The association between number of learners and pharmacist and technician levels of burnout.

PURPOSE: Little is known about the relationship between learner load and pharmacist and pharmacy technician burnout. Therefore, the purpose of this study was to examine the association between burnout and the number of learners (residents, students, and new employees) assigned to pharmacists or pharmacy technicians. METHODS: A validated survey to measure burnout and professional fulfillment was administered to employees of a university health system's pharmacy service in 2019. A threshold analysis determined the optimal cutoff for number of learners trained that maximized the ability to predict binary outcomes. Chi-square and Fisher's exact tests were used, and effect sizes between percentages were reported. Finally, the adjusted associations between number of learners and outcomes were assessed using logistic regression. RESULTS: A total of 448 pharmacy staff members were included in the analysis. Of those, 57% (n = 254) worked in ambulatory care, 27.4% (n = 122) worked in an inpatient setting, and 15.7% (n = 70) worked in infrastructure. Pharmacists working in an inpatient setting who reported training 4 or more learners per year indicated significantly higher rates of burnout than those training fewer learners on both a single-item burnout assessment (64.3% vs 31.0%; P = 0.01; effect size, 0.68) and a 10-item burnout assessment (54.8% vs 13.8%; P = 0.01; effect size, 0.91). Similar results were not observed in pharmacists working in ambulatory care and infrastructure positions or in pharmacy technicians. CONCLUSION: Added precepting and training responsibilities may be associated with higher levels of burnout among pharmacy team members, particularly inpatient pharmacists.

Improving Patient Access to Primary Care Providers Using a Pharmacist-Physician Co-Visit Model.

Background: Implementation of a clinical pharmacist in the primary care setting can offset provider time spent managing chronic diseases using Collaborative Practice Agreements (CPAs). The pharmacist-physician co-visit model presents an opportunity for pharmacists to increase patient access to their primary care provider (PCP). Studies of the co-visit model show that co-visits increase clinic efficiency by allowing the PCP to see additional patients and achieve more health care goals compared with independent visits1-4. Objectives: The aim of this study was to increase patient access to their PCP by utilizing a pharmacist-physician co-visit model at the Madsen Health Center Family Medicine (MHC FM) Clinic. The primary outcome was to identify the number of co-visits completed compared to the number of possible co-visits, and the number of appointment slots made available. The secondary outcomes were to track the time spent with patients and to obtain provider feedback via a survey. Methods: The co-visit model was implemented as a 4-month pilot study at the MHC FM Clinic. Complex care appointments lasting 40 minutes were selected based on inclusion and exclusion criteria. Potential co-visit appointments were identified one week prior then provider consent was obtained to change the appointment into two separate 20-minute visits. Schedules were reviewed to determine if the appointment slot opened by the co-visit was filled by another patient. Upon completion of the study, a survey was distributed to providers to collect feedback. Results: A total of five co-visits were completed out of a possible 19 (26%). All the appointments made available were filled by another patient. On average, the provider and pharmacist spent 15 and 14 minutes with the patient, respectively. Conclusion: Implementation of the physician-pharmacist co-visit model increased the availability of the PCP to see more patients without disrupting clinic workflow and provider schedules.

Assessment of pharmacy technician job satisfaction and duties in ambulatory care pharmacy settings: A mixed-methods analysis.

PURPOSE: Expansion of pharmacy services into ambulatory care has prompted the integration of pharmacy technicians into this setting. Many models exist for technician practice in ambulatory care, and job satisfaction in these settings needs evaluation. This study assessed the job satisfaction of ambulatory care pharmacy technicians, obtained a deeper understanding of their varied roles, and examined commitment to the pharmacy technician career and their employing organization. METHODS: This study used a mixed-methods sequential explanatory design of quantitative followed by qualitative data analysis. The phases included a validated questionnaire on job satisfaction and semistructured interviews using a modified guide and findings from the quantitative data. Descriptive statistics and constant comparative analysis were used to analyze quantitative and qualitative data, and data were integrated in the discussion. RESULTS: The questionnaire was sent to 125 potential participants at 11 organizations in 8 unique states. Seventy-four technicians participated in the quantitative phase. Seventeen of these were interviewed in the qualitative phase. Interviewees represented 7 different institutions in 6 states in the Southeast, Midwest, and Western regions of the US. Both phases indicated that respondents felt a strong commitment to their organization, with 60% of respondents indicating this on the questionnaire. Reasons for this commitment were further elucidated in the qualitative phase, which indicated high satisfaction with technician autonomy, work schedules, and ability to provide important services to patients. It was also found in both phases that technician duties varied greatly among organizations, although most technicians were involved in facilitating medication access. CONCLUSION: Ambulatory care pharmacy technicians are highly satisfied with their positions and careers. Although technician roles vary within ambulatory care settings, the majority involve facilitating medication access in various ways. As these positions become more prevalent in pharmacy practice, it will be important to continue to capitalize on satisfiers and mitigate dissatisfiers to advance the profession and ultimately provide optimal patient care.

Comparison of a Self-Care Therapeutics Course Taught in the P1 vs the P2 Year.

Objective: The objective of this study was to compare student learning outcomes, behaviors, and attitudes in a non-prescription drug and self-care therapeutics course taught in the second professional (P2) year vs the first professional (P1) year at one pharmacy school. Methods: Mean performance of students by class year on case consultations and exam scores was compared. Focus groups with student volunteers and course teaching assistants (TAs) and one-on-one interviews with a subset of instructors were conducted by an outside educational evaluation specialist to capture perceptions of student learning behaviors and attitudes. Results: There was no difference in performance on graded case consultations (mean difference = 0.16, P = .74, 95% CI [-0.77 to 1.09]), mid-term examinations (mean difference = 0.53, P = .62, 95% CI [-1.59 to 2.65]), or final examinations (mean difference = 0.73, P = .57, 95% CI [-1.83 to 3.30]) between P1 and P2 students. P1 students reported being more consistent in completing pre-class readings and in feeling less distracted by other courses than did P2 students. Students, TAs, and instructors consistently spoke about advantages of the course in the P1 year (e.g., less stress and greater eagerness to learn and apply skills at work) and disadvantages in the P2 year (e.g., distraction from concurrent P2 integrated pharmacotherapeutics course and tension between real-world experience and constraints of grading rubric). Conclusion: P1 students, despite one year earlier in their curriculum, performed equally well as P2 students. All stakeholders agree that the advantages of teaching a self-care course on students' learning behaviors and attitudes in the P1 year outweigh disadvantages.

Burnout, professional fulfillment, sleep impairment, and self-compassion within an academic medical center pharmacy department.

PURPOSE: To examine the prevalence of burnout, professional fulfillment, sleep impairment, and self-compassion within an academic medical center pharmacy department across varying job titles and practice settings. METHODS: In fall 2019, pharmacy staff completed a REDCap-based survey that consisted of a validated instrument relating to burnout, professional fulfilment, sleep-related impairment, and self-compassion. Burnout was measured by both single-item and extended 10-item questions on the survey. Survey outcomes from each domain were compared between pharmacists and pharmacy technicians/interns, as well as among practice settings (inpatient, ambulatory care, and infrastructure). RESULTS: A total of 593 surveys were completed by pharmacy personnel, representing a preliminary response rate of 71.8% (593/826). A total of 505 survey responses were analyzed (235 [46.5%] for pharmacists and 270 [53.5%] for pharmacy technicians/interns). Inpatient pharmacists reported the highest level of burnout (50.7%), followed by ambulatory care pharmacists (29.3%) and those working in infrastructure (24.3%). Pharmacy technicians working in infrastructure reported the highest level of burnout (36.4%), followed by inpatient (30.8%) and ambulatory care (28.3%) pharmacy technicians. There was no association between job type or location and burnout according to both single-item and 10-item burnout measures. A higher rate of burnout, sleep impairment, and decreased self-compassion and a lower rate of professional fulfillment were observed for inpatient pharmacists compared to pharmacists in ambulatory care or infrastructure. Except for higher rates of reported professional fulfillment, a similar trend was observed for pharmacy technicians. CONCLUSION: Burnout was reported across the pharmacy team regardless of practice site.

Effects of 5 Dynamics on student perception of team performance.

INTRODUCTION AND LEADERSHIP FRAMEWORK: Leadership development has emerged as an essential component of pharmacy school curricula. Recognizing the need for curricular integration of leadership and teaming throughout each year, the University of Utah implemented a longitudinal leadership framework called Relational Leadership. 5 Dynamics was used as a tool to teach concepts of effective teamwork and leadership in different courses within this framework. EDUCATIONAL CONTEXT AND METHODS: 5 Dynamics was used within two courses in the curricula. 5 Dynamics is designed to enhance self-awareness and improve team skills by providing a detailed assessment of how each student prefers to work and collaborate and how their respective preferences or energies can be utilized in a team setting. Learning outcomes were assessed using the Team Performance Survey. FINDINGS AND DISCUSSION: Each student was provided with an individualized energy profile from 5 Dynamics and used their particular energies to complete various activities, assignments, and projects. The highest energy was Examine, with 61% of students being either "effortless" or "abundant". A total of 64% of students reported they strongly agreed with the statement that they understood how to apply their 5 Dynamics results to learning, work, and collaboration. Student survey scores from the Team Performance Survey administered at the end of each course indicated high-quality team interactions between students. IMPLICATIONS: 5 Dynamics is a tool that may help students in maximizing their leadership and teamwork skills. This tool may be utilized by other institutions in diverse courses to teach concepts of teaming, leadership, and self-awareness.

Diabetic Nephropathy Screening in a Residency Clinic: Improvements Also Reveal Limits of Healthcare Effectiveness Data and Information Set (HEDIS) Metric.

Quality Improvement Success Stories are published by the American Diabetes Association in collaboration with the American College of Physicians, Inc., and the National Diabetes Education Program. This series is intended to highlight best practices and strategies from programs and clinics that have successfully improved the quality of care for people with diabetes or related conditions. Each article in the series is reviewed and follows a standard format developed by the editors of Clinical Diabetes. The following article describes a resident-led initiative that improved diabetic nephropathy screening in a primary care clinic. It also highlights the challenges of complex metrics, as well as the potential unintended consequences of emphasizing one dimension of a care process over another.

Volunteering as medical staff at a diabetes summer camp as a component of a pharmacy residency program.

A number of summer camps across the country have been developed specifically for children with diabetes, most of whom would not be able to attend a traditional summer camp due to the extensive medical attention and scheduling considerations required to continually maintain appropriate glycemic control. These camps rely on the service of various medical practitioners to ensure the safety of the children. In addition to providing an important service to the campers, volunteering at such camps offers both personal and professional rewards for the practitioners. Furthermore, such experiences provide tremendous learning opportunities for medical trainees. However, while a limited number of articles were identified discussing the experience of nurses, physicians, and pharmacy students volunteering at diabetes camps, no such accounts from the perspective of pharmacy residents were found in the medical literature. This educational case report briefly describes the recent experience of ambulatory care pharmacy residents serving as diabetes camp medical staff.