Hematology/Oncology APPE

Multi-site location: All students will spend time at Saint Luke’s Hospital of Kansas City and may also spend time at Saint Luke’s South Hospital, Saint Luke’s East Hospital, Saint Luke’s North Hospital, and/or Liberty Hospital.

Saint Luke’s Hospital Hematology/Oncology (ONC) Advanced Pharmacy Practice Experience (APPE) Rotation is a four-week experiential rotation for pharmacy students. The area of practice is primarily in the oncology infusion centers across Saint Luke’s Health System hospitals, including both inpatient oncology and neuro step-down. 

This rotation focuses on outpatient infusion centers, including daily operations, patient education, and patient therapy monitoring. This rotation also exposes the student to supportive care for patients with leukemia, lymphoma, solid tumors, and hematologic disorders including anemia, sickle cell disease, and idiopathic thrombocytopenic purpura (ITP) in the inpatient setting.

Core Content

Specific topics students will learn through readings, lectures, patient care rounds, and patient discussions include:

  • Anti-emetic practice guidelines and strategies
  • Prevention and treatment of cancer-related infections
  • Use of growth factors (ESAs, G-CSF)
  • Supportive care including management of tumor lysis syndrome, GI toxicities of chemotherapy, and management of extravasations
  • Hypercoagulability of malignancy
  • General review of antineoplastic agents’ mechanism of action, dose-limiting, and hallmark toxicities
  • Other issues pertaining to oncology brought forth by the student

Daily Activities

Outpatient requirements

  • Daily review of patient’s current chemotherapy regarding current course of therapy as well as history of disease and progression of care
  • Ensure safety and efficacy information for patient chemotherapy regimen, including correct dose, form, rate of administration, diluents, and other special considerations as warranted by each individual chemotherapy agent
  • Interpret and understand necessary lab parameters to ensure safe administration of chemotherapy
  • Understand and anticipate hallmark toxicities of specific chemotherapy
  • Use and follow safe handling of cytotoxic medications principles as well as understanding the principles of preparation of chemotherapy
  • Understand some basic purchasing and distribution issues surrounding the 340b program
  • Interview new patients and be able to obtain pertinent patient information as well as counsel them on use of breakthrough anti-emetic medications
  • Understand the role of research and use of clinical trials as it relates treatment of cancer patients and the necessary steps required to ensure study medications are appropriately managed

Inpatient requirements

  • Supervised participation in rounds with Saint Luke’s Cancer Institute Specialist in Cancer Care (Hem/Onc team)
  • Targeted drug therapy and TPN monitoring
  • Medication profile review and drug interaction screening
  • Adverse drug reaction and medication error reporting
  • Nursing education and participation in teaching opportunities with nursing staff
  • Drug information searches and responses
  • Required readings as requested by preceptor
  • Patient/family education including warfarin, enoxaparin, and immunizations

Rotation Projects

Students will be required to complete a combination of the following projects:

  • Provide a five-minute clinical pearl, new medication overview, or medication update to the nursing staff
  • Provide a 15-minute new medication overview or medication update to pharmacy staff and may coincide with nursing in-service
  • Complete one or two rotation projects that will focus on improving patient care, drug utilization, or improving the competency and/or training of medical staff
  • Weekly or more frequent topic discussion pertaining to care of oncology patients (see core content above); topic will be selected by student and presented to the pharmacist for discussion
  • An open-book, take-home test will be distributed at the beginning of the rotation; this will be due approximately the last week of the rotation; it will be graded and will factor into the student’s overall rotation grade

Assessment 

Assessment of student performance will be done using the affiliated school of pharmacy’s evaluation form. The student and preceptor will meet at the beginning of the rotation to identify any additional goals/objectives/projects to be accomplished during the rotation and negotiate appropriate timelines. Development of a rotation calendar is strongly encouraged. A formal verbal assessment will be done at the midpoint of the rotation using the evaluation form as a platform. The preceptor will provide a formal written assessment at the completion of the rotation.

Location

Preceptors

Jennifer Collier, PharmD, BCPS, BCOP
  • School of pharmacy: University of Kansas
  • Residency training: PGY1—Saint Luke’s Hospital of Kansas City
  • Specialty interests: Immunotherapy ADRs, Student Education
  • Professional involvement: Co-Chair Student Pharmacy Education Team
  • Health system, hospital, pharmacy, and residency committee involvement: Hematology Oncology Pharmacy Association
Rachel Vaught, PharmD, BCOP
  • School of pharmacy: University of Missouri-Kansas City School of Pharmacy
  • Specialty interests: Oncology/Hematology
  • Health system, hospital, pharmacy, and residency committee involvement: Co-Representative, Oncology Med Safety
  • Professional involvement: Hematology/Oncology Pharmacy Association (HOPA)
Lindsey Douglass, PharmD, BCPS, BCOP
  • School of pharmacy: University of Missouri-Kansas City School of Pharmacy
  • Residency training: PGY1—Saint Luke’s Hospital of Kansas City
  • Specialty interests: Hematology, Precision Oncology
  • Health system, hospital, pharmacy, and residency committee involvement: Oncology P&T Subcommittee Co-facilitator
  • Professional involvement: Hematology/Oncology Pharmacy Association (HOPA )
Beth Gustufson, PharmD, BCOP
  • School of pharmacy: Creighton University
  • Residency training: PGY1—University of Missouri; PGY2 Hematology/Oncology—Providence Medical Center
  • Specialty interests: Pharmacogenomics, Precision Oncology
  • Health system, hospital, pharmacy, and residency committee involvement: Co-chair, Ambulatory Clinical User Group; Quality Oncology Practice Initiative Workgroup
  • Professional involvement: Hematology/Oncology Pharmacy Association (HOPA)
  • Pharmacy awards, accolades: 2018 Saint Luke’s Hospital Good Catch Award
Lai Kheng Chan, PharmD, BCPS, BCOP
  • School of pharmacy: Kansas University School of Pharmacy
  • Residency training: PGY1—Saint Luke’s Hospital
Anne Kaminski, PharmD, BCPS
  • School of pharmacy: Creighton University
  • Residency training: PGY1—Rush University Medical Center
Chang Kun (CK) Kim, PharmD
  • School of pharmacy: Massachusetts College of Pharmacy and Health Sciences
  • Residency training: PGY1—Saint Luke’s Hospital
  • Specialty interests: Oncology
Phillip Lorhan, PharmD, BCPS
  • School of pharmacy: Creighton University
  • Residency training: PGY1—Creighton University
  • Specialty interests: Oncology
  • Health system, hospital, pharmacy, and residency committee involvement: Beacon Oncology SME
Blake Buzard, PharmD, BCOP
  • School of pharmacy: University of Kansas
  • Residency training: PGY1—Ascension Via Christi of Wichita, KS  ; PGY2 in Oncology at Houston Methodist
Jordan Wiarda, PharmD, BCOP
  • School of pharmacy: UMKC School of Pharmacy
Jennifer Guy, PharmD, BCPS
  • School of pharmacy: University of Missouri-Kansas City
  • Residency training: PGY1 Saint Luke’s Hospital of Kansas City
  • Specialty interests: Abdominal Solid-Organ Transplant (Liver/Kidney); Nephrology; Ambulatory
  • Health system, hospital, pharmacy, and residency committee involvement: Kidney Transplant Patient Selection Committee Member; Liver Transplant Patient Selection Committee Member; Kidney & Liver Transplant Quality Committees; Kidney Transplant Outcomes Committee; Ambulatory Pharmacy Clinical User Group, Transplant Representative; Transplant Pharmacy Team committee member
  • Professional involvement: Missouri Society of Health-System Pharmacists (MSHP)
  • Pharmacy awards, accolades: 2020 MSHP Platform Presentation Research Honor—Preceptor; 2012 MSHP Research and Education Foundation Best Practice Award
Rachel Doering, PharmD, BCPS
  • School of pharmacy: University of Nebraska Medical Center
  • Residency training: PGY1 Saint Luke’s Hospital of Kansas City
  • Health system, hospital, pharmacy, and residency committee involvement: Pediatric Evidence Based Practice Team; Obstetrics Evidence Based Practice Team; System Pharmacy Clinical User Group Co-Chair; System Pharmacy Advancement Committee; NICU Multidisciplinary Committee
  • Professional involvement: ACCP
  • Pharmacy awards, accolades: Saint Luke’s Hospital Pharmacy Resident’s Preceptor Recognition Award (2008); Saint Luke’s East Hospital Safety Hero (2015); Saint Luke’s East Clinical Excellence Award (2021)