Detailed Site Information
Institution
Paynesville Area Health Care System is a independent rural health provider for 10 rural communities located between St Cloud and Willmar. The System is made of a 25 bed critica access hospital, an attached clinic in Paynesville, six satellite clinics, two nursing homes, and two assisted living facilities.
The Pharmacy Department provides both clinical and dispensing services for the Health System. Patients are seen by clinical pharmacists for diabetes, anticoagulation and MTM services during schedule clinic appointments within the main clinic in Paynesville. Pharmacists work side by side with physicians, dietitians, nurses and social workers in the clinic. Time not spent seeing patients is often spent consulting on patient issues with other health care providers.
Pharmacist have a wide scope of practice that allows for medication initiation, adjustment and monitoring in the clinic as well as the in the hospital and long term care facilities. The pharmacy department also runs the ADA accredited diabetes education program with assistance from the dietitian and a cardiac rehab nurse.
The Pharmacy Department is staffed with two pharmacist, a pharmacy resident, and three technicians. The dispensing duties include profile driven delivery of medications through Omni cell automated medications dispensers in the general medicine, emergency and surgical departments. Chemotherapy services as well as other IV products are prepared in USP 797 compliant barrier isolators. Nursing home resident medications are provided in unit dose blister packaging.
Institutional Mission Statement and Vision
Providing quality care to improve the health and well being for the people and community we serve.
Pharmacy Services
Being a rural pharmacist means you do a little of everything every day. There is rarely a day that is the same. The pharmacist may be teaching a patient how to use a blood glucose meter one moment and then quickly calculating rapid sequence intubation doses in the emergency department for a car accident victim the next moment. The pharmacist may be checking a long term care residents medication order one moment and the next explaining over the phone to a panicking mother what dose of ibuprofen to give her 5 month old child. Pharmacists within the Paynesville Area Health Care System have developed a good working relationship with the other health care professionals and are relied upon to be very active in the care of patients seen within the system.
Todd Lemke, the director of the department, splits his time between administrative duties of running the department, staffing the hospital pharmacy each morning, coordinating the P&T committee and Diabetes Education Program, and seeing patients in the Paynesville Clinic. Todd works primarily with patients with diabetes (type 1, 2 and gestational) and patients requiring anticoagulation monitoring. Our department is currently expanding to general MTM services and should be up an running by mid 2008. Todd is also a certified diabetes educator and the primary educator for patients diagnosed with diabetes in the system. Beside general education, Todd also is a certified pump trainer for Medtronic and starts approximately 3-5 patients on pumps each year.
Tom Plihal currently works as the hospital staff pharmacist. He has been a past pharmacy director of Waconia Ridgeview and Buffalo Hospitals and wanted to get back to the basics of pharmacy. His duties include chemotherapy admixtures, order entry, overseeing day to day operations of the nursing home pharmacy and checking technician work. Tom is active clinically in the hospital.
The current resident that is part of the University of Minnesota College of Pharmacy Ambulatory Residency program performs the same clinical duties as Todd. The resident is also responsible for clinical monitoring of nursing home residents within the system.
Professionalism and Assessment
Professionalism- it is expected that students are at the rotation site to learn and will conduct themselves in a manor that fits this expectation. I expect students to monitor their own time, time spent on the computer, sick days, vacation, school meetings and other activities so that our site is aware of when they will be gone and so that we will know the task students may be responsible for are getting done.
Assessment- At the end of each week, students will be given an outline of the learning experiences and topics we will be working on for the following week. With each activity there are goals and objectives. At the end of the following week, we review each goal and objective and perform a mini-evaluation to see if changes need to be made for the upcoming week. These changes may be adjusting the learning activity to better fit how the student learns, accelerating or slowing down the pace or providing additional learning activities. A final grade is made using the UofM rotation evaluation form and is done with Todd Lemke and may also involve the pharmacy resident.
Resources
Students are provided a work space, computer with internet access, free on-site parking, and a discount lunch card (if you like hospital food).
Ambulatory/Patient Care- same experience for both APPE classifications.
Primary Preceptor
Todd Lemke, PharmD CDE
Clinical Pharmacist
tlemke@pahcs.com
320-243-7772
Preceptors
Students will work in clinic or other care areas with the current pharmacy resident.
APPE Structure
Students will work primarily with Todd Lemke and the current pharmacy resident in caring for clinical pharmacy needs of patients in the ambulatory care clinic, hospital and nursing home. Patients schedule to see the pharmacist in the clinic and students will spend much of the time preparing to see patients (pre-reading charts), seeing patients in clinic with the pharmacist, and documenting the patient visit in the electronic medical record. Students will also assist the pharmacist in seeing patients in the hospital for clinical issues, monitoring medication therapy of nursing home residents and research clinical questions for other health care providers. Independent reading and learning time will also be provided to review study topics and prepare at least one oral presentation. Time will be carved out each week to review a study topic in discussion format
Student Roles and Responsibilities
Students will be responsible for working up at least one patient each day and seeing all patients with the pharmacist. Over the course of the rotation the depth of the work up and number of patients will increase. Students will also have a weekly study topic to research and read up on for a topic review at the end of the week. At least one presentation will be done to pharmacy staff, medical staff or nurses. Students will also participate in any health fairs, health screenings or community education activities that are scheduled during the rotation.
Educational Opportunities:
Lunch and learn, journal clubs and topic reviews will be scheduled throughout the rotation. Students may also sit in on committee meetings that come up during the rotation.
Other Requirements
If a student has specific questions about the rotation before registration, I invite them to email me. I generally respond the same or next day.
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