Unmasking the Unrecognized: Exploring Registered Pharmacy Technicians' Stressors During COVID-19 Through a Demands-Resources Inquiry and Looking Ahead.

Canadian registered pharmacy technicians (RPTs) were vital in supporting pharmacy operations during the pandemic. However, they have received little attention during or pre-pandemic. This study aimed to identify and understand the stressors experienced by Canadian RPTs during the pandemic and gain insights on lessons learned to help improve the profession. Through a descriptive qualitative design, virtual semi-structured focus groups were conducted with RPTs who were recruited through various sampling methods across Canada. Data were inductively analyzed and then deductively; themes were categorized using the Job Demands-Resources (JD-R) model. We reached data saturation after 4 focus group sessions with a total of 16 participants. As per the JD-R model, job demands included: (1) increased work volume and hours to meet patient demand; (2) drug shortages and managing prescriptions increased due to influx of orders coinciding with restricted access to medications; (3) fear of the unknown nature of COVID-19 met with frequent change in practices due to protocol changes and ineffective communication; and, (4) the pandemic introduced several factors leading to increased staff shortages. Themes pertaining to resources included: (1) poor incentives and limited access to well-being resources; (2) limited personal protective equipment delaying work operations; (3) and a general lack of knowledge or appreciation of the profession impacting work morale. Lessons learned from the pandemic were also provided. Overall, our findings revealed an imbalance where RPTs experienced high job demands with limited resources. Improved leadership within pharmacies, including improved communication between team members, is required. Furthermore, efforts to highlight and recognize the work of RPTs to the public is important to help improve enrollment, especially with their recent scope of practice expansion.

Pharmacy work: Intrinsic motivation and extrinsic rewards across role and setting.

BACKGROUND: Pharmacists' and pharmacy technicians' stress and job turnover are at an all-time high. Both intrinsic motivations and extrinsic rewards play key roles in workplace satisfaction. Differences in workplace satisfaction have been identified when comparing chain pharmacies, independent pharmacies, and health systems work settings. OBJECTIVES: Cognitive evaluation theory was applied to explore the influence of intrinsic motivations and extrinsic rewards on both pharmacists' and pharmacy technicians' perceptions of motivations and rewards across various workplace settings. METHODS: A 92-item questionnaire was administered to 129 pharmacists and 111 pharmacy technicians. Participants were primarily recruited at a state pharmacy association annual meeting and via online forums. The questionnaire captured participant demographics including role and work setting (i.e., chain, independent, or health systems), demographic variables, and perceptions about work including autonomy, competence, relationships, pay satisfaction, and benefit satisfaction. RESULTS: A 2-way multivariate analysis of covariance was conducted to test hypothesized differences by role (pharmacist or pharmacy technician) and setting (chain, independent, or health systems). Results show pharmacy personnel in independent and hospital systems settings felt more positive about relationships, competence, pay satisfaction, and benefit satisfaction than those in chain settings. There were no role differences between pharmacists and pharmacy technicians on these outcomes. DISCUSSION: These findings highlight challenges of working in chain pharmacy environments. Results reveal that although pay does not differ across work settings, feelings about both the work and compensation satisfaction do vary across settings. Because role did not drive these relationships, this suggests a need to attend to working conditions for pharmacy personnel. CONCLUSION: Intrinsic motivation elements of competence and relationships are statistically different among employment settings. Relationships and feelings of competence are perceived more favorably in independent and health systems, rather than chain settings. More studies on intrinsic motivations of pharmacy employees within these settings are needed.

Assessment of technology-assisted technician verification of compounded intravenous sterile preparations versus pharmacist verification.

PURPOSE: This study is an evaluation of technology-assisted technician verification (TATV) of the compounded sterile product (CSP) preparation process as an alternative to final verification by a pharmacist. METHODS: A 2-phase, single-center noninferiority study was conducted to assess the accuracy and CSP processing time with TATV versus pharmacist verification. Phase I of the study was a validation of the internal pharmacist accuracy rate in which 2 pharmacists checked each CSP. In phase II, prepared CSPs were first checked by a technician and then checked by a pharmacist. Technicians were required to complete baseline credentialing and training requirements to participate in the study. The primary outcome was the error rate for the pharmacist check in phase I and the error rate of the technician check in phase II. Secondary outcomes included total verification time and total dose processing time in each phase. The Farrington-Manning test was used for noninferiority assessment of accuracy, and the Wilcoxon rank sum test was used to detect a difference between the processing times. RESULTS: A total of 4,000 doses were checked in each phase. Pharmacist accuracy was 99.600% in phase I, compared to TATV accuracy of 99.575% in phase II. TATV of CSPs was noninferior to pharmacist verification (absolute difference in accuracy, 0.025%; 95% CI, -0.26% to 0.31%; P = 0.0016). Total verification time and total dose processing times were significantly lower in Phase II. CONCLUSION: This study showed that TATV of CSPs is noninferior to pharmacist final verification and does not negatively impact the time to check CSPs or total CSP processing time.

Pharmacy technicians trained as community health workers: A prospective multicenter cohort study.

BACKGROUND: Community health workers (CHWs) are health professionals who are experts in linking patients to health resources. Although CHWs are employed in a variety of health institutions, access to their services may be challenging for patients in underserved locations. Community pharmacies are uniquely positioned to mitigate this barrier as they provide readily accessible care for patients residing in these areas. OBJECTIVES: To 1) quantify and report the CHW services provided by certified pharmacy technicians (CPhTs) in an underserved population and 2) provide an initial framework for the implementation of CHW services in community pharmacies or similar health care settings. METHODS: This prospective cohort study reports the findings of training CPhTs as CHWs in 3 independent community pharmacies from January 1, 2021 to July 1, 2021. CPhT-CHWs conducted monthly visits by phone, patient home, or pharmacy and documented services using a standardized assessment form. Descriptive statistics were used to summarize the baseline characteristics of the patient population, service codes, types of services and referrals made, and time spent per visit by CPhT-CHWs. RESULTS: A total of 198 patient visits by phone, patient home, or at the pharmacy were completed in a 6-month timespan. During these visits, the CPhT-CHW provided 351 services (203 primary services and 149 secondary services) and completed 51 referrals. The average time spent per visit (standard deviation) was 15.5 (11.5) 68.9 (35.4), and 30.6 (16.8) minutes for phone, home, and pharmacy visits, respectively. Patient home visits resulted in the highest average primary services per visit, longest time spent with the patient, and accounted for a majority of social services. CONCLUSION: CPhT-CHWs were able to use various methods to contact these patients to further develop patient-to-provider and patient-to-pharmacy relationships. Training CPhTs as CHWs can be an effective way to increase patient contact and provide additional health services.

Pharmacy technician development: Insight into training, preparedness, and career-path perceptions.

BACKGROUND: Although opportunities for pharmacy technicians may be expanding, an increasing number of technicians have transitioned out of their roles. It is important to consider what could be done within education and training to promote the retention of pharmacy technicians. OBJECTIVES: The purpose of this study was to survey pharmacy technicians in the state of Ohio to identify key components of professional development. METHODS: A survey was distributed through REDCap to 24,444 pharmacy technicians with active pharmacy technician licenses in the state of Ohio. Inclusion criteria required survey respondents to be at least 18 years old and currently working as a pharmacy technician. RESULTS: A total of 1386 surveys were fully completed (approximately 6% response rate). Professional development opportunities provided by employers varied across most practice sites, but continuing education was the most reported opportunity. Attending conferences, taking specialized training courses, and tuition reimbursement were less common. The top 3 barriers to professional development participation included additional cost, time, and perceived value. Guidance and mentorship from peers, achieving national certification, and formal on-the-job training were the most helpful in job preparation and training. The main reasons to achieve certification included increased pay, development opportunity, or employer requirement. When considering preparation for new roles, 57% of pharmacy technicians felt prepared or very prepared for the job after 90 days. As technicians continued throughout their careers, the training transitioned from formal hands-on training to self-guided training. CONCLUSION: Pharmacy technicians have a desire to remain in their roles, but participation in professional development opportunities was lacking owing to availability of options and barriers. Pharmacy practice sites interested in retaining technicians should invest in offering and encouraging pharmacy technicians to participate in development opportunities. To continue to develop pharmacy technicians, ongoing education and training tied to increased compensation may improve retention and foster an improved learning environment.

Implementation of a technician success and onboarding coordinator to reduce technician turnover.

PURPOSE: This article provides an overview of changes implemented at an academic medical center to reduce pharmacy technician turnover. SUMMARY: Pharmacy technician turnover has been a problem for years. Technicians come and go; they move on to other positions, and continuous turnover is an avoidable expense. With greater focus on creating a successful onboarding experience for newly hired technicians, turnover should decrease and satisfaction and engagement should increase. When a newly hired technician leaves a department within the first year, it can have a negative impact on the engagement of the remaining technicians who spent time training new hires in how to complete tasks, mentoring them, and incorporating them into the team. Creating a positive onboarding experience will decrease expenses accrued and minimize wasted resources and staff time dedicated to a technician who will not be around in 6 months to 1 year. At M Health Fairview, a Minneapolis, MN-based health system, technician retention has been improved through a standardized approach to onboarding and orientation, including creation of the new staff role of technician success and onboarding coordinator (TSOC). CONCLUSION: A standard approach to onboarding pharmacy technicians and integrating them into the pharmacy department has proven to be essential to technician retention at M Health Fairview. To get started, it is important to find the right person for the TSOC role to coordinate successful onboarding of newly hired pharmacy technicians. That person should be an individual with passion to engage and inspire newly hired technicians, with several years of experience, and with the ability to cascade knowledge.

Health-system specialty pharmacy: Overview of a hybrid clinical model.

PURPOSE: The prevalence of specialty pharmacies has grown, especially within the hospital setting. These pharmacies have shown benefits in the areas of patient education and adherence, financial support, and patient and provider satisfaction. Currently, there are gaps in literature describing use of a hybrid clinical model in health-system specialty pharmacies. SUMMARY: The UofL Health - UofL Hospital Specialty Pharmacy (UofL Health SP) is attached to a retail pharmacy in a larger health system. Pharmacists in the UofL Health SP utilize a hybrid clinical model in which they split their time between working in a specialty clinic and staffing in the specialty pharmacy. The specialty pharmacy and its oncology satellite pharmacy each have a primary staffing pharmacist, and 5 other pharmacists participate in this hybrid clinical model. In addition to the specialty pharmacists, pharmacy technicians and patient care advocates support the operations of the specialty pharmacy and ensure financial access to medications for patients. CONCLUSION: With the hybrid clinical model at UofL Health SP, there is increased workflow efficiency and better communication between specialty clinics and the specialty pharmacy, which results in a streamlined patient experience. Additionally, there has been an increase in specialty pharmacy prescriptions dispensed in the specialty pharmacy since the implementation of this hybrid clinical model.

Evaluation of technician immunization administration.

OBJECTIVES: To (1) assess technician and supervising pharmacists' attitudes and perceptions toward technicians administering immunizations after a technician training initiative, (2) describe the public health impact of technician-administered COVID-19 immunizations, and (3) describe best practices for technician-administered immunizations. DESIGN: A mixed-methods study collected quantitative and qualitative data. SETTING AND PARTICIPANTS: Kentucky technicians who completed an immunization administration training, and their supervising pharmacists. OUTCOME MEASURES: Surveys were administered to Kentucky technicians who completed immunization administration training between January and September 2021. Surveys assessed the effectiveness of the training, integration of technicians in the immunization workflow, and impact of technicians in their organization's immunization efforts. Similar surveys were deployed to supervising pharmacists. Response frequencies were recorded for each question and descriptive statistics were calculated for each item included in the survey. Key informant interviews were conducted with technicians and pharmacists to further explore study concepts, assess needs, and discuss best practices for implementation. Interviews were audio recorded, transcribed verbatim, and analyzed using inductive thematic analysis. RESULTS: Fifty-seven technicians and 37 pharmacists responded to the survey. Technicians were easily integrated into community pharmacy immunization workflow that allowed for increased immunization administration. Ninety-four percent of supervising pharmacists and 98% of technicians supported the use of technicians in the immunization workflow beyond the pandemic. Twenty-seven interviews were conducted. Major themes that emerged from the data included using the "right" technicians, role delineation and collaboration, policies, logistics, financial implications, and public health impact. CONCLUSION: The utilization of pharmacy technicians in administration helped to accelerate the immunization process, alleviate the burden on pharmacists and other health care professionals, and ensure widespread vaccine distribution to combat the pandemic.

Compensation for Board of Pharmacy members in the United States.

BACKGROUND: No published data exist regarding per diem pay differences between the 50 United States Boards of Pharmacy. OBJECTIVES: The purpose of this study was to quantify and compare the per diem pay rate of Board of Pharmacy members for each state in the U.S. Compensation for mileage and meals, as well as demographic information regarding U.S. Board of Pharmacy members, was also evaluated. METHODS: In June 2022, each state Board of Pharmacy was contacted to gather data including per diem pay, mileage and meal compensation, number of meetings per year, number and gender of Board members, length of appointment, and regulatory statutes. RESULTS: The average per diem pay for Board members was $75.86 (median = $50.00, range = $0.00-$250.00, n = 48 states). Most states report paying Board members for mileage (95.1%, n = 39 of 41) and meals (80.0%, n = 28 of 35). On average, Boards are composed of 8.3 members (median = 7.5, range = 5-17, n = 50), meet 8.3 times annually (median = 8, range = 3-16, n = 47), and have a 4.5-year length of appointment (median = 4, range = 3-6, n = 47). Men represented 61.2% of occupied Board positions, and pharmacists accounted for 74.2% of all positions. The average year for per diem pay statute update was 2002. CONCLUSION: The per diem pay for U.S. Board of Pharmacy members varies from state to state, ranging from unpaid (n = 8 states) up to $250.00 per diem. Fair compensation, increased pharmacy technician and women representation, and more timely pharmacy statute updates are necessary in order to achieve inclusion, diversity, and equity across state Boards of Pharmacy.

ASHP National Survey of Pharmacy Practice in Hospital Settings: Workforce - 2022.

PURPOSE: Results of the 2022 ASHP National Survey of Pharmacy Practice in Hospital Settings are presented. METHODS: Pharmacy directors at 1,498 general and children's medical/surgical hospitals in the United States were surveyed using a mixed-mode method of contact by email and mail. Survey completion was online. IQVIA supplied data on hospital characteristics; the survey sample was drawn from IQVIA's hospital database. RESULTS: The response rate was 23.7%. Inpatient pharmacists independently prescribe in 27.1% of hospitals. Advanced analytics are used in 8.7% of hospitals. Pharmacists work in ambulatory or primary care clinics in 51.6% of hospitals operating outpatient clinics. Some level of pharmacy service integration is reported in 53.6% of hospitals. More advanced pharmacy technician roles are emerging. For health systems offering hospital at home services, 65.9% of pharmacy departments are involved. Shortages of pharmacists and technicians were reported but are more acute for pharmacy technicians. Aspects of burnout are being measured in 34.0% of hospitals, and 83.7% are attempting to prevent and mitigate burnout. The average number of full-time equivalents per 100 occupied beds is 16.9 for pharmacists and 16.1 for pharmacy technicians. CONCLUSION: Health-system pharmacies are experiencing workforce shortages; however, these shortages have had limited impact on budgeted positions. Workforce challenges are influencing the work of pharmacists and pharmacy technicians. Adoption of practice advancement initiatives has continued the positive trend from past years despite workforce issues.

Pharmacy personnel comfort and confidence in screening for social needs: A pilot study.

BACKGROUND: Addressing social needs (such as lack of adequate housing, food, and transportation) has been shown to improve medication adherence and overall patient outcomes. However, screening for social needs during routine patient care can be challenging due to lack of knowledge of social resources and adequate training. OBJECTIVES: The primary objective of this study is to explore the comfort and confidence of community pharmacy personnel in a chain community pharmacy when discussing social determinants of health (SDOH) with patients. A secondary objective of this study was to assess the impact of a targeted continuing pharmacy education program in this area. METHODS: Baseline confidence and comfort were measured through a brief online survey consisting of Likert scale questions regarding various aspects of SDOH (e.g., importance and benefit, knowledge of social resources, relevant training, workflow feasibility). Subgroup analysis of respondent characteristics was conducted to examine differences between respondent demographics. A targeted training was piloted, and an optional posttraining survey was administered. RESULTS: The baseline survey was completed by 157 pharmacists (n = 141, 90%) and pharmacy technicians (n = 16, 10%). Overall, the pharmacy personnel surveyed lacked confidence and comfort when conducting screenings for social needs. There was not a statistically significant difference in comfort or confidence between roles; however, subgroup analysis revealed trends and significant differences between respondent demographics. The largest gaps identified were lack of knowledge of social resources, inadequate training, and workflow concerns. Respondents of the posttraining survey (n = 38, response rate = 51%) reported significantly higher comfort and confidence than the baseline. CONCLUSION: Practicing community pharmacy personnel lack confidence and comfort in screening patients for social needs at baseline. More research is needed to determine if pharmacists or technicians may be better equipped to implement social needs screenings in community pharmacy practice. Common barriers may be alleviated with targeted training programs to address these concerns.

[Preparation of injectable anticancer drugs within chemotherapy preparation unit: What levers are available to optimize and secure production?] / Préparation des traitements anticancéreux injectables au sein d'une unité de pharmacotechnie : quels leviers disponibles pour optimiser et sécuriser la production ?

Preparation of injectable anticancer drugs is centralized within chemotherapy preparation unit of hospital pharmacies under pharmaceutical responsibility. Improving the chemotherapy preparation unit's efficiency in the face of increasing demand, resource constraints and the need to ensure high quality is a challenge. Hospital pharmacists in search of efficiency in order to combine productivity and quality, have several tools to respond to this problem. These are in particular the quality management, whether they go through certification or not, a source of rationalization of activities and which will strengthen the cohesion of the staff through common objectives. The management of production flows, early preparation or dose-banding will allow a smoothing of activity reducing the risk of medication error and patient waiting times. The continuous training of hospital pharmacy technicians is an important lever so that they acquire and then maintain these specific skills. Finally, the use of the most recent technologies constitutes an important part of the possibilities offered to hospital pharmacists : computerization, automated production and quality controls.