If you know me then you know that Iâ€™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, thereâ€™s a nice article in the most recent ASHP InterSections titled â€œInnovative Technician Practices Debuting in Hospitalsâ€. The article discusses not only tech-check-tech, which is the most commonly cited â€œadvancedâ€ technician practice, but the use of technicians to perform medication reconciliation as well.
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.
â€œWe have technicians checking other technicians for 75 to 80 percent of our medications,â€ said Brent Kosel, Pharm.D., M.S., pharmacy operations manager. â€œOur 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 patientsâ€™ clinical needs.â€
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.
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 patientâ€™s admission are inaccurateâ€”a common story at hospitals across the country.
â€œWe wanted to see how we could get a better list up front, because itâ€™s not a primary focus of nursing and we donâ€™t have enough pharmacists to obtain medication histories on all of our patients,â€ said Dianna Gatto, Pharm.D., BCPS, manager of pharmacy clinical services. â€œI thought we could train our technicians to do this.â€ 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 programâ€™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. Theyâ€™re more than capable of handling more advanced duties.
2 thoughts on “Expanding the role of pharmacy technicians”
I am curious about the safety impact your technician’s are having while performing this service? The current elements of performance in The Joint Commission NPSG’s depict this as the responsibility of a “qualified individual”; Do you consider your technicain’s qualified to this NPSG? More qualified than a pharmacist? I would truly like some honest feedback as I have been a part of a pharmacist-led med rec service for the past 3 years at a 450 bed acute care facility and I don’t see that our technician’s could adequately meet the safety aspects of this service. Thoughts? Feel free to phone me M-F 8a-4p at 615-456-5431. Sincerely.
Unfortunately I can’t really answer that question. I no longer practice in a hospital setting. I made the leap to the dark side and now work as a product manager for a company that specializes in pharmacy automation and technology.
I believe that technicians are more than capable of handling this type of activity, and I don’t think it would generate any safety issues. Of course, pharmacy administration will have to structure the program in such a way that education and procedure are the top priority. I think we underestimate the capability of our technician colleagues. I would highly recommend that you contact ASHP for some guidance. They have some great resources, including contact information for pharmacists across the country that are expanding the role of the pharmacy technician with great success. I’ve spoken with a few and they have me convinced. At the very least, do a lit search on the subject. You’ll be pleasantly surprised at what you find. If you would like to speak about this in more detail just let me know. I’d be happy to set up a time for us to talk by phone.