2016 Accreditation Services/COC Update and Pharmacademic Update James Kalus, PharmD, BCPS, FASHP PGY1 RPD and Director of Pharmacy Henry Ford Health System

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

Residency Capacity

1,861

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

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

Top PGY2 Residency Programs by Number of Programs Includes Accredited, Candidate Status, and Pre-Candidate Status Programs as of 4/15/2016

Other PGY2 Residency Programs 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

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

92% fill rate

90% fill rate

Going Into the Scramble End of Match or Phase II 2015Unfilled PositionsUnmatched Applicants PGY PGY Total PGY PGY22476 Total37969 Reduced Unfilled Positions by 90% Reduced Unmatched Applicants by 45%

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

News from the Commission on 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 s 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 residency year

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)

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 of short- and long-term goals of the pharmacy and the organization 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

Objective R3.1.2 (Applying): Apply a process of ongoing 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 objectives. 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 ongoing self evaluation and personal performance improvement How it will be surveyed Review of: Strategy for self-evaluation, if written, or verbal description of strategy in discussions with RPD, preceptors, and residents. Evidence that preceptors track resident progress toward achievement of this objective.

Top Citings: 2014 PGY1 Standard 47 programs surveyed on new standard as of March On average, surveyors cited 21 elements per survey. The range was 7-40 elements cited.

2014 PGY1 Standard: Top 5 Citings by Frequency Cited Standard Number Standard VerbiagePercent 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 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%

2005 PGY 1 Standard: Common Areas of Partial Compliance COC March 2014 PercentStandard(s)Issue 77%5.9Preceptors do not meet 4/7 criteria for commitment and contribution to pharmacy 76%4.1dLearning 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

2014 PGY1 Standard: Top Items Cited Related to Program Policies Standard Number Standard VerbiagePercent of 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 VerbiagePercent 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% 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%

Top Items Cited Related Pharmacy Services Standard Number Standard VerbiagePercent 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 optimize 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 on the old standard until July Notify PharmAcademic if not converting in July, Guidance for both standards expected to be updated twice a year. Remember to check for updates in late April and September.

Pharmacademic Update

Updates to Pharmacademic ARE Coming Selected UpdatesWhen? Resitrak data available in Pharmacademic Already here Copy learning experience to a new learning experience Already here Allow reports and evaluations to be viewable on mobile devices Already here New residents PRE-ENROLLED in Pharmacademic Very soon Better Reports Raw data vs. metric based dashboards Send back for edit report Sometime soon? Ability to upload documents related to a learning experience Later in 2016 ACHR change log Later in 2016 Custom Scale issue – evaluators don’t know what the rating is, just see the definition Later in 2016

Updates to Pharmacademic PROBABLY Coming Selected Updates Addressing the issue of goals requiring evaluations when only SOME of the objectives are selected for an evaluation Allow functionality for ALL Preceptors to be able to see any resident’s evaluations, regardless of whether the resident will complete the preceptor’s rotation during the residency year Improved navigation…aka: BACK BUTTON! Improved views of an individual resident’s evaluations, as well as side-by-side views when program opts to use written self-evaluations Inclusion of Preceptor A&P Form in Pharmacademic Multiple preceptor issue – probably not going to be completely addressed in Pharmacademic

Future Updates Under Discussion Better Reports for Preceptor/Learning Experience Better User Guides Preceptor Development Module Duty Hour Tracking

QUESTIONS?