Madison Clinic
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Pharmacy Practice Residency Rotation
Goals and Objectives

Preceptor Pager Email
Bradley Kosel, PharmD 982-5195 bkosel@u.washington.edu
Bob Loeffelbein, PharmD 994-6863 bloeffel@u.washington.edu
Ji Lee, PharmD 540-4268 jilee2@u.washington.edu

Description

The Madison Clinic at Harborview is an HIV/AIDS multidisciplinary clinic that provides care for approximately 1300 patients. The 45 providers affiliated with the Madison Clinic oversee 50 to 80 patient visits each day. The prime goal of the clinic is to provide a full range of care to its clients, including Primary Care.

The face of AIDS has changed with the advent of Highly Active Antiretroviral Therapy or HAART. The goal at the Madison Clinic is to ensure that every person starting on HAART has an above average chance of succeeding on therapy. The pharmacy, along with nutrition, social work, and the medical provider are all involved in providing education as a part of the HAART protocol. As a resident on this rotation, you will become involved in the many aspects of the HAART protocol.

Schedule

Clinic Hours Monday - Friday 0900-1700
Location 2 West Clinic

General Requirements

The resident is expected to:

  • Maintain a professional demeanor
  • Respect patient confidentiality
  • Dress in appropriate attire and wear nametags at all times while in the Madison Clinic
  • Arrive at the Madison Clinic by 0830 each morning
  • Notify the preceptor in the event of tardiness or absence

Performance Objectives

By the end of the first week, the resident should present the preceptor with a goal statement. This statement should summarize in one or two sentences what the resident expects to learn during the rotation. The resident and the preceptor will then sit down and develop a list of learning activities that will help to accomplish these goals. Furthermore, there are certain goals and objectives specifically related to the care of HIV/AIDS patients, which the resident is expected to complete during the rotation.

The resident is expected to:

  1. Demonstrate knowledge of antiretroviral therapy by describing usual doses, dose modifications, side effects, drug monitoring parameters, drug interactions, resistance patterns, and mechanisms of action of all antiretroviral medications used in the treatment of HIV disease. The information will be assessed by a written post-test or through verbal communication.
  2. Demonstrate knowledge of the prophylaxis, treatment, and maintenance therapies available for opportunistic infections. This information will be assessed by a written post-test or through verbal communication.
  3. Perform patient teaching and patient counseling in the distributive setting as well as in the more formal HAART protocol format.
  4. Understand and describe the importance of adherence to HAART, barriers to adherence, tools used to improve adherence and the association of non-adherence to drug-resistant HIV. This information will be assessed by active participation in the HAART protocol.
  5. Identify and utilize the various information databases available for responding to drug information questions in the HIV/AIDS practice setting.

Learning Objectives

  1. Understand and participate in the HAART protocol by interacting and educating patients in all phases of the protocol, including pre-HAART, new HAART starts, and On-HAART interventions. All patient interactions should be documented in the patient medical records using S.O.A.P format. By the end of the rotation, the resident should have completed at least one pre-HAART, one new HAART start and one On-HAART patient visit.
  2. Follow inpatients from the Madison Clinic and perform patient work-ups to assess and discuss drug-related problems, selection of therapeutic regimens, and initiation of monitoring plans. The resident should follow inpatients on a daily basis as determined by his preceptor.
  3. Understand and participate in distribution activities to appreciate the importance of problem solving and patient counseling in this environment. The resident should spend at least 60 minutes a day in the distribution role as determined by his preceptor.
  4. Initiate a compliance or adherence education appointment with a patient who may benefit from this intervention to improve adherence. Identify at least one patient by the end of the rotation.
  5. The resident must be prepared to discuss weekly topics with the preceptor as outlined on the rotation calendar. The articles will either be provided by the preceptor, or the resident may be instructed to conduct a literature search to identify 1 or 2 current articles on the weekly topic.
  6. Prepare a 60 minute presentation to be delivered to the pharmacists and preceptors at the end of the rotation. This presentation should include an interesting patient case that was encountered during the rotation. The resident should discuss any special interests with the preceptor during the first week of the rotation, so that the final presentation can be tailored to satisfy the resident’s interests.

Additional Requirements

  1. Become familiar with and adhere to the University of Washington guidelines for professional conduct. Patient confidentiality is of paramount importance in this practice setting.
  2. It is important to attend all educational sessions at the Madison Clinic; this includes monthly clinical conference, bi-monthly journal club meetings, afternoon educational sessions and any other opportunities that may be available. The confirmed dates and times of the required educational sessions will be marked on the resident’s rotation calendar.
  3. Read and evaluate all required readings and be prepared to discuss the weekly topic(s) with the preceptor.

Optional Activities

  1. Present an article to the pharmacists in journal club format.
  2. Observe a patient examination given by one of the medical providers.
  3. Design and implement a Drug Use Evaluation form.
  4. Deliver an in-service talk to nurses, pharmacists, social workers or medical providers.
  5. Become familiar with the current strategies that are being utilized to develop HIV vaccines.
  6. Prepare a patient information sheet for a commonly prescribed medication. The information must be written in simple language that patients can understand.

Preceptor Schedule

  • The Madison Clinic pharmacists rotate through different job responsibilities on a weekly basis.
  • The preceptor of the week will be the pharmacist in the clinical role. The name of that person will be listed on the resident’s rotation schedule.
  • The resident will be assigned to a Primary preceptor during the first week of the rotation. This person will be responsible for completing the rotation evaluation. The resident is responsible for providing the appropriate evaluation forms in a timely manner to the Primary preceptor. Any problems or issues should be discussed with the Primary preceptor. The Primary preceptor will help coordinate the rotation in the Madison Clinic.

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