Ambulatory Care APPE

Saint Luke’s Population Health Ambulatory Care–Primary Care, Advanced Pharmacy Practice Experience (APPE) Rotation is designed to provide learners with an understanding of disease states and pharmacotherapy as they relate to the management of patients in the ambulatory care practice setting. Throughout the rotation, you will develop skills in the provision of pharmaceutical care, including obtaining medication histories, assessing the appropriateness of medication regimens, counseling patients, monitoring therapies, identifying and overcoming barriers to medication access, and providing appropriate drug information to patients and members of the health care team. 

This rotation places emphasis on the care of the ambulatory patient with focus in diabetes, hypertension, hyperlipidemia, and polypharmacy. Students are expected to be at the specified clinic 8 a.m. – 4:30 p.m., unless otherwise stated by pharmacist on site. 

Rotation Objectives

  • Collect and organize accurate, comprehensive subjective and objective patient information from a variety of sources, including the patient, caregiver, members of the health care team, patient profile, or medical record.
  • Perform selected aspects of physical assessment, as appropriate
  • Assess information collected and analyze clinical effects of drug therapy
  • Develop a complete medical and drug therapy problem list
  • Retrieve, analyze, and interpret the professional, lay, and scientific literature to make informed, rational, and evidence-based decisions
  • Select and recommend appropriate drug and non-drug therapy with defined therapeutic goals and measurable outcomes
  • Monitor and evaluate the effectiveness of the care plan
  • Assist patients with medication assistance and savings programs
  • Document patient care activity in Epic
  • Utilize technology to perform video and/or telephone patient care interactions
  • Demonstrate efficient and appropriate communication with care providers

Rotation Activities

  • Journal Club
  • SOAP note
  • Treatment guideline analysis
  • Interprofessional education reflection
  • Patient care logs
  • Formal case presentation
  • Additional activities as required by school of pharmacy or preceptor

Rotation Progression

Day 1: The student is expected to look through the rotation calendar and recommended readings and guidelines in order to come to the rotation prepared. The student will be oriented to the rotation learning description and daily activities. The rotation expectations will be discussed, and the student will have time to ask questions. 

1st quarter: Students will become familiarized with practice site workflow and team dynamics. The student will shadow the pharmacist as they model what is expected when seeing patients in clinic. 

2nd quarter: The student will participate in review and assessment of all patients that the pharmacist is responsible for on this practice site. Student will work to recognize own knowledge limitations and reach out to preceptor in situations of uncertainty.

3rd quarter: Student should be getting more comfortable with managing most daily tasks, and patient care and professional interactions with preceptor oversight. The student shows initiative in medication problem identification and resolution. 

4th quarter: Students should feel comfortable and more confident leading patient visits, developing therapeutic plans, which will be reviewed by the preceptor, and documenting patient care activities in Epic. 

Assessment

The student will be assessed with evaluation forms provided by the student’s school of pharmacy or as determined by the preceptor. The student and preceptor will meet at the beginning of the rotation to identify any additional goals/objectives/projects to be accomplished during the course of the rotation and develop a student schedule/timeline. The preceptor shall provide a written/electronic assessment of student’s performance at the midpoint of the rotation and a written/electronic assessment will be performed upon completion of the rotation. In addition, the student will provide a written/electronic self-assessment at midpoint and final evaluation which shall be discussed with the preceptor. The student is also expected to provide constructive feedback regarding the rotation and the preceptor’s teaching performance. The preceptor will provide regular feedback daily and the student may request feedback throughout the rotation.  

Population Health Pharmacists

Theresa Lockwood, PharmD, BCACP    
  • School of pharmacy: University of Missouri-Kansas City
  • Residency training: PGY1—Saint Luke’s Hospital of Kansas City
  • Specialty interests: Diabetes, Cholesterol Management, Deprescribing
  • Health system, hospital, pharmacy, and residency committee involvement: Primary Care Evidence-based Practice Team; Co-chair Ambulatory Clinical Pharmacy User Group
Melinda Johnson, PharmD
  • School of pharmacy: University of Missouri-Kansas City
  • Residency training: PGY1—Saint Luke’s Hospital of Kansas City
  • Specialty interests: Ambulatory Care, Diabetes, Cardiology
  • Health system, hospital, pharmacy, and residency committee involvement: Medicine Evidence-Based Practice Team (EPT) 
Madison Auten, PharmD
  • School of pharmacy: University of Kansas
  • Residency training: PGY1- University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences; PGY2 Ambulatory Care – University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences and UCHealth
  • Specialty interests: Chronic disease state management (DM, HTN, HLD)
Katie Wilson, PharmD, BCACP
  • School of pharmacy: Drake University
  • Residency training: PGY1—University of Cincinnati Medical Center; PGY2 Ambulatory Care—University of Cincinnati Medical Center
  • Specialty interests: Chronic Disease State Management (DM, HTN, HLD)
  • Health system, hospital, pharmacy, and residency committee involvement: Primary Care Evidence-Based Practice Team (EPT), Saint Luke’s Health System Pharmacy Education Team (SPET)
  • Professional involvement: American Society of Health-System Pharmacists (ASHP), Kansas Council of Health-System Pharmacy (KCHP)
  • Pharmacy awards, accolades: 2019 KCHP Emerging Leader
Joe Windscheffel, PharmD, BCACP
  • School of pharmacy: University of Kansas
  • Residency training: PGY1—University of Utah; PGY2 Ambulatory Care—University of Utah
  • Specialty interests: Ambulatory Care, Primary Care, Cardiology
  • Health system, hospital, pharmacy, and residency committee involvement: Saint Luke’s Health System Education Committee, Primary Care Evidence-based Practice Team (EPT), Antimicrobial and Diagnostic Advisement Program (ADAP) Committee
Blaire White, PharmD, BCACP
  • School of pharmacy: University of Missouri – Kansas City 
  • Residency training: PGY1 – Froedtert and the Medical College of Wisconsin; PGY2 Ambulatory Care – Denver Health Medical Center
  • Specialty interests: Diabetes, hypertension, hyperlipidemia, osteoporosis 
  • Health system, hospital, pharmacy, and residency committee involvement: St. Luke’s Health System Pharmacy Education Team (SPET), Ambulatory Pharmacy Clinical User Group (APCUG)