Saturday, November 18, 2017

Rotation 4: Nontraditional - Amb Care Administration

Posted by Josephine at Saturday, November 18, 2017

Block 4: Non-traditional - Ambulatory Care Administration

This rotation was truly a whirlwind rotation for me, meaning that everyday was different and I often had to shift gears fairly quickly. The hours were generally 8 AM - 5 PM, but in the world of admin, that time constraint means very little (some days I would leave early or stay later, and occasionally stay up really late to finish spontaneous rotation work).

Despite this, I was very fortunate because my preceptor strongly believes in bringing the P4 student along in everything that she is already doing. This means that I got to attend various meetings and that my schedule ended up being very fluid (some days I would have chunks of project time, while other days I would have back-back meetings the entire day). This rotation also required me to think on my feet and shift gears quickly, which were skills I hadn't really practiced before this rotation, so I was grateful to have this experience.

Unfortunately, I can't really talk about the specifics of the projects that I did (my preceptor likes to call it "admin HIPAA" due to the sensitive nature of the meeting discussions and project content). However, I can say that I did a profound amount of data collection on MiChart, a lot of data analysis using Excel, and made/edited several presentations to Michigan Medicine leadership. I also learned my fair share about the following: team dynamics/interpersonal interactions, conflict navigation, utilizing connections, giving feedback to employees, how to run a meeting (utilizing time, moving agenda items forward), how to overcome pushback from collaborators, practice change management, initiating a clinical service, project management (reporting results, informing stakeholders, process improvement, etc), value proposition, and billing.

Unlike in my previous rotation (where I mainly had context with 3 other P4s), during this rotation I was, for the most part, attached to my preceptor's side. This was a huge benefit to me because this preceptor is a pretty dynamic, forward-thinking, vision-casting type of person, with multiple connections and projects happening around the state. In a different administration rotation I might have been mainly based in a hospital, attending meetings within that institution. But during this rotation, I was able to see things happening across institutions. Consequently, I felt that I got a taste of the "progressiveness" that characterizes the Amb Care space.

Rotation 3: Health System/Hospital

Posted by Josephine at Saturday, November 18, 2017

Hi Everyone,

I's been very busy recently (with the secondary projects of P4 year - finishing up the PharmD Investigations Project with a polished manuscript, and completing the P4 Seminar). It truly feels good to be done. But as a result of being busy I haven't been able to post about rotations, so I'll start with 3 now.

Block 3: Institutional/Health System/Hospital Rotation @ a local community-based teaching hospital
During this rotation, I was very fortunate to have a variety of responsibilities. The preceptor is very organized and open to feedback. I rotated through the various duties on a 4-day schedule with three other P4 students (2 from Michigan including myself, 1 from the University of Toledo, 1 from Midwestern):

  • Verification duties:
    • Unverified Orders Monitor (UVOM) - sitting in the central pharmacy and helping them clear the orders that have either already been given or have been discontinued
    • Anesthesia Trays
    • Pyxis Cart Refills
    • ACS Boxes and A-Packs
  • Patient Counseling:
    • Discharge counseling on Orthopedic Surgery patients
    • Anticcoagulation counseling on new-starts (rivaroxaban, apixaban, dabigatran)
  • Miscellaneous:
    • Constantly checking MedMined (the pharmacy's surveillance system) to assess the clinical significance of each alert and determine potential interventions (renal dose adjustments, duplicate medications, adverse effects)
    • Answering random DI questions
In addition to the above duties, I also was able to shadow several times (Emergency Department, Nursing, SICU, MICU, IV room). The preceptor is curious about your interests and works very hard to set up opportunities in that area. I also was required to present a journal club with all of the other P4 students rotating at this hospital (so there were about 10 students in the room). In addition, ther were miscellaneous other presentations to attend: student presentations, pharmacy presentations to nursing, as well as noon conferences for doctors (free food!)

Overall, this rotation was rather relaxing (compared to what I imagine an inpatient rotation would be like). The day was generally 7:30 AM - 4 PM (with 30 minutes for lunch). I never took work home and was not able to access the medical record from home anyway. The preceptors at this institution are very friendly and eager to teach. 

Besides all of this, the rotation was made the most enjoyable by the people! (ie: the other pharmacy students). As I said there were 3 other P4's with me (as well as a P3 from Toledo completing a 2-week IPPE). Honestly, the 5 of us had a lot of fun together, going through all the responsibilities and learning about each others' respective pharmacy schools and various interests. We would eat lunch together everyday and sometimes even hang out after rotation (I'm still in touch with one of the Toledo students even now). I think it could have been easy to simply go through all of our responsibilties without exchanging a word. But this rotation shows me that it's this camaderie-building relationship that truly makes work enjoyable (also, best way to network!). 

(See next post for Rotation 4 details)