Allina Mercy Hospital Pharmacy

APPE Experience Types
Acute Care
Institutional Care
Clinical Pharmacy Emergency Medicine

Address
4050 Coon Rapids Blvd
Coon Rapids, MN 55433

Main Contact
Peter Nyhus, PharmD
Pharmacy Clinical Manager
Email: Peter.Nyhus@allina.com
Phone: 763-236-7538

Teaching Philosophy
We are committed to maintain an environment conducive to education and learning through encouraging and promoting continued professional growth for all staff and students.  We focus on providing evidence-based, patient-centered care.  It is our goal to help students gain exposure to a broad array of medical conditions, to enhance clinical competence and confidence, and to improve communication skills.  Clinical focus areas include oncology, critical care, cardiology, infectious diseases and emergency care.

It is also our expectation that students who are interested in completing rotations at our site are those who come prepared, motivated and enthusiastic about pharmacy practice.  Preceptors provide direct supervision and much guidance at the beginning of the rotation and as the rotation progresses, students are expected to become more independent and confident with their clinical skills.  In addition, we embrace collaboration with other disciplines and encourage our students to gain a broader scope of patient care.  Thus, we provide opportunities to job shadow professionals outside of the pharmacy department, including respiratory therapy, catheterization lab, and operating room.  Additional time for self-directed learning outside of the rotation is to be expected. 

Detailed Site Information

Institution
Mercy Hospital is a 271-bed non-profit hospital that serves the northern Minneapolis-St Paul metropolitan area.  The hospital provided care to more than 165,000 people in 2006.  Mercy responds to a wide range of health needs with specialty services including behavioral health services, cancer care, heart and vascular services, orthopedics, neurosciences, and women’s and children’s services.

Institutional Mission Statement and Vision
At Allina Hospitals & Clinics, our mission is to serve our communities by providing exceptional care, as we prevent illness, restore health and provide comfort to all who entrust us with their care.

We put the patient first; make a difference in people’s lives by providing exceptional care and service; create a healing environment where passionate people thrive and excel; and lead collaborative efforts that solve our community’s health care challenges.

Pharmacy Services
Mercy & Unity Pharmacy is committed to be a national leader in assuring the optimal use of medications resulting in safe, effective, and cost-appropriate outcomes in a collaborative, patient-focused environment.  The core values of integrity, respect, trust, compassion and stewardship are the cornerstones of our work.  The pharmacy department services all inpatients as well as patients in the operating room, emergency department, procedural care center and outpatient oncology clinic.  We also serve a key role in Pharmacy and Therapeutics (P&T), Medication Management and Medication Safety Committees among others. 

The pharmacy department uses evidence-based medicine and best practice literature to create safe, effective and cost-appropriate medication use.  Our pharmacists routinely provide clinical services such as kinetics and TPN monitoring, warfarin dosing, infectious diseases and ICU rounding.  We also collaborate with certified nurse practitioners in Pain Team and Geriatric consultations.  We are proud of our progressive role in the organization and we continue to seek ways to advance our practice and services.

Professionalism and Assessment
Our department practices in compliance with the Pharmacist Oath of Ethics as well as the five values of our organization as described above, and we expect our students to do the same.  Our staff is very involved and dedicated to precepting students and residents.

Formal evaluations are conducted twice during the rotation, one at mid-rotation and the other at the end of the rotation.  Two-way communication and feedback are ongoing; we seek and encourage students to provide input throughout the rotation.  The goal is to ensure the rotation is meeting the students’ professional needs.

Resources
All patient specific information is found in our comprehensive electronic medical record.  The Allina Intranet provides many medical and pharmacy references and is available to students at any computer in our facility.  Print references are also easily accessible in the pharmacy and the library at Mercy Hospital.  Workspace and computers are provided for students in the pharmacy or decentrally in patient care areas.

On site parking is free.  Refrigerator, microwave oven, and lockers are available for students in the pharmacy.  Students are notified of and encouraged to attend Lunch & Learns and conferences whenever possible.

Acute Care

Primary Preceptor
Letty Tam, PharmD

Preceptors
Jeralyn Furst, PharmD
Janice Dow, PharmD
Gary Sundeen, RPh
Kelly Morgan, PharmD
Justin Hora, PharmD
Debbie Hodel, PharmD

APPE Structure
In general, the student will spend 3 weeks each in our oncology, cardiology, and intensive care unit (Hours in general: 0730-1600); and one week in the emergency department (Hours: 1400-2230). 

Direct interaction between the student and preceptor will consist of 15% of student time.  Roughly 60% of student time will be spent gathering patient specific information from the electronic medical record, researching and preparing for cases or rounds.  The student will be presenting to preceptor or group 10% of the time.  The remaining time will be spent shadowing other disciplines, attending meetings, or completing projects.

Student Roles and Responsibilities
The focus of the rotation is three-fold: 
1)  To gain clinical competency and confidence through exposure and experience with patients. 
2)  To enhance oral and written communication skills. 
3)  To continue professional growth.

Students are assigned patients to monitor.  The student will assess patient-specific data, develop an understanding of the patient’s disease states and appropriate pharmacology interventions for the patient, and research and resolve pharmacotherapeutic issues on a daily basis.  Students will also provide drug information or education to other health care providers when appropriate.

Students will be participating in multidisciplinary rounds in the ICU, Pain Team consultation, Geriatric consultation, and infectious diseases rounds.  Other clinical training includes warfarin dosing, TPN and kinetics monitoring.  In the emergency department, students will participate in critical and trauma response.  Throughout the rotation, the student is responsible for gathering literature-supported guidelines for diagnosis and treatment of 30 commonly encountered medical conditions or diseases and presenting a case with each topic.  These are 15-minute short case presentations, and the expectation is to complete three per week.  The student is required to lead two journal discussions (15-30 minutes in length) and give two major case presentations (45 minutes in length).  

Focused discussion on ten major topics will be held during the rotation.  Students will also write up to two educational flyers for the nursing staff.  Additional projects, such as drug use evaluations, will be assigned.

Educational Opportunities
Students will also attend and/or present at clinical meetings such as the Pharmacy and Therapeutics Committee.  Students are also required to attend all available conferences and learning opportunities.  Additional shadowing experiences will be arranged.

Other Requirements
There are no additional requirements for entrance into this APPE.

Institutional Practice

Primary Preceptor
Jeralyn Furst, PharmD

Preceptors
Janice Dow, PharmD
Gary Sundeen, RPh
Kelly Morgan, PharmD
Justin Hora, PharmD
Debbie Hodel, PharmD
Letty Tam, PharmD

APPE Structure
The student will spend much time learning the operations of a hospital pharmacy through reading, discussion and meeting with various pharmacy staff.  Approximately 30% of student time will be spent becoming familiar with regulatory requirements, 30% performing clinical decentral pharmacy work, 10% in job shadowing, 10% in meetings, 10% in discussions and 10% on projects.

Student Roles and Responsibilities
The focus of the rotation is four-fold: 
1)  To gain a basic understanding of operations and workflow of a hospital pharmacy. 
2)  To describe the role of the pharmacy department in a hospital. 
3)  To enhance oral and written communication skills. 
4)  To continue professional growth.

The student will spend much time in self-directed learning and reading about legal and regulatory agencies and requirements.  The student will also have the opportunity to meet with various pharmacy staff; including pharmacy operations manager, clinical manager, performance improvement manager, pharmacy buyer, pharmacy systems coordinator, and the pharmacy director; to learn first-hand about regulatory requirements, inventory control and pharmacy informatics among other topics.  The student will also job shadow various staff members, both inside and outside the pharmacy department. 

When assigned to be decentral, institutional practice students will provide clinical pharmacy services similar to that of an acute care student, including participation in multidisciplinary rounds in the ICU, Pain Team consultation, Geriatric consultation, and infectious diseases rounds. 

To understanding how pharmacy plays an integral part in collaboration with other disciplines, the student will attend and/or present at many relevant meetings, such as Pharmacy and Therapeutics Committee.  Students will also write an educational flyer for the nursing staff.  Additional projects, such as drug use evaluations, will be assigned.

Educational Opportunities
Students are strongly encouraged to attend all available conferences and learning opportunities.  Additional shadowing experiences can be arranged.

Other Requirements
There are no additional requirements for entrance into this APPE.

Clinical Pharmacy Emergency Medicine

Primary Preceptors
Kim Glasoe, PharmD
Melissa Lerberg, PharmD

APPE Structure
Student will rotate through the following areas of Emergency Department (ED): Pre-hospital paramedic ride-alongs (if available), triage, shadowing of ED Techs, shadowing of ED nurses, shadowing of ED physicians and working closely with ED pharmacists.  This rotation necessitates a flexible schedule and is comprised of all evening shifts, except where schedule adjustments are necessary for ride-alongs if available.  The student will need to work 4 ten hour shifts within a 7 day work week and can set that schedule up at the beginning of the rotation, hours expected are 2:00pm to 12:30am. 

Most of the student time will be spent in direct interaction with the ED pharmacist assisting with conscious sedations, critical responses, reviewing lab values, patient charts, medication histories, indications and safety of medications administered in the emergency department.  The remaining time will be spent shadowing other disciplines, attending meetings, answering drug information questions, or completing projects. 

Student Roles and Responsibilities
The focus of the rotation is four-fold: 
1)  To experience clinical emergency medicine through a pharmacists perspective 
2)  To learn critical care in the initial stages as patients present to the emergency department 
3)  To understand basic patient etiology and its relation to pharmaceutical care 
4)  To fully understand interdisciplinary care as it pertains to emergency medicine.

In the Emergency Department, students will be participating in medical codes, critical responses, trauma responses, toxicology cases, conscious sedations, STEMI’s (ST segment elevated myocardial infarctions), order verification, lab review, and recommendations to Emergency Department and admitting physicians to ensure proper medication therapy.  Students will be assisting the ED pharmacist, or other health care provider being shadowed, with providing direct patient care, as needed.  The student will assess patient-specific data, develop an understanding of the patient’s disease states and appropriate pharmacology interventions for the patient, and research and resolve pharmacotherapeutic issues as they arise.  Students will also provide drug information and/or education to patients or other health care providers when appropriate.

Throughout the rotation, the student will gather literature-supported guidelines for diagnosis and treatment of commonly encountered medical conditions or diseases and complete a one-page summary of the information.  Projects may be assigned based upon need (such as development of quick reference tools, drug utilization projects or in-services, etc).

Other Requirements
No requirements for interview prior to entrance into this APPE.