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Advancing Pharmacy Technician Roles
June 2014 - Vol. 11 No. 6 - Page #2

The role of the pharmacy technician has evolved significantly in recent years. In the past the technician was simply considered the pharmacist’s helper—responsible mainly for drug distribution activities—but now pharmacy technicians often play an integral role in their own right, and the option of becoming a technician has become a sought-after career choice for many. Technicians can, and should, play an increasingly vital role in ensuring medication safety and optimizing patient care. While traditional roles for technicians include drug acquisition, preparation, and distribution under a pharmacist’s supervision, non-traditional roles are worth considering.

As technician responsibilities have evolved, so has its attractiveness as a career choice. According to the Bureau of Labor and Statistics (BLS), employment of pharmacy technicians is expected to increase by 20% from 2012 to 2022.1 The BLS also suggests that pharmacy technicians with formal education and training, previous work experience, and national certification will be specifically sought after to fill these positions. To this end, the time to advocate for nationwide standards for training and certification of pharmacy technicians has come; consistent, universal standards for technicians would be especially effective to advance the role of technicians. As the career path for pharmacy technicians expands, evaluating non-traditional roles for technicians can introduce new opportunities to impact patient care.

The Children’s Mercy Hospital (CMH) inpatient pharmacy recognizes the benefits of implementing new opportunities for pharmacy technicians. Located in Kansas City, Missouri, CMH has two hospitals and five satellite facilities in the metropolitan area. As a comprehensive pediatric hospital, CMH provides more than 40 pediatric specialty services, is the region’s only level one pediatric trauma center, and has the region’s only critical care transport team. To improve patient care, the CMH inpatient pharmacy undertook a department-wide practice model change in February 2009 that relied heavily on the redeployment of pharmacy technicians to designated medical teams, coined the team technician model.

Reasons to Expand Pharmacy Technician Roles
Expanding the roles of pharmacy technicians can provide myriad benefits, including reduced costs, improved patient care, enhanced nursing/pharmacy communication, and increased technician job satisfaction by offering specific responsibilities and autonomy. Utilizing pharmacy technicians to their full potential can have a positive effect on the financial performance of the pharmacy. The average salary of a hospital pharmacist is approximately $115,000 per year,2 while the salary for a hospital pharmacy technician is about $35,000.3 Although the calculation is not completely linear, shifting more distributive duties to pharmacy technicians is certainly financially beneficial. Therefore, identifying opportunities in your pharmacy for technicians to take over drug distribution duties that do not require clinical knowledge is prudent.

Another significant reason to expand the roles of pharmacy technicians is the reduction of technician turnover due to lack of job fulfillment. Technicians who feel their contributions are respected and appreciated experience higher job satisfaction and are less likely to resign. The rate of technician turnover is more than double that of pharmacists—approximately 13%.4 This may be unsurprising, considering the monotony of the rote tasks many technicians perform for a majority of their workday. A technician who feels their work is valued and who has the potential to assume varied, advanced tasks will experience more job satisfaction. The department benefits by treating each employee as an investment that will increase in value. Moreover, data suggest that employees who enjoy their jobs are 12% more productive.5 Pharmacy technicians are inclined to work harder for their employers if they are supported and know their work is valued.

The Team Technician Model
When evaluating new roles for technicians, it is vital to consider licensure and safety. ASHP’s Pharmacy Practice Model Initiative (PPMI) to advance the use of pharmacy technicians in drug distribution was taken into consideration when creating the team technician model. The PPMI states that pharmacy technicians who have appropriate education, training, and credentials could be used much more extensively to free pharmacists from drug distribution activities.6 The intent behind the team technician model is to provide each nursing unit with a dedicated pharmacy technician who acts as a liaison between pharmacy and nursing to improve communication and simplify workflow. 

The team technician model also improves relations between pharmacy and nursing. It is not uncommon for the relationship between pharmacy and nursing to become strained. Assigning a pharmacy technician to a nursing unit opens up new lines of communication to an extent rarely experienced by either party. For example, the use of team technicians provides nursing with a point person to call with questions about the location or expected delivery time of medications, and also supports the formation of a positive relationship between the departments.

How It Works
Traditionally, technician duties are assigned on a task basis; for example, on a certain day, one technician may be charged with refilling an ADC, while another technician is responsible for hospital-wide delivery of medications. The majority of phone calls for missing doses are usually received in the main pharmacy where the technicians are responsible for dose production. 

The team technician model combines all of these duties into a single job, completed by one technician. The team technician is responsible for maintaining and refilling ADC stock on a daily basis, and loading new medications into the cabinet. Assigning a technician the responsibility of maintaining these cabinets allows nursing to pull all their daily medications from one cabinet, which drastically reduces administration times. The team technician also is responsible for all medication deliveries to their area; thus, the technician is aware of the status of the medication deliveries throughout the day and can be a resource to nursing or other members of pharmacy when necessary. In addition to the specialized duties required for their floors, the team technicians play an integral role in the main pharmacy. All team technicians are involved in non-sterile dose production, as well as compounding and re-packaging of medications. 

When one technician completes all essential tasks for a given area, communication between nursing and pharmacy is crucial. The team technicians are issued phones that allow them to remain in constant contact with nursing, as well as the main pharmacy. Instead of multiple phone calls being made to the main pharmacy regarding a missing dose, nursing contacts their technician directly to locate the medication. 

The team technician model at CMH was developed based on the physical layout of the hospital, as well as patient acuity. The pediatric intensive care unit and the neonatal intensive care unit each are assigned their own team technician. The remainder of the inpatient floors are divided among the technicians, with each technician responsible for roughly the same number of ADCs. CMH’s main campus currently staffs five team technicians per shift, which allows for full team technician coverage from 6AM to 9:30PM. 

Creating a New Job Model
When developing the team technician model in the hospital setting, it is essential to create job outlines that specify each technician’s unique responsibilities. An additional benefit of developing this model is to provide technicians freedom to complete tasks independently and troubleshoot challenges without direct supervision. This autonomy is an important element of increased job satisfaction. To develop these job outlines, certain questions must be answered:

  • How should the hospital be divided into teams, based on physical layout, patient acuity, or a combination of both?  
  • Will national certification be required for team technicians? 
  • How much experience is adequate to complete the responsibilities independently? How much pharmacist oversight is required?
  • What and how many responsibilities should be assigned to each team technician? 

Results
Utilizing a team technician approach has improved patient care at CMH. Moreover, nursing is extremely pleased with the program, as they realize the benefits from increased communication, improved employee morale, and enhanced time management. Having access to a single individual who prioritizes their unit’s specific needs enables quick resolution to daily challenges. In addition, the team technician model has improved technician job satisfaction and allowed pharmacists to focus on tasks that require clinical expertise.

As the roles of pharmacy technicians are rapidly changing, the development of consistent nationwide standards would be especially useful to guide the process. In the absence of nationwide standards, each hospital must evaluate the opportunities available to assist each technician in creating the technician career path.

References

  1. US Department of Labor. Bureau of Labor Statistics Web site. Occupational Outlook Handbook: Pharmacy Technicians. http://www.bls.gov/ooh/healthcare/pharmacy-technicians.htm Accessed May 19, 2014.
  2. US Department of Labor. Bureau of Labor Statistics Web site. Occupational Employment Statistics. Occupational Employment and Wages, May 2013, 29-1051 Pharmacists.http://www.bls.gov/current/oes291051.htm Accessed May 20, 2014.
  3. US Department of Labor. Bureau of Labor Statistics Web site. Occupational Employment Statistics. Occupational Employment and Wages, May 2013, 29-2052 Pharmacy Technicians.http://www.bls.gov/oes/current/oes292052.htm Accessed May 20, 2014.
  4. American Society of Health-System Pharmacists. 2011 ASHP Pharmacy Staffing Survey Results. http://www.ashp.org/DocLibrary/MemberCenter/SPPM/2011-Staffing-Survey.aspx. Accessed May 20, 2014.
  5. Oswald AJ, Proto E, Sgroi D. Happiness and productivity (working paper). http://www2.warwick.ac.uk/fac/soc/economics/staff/academic/proto/workingpapers/happinessproductivity.pdf Accessed May 19, 2014.
  6. The consensus of the Pharmacy Practice Model Summit. Am J Health-Syst Pharm. 2011;68:1148-1152.

Rachel Eckles, BS, CPhT, is the coordinator of pharmacy purchasing at Children’s Mercy Hospital in Kansas City, Missouri.


Jennifer Comford, CPhT, is the lead technician of inpatient pharmacy at Children’s Mercy Hospital. 

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