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The Instructors from Chester County Hospital's Pharmacy Residency Program

The pharmacy department at Chester County Hospital in West Chester, PA is preparing to launch what will be the community hospital's first residency program. While preparations began in earnest last summer, the program has been a goal of the department and the hospital for several years.

"We've put a lot of effort into the development of our clinical programs in recent years. Since we joined Penn Medicine about seven years ago, and we saw that we were the only hospital in the health system without a residency, it's been one of our goals to eventually have a residency program," says James A. Curtis, PharmD, MHA, BCPS, BCCCP, Associate Director of the Pharmacy Department at Chester County Hospital. "We've been gradually developing the necessary infrastructure. And within the last year-and-a-half, we felt we had enough to support it."

Ricky DiPasquale, PharmD, BCP

Ricky DiPasquale, PharmD, BCPS
Director, Chester County Hospital Pharmacy Residency Program

Curtis appointed Frederick "Ricky" DiPasquale, PharmD, BCPS, to serve as the program's director. DiPasquale joined the hospital in 2017 as a clinical pharmacist, a role he maintains in addition to his new responsibilities. (DiPasquale also bought his first home last summer, and he's getting married in early 2021. And he's in the midst of pursuing a master’s in business administration. To say it's been a busy year for him is a gross understatement).

DiPasquale earned his doctor of pharmacy in 2016 at the University of the Sciences, in Philadelphia, PA. He then did his postgraduate year one (PGY1) pharmacy residency at Abington Hospital-Jefferson Health. A PGY1 pharmacy residency, which is what Chester County Hospital will be offering, is a one-year residency that typically follows the completion of one’s doctor of pharmacy education.

"Ricky's very smart," Curtis says. "He’s also a great people person. He connects with everyone he comes into contact with, and his enthusiasm is contagious. Those are critical qualities when you’re creating a residency program from scratch."

As the American Society of Health-System Pharmacists (ASHP), the accrediting body for pharmacy residencies, notes: "Starting a residency program is a multi-year endeavor that requires both program organization and cultivation of widespread support from various groups within the specific practice site."

For the last few months, DiPasquale has been meeting with central figures around the hospital, including Sharon Scott, Director of Quality and Patient Safety, with the singular aim of raising awareness about the residency program. With Chester County Hospital's Kevin Sowti, MD, MBA, Medical Director of the Hospitalists and Vice-Chief of Staff, and Shafinaz Akhter, MD, the hospital's Director of Antimicrobial Stewardship, DiPasquale has also been exploring how exactly the residents — there will be two in the first year, in accordance with ASHP recommendations — will interact with doctors, nurses and physician assistants.

That dialogue is a continuation of the evolution of the clinical pharmacist at the hospital, as DiPasquale sees it. 

"When I first started, the doctors weren't quite sure what to make of my presence during rounds. But as I was able to show them all the ways that I could help, I became a trusted advisor," he says. "If we can position the residents in a similar manner, the residency program will benefit everyone in the hospital, not just the pharmacy department."

That said, the commitment of everyone in the pharmacy department is an essential component of the program's foundation. That much was clear from the first development meeting in June.

"One of the most important concepts presented by the standard is that pharmacists must be trained by other pharmacists," the ASHP advises. "This is not to understate the importance of physicians, nurses, and other healthcare practitioners who contribute to a complete training experience, but the most central and material training and preceptorship for residents must come from pharmacist practitioners."

"When you're educating residents, you're also re-educating yourself because they're going to be asking questions that, in some instances, you may not have thought about for 10 years," Curtis says. "Which means that you're going to have to do the necessary research in order to provide a thoughtful answer."

Learning experiences, as they're called, will make up the majority of the residency program. They are temporary situational experiences in which the resident is placed in different practice settings, similar to a medical student's rotations. 

"So, step one was consulting all of our pharmacists and asking them what types of experiences we could offer them," DiPasquale says. 

From there, he began creating a syllabus from scratch for each learning experience that outlines what the residents will be doing, what will be expected of them, and how they'll be evaluated. For guidance, he attended a couple of conferences. The standards for accreditation by the ASHP have also provided a roadmap. 

Because it's such an all-encompassing process and also because the accreditation audit won't begin until the residency is underway, DiPasquale said it’s been difficult to gauge his progress. Complicating matters further has been the pandemic, which, understandably, has consumed a significant amount of attention for many across the hospital since March.

"There are greater concerns among the administrators and providers here, so I've tried to be mindful that what may feel urgent for me on a given day simply isn’t for most," he says.

For DiPasquale, at least, July 2021, when the hospital’s first two pharmacy residents will begin, will be here in the blink of an eye, if the last several months are any indication. And when it is, he'll be ready.

"I appreciate that the residency program has the potential to draw even more awareness to the pharmacy department and foster all the relationships that we’ve been nurturing around the hospital"” he says."It's a big win for us, it's a big win for the hospital."

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