Ambulatory Care Residency Program > Emphasis Areas and Site Descriptions > Paynesville Area Health Care System
Paynesville Area Health Care System
Vital Site StatsHost Site: Paynesville Area Health Care System SITE PROFILE |
 |
Organization:
Paynesville Area Health Care System is an independent rural health system in central Minnesota. The system has seven clinics, a twenty-five bed critical access hospital, a hospital based specialty services clinic, two nursing homes, an assisted living facility and senior apartments. The system is staffed by ten physicians, four mid-levels, a dietitian, therapy department and Pharm.D clinical staff.
Pharmacy Services:
The Paynesville Pharmacy Department has three main functions:
- Ambulatory care clinic- patient are referred to clinical Pharm.D by medical staff for diabetes education, diabetes management, anticoagulation services, medication reviews, smoking cessation, and other chronic conditions. Pharmacists, through a clinical scope of practice, initiate and adjust medications, give vaccinations, order lab tests and routinely see patients for follow up of their health conditions. Patient visits are done in the main clinic which allows direct interaction with other health providers. University of Minnesota and other colleges have APPE rotations based in the clinic and weekly pharmacotherapy sessions during rotations provide an educational experience for students, residents and staff. Drug information questions, one time clinical consults, ADA accredited diabetes education program, monthly diabetes support and education groups, health screenings and other community education events are also coordinated through the ambulatory care clinic.
- Hospital services- pharmacists are involved in the clinical use and dispensing use of medications for acute care patients. Pharmacists round on patients, suggest therapy changes or make changes based on scope of practice. Omnicell and a hospital pharmacy computer system allow for automated dispensing of 97% of medications. The specialty services clinic provides experience with oncology and surgical services. Pharmacists share a call schedule providing medication information to hospital staff after hours.
- Long-term care services- pharmacists are also involved in the clinical use and dispensing of medications for long term care residents. Pharmacists oversee technicians in the dispensing of unit-dose medications for nursing home residents. Clinically, pharmacists manage the anticoagulation and diabetes of the majority of residents.
Resident’s Educational Experience:
Direct Patient Care
The resident’s primary day to day activities are based on providing patient care in the ambulatory care clinic. Depending on the resident’s baseline experience in working with patients, the resident may do a mini-ambulatory care rotation to hone his/her patient skills before seeing patients alone or do patient visits with the residency preceptor. As the resident’s skills and confidence increase, patients are referred directly to the resident to be seen. During time that resident is seeing a patient, the residency preceptor is available for consultation. Approximately fifty percent of the resident’s week is seeing patients in the ambulatory care clinic.
The resident is also involved in direct patient care in the hospital and long-term care settings through patient rounds and assignment of long-term care patients that have chronic conditions that pharmacy manages. The resident may be involved with patient care conference for both hospital and long term care patients.
Practice Management
One of the goals of the residency is to prepare a pharmacist practitioner that would be able to go out on his/her own and create their own practice. Experiences are created to expose the resident to practice management skills and opportunities. The resident is involved in the pharmacy and therapeutics committee, diabetes team, and management pearls from the preceptor as they arise. Through the University of Minnesota, the resident is involved in the drug literature evaluation course and curbside consults.
Research
The residency project allows the resident to learn the process of completing a research or practice improvement project. Past residents have used the project to create a new clinical service, evaluate services against clinical guidelines,or explore the impact of current clinical services.
Teaching and Precepting
Multiple opportunities for precepting APPE students on rotations exist as the resident becomes more clinically confident and desires this interaction. Three to six APPE students do clinical rotations during the resident year. Weekly educational topics while the students are on rotations allow for teaching opportunities. High school and community education events such as the monthly diabetes support and education group, health fairs and career day, allow for community outreach opportunities. Past residents have taught through the College of Pharmacy if the resident had interest.
Staffing
Besides a normal clinic schedule, the resident assists in providing some coverage in the hospital and long-term care pharmacy. The resident will spend two days every third week as the primary pharmacist in the hospital during the week as well as two days (approximately 4 hours per day) as the weekend pharmacist. During the week before the weekend worked, the resident will be on-call and be the pharmacy staff member called with medication and therapy questions during the hours the hospital pharmacy is closed. Additionally, the resident may be asked on occasion to assist in the hospital when there is a staff vacation or illness.
Sample week:
Monday
Morning – see patients in the clinic (primary reasons for referral are diabetes management and education and anticoagulation management)
Afternoon – residency activity time (this time is set aside for you to work on any projects, papers, or other residency activities you may have)
Tuesday
Morning – assist in hospital pharmacy if needed, round on patients, round on nursing home patients
Afternoon – see patients in the clinic
Wednesday
All day- see patient in the clinic
Thursday
All day- time for residency tasks, project and reading
Friday
Morning – assist in hospital pharmacy if needed, round on patients, round on nursing home patients
Afternoon – see patients in clinic
Saturday and Sunday
Work 1 out of every 3 weekends
On the weekend that you work, you will staff the hospital pharmacy from roughly 10 AM to 1 PM and will also be the on-call pharmacist that week. Being on-call involves being the pharmacist that nurses and physicians will call with medication and therapy questions. Most calls can be handled over the hospital provided cell phone and only occasionally does a on-call pharmacist come in to the hospital. There is a training period at the beginning of the years so that residents have back-up the first few months on-call. The week following a call period, you get two days off.
Site Coordinator:
Todd Lemke, Pharm.D.
Licensure and Certification
Registered Pharmacist, Minnesota Board of Pharmacy #116840-4 active since 1999
Certified Diabetes Educator #2222-0288 active since 2002
Current Position
Clinical Pharmacist, Paynesville Area Health Care System since 2000
Director of Pharmacy Services. Paynesville Area Health Care System since 2002
Clinical Assistant Professor, University of Minnesota College of Pharmacy since 2000
Coordinator, Paynesville Diabetes Education Program since 2003
Education, Certification and Training
1988-1992 Bachelor of Science, Genetics and Cell Biology, University of Minnesota
1995-1999 Doctor of Pharmacy, University of Minnesota
1999-2000 Rural Ambulatory Care Pharmacy Residency, University of Minnesota
2002 Certified Diabetes Educator, American Association of Diabetes Educators
2006 Certified Medtronic Diabetes Pump Trainer
2007 Advanced Cardiac Life Support
Practice Interests
Diabetes, ambulatory and primary care pharmacy, emergency medicine.