2016 Regional Residency Conference Outline Discuss current - - PDF document

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2016 Regional Residency Conference

Outline

• Discuss current residency capacity
• Examine the results of the March residency two-phase

match process

• Provide an update regarding recent Commission on

Credentialing decisions

• Discuss current findings of partial compliance with the 2014

PGY1 standard and how they differ from top findings with the 2005 standard

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Residency Capacity

500 1000 1500 2000 2500

ASHP Accredited Pharmacy Residency Program Growth in Last 20 Years

Hospital Pharmacy Practice PGY1 Clinical Specialized PGY2

2,044 1,861

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Types of Residency Programs

1166 809 69

200 400 600 800 1000 1200 1400 PGY1 PGY2 COMBINED PGY1/PGY2

Includes Accredited, Candidate Status, and Pre-Candidate Status Programs as of 4/15/2016

PGY1 Residency Programs

993 127 46

200 400 600 800 1000 1200

PGY1 PGY1 COMMUNITY PGY1 MANAGED CARE Includes Accredited, Candidate Status, and Pre-Candidate Status Programs as of 4/15/2016

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Audience Participation Question: Which type of PGY2 residency had the largest increase in number of programs between 2015 and 2016?

A. Critical Care B. Ambulatory Care C. Emergency Medicine

• D. Psychiatric Pharmacy

Top PGY2 Residency Programs by Number of Programs

20 40 60 80 100 120 140 2015 2016

Includes Accredited, Candidate Status, and Pre-Candidate Status Programs as of 4/15/2016

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Other PGY2 Residency Programs

5 10 15 20 25 2015 2016

Includes Accredited, Candidate Status, and Pre-Candidate Status Programs as of 4/15/2016

Residency Growth Summary

• PGY1, PGY2, and combined PGY1/PGY2 programs

continue to grow

• 21% increase in programs in past 3 years
• PGY2 and combined programs outpacing PGY1

programs in percent growth from 2015-2016

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2016 Two Phase Match

Applicants Participating and Positions Offered Increased in 2016

• PGY1

– 7.9% increase in positions offered – 11.6% increase in applicants participating in Match

• PGY2*

– 8.9% increase in positions offered – 22.7% increase in applicants participating in match

* Includes early commitment process

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1900 2092 2508 2915 3277 3706 3933 4142 4358 4609 1162 1612 1769 1873 1951 2173 2413 2694 2862 3081 3309 282 1343 1487 1651 1801 2027 2268 2495 2640 2811 3041 269

500 1000 1500 2000 2500 3000 3500 4000 4500 5000

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Phase I 2016 Phase II

ASHP Resident Matching Program 2007-2016 PGY1

# applicants # positions # matched

95% fill rate 92% fill rate 239 330 384 483 541 677 777 917 1002 1148 140 286 334 380 439 514 585 692 792 906 1000 88 195 267 297 369 438 505 601 706 794 899 64 41 81 88 114 144 179 230 260 297 319

200 400 600 800 1000 1200 1400

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Phase IPhase II

ASHP Resident Matching Program 2007-2016 PGY2

# applicants (includes early commits) # positions (includes early commits) # total match (early commit+match) # early comit

73% fill rate 90% fill rate

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Audience Participation Question: What percent of PGY1 applicants DID NOT match with a program by the end of Phase II?

A. 8% B. 19% C. 33%

• D. 50%

Going Into the Scramble

End of Match or Phase II End of Match or Phase II 2015 Unfilled Positions Unmatched Applicants PGY1 270 1547 PGY2 112 208 T

• tal

382 1755 2016 PGY1 13 893 PGY2 24 76 T

• tal

37 969 Reduced Unfilled Positions by 90% Reduced Unmatched Applicants by 45% Overall position fill rate for PGY1 and PGY2 was 99.1%

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288 323 635 964 1104 1293 1239 1491 1373 1297

200 400 600 800 1000 1200 1400 1600 1800

2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

PGY1 Gap - Applicants to available Positions

Two Phase Match Summary

• Match results reflect significant growth in residency

programs and additional residency positions in past 3 years

• Still significantly more applicants than positions
• Two phase match process was successful in filling

majority of residency positions in an orderly fashion

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News from the Commission

• n Credentialing

Changes to Standards and Competency Areas for PGY2 Programs

• New PGY2 standard approved – August 2015

– Optional implementation – July 2016 – Required implementation – July 2017

• New PGY2 guidance document approved –March 2015
• PharmAcademic will default to 2015 PGY2 standard for 2016

residency unless program emails them

• Current outcomes, goals, and objectives can be utilized with new

standard

• Competency areas, goals, and objectives currently under

development

– Order of development based primarily on number of PGY2 programs – First sets of revised goals and objectives expected to be approved at August 2016 COC meeting and ready for implementation in PharmAcademic for 2017-2018 residency year

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PGY2 Goals and Objectives in Process

• Critical Care
• Ambulatory Care
• Oncology
• Infectious Diseases
• Psychiatry
• Pediatrics
• Solid Organ Transplant
• Cardiology
• Internal Medicine
• Pharmacotherapy

New Changes to the Guidance Document for the 2014 Standard (April 2016)

• Standard 1.5: Consequences of residents’ failure to obtain

appropriate licensure either prior to or within 90 days of the start date of the residency must be addressed in written policy of the residency program

– Added as a critical factor – Guidance added: Programs ensure a minimum of 2/3 of residency is completed as a pharmacist licensed to practice in the program’ s jurisdiction.

• Standard 3.1: Purpose statement (see standard for required

purpose statement)

– Guidance changed to: The program documents the required purpose statement in program materials. (changes in red)

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New Changes to the Guidance Document for the 2014 Standard-April 2016 (continued)

• Standard 6.3: The pharmacist executive must provide

effective leadership and management for the achievement

• f short- and long-term goals of the pharmacy and the
• rganization for medication-use and medication-use policies.

– Removed definitions of short-term goals as one year and long-term goals as greater than 2 years – Changed how it will be surveyed to:

• Review of department of pharmacy strategic plan and specific

departmental goals and initiatives

• Discussion with organization and pharmacy leaders, physicians, nurses

and pharmacy staff about the role of pharmacy in strategic planning for the organization and medication-use process

New Changes to the Guidance Documents for the 2014 Competency Areas, Goals, and Objectives (April 2016)

• Objective R3.1.2 (Applying): Apply a process of ongoing self

evaluation and personal performance improvement

– Added guidance on minimum number of times objective must be assigned to be taught and evaluated.

• Objective must be taught and formally evaluated at least 3 times

– Assigned to 3 different learning experiences – Assigned to be evaluated in 1 learning experience and twice in a longitudinal learning experience – Assigned to be evaluated 3 times in a longitudinal learning experience

• How it will be surveyed section also changed to reflect new
• guidance. Exact wording in next slide

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Objective R3.1.2 (Applying): Apply a process of

• ngoing self evaluation and personal performance

improvement

Guidance

The residency program creates a strategy describing what residents will do, and how they will do it, that will help residents develop the skills to effectively self-evaluate. Residents compare their self-evaluation with the preceptor for feedback during formative and summative evaluations, if applicable, to determine the degree of accuracy of their self-evaluation. An example for formative might include asking the resident what they thought they did well and how they can improve on specified

• bjectives.

Residents are able to identify their strengths and areas for improvement and define a plan for improving, where indicated. This objective is included in at least three learning experiences or one learning experience and two times in a longitudinal learning experience or required 3 times in a longitudinal learning experience. Beyond the requirements, programs are encouraged to use other methods.

Objective R3.1.2 (Applying): Apply a process of

• ngoing self evaluation and personal

performance improvement

How it will be surveyed

Review of:

• Strategy for self-evaluation, if written, or verbal description
• f strategy in discussions with RPD, preceptors, and

residents.

• Evidence that preceptors track resident progress toward

achievement of this objective.

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Top Citings: 2014 PGY1 Standard

• 47 programs surveyed on new

standard as of March 2016.

• On average, surveyors cited 21

elements per survey. The range was 7-40 elements cited.

Audience Participation Question: The most frequently cited element of the current standard is:

A. 4.8c – related to preceptor qualifications B. 1.5 – related to licensure requirements C. 3.3c(1)(d) – related to learning experience descriptions

• D. 3.4c(1) – related to preceptor evaluation of residents

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2014 PGY1 Standard: Top 5 Citings by Frequency Cited

Standard Number Standard Verbiage Percent of Time Cited 3.4c(1) At the end of each learning experience, residents receive, and discuss with preceptors, verbal and written assessment on the extent of their progress toward achievement of assigned educational goals and objectives, with reference to specific criteria 79% 3.3c(1)(d) For each objective, the learning experience contains a list of learning activities that will facilitate its achievement 68% 1.6 Requirements for successful completion and expectations of the residency program are documented and provided to applicants invited to interview, including policies for professional, family, and sick leaves and the consequences of any such leave on residents’ ability to complete the residency program and for dismissal from the residency program 64% 6.6k The medication system includes a system ensuring accountability and

• ptimization for the use of safe medication-use system technologies.

62% 6.8a(2) Professional, technical, and clerical staff complement is sufficient and diverse enough to ensure that the department can provide the level of service required by all patients served. 51%

2005 PGY 1 Standard: Common Areas of Partial Compliance COC March 2014

Percent Standard(s) Issue

77% 5.9 Preceptors do not meet 4/7 criteria for commitment and contribution to pharmacy 76% 4.1d Learning experience descriptions not adequately developed 64% 4.1e(3) Preceptor and learning experience evaluations not scheduled at end of the learning experience or at least quarterly for longitudinal learning experiences 61% 4.2d(1)-4.2d(3) Preceptors do not complete all aspects of the assessment

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2014 PGY1 Standard: Top Items Cited Related to Program Policies

Standard Number Standard Verbiage Percent

• f Time

Cited 1.6 Requirements for successful completion and expectations of the residency program are documented and provided to applicants invited to interview, including policies for professional, family, and sick leaves and the consequences of any such leave on residents’ ability to complete the residency program and for dismissal from the residency program 64% 1.5 Consequences of residents’ failure to obtain appropriate licensure either prior to or within 90 days of the start date of the residency are addressed in written policy of the residency program. 36% 2.4b Residents’ acceptance of these terms and conditions, requirements for successful completion, and expectations of the residency program is documented prior to the beginning of the residency. 36% 2.2 The program complies with the ASHP Duty-Hour Requirements for Pharmacy Residencies. 32%

2014 PGY1 Standard: Top Cited Items - Program Structure & Preceptors

Standard Number Standard Verbiage Percent of Time Cited 3.4c(1) At the end of each learning experience, residents receive, and discuss with preceptors, verbal and written assessment on the extent of their progress toward achievement of assigned educational goals and

• bjectives, with reference to specific criteria.

79% 3.3c(1)(d) For each objective, the learning experience contains a list of learning activities that will facilitate its achievement 68% 3.3c(1)(a) Learning experiences include a general description, including the practice area and the roles of pharmacists in the practice area 49% 3.4d(2) On a quarterly basis, the RPD or designee assesses residents’ progress and determines if the development plan needs to be adjusted. 47% 4.4e The RPD serves as the organizationally authorized leader of the residency program and has responsibility for creating and implementing a preceptor development plan for the residency program. 45%

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Top Items Cited Related Pharmacy Services

Standard Number Standard Verbiage Percent of Time Cited

6.6k

The medication distribution system includes the following components: a system ensuring accountability and optimization for the use of safe medication-use system technologies.

62% 6.8a(2)

Professional, technical, and clerical staff complement is sufficient and diverse enough to ensure that the department can provide the level of service required by all patients served.

51% 6.2d

Pharmacy services extend to all areas of the practice site in which medications for patients are prescribed, dispensed, administered, and monitored.

47% 6.7b

The following patient care services and activities are provided by pharmacists in collaboration with other health-care professionals to

• ptimize medication therapy for patients: prospective participation in

the development of individualized medication regimens and treatment plans.

43%

COC News Summary

• Remember programs have the option to use the

PGY2 standard, starting July 2016, but can remain

• n the old standard until July 2017.
• Notify PharmAcademic if not converting in July,

2016.

• Guidance for both standards expected to be

updated twice a year. Remember to check for updates in late April and September.

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QUESTIONS?