scholarly journals Advancing Community Pharmacy Practice – A Technician Product Verification Pilot to Optimize Care

2020 ◽  
Vol 11 (2) ◽  
pp. 14
Author(s):  
Michael Andreski ◽  
Erica Martin ◽  
Victoria Valentine Brouner ◽  
Sarah Sorum
Keyword(s):  
Community Pharmacy ◽  
Patient Care ◽  
Error Rate ◽  
Pharmacy Practice ◽  
Direct Patient Care ◽  
Utilization Review ◽  
Original Research ◽  
Pharmacy Technician ◽  
Pharmacy Technicians ◽  
Product Verification

Elevating the technical role of pharmacy technicians to perform Technician Product Verification (TPV) is one strategy that has shown promise to optimize pharmacy practice models. This is done by better positioning pharmacists to provide clinical care, in line with their education and expertise. TPV permits a Validated Pharmacy Technician, as defined by the Wisconsin Pharmacy Examining Board, to verify the accuracy of a product filled by another technician. The pharmacist maintains responsibility for assessing the clinical appropriateness of the prescription, including drug utilization review, data entry, and patient counseling.  During the study period, 12,891 pharmacist-verified prescriptions (baseline) and 27,447 Validated Pharmacy Technician-verified prescriptions were audited for accuracy. The aggregate verification error rate for pharmacist-verified prescriptions was 0.16% and 0.01% for Validated Pharmacy Technician-verified prescriptions. The mean error rate was significantly less for Validated Pharmacy Technician-verified prescriptions than for pharmacist-verified prescriptions (0.19 ± 0.174 % vs 0.03 ± 0.089 %, p=0.020) (Figure 3). This suggests TPV in the community pharmacy setting maintained patient safety. In this study, Validated Pharmacy Technicians were shown to be more accurate than pharmacists at performing product verification. The ability to delegate the product verification task holds the potential to free up pharmacist time for increased direct patient care. Increasing direct patient care by pharmacists in community pharmacies may have significant implications for improving patient outcomes and pharmacy quality.   Article Type: Original Research

scholarly journals Time and Motion Study of Influenza Diagnostic Testing in a Community Pharmacy

2014 ◽  
Vol 5 (2) ◽  
Author(s):  
Donald Klepser ◽  
Allison Dering-Anderson ◽  
Jacqueline Morse ◽  
Michael Klepser ◽  
Stephanie Klepser ◽  
...  
Keyword(s):  
Community Pharmacy ◽  
Clinical Laboratory ◽  
Vital Signs ◽  
Pharmacy Practice ◽  
Original Research ◽  
Pharmacy Technician ◽  
Time And Motion Study ◽  
Time And Motion ◽  
Motion Study ◽  
Time Required

Background: It has been shown that use of rapid diagnostic tests (RDTs) is able to reduce costs and improve the prescribing practice of antivirals (i.e. oseltamivir) among patients with influenza-like illnesses (ILIs). Using existing Clinical Laboratory Improvement Amendment (CLIA)-waived RDTs and collaborative practice agreements, similar to those used to allow pharmacists to administer vaccines, it is possible for patients to seek point-of-care treatment for influenza or flu-like symptoms at a local pharmacy. Following a review of the patient's symptoms by a trained pharmacist, the qualified patient is offered an RDT to determine if the influenza virus is the cause of the symptoms. Based on the results of the RDT, the patient is provided with the appropriate treatment as defined by an approved practice agreement. Objective: The aim of this study was to evaluate the feasibility of incorporating an RDT for influenza into community pharmacy practice. Methods: This time and motion study was conducted at three community pharmacy locations, and a total of eight simulated patient visits were completed utilizing a standardized patient. In addition to determining a total time of the encounter, each simulation was divided into nine timed sub-categories. For data analysis, the time spent in each of the nine sub-categories was assigned to the pharmacist, pharmacy technician, or patient. Time and motion methodologies were used to estimate the total time required to provide the RDT service, to determine the amount of active time required of the pharmacist and pharmacy technician, and to evaluate the ability of the staff to provide the service within its existing workflow. Results: The average total time to complete the entire patient encounter for an influenza assessment utilizing an RDT was 35.5 minutes (± 3.1 minutes). On average, the pharmacist spent 9.4 minutes (± 3 minutes) per encounter or about 26.5% of the entire encounter. When the pharmacy technician collected the vital signs, the pharmacist-required time was reduced to 4.95 minutes (± 2.7 minutes), which was about a 48% reduction. Conclusions: The results indicate that an RDT program for influenza assessment required no more than a modest amount of pharmacist time and could be successfully incorporated into regular workflow with little to no disruption of other activities. As such, this approach to influenza management may be a feasible service for community pharmacies to offer patients. This was especially true if the pharmacy had well-trained technicians on staff that could support the service with collection of patient histories and vital signs.   Type: Original Research

scholarly journals Pharmacy Technicians’ Willingness to Perform Emerging Tasks in Community Practice

Pharmacy ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 113 ◽  
Author(s):  
William Doucette ◽  
Jon Schommer
Keyword(s):  
Community Pharmacy ◽  
Online Survey ◽  
Pharmacy Practice ◽  
Full Time ◽  
Community Practice ◽  
Factors Affecting ◽  
Pharmacy Technician ◽  
Pharmacy Technicians ◽  
Stress At Work ◽  
Finger Stick

New tasks are being developed for pharmacy technicians in community practice. The objectives of this study were to (1) assess the willingness of community pharmacy technicians to perform new tasks, and (2) to identify factors affecting technicians in assuming new tasks in community pharmacy practice. An online survey asked about the respondent characteristics, involvement in pharmacy technician tasks, willingness to perform emerging pharmacy technician tasks, and influences on pharmacy technicians’ performance of emerging tasks. Descriptive statistics were calculated for all items. A total of 639 usable surveys from community pharmacy technicians were used in the analyses. The respondents reported a mean of 11.5 years working as a pharmacy technician, with 79.2% working full time. Technicians reported high willingness to perform four emerging tasks, moderate willingness for six tasks, and low willingness to perform two tasks. The low willingness tasks were administering a vaccination and drawing a blood sample with a finger stick. Four workplace influences on willingness to perform emerging tasks were insufficient staffing, insufficient time to complete additional tasks, employers not classifying technicians based on specialized skills, and usually feeling stress at work. It appears likely that pharmacy technicians will be willing to perform the new tasks needed to support the emerging patient care services in community pharmacies.

scholarly journals Tech-Check-Tech in Community Pharmacy Practice Settings

2016 ◽  
Vol 33 (2) ◽  
pp. 47-52 ◽  
Author(s):  
Timothy P. Frost ◽  
Alex J. Adams
Keyword(s):  
Community Pharmacy ◽  
Patient Care ◽  
Relevant Literature ◽  
Pharmacy Practice ◽  
Direct Patient Care ◽  
Community Settings ◽  
Practice Model ◽  
Term Care ◽  
Institutional Settings ◽  
Community Pharmacy Practice

Objective: The benefit of a tech-check-tech (TCT) practice model in institutional settings has been well documented. To date, few studies have explored TCT beyond institutional settings. This article summarizes the existing evidence in community pharmacy–based TCT research with respect to dispensing accuracy and pharmacist time devoted to direct patient care. Data Sources: A literature review was conducted using MEDLINE (January 1990 to August 2016), Google Scholar (January 1990 to August 2016), and EMBASE (January 1990 to August 2016) using the terms “tech* and check,” “tech-check-tech,” “checking technician,” and “accuracy checking tech*”. Bibliographies were reviewed to identify additional relevant literature. Study Selection and Data Extraction: Studies were included if they analyzed TCT and were conducted in a community pharmacy practice site, inclusive of chain, independent, mass merchant, supermarket, and mail order pharmacies. Studies were excluded if the TCT practice model was conducted in an institutional or long-term care setting. Survey data on theoretical models of TCT in community pharmacy practice settings were also excluded. Data Synthesis: Over the past 14 years, 4 studies were identified indicating TCT has been performed safely and effectively in community settings. The studies demonstrate that trained community technicians perform as accurately as pharmacists and that TCT increased the amount of pharmacist time devoted to clinical activities. In the 2 studies that reported accuracy rates, pharmacy technicians performed at least as accurately as pharmacists (99.445 vs 99.73%, P = .484; 99.95 vs 99.74, P < .05). Furthermore, 3 of the studies reported gains in pharmacist time, with increases between 9.1% and 19.18% of pharmacist time for consultative services. Conclusions: The present studies demonstrate that TCT can be safe and effective in community pharmacy practice settings, with results similar to those found in institutional settings. It is anticipated more states will explore TCT in community settings in the years ahead as a strategy to improve patient care.

scholarly journals Comparing the Research Contributions of Community Pharmacy Foundation Funding on Practice Innovation Between Non-Academics and Academics

2017 ◽  
Vol 8 (3) ◽  
pp. 3 ◽  
Author(s):  
Anthony W Olson ◽  
Brian Isetts ◽  
Anne Marie Kondic ◽  
Jon Schommer
Keyword(s):  
Community Pharmacy ◽  
Patient Care ◽  
Quantitative Data ◽  
Qualitative Data ◽  
A Priori ◽  
Pharmacy Practice ◽  
Threshold Level ◽  
Original Research ◽  
Continuous Quality ◽  
Community Pharmacy Practice

Objective: Evaluate and compare the research contributions of Community Pharmacy Foundation (CPF) funding on community pharmacy practice innovation between non-academic and academic principal investigators (PIs) with respect to the following measurements: 1) “Pharmacy Practice Activity Classifications” (PPAC); 2) CPF “Coordinated Use of Medications”; and 3) CPF Investigator Impact. Methods: Quantitative data for all 124 CPF-funded grants awarded from 2002-2016 were obtained from the CPF website and personnel, while ethnographic qualitative data was generated from queries of PIs. Grant categorization was conducted by researchers serving as judges trained on the rules and procedures for coding. A threshold level of 90% agreement in scores of independent judging was established a priori. Findings were summarized and groups were compared using descriptive statistics for quantitative data and a thematic analysis of PI ethnographic reflections for qualitative data. Results: There were no differences between non-academic and academic PI groups for Coordinated Use of Medications and PPAC domains, but non-academics contributed more to two dispensing-related PPAC subclasses: ‘Preparing the Product’ (10% vs. 2%) and ‘Delivering the Medication or Device’ (13% vs. 2%). Analysis of investigator reflections revealed similarities between groups regarding impact on practice innovations, expanded collaborations, new practice tools, and patient-care financing models. Conclusions: CPF funding contributed new knowledge and resources for expanding and enhancing practice innovations as shown by quantitative (PPAC & Coordinated Use of Medications) and qualitative (PI impact) measures. Similarities between PI groups suggest that the CPF has established a funding niche with unique diversity of practice innovation opportunities. This investigation’s findings may be useful to the CPF’s continuous quality improvement efforts, as well as future grant applicants to assess research gaps in the medication use process and develop sustainable, transferable, and replicable patient-care innovations in community pharmacy practice. Conflict of Interest This program evaluation analysis was funded by the Community Pharmacy Foundation (CPF). Co-author Anne Marie Kondic is Executive Director and Grants Administrator for the Community Pharmacy Foundation. The ideas articulated in the manuscript are those of the authors to characterize historical CPF grant funding and do not necessarily indicate or impact future funding priorities.   Type: Original Research

scholarly journals The Community Pharmacy Technician’s Role in the Changing Pharmacy Practice Space

2020 ◽  
Vol 11 (2) ◽  
pp. 11
Author(s):  
Brooke Taylor ◽  
Bella Mehta
Keyword(s):  
Community Pharmacy ◽  
Clinical Laboratory ◽  
Pharmacy Practice ◽  
Pharmacy Technician ◽  
Medication Therapy ◽  
Medication Information ◽  
Article Type ◽  
Pharmacy Technicians ◽  
Clinical Laboratory Improvement Amendments

Purpose: The practice of pharmacy and role of pharmacists has evolved over the decades but markedly since the introduction of the Affordable Care Act (ACA) in 2010. The ACA allowed patients to have increased access to community pharmacy services, such as medication therapy management, leading to an increase in the clinical services provided by pharmacists. This expansion of pharmacist’s roles has led to pharmacists to feel an increase in workload which negatively impacts the time spent with patients. One way for this shift to occur without continuing to increase the pharmacist’s workload is by using technicians as pharmacist extenders to take on more technical tasks. Summary: The role of pharmacy technicians has been slow to expand from fear of public safety due to the lack of required education and training. Today, state requirements to practice as a pharmacy technician have become stricter with state requiring licensing, registration or certification. This increase in requirements as led to the expansion of pharmacy technician duties. Studies show that pharmacy technicians are able to perform technician accuracy checking, provide immunization and perform Clinical Laboratory Improvement Amendments (CLIA)-waived screenings. In addition to these duties, pharmacy technicians are being utilized in more novel ways such as collecting medication information in primary care and telepharmacy settings. Conclusion: In order for pharmacy to continue to grow as a profession, pharmacists need to use pharmacy technicians as extenders. As pharmacy technicians begin to take on more of the technical duties, pharmacists are able to increase the time spent with patients.   Article Type: Commentary

scholarly journals Embracing the Evolution of Pharmacy Practice by Empowering Pharmacy Technicians

Pharmacy ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 66 ◽  
Author(s):  
Ryan Burke
Keyword(s):  
United States ◽  
Pharmacy Practice ◽  
The United States ◽  
Professional Organizations ◽  
Medication History ◽  
Pharmacy Technician ◽  
Pharmacy Technicians ◽  
Product Verification ◽  
Certification Requirements

While pharmacy technician roles in some practice settings are expanding beyond the traditional dispensing activities to include advanced or specialized tasks such as immunization administration, medication history collection, and final product verification, these practices are not yet widespread. There are apparent barriers to expanding the role of pharmacy technicians, including inconsistency in the education, training, and certification requirements across the United States, and regulations that have not kept pace with the evolving role of pharmacy technicians. Every corner of the profession has an opportunity, and responsibility, to elevate pharmacy technicians in an effort to advance safety and better serve patients. Regulators can expand the responsibilities that may be delegated to technicians, professional organizations can bring pharmacy technicians into the fold, employers can build career ladders to allow for advancement, and individual pharmacists and pharmacy technicians can advocate and engage.

scholarly journals Facilitating integration of regulated pharmacy technicians into community pharmacy practice in Ontario: Results of an exploratory study

2018 ◽  
Vol 151 (3) ◽  
pp. 189-196 ◽  
Author(s):  
Luna Salameh ◽  
Daniel Yeung ◽  
Natali Surkic ◽  
Paul Gregory ◽  
Zubin Austin
Keyword(s):  
Identity Formation ◽  
Community Pharmacy ◽  
Pharmacy Practice ◽  
Implementation Strategies ◽  
Direct Patient Care ◽  
Successful Implementation ◽  
Community Practice ◽  
Community Pharmacy Practice ◽  
Pharmacy Technicians

Background: The integration of regulated pharmacy technicians (RPTs) into community pharmacy practice was intended to relieve pharmacists of certain technical duties to facilitate greater provision of direct patient care services, commensurate with expanded scope of practice. There is scant data available regarding the success, value and impact of RPT integration, either in Canada or in other jurisdictions. Methods: Pharmacists and RPTs working in community practices were interviewed. Qualitative data were categorized using an iterative coding process to identify themes related to barriers and facilitators to integrating and optimizing the role of the RPT in community practice in Ontario. Results: A total of 16 RPTs and 12 pharmacists were interviewed from community sites in Ontario. Strategies for facilitating successful integration of RPTs into daily workflow were identified, based on 4 major themes: environmental factors, interpersonal factors, professional identity formation and innovative use of delegation. Interpretation: Integration of RPTs into community practice is complex and requires careful management, planning, training and follow-up to ensure attainment of objectives. Simply hiring RPTs and placing them into existing workflow patterns is generally not a successful implementation strategy. Conclusions: Implementation strategies identified through this study can provide employers, managers, pharmacists and RPTs with opportunities to enhance RPT integration and optimize the role of both pharmacists and RPTs in community practice.

Expanding the role of pharmacy technicians to facilitate a proactive pharmacist practice

2019 ◽  
Vol 76 (6) ◽  
pp. 398-402 ◽  
Author(s):  
Brandi Newby
Keyword(s):  
Patient Care ◽  
Pharmacy Practice ◽  
Medication Therapy Management ◽  
Direct Patient Care ◽  
Order Entry ◽  
Practice Model ◽  
Therapy Management ◽  
Pharmacy Technician ◽  
Medication Therapy ◽  
Pharmacist Role

Abstract Purpose This study describes a change in pharmacy practice to expand pharmacy technician roles to allow dispensing without a pharmacist check, thereby enhancing the pharmacist role in direct patient care. Summary In an effort to optimize patient care with limited resources, we set out to change our pharmacy practice model. We transferred duties that did not require clinical judgment in the dispensary from the pharmacist to the regulated technician. The transferred roles included order entry, order entry verification, and final check of medications and preparations. The changes in roles were well received by the pharmacy staff. The pharmacist practice changed from a reactive process, where the pharmacist waited for orders to be sent to the pharmacy, to a proactive process where the pharmacist collaborated directly with patients and the health care team. The pharmacists were able to provide daily medication therapy management for every inpatient in the new practice model compared with only reactive targeted care in the former practice model. Implementation of the new practice model at our site led to a reduction in time for medications to be delivered to the patient and reduced pharmacy-related medication errors. Conclusion A new pharmacy practice model was successfully implemented whereby the pharmacy technician roles were expanded to the point where they perform all the distribution roles in the dispensary. This, in turn, allowed a change in the pharmacist role, which was focused on daily proactive direct patient care and medication therapy management.

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