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The Great Technician

The Canadian Healthcare Network

The article below, written by Ali Aohouri, was published online February 12, 2016 on CANADIANHEALTHCARENETWORK.CA.
In our pharmacy design business we are adapting to the use of registered technicians so we thought we’d share the article with our readers. Hope you enjoy it

Exploring the benefits of registered pharmacy techs and busting some myths.

Recently, the Ontario College of Pharmacists published a great video on how to integrate regulated pharmacy technicians into practice to optimize workflow and patient experience.

In this blog, I will explore these benefits further and bust some myths! I apologize in advance to colleagues in other provinces as this will be a bit Ontario-centric, but I’m sure the ideas can be applied in other jurisdictions.

The fact is that integrating technicians into the workflow will open up the pharmacist’s time to focus on the ever-expanding clinical roles and responsibilities. Here are some great ways you can utilize a technician’s scope of practice to its fullest extent.

Tip 1. Hand the phone to techs

The doctor is on the phone calling in a prescription, the hospital pharmacist wants to verify a patient’s medication profile or a technician is calling to transfer a patient’s file. Train your staff to turn to the technician first before the pharmacist.
Since technicians cannot take verbal prescriptions for controlled drugs, your staff should answer the phone by saying: “I’ll get the right pharmacy staff to take your verbal order. Does the order include a controlled drug?”

Your staff have been used to calling a pharmacist every time, so coach them to pass the phone to the right person.

Tip 2. Delegate blister pack checks

Are you still checking blister packs even after the technician has checked them? If you are concerned that the technician is making mistakes, then use proper coaching techniques to rectify any skills deficiencies. But if you are simply duplicating work because you don’t trust the technician, then the problem may be you and not the technician.

The solution is to fully delegate the roles and responsibilities of blister pack technical verification to the technician. The pharmacist should perform a therapeutic verification at least every three months and whenever there is any change in the patient’s medication therapy (even if the drug is not in the blister pack).

For therapeutic verification, the pharmacist is not required to physically check the blister pack again. However, the pharmacist is required to document therapeutic assessment, such as using the Three Month Review (TMR) report in Kroll.

In this example, the technician will prepare the TMR report every three months or whenever there is a change in the medication profile, then the pharmacist reviews, documents and signs the report, which is subsequently scanned into the patient’s profile by an assistant.
Check with your pharmacy software vendor for options on how to generate and scan such reports for legal and auditing proposes. To further optimize workflow, train your pharmacist assistants to bill and package the blister packs in order to open up valuable time for the technician to perform other duties, such as technical verification of regular prescriptions.

Tip 3. …Make that all technical checks

Who is checking the regular prescriptions? Is the pharmacist still performing both technical and therapeutic verifications? To fully engage the technician and to optimize the pharmacist’s clinical experience, the technician should take charge of all technical verifications and not just for blister packs.

This will guarantee enhancements in your pharmacy’s workflow. It will save the pharmacist time and you will avoid the bottleneck effect as baskets tend to pile up beside the pharmacist, who is also responsible for counseling, MTMs and other clinical duties.

In fact, you can set up your pharmacy software to access therapeutic verification queue from the counseling room, so you can check on urgent prescriptions even if you are in a meeting with a patient. This will not disrupt your one-on-one session but will instead enhance your dispensary workflow.

Tip 4. Clarify everyone’s roles

Who should bill and package the prescriptions? I touched on this already. This is the role of the pharmacy assistants and clerks. Train your staff to better understand the specific roles and responsibilities of individual pharmacy members.

If you experience resistance, coach your staff and explain the benefits of integrating technicians. These benefits include a smoother and faster workflow in the pharmacy, more professional satisfaction for the pharmacist and technician and, above all, better patient experience.

Dispelling myths and misinformation

Now that I reviewed ways to integrate a technician into pharmacy workflow, let me address the elephant in the room: Many pharmacists are still holding back on embracing this change. Concerns range from fear of liability to loss of control of pharmacist’s roles and responsibilities and perhaps the greatest pharmacist fear of all: Loss of employment!

It’s a myth to believe that the pharmacist is liable for the technical verification done by a technician… This is untrue. The pharmacist is liable for the therapeutic verification and the technician holds a separate liability for the technical verification.

Therefore, I urge you to trust your technicians and let them practice their profession to the fullest extent. At the same time, please keep in mind that each scenario is unique and one cannot assume responsibility and liability without all the facts.

If you are afraid of losing control of your roles and responsibilities, then you need a reality check! The reason you are a pharmacist is that society believed that the existence of the pharmacy profession was in the public’s best interest and so the government enacted legislation to regulate the pharmacist title and to grant us authority to perform restricted acts for the benefit of the public.

Our roles and responsibilities have changed dramatically, as it has been shown that expanding the pharmacist’s scope of practice is in the public’s best interest. In other words, our roles and responsibilities are a privilege and may be changed or even eliminated if that was shown to be best for the public (I hope that’s not the case!).

So the technician’s role expanded because that would also benefit patients. To believe that the technician’s roles and responsibilities should only be performed by a pharmacist is just as shortsighted as the belief by some physicians that pharmacists should only dispense and not provide MTMs, assess drug therapy problems (DTPs), extend prescriptions or give flu shots.
And finally, why is it that we always believe that to hire a technician we must eliminate pharmacist hours? It is still possible for businesses to remain viable and at the same time integrate technicians into practice without eliminating pharmacist jobs.

If the overlapping pharmacist is only performing technical duties, such as entering prescriptions or checking blister packs, then perhaps a re-evaluation of that pharmacy’s labour model is in order.

That pharmacist is not practising his professional duties to the fullest extent and that position is neither professionally rewarding for the pharmacist nor financially viable for the business.

However, if overlapping pharmacists are inundated with therapeutic verification, patient counselling and requests for clinical services such as MTMs, DTP opinions, extension assessments, flu shots, etc., then adding a technician position is essential.

In this case, eliminating a pharmacist position will put the situation back to square one and may even negatively impact patient experience.

It is prudent that pharmacy owners who wish to eliminate overlap pharmacist positions reflect on the benefits of any financial gain at the expense of overwhelming a pharmacist with more professional duties, which may increase the risk of distractions and dispensing errors.
Why not consider replacing pharmacy assistant or clerk hours instead? We need both great pharmacists and great technicians in our pharmacies.