2019-2020 Annual Report

NHRMC Residency Program

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Director's Letter

Editor's note: A special welcome to Mike Melroy, our new Systems Director of Pharmacy. Mike joined us in March 2020 (right before the shut down). He completed his PharmD degree from the University of Georgia, and Pharmacy Practice residency at the VA in Tampa, Florida. He initially practiced as a Critical Care pharmacist, but has been in pharmacy administration for several years. We are so excited to have Mike with us as he also has a plethora of residency experience, including just recently completing a term as a member of the ASHP Commission on Credentialing.


This year has been like no other. 2020 brought the challenge of a global pandemic to our health care system and our lives. As we learned about the virus early on, there were many more questions than answers, especially around the use of medications. Even the president opined on the use of hydroxychloroquine and professed to taking it knowing that the literature support was sparse. Even as I write this, we are eagerly awaiting the first vaccine to hit the market and we are evaluating ultra-low freezers for cold chain storage. Managing COVID patients both on the floors and the ICUs has been a big challenge for our pharmacy team, but they have risen to that challenge. Technicians have worked hard to learn how to properly don and doff PPE to refill pyxis machines and deliver medications to COVID units. Pharmacists have worked tirelessly optimizing medications to care for our patients. The procurement team has worked hard to ensure we have enough medications to care for patients who in some instances required much more pharmacological management than non-COVID patients. We worked with both the state and federal government to participate in the Emergency Use Authorization processes for newly emerging therapies.


COVID did not slow down the growth and expansion of NHRMC during 2020. In April, our outpatient infusion center (OPMC) officially opened off campus to provide non-hazardous infusions to our patients. That space in the hospital was quickly filled with patients undergoing procedures at the main campus on 17th Street. Brunswick Forest Cancer Center also opened in July with a USP<800> compliant cleanroom and has grown very quickly in just three months of operation. Plans for a hospital at Scotts Hill in Northern New Hanover County have been submitted as a certificate of need request for a 66-bed hospital slated to open in late 2024 adjacent to the current ED North campus. At the main campus on 17th Street, the North Tower opened to care for medical surgical patients to decompress the South Tower and the ED. There are now ICU and floor patients in the North Tower. Our automation and procurement team worked hard to set up those areas sometimes with very short notice of operations. Pharmacists and technicians pivoted quickly to care for those patients and supply medications to these new units. We had our accreditation survey from DNV in September, which gave the department the opportunity to share many of our successes.


Our health-system continues to gain accolades of various organizations for the care we provide to our patients. Over the past year we've received awards from the American Heart Association, Healthgrades, Newsweek, and NCQA, just to name a few. We are especially pleased to have been designated an LGBTQ Healthcare Equality top performer by the Human Rights Campaign Foundation. This reflects the work of our institution in promoting diversity and inclusion for patients and employees.


During 2020, we also learned of the partnership between NHRMC, Novant Health and UNC. This partnership will help bring even higher quality care to our community through innovative relationships and improved access. This partnership will strengthen our commitment to our community and provide the resources needed to be even more successful in today’s health care environment.


The pharmacy team continues to be a valued team across the system. While we have our challenges, our team time and time again steps up to the meet the needs of our patients and fellow health care workers. We continue to commit to teaching the next generation of pharmacists through our student and residency programs.


Sincerely,


Mike Melroy

Deartment and Health-System Updates

2020 - What a Year!!!

In addition to the pandemic, we've had a lot of changes this year at New Hanover.


Within the department, we've expanded our pharmacy services in the outpatient arena. We now have two outpatient pharmacies. In addition to our discharge pharmacy as part of the 17th Street campus, our new Employee Pharmacy, which also includes specialty pharmacy services, is up and running. Our team has worked to achieve both URAC and ACHC accreditation. And our specialty pharmacy now services New Hanover Medical Group, the Internal and Family Medicine clinics, as well as 8 specialty practices. We've hired one of our residency graduates to promote the safe and cost-effective utilization of specialty meds.


Under the traditional community pharmacy realm, we are now offering pneumococcal and shingles vaccines to our employees and their family members. Our outpatient pharmacy advantage program now serves over 2,000 patients with med sync, shipping, and MTM services. We've also recently established an outpatient pharmacy clinic to provide direct patient care services for patients of our non-hospital based NHRMC-affiliated practices. In just 4 months, our team has over 100 patient encounters!


On the inpatient side, our team has been working hard with the opening of the 17th Street North tower. With 16 ICU beds and 36 medical beds, this tower has helped provide overflow services for medical patients. We are finishing the year with some big changes in the central pharmacy as we work to provide an updated, compliant clean room. Check out the transformation pictures!


As always, our pharmacy team shines in the face of adversity. Based on our response to Hurricane Florence, we received ASHP's CEO Award for Courageous service. When you have a chance, watch the awesome video that ASHP put together of all the award winners here: https://youtu.be/Xa7RXDITrvg


We are very proud of one of our technicians (and former residency program assistant), Deb Hewitt, who received the Technician of the Year award from North Carolina Association of Pharmacists last fall. Way to go Deb!


And last, but certainly not least, Diane Graham recently retired after serving the pharmacy department for over 46 years. We wish Diane the best, and hope she is enjoying time with her family. We will miss you!

What's New With NHRMC Residency Programs?

We are excited to report that our PGY1 Community-Based program underwent an ASHP accreditation site visit in November 2019. We received some great feedback and were awarded 4 years accreditation!


With a change in leadership, our new System Director of Pharmacy now has weekly meetings with residents to check in and see how things are going. Thank you Dr. Melroy for being so supportive of our residents!


Over the past residency year, our residents continued to be involved in Leading Our Community to Outstanding Health. Even with the pandemic shut down, our residents provided over 190 hours of service to the surrounding community.


In addition, our resident-provided continuing education remains highly-attended events. For 12 hours of CE over the course of the residency year, there were 538 attendees, an average of over 53 attendees per event!

2020-2021 Current NHRMC Residents

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NEW PRECEPTOR SPOTLIGHTS

PRECEPTOR NATIONAL/REGIONAL INVITED PRESENTATIONS

Edgerton L. The opioid crisis at home: check your cabinets. UNCW Oscher Lifelong Learning Institute Women on Wednesday.

Edgerton L. Panelist: Opioid addiction. United Methodist Business Leader Network

Sweeney L. Antiplatelet updates in stroke. 2019 Cardiovascular and Stroke Regional Conference.

PRECEPTOR CERTIFICATIONS/AWARDS/APPOINTMENTS


Edgerton L. Wilma's Leadership Institute Graduate

Jurado L. Emergency Neurological Life Support Certification

Jurado L. Carolinas Virginias Chapter of SCCM Presidential Citation

King M. NHRMC Hypertension Quick Wins team

King M. Epic Clinical Content Builder

King M. NHRMC Department of Pharmacy Employee of Quarter

King M. North Carolina Medical Advisory Committee for HIV Medication Assistance Program

Pederson G. NHRMC Department of Pharmacy Employee of Quarter


National Councils

Blair M. Annals of Pharmacotherapy Ambulatory Care Editorial Board

Farrington E. Journal of Pediatric Pharmacology and Therapeutics Editorial Board

Farrington E. SCCM 49th Critical Care Congress Program Planning Committee

Farrington E. ACCP Credentials: Fellowship Committee

Jurado L. SCCM Diversity and Inclusion Committee

Melroy M. ASHP Commission on Credentialing

ALUMNI/PRECEPTORS PEER REVIEWED PUBLICATIONS: 2019-2020

Caudle KE, Gammal RS, Karnes JH, Afanasjeva J, Anderson KC, Barreto EF, Beavers C, Bhat S, Birrer KL, Chahine EB, Ensor CR, Flowers SA, Formea CM, George JM, Gosser RA, Hebert MF, Karaoui LR, Kolpek JH, Lee JC, Leung JG, Maldonado AQ, Minze MG, Pulk RA, Shelton CM, Sheridan M, Smith MA, Soefje S, Tellez-Corrales E, Walko CM, Cavallari LH. PRN Opinion Paper: Application of precision medicine across pharmacy specialties. J Am Col Clin Pharm. 2019;2:288-302. doi: 10.1002/jac5.1107.


Cieri-Hutcherson NE, Harris JB, Karaoui LR, Lakdawala L, Lodise NM, Stone RH, Vernon V. Infertility management and pharmacotherapy: what every pharmacist should know. J Pharm Pract. 2020:June 26 [e-published ahead of print]. doi: 10.1177/0897190020930969


Edgerton L, Herndon O, Pino J. Reducing harm from opioids – lessons learned. Southern Pain Society Newsletter. Winter 2020.


Harris JB, Holmes AP, Eiland L. The influence of the food and drug administration pregnancy and labeling rule on drug information resources. Ann Pharmarcother. [e-published ahead of print]. doi: 10.1177/1060028020956658


Hudgins DK, Holmes AP, Parman MG, Harris JB. Comparison of neonatal outcomes from utilizing a soybean oil-based lipid injectable emulsion versus a soybean oil, medium chain triglyceride, olive oil, fish oil lipid injectable emulsion. Am J Hosp Pharm. [in press].


Hwang AY, Smith SM. Partnering with Pharmacists to Reduce Cardiovascular Risk in Outpatient Settings. J Am Heart Assoc 2019;8:e014705.


Irons, BK, Minze MG, Terrell, BT, Edwards KE. Implications of haptoglobin genotype and cardiovascular risk in patients with diabetes. Series Endo Diab Met. 2020;2:41-9.


Irons, BK, Minze MG, Chastain L, McMurry ME. Updates in the treatment of diabetic kidney disease. Glob J Obes Diabetes Metab Syndr. 2020;7(2):12-7.


Irons, BK, Minze MG, Chastain L, McMurry ME. Updates in the treatment of diabetic kidney disease – a focus on incretin mimetics and sodium glucose co-transporter 2 inhibitors. J Endocr Disord. 2020;6:1033.


LaRochelle JM, Smith KP, Benavides S, Bobo K, Chung AM, Farrington E, et al. Evidence demonstration the pharmacist's direct impact on clinical outcomes in pediatric patients: an opinion of the pediatrics practice and research network of the american college of clinical pharmacy. J Am Coll Clin Pharm 2020;3:786-92


McQuade BM, Reed BN, DiDomenico RJ, Baker WL, Shipper AG, Jarrett JB. Feeling the burn? A systematic review of burnout in pharmacists. J Am Coll Clin Pharm. 2020;3:663-75. https://doi.org/10.1002/jac5.1218


McQuade BM, Jarrett JB, Albright E, Morris L. Should we use zoledronate to reduce fractures in women with osteopenia? Family Physicians Inquiries Network. Evidence-Based Practice. 2020.


McQuade BM, Jarrett JB. Dupilumab (Dupixent) for moderate to severe atopic dermatitis. Family Physicians Inquiries Network. Evidence-Based Practice. 2019.


Muckle T, Blair M, Badowski M, Yam F, Johnson SG. Role delineation for pharmacotherapy specialists: re-evaluating the clinical relevance of a patient-centered credential. J Am Coll Clin Pharm 2020;3:1113-21.


Nealy KL, Harris KB. Romosozumab: a novel injectable sclerostin inhibitor with anabolic and antiresorptive effects for osteoporosis. The Annals of Pharmacotherapy. 2020. Online ahead of print. DOI: 10.1177/1060028020952764


Stanke L, Farrington E, Stoiko M. Toxic shock syndrome related to the use of a menstrual cup in a pediatric patient. Critical Care & Shock 2020;23:185-60


Yuan X, Chaisson J, Cantrell D, Mohundro BL, Carby M, Ford M, Liu M, Ouyang J, Zhang Y, Williams HC, Vicidomina B, Washington V, Nigam S. Value based insurance design in louisiana: blue cross blue shield’s zero dollar co-pay program. Am J Manag Care. 2020;26:e179-83.

ALUMNI UPDATES

Megan Rose ('01-'02) Completed 200 hour yoga teach training and registered with Yoga Alliance, Bachelors in Metaphysics, now ordained minister

Brice Mohundro ('05-'06) Promoted to Senior Clinical Pharmacist, Population Management. Blue Cross and Blue Shield of Louisiana - Appointed to Louisiana Experiment to Address Diabetes: Zero-Dollar Copayment steering committee

Molly (Graham) Minze ('06-'07) ACCP Leadership certificate, Member of Executive Leadership Program, One Team Fellows, Texas Tech University HSC

Brock Harris ('07-'08) Director of Assessment, Wingate University School of Pharmacy, ASHP Local Chapter Affiliate Chair Award

Kim Nealy ('08-'09) Chair-Elect of AACP Geriatric Special Interest Group - Award for Excellence in Online Programming, AACP Geriatric SIG, AACP Walmart Scholar Mentor, At-Large Member of NCAP Inaugural Ambulatory Care Academy Executive Committee

Blake King ('09-'10) Certificate of Merit in Precepting, University of Washington - Member ASHP SAG for Strategy and Industry Disrupters

Lindsey Elmore ('10-'11) Expanded to total of 5 brands including world's largest Young Living education database, branding and marketing program for health/wellness influencers, Rasayana yoga which blends movement, essential oils, crystals, and Ayurveda, and a podcast

Eddie Seijo ('11-'12) Director of Pharmacy Operations, Atrium Health, Charlotte, NC

Kristen Zorn ('11-'12) Clinical Staff Pharmacist, Sentara Virginia Beach General Hospital

Jessica (Porter) Glass ('11-'12) Sacred Heart Emergency Medicine Primary Preceptor - Appointed as Gulf Coast Regional Pharmacist on Emergency Medicine and Trauma Expert Review Panel for Ascension Hospitals

Brianna McQuade ('13-'15) Clinical Assistant Professor in Family Medicine/Substance Use Disorder/Mental Health, UI Health, Chicago, IL - Master of Health Profession Education (MHPE) from UIC COM

Andrew Hwang ('14-'15) Section Editor, Endocrinology, PharmacotherapyFirst, APhA Books and Digital Publishing

Mandi (Boykin) McCoy ('15-'16) Promoted to Lead Clinical Pharmacist - Carolina Assessment of Medications Program

Celia Morton ('17-'18) BCCCP certification

Mallory Moore ('18-'19) BCACP certification

Geena Eglin ('19-'20) Ambulatory Care Clinical Pharmacist specializing in Specialty Pharmacy Services, NHRMC


Personal updates:

Marriages: Kristen Zorn ('11-'12), Jessica Porter ('11-'12), Joshua Jones ('17-'18)

Moves: New house in Seattle, WA - Blake King ('09-'10), Moved to Asheville, NC - Lindsey Elmore ('10-'11)

Family Updates: Engagement - Jenna Picton ('16-'17), New kitten and puppy - Lindsey Elmore ('10-'11)

ALUMNI SPOTLIGHT - KERI DENCHFIELD (MORGAN)

When did you complete a residency at NHRMC?

After graduating from West Virginia University School of Pharmacy, I completed the 2013-2014 PGY1 residency program.

Why did you choose NHRMC?

I loved the variety of critical care and cardiology learning experiences available, and let’s be honest—the coastal location was a huge draw! During the interview process, the residents and pharmacists also demonstrated a great team mentality which reflected a supportive environment.

What is your current role/position?

I am currently a Critical Care Clinical Pharmacy Specialist at Adventist Health Care Shady Grove Medical Center in Rockville, Maryland, a preceptor for fourth year pharmacy students from University of Maryland, and our residency program coordinator and preceptor development leader. In addition to serving on many multidisciplinary, hospital and entity wide committees, I also act as a pharmacy education leader through the development and management of a local continuing education series.

How did your NHRMC residency prepare you for your current job?

NHRMC provided comprehensive experiences that prepared me for both the clinical and administrative roles of my current position. More specifically, active participation in multidisciplinary committees, interdepartmental process improvement, assisting in the roll out of new initiatives and pharmacy services, and structured teaching experiences gave me the tools to create meaningful change in my practice. These real-world skills allow me to elevate the practice within our department and optimize care for patients –not only with direct patient care at the bedside, but also via systematic approaches. Since my time at NHRMC, I now understand that this is a unique attribute, and I am lucky to be a graduate of the program.

Do you have a funny residency story to share?

I earned the affectionate nickname of “Hurricane Keri” from my co-residents. My desk wasn’t the neatest, and I spilled drinks everywhere I went.

What do you miss most about NHRMC?

I miss working in the ED and ICU with the trauma team and collaborating with the post-cardiac arrest coordinator. I might also add that in retrospect, the food options were pretty great, and I do miss EPIC!

What would you say to someone considering applying to a NHRMC residency?

If you want a residency that will push you to be the best pharmacist you can be—do it!

2019 RESIDENT GRADUATES - CURRENT POSITIONS

Sarah Anderson (PGY1 Pharmacy) - PGY2 Internal Medicine, Indiana University Health, Indianapolis, IN

Logan Doriety (PGY1 Pharmacy) - PGY2 Critical Care, New Hanover Regional Med Ctr, Wilmington, NC

Geena Eglin (PGY2 Ambulatory Care) - Specialty Pharmacist, New Hanover Regional Med Ctr, Wilmington, NC

Tomi Farotimi (PGY1 Pharmacy) - PGY2 Ambulatory Care, New Hanover Regional Med Ctr, Wilmington, NC

Courtney Olesky (PGY2 Critical Care) - Pharmacist, Cabell Huntington Hospital, Huntington, WV

Hannah Sharpe (PGY1 Community-Based Practice) - Pharmacist, CVS, Wilmington, NC

Jenna Sorgenfrei (PGY1 Pharmacy) - PGY2 Critical Care, Prisma-Health Upstate, Greenville, SC

Maci Zwolski (PGY1 Pharmacy) - Pharmacist, New Hanover Regional Med Ctr, Wilmington, NC

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2019-2020 Resident Awards (First Ever Virtual Presentations)

Mark E. Allen Resident Research Award


NHRMC Pharmacy Residency program hosted its 9th annual Pharmacy Residency Research Day in June. Residents presented their projects to a panel of judges, and the research award was based on a combination of the longitudinal research project and MUE. This year, Jenna Sorgenfrei, PGY1 Pharmacy resident received this prestigious award for her project, "Effects of obesity on caloric and lipid intake from propofol in mechanically ventilated patients in the intensive care unit." Her project showed that obese patients received over 35% of their total calories from propofol for more days than the non-obese population. Jenna's primary preceptor for this project was Lucy Stanke.

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Resident Teaching Award


The teaching award is given to the resident who demonstrates excellent teaching skills and is voted on by resident preceptors and students. Two of our residents were recipients for the 2019-2020 year, PGY2 Ambulatory Care resident, Geena Eglin, and PGY1 Pharmacy resident, Maci Zwolski.


Resident Practice Award


The practice award is voted on by the entire pharmacy department and is given to the resident who embodies the four pillars of NHRMC: compassion, ownership, teamwork, and communication. For the first time in the history of the award, the 2019-2020 Practice Award was a three-way tie. Congratulations to PGY1 residents, Sarah Anderson and Maci Zwolski, and PGY2 Ambulatory Care resident, Geena Eglin.

STUDENT UPDATE

By The Numbers:
  • 104 APPE rotations to students from Wingate, High Point, and other schools in the 2019-2020 school year
  • 198 offered rotations for 2020-2021 school year (increase from 41 preceptors to 55)
  • 30% of students rotating at NHRMC apply for NHRMC residency programs

"This is the rotation zone to be at if you want a residency" - 4th year High Point student


More on Student Successes

  • Formed Student Advisory Committee and started mentor program
  • 5 student posters at 2019 AHSP midyear meeting


Students as Pharmacist Extenders 2019-2020

  • 894 admission med histories performed (84% increase from previous year)
  • 394 patient education encounters (162% increase from previous year)


Our student preceptors also presented on redesign of the advanced hospital APPE rotation at the 2019 ASHP National Pharmacy Preceptor's Conference.

Residency Program Directors

PGY1 Pharmacy - Holly Snider

PGY1 Community-Based - Michelle Rager

PGY2 Ambulatory Care - Lisa Edgerton

PGY2 Critical Care - Joshua Steelman


Annual Report published November, 2020 - Editor: Melissa Blair