the opportunity to work more independently, gaining confidence by assuming total responsibility for safe and effective pharmacotherapy. The resident will be presented with unique situations which will not be encountered on other rotations, and this rotation will enhance the resident’s ability to form relationships and manage support staff. The resident will also have the opportunity to develop independence in answering drug information requests and provide education to healthcare professionals as well as patients and caregivers. Routine responsibilities include: reconciling medications for all patients admitted to the team, addressing formal consults for non-formulary drug requests, therapeutic drug monitoring, and anticoagulation.

Drug Information
This longitudinal learning experience provides the resident an opportunity to focus on professional and accurate dissemination of drug information through evidence-based practice and research. Areas of focus during the rotation include formal drug information responses, formulary reviews, drug class reviews, drug protocols, medication use evaluations, presentation materials and patient education materials. Residents will be responsible for preparing written and verbal responses to drug information questions from various members of the healthcare team and/or patients. The resident will become an active participant in the Pharmacy and Therapeutics Committee. Focus and emphasis will also be placed on building the resident’s skills and abilities as a preceptor through education, training and day-to-day oversight of pharmacy students. The resident will also perform educational presentations to health care professionals during the year.

Practice Management
This longitudinal learning experience will provide the resident an opportunity to understand and practice pharmacy leadership and management functions and skills. The resident will experience administrative aspects of pharmacy including departmental strategic planning, regulatory and safety requirements, financial management, change management, and the overall pharmacy enterprise. The resident will also learn to manage their own personal and professional development through self-assessment, time management, goal setting and planning, adherence to core values, and involvement in pharmacy association activities.

Project Management
This longitudinal learning experience provides the resident an opportunity to develop and implement a practice-related project. Areas of focus during this experience include time management, project management and practice leadership. The resident will learn about St. Vincent Healthcare policies and procedures regarding research (Investigational Review Board), statistics and appropriate quality indicators, and how to collect and analyze data. The resident will also develop both verbal and written communication skills.

Ambulatory Care
This longitudinal learning experience provides the resident an opportunity to develop skills necessary to provide Comprehensive Medication Management (CMM) pharmacy services. The resident will become proficient in individualizing care plans that achieve the intended goals of therapy, by maximizing the benefits medications offer in improving patient outcomes. The resident will work directly with patients, caregivers and prescribers while developing collaborative professional and pharmacist-patient relationship skills. The resident will be responsible for ensuring safe and effective medication use for all patients by systematically identifying and resolving drug therapy problems, and scheduling appropriate follow-up. CMM services are provided face-to-face in the clinic or telephonically.

Medicine
This 6 week core learning experience provides the resident with an opportunity to be responsible for ensuring safe and effective medication use, monitoring medicine patients (therapeutic drug monitoring of warfarin, enoxaparin, vancomycin, aminoglycosides, TPN, and heparin), addressing non-formulary drug requests, and providing drug information and education to healthcare professionals as well as patients and caregivers. Topic discussions and reading key articles will be used to help develop the resident’s clinical skills and knowledge, and will highlight disease states commonly found in this practice area, such as bone and joint infection, neurology and stroke.

Critical Care
This 7 week core learning experience provides the resident an opportunity to practice in the treatment of critical care patients in the Intensive Care Unit. Residents will review patient profiles, monitor target medications, and consult on specific disease states and general hospital prophylactic measures. Residents will participate in daily multidisciplinary rounds, making recommendations to therapeutic regimens and providing drug information. The Critical Care rotation will enhance the resident’s understanding of the pathophysiology and pharmacotherapy of the critically ill patient, and provides an opportunity to apply their knowledge in developing treatment plans for individual patients.

Infectious Disease
This 4 week core learning experience provides the resident training in pharmacokinetic consults and the treatment of patients with infectious disease processes. The resident will have the opportunity to work on interdisciplinary teams to manage patients throughout the hospital who are receiving antibiotic therapy. Interdisciplinary teams include the clinical pharmacist, the infectious disease physician, infection control nurses, microbiology laboratory technicians, and other members of the healthcare team. The resident will complete kinetic consults, review medication profiles of patients receiving  antibiotic regimens, review positive culture results, help formulate therapeutic plans, and make appropriate recommendations based on the most current clinical guidelines. Antibiotic stewardship responsibilities include, proper antibiotic selection for empiric coverage given any infectious process, streamlining antibiotic therapy using culture and lab results, de-escalation of antimicrobial therapy, education of staff and maintenance of hospital antibiograms.

Emergency Medicine
This 5 week core learning experience will provide the resident with training in the acutely ill patients in the emergency department. The resident will have an opportunity to conduct thorough medication review for all ED orders, conduct medication reconciliation on all patients admitted, and initiate and help manage several medication therapies. The resident will participate in antibiotic selection and dosing based on indication and renal function. The resident will also be expected to help initiate and titrate various drips, such as heparin, insulin, vasopressors, propofol and dexmedetomidine. The resident responds to all activations which include CPR’s, trauma, stroke, and septic swarms. The resident will have the opportunity to assist ED providers with dosing for procedural sedations such and rapid sequence intubations, lumbar punctures, and closed reductions of joint subluxations and long-bone fractures. The resident will have opportunities for ride-alongs with Help Flight, both on the helicopter and fixed wing.

Pediatrics
This 4 week core learning experience will provide the resident with training in the treatment of pediatric medicine patients in the Pediatric Unit, Pediatric Intensive Care Unit, Neonatal Intensive Care Unit, and Mother Newborn Care Unit. The resident working in this area will review patient profiles, monitor target medications, and consult on specific disease states, formulate therapeutic plans and make recommendations to health care providers when appropriate. The resident will participate in PICU and NICU rounds, provide patient education, participate in pediatric codes, preparation of extemporaneous products, and aid providers in total parenteral nutrition formulation.

Administration
This 4 week elective learning experience provides the resident an opportunity to learn and understand aspects of pharmacy administration participate in administrative activities and utilize leadership skills. The resident will experience administrative aspects of pharmacy including departmental strategic planning, regulatory and safety requirements, financial management, policy/procedure development and maintenance, technology, human resource issues, committee responsibilities, inter- and intradepartmental relationships, and time management.

Oncology
During this 4 week elective learning experience, the resident will gain experience in the treatment of oncology patients. Areas of focus during this experience include reviewing medication orders, including monitoring important patient parameters and verifying dosing and indication, providing answers to drug information questions, compounding chemotherapy, and procurement and restocking of medications. In addition, the resident will have the opportunity to shadow in various clinical oncology areas including medical oncology and radiation oncology. The resident will meet with the preceptor daily. Topic discussions and reading key articles will be used to help develop the resident’s oncology skills and knowledge.

Perioperative
This 4 week elective learning experience will provide the resident an opportunity to interact with patients and healthcare professionals in preoperative, operative, and post-anesthesia areas, as well as hospital units patients transition to post-operatively. The resident will interact daily with patients, nurses, pharmacists, physicians’ assistants, anesthesiologists, surgeons and attending providers and resident physicians. The resident in this learning experience will receive in-depth exposure to pharmacy perioperative issues and philosophies, and opportunities to improve patient care. Areas of focus during this experience include beta-blocker utilization to reduce the incidence of perioperative myocardial infarctions and acute post-operative pain management in patients with and without chronic pain, OR pharmacy operations, DVT and bleeding risk assessment, prophylactic antibiotics, and glucose control.