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Good Evening and Happy April!

Even though it remains relatively cold here in Chicago, I know spring is here by the number of consecutive days of rain I have seen.  I took advantage of one of those many rainy days to complete my first ASHP re-certification module for BCPS: Pharmacotherapy Intensive Study A - Pharmacogenomics.

I remember learning a little about pharmacogenomics in pharmacy school, mainly in regards to the use of warfarin and a few chemotherapy agents.  However, since those few therapeutic lectures, I rarely gave this area much thought.  The re-certification module provided a good refresher on what pharmacogenomics is, the role a pharmacist can (and should) play, some specific examples of the impact genetic testing can have on pharmacotherapy selection, and some controversies surrounding the practice.

One thing that most stuck out to me was a question asked by the presenter: if a patient came to you with results of CYP2C9 genetic test (showing 2C9*3 allele) and a prescription for 10mg of warfarin, what would you do?  I, along with most of the participating audience, responded that we would recommend decreasing the dose of warfarin since the patient likely would require a lower dose in order to have a therapeutic INR.  This reminded me and the audience that despite the controversies surrounding pharmacogenetic testing, if we had the information available to us we would likely change therapy empirically.
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General : Accreditation, ASHPCerts, Continuing Education

I found some time to finish the first module of the recertification course over the past couple days. Module 1A includes an interesting article on non-persistence of medication after pill appearance changes (color or shape), a couple less interesting articles on nested case control studies (does anyone actually like statistics?), and finally an article from NEJM on spironolactone in heart failure. I thought for the most part the articles were good reads. The only exception was that I thought there was some overlap in the 2 articles on nested case control, and I probably could have gotten the same information out of just one.

I said in my first post that I was going to focus on the time it took me to finish each module. The four papers took me a little over 2.5 hours to read, with some minor distractions. The test itself took around 30 minutes to finish 18 questions. The test was not overly difficult and most of the answers were straight forward out of the text. There were maybe 2-3 I was not sure about, but I ended up with 100% so if you read the papers and understand the questions you should be fine. 

I'll post my twitter name again, feel free to add me if you want to know when I post my next blog on module 1B (more cardiology and statistics!): 
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Happy April everyone!  I hope that your weather has warmed up in the last month.  I was fortunate to be able to attend the Women’s Final Four here locally at the beginning of the month, checking that off my bucket list!  In less than 2 weeks, I’ll be taking a group of pharmacy students to Ireland and the UK to learn about health care systems, pharmacy practice, and pharmacy education in those countries.  It’ll be my first time traveling to those countries, so it’s been a true bucket list kind of months.  What’s on your personal or professional bucket list?  Does it include Board Certification?

I managed to find some time to do the Literature Review Module 1B “Cardiology and Statistics (Meta-Analysis)” this month.  As a reminder, as an Ambassador, the Recertification products were given to me for free by ASHP, but the opinions are solely my own. 

As with other Literature Review Modules, I got full text access to 4 articles: 2 clinical studies (one being a meta-analysis and one a RCT published in NEJM) and 2 statistics articles about meta-analyses, none of which I had read previously.

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Interprofessional work is one of the key aspects to expanding the role of pharmacists. It has become clear that we must establish our place on the health care team and I believe it is important to start embracing this role as students. One way for us to become more familiar with interprofessional collaboration is to participate in an interprofessional course.

I am currently enrolled in an Interprofessional Honors Colloquium offered by my school. This course is designed to provide an opportunity for health profession students to explore the implications of collaborative interprofessional practice. So far, it has been a very enriching experience. I had the opportunity to shadow a healthcare professional in a different field and learn more about various health professions including dentistry, nursing, medicine, public health and social work.

I am also working on a project with other health profession students aimed at identifying problems and suggesting solutions to improve transitions of care. It is a very interesting activity that has allowed me to better understand what every member of the healthcare team can bring to patient care and how we should go about combining our roles to improve healthcare outcomes. It is also a great opportunity to start promoting what pharmacists can do and prove to future healthcare professionals how we can help improve patient care. In my opinion, it is a great way to start building trust among future colleagues and optimize future collaborations.

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Family, friend, acquaintance, classmate, teacher, colleague, mentor, preceptor, manager. There are many names and titles to the relationships that we forge throughout our lifetime. Some are intuitive from childhood but others are learned and created in the path to professionalism.

Most of these titles are well defined. Being a mentor is often more elusive and its value can often be lost in the midst of being a preceptor, teacher, or being a manager to another. As I sit and encourage others to become a mentor I cannot help but reflect on those that have been a mentor to me.

The mentors in my career path were created long before I entered pharmacy school. I see mentors as those that were heavily involved in influencing my choice to go into pharmacy school, my involvement during pharmacy school, or those that helped identify my passion for oncology and clinical pharmacy practice. There are also mentors that did more than help me get into my current role but also ensured that I developed skills in leadership, communication, precepting, and mentoring myself.

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In Good Leaders Ask Great Questions, Your Foundation For Successful Leadership John Maxwell shares the following. Also review my blog posting on April 16 for the value of asking questions and questions leaders should ask themselves.

  • What questions do I ask my team members and really listen to the answers
    • What do you think which gets you the other person’s strength, heart and mind
    • How can I serve you which helps you not develop a positional mind-set whereby you start thinking you know best
    • What do I need to communicate as success in communication comes from the context more than the content
    • Did we exceed expectations which stimulates you to continue to improve your services
    • What did you learn which prompts people to evaluate their experience and make an assessment so they can learn
    • Did we add value and specifically how
    • How do we maximize this experience so we don't take anything for granted
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This month, I was able to complete another module in ASHP's BCPS recertification credit series literature review. The topics I completed this month involved the pulmonary system, including pulmonary embolism (PE) and pneumonia. The readings included European Guidelines for PE and 2 articles dealing with pneumonia. Both pneumonia readings were from the New England Journal of Medicine, involving the PCV7 vaccine and a review article for the treatment of pneumonia. All 3 of these articles very very interesting and added to my knowledge base. I enjoyed this module since it was able to reinforce what I already new, but give me new aspects of these topics, including European guidelines for PE treatment. The quiz was very difficult, but it proved to me that I was able to learn something on these topics which are dealt with on pretty much a daily basis in both in- and outpatient settings.
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My name is Trang Truong and I am a Post-doctoral Medication Safety Resident with Purdue University College of Pharmacy’s Center for Medication Safety Advancement. I am conducting a research survey to assess the need for medication safety education and training for physicians, pharmacists, and nurses across different healthcare settings. 

The Institute of Medicine (IOM) estimated that as many as 44,000 to 98,000 Americans die each year as a result of preventable medical error. The annual cost associated with preventable errors is approximately $17 billion. While most errors committed are system errors, safety education and training have been associated with a reduction in the number of preventable errors. Further research in medication safety education is needed to assess healthcare professionals’ understanding of medication safety terminology, knowledge about medication safety concepts, research, and best practices. The goal of the survey is to assess the current level of medication safety education provided to physicians, pharmacists, and nurses and to identify key interest areas to improve future training and education. 
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In Good Leaders Ask Great Questions, Your Foundation For Successful Leadership John Maxwell shares the following.

  • Why are questions so important for leaders
    • You only get answers to the questions you ask which makes them so powerful
    • Questions unlock and open doors that otherwise would remain closed and we would miss all kinds of possibilities leading to opportunities, experiences and people
    • Questions are the most effective means of connecting with people which is how leaders have influence through relationships
    • Questions cultivate humility, which enables us to be authentic, vulnerable, trustworthy and intimate with others. People are open to those that are open with them
    • Questions help you engage others in conversations by getting to know them and showing that you want to add value to them
    • Questions allow us to build better ideas because of the input from others so they can become great ideas
    • Questions give us a different perspective so we don't act on faulty assumptions
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Audience : Pharmacy Leadership

As provider status looms on Capitol Hill, there are a number of steps health care institutions can take to prepare for the possible recognition of pharmacists as providers among health care teams.

Regardless of provider status, one step many institutions are pursuing (or have already pursued) is credentialing and privileging of their pharmacists.  To assist with this process, ASHP has recently developed a resource center dedicated specifically to credentialing and privileging:

How has your hospital or health system addressed credentialing and privileging of pharmacists?  Many of us would greatly benefit from dialogue about the successes and failures of others.

Posted on behalf of the SAG on Clinical Leadership, Section of Clinical Specialists and Scientists

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Is anyone aware of a working list of Licensed 503B Outsourcing Facilities and lists of which drugs those facilities are currently producing?

Would anyone be willing to share this information based on your own procurement of 503B facility - prepared items?   

For example, if I am looking for cyanocobalamin injection (I need more than I am allocated to meet my patient needs) how would I find an outsourcer who is currently producing cyanocobalamin injection?


Gigi Davidson, BSPh, DICVP
Visiting Scholar UNC Eshelman School of Pharmacy 2014-15
Chair, USP Compounding Expert Committee, 2010-2015
Director of Clinical Pharmacy Services
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(Written by Allie Sturm Vecchiet*)  In Bringing Strategy Back Jeffrey Sampler presents four “strategic shock absorbers” that enable leaders to build resilient organizations that can withstand even the most unexpected turbulence and change. More often than not, strategic change occurs exclusively in reaction mode. Sampler explains that the challenge is to make strategic planning proactive and preemptive as a matter of course.

 How can companies and departments move quickly and fluidly even amid massive turbulence? Sampler offers managers four tools that he calls, “strategic shock absorbers.”

  1. Accuracy – delivers on-target forecasting; enables granularity and specificity
  2. Agility – delivers speed and flexibility in terms of strategic options
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Charging the Hill: A Students Guide for Advocacy and Student Legislative Day

By: Sabrina La Spisa and Samantha Boartfield

When I achieved BCPS I started dreading completely the re-certification credit. At that point in time the only option available to complete the credit was the Pharmacotherapy Self-Assessment Program. I dreaded completing them from day one, but also dreaded the thoughts of ever having to retake the examination. Then ASHP created a way for pharmacists to have options in completing the required credit. There are now different ways that I can consider when deciding how to finish my requirements. This excites me. Call me a nerd, but having options makes me jump for joy! ASHP offers two different types of re-certification credit. The literature study module and then the intensive re-certification class. I truly can not wait to get started in these options and share my journey along with you all!
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Student Rotations in Pharmacy Informatics

Brandon Ordway

The last several years have provided for significant growth in our pharmacy schools’ curriculums to include various facets of pharmacy informatics and technology.  Some have chosen to include stand-alone classes in pharmacy informatics, either as mandatory or elective options, and others as various topics and lectures scattered throughout several courses.  This has had a great impact on our future workforce as it exposes  students to a non-traditional opportunity within health-system pharmacy.  Additionally, does any pharmacist not use some sort of computers or informatics as part of their job these days?  Providing for the basics of pharmacy informatics positively impacts pharmacists in all practice settings.

I personally started a Health Informatics APPE rotation with the University of Minnesota five years ago.  There was one other informatics student rotation in the state so obviously there was an opportunity for another one!  When creating the rotation there were a just a few resources that existed to help me out, as the profession was really still defining what pharmacy informatics was!  Now there is a plethora of information and resources out there.  The Section of Pharmacy Informatics and Technology website provides for a sample informatics student rotation description, a student informatics informational brochure, and lots of other pertinent information on informatics residencies and those pursuing careers in pharmacy informatics.

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Some time last Fall, nestled between my busy Cardiac ICU and Emergency Dept learning experiences I managed to squeeze in some time to take a BPS exam in pharmacotherapy.  It was a blur, and I had a lot of responsibilities to occupy my time and not stress about whether I passed, etc.  I was fortunate to receive a random email in mid-November informing me to check out the testing administration website.  So yea, BCPS certified!!!  

Then one of my pharmacy mentors asked what my plans for recertification are?  record scratching noise... Wait what?

I think I had read about recertification in the extensive manual prior to signing up for the BCPS exam; but the information had not stayed with me.  I was familiar with other programs from some of my clinical learning experiences as a student and resident; then the email for ASHP's recert program and was fortunate to be selected as an ambassador for this program.  I look forward to beginning my recertification journey with the ASHP intensive study - let the learning begin!
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I'm super excited to participate in the BCPS ambassador program!  I'm more than a little intimidated to start blogging, but it's a small price to pay for the opportunity.  I get to use ASHP's pharmacotherapy recertification materials in exchange for sharing my experience with them over the next 12 months. When I was starting the second half of the BCPS exam, I was thinking "I NEVER want to take this test again!" I'm glad I passed and I'm glad ASHP has given me this opportunity.

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If you had asked me a year ago when I was prepping for P4 rotations if I thought I would have to go through the Scramble, I probably would have laughed in your face. I have known I wanted to do residency since the beginning of my pharmacy school career. I did everything I needed to do to prepare for getting a residency position, and not even because I thought I had to, but because I enjoyed doing it all. I built up my leadership skills by holding positions on a local, state, and national level, I presented numerous posters at conferences, I volunteered in the little amount of free time that I had, I worked every other weekend as an intern, and I even selected a hard P4 rotation schedule. My CV was 5 pages long, I thought my letters of intent were great, I thought I nailed my interviews, and I ranked 6 programs overall. I thought I was set.

Then Match Day came.

Thursday night, I was anxious because my future was about to be revealed to me in less than 24 hours. I didn't sleep well that night at all. Friday morning brought more anxiety. I could barely focus on working up my patients at rotation. Then, at 8:00am during morning report, I saw the email flash across the top of my iPad screen. I turned to the resident next to me asking if it was ok to open it. When I opened that email and saw "we regret to inform you...", my heart literally dropped. I had to reread the email. I thought it was a mistake. The whole time during morning report, I kept refreshing my email for an apology email that would tell me where I really matched. Spoiler alert; that email never came. I honestly thought all of my hard work was for nothing.
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Hi all,

Welcome to my blog.  My name is Adam Utley, I am from way up north in Michigan (Boyne Falls), I attended Ferris State University's College of Pharmacy (graduated 2010) and I work as a clinical pharmacist at McLaren Northern Michigan Hospital (202 beds). 

As I read that back it kinda sounds like I am on Wheel of Fortune.

I guess the point of this year-long ambassador program is to spread the word on board certification.  I think we as pharmacists have done a pretty poor job of advertising our impact on patient care.  Does anyone know what a pharmacist does?   My friends are in the dark.  One of the valuable lessons I learned in pharmacy school was...if you don't document it, it didn't happen.  The same goes for letting people know about our impact on patient care...if we don't tell people how we help patients, then no one else will.  So this blog focus on my role as an ambassador. 

Over the course of the next year, I am going to tell everyone how I take care of my patients, why I became board certified for my patients and how my board certification helps me take care of my patients.  Along the way I will provide some insight into the ASHP recertification product I am testing.
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