School of Pharmacy UNIVERSITY OF WISCONSIN - MADISON Meet Our Residents Brenda Basile University at Buffalo – PharmD, Class of 2016 University of Wisconsin-Madison – MS Chemistry, 2010 University at Buffalo – BS Biochemistry/BA Chemistry, 2009 PGY1 resident at SSM Health Pharmacy in Madison, Wisconsin Residency Project: My project entails evaluating the impact of an outpatient pharmacy-based medication box service on healthcare utilization within an integrated healthcare system. Patients who demonstrate high healthcare utilization are identified by a nurse care manager, a primary care clinical pharmacist, or a provider. After identification, patients are offered a pharmacist-led comprehensive medication review and assessment followed by an opportunity to enroll in the medication box service provided by the outpatient pharmacy. Those who enroll have their medications synchronized, packaged in medication boxes, and delivered to their homes. The goal of the service is to improve adherence with the aim of reducing healthcare utilization. Career Goals: I plan to become a clinical pharmacist in an outpatient setting. I also hope to serve in some capacity as an educator for pharmacy students, patients, and other healthcare professionals. Factors I considered when choosing a residency program: During my residency search, I contemplated several factors including my comfort level with the preceptors and the site, the affiliation of the program with a school of pharmacy, the option to complete a teaching certificate program, and the availability of rotations or electives to broaden my experience and help me grow as a pharmacist. Why I chose this program: This program offers a wide array of experiences such as the opportunity to participate in a teaching certificate program, to work on research projects, and to partake in management endeavors. I was especially interested in the SSM Health sites because of the drug information rotation and exchanges with managed care residents. Additionally, my practice site has electronic health record access and collaborative practice agreements that allow pharmacists to expand their scope of practice beyond the traditional dispensing role. Advice for future residents: When you are beginning your residency search, take some time to write down a list of goals that you hope to accomplish as a resident, and then look for a program that will help you reach those goals. Joshua Hevener Creighton University School of Pharmacy & Health Professions – PharmD, Class of 2016 PGY1 resident at Streu’s Pharmacy Bay Natural in Green Bay, Wisconsin Residency Project: For my residency project, I am working toward implementing a community pharmacist led transitions of care service for patients who are being discharged from a skilled nursing facility (SNF) to their home or assisted living. I am working with patients who are temporarily in the SNF, in order to prevent hospital readmissions and avoid the recently introduced penalties. When these patients are identified through our service, I meet with the patient and their families to complete comprehensive medication reviews in order to assist in their recovery. I also work closely with the providers responsible for the orders to avoid potential drug therapy problems. At the time of SNF discharge, I provide a discharge packet that is delivered to the patient and follow-up with the patient periodically. Career Goals: My career goal in the pharmacy profession is to work in an outpatient setting that allows me to provide patient education to ensure their understanding of their disease states and medications. Ideally, I would like to work in an ambulatory setting which allows me to interact with various medical professionals, access medical records, precept students, and continue to innovate the practice of pharmacy. Factors I considered when choosing a residency program: First and foremost, I looked for a setting that would provide me with an opportunity to further expand my knowledge and clinical skills in an outpatient pharmacy setting. Also, I looked for a pharmacy that had goals that aligned with mine, particularly with innovation of practice. Another consideration that I took into account was finding a program that would allow me the freedom to tailor my own resident experience. Why I chose this program: I chose this residency program, and this site specifically, because I believe our goals align nicely. Also, this program provides a unique opportunity to enhance my precepting and teaching skills by training and experience. Additionally, I chose my site because it encourages a more clinical role for a pharmacist in a community setting. Advice for future residents: Set aside some time to reflect on your past experiences and learning in order find what you are most passionate about. Then, search for a program that will help you better yourself as a pharmacist and a person, along with providing great opportunities that will help you achieve your goals. Stay honest with yourself in what you want out of a residency, and let that guide you to the most prosperous opportunity and the program with the right fit. Tucker Stewart University of Wisconsin-Madison School of Pharmacy – PharmD, Class of 2016 PGY1 resident at The Medicine Shoppe in Two Rivers, Wisconsin Residency Project: During my APPE rotations I found older adults to be open about their health goals and enthusiastic about interacting with their pharmacist to meet these goals. With this in mind I developed a falls risk assessment and mitigation program targeting assisted living residents. I perform medication profile reviews to identify patients at high risk of future falls due to multiple CNS medications, cumulative anticholinergic burden, and exacerbations of orthostatic hypo-tension. It is my hope that a falls assessment can be used to develop a frank, open conversation regarding the risks and benefits of specific medications. I believe that preventing falls will advance the goal of ensuring the older adults in our community can support their quality of life and enjoy their retirement to its fullest. Outside of my residency project I have taken additional steps in falls prevention in Manitowoc County by joining a monthly Falls Prevention Coalition, teaching Stepping On courses, and fitting orthotic footwear. Career Goals: I feel that community pharmacy is the best complement of my skills and interests. Direct, longitudinal patient interactions allow me to share in my patients’ successes. As a community pharmacist I am well-positioned to educate and motivate every patient that comes through our doors. In the future I may seek a career in an independent pharmacy due to its inherent freedom and flexibility. I believe that community pharmacy in the next ten years will evolve beyond traditional dispensing roles. Pharmacists will utilize their strong clinical backgrounds to provide cognitive services and assist their patients in meeting their health goals. Factors I considered when choosing a residency program: Staying close to friends and family is important to me, so I focused on residency programs in Wisconsin. When considering the type of residency I wanted to pursue, I emphasized finding a setting that would be supported by my strengths and experiences and that I found most rewarding. The key to finding a residency program that will be a good match is to consider two questions. What unique skills, strengths, and experiences can I offer to the residency program? And reflexively, what opportunities will the residency program create for me to use and develop those strengths? Why I chose this program: The experiences I found most rewarding during my career as a pharmacy student were the opportunities to pull patients aside and engage in comprehensive medication teaching. This residency program offers focused patient education through community practice, MTM, and community-based health programs. I am enthusiastic about working closely with the owner of the pharmacy. Strategizing implementation of pharmacy services that can both support business profitability and benefit the well-being of the community will be incorporated in the residency experience. Last but not least, Two Rivers seemed like a fantastic community to work and live. Advice for future residents: APPE students are told that each day on rotation is like a job interview. It is important to approach every rotation with enthusiasm and an eagerness to expand your existing knowledge. Your preceptors can be a great asset by connecting you to residency programs and writing letters of recommendation. Jacqueline Ye Drake University College of Pharmacy & Health Sciences – PharmD, Class of 2016 PGY1 resident at SSM Health Pharmacy in Madison, Wisconsin Residency Project: My residency is evaluating the impact of a medication synchronization service on workflow efficiency. Implementing the service will help pharmacists and each patient stay up-to-date on the most current medication list while aligning all routine medications to a single pick-up date every 30 or 90 days. The pharmacy can address any inventory issues and refill requests to the provider’s office days before the patient’s scheduled pick-up date. My hypothesis is that it will reduce the amount of phone calls, visits, prescriptions returned to stock, and partially-filled prescriptions due to inventory shortages. Career Goals: I would love to continue using my ambulatory care skills, preferably in a primary care clinic setting where I’m part of the health care team. One of these options includes pursuing a PGY-2 in ambulatory care. Factors I considered when choosing a residency program: I looked at the type of pharmacy practice setting, how I would grow as a pharmacist, innovative services utilized, and geography. I learned later during my APPE year that I liked being in the outpatient setting the most. I also wanted to see if there were any community or ambulatory care PGY-1s in the area that focused on collaborative practice agreements, a teaching certificate program, opportunities to precept pharmacy students, and if the residency program was directly affiliated with a university’s pharmacy school or health system. Finally, I wanted to be in a state in which pharmacy practice was progressive in which I can be a more advanced pharmacist. Why I chose this program: I pursued this residency after years of being a pharmacy intern and going through amazing community and ambulatory APPEs. I realized that my strengths and joys within pharmacy practice were being able to collaborate with patients and providers, being in the outpatient setting in which patients can always voice their opinions in their treatment plan, and being able to utilize my clinical skills more meaningfully through progressive pharmacy practice services. My practice site in particular has a hybrid of ambulatory care services being implemented within the SSM Health clinic side and in the SSM Health retail pharmacy end. It’s like getting the best of both worlds among two different practices within outpatient pharmacy. Advice for future residents: “I am not throwing away my shot” is a very relevant quote from Lin-Manuel Miranda’s Hamilton because it is similar to Alexander Hamilton’s work ethic and perspective. It’s a good analogy of the hard work it takes to graduate from pharmacy school and pass two exams to attain pharmacist licensure. In other words, remind yourself of the big picture and don’t get weighed down by the daily activities. Time management is also one key to successfully being able to keep a work/life balance, but knowing how to appreciate and reflect on the big picture of pursuing a pharmacy residency is how you can successfully gain the most out of the one-year experience.