4700.80 PHM Pharmacy Report 2023-24 Optimizing Outcomes flip_2

Optimizing Outcomes Lee Health Biennial Pharmacy Services Report 2023-2024

Pharmacy Mission Optimizing Patient Outcomes Through Interdisciplinary Medication Management Pharmacy Directors from Left to Right: Benjamin Harding (HSPAL Resident), Anson Phetteplace (Lee Pharmacy), Tina Gegeckas (Regional Cancer Center), Peter Duggan (Gulf Coast Medical Center), Nina Farhoudi (Lee Memorial Hospital), John A. Armitstead (System Director), Yanela Lozano (HealthPark Medical Center), Michael G. Koleff (Lee Health Home Infusion), Diana Elnemr (Golisano Children’s Hospital), Steve Kessinger (Cape Coral Hospital), Alexis Vanderlee (HSPAL Resident) EDITORS/AUTHORS Alexis Vanderlee, PharmD, BCPS, CPh, Jeanette Alava, PharmD, CPh, DPLA Suzanne Turner PharmD, FASHP John A. Armitstead, MS, RPh, FASHP

Pharmacy Services Biennial Report | 1 TABLE OF CONTENTS Message from System Director of Pharmacy .....................................................................................2 Service Overview..............................................................................................................................................3 Hurricane Response........................................................................................................................................4 Acute Care Hospitals......................................................................................................................................6 Cape Coral Hospital..................................................................................................................................6 Golisano Children’s Hospital of Southwest Florida....................................................................7 Gulf Coast Medical Center.....................................................................................................................8 Lee Memorial Hospital.............................................................................................................................9 HealthPark Medical Center..................................................................................................................10 Population Health and Wellness...............................................................................................................12 Lee Pharmacy.............................................................................................................................................13 Clinical Ambulatory Services ..............................................................................................................15 Health Plan Pharmacy...........................................................................................................................16 Lee Health Specialty Pharmacy.........................................................................................................17 Infusion Centers ..............................................................................................................................................19 Complex Care Center ...........................................................................................................................20 Lee Health Home Infusion..................................................................................................................20 Regional Cancer Center........................................................................................................................22 Skilled Nursing Facilities ............................................................................................................................ 24 LeeSar and Cooperative Services of Florida.................................................................................... 25 Antimicrobial Stewardship........................................................................................................................ 26 Informatics and Automation.................................................................................................................... 28 Financial Summary.......................................................................................................................................30 340B Program..........................................................................................................................................30 Education and Training............................................................................................................................... 32 Pharmacy Residency Programs....................................................................................................... 32 PGY1 Gulf Coast Medical Center ................................................................................................ 32 PGY1 Community Based................................................................................................................ 33 PGY2 Infectious Diseases Pharmacy Residency.................................................................34 PGY2 Health System Pharmacy Administration and Leadership Residency........ 35 PGY2 Critical Care Pharmacy Residency...............................................................................36 PGY2 Pediatric Pharmacy Residency.......................................................................................37 Residency Year Book............................................................................................................................ 38 Pharmacy Technician Training Program .......................................................................................41 Technician Accolades......................................................................................................................42 Student Pharmacist Program............................................................................................................44 Pharmacy Internship Program..........................................................................................................44 Performance and Quality Improvement.............................................................................................45 Professional Recognition...........................................................................................................................46 Platform Presentations......................................................................................................................... 47 Poster Presentations.............................................................................................................................48 Publications...............................................................................................................................................50 Additional Certifications........................................................................................................................51 Awards..........................................................................................................................................................52

2 | Lee Health John A. Armitstead, M.S., R.Ph., FASHP Message from System Director of Pharmacy I am pleased to share the Lee Health Biennial Pharmacy Services Report: Optimizing Outcomes 2023-2024. Our pharmacy team members are committed to the Lee Health Mission and Vision. Our pharmacists and pharmacy technicians demonstrate the Pharmacy Mission every minute, hour, and day of the year. We never stop caring for our patients. Our acute care operations have served as a strong foundation to build our expanding professional services to include a comprehensive acute care, ambulatory care, community care, outpatient infusion services, specialty care, managed care, long term care, and home infusion services to patients that reach into the community to address our commitment to our patients. For more than a decade we have been following the Hedgehog and Flywheel concept identified by Collins in the book Good to Great. Our Lee Health “Hedgehog Concept” has been: Optimizing Patient Outcomes Through Interdisciplinary Medication Management. Our “Flywheel” has been the expanding, comprehensive pharmacy services across the continuum of care to our patient of Lee County. “A Hedgehog Concept is a simple, crystalline concept that flows from deeply understanding the intersection of the following three circles: (1) what you’re deeply passionate about, (2) what you can be the best in the world at, and (3) what drives your economic or resource engine.” “The Flywheel, when properly conceived and executed, creates both continuity and change. On the one hand, you need to stay with a flywheel long enough to get its full compounding effect. On the other hand, to keep the flywheel spinning, you need to continually renew, and improve each and every component.” — Jim Collins Collins J, 2001, Good to Great, First Edition, HarperCollins Publishers Inc., New York, NY. Whether we are completing our battle with COVID-19 or recovering from Hurricane Ian, we are truly thankful for the health, safety, and well-being of our diverse and inclusive work force. Thank you for the unique and individual contributions this past year of our pharmacy team members, healthcare team members and our community. You make Southwest Florida a great place to practice and live! Guiding Principles for Pharmacy Leadership at Lee Health • Creating an environment for individual excellence and team success in Optimizing Patient Outcomes Through Interdisciplinary Medication Management. • Advance, expand, and promote Lee Health Pharmacy Services in which pharmacy is recognized as a leader in the State of Florida, advancing practice and care to patients where continuity of care from the patient’s perspective is expected and delivered. • Contribute to providing an environment and culture for personal and professional growth for pharmacists and pharmacy technicians through encouragement, education, training, continuous professional development, recognition and utilization of the skills, talents and strengths of the individual, while fostering teamwork to enhance success. • Develop and expand pharmacy training programs for pharmacy residents, students, interns, and pharmacy technician students. Through these programs the participants will demonstrate professionalism, competence, and excellence while developing highly trained pharmacy personnel for Southwest Florida, Florida, and beyond. John A. Armitstead, MS, RPh, FASHP System Director of Pharmacy PLANTATION RD EXIT 136 EXIT 131 EXIT 123 METRO PKWY 1 1 2 3 4 5 6 7 8 9 2 9 3 4 5 6 7 8 BREAKTHROUGH! DISCIPLINED THOUGHT CONFRONT THE BRUTAL FACTS HEDGEHOG CONCEPT DISCIPLINED ACTION CULTURE OF DISCIPLINE TECHNOLOGY ACCELERATORS DISCIPLINED PEOPLE LEVEL 5 LEADERSHIP FIRST WHO... THEN WHAT FLYWHEEL BUILDUP...

PLANTATION RD EXIT 136 EXIT 131 EXIT 123 METRO PKWY 1 1 2 3 4 5 6 7 8 9 2 9 3 4 5 6 7 8 SERVICE OVERVIEW Lee Health is a non-profit organization committed to clinical practice, education, and providing exceptional care to all patients. The Lee Health system spans across the Southwest Florida area and offers a variety of healthcare services. With locations in Estero, Naples, Fort Myers, and Cape Coral, Lee Health is accessible to a multitude of patient populations to deliver expert personalized care. The Pharmacy Services Department at Lee Health prides itself on optimizing patient outcomes through interdisciplinary medication management with a team of over 400 staff members. Pharmacists provide care to our patients at the four adult acute care campuses and one acute care campus dedicated to the pediatric population. Lee Pharmacy, a community pharmacy, is embedded in each acute care hospital, which allows for patient transitions of care processes to be streamlined following hospital discharge. The health system also comprises a pharmacy presence in several additional practice settings, including The Regional Cancer Center (an outpatient infusion center), two primary care clinics, a standalone hybrid emergency department, an Employee Health Plan Pharmacy, a Specialty Pharmacy, Skilled Nursing Facilities and Units, a Home Infusion Service, and one clinic-based community pharmacy. Pharmacists practicing in the outpatient setting are embedded within rheumatology, pulmonology, anticoagulation, and oncology clinics serving as the medication expert for the medical team. Pharmacists provide care by facilitating transitions of care through patient education and optimization of medication therapy. Comprehensive pharmacy clinical services in the acute care setting are provided to many of the hospital service lines including the emergency departments, intensive care units, and general medical/ surgical floors. These services include medication reconciliation, antimicrobial stewardship, anticoagulation services, pharmacokinetic dosing, patient education, and 24/7 emergency code response. The pharmacy department leaders also prioritize developing and maintaining effective recruitment, orientation, training, engagement and retention strategies to sustain a competent and qualified workforce. The Lee Health Pharmacy team is dedicated to their overall mission of optimizing healthcare outcomes. Cape Coral Inpatient Pharmacy, Health Plan Pharmacy and Lee Pharmacy Lee Memorial Inpatient Pharmacy, Lee Pharmacy and Complex Care Center Regional Cancer Center Pharmacy Lee Pharmacy at Page Field Lee Health Home Infusion Gulf Coast Inpatient Pharmacy, Lee Pharmacy HealthPark Inpatient Pharmacy, Lee Pharmacy, Golisano Children’s Hospital Coconut Point Inpatient Pharmacy and Specialty Pharmacy LeeSar and Cooperative Services of Florida PLANTATION RD EXIT 136 EXIT 131 EXIT 123 METRO PKWY 1 1 2 3 4 5 6 7 8 9 2 9 3 4 5 6 7 8

4 | Lee Health Hurricane Ian made landfall in Florida on Wednesday, September 28th, 2022 as a powerful Category 4 storm which invoked a Lee Health system-wide hurricane response. The National Hurricane Center warned residents of “life-threatening storm surge, catastrophic winds and flooding in the Florida Peninsula,” with much of Southwest Florida under evacuation orders. Maximum sustained winds were around 150 mph as it hit the southwest coast of Florida directly affecting the Lee Health patient and staff population. Everyone in Southwest Florida was affected, with some more than others. More than a dozen pharmacy employees lost their homes/housing in this event and more than 30 pharmacy staff members lost their vehicles due to the storm surge, with more than 20 occurring in Lee Health parking lots while the pharmacy team members were serving patients. The pharmacy team was essential in providing high-quality care throughout the storm and in the days immediately following. Hurricane Response • Prior to the storms arrival, patients at HealthPark Care & Rehabilitation Center were evacuated to the GCMC SNU and the LMH SNU locations. The acute care pharmacy teams at HPMC, LMH, and GCMC successfully transitioned the medication regimens for these patients to their temporary locations. • The Pharmacy Informatics team prepared teams and provided non-stop IT support in the event of an anticipated power outage. No major hospital outages occurred throughout the storm. • Pharmacy services continued 24/7 without interruption at all of the Lee Health acute care hospitals. • Lee Pharmacy locations at each of the four acute care hospital sites were extended to 24 hours for the first four days after the storm. The Lee Pharmacy locations remained in a high volume prescription mode for the entire first week as power restoration unfolded in community pharmacies. • Patients who lost everything, including their medication, in the storm were able to find some comfort in obtaining their medication with ease through our compassionate team of ambulatory pharmacists and technicians. The tremendous increase in volume warranted innovative thinking, such as a makeshift drive-through at LMH. • Lee Health Home Infusion prepared patients in advance for the storms with medication and supplies and opened on Day 4 post-Ian. • Lee Health Specialty Pharmacy opened on Day 2 and successfully reopened their call center to Coconut Point for the first week. Without UPS and courier services, LHSP enhanced pick-up opportunities extending hours and utilizing personal vehicles for deliveries. • The Regional Cancer Center Pharmacy opened up on Day 4 after the hurricane and scheduled patients in expanded hours to get patients back on their medication regimen schedules. • The Health Plan Pharmacy re-opened on Day 4 and provided enhanced pick up options for patients until UPS delivery service was restored.

Pharmacy Services Biennial Report | 5 In addition to maintaining high-quality patient care, pharmacy leadership also placed an emphasis on staff communication, wellness and safety to ensure staff felt valued while facing several challenges both at home and at work. The pharmacy team displayed remarkable resilience and teamwork throughout the hurricane and beyond. Many employees acted selflessly in the aftermath of the storm putting personal losses aside to support the team’s successful efforts to provide uninterrupted care. While natural disasters are challenging, the Lee Health pharmacy team’s remarkable ability to rise to the occasion speaks volumes and provides evidence that the mission statement is lived by regardless of the circumstances. Lee Health Pharmacy Staff, Our heartfelt appreciation and thankfulness for the safety of each employee, your families, and friends. Hurricane Ian and its aftermath have been a catastrophic event for our people, our families, our homes, our possessions, and our entire community. This hurricane continues to directly affect the basic needs of many of us. Please reach out if your Lee Health colleagues can be of ongoing assistance as you personally recover from this disaster. Thank you for your tireless efforts in continuing the care of our Lee Health patients. Whether you were Team A or Team B, your contributions have been extraordinary and highly valued by our patients and our community. I have heard many, many, many stories of your challenges and your attempts to address and meet those challenges. The Lee Health Pharmacy Team has been miraculous in its performance. Even if you experienced hardships that precluded your active participation in either Team A or Team B, this disaster was of such a great magnitude, simply your support of your teams is part of the higher cause. As we move into recovery, continue to contribute when you can and take a break when you need to do so. Your family needs your strengths and abilities as we in the healthcare community do too. Sincerely, thanks for your efforts to Optimize Patient Outcomes Through Interdisciplinary Medication Management. Continued best wishes to you as we recover stronger from this Southwest Florida disaster. John A. Armitstead, MS, RPh, FASHP System Director of Pharmacy Together we are #LeeHealthStrong

6 | Lee Health Acute Care Hospitals Mariamo Oyebanjo, PharmD, BCPS (Pharmacy Manager) & Stephen M. Kessinger RPh, MS, MBA, CGP (Pharmacy Director) Cape Coral Hospital Cape Coral Hospital (CCH) was established in 1977 as an independent entity to serve the growing city of Cape Coral and subsequently joined Lee Health in sister city Fort Myers in 1996. The hospital is a 291-bed adult acute care facility located on the west side of the Caloosahatchee River in Lee County, Florida. The CCH acute care pharmacy department is staffed by 49 employees and includes 23 pharmacists, 18 registered pharmacy technicians, 3 clinical specialists, 2 pharmacy interns, and 1 pharmacypurchasing specialist. The leadership team is comprised of a pharmacy director and pharmacy manager. As the only hospital in the city, CCH serves as the primary source for acute care services, providing obstetrics/gynecology, general medical/surgery, neurosurgery, orthopedics, cardiac, pulmonary medicine, neurology, intensive care, emergency medicine, endoscopy, and general/ vascular surgery services to the Cape Coral community. CCH was the first community hospital in Florida to receive the Governor’s Sterling Award, a prestigious honor that recognizes excellence in leadership, strategic planning, operations, and overall performance. CCH has achieved Healthgrades Top 100 Best Hospitals in America in 2021 and 2022, as well as the Patient Safety Excellence Award for both years. Pharmacists are integrated in decentralized roles on patient care units as well as the emergency department and intensive care units. CCH also houses Lee Pharmacy, an outpatient pharmacy, on the premises. In July 2022, CCH launched an internal medicine residency program in affiliation with Florida State University. In support of the medicine residency program, the Pharmacy Department will be housing a PGY1 Pharmacy Residency program beginning in July 2023. Cape Coral Hospital is proud to be the lead provider of acute care based services to the Cape Coral community.

Pharmacy Services Biennial Report | 7 Golisano Children’s Hospital of Southwest Florida Established in 1994 as the only children’s hospital located between Tampa and Miami, Golisano Children’s Hospital of Southwest Florida (GCHSWF) provides vital and lifesaving care for children and their families. In 2017, GCHSWF was rebuilt as a 7-story state-of-the-art facility dedicated specifically to the pediatric population. GCHSWF’s highly trained team members are motivated by the belief that every child is special and deserves the best care possible. The pharmacy department serves 135 beds, the emergency department, two oncology infusion clinics, and a cystic fibrosis clinic with a team of 21 pediatric-trained pharmacists, 19 pharmacy technicians, three clinical specialists, and one purchasing specialist. GCHSWF is the sole provider of Southwest Florida’s pediatric hematology/oncology program, which is nationally certified by the Children’s Oncology Group, and is home to Southwest Florida’s only statedesignated Regional Perinatal Intensive Care Center. The hospital offers various community outreach programs and conferences to support the Kid Mind Matter mission, a unified movement in Southwest Florida dedicated to advancing pediatric mental and behavioral health services. In addition, GCHSWF is a member of Solution for Patient Safety (SPS) and an affiliate of Johns Hopkins Hospital as a way of advancing pediatric care in Southwest Florida Due to this commitment to excellence, GCHSWF has achieved many pediatric accolades. These include being named The Top Children’s Hospital by The Leapfrog Group four times, recognition as a Center of Excellence by the Society of Pediatric Sedation, an Asthma Friendly Hospital by the Florida Asthma Coalition, and being awarded the Lantern Award by the Emergency Nurses Association in both 2019 and 2022. Pharmacists are integrated within the patient care units and clinics to provide interdisciplinary care. The pediatric focused clinical pharmacy team is available to provide pediatric consultations to pediatric patients admitted to the adult acute care hospitals. GCHSWF is also passionate about providing a safe patient transition of care. The acute care pharmacy team works closely in collaboration with Lee Pharmacy at HealthPark Medical Center to coordinate customized pediatric formulations as patients transition from the acute care or clinic setting to home. GCHSWF provides excellent training opportunities to the future of pediatric clinical pharmacy through the ASHP accredited PGY2 Pediatric Residency Program. GCHSWF’s pharmacy team serves as a key interdisciplinary team member to provide optimal care for the pediatric population of Southwest Florida. Acute Care Pharmacist Education Provided - System Wide 2018 2019 2020 2021 2022 14 _________________________________________ 12 _________________________________________ 10 _________________________________________ 8 _________________________________________ 6 _________________________________________ 4 _________________________________________ 2 _________________________________________ 0 _________________________________________ Thousands Number of Patient Encounters per Year From Left to Right: Brian Lawson, RPhT, CPhT (Pharmacy Product Technician), Megan Patch, MS, PharmD, BCPS, BCIDP, BCPPS (Pediatric Infectious Diseases Clinical Specialist), Diana Elnemr, PharmD, CPh, DPLA, MBA (Pharmacy Director), Melanie Levy, RPhT, CPhT (Pharmacy Technician Supervisor), Jordan Wallace, PharmD (Pediatric Oncology Clinical Specialist), Ingrid Kelley, PharmD, CPh (Pharmacy Manager)

8 | Lee Health Gulf Coast Medical Center Gulf Coast Medical Center (GCMC) was established in 1990 as an independent entity to serve the Fort Myers area and subsequently joined Lee Health as a non-profit organization in March 2009. In 2021, the hospital expanded to add three stories and 216 patient beds, for a total of 624 beds making it Lee Health’s main trauma center. This expansion was completed two months ahead of schedule in order to meet the community’s demands during the COVID-19 pandemic. Sixty-eight dedicated and highly skilled pharmacists and pharmacy technicians service GCMC’s pharmacy needs. GCMC service lines include a Level II trauma center, the area’s only comprehensive stroke center, oncology, interventional cardiology, colo-rectal surgery, orthopedics, vascular and general surgery and additional services. The acute care pharmacy also provides medication management for the adjacent 75-bed Skilled Nursing Facility. A range of outpatient services provided at GCMC includes dialysis, endoscopy, diagnostic imaging, nuclear medicine, and same-day surgery. In January 2020, GCMC was awarded the American Heart/American Stroke Association’s Get with the Guidelines Stroke Gold Plus Target Stroke Elite Plus Honor Roll Quality Achievement Award – the highest possible level for stroke care. GCMC has also received a Leapfrog Hospital Safety Grade rating of “A” for the fifth straight reporting period in the spring of 2022. The decentralized approach to care has fully integrated pharmacists within the healthcare team making them a vital component of outcome driven goals. Pharmacists are present 24/7 in the emergency department. Pharmacists also provide extended coverage to the intensive care unit, the oncology unit, and are a key part of the interdisciplinary team on all acute care units, as well as the preoperative unit and post-anesthesia care unit. The PGY1 Pharmacy Residency program is housed at GCMC, offering meaningful opportunities for staff to mentor the next generation and shape future practice. Lee Pharmacy, located in the lobby, also provides a unique opportunity for coordination between acute care and outpatient medication management with commensurate improvement in the health of the community. The team at GCMC is proud to serve the community by providing care to patients experiencing a wide array of conditions. From Left to Right: Jennifer Moenander, RPhT, CPhT (Pharmacy Technician Supervisor), Antwanette Ghattas, PharmD, BCPS, CPh (Pharmacy Manager), Peter Duggan, RPh, CPh, DPLA (Pharmacy Director), Farah Zuberi, MS, RPh, BCPS, BCSCP (Pharmacy Manager), Laura Walton CPhT (Pharmacy Purchasing Specialist)

Pharmacy Services Biennial Report | 9 Lee Memorial Hospital Lee Memorial Hospital (LMH) was established in 1916 with repurposed lumber from a local courthouse and $300 as a ten-bed, four-room institution. As of 2023, LMH has grown from its humble beginnings to a community hospital that encompasses 240 beds, which includes a rehabilitation hospital (60 beds) and a skilled nursing unit (18 beds). LMH is also home to the Complex Care Center, a 12-chair outpatient infusion center. The Department of Pharmacy at LMH offers 24/7 interdisciplinary patient care services with a professional staff of 27 pharmacists, 28 pharmacy technicians, and one pharmacy intern. This highly talented and exceptionally trained staff provides lifesaving care to the residential communities in Lee County. The acute care and outpatient service lines offered to patients include behavioral health, general surgery, cardiology, advanced imaging services, infectious disease, neurology, family medicine, and vascular surgery. In 2022, LMH earned an “A” grade for patient safety, which is the highest patient safety rank awarded by The Leapfrog Group, a leading healthcare nonprofit organization committed to driving quality, safety, and transparency in health systems across the United States. LMH is also a designated chest pain center and fully accredited by the Society of Chest Pain Centers. In addition, the Agency for Healthcare Administration designated LMH as a Certified Primary Stroke Center. Pharmacists are integrated into the internal medicine floors, emergency medicine department, medical and surgical intensive care units, and the complex care center. The acute care pharmacy also supports ambulatory patient care services by coordinating drug distribution and providing medications to over 100 Lee Physician Group outpatient clinics. With 100 years of history behind it, LMH has a longstanding history of being a trusted entity within Lee County and continues to provide exceptional patient care to the Southwest Florida community. Acute Care Pharmacy Doses Dispensed - System Wide FY19 FY20 FY21 FY22 12 __________________________________ 10 __________________________________ 8 __________________________________ 6 __________________________________ 4 __________________________________ 2 __________________________________ 0 __________________________________ Thousands From Left to Right: Joey Dabringer, PharmD, MBA, CPh, DPLA (Pharmacy Manager), Nina Farhoudi, PharmD, CPh (Pharmacy Director), Carla Emrick, RPhT, CPhT-Adv (Pharmacy Technician Supervisor)

10 | Lee Health HealthPark Medical Center Located in the heart of South Fort Myers, HealthPark Medical Center (HPMC) is a 461-bed facility that has been serving the community with a modern approach to health and wellness since 1991. Pharmacy services are provided by an outstanding team of 34 pharmacists, 26 pharmacy technicians, and support personnel, whose mission is to optimize patient outcomes through interdisciplinary medication management. The acute care and outpatient service lines offered to patients include cardiology, obstetrics and gynecology, various specialized and general surgical services, rehabilitation, radiology, and a full-service 24/7 emergency care center. The campus also provides postacute care to patients through a 112-bed HealthPark Care and Rehabilitation Center facility. Since opening, the hospital has continued to expand in order to meet the needs of the surrounding community. HPMC features comprehensive OB/GYN services, including an OB emergency room and state-of-the-art birthing suites. It has one of the busiest obstetric units in the state of Florida, with over 6,100 newborn deliveries every year, and is co-located with Golisano Children’s Hospital of Southwest Florida, the only children’s hospital in the region. The facility is one of 11 hospitals in Florida certified as a Regional Perinatal Intensive Care Center, providing high-risk and low-risk obstetrical care. The HPMC team worked diligently with the Florida Perinatal Quality Collaborative to implement best practices to improve maternal care and patient outcomes and, in doing so, achieved a recognition badge from the Alliance for Innovation in Maternal Health (AIM) in 2022. Additionally, HPMC has earned an “A” grade for patient safety from The Leapfrog Group for six straight reporting periods. In July 2022, the institution was awarded four stars by the Center for Medicare and Medicaid Services (CMS). The institution has received several accolades for its range of high-quality cardiology services, cardiothoracic surgery, and advanced cardiac diagnostics. HealthPark Medical Center was the first hospital in Southwest Florida to perform a minimally invasive VATS lung lobectomy procedure and remains the only structural heart program in the region, caring Bottom from Left to Right: Jesse Grojean, PharmD, BCCCP (Critical Care Specialist), Yanela Lozano, PharmD, DPLA, MBA (Pharmacy Director); Kristin Quarterman, PharmD, BCPS (Internal Medicine Specialist), Mohit Patel, PharmD, DPLA, CPh (Pharmacy Manager) Top from Left to Right: Marissa Rivas RPhT, CPhT (Pharmacy Technician Supervisor), Terra Sanchez RPhT, CPhT (Pharmacy Technician Supervisor), Brenda Moncibaez RPhT, CPhT (Pharmacy Purchasing Specialist), Michelle Elcik RPhT, CPhT (Pharmacy Product Technician)

Pharmacy Services Biennial Report | 11 IV Chemo Verification Medication Reconciliation-Discharge with Corrections Identify Home Med Nutrition Consult Emergency Management Prior to Admission Medication History by Pharm Tech Patient Education Prior to Admission Medication History by Pharmacist Renal Dosing Medication Reconciliation-Discharge Approved Pharmacotherapy Consult Therapeutic Drug Monitoring Antimicrobial Stewardship Adverse Drug Reaction Avoidance Anticoagulation Pharmacy Communication Clinical Pharmacy Interventions - System Wide 348,487 Documented Encounters in FY22 45,000 __________________________________________________________________________________________ 40,000 __________________________________________________________________________________________ 35,000 __________________________________________________________________________________________ 30,000 __________________________________________________________________________________________ 25,000 __________________________________________________________________________________________ 20,000 __________________________________________________________________________________________ 15,000 __________________________________________________________________________________________ 10,000 __________________________________________________________________________________________ 5,000 __________________________________________________________________________________________ 0 __________________________________________________________________________________________ for patients with high-risk valve disease and atrial fibrillation. HealthPark Medical Center is the recipient of several recognitions, such as being named the Top 50 Cardiovascular Hospital in the nation by IBM Watson Health. The highly trained HPMC pharmacy team members support safe and effective medication management for the acute care, outpatient, diagnostic, and adjacent rehabilitation centers. The pharmacists are active participants on the outpatient interdisciplinary care team in the heart failure management clinic, the rapid diuresis clinic, and post-cardiac catheterization care management. In collaboration with the Shipley Cardiovascular Center, the pharmacy team developed an initial medication education program on common heart medications for preand post-cardiac surgery patients. HealthPark Medical Center is proud to provide comprehensive care to the unique and expanding local patient population of South Fort Myers.

12 | Lee Health Population Health and Wellness

Pharmacy Services Biennial Report | 13 Lee Pharmacy There are six Lee Pharmacy locations strategically embedded within Lee Health’s acute care and outpatient campuses with the goal of providing convenient outpatient pharmacy services to the Lee Health community. In 2022, the Lee Pharmacies celebrated one decade of Lee Pharmacy services, and reflected on the growth that has occurred since opening. Currently, the Lee Pharmacy team consists of 58 employees. In fiscal year 2022, Lee Pharmacies dispensed over 320,000 prescriptions, increasing their prescription volume by over 16% from the previous year. The Lee Pharmacies at Lee Memorial Hospital, HealthPark Medical Center, Gulf Coast Medical Center, and Cape Coral Hospital are focused on optimizing transitions of care and removing barriers to adherence for patients served by these acute care facilities. The team specializes in providing services to patients being discharged following an acute care stay, an outpatient surgery, or an emergency room visit. Furthermore, the pharmacists provide medication education, prescription dispensing, medication compounding, immunizations, and refer patients to Lee Pharmacies’ expanded patient care service. These service lines include Medication Therapy Management (MTM) and the targeted transition of care service focused on patients with Chronic Obstructive Pulmonary Disorder (COPD). In addition, Lee Pharmacies provide prescription services to employees and their dependents. The acute care-based Lee Pharmacy locations offer a Prescription Bedside Delivery Program, known as Meds to Beds, which delivers prescriptions directly to a patient’s room prior to discharge. This program allows patients to start therapy immediately upon discharge and improves patient satisfaction by preventing an additional trip to a community pharmacy prior to leaving the acute care facility premises. The Lee Pharmacy at Page Field is embedded within a pediatric primary care office and adjacent Outpatient Prescriptions Dispensed Annually FY18 FY19 FY20 FY21 FY22 360 ____________________________________ 310 ____________________________________ 260 ____________________________________ 210 ____________________________________ 160 ____________________________________ 110 ____________________________________ Thousands 2019 Meds to Beds Implementation 2021 Specialty Pharmacy Begins Dispensing Operations From Left to Right: Anson Phetteplace, PharmD, CPh, DPLA (Pharmacy Director) and Michelle Sadler, PharmD, BCACP, CPh (Pharmacy Manager), Michelle Estevez, PharmD, DPLA, CPh, BCPS (Pharmacy Manager)

14 | Lee Health to a convenient care center and other Lee Health provider specialty offices. This convenient location allows pharmacy services to be integrated into a patient’s office visit or convenient care visit. Providers send prescriptions to the pharmacy for processing while in the room with the patient. This streamlined process ensures that upon completion of the provider visit, patients and caregivers can pass through the pharmacy to pick up the medications before leaving the premises. The pharmacy at Lee Health Coconut Point has a unique hybrid practice model. This pharmacy provides both acute care and outpatient services to support an emergency department, surgery center, and primary care offices. The outpatient pharmacy is open for prescription dispensing Monday through Friday. However, the emergency department is staffed 24/7 by a pharmacist who is cross-trained in both emergency medicine and ambulatory practice. This hybrid model allows patients to have their prescriptions filled immediately upon discharge from the emergency department, day or night. The Lee Pharmacies are also home to the ASHP-accredited PGY1 community-based pharmacy residency program. The residency program is now in its third year of training new pharmacy school graduates in a year-long program where the residents are immersed in direct patient care to provide counseling, immunizations, and the removal of barriers to transitions of care while simultaneously developing through interdisciplinary healthcare experiences. Residents contribute to the healthcare system as a whole by participating in research, implementing novel pharmacy services, and continually improving medication safety. Lee Pharmacy is extremely proud to have contributed to the relief and recovery efforts during and following Hurricane Ian in September 2022. Lee Pharmacy staff stayed onsite to ensure outpatient prescription services were available during this state of emergency. As part of the response following the deadliest hurricane to hit Florida since 1935, Lee Pharmacy staff provided an unprecedented 24- hour service line and prescription relief to any patient in need. The Lee Pharmacy is an essential part of the transition of care process. The Lee Pharmacies provide a number of high-quality patient care services in order to support the pharmacy’s mission statement through dedicated and highly trained pharmacy staff.

Pharmacy Services Biennial Report | 15 105 - Telehealth 90 - In-person 82 - Telephone Medication Therapy Management Visits by Appointment Type FY22 Clinical Ambulatory Services While overall pharmacy services at Lee Health have grown in the last decade, one area that has grown tremendously is outpatient pharmacy services. Several ambulatory care clinical pharmacy roles have been introduced to assist in care transitions and post-acute care processes. Within the Florida State University Family Medicine Residency Program at Lee Memorial Hospital, a dedicated clinical pharmacist aims to enhance the Family Medicine Resident’s educational experience through collaborative, interdisciplinary practice. This pharmacist operates under a collaborative practice agreement (CPA), which allows them to meet with anticoagulation patients, provide education, and adjust medication doses as needed. Providers routinely refer patients with complex medication regimens to the pharmacist for medication reconciliation, medication therapy review, and medication education services. This dedicated pharmacist is also heavily involved with the Family Medicine Residency Program’s acute care family medicine service, providing pharmacy-focused didactic sessions once a week and participating in interdisciplinary patient rounding each morning. To improve outcomes for patients with Chronic Obstructive Pulmonary Disorder (COPD), Lee Health has established a disease-focused transition-of-care program. This program provides resources for COPD patients being discharged from any of the Lee Health acute care hospitals. The pharmacist embedded within this program provides medication reconciliation, delivers patient education, and helps patients navigate resources to access medications, equipment, and services in the ambulatory setting. To streamline many of these processes, this pharmacist utilizes the power of CPAs in collaboration with Lee Physician Group pulmonologists. From this COPD transition of care program, several system improvements have been established, most recently a system-wide electronic referral for tobacco cessation services. The Medication Therapy Management (MTM) program started as a research project by the inaugural class of PGY1 Community-Based residents in 2020–2021 and has since been further developed into a robust pharmacy service. The outpatient pharmacy program aims to optimize patients’ medication therapy by identifying and resolving medication problems and collaborating with the patient and their providers. Currently, the program receives patient referrals from professionals, such as providers, nurses, and case managers, across the health system. In addition to the lead MTM pharmacist, twelve ambulatory pharmacists have been trained to provide MTM services to further increase patient access. The development of outpatient clinical services has been a priority for the Lee Health Pharmacy team. Over the past year, various roles have been established to assure continued care as patients transition into the outpatient setting. Continued expansion, including the establishment of additional CPAs and integration into additional primary care offices, is planned. Julianna Hennig, PharmD, CPh, BCACP & Bryan Brubaker, PharmD, CPh, BCACP, TTS

16 | Lee Health Health Plan Pharmacy The Lee Health Plan Pharmacy was established in 2004 with the goal of providing a walk-in and mail-order prescription dispensing option to members of the health system’s self-insured employee health plan. In 2008, the health plan pharmacy benefit design was revised to require utilization of the mail-order pharmacy for maintenance medications. Plan membership has grown steadily, and the plan currently serves approximately 22,000 people. The mail-order pharmacy consistently dispenses nearly 50% of all prescription claims for the health plan, totaling nearly 90,000 prescription fills in fiscal year 2022. Employees and dependents frequently cite the mailorder pharmacy service as one of the top benefits offered by the health system, with “Excellent” ratings achieved on both the 2021 and 2022 customer satisfaction surveys by greater than or equal to 86% of respondents. The pharmacy staff of five pharmacists and six pharmacy technicians maintains responsibility for dispensing activities in addition to numerous managed care functions for the health plan’s pharmacy benefit. Specialized managed care functions include prior authorization reviews, quantity limits, and formulary exceptions. The initial internal review of these maintenance and specialty formulary exceptions by the Lee Health Plan Pharmacy team helps to avoid potential fees associated with these services and provides cost savings for the healthcare system and the patient. The Lee Health Plan Pharmacy also prioritizes education and offers a Managed Care Pharmacy learning experience for Advanced Pharmacy Practice Experience (APPE) students, PGY1 Community-Based Pharmacy residents, and PGY2 Health System Pharmacy Administration residents. The Lee Health Plan Pharmacy is proud to serve the system’s employees by providing truly excellent care while also supporting the organization fiscally. 90,000 __________________________________ 88,000 __________________________________ 86,000 __________________________________ 84,000 __________________________________ 82,000 __________________________________ 80,000 __________________________________ 78,000 __________________________________ 76,000 __________________________________ 74,000 __________________________________ FY19 FY20 FY21 FY22 Health Plan Prescription Volume Diane Bush, RPh, CPh (Pharmacy Manager)

Pharmacy Services Biennial Report | 17 From Left to Right: Richmond Freudenberg, PharmD, CPh, CSP (Pharmacist Lead); Abbey Hunter, PharmD, BCACP (Clinical Operations Manager); Danielle Fortier, CPhT (Liaison Lead); Dakota Freudenberg, PharmD, CSP (General Manager); Natilee Azzara, PharmD (Pharmacist Lead); Jessica Maroti, CPhT (Liaison Lead); Mindy Roselli, PharmD, BCGP, CPh, CSP (Clinical Operations Manager); Steven Springle, CPht-Adv (Liaison Lead) Lee Health Specialty Pharmacy Lee Health Specialty Pharmacy (LHSP), with dispensing services based out of Lee Health Coconut Point, provides unique solutions to the challenges that patients and healthcare providers face with specialty medications throughout the health system. The LHSP team has rapidly grown to include 16 pharmacists and 24 pharmacy technician liaisons, with further expansion planned. Services are offered in over 65 outpatient Lee Physician Group (LPG) clinics, with pharmacists and pharmacy technician liaisons directly embedded in the clinic or providing services remotely. These services are offered to patients seen at LPG clinics that focus on various disease states, including but not limited to autoimmune disorders, cardiology, neurology, and pulmonology. The LHSP team is also embedded within pediatric specialty clinics to manage and support this unique patient population. Whether in the clinic or located remotely, the pharmacists practice at the top of their licenses through providing dose modification, patient education, provider education, and therapy plan management. Typical pharmacy technician liaison services within these practice settings include assisting patients by managing insurance requests, linking patients with financial assistance, and facilitating the timely delivery of medications. The team dedicates a substantial amount of time to ensuring patients can obtain these high-cost medications through grants and other patient assistance programs. Since opening in February 2020, Lee Health Specialty Pharmacy has grown from serving 50 patients the first month to almost 8000 patients in September 2022. Due to the expertise of the pharmacy team, Lee Health Specialty Pharmacy has also

18 | Lee Health provided over $15 million in savings to patients and significantly reduced the average turnaround time for insurance approval of these unique specialty medications. All of the pharmacists and pharmacy technician liaisons are either currently pursuing or actively holding advanced certifications and collaborate closely with the acute care and outpatient service lines within Lee Health. Lee Health Specialty Pharmacy is dualaccredited, having recently obtained both Accreditation Commission for Healthcare (ACHC) and Utilization Review Accreditation Commission (URAC) accreditation. LHSP plans to maintain rapid growth in both personnel and services offered in order to serve the community through increased clinic presence and the development of new collaborative practice agreements (CPAs). Feb-20 — Mar-20 — Apr-20 — May-20 — Jun-20 — Jul-20 — Aug-20 — Sep-20 — Oct-20 — Nov-20 — Dec-20 — Jan-21 — Feb-21 — Mar-21 — Apr-21 — May-21 — Jun-21 — Aug-21 — Sep-21 — Oct-21 — Nov-21 — Dec-21 — Jan-22 — Feb-22 — Mar-22 — Apr-22 — May-22 — Jun-22 — Aug-22 — Sep-22 — Jul-21 — Jul-22 — Specialty Pharmacy Patients Volume 8,000 _________________________________________________________________________ 7,000 _________________________________________________________________________ 6,000 _________________________________________________________________________ 5,000 _________________________________________________________________________ 4,000 _________________________________________________________________________ 3,000 _________________________________________________________________________ 2,000 _________________________________________________________________________ 1,000 _________________________________________________________________________ 0 _________________________________________________________________________ Number of Patients

Pharmacy Services Biennial Report | 19 Infusion Centers

20 | Lee Health Complex Care Center The Complex Care Center (CCC) is a hospitalbased outpatient clinic located in the Medical Office Building adjacent to Lee Memorial Hospital. Pharmacy services are provided by the CCC satellite pharmacy embedded within the clinic. The onsite pharmacy staff includes both pharmacy technicians and ambulatory care pharmacists. The CCC clinic provides a wide range of outpatient services, including transitions of care for patients postdischarge at high risk for readmission, wound care management, a pharmacist-run anticoagulation clinic, and the administration of outpatient infusions. The pharmacists collaborate with providers in the development and delivery of patient treatment plans, conduct patient visits for anticoagulant management, and dispense intravenous infusions. The CCC clinic is at the forefront of offering innovative patient care options, including rapid diuresis for congestive heart failure (CHF) and investigational COVID-19 antibody infusions. Since 2022, a clinical pharmacist that practices under a Collaborative Practice Agreement (CPA) has overseen the anticoagulation clinic rooted within the CCC. Drug therapy management includes patients on warfarin, enoxaparin, or direct oral anticoagulants. Patients with CHF utilize the outpatient setting to prevent hospitalization by receiving rapid diuresis. Additional infusion services include management of autoimmune conditions, infectious diseases, and iron deficiency. Pharmacists review the infusion therapy plan to ensure the regimens are monitored appropriately and the patient receives proper pre-medication. Pharmacists at the clinic also help with side effect management.The CCC team works closely with the informatics and automation staff to develop specific evidence-directed therapy plans for each medication dispensed in the clinic and assists in the development of new plans for emerging therapies. The treatments offered at the CCC are constantly evolving, and pharmacists play an essential role in the management of these patients. Lee Health Home Infusion Since 1995, Lee Health Home Infusion (LHHI), previously known as Access Infusion, has provided medications, treatment management, nursing resources, and financial navigation support to patients requiring home infusion and nutrition support therapies. LHHI is one of the leading suppliers of nutrition support in Southwest Florida and services both the geriatric and pediatric populations. In addition, the team provides almost $2 million in financial assistance to the residents of Southwest Florida annually. In fiscal year 2022, LHHI provided roughly 250,000 doses to patients at home. Home Infusion Services are expected to grow in the future as payers, patients, and providers accept home care as the standard of care. LHHI provides compassionate care and personalized service utilizing a strong 16-member team. The team includes three pharmacists, two

Pharmacy Services Biennial Report | 21 pharmacy technicians, four registered nurses, two dietitians, and five administrative and distribution support roles. The team routinely collaborates with other members of the Lee Health continuum of care team and external healthcare entities to provide an exceptional patient experience in the comfort of the patient’s home. This wide-ranging collaboration includes, but is not limited to, discharge planning and assessing the affordability of therapy to ensure the transition of care process is streamlined for the patient. LHHI is fully accredited by the Community Health Accreditation Partner (CHAP) and is licensed by the Centers for Medicare and Medicaid Services (CMS) to provide therapies in a home care setting. For the past 27 years, LHHI has been a key player in providing comprehensive healthcare beyond the four walls of the health system. The LHHI team prides itself on the delivery of excellent care to this unique and expanding patient population. Kathleen Dolan, RPh (Pharmacy Manager) & Michael Koleff (Pharmacy Director)

22 | Lee Health Regional Cancer Center Lee Health Oncology Services began as Lee Cancer Care in 1998 and evolved into the Regional Cancer Center (RCC) in 2008. RCC is a collaboration between the entire healthcare team to offer patients treatment for every aspect of their cancer care under one roof. Clinical services include genetic counseling, clinical trials, support services, rehabilitation, survivorship, palliative care, and nutrition counseling. In addition, RCC hosts an on-site infusion pharmacy that provides a wide variety of therapies, such as chemotherapy, immunotherapy, and monoclonal antibodies, as well as treatments for rheumatology, gastrointestinal disease, and immunodeficiency. With over 21,000 infusion preparations per year, the pharmacy staff of 11, including two Board Certified Oncology Pharmacists (BCOP), provides comprehensive, collaborative pharmaceutical services to adult outpatients. Pharmacists ensure treatment regimens are tailored to each individual patient, consistent with published treatment guidelines, monitor lab values and adverse effects, and provide patient education. Collectively, the pharmacy technician and oncology financial navigator have grown the patient assistance program, resulting in an annual medication cost recovery of over $4 million. Lee Health Oncology also utilizes a collaborative chemotherapy stewardship committee to oversee the appropriate use of resources for our patients. RCC Investigational Drug Services currently has over 30 open, ongoing clinical trials that are sponsored by both industry and the National Cancer Institute, with new trials added on a regular basis. In an effort to meet growing patient needs, the oncology program plans to expand with an additional infusion center location in Bonita Springs, Florida. Lee Health Oncology is dedicated to serving patients in the Southwest Florida region with exceptional care and passion, and the pharmacy team ensures patient needs are met clinically and financially. Oct-21 Nov-21 Dec-21 Jan-22 Feb-22 Mar-22 Apr-22 May-22 Jun-22 Aug-22 Sep-22 Jul-22 Regional Cancer Center Biosimilar Savings FY 22 Total Savings: $2,794,159 $600,000 __________________________________________________ $500,000 __________________________________________________ $400,000 __________________________________________________ $300,000 __________________________________________________ $200,000 __________________________________________________ $100,000 __________________________________________________ $0 __________________________________________________ Tina Gegeckas, RPh, BCOP, FFSHP (Pharmacy Director)

Pharmacy Services Biennial Report | 23

24 | Lee Health Skilled Nursing Facilities The Lee Health acute care pharmacies began providing pharmacy services to the Skilled Nursing Facility (SNF) and the two Skilled Units (SNU) in July 2020. The incorporation of the SNF and SNU within the Lee Health pharmacy has allowed the health system to provide a seamless transition of care from the acute care setting to the skilled nursing setting. The pharmacy team at Lee Health provides services such as monthly medication clinical reviews, admission medication reconciliation, psychotropic agent usage review, patient education, and all medication distribution activity. The SNF and SNU locations include: HealthPark Care and Rehab Center, a 112-bed freestanding SNF on the HealthPark Medical Center campus that offers both rehabilitation and long-term care beds; Gulf Coast SNU, the newest facility, a freestanding unit located on the Gulf Coast Medical Center campus consisting of 75 private rehabilitation beds; and Lee Memorial SNU, an 18-bed rehabilitation unit located within Lee Memorial Hospital. All SNF/SNU locations have been named award recipients for quality by the Agency for Healthcare Administration (AHCA). Lee Memorial SNU and Gulf Coast SNF have received the bronze designation, while HealthPark Care and Rehab Center have received silver designations. Currently, the average verification time is an impressive 12 minutes. This quick turnaround time allows for rapid medication availability and medication administration. In addition, bar code medication administration (BCMA) was implemented as an additional safeguard. The SNF has exceeded the national Leapfrog safety goal of a BCMA scan rate of 95% and achieved the more stringent Lee Health system goal of 98% BCMA compliance. The acute care pharmacy teams on the associated campus partner with the SNF/SNU site to provide medication distribution. This distribution includes the fulfillment of the automated dispensing machines, which provide 98% of all doses dispensed. In addition to the medication distribution services provided internally, a full-time clinical specialist is dedicated specifically to the three SNFs and SNUs. The dedicated clinical pharmacist is in charge of monthly medication reviews, admission reconciliation, and on-site pharmacy support.This position allows frequent contact with providers, nursing, administration, and patients for educational opportunities. The specialist dedicated to the SNF and SNU locations acts as the pharmacy liaison between the two practice settings and offers pharmacy-centered input when developing system-level policy and quality improvement projects. This pharmacist works closely with both teams to improve patient care at every stage of the continuum, including admissions, discharges, formulary management, and policy development. The pharmacy staff was a welcome addition to the interdisciplinary care team that continues to provide outstanding, high-quality care to this growing patient population. Nov-20 — Dec-20 — Aug-21 — Sep-21 — Aug-22 — Jul-20 — Aug-20 — Sep-20 — Jan-21 — Feb-21 — Mar-21 — Apr-21 — May-21 — Oct-21 — Nov-21 — Dec-21 — Jan-22 — Feb-22 — Mar-22 — Apr-22 — May-22 — Oct-20 — Jun-21 — Jun-22 — Jul-21 — Jul-22 — Bar Code Medication Administration Compliance Percentage 100 _______________________________________________________________ 98 _______________________________________________________________ 96 _______________________________________________________________ 94 _______________________________________________________________ 92 _______________________________________________________________ 90 _______________________________________________________________ 88 _______________________________________________________________ 86 _______________________________________________________________ 84 _______________________________________________________________ 82 _______________________________________________________________ 80 _______________________________________________________________ Percentage Scanned System Average Lee Health Standard Leapfrog Standard Joy Darnell, RPh, CPh (Skilled Nursing Clinical Specialist)

Pharmacy Services Biennial Report | 25 LeeSar and Cooperative Services of Florida LeeSar and Cooperative Services of Florida (CSF), founded in 1997 as a joint venture between Lee Health and Sarasota Memorial Healthcare System, have since grown to 350 employees across multiple facilities in Fort Myers and Sarasota with over 400,000 square feet of support services.LeeSar is a regionally ranked supply chain organization that provides medications, supplies, and services to member healthcare organizations. CSF serves as the regional aggregation group and grouppurchasing organization, in partnership with Vizient, to ensure medications procured by members, which include UF Health, Sarasota Memorial Healthcare, Jupiter Medical Center, and Lee Health, remain at the lowest costs possible. LeeSar and CSF also provide educational opportunities by offering tours and informational sessions to pharmacy residents from around the state and exposing them to nontraditional pharmacy careers. LeeSar’s pharmacy support includes a central distribution center for bulk buy repackaging, a 503B sterile-to-sterile robotic compounding suite, a tray exchange program, nuclear pharmacy services, and a first responder division for the surrounding local community. CSF’s pharmacy team collaborates with key stakeholders to gain an understanding of significant clinical topics within the health system. The team also collaborates with the senior hospital administration to target collective member-driven initiatives, pursue areas for standardization, and maximize purchasing power through an established negotiation, bid, and contracting process. With the use of innovative technology, LeeSar and CSF eliminate supply barriers, streamline distribution pathways, and use benchmarking analytics to optimize financial savings while mitigating supply shortages, allowing for optimized patient care at the clinical level. From Left to Right: Mallory Fiorenza, PharmD, BCPS, BCCCP (Vizient Executive Director), Jonathan Girnys, PharmD, MBA, BCPS (LeeSar and Cooperative Services of Florida Vice President of Pharmacy Services ) and Kelly Amati, PharmD, CPh (LeeSar Pharmacy Operations and Compliance Coordinator)

26 | Lee Health Antimicrobial Stewardship Apr-21 — May-21 — Jun-21 — Jul-20 — Aug-20 — Sep-20 — Oct-20 — Nov-20 — Dec-20 — Jan-21 — Feb-21 — Apr-21 — May-21 — Jun-21 — Aug-21 — Sep-21 — Oct-21 — Nov-21 — Jul-21 — Total Ceftaroline Usage per 1,000 Patient Days 25 _______________________________________________________________ 20 _______________________________________________________________ 15 _______________________________________________________________ 10 _______________________________________________________________ 5 _______________________________________________________________ 0 _______________________________________________________________ MARCH 2021 IMPLEMENTATION

Pharmacy Services Biennial Report | 27 From Left to Right: Elisabeth Chandler, PharmD, BCIDP, Megan Patch, MS, PharmD, BCPS, BCIDP, BCPPS and Manuel Escobar, PharmD, BCIDP During calendar year 2021, key initiatives for the Antimicrobial Stewardship Program included the following: • Implementation and education of emergency use authorization pharmacotherapies for COVID-19, such as monoclonal antibodies • The initiation of a ceftaroline antimicrobial stewardship initiative, which resulted in significantly reduced utilization over an 8-month period and a $100,000 cost savings impact. • Implementation or update of multiple guidelines, including institutional antibiograms, hospital- and ventilatorassociated pneumonia order set creation, the T2 guidance document, and perioperative antibiotic redosing recommendations for adults and pediatrics • Implementation and updates of treatment pathways, including the skin and soft tissue infection pathway, the sexually transmitted infection pathway, and the urinary tract infection pathway • Initiation and completion of multiple research and medication use evaluation projects for optimization of antimicrobial use across the system • Numerous educational initiatives, including the publication of ten “The Dose of Infectious Diseases” newsletters, all associated with both medical and pharmacy continuing education credits, the precepting of 19 pharmacy student and resident rotations, and various local and national CE speaking engagements. • Acceptance and publication in Infection Control and Hospital Epidemiology (ICHE) of the fluoroquinolone community antimicrobial stewardship project can be found here. The Lee Health Antimicrobial Stewardship Program (LHASP), established in 2008, has evolved into a robust, health system-wide interdisciplinary program. LHASP aims to create excellence in infectious disease care by optimizing antimicrobial therapy at every opportunity. Program goals include promoting the safe and appropriate use of antimicrobials, minimizing unintended effects of antimicrobials (toxicity, adverse events, selection of resistant pathogens), and providing costeffective care. The LHASP team includes two full-time adult Infectious Diseases Pharmacy Clinical Specialists, one part-time pediatric Infectious Diseases Pharmacy Clinical Specialist, one PGY2 Infectious Diseases Pharmacy Resident, and adult and pediatric Physician Champions who oversee antimicrobial stewardship activities. Antimicrobial stewardship activities encompass all four adult acute care facilities: Golisano Children’s Hospital of Southwest Florida, Coconut Point Emergency Department, Complex Care Center, Lee Memorial Hospital Rehab Hospital, Lee Health’s three Skilled Nursing Facilities, and other ambulatory clinics and settings. The Antimicrobial Stewardship Committee reports to the Infection Control Committee, the Pharmacy and Therapeutics (P&T) Committee, and other committees as applicable to individual initiatives.

28 | Lee Health The Pharmacy Informatics Team provides comprehensive interdisciplinary support to Lee Health employees in all aspects of medication management. This support spans the entire medication management process, including ordering, providing clinical decision support, preparing, dispensing, administering, charging, and reporting. The team comprises a collaborative effort of eight pharmacists, six pharmacy technicians, and two registered nurses. Primary areas supported include acute care and outpatient pharmacies, specialty pharmacies, the complex care center, and the regional cancer center. The team also works toward individualizing the medication management process for staff across multiple departments in the health system. The team is responsible for providing initial and ongoing pharmacy informatics training to all pharmacy department employees, residents, and students. Training experiences include initial Epic Willow training for acute care pharmacy team members and Epic Beacon/therapy plan training for new oncology pharmacists (adult and pediatric). Ongoing educational experiences include Pharmacy Tips of the Week, a weekly newsletter that provides updated system changes to pharmacy staff, and Beacon Tips and Updates, a weekly email with updated system changes for pharmacy, providers, and nursing. The team also dedicates time to training both PGY1 and PGY2 residents through a pharmacy informatics learning experience elective. The informatics team provides support for ten applications, including Epic (Willow Acute Care, Ambulatory, Inventory, Beacon Oncology Module, Long Term Care), BD Pyxis ES, Remote Assist, HealthSight Diversion Management, Logistics, Emporos MerchantSoft Point of Sale system, MacroHelix 340b Software, Dr. First Medication History Service, Baxter Abacus TPN Compounding software/EM 1200 and EM 2400 TPN As Lee Health continues to grow and expand patient care service lines, the Pharmacy Informatics Team’s primary goal is to facilitate change and promote pharmacy growth. This is demonstrated through the achievement of six recent best practice goals. Approximately half of the team’s time is aimed at maximizing and maintaining existing systems. This process has been optimized through the informatics department’s conversion to ServiceNow support software. Informatics and Automation

Pharmacy Services Biennial Report | 29 A concerted effort has been made to address and reduce the outstanding request burden by over 60% in less than 12 months. In the past year, major projects included the implementation of diversion management software, the installation of image capture for compounded sterile products (Epic dispense prep images), the development of the medication history service, the execution of real-time prescription benefit checks, pharmacist telemedicine visits, and the integration of the Prescription Drug Monitoring Program into Epic. Other notable recent accomplishments include interfacing Epic orders to TPN compounders, improving pediatric tumor board workflow, and interfacing Epic lab data to specialty pharmacy 3rd party software. In addition, the recent establishment of a pharmacy informatics liaison committee has improved interdisciplinary communication with the informatics department. Throughout Hurricane Ian, the Pharmacy Informatics team also provided 24/7 support remotely and on site, ensuring uninterrupted patient care. Large-scale planned projects for the year ahead include the implementation of Pyxis Anesthesia Stations encompassing 80+ operating rooms, coordination of a bidirectional interface between Epic and infusion pumps, migration to Epic Hyperdrive, and expansion of outpatient oncology services. The Pharmacy Informatics Department is proud to be an essential part of the pharmacy and interdisciplinary healthcare team. From Left to Right: Renee Sheppard, MSN, RN, OCN (Supervisor), Chris Scott, PharmD (Pharmacy Informatics Manager), David Wallace, RPh (Supervisor)

30 | Lee Health 340B Program The 340B Drug Discount Program was established by the United States Federal Government in 1992 with the goal of “stretching federal resources as far as possible, reaching more eligible patients, and providing more comprehensive services.”The program, enforced by the Health Resources and Services Administration (HRSA), requires drug manufacturers to provide outpatient drugs to eligible healthcare organizations and “covered entities” at significantly reduced prices in exchange for federal health plan reimbursement. In 2017, the oversight of the Pharmacy and 340B Program Compliance Program was placed within the Compliance and Internal Audit Department of Lee Health. In the five years since, the staff has grown to include a 340B program auditor and two 340B program analysts. Continued department expansion occurred in late 2021 when the drug diversion team, led by two experienced Registered Nurses, was merged into the department. Lee Health actively participates in the 340B Drug Discount Program with registered Disproportionate Share Hospitals (DSH) and Federally Qualified Health Center Look-Alike (FQHCLA) covered entities. The scope of the DSH 340B program at Lee Health includes 35 registered locations encompassing Lee Memorial Hospital, HealthPark Medical Center, Golisano Children’s Hospital, the Regional Cancer Center, Lee Health Coconut Point, and numerous outpatient clinics throughout the organization. The FQHCLA 340B program at Lee Health consists of 22 registered locations, which include Lee Community Healthcare clinics and numerous pediatric and adult outpatient care locations. The value of the 340B program, as measured in drug cost avoidance and contract pharmacy revenue, has grown from $26 million in 2020 to over $50 million for fiscal year 2022. The organization uses the revenue and savings to expand vital services, which include OB/GYN, pediatric care, and mental health services for both adults and children. In addition, Lee Health is able to provide vulnerable, uninsured patients with essential medications (i.e., insulin, respiratory medications, and cardiac medications) often for pennies on the dollar. The in-house 340B auditor performs various program self-audits on a monthly, quarterly, and yearly basis, as well as assisting with external audit requests as needed. The auditor reviews thousands of 340B claims annually for compliance with eligibility requirements and the prevention Financial Summary

Pharmacy Services Biennial Report | 31 of diversion, GPO prohibition, and duplicate discounts. The 340B analysts work closely with pharmacy teams throughout the health system to assist with inventory management and the maintenance of each pharmacy’s billing and recording software. These efforts assure compliance and yield optimal benefits from the 340B program. The 340B program at Lee Health successfully completed an HRSA audit in 2020 with minimal corrective actions required. In addition to audits from drug manufacturers and regulatory bodies (i.e., HRSA), Lee Health undergoes an annual on-site audit conducted by an independent third-party vendor to identify areas for improvement. The Drug Diversion Program utilizes an interdisciplinary approach including leadership governance, investigational strategy, and artificial intelligence to detect and prevent drug diversion at Lee Health. By observing behavioral analytics, risk analysis, medication administration documentation trends, and other data elements, the team is able to identify and mitigate the occurrence and risk of drug diversion. Through the efforts of the drug diversion team, awareness, education, and resources are made available to all employees of Lee Health, beginning at new hire orientation and extending through annual competency education. Compliance is a key component of any healthcare system, and the pharmacy department at Lee Health provides exceptional resources to maintain program integrity. Collaboration between the 340B Compliance Team and system pharmacy leadership ensures that appropriate resources are dedicated to maintain a strong program. From Left to Right: Maricor Hostetter, BSPharm, CPhT, RPhT (340B Program Analyst), Brian Sorbello, RN (Drug Diversion Specialist), Brooke Perna, BS (340B Program Analyst), Monika Bartsch, MBA, BSBM, CPhT, RPhT, 340B ACE (340B Program Auditor), Joe Bitner, PharmD, CPh, CHC, 340B ACE (Pharmacy and 340B Program Compliance Officer), and Holly Borkowski, BSN, RN (Drug Diversion Specialist)

32 | Lee Health PGY1 - Gulf Coast Medical Center The Lee Health PGY1 Residency Program started in 2009 and was the first accredited pharmacy postgraduate training opportunity at Lee Health. Since its establishment, fifty-four residents have graduated as of July 2022. Upon graduation, 43% of graduates went on to complete a PGY2 residency, 62% of graduates hold at least one board certification, and 43% are currently on staff at Lee Health. Lee Health PGY1 residents contribute to the pharmacy’s mission statement through their daily patient care activities, medication use evaluations, performance improvement projects, and major research projects. Residents actively participate in formulary management by conducting drug class reviews to present at pharmacy and therapeutics committee meetings. They also participate in a number of department and system committees, including Antimicrobial Stewardship and Medication Safety. As Lee Health is an ACPE Provider, PGY1 residents are able to complete an ACPE accredited Teaching Certificate Program to develop the skills needed to effectively precept IPPE and APPE students from six different colleges of pharmacy. Residents also provide instruction in the classroom setting to students in our Lee Health ASHP accredited Technician Training Program as well as pharmacology lectures to physician assistant students. A unique component of the residency program is the longitudinal leadership and administrative learning experiences. Residents are able to work with many different leaders within the pharmacy department to focus on medication safety, clinical decision support, human resource management, lean principles, Lee Health has been an Accreditation Council for Pharmacy Education (ACPE) accredited provider since 2008. In 2020, Lee Health successfully completed the ACPE re-accreditation process and received continued accreditation through 2027. The ACPE mission is to provide easily accessible, evidence-based, and relevant educational offerings to all Lee Health pharmacists and technicians. ACPE educational offerings are high-level educational programs that are easily accessible to Lee Health employees. Educational programs are tailored to meet the needs of each team member’s individualized practice setting. These programs ensure that pharmacists and technicians have the ability to practice at the top of their licenses and are equipped with the tools needed to optimize patient outcomes. In 2022, Lee Health provided over 55 programs for staff members. Educational credits are offered in a variety of subject matters and media, including live, virtual, and home study options. In the upcoming year, continued expansion is planned with the goal of increasing educational programs for pharmacy technicians. Pharmacy Residency Programs The pharmacy residency programs at Lee Health are committed to providing excellent training experiences that support the residents’ clinical, academic, and professional interests. With 6 ASHP-accredited programs and over 70 preceptors, the postgraduate training is dedicated to preparing future pharmacy clinicians and leaders by promoting confidence, leadership, and professional skills. In 2023, Lee Health pharmacy residencies will be expanding with the addition of two new programs: a second PGY1 Pharmacy Residency located at Cape Coral Hospital and a PGY2 Emergency Medicine Residency program. Lee Health values the growth of the next generation of pharmacists and continues to find areas for future development in training. Education & Training

Pharmacy Services Biennial Report | 33 2022 – 2023 Lee Health Pharmacy Residency Class: Left to Right: Jeanette Soto (PGY1 Community Based), Khawla Farah (PGY1 Acute Care), Gerard Jacinto (PGY1 Acute Care), Alexis Vanderlee (PGY2 Health System Pharmacy Administration and Leadership), Benjamin Harding (PGY2 Health System Pharmacy Administration and Leadership), Shayne McKee (PGY1 Acute Care), Michael Vincent (PGY2 Critical Care), Min J Kim (PGY1 Acute Care), Katherine Schojan (PGY1 Acute Care), Kymberly Buzzeo (PGY2 Pediatrics), Christine Cardi (PGY1 Community Based) performance improvement activities, and supply chain management concepts. The scope of subjects covered over the year successfully lays the foundation for residents to have a well-rounded practice in a contemporary healthcare system. The residency program has a robust mentor structure, with preceptors serving as resident advisors and residents serving as APPE student mentors. Preceptors and residents alike share the “pay it forward” mentality, as many preceptors were past residents or students at Lee Health. Since 2009, the PGY1 residency program has remained a key component of the Lee Health pharmacy department’s success. PGY1 Community Based The American Society of Health System Pharmacy’s (ASHP) accredited PGY1 Community-Based Residency program started in 2020 and is embedded within a multi-hospital health system. This comprehensive setting allows residents a unique training opportunity to enhance their pharmacy skills in a variety of ambulatory areas across the care continuum. Residents execute the mission statement through interdisciplinary, patientcentric, care activities in longitudinal experiences such as community pharmacy practice, primary care, medication therapy management, medication safety, and transitions of care. Condensed learning experiences in pharmacy administration, oncology, and rheumatology are incorporated into our residency year. Additionally, residents can select elective opportunities in a wide range of acute and ambulatory pharmacy settings. Throughout the year, preceptors take a progressive learning approach to prepare residents for independent practice. Residents interact with patients directly in the community by conducting patient outreach programs such as immunization clinics, brown bag events, medication education presentations,

34 | Lee Health and other wellness events. This provides access to necessary pharmacy services for patients who may not be able to travel to the pharmacy. Community Pharmacy residents also publish The Dose of Ambulatory Pharmacy, a pharmacy newsletter that updates health providers on ambulatory topics and guidelines. Each resident conducts a research project that culminates in a presentation at the Florida Residency Conference. They also produce a research manuscript ready for publication submission. This process improves and develops both professional presentation and writing skills. The PGY1 Community-Based Residency program has been successful in developing prepared, wellrounded, pharmacy practitioners ready to optimize patient outcomes in the community setting. PGY2 Infectious Diseases Pharmacy Residency The American Society of Health System Pharmacy’s (ASHP) PGY2 Infectious Diseases Pharmacy Residency, established in 2011, is dedicated to developing infectious diseases pharmacy clinicians through advancing knowledge, leadership, and professional skills. Residents train throughout the health system’s multiple acute care locations. The PGY2 Infectious Diseases Resident has the opportunity to train in all areas of infectious diseases with core rotations including: ■ Microbiology ■ Antimicrobial Stewardship (I and II) ■ ID Consult (I and II) ■ Critical Care ■ Antimicrobial Stewardship Administration. The resident also has the option to participate in several elective opportunities, including Emergency Residency Program Directors: Program Directors from Left to Right: Bradley Murnyack (Upcoming 2023 PGY1 Cape Coral Hospital), Anson Phetteplace (PGY1 Community-Based), Suzanne Turner (PGY1 Gulf Coast Medical Center), Elisabeth Chandler (PGY2 Infectious Disease), Megan Patch (PGY2 Pediatrics), Stephanie Walton (PGY2 Critical Care), Kari Duckworth (Upcoming 2023 PGY2 Emergency Medicine), John Armitstead (PGY2 Health System Pharmacy Administration and Leadership)

Pharmacy Services Biennial Report | 35 Medicine, outpatient HIV Clinic, Acute care HIV, Informatics, Pediatric Antimicrobial Stewardship/ Infectious Diseases Consult, and Pharmacy Leadership. In addition, residents will be involved in longitudinal research and quality improvement projects, The Dose of Infectious Diseases newsletter, the presentation of two ACPE programs, and participation in pharmacy practice service. The Infectious Diseases resident is an active member of the Lee Health Antimicrobial Stewardship Committee, Pharmacy and Therapeutics Committee and the Infection Prevention Committee. PGY2 Infectious Diseases resident alumni are: • Lauren Tesh Hotaki – Antimicrobial Drugs Advisory Committee/Oncological Drugs Advisory Committee, Designated Federal Officer, CDER, OEP, FDA • Aileen Martinez – Infectious Diseases Specialist, Cleveland Clinic Martin Health, Stuart, FL • Marylee Worley- Assistant Professor, Nova Southeastern University College of Pharmacy, Ft. Lauderdale, FL • Jonathan Cho – Director of Pharmacy, MountainView Hospital, Las Vegas, NV • Megan Patch – Pediatric Infectious Diseases Clinical Specialist, Golisano Children’s Hospital of Southwest Florida, Fort Myers, FL • Edgar Turner – Emergency Medicine Pharmacist, Lee Health, Fort Myers, FL • Emily Weisz – Infectious Diseases Clinical Specialist, Bridgeport Hospital, Bridgeport, CT • Mike Turk – Antimicrobial Stewardship Pharmacist, St. Elizabeth Healthcare, Edgewood, KY • Ian Murphy – Clinical Pharmacist Specialist- Adult Infectious Diseases, Orlando Health, Orlando, FL • Stephanie Ducas – Clinical Pharmacy Specialist, NCH Healthcare System, Naples, FL PGY2 Health System Pharmacy Administration and Leadership Residency The PGY2 Health System Pharmacy Administration and Leadership Residency program, established in 2014, is designed to develop and propel the resident’s knowledge, experience, and competency in contemporary pharmacy practice administration and leadership. The program utilizes innovative and overlapping learning experiences integrated throughout the entire health system. To develop leadership and administrative competencies, various patient populations and pharmacy service lines (e.g., adult and pediatric populations, acute care, ambulatory, and community services) are used. The PGY2 HSPAL Resident develops strong presentation skills through chairing system-wide committees such as Pharmacy and Therapeutics, Pharmacy Director’s Meetings, and Medication Safety, as well as leading process improvements and transactional changes. Residents are required to complete a major project, a research project, and coordinate a medication use evaluation analysis. The PGY2 HSPAL resident completes overlapping experiences that include: ■ Human Resources ■ Pharmacy Business Development ■ Clinical Practice Management ■ Acute Care I ■ Ambulatory Care I ■ Medication Safety ■ Quality and Financial Management ■ Pharmacy Informatics. The elective learning experiences within the health system can be focused on Acute Care II, Ambulatory Care II , Specialty Pharmacy, Managed Care

36 | Lee Health Practice, 340B Operations, Group Purchasing Organizations and Contracting, Centralized Service Provision, 503B Operations, Pediatrics, Oncology, Emergency Medicine, Education and Training, executive suite rotations, and other rotational experiences as desired. Lee Health PGY2 HSPAL resident alumni include: • Jonathan Girnys – Vice President of Pharmaceutical Services, LeeSar CSF, Fort Myers, FL • Farima Fakheri Raof – Pharmacy Manager, System Infusion Pharmacy Services, Baptist Health System, Miami, FL • Michelle Estevez – Pharmacy Manager, Lee Health - Coconut Point, Estero, FL • Jeanette Alava – Pharmacy Manager, Lee Health - Bonita Health Center, Estero, FL PGY2 Critical Care Pharmacy Residency The American Society of Health System Pharmacy’s (ASHP) accredited PGY2 Critical Care Pharmacy Residency, established in 2015, builds upon a resident’s PGY1 residency training to provide them with the essential knowledge and skills to become an advanced critical care pharmacist. The PGY2 Critical Care Resident trains at Gulf Coast Medical Center, a level II trauma center, exposing them to a complex patient population. The PGY2 Critical Care Resident has the opportunity to train in all areas of critical care with core rotations, including: ■ Medical ICU ■ Surgical ICU ■ Cardiology/cardiac surgical ICU ■ Neurology ICU ■ Trauma ICU ■ Infectious disease consult ■ Emergency medicine The Residency Program also offers elective rotations in nutrition support, antimicrobial stewardship, acute care hematology/oncology, pharmacy leadership, and preceptor training and experience. As a PGY2 Critical Care Resident, the resident will refine their time and project management skills with their longitudinal projects, including; The Dose of Critical Care newsletter, a medication use evaluation, a major research project, and two formal ACPE accredited lectures. The resident will also develop their leadership skills with their involvement in the Pharmacy Clinical Practice Council, the ICU Excel meeting, the Trauma Excel meeting, and the Critical Care Quality Conference. Lee Health PGY2 Critical Care alumni include: • Amy West – Critical Care Clinical Specialist (Medical/Surgical/Emergency Medicine) for Orlando Health Dr. P. Phillips Hospital, Orange County, FL • Paul Ahearn – Critical Care Clinical Specialist (Medical/Cardiac ICU) for Bridgeport Hospital, Bridgeport, CT • Michelle Henninger – Critical Care Clinical Pharmacist (Surgical ICU) for Cleveland Clinic, Weston, FL • Kelly Groover – Critical Care Pharmacist for Gulf Coast Medical Center, Fort Myers, FL • Kelsey Smith – Critical Care Pharmacist for Gulf Coast Medical Center, Fort Myers, FL

Pharmacy Services Biennial Report | 37 PGY2 Pediatric Pharmacy Residency Established in 2017, the American Society of Health System Pharmacy’s (ASHP) accredited Pediatric PGY2 Pharmacy Residency program is dedicated to preparing future pediatric pharmacy clinicians and leaders by promoting confidence, leadership, and professional skills. Residents have the unique opportunity to train at Golisano Children’s Hospital of Southwest Florida, a freestanding 128-bed pediatric hospital. The PGY2 Pediatrics Resident has the opportunity to train in many areas within pediatrics with core rotations including: ■ Pediatric Medical/Surgical Care ■ Pediatric Intensive Care I &II ■ Neonatal Intensive Care I & II ■ Pediatric Infectious Diseases and Antimicrobial Stewardship ■ Pediatric Hematology/Oncology ■ Pediatric Emergency Medicine ■ Scholarly Research In addition to the core rotations, residents have the option of a variety of elective experiences, including Transitions of Care, Pharmacy Practice Leadership and Administration, Antimicrobial Stewardship Administration, as well as an additional rotation in a core area. Residents are involved in a variety of longitudinal experiences, including; The Dose of Pediatrics newsletter, Medication Safety, Pharmacy Practice Experience, and the Pediatric Cystic Fibrosis Clinic. Additionally, the pediatric resident presents two ACPE programs, completes a major research project, and facilitates a medication use evaluation. PGY2 Pediatrics resident alumni include: • Christina Schwartz – Clinical Pharmacy Manager and PGY1 Pharmacy Residency Director, Driscoll Children’s Hospital, Corpus Christi, Texas • Elizabeth Faville – Intensive Care Nursery Clinical Pharmacy Specialist, Pennsylvania Hospital, Penn Medicine, Philadelphia, PA • Christopher Kennie-Richardson – Pediatric Clinical Pharmacist, Phoenix Children’s Hospital, Phoenix, AZ • Arielle Charles – Neonatal Intensive Care Pharmacist, Northside Hospital, Atlanta, GA • Erica Bergeron – Pediatric Clinical Pharmacist, Golisano Children’s Hospital of Southwest Florida, Fort Myers, FL

38 | Lee Health PGY1 Khawla Farah, Pharm.D. PGY1 Resident – Acute Care 2022-2023 Education: University of South Florida – Tampa, FL Gerard Jacinto, Pharm.D. PGY1 Resident – Acute Care 2022-2023 Education: Medical University of South Carolina – Charleston, SC Min Jee Kim, Pharm.D. PGY1 Resident – Acute Care 2022-2023 Education: University of Louisiana Monroe – Monroe, LA Shayne McKee, Pharm.D. PGY1 Resident – Acute Care 2022-2023 Education: University of Florida – Gainesville, FL Katherine Schojan, Pharm.D. PGY1 Resident – Acute Care 2022-2023 Education: University of Florida – Gainesville, FL Christine “KC” Cardi, Pharm.D. PGY1 Resident – Community Based 2022- 2023 Education: Northeastern University – Boston, MA Jeanette Soto, Pharm.D. PGY1 Resident – Community Based 2022- 2023 Education: Florida Agricultural and Mechanical University – Tallahassee, FL PGY2 Kymberly Buzzeo, Pharm.D. PGY2 Resident – Pediatrics 2022-2023 Education: High Point University – High Point, NC Training: PGY1 Residency, Novant Health New Hanover Regional Medical Center, Wilmington, NC Benjamin Harding, Pharm.D. PGY2 Resident – Health System Pharmacy Administration and Leadership 2022-2023 Education: Auburn University – Auburn, AL Training: PGY1 Residency, Princeton Baptist Medical Center, Birmingham, AL Lexi Vanderlee, Pharm.D. PGY2 Resident – Health System Pharmacy Administration and Leadership 2022-2023 Education: Midwestern University – Downers Grove, IL Training: PGY1 Residency, Riverside Healthcare, Kankakee, IL Michael Vincent, Pharm.D. (L70) PGY2 Resident - Critical Care 2022-2023 Education: University of Florida – Gainesville, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL Kristen South, Pharm.D. (L69) Clinical Pharmacist, Health Park Medical Center, Lee Health, Fort Myers, FL Education: University of Wisconsin – Madison, WI Training: PGY1 Residency, Lee Health, Fort Myers, FL Megan Sosa, Pharm.D. (L68) Clinical Pharmacist, Gulf Coast Medical Center, Lee Health, Fort Myers, FL Education: University of Florida – Gainesville, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL Frances Pamittan, Pharm.D. (L67) Clinical Pharmacist, Health Park Medical Center, Lee Health, Fort Myers, FL Education: University of Florida – Gainesville, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL Samuel Morton, Pharm.D. (L66) Oncology Pharmacist, Gulf Coast Medical Center, Lee Health, Fort Myers, FL Education: University of Tennessee Health Science Center – Nashville, TN Training: PGY1 Residency, Lee Health, Fort Myers, FL Katie Hensley, Pharm.D. (L65) Emergency Department Pharmacist, Lee Memorial Hospital, Lee Health, Fort Myers, FL Education: Concordia School of Pharmacy – Mequon, WI Training: PGY1 Residency, Lee Health, Fort Myers, FL Current Residents Past Residents Tess Bernstein, Pharm.D. (L64) Ambulatory Pharmacist, Lee Pharmacy, Lee Health, Fort Myers, FL Education: Massachusetts College of Pharmacy an Health Sciences – Boston, MA Training: PGY1 Community Based Residency, Lee Health, Fort Myers, FL Ellen Volovich, Pharm.D. (L62) Oncology Pharmacist, Gulf Coast Medical Center, Lee Health, Fort Myers, FL Education: Nova Southeastern University – Fort Lauderdale, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL Kelsey Smith, Pharm.D. (L61) Critical Care Pharmacist, Gulf Coast Medical Center, Lee Health, Fort Myers, FL Education: University of Florida – Gainesville, FL Training: PGY1 Residency and PGY2 Critical Care, Lee Health, Fort Myers, FL Shelly Kearns, Pharm.D. (L60) Clinical Pharmacist, Cape Coral Hospital, Lee Health, Cape Coral, FL Education: Lake Erie College of Osteopathic Medicine – Bradenton, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL Stephanie Ducas, Pharm.D. (L59) Infectious Diseases Clinical Pharmacy Specialist, NCH Healthcare System, Naples, FL Education: University of Florida – Gainesville, FL Training: PGY1 Residency and PGY2 Infectious Diseases, Lee Health, Fort Myers, FL Erica Bergeron, Pharm.D. (L58) Pediatric Pharmacist, Golisano Children’s Hospital of Southwest Florida, Lee Health, Fort Myers, FL Education: University of Oklahoma Health Sciences Center – Oklahoma City, OK Training: PGY1 Residency and PGY2 Pediatrics, Lee Health, Fort Myers, FL Julianna Hennig, Pharm.D. (L57) Ambulatory Pharmacist, Lee Pharmacy, Lee Health, Fort Myers, FL Education: University of Pittsburgh – Pittsburgh, PA Training: PGY1 Community Based Residency, Lee Health, Fort Myers, FL Natilee Azzara, Pharm.D. (L56) Clinical Specialist, Specialty Pharmacy, Lee Health, Fort Myers, FL Education: University of South Carolina – Columbia, SC Training: PGY1 Community Based Residency, Lee Health, Fort Myers, FL Ian Murphy, Pharm.D., BCIDP (L55) Infectious Diseases Clinical Pharmacist, Orlando Health, Orlando, FL Education: Albany College of Pharmacy and Health Sciences – Albany, NY Training: PGY1 Residency, Rochester General, Rochester, NY and PGY2 Infectious Diseases, Lee Health, Fort Myers, FL Arielle Charles, Pharm.D. (L53) NICU Pharmacist, Northside Hospital, Atlanta, GA Education: University of Georgia – Athens, GA Training: PGY1 Residency, Erlanger Health System, Chattanooga, TN and PGY2 Pediatrics, Lee Health, Fort Myers, FL Jeanette Alava, Pharm.D. (L52) Pharmacy Manager, Bonita Health Center, Lee Health, Estero, FL Education: Nova Southeastern University – Fort Lauderdale, FL Training: PGY1 Residency, Cleveland Clinic, Martin Health, Stuart, FL and PGY2 Health System Pharmacy Administration and Leadership, Lee Health, Fort Myers, FL Chris Kennie-Richardson, Pharm.D., BCPPS (L51) Pediatric Clinical Specialist at Phoenix Children’s Hospital Phoenix, AZ Education: Xavier University of Louisiana – New Orleans, LA Training: PGY1 Residency, Our Lady of the Lake Regional Medical Center, Baton Rouge, LA and PGY2 Pediatrics, Lee Health, Fort Myers, FL Emily Thorp, Pharm.D. (L50) Appeals Pharmacist, Medical Review Institute of America Education: University of Florida – Gainesville, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL and PGY2 Emergency Medicine, CaroMont Health, Gastonia, NC Chrissy Tabulov, Pharm.D., BCPPS (L49) Assistant Professor, Department of Pharmacotherapeutics and Clinical Research, University of South Florida Health Taneja College of Pharmacy, Tampa, FL Education: University of Florida – Gainesville, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL and PGY2 Pediatrics, Children’s National Medical Center, Washington DC Steven Reynolds, Pharm.D. (L48) Clinical Pharmacist, Genesis Care, Ft Myers, FL Education: University of Florida – Gainesville, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL RESIDENCY YEAR BOOK

Pharmacy Services Biennial Report | 39 Sejada Kastrati, Pharm.D. (L47) Internal Medicine Clinical Pharmacist, Advent Health, Tampa, FL Education: University of South Florida – Tampa, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL Kirstyn Hill, Pharm.D., MPH (L46) Clinical Operations, Pediatric Pharmacist, Rush University Medical Center, Chicago, IL Education: University of Kentucky – Lexington, KY Training: PGY1 Residency, Lee Health, Fort Myers, FL Alyssa Dungca, Pharm.D. (L45) Advanced Clinical Pharmacist, UCF Lake Nona Hospital, Orlando, FL Education: University of Florida – Gainesville, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL Michelle Henninger, Pharm.D., BCCCP (L44) Intensive Care Unit / Emergency Medicine Clinical Pharmacist, Cleveland Clinic, Weston, FL Education: Nova Southeastern University – Fort Lauderdale, FL Training: PGY1 Residency, Cleveland Clinic, Weston, FL and PGY2 Critical Care, Lee Health, Fort Myers, FL Robert “Bobby” Sheridan, Pharm.D., BCPS (L43) Clinical Pharmacist, Health Park Medical Center, Lee Health, Fort Myers, FL Education: Lake Erie College of Osteopathic Medicine – Bradenton, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL Melanie Rolfe, Pharm.D., BCPS (L42) Clinical Pharmacist, Health Park Medical Center, Lee Health, Fort Myers, FL Education: University of Florida – Gainesville, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL Kelly Groover, Pharm.D., BCPS, BCCCP (L40) Critical Care Pharmacist, and PGY1 GCMC Residency Program Director Gulf Coast Medical Center, Lee Health, Fort Myers, FL Education: Auburn University – Auburn, AL Training: PGY1 Residency and PGY2 Critical Care, Lee Health, Fort Myers, FL Michelle Estevez, Pharm.D., DPLA, BCPS (L39) Pharmacy Manager, Lee Pharmacy Coconut Point, Lee Health, Fort Myers, FL Education: University of Colorado – Aurora, CO Training: PGY1 Residency and PGY2 Health System Pharmacy Administration and Leadership, Lee Health, Fort Myers, FL Jordan Barkes, Pharm.D., BCPS (L38) Internal Medicine Clinical Pharmacist, UNC Medical Center and UNC Hospital Region Experiential Assistant Director, Chapel Hill, NC Education: University of North Carolina – Chapel Hill, NC Training: PGY1 Residency, Lee Health, Fort Myers, FL and PGY2 Internal Medicine, Medical University of South Carolina, Charleston, SC Emily Weisz, Pharm.D., BCPS, BCIDP (L37) Clinical Specialist, Infectious Diseases, Bridgeport Hospital, Bridgeport, CT Education: University of Georgia – Athens, GA Training: PGY1 Residency, CaroMont Regional Medical Center, Gastonia, NC and PGY2 Infectious Diseases, Lee Health, Fort Myers, FL Mike Turk, Pharm.D., BCPS, AAHIVP (L36) Antimicrobial Stewardship Pharmacist, St. Elizabeth Healthcare, Edgewood, KY Education: University of Florida – St. Petersburg, FL Training: PGY1 Residency, Sarasota Memorial Hospital, Sarasota, FL and PGY2 Infectious Diseases, Lee Health, Fort Myers, FL Paul Ahearn, Pharm.D., BCPS, BCCCP (L35) Medical / Cardiac Intensive Care Unit Pharmacist, Bridgeport Hospital, Bridgeport, CT Education: University of Connecticut – Mansfield, CT Training: PGY1 Residency, UMass Memorial Medical Center, Worcester, MA and PGY2 Critical Care, Lee Health, Fort Myers, FL Mary Lynn Skruck, Pharm.D., BCPS, BCCCP (L34) Emergency Department Pharmacist, Gulf Coast Medical Center, Lee Health, Fort Myers, FL Education: Palm Beach Atlantic University – West Palm Beach, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL Jamie Reed, Pharm.D. (L33) Internal Medicine Specialist, Hepatology, IU Health University Hospital, Indianapolis, IN Education: Purdue University – West Lafayette, IN Training: PGY1 Residency, Lee Health, Fort Myers, FL and PGY2 Internal Medicine, Mayo Clinic, Rochester, MN Farima Fakheri Raof, Pharm.D., BCPS, DPLA, 340B-ACE (L32) Pharmacy System-Manager, Infusion Services, Baptist Health South Florida, Miami, FL Education: Nova Southeastern University – Fort Lauderdale, FL Training: PGY1 Residency and PGY2 Health System Pharmacy Administration and Leadership, Lee Health, Fort Myers, FL Bradley Murnyack, Pharm.D., BCPS (L31) Internal Medicine Clinical Pharmacist and PGY1 CCH Residency Program Director, Cape Coral Hospital, Lee Health, Cape Coral, FL Education: Lake Erie College of Osteopathic Medicine – Bradenton, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL Elizabeth Faville, Pharm.D., BCPPS (L30) Intensive Care Nursery Clinical Specialist, Pennsylvania Hospital, Philadelphia, PA Education: Lake Erie College of Osteopathic Medicine – Bradenton, FL Training: PGY1 Residency and PGY2 Pediatrics, Lee Health, Fort Myers, FL Arya Cader, Pharm.D., BCPS, BCACP, BCCCP, DPLA (L29) Clinical Hospital Pharmacist – Emergency Medicine, Jackson Health System, Miami, FL Education: University of Florida – Gainesville, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL Christina (Martin) Schwarz, Pharm.D., BCPPS (L28) Clinical Pharmacy Manager and PGY1 Residency Program Director, Driscoll Children’s Hospital, Corpus Christi, TX Education: Lake Erie College of Osteopathic Medicine – Bradenton, FL Training: PGY1 Residency and PGY2 Pediatrics, Lee Health, Fort Myers, FL Isabelle Gallagher, Pharm.D., BCPS (L27) Education: University of Florida – Gainesville, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL Karina Esquivel, Pharm.D., BCPS (L26) Clinical Pharmacist, Swedish Medical Center, Seattle, WA Education: University of Florida – Gainesville, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL Ashley Cubillos, Pharm.D., BCPS, BCIDP (L25) Antimicrobial Stewardship and Infectious Diseases Clinical Pharmacist, Banner Pharmacy Services, Northern Colorado Education: Lake Erie College of Osteopathic Medicine – Bradenton, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL and PGY2 Infectious Diseases, University of Minnesota Health, Minneapolis, MN Edgar Turner, Pharm.D., BCPS, BCIDP, BCCCP (L23) Emergency Department Pharmacist, Gulf Coast Medical Center, Lee Health, Fort Myers, FL Education: University of Toledo – Toledo, OH Training: PGY1 Residency and PGY2 Infectious Diseases, Lee Health, Fort Myers, FL Aaron Joseph, Pharm.D., BCPS (L22) Clinical Pharmacist, Erlanger Health System, Chattanooga, TN Education: University of Florida – Gainesville, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL Kari Duckworth, Pharm.D., BCPS (L21) Emergency Department Pharmacist, and PGY2 Emergency Medicine Residency Director Gulf Coast Medical Center, Lee Health, Fort Myers, FL Education: South University – Savannah, GA PGY2 Emergency Medicine Residency Program Director Training: PGY1 Residency, Lee Health, Fort Myers, FL Catalina Acosta, Pharm.D., BCPS, BCCCP (L20) Pharmacy Clinical Coordinator, NCH Healthcare System, Naples, FL Education: Nova Southeastern University – Fort Lauderdale, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL Amy West Pharm.D., BCPS, BCCCP (L19) Critical Care Specialist, Orlando Health, Orlando, FL Education: University of Florida – Gainesville, FL Training: PGY1 Residency and PGY2 Critical Care, Lee Health, Fort Myers, FL Megan Patch, MS, Pharm.D., BCPS, BCIDP, BCPPS (L18) Pediatric Infectious Diseases Clinical Specialist and PGY2 Pediatrics Residency Program Director, Golisano Children’s Hospital of Southwest Florida, Lee Health, Fort Myers, FL Education: University of Georgia – Athens, GA Training: PGY1 Residency and PGY2 Infectious Diseases, Lee Health, Fort Myers, FL Julie Katz Pharm.D., BCPS (L17) Emergency Department Pharmacist, Cape Coral Hospital, Lee Health, Cape Coral, FL Education: University of Florida – Gainesville, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL Jennifer (Greenup) Jelley Pharm.D. (L16) Education: University of Florida – Gainesville, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL Ryan Hire, Pharm.D., BCCP (L15) Critical Care Pharmacist, Gulf Coast Medical Center, Lee Health, Fort Myers, FL Education: University of Florida – Gainesville, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL

40 | Lee Health Karl Healy, MS, Pharm.D., BCCCP, BCPS (L14) Emergency Department Pharmacist, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC Education: University of Florida – Gainesville, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL Kelly (Glover) Zavitz, Pharm.D., BCPPS (L13) Clinical Pharmacist Pediatric Hematology/ Oncology, UK Healthcare DanceBlue Kentucky Children’s Hospital, Lexington, KY Education: University of Kentucky – Lexington, KY GCMC Residency Program Director Training: PGY1 Residency, Lee Health, Fort Myers, FL Jonathan Girnys, Pharm.D., MBA, BCPS (L12) Vice President of Pharmacy, LeeSar, Inc, Fort Myers, FL Education: University of Georgia – Athens, GA Training: PGY1 Residency and PGY2 Health System Pharmacy Administration and Leadership, Lee Health, Fort Myers, FL Jonathan Cho, Pharm.D. (L11) Director of Pharmacy MountainView Hospital, Las Vegas, NV Education: University of the Pacific – Stockton, CA Training: PGY1 Residency and PGY2 Health System Pharmacy Administration and Leadership, Lee Health, Fort Myers, FL Marylee Worley, Pharm.D., BCPS, BCIDP (L10) Assistant Professor, Nova Southeastern University, Fort Lauderdale, FL Education: Temple University – Philadelphia, PA Training: PGY1 Residency, Palmetto Hospital, Hialeah, FL and PGY2 Infectious Diseases, Lee Health, Fort Myers, FL Stephanie (Tears) Walton, Pharm.D., BCPS, BCCCP (L9) Critical Care Pharmacist, Gulf Coast Medical Center and PGY2 Critical Care Residency Program Director, Lee Health, Fort Myers, FL Education: University of Florida – Gainesville, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL and PGY2 Critical Care, Jackson Memorial Hospital, Miami, FL Rebecca Gonzalez Winegar, Pharm.D., BCOP (L8) Bone Marrow Transplant Pharmacist, Moffitt Cancer Center, Tampa, FL Education: University of Florida – Gainesville, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL and PGY2 Oncology, West Virginia University, Morgantown, WV Joseph Pardo, Pharm.D., BCIDP (L7) Antimicrobial Stewardship Program Manager, North FL / South GA Veterans Health System, Gainesville, FL Education: University of Florida – Gainesville, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL and PGY2 Infectious Diseases, UF Shands Hospital, Gainesville, FL Aileen Martinez, Pharm.D., BCPS, BCIDP (L6) Pharmacy Specialist, Infectious Diseases, Cleveland Clinic Martin Health, Stuart, FL Education: Nova Southeastern University – Fort Lauderdale, FL Training: PGY1 Residency, Indian River Medical Center, Vero Beach, FL and PGY2 Infectious Diseases, Lee Health, Fort Myers, FL Irene (Borrero) Arias, Pharm.D., BCOP (L5) Organized Custom Field Medical Director – Breast Cancer, Pfizer Education: Nova Southeastern University – Fort Lauderdale, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL Harrison Bachmeier, Pharm.D., BCPS (L4) Internal Medicine Pharmacist, Moffitt Cancer Center, Tampa, FL Education: University of Florida – Gainesville, FL Training: PGY1 Residency, Lee Health, Fort Myers, FL and PGY2 Infectious Diseases, University of Kentucky, Lexington, KY Lauren Tesh Hotaki, Pharm.D., BCPS, BCIDP (L3) Senior Regulatory Health Project Manager, FDA, Silver Spring, MD Education: University of the Sciences in Philadelphia – Philadelphia, PA Training: PGY1 Residency and PGY2 Infectious Diseases, Lee Health, Fort Myers, FL Kristen (Kirdahy) Crawford, Pharm.D., BCPS, BCOP (L2) Oncology Pharmacist, Investigational Drug Service and Student Co-Coordinator, Lee Health, Fort Myers, FL Education: University of Kentucky – Lexington, KY Training: PGY1 Residency, Lee Health, Fort Myers, FL Emily John, Pharm.D. (L1) NICU Pharmacist, Northside Hospital-Forsyth, Cumming, GA Education: Rutgers University – New Brunswick, NJ Training: PGY1 Residency, Lee Health, Fort Myers, FL

Pharmacy Services Biennial Report | 41 Pharmacy Technician Training Program Since it was established in the fall of 2017, Lee Health has been home to Southwest Florida’s only Pharmacy Technician Training Program (PTTP). This program provides students with the essential skills to successfully practice in a diverse number of pharmacy settings, including adult acute care, outpatient settings, and specialty areas such as pediatrics, oncology, and outpatient infusion centers. Lee Health PTTP remains the only American Society of Health System Pharmacists (ASHP) and Accreditation Council for Pharmacy Education (ACPE) accredited pharmacy technician program serving the local area. The Lee Health PTTP is designed to educate, train, and retain students as employees upon program completion. The 16-week program utilizes multiple methods of training, including didactic learning, simulated experiences, and onsite experiential training. Students dedicate 300 hours to didactic topics, such as pharmacology and mathematical calculations. Simulated experiences, including aseptic technique, proper garbing, IV mixing, reconstitution, and repackaging, span over 100 hours. Students participate in 200 hours of onsite experiential learning alongside the acute care and outpatient pharmacy teams. 34% - Registered Pharmacy Technician I 31% - Pharmacy Product Technician and Pharmacy Technician II 31% - Pharmacy Purchasing Specialist and Pharmacy Technician III 4% - Pharmacy Technician Supervisor Pharmacy Technician Training Class Fall 2022 Following program completion, instructors offer support and continued guidance in preparation for the Pharmacy Technician Certification Board (PTCB) Exam. As of 2022, the program has achieved a 98% graduation rate, a 98% Florida pharmacy technician registration rate, an 80% Lee Health retention rate, and is on track to earn a 76% PTCB certification rate. The Lee Health PTTP offers a dynamic educational experience for pharmacy technician students while empowering them to become high-achieving leaders in the pharmacy profession. Upon graduation, pharmacy technician students are able to cultivate relationships with patients and serve as a key member of a multi-disciplinary healthcare team. Lee Health PTTP graduates are a key component of providing optimal patient-centered care. Pharmacy Technician Career Ladder

42 | Lee Health Technician Accolades ADVANCED TECHNICIAN CERTIFICATIONS In addition to the Lee Health requirement for all pharmacy technicians to obtain the Pharmacy Technician Board Certification by the end of their first year, many technicians have strived to further advance their practice by obtaining advanced certifications. Advanced Certified Pharmacy Technician Carla Emrick Steven Springle Billing and Reimbursement Danielle Santos Certified Vaccination Technician Felishia I Wilson La’Shim Hardy Controlled Substance Diversion Prevention Carla Emrick Danielle Santos Medication History Andrea Malinguaggio Medication Therapy Management Carla Emrick Regulatory Compliance Carla Emrick Technician Product Verification Carla Emrick Danielle Santos DECADE OF TECHNICIAN COMMITMENT TO LEE HEALTH 1976 Jacqueline Thomas 1988 Lana Warman 1995 Deloris Barrett 1996 Martha Mytholar 1998 Amanda James 1999 Colleen Tinsley 2000 Jenney Lortie 2002 Sheila Carr 2003 Darren Brown Marissa Rivas 2004 Brenda Moncibaez Coleen Arnold Lilia Abad 2006 Lyudmila Kim Sangita Lala Teresa Greenup 2007 Catrina Sorey Stacey Hristov 2008 Andrea Malinguaggio Jamie Foster Jennifer Moenandar 2009 Joseph Collins Jose Rangel 2011 Kim Altmann Naomi Raynor Rachel Andrews Sarah Bowman 2012 Arthur Jong Christine Young Danilo Gonzalez Posada Delilah Perez Mystique Reed Rebecca Scott 2013 Bianca Febres Danielle Fortier Kellie Griffiths Melanie Levy Patricia Maynard Stacey Fisher PHARMACY TECHNICIAN SUPERVISOR Amanda Teckenbrock (Pharmacy Technician Program Supervisor) Carla Emrick Jennifer Moenandar Marissa Rivas Melanie Levy Terra Sanchez Latoya Rhodes PHARMACY PURCHASING SPECIALISTS Anita Drljaca Brenda Moncibaez Coleen Arnold Lana Warman Laura Walton

Pharmacy Services Biennial Report | 43 PHARMACY PRODUCT TECHNICIAN Brian Lawson Jordyn Gottschalk Michelle Elcik Sangita Lala Stacey Fisher REGISTERED PHARMACY TECHNICIAN III Amanda Langley Andrea Malinguaggio Bianca Febres Brittney Ealy Catrina Sorey Danielle Santos Danilo Gonzalez Posada Darren Brown Deloris Barrett Fadi Zeineddine Jamie Foster Jenney Lortie Jessica Jones Jose Rangel Juan Quinones Benitez Kara Moreland Kellie Griffiths Lilia Abad Lyudmila Kim Naomi Raynor Patricia Maynard Penny Thorne Phattaranid Treekulphiphat Rachel Andrews Rebecca Scott Valerie Vega Werner Van Der Heyde Zachary Turner

44 | Lee Health Student Pharmacist Program Lee Health serves as a clinical clerkship site for numerous colleges of pharmacy within the state of Florida and several outof-state locations. The program provides both advanced (APPE) and introductory pharmacy practice experiences (IPPE) in the acute care and outpatient settings. Lee Health offers all requisite APPE experiences for licensure as well as an extensive list of electives such as, infectious diseases, emergency medicine, critical care, leadership, and many more. Lee Health has been precepting students for over three decades and is continually growing. Within the last 5 years, the program has averaged greater than 105 months of student learning per year. The APPE Block Program was established in 2008 and is now a “residency-prep” program that provides numerous longitudinal activities to help prepare students interested in pursuing residency training post-graduation. Students are required to complete a medication use evaluation (MUE), the majority of which are presented in a poster format at state or national meetings. Students also complete a Grand Rounds presentation, along with participating in systemwide activities such as weekly educational presentations, topic discussions, and pharmacy and system level committee meetings. Lee Health utilizes a layered learning approach where enrolled students work closely with both PGY1 and PGY2 residents on core rotations and as their assigned mentors in the unique Lee Health Mentor Program. The Student-Resident Forum provides an opportunity for students to have dedicated time with current Lee Health residents to discuss non-clinical topics, such as the residency application process, job applications, and interview techniques. The doctor of pharmacy students play an essential role as pharmacy extenders, providing optimal patient care to the Lee Health community. Pharmacy Internship Program The Lee Health Pharmacy Internship Program is a longitudinal experience that allows motivated pharmacy students to develop their pharmacy skills in a multi-hospital community health system. The unique internship allows interns to participate in an acute care or outpatient structured training program that complements their knowledge and skillset acquired during pharmacy school. Throughout the duration of the program, pharmacist interns are exposed to clinical and operational pharmacy processes, as well as direct patient care activities. Experiences include assisting in preparation, dispensing, distribution, and control of medications in the hospital; conducting prior-toadmission medication histories; filling automated dispensing machines; compounding sterile and non-sterile products; and administering vaccines in the outpatient pharmacies. Lee Health’s Pharmacy Intern Program was created out of the desire to facilitate the development of the next generation of pharmacists. Since its inception in 2020, the program has enrolled nearly 30 pharmacist interns, many of whom have either stayed on as pharmacist residents or are employed pharmacists. Lee Health looks forward to continuing to invest in the growth of future pharmacists through this robust program. APPE Rotations Provided in 2001-2022 19% - Hospital 17% - Medicine 14% - Community 18% - ED/Critical Care/ID 11% - Ambulatory 8% - Specialty, Managed Care, TOC 8% - Sub-Specialty (neurology, oncology, cardiology, pediatrics) 4% - Leadership 140 ________________________________________ 120 ________________________________________ 100 ________________________________________ 80 ________________________________________ 60 ________________________________________ 40 ________________________________________ 20 ________________________________________ 0 ________________________________________ FY18 FY19 FY20 FY21 FY22 Months of Doctor of Pharmacy Student Experiential Training

Pharmacy Services Biennial Report | 45 Performance and Quality Improvement Pharmacy improvement through quality research and medication use evaluations is embedded in the Lee Health Pharmacy Department. The Research and Scholarly Subcommittee (RSS) is a subcommittee of the Residency Advisory Council (RAC) established at Lee Health to assess and encourage pharmacy research and development. In addition, the RSS works directly with Lee Health’s Institutional Review Committee (IRC) to promote interdisciplinary protocol development. The IRC is comprised of interdisciplinary members, both clinical and nonclinical, who evaluate all projects that include human subject research at Lee Health. All projects conducted by pharmacy personnel or within the department of pharmacy, including medication use evaluations, performance and quality improvement projects, and primary research, are submitted to the RSS for review and approval prior to IRC submission. Project proposals are prioritized based on health system need, health system impact on patient care or operations, and level of expertise required (i.e., student, resident, pharmacist, specialist, etc.). In addition, each resident research project is directly assigned to at least one RSS member to provide mentorship throughout the year. Mentorship includes the provision of feedback on protocol development, data collection and analysis, and manuscript production. The number of research projects conducted by pharmacy staff has increased dramatically over the last decade. In addition to research projects, pharmacy personnel are encouraged to participate in medication use evaluations and performance/ quality improvement projects. This increase in research and development is due to the continuously growing pharmacy residency programs at Lee Health. Pharmacy members who participate in human research are required to obtain certification through the Collaborative Institutional Training Initiative (CITI). This course provides foundational training for the development of human research to improve quality in research conduct and compliance. In addition, leaders of the RSS are required to obtain additional certification through the American Society of Health-System Pharmacists (ASHP) Research Skills Certification program. Through training, mentorship, and clinical excellence, the pharmacy department has been granted multiple awards for excellence in clinical research. In both 2019 and 2021, Lee Health research teams were awarded the Florida Society of Health System Pharmacist Research Poster of the Year Awards for their work and dedication to the advancement of pharmacy practice. Pharmacy improvement through research and medication use evaluations remains a core value for the Lee Health Pharmacy Department in its overarching mission to optimize outcomes through interdisciplinary management. Lee Health employees can review a list of all ongoing and past projects via the Lee Health Pharmacy Webpage. Student MUE Resident MUE Resident Research Project Clinical Pharmacist Research 25 _____________________________________________________________ 20 _____________________________________________________________ 15 _____________________________________________________________ 10 _____________________________________________________________ 5 _____________________________________________________________ 0 _____________________________________________________________ Research Projects and Medication Use Evaluations 2018-2019 2019-2020 2020-2021 2021-2022 2022-2023 Number of Completed Projects

46 | Lee Health Professional Recognition

Pharmacy Services Biennial Report | 47 PLATFORM PRESENTATIONS • Alava JA. Armitstead JA. Legislative Update. University of Florida Student Society of Health System Pharmacists. 2020. • Antigua A. Mckee S. Reals T. Turner S. Don’t Let Phase II Phase You Out! Florida Society of Health system Pharmacists Annual Meeting. 2022. • Armitstead JA. Strategic Planning for Health System Pharmacy in Turbulent Times. National Premier/Acurity Webinar. 2021. • Armitstead JA. Value Added Pharmacy in a Post-COVID World. Western New York Society of Health System Pharmacists. 2022. • Chandler E. Masterclass: Conquering Difficult to Treat Infections. Florida Society of Health System Pharmacists Annual Meeting. 2022. • Estevez MM. Bite Size Advice for Integrating Life and Career for Busy Pharmacists: Automating More Than Just Your Refills. American Society of Health System Pharmacists Midyear Clinical Meeting. 2020. • Estevez MM. Using Layered Learning to Achieve Information Technology Competencies. Wyoming Pharmacist Association / Wyoming Society of Health System Pharmacy 105th Annual Meeting. 2022. • Estevez MM. Two Decades Later: The Opioid Epidemic and Substance Abuse Disorder. Wyoming Pharmacist Association / Wyoming Society of Health System Pharmacy 105th Annual Meeting. 2022. • Estevez MM. Pharmacy Preceptor Pearls 2022: Directing Through Influential Leadership. American Society of Health System Pharmacist National Pharmacy Preceptor Conference. 2022. • Groover K. Everybody Hurts: Managing Pain in Special Populations. Florida Society of Health System Pharmacist Annual Meeting. 2022. • Lozano Y. ASHP New Practitioners Forum – PAI 2030. Recommendations to Bolster Pharmacy Technician Training Program. ASHP Intersections. 2020, 2021. • Patch M. There’s a Little Fungus Among Us: Review of Antifungal Therapeutics within Pediatrics. Pediatric Pharmacy Association Annual Meeting. 2021. • Reed BN. Armitstead JA. Leading the Future Workforce – Balancing Innovation with Resilience. American Society of Health System Pharmacists - Virtual Conference for Pharmacy Leaders. 2020. • Roselli M. Examining the Role of Current and Emerging Therapies in the Treatment of ALS: Live and Enduring Digital Webinar Program - Featuring a Patient/Caregiver Perspective. Pharmacy Times Continuing Education Webinar. 2023. • Roselli M. Novel Treatment Approaches for Alzheimer Disease. Asembia Specialty Pharmacy Summit. 2022. • Roselli M. Targeting the Sickle Cell Disease Cascade and Shifting Approach to Care. Academy of Managed Care (AMCP) Nexus. 2022. • Shane R. Armitstead JA. Ortega M. McGladrigan. Moderator Robb. K. ASHP Policy Deep Dive (Address Payer Mandated White Bagging). American Society of Health System Pharmacists Webinar. 2021. • Skiff AE. Wong W. Azzara N. The role of a Pharmacist in different ambulatory care settings. Southern Gulf Society of Health System Pharmacists. Transition of Care Track CE program. 2022. • Turner S. ACPE CPE 2020 Virtual Symposium: Commitment to Excellence! CPD Expert Panel Speaker. 2020. • Turner S. Building your Residency Application Packet: How to Do More than Just Measure Up. 2020 Virtual Student Track and Research and Education Florida Health System Pharmacist Foundation Residency Showcase. 2020. • Turner S. Residency Program Design and Conduct (RPDC) PGY1 Existing Programs Workshop Faculty. American Society of Health System Pharmacists Midyear Clinical Meeting. 2022. • Turner S. Using the Continuing Professional Development Approach to Combat Burnout. National Premier/ Acurity Webinar. 2021.

48 | Lee Health POSTER PRESENTATIONS • Alava JA. Armitstead JA. Lozano. Y. Evaluation of Adult Acute Care Hospital Pharmacy Productivity Metrics. American Society of Health System Pharmacists Midyear Clinical Meeting. 2021. • Chandler E. Patch M. Murphy I. Smith K. et al. Evaluation of Nephrotoxicity with Vancomycin Area Under the Concentration-Time CurveGuided Dosing vs. TroughGuided Dosing Associated with Vancomycin and Piperacillintazobactam Combinations. MAD-ID. 2022. • Alwine K. Barreto I. Barberio M. Patch M. Ward P. Incidence of Thrush in NICU Patients Receiving Inhaled Budesonide Therapy. American Society of Health System Pharmacists Annual Meeting. 2021. • Bergeron E. Charles A. Patch M. Masse H. Stovall S. Antimicrobial Stewardship Opportunities for IV to PO Conversion in Pediatric Patients with Intra-Abdominal Infections. American Society of Health System Pharmacists. Annual Meeting. 2020. • Bergeron E. Patch M. Charles A. Ward P. Effect of Intralipid compared to SMOFlipid on incidence of parenteral nutrition associated cholestasis in the neonatal intensive care unit. Pediatric Pharmacy Advocacy Group Annual Meeting. 2022. • Chandler E. Murphy I. Cubillos A. Guglielmo C. Pharmacistdriven penicillin allergy interviews decrease nonpreferred antibiotic utilization and antibiotic expenditure. MAD-ID. 2021. • Cubillos A. Chandler E. Cioffi F. Utilization of a novel diagnostic assay to improve turnaround time and accurate diagnosis and treatment of secondary candidemia in a critically ill immunosuppressed COVID-19 patient. CAP21. 2021. • Cubillos A. Caulder E. Patch M. Saunders M. Lynch L. Gieselman M. Calkins K. Antimicrobial Stewardship Intervention Bundle Decreases Fluoroquinolone Prescribing for Urinary Tract Infection in Urgent Care and Primary Care Clinic. IDWEEK Annual Meeting. 2020. • Dostie A. Laurin J. Smith K. Groover KM. Venous Thromboembolism Prophylaxis Dosing and Incidence of Thrombosis in Trauma Patients at a Level II Trauma Center. American Society of Health System Pharmacists Midyear Clinical Meeting. 2022. • Ducas S. Chandler E. Cubillos A. Volovich E. Smith K. Saunders M. MultiIntervention Stewardship Bundle to Optimize Ceftaroline Prescribing at a Community Health System. MAD-ID. 2022. • Ducas S. Cubillos A. Chandler E. Emergency Department Antimicrobial Stewardship Intervention Bundle to Optimize Antibiotic Prescribing in Urinary Tract Infections and Skin and Soft Tissue Infections. IDWEEK Annual Meeting. 2022. • Groover K. Fiorenza M. Kasiewicz J. High versus low rate continuous hypertonic saline infusions for traumatic brain injury: effects on sodium levels. Society of Critical Care Medicine Annual Meeting. 2020. • Groover K. Henninger M. Fiorenza M. Marcus M. Johnson C. Hamel M. Evaluation of the effects of pre-hospital ketamine on hospital length of stay and mechanical ventilation days. Society of Critical Care Medicine Annual Meeting. 2020. • Harding B. Grojean J. Lozano Y. Blaze J. Kiriyenko Y. Intraoperative Methadone’s Impact on Post-Cardiothoracic Surgery Opioid Consumption. American Society of Health System Pharmacists Midyear Clinical Meeting. 2022. • Hensley K. Smith K. Fiorenza M. Hire R. Octreotide Infusions for Upper Gastrointestinal Bleeding within a Multicenter Community Health System. American Society of Health System Pharmacists Midyear Clinical Meeting. 2021. • Hickman A. Hanson N. Leist S. Mounts D. Mourani J. Rubinstein J. Roselli M. Skrtic A. Taylor K. Tiger K. Wang H. Williamson A. Zitterkopf C. Generic Perceptions: Measuring MS patient opinions on generic Disease Modifying Therapies (DMTs). The Consortium of Multiple Sclerosis Centers Annual Meeting. 2021. • Hickman A. Skrtic A. Webster N. Canup K. D’Angelo N. Roselli M. Tiger K. Wang H. Zitterkopf. Kimball S. Kow J. Patel H. Tran P. Waite S. Follow the Script: Assessing Access Time and Adherence in Patients with MS. National Association of Specialty Pharmacy Annual Meeting & Expo. 2022.