Expanding the role of pharmacy technicians

If you know me then you know that I’m a proponent of expanding the role of pharmacy technicians in the acute care pharmacy setting. I believe pharmacy technicians are underutilized and are capable of doing many functions within a healthcare system to improve patient care, both directly and indirectly, as well as free up pharmacists to do the things they should be doing.

Anyway, there’s a nice article in the most recent ASHP InterSections titled “Innovative Technician Practices Debuting in Hospitals”. The article discusses not only tech-check-tech, which is the most commonly cited “advanced” technician practice, but the use of technicians to perform medication reconciliation as well.

Tech-Check-Tech:

In 2008, the pharmacy department [at Mercy Hospital in Coon Rapids, Minn] instituted a tech-check-tech program, in which a certified pharmacy technician checks the accuracy of orders filled by another technician and provides final verification prior to patient administration.

“We have technicians checking other technicians for 75 to 80 percent of our medications,” said Brent Kosel, Pharm.D., M.S., pharmacy operations manager. “Our auditing data shows that technicians do just as good a job as pharmacists. The pharmacists are champions of this program because they can focus more on our patients’ clinical needs.”

The last audit, which covered about 7,500 doses, resulted in a 99.8 percent accuracy rate, according to Kosel. For now, the technicians check doses for automated dispensers, while pharmacists still conduct the final review for high-risk and intravenous drugs.

Medication Reconciliation:

At Good Samaritan Hospital in Puyallup, Wash., pharmacy technicians have pretty much taken over the medication-reconciliation process at admission. In too many cases, the medication lists at the time of a patient’s admission are inaccurate—a common story at hospitals across the country.

“We wanted to see how we could get a better list up front, because it’s not a primary focus of nursing and we don’t have enough pharmacists to obtain medication histories on all of our patients,” said Dianna Gatto, Pharm.D., BCPS, manager of pharmacy clinical services. “I thought we could train our technicians to do this.” So she did.

After a month-long pilot program involving two technicians, the program rolled out in the emergency department (ED), which treats about 175 patients daily (20 percent of whom are admitted). Since the program’s debut, it has expanded significantly, with three technicians working daily to spend an overlapping 28 hours on medication reconciliation. Medication lists are obtained for ED patients and direct admissions. A pharmacist reviews each updated medication list before physician reconciliation.

Pay attention pharmacists. If you want to change your practice environment make better use of pharmacy technicians. They’re more than capable of handling more advanced duties.