Evolution and operation of a pharmacy residency on-call program.

A pharmacy residency on-call program designed to contribute to residents' competence in patient care and to extend the functions of the pharmacy department is described. The program, which was begun at the University of Kentucky Chandler Medical Center in 1984, offers a supportive environment in which the resident is held accountable for pursuing optimal outcomes of drug therapy. The program provides opportunities for the resident to engage in independent decision-making, care for a wide variety of patients, and manage acute illness. On-call services are provided in single 24-hour shifts beginning at 0800 each day. Residents assess and respond to supratherapeutic serum drug concentrations, perform pharmacokinetic monitoring, provide drug information, evaluate patients for specific drug therapy, obtain medication histories for HIV-seropositive patients, and participate in emergency patient management. Residents provide services in the absence of the primary pharmacist on nights, weekends, and holidays and devote a four-hour period to drug distribution. Each pharmacy resident participates in the on-call program, regardless of the chief focus of his or her residency. Residents' activities are documented electronically, and preceptors give feedback via e-mail. The program and its activities have evolved over the years to reflect changes in pharmacy practice. An on-call program for pharmacy residents provides a valuable learning experience while enhancing patient care.