QUARTERLY SUMMATIVE EVALUATION

HOSPITAL PHARMACY PRACTICE

Resident: / Date Completed:

Preceptor: / Time Period of Learning Experience:
  • This form documents resident attainment of goal areas formally taught in the learning experience. Evaluation of goal mastery is based on preceptor judgment of resident performance on the associated objectives listed below each goal.
  • There are two categories of evaluation. The first category is an evaluation of goals designated for formal evaluation. The second category is of goals selected to be formally taught in the learning experience, but not chosen for formal evaluation.
  • Preceptor will provide a narrative commentary for each goal in the first category of evaluation which is based on current resident performance level and reflects the aggregate resident activity during the rotation.

NI = Needs Improvement; SP = Satisfactory Progress; ACH = Achieved

Category 1: Goals Designated for Formal Evaluation

GOALS AND ASSOCIATED OBJECTIVES / DESCRIPTION OF REQUIREMENTS / NARRATIVE COMMENTARY / NI / SP / ACH
(Quarters: 1, 2, 3, 4)
Goal S3:Demonstrate the characteristics of a professional.
OBJ S3.1(Organization) Choose daily activities so that they reflect the pursuit of expertise in the development of direct patient-care problem-solving skills.
OBJ S3.3(Application) Dress in attire that conveys a professional image.
OBJ S3.4(Characterization) Consistently maintain personal self-control and professional decorum.
OBJ S3.5(Characterization) Demonstrate acceptance of one's professional responsibility toward colleagues and the health system through commitment to one's team.
OBJ S3.7(Organization) Present pharmacy concerns,
solutions, and interests in an assertive manner. / The resident is expected to be punctual for assigned shifts. Initiative on the part of the resident is expected to gain competency at tasks required by a pharmacist to staff assigned area. Resident is expected to be present for entire assigned shift. Daily activity is directed toward improved patient outcomes and documentation of time, interventions and communications with patients and other health care professionals is expected. Findings regarding medication problems, omissions, and needs are communicated to the health care team and resolved appropriately. The resident shows progress in designing and managing their day for efficiency, and these activities are timely.
(Quarters 3 and 4)
Goal S9:Solve practice problems efficiently.
OBJ S9.1(Application) Demonstrate consistent use of a systematic approach to problem solving.
OBJ S9.2(Application) Use consensus-building skills. / The resident gathers appropriate information and engages assistance of others when necessary to resolve problems. Actions taken in the pharmacy are presented without undue emotion and differences and conflicts are handled professionally, without patient involvement. The resident directs energy and goals to the good of the patient and the institution. The resident is as assertive as necessary without alienating another member or pharmacy as a service.These should be documented and part of the monthly review with the resident’s staffing mentor.
(Quarters 1, 2, 3, 4)
Goal S19:Manage time effectively to fulfill practice
responsibilities. / Residents are responsible for assuring coverage of assigned shifts. Missing a shift is not an option unless agreed upon by the preceptor. Follow up with pharmacy personnel prior to leaving a shift on outstanding questions or issues are imperative.
(Quarters 1, 2, 3, 4)
Goal P1:Establish a collaborative working relationship with
physicians and other health care providers in the
health system. / Work to understand the motivations, requirements, needs and challenges of the customers of the pharmacy (nurses, doctors, patients, pharmacists, etc) and to better support them and their patient related activities. Attempt to anticipate their needs and surpass them.
(Quarters 1, 2, 3, 4)
Goal P3:Provide concise, applicable, comprehensive, and timely responses to requests for drug information from patients, health care providers, and the public. / Drug information questions, queries, analysis, etc, will be the responsibility of the resident. Guidance by other pharmacy staff should be sought as needed. Proper sources for answering questions are available in the pharmacyand should be used. Delivery of the answer to the question must be pertinent to the patient situation and to the practitioner. These should be documented and part of the monthly review with the resident’s staffing mentor.
(Quarters 1, 2, 3, 4)
Goal P8:Prepare and dispense medications following existing standards of practice and the health system’s policies and procedures.
OBJ P8.1(Evaluation) Interpret the appropriateness of a medication order before preparing or permitting the distribution of the first dose.
IO P8.1.1(Application) Use effective prescriber education techniques to secure agreement on modifications to medication orders.
IO P8.1.2(Application) Document modifications to medication orders according to the health system’s policies and procedures.
OBJ P8.2(Application) Follow the health system’s policies and procedures to maintain the accuracy of the patient’s medication profile.
OBJ P8.3(Application) Prepare medication using appropriate techniques and following the health system’s policies and procedures.
OBJ P8.4(Application) Dispense medication products
following the health system’s policies and
procedures. / Residents are expected to carry out pharmacist duties in assigned shifts. These include “vopping” medication orders, checking medications prior to dispensing; assuring dispensing is in accordance with all legal requirements as well as department safety requirements. All interventions, drug information and problems encountered during dispensing are documented and turned in to mentor on a monthly basis (or sooner if situation necessitates).
(Quarters 1, 2, 3, 4)
Goal M13:Participate in the departmental performance improvement program.
OBJ M13.1(Application) Effectively apply the guidelines of the department’s performance improvement process. / The resident is expected to participate in the daily pyxis and cart fill log sheet.Participation will be reviewed on an ongoing basis by the mentor team.

Category 2: Goals Selected to Be Formally Taught But Not Formally Evaluated

GOALS AND ASSOCIATED OBJECTIVES / NEEDS ATTENTION
Goal S8:Maximize work efficiency through the use of computers and information systems. / The resident is expected to utilize HEO/WizOrder, HMM series, StarPanel/StarChart to process medication orders. The resident should be familiar with Pyxis. The resident is expected to become familiar with and utilize the electronic drug information databases as appropriate and necessary.
Goal S11:Display a caring attitude toward patients in all aspects of job responsibilities. / The resident considers working with patients a privilege, and considers the patient and their companions guests in the institution. The resident works to assure the patient is as comfortable, as informed, and as cared for as possible. The resident shows the patient respect, and shows compassion and assurance as the patient attempts to succeed in caring for themselves.
Goal S12:Maintain confidentiality of patient and proprietary business information. / Patient information, business information, research information and the personal information of co-workers are to be protected. Verbal, electronic, written and implied communication of this information is not tolerated and jeopardizes the trust instilled in employees, and the trust built between practitioners and patients. Policy of the institution is to be read, and honored.
Goal S15:Understand direct patient care delivery systems in multiple practice settings. / Residents will spend some time in the various satellites to understand to pharmacy processes utilized to maximize patient care.
Goal M1:Identify a core library, including electronic media, appropriate for a specific practice setting. / The resident will be given guidelines for developing a personal library in the hospital pharmacy practice setting. This library should be utilized with emphasis on the patient situations encountered to gain efficiency and confidence.
Goal M10:Understand steps that must be taken to ensure departmental compliance with accreditation, legal, regulatory, and safety requirements (e.g., NCQA and JCAHO requirements; ASHP standards, statements, and guidelines; state and federal laws regulating pharmacy practice; and OSHA regulations). / The resident will be familiar with the steps the department takes to be compliant with regulatory, safety, and legal requirements through orientation activities as well as specific task training.

Overall Comments:

Areas of strength (required):

Areas to focus on for enhancement/improvement (required):

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Resident Signature Preceptor Signature Program Director Signature