1. Pharmacy Practice Residency – Year 3 Janet Silvester, RPh, MBA, FASHP Operations Committee October 13, 2009

2. What have we achieved? 4 residents have completed the program R1 – ED pharmacist in 100 bed ED at Carilion R2 – employed by MJH – first as a night pharmacist replacing Elaine Kroner and now in a regular slot R3 – Completing a PGY2 residency at University of Washington Hospital in Seattle in Primary Care R4 – Working in Maryland in ambulatory practice 2 residents at MJH currently (3 rd class) Received 3 year ASHP accreditation in September 2008!!!

3. Activities Journal Club monthly in conjunction with UVa residents Formal educational presentations routinely Collaboration with UVA Our residents have done rotations at UVa TCV Post Op, toxicology (poison control), ambulatory UVa resident has come here Administrative rotation Longitudinal rotation with Wellness/MTM program with Joe Connor This year implementing the lipid program as a research project and presenting as a poster at Midyear Clinical meeting in December Medication Use evaluation as part of Drug Information rotation – present routinely at P&T Committee Present their research projects at Eastern States Residency Conference in the spring Round out our clinical coverage on weekends – adds a 5 th pharmacist to the weekend coverage – staffing every other weekend – satisfier for pharmacists

4. Rotations Internal Medicine Critical Care Oncology/Palliative Care Drug Information/Med Safety Administration Ortho/Spine Ambulatory Care (Wellness and MTM w/Joe) Sterile Compounding IS (mini rotation) Elective

5. Benefits Enhance practice model Research projects Raise level of practice of existing staff Recruitment tool Saved us $25,000 in recruitment fees when Elaine retired from her night position – 1 st year of residency Enhance reputation of MJH More visible in pharmacy profession Every MJH resident that goes on to do well reflects positively on MJH

6. Medicare GME Funding 2006 estimates 2008 Actual Difference Total Direct Education Costs $215,545$246,432($30,887) Medicare Reimbursement (estimated) ($140,820)($144,466)($3,646) Staffing Contribution by residents (8 hours per week each) ($45,793)($50,752)($4,959) Teaching and Administrative time (salary dollars exist today) ($113,865)($129,841)($15,976) Net Costs Associated with Pharmacy Practice Residency Program ($84,933)($78,627)$6,306

7. Total cost and reimbursement Total Direct and Indirect Costs $320,535 – only $92,803 new Total Reimbursed $144,466 Percentage of Direct cost reimbursed 58.62% Percentage of Indirect cost reimbursed 45.07%

8. Success!!!