National Dialogue on Pharmacy Technicians Panel/Plenary and Breakout Discussions Summary of Outcomes PREPARED BY: JANUARY 14, 2007

Transcription

1 National Dialogue on Pharmacy Technicians Panel/Plenary and Breakout Discussions Summary of Outcomes PREPARED BY: JANUARY 14, 2007

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3 Acronyms Alberta College of Pharmacists (ACP) Association Québécoise des Assistant(e)s-Techniques en Pharmacie Secteur Public et Secteur Privé (AQATP) Canadian Association of Pharmacy Technicians (CAPT) Canadian Council for Accreditation of Pharmacy Programs (CCAPP) Canadian Pharmacists Association (CPhA) Canadian Pharmacy Practice Research Group (CPPRG) Canadian Pharmacy Technician Educators Association (CPTEA) Canadian Society of Hospital Pharmacists (CSHP) College of Pharmacists of British Columbia (CPBC) Association des Pharmaciens des Établissements de Santé du Québec (A.P.E.S.). Association Québécoise des Pharmaciens Propriétaires (AQPP) Association paritaire pour la Santé et la Sécurité du Travail du Secteur Affaires Sociales (ASSTSAS) Ordre des Pharmaciens du Québec (OPQ) National Association of Pharmacy Regulatory Authorities (NAPRA) Ministère de l Éducation, du Loisir et du Sport du Québec (MELS) Ontario College of Pharmacists (OCP) The Pharmacy Examining Board of Canada (PEBC) Provincial Pharmacy Regulatory Authorities (PRAs) Saskatchewan College of Pharmacists (SCP) 2008 Canadian Pharmacists Association 1

4 Background On Wednesday April 10, 2002 a meeting of national pharmacy technician stakeholder organizations and educators was convened at the OCP office in Toronto. The stated goal of that meeting was to achieve consensus on a national strategy to develop the role of pharmacy technicians to support pharmacy practice. The participants articulated a broad set of actions or areas needing attention if such a national strategy was to be a reality. These can be summarized as, the need to: develop a set of principles to guide the development of technician roles and responsibilities; define a national competency profile for technicians; examine a process for voluntary certification for pharmacy technicians; examine a possible regulatory approach, and ensuing need to define building blocks required for regulated or registered pharmacy technicians; and develop a plan for accreditation of pharmacy technician programs. A specific funding proposal to move forward on these actions was developed by the CPhA and CAPT and submitted to Human Resources and Skills Development Canada (HRSDC) to further the ideas set out by this group; unfortunately, it was not accepted. Nevertheless, pharmacy technician stakeholders have risen to the challenge and successfully carried out many of the actions proposed at that original meeting. Some examples include: National entry-to-practice competencies for pharmacy technicians (NAPRA) Process and standards to accredit community college pharmacy technician programs (CCAPP) Educational outcomes for pharmacy technician education programs (CPTEA) Progress on national certification and evaluation exams for pharmacy technicians (PEBC) Successfully assembling the building blocks to enable pharmacy technician registration or regulation in several provinces, from initial consultations all the way to provincial legislative changes. (e.g. ON, BC, AB) Moving Forward: Pharmacy Human Resources for the Future At the same time, another funding proposal to HRSDC, focusing on pharmacy human resources (HR) needs (not just technicians) was developed. This is now known as Moving Forward: Pharmacy Human Resources for the Future (Moving Forward). Moving Forward is a project strategically focused on pharmacy HR pharmacists and pharmacy technicians. The questions that lay at the heart of the effort revolve around recruiting, training, deploying and retaining the people required to meet the pharmacy needs of Canadians. One objective of Moving Forward was to assess the feasibility of pharmacy technician certification; however, by the time the proposal was accepted and funded, the pharmacy technician landscape had changed, and it was decided that it would be more appropriate to look at what remains to be done to support or enable an enhanced role for pharmacy technicians. Funded by the Government of Canada ($1.5M), Moving Forward will wrap up its work and release its findings in June In June 2006 Moving Forward hosted a teleconference with hopes to establish a National Pharmacy Technician Task Force to champion this aspect of the Moving Forward project. Moving Forward also embarked on a series of related research studies to help fill the information gaps regarding the pharmacy technician workforce. This research includes the 2006 Environmental Scan on Pharmacy Technicians: Roles and responsibilities, education and accreditation, and certification and the 2007 Pharmacy Technician Workforce in Canada: Roles, Demographics and Attitudes. Both of these reports can be downloaded at 2 National Dialogue on Pharmacy Technicians: Summary of Outcomes

5 The Blueprint for Pharmacy Meanwhile, at the end of 2005, the pharmacy sector also began work on the Blueprint for Pharmacy (the Blueprint) initiative. The Blueprint, a strategic action plan for the pharmacy profession in Canada, is a broad based vision for the future of pharmacy in Canada. This vision includes education and continuing professional development (CPD), information and communication technology, financial viability and sustainability, legislation, regulation and liability, as well as pharmacy HR. The Blueprint is a long-term process that will move beyond the development of the Blueprint and vision definition stage, and will include further consultation and detailed action planning and implementation over many years. For more information on the Blueprint please visit Moving Forward and the Blueprint are complementary to each other and have already been integrated in the past and will continue to do so in the future Canadian Pharmacists Association 3

6 National Dialogue on Pharmacy Technicians Objective and Expectations On November 23rd, 2007 the National Dialogue on Pharmacy Technicians was held in Toronto. This consultation was a unique opportunity for key leadership stakeholders including pharmacy technicians, provincial and national representatives, regulators, educators, community and hospital pharmacists and employers to come together to share progress since 2002 and to learn, collaborate, discuss and identify common priorities and collectively map a way forward to support the changing role of the pharmacy technician. (For a list of participants see Appendix A). The objectives of this consultation were to: Present information on the different approaches that are in place to address the changing role of pharmacy technicians and to highlight some of the barriers and successes that participants have faced in this endeavor. Identify common priorities, potential strategies and key leaders that will support role evolution, changing aspects of the education and training, credentialing, role and certification and/or regulation of the profession as well as the advancement of pharmacy technicians in the pharmacy workforce. In addition to the stated objectives, participants identified a number of expectations for the consultation as follows: Share ideas and strategies Obtain a clear picture of the steps to be taken over the next 2 year period in order to advance the role of pharmacy technicians in the workplace. Start the process that will expand technicians job duties thus creating more time for pharmacists to focus on clinical duties Establish consensus on competencies to practice and the need for different training, licensing, and support of technicians from different regions across Canada Develop a consistent role description for technicians in community and hospital practice settings. Work toward common standards and resourcing across Canada to improve efficiency. Discuss: important changes upcoming in pharmacy and how those changes affect pharmacy technicians and patients accreditation of education and training programs licensing requirements and the need for all provinces to formally acknowledge the role of pharmacy technicians (similar to Licensed Practical Nurses (LPN)) collaboration and other opportunities for advancing technicians roles opportunities to support more research on the role of the technician in the provision of health care services (similar to LPN) opportunities that will become available in the expanded regulated role as well as maintaining current scope for individuals who choose to remain in their current roles. Obtain a better understanding of: the different perspectives regarding the utilization of pharmacy technicians in the workforce. how other provinces are moving forward with respect to attaining certification for pharmacy technicians how hospitals are coping with these changes and in particular their experiences with short and long term strategies for addressing change The work carried out in this consultation culminated in the identification of both the organizational leads and strategies that are required to support the role evolution of pharmacy technicians. The outcomes from the consultation will inform the development of the final recommendations/strategies put forth by Moving Forward. Moreover the strategies, priorities, leads and networks developed at this consultation are now in the domain of national and provincial representatives. All participants now have a new resource to facilitate and further support the expansion of the role of the pharmacy technician within their own regions and jurisdictions. 4 National Dialogue on Pharmacy Technicians: Summary of Outcomes

7 Organization of the Day The National Dialogue on Pharmacy Technicians consultation opened with a welcome and introduction by Janet Cooper, Senior Director of Professional Affairs of the CPhA, which is the secretariat office for both the Moving Forward and Blueprint initiatives. Janet provided orientation information to support the consultation and the way forward. This was followed by a brief message from Tim Fleming, the President of CAPT who expressed that this was an exciting time for pharmacists and pharmacy technicians alike. As a managing partner of the Moving Forward project, CAPT is proud to be a part of this very important initiative. The introduction and welcome was followed by two panel presentations (national and provincial) which helped frame the remainder of the day. The national panel presentation included representation from the PEBC, NAPRA, CPTEA, CCAPP and CSHP and demonstrated progress made since 2002 in enhancing the role of the pharmacy technician. It also highlighted some of the challenges and successes experienced along the way. The provincial panel included presentations from Nova Scotia, Quebec, Ontario, Alberta and British Columbia. These presentations provided an overview of the various approaches to enhancing the role of pharmacy technicians taken in these provinces, as well as their associated challenges, successes and lessons-learned. Recognizing the important work that provincial regulatory authorities are engaged in and the different stages of regulation each is at, invitations were extended to all provinces to present the status of any initiatives underway. Panel presentations were followed by two breakout sessions where participants were assigned to designated workgroups to explore a series of questions and to then report back to the group so that consensus could be reached Canadian Pharmacists Association 5

8 Summary of Outcomes CHALLENGES AND OPPORTUNITIES To initiate discussions, participants were asked to consider the approaches described in the panel presentations and to discern what challenges and opportunities exist for the advancement of the role of the pharmacy technician. Discussions revealed a general consensus that there has been progress in expanding the pharmacy technician role in most regions across Canada and that there is a need to build on collaboration that exists among key stakeholders including PRAs. While participants noted a number of emerging opportunities for role advancement, a number of challenges were also identified. These challenges exist partially as a result of the divergent approaches in each region to defining and expanding the role of pharmacy technicians. Questions explored during the first breakout session included: Key Challenges and Opportunities: 1) What do you think about the approaches that are being taken at the national and provincial levels? What challenges and possible opportunities do these approaches present to implementing an enhanced role for pharmacy technicians in your province or jurisdiction? 2) Is there a sufficient national framework to support the sustainable implementation of an enhanced role for pharmacy technicians? If not, what else is needed? Summary of Key Challenges Upon reflection of the national and provincial approaches a number of challenges were identified to implementing an enhanced role for pharmacy technicians in the various provinces and jurisdictions. These include: Communication and Collaboration (in three critical areas): Definitions Provinces and territories should take similar approaches to defining pharmacy technicians roles. Terminology should define and clarify roles such as technicians, pharmacy assistants, and pharmacy technician assistants. Clarification and agreement is needed as to whether pharmacy technicians should be regulated under their own regulatory authority or under existing provincial regulatory organizations. Change Management All key pharmacy stakeholders need to be involved in communicating key and constant messages and outreach. In particular, messages related to the need for an evolving role of the pharmacy technician to advance in parallel or concurrently with the evolving role of pharmacists. Stakeholders need to develop a change management plan and transitional supports to assist with role evolution Employers, technicians, other staff, management and the public need to be educated about this process and why it is important for them Need for best practices to demonstrate outcomes and lessons learned Development of a Business Case Value added from the expanded role including the benefit to the patient must be communicated. Important economic implications for employers must be clear Public and employer concerns about competency and medication safety must be addressed The impact by and on unions regarding role change/evolution must be addressed 6 National Dialogue on Pharmacy Technicians: Summary of Outcomes

9 Regulation and Standards Is there a need for title protection? Regulation should also be clarified and standardized. Self-regulation or through provincial organizations? Development of national standards and requirements is critical for effective labour mobility and portability for technicians. Education and Experiential Learning Ministries of Health and Education need to be on board, and on the same page to facilitate change Changing/emerging technology must be recognized and linked to education and training. Who will provide this training and how? What are the implications of differential learning (and technology use) on/for the performance based exam? (As PEBC has proposed) What education and learning can facilitate professional integration? Training program costs and wage rates must be more carefully considered and addressed Differences within the Profession Older vs. new graduates Recognized training program vs. on-the-job training Silos within the profession Urban v. rural practice settings Pace of change Too fast insofar as the pharmacists role is evolving more quickly than that of pharmacy technicians Too slow in that as more pharmacists take on expanded roles, pharmacy technicians need to be ready to take on an expanded role to fill gaps Address the risk of bottleneck created by different implementation timelines for role expansion for pharmacists and pharmacy technicians Need to ensure that where we are going is sustainable Summary of Opportunities Participants identified a number of opportunities to improve prospects for change: Learning from Other Professions Look to other professions for role models. Fostering inter/intra professional collaboration. Considering others approaches to education, testing, accreditation, role definition etc. Consider others approaches to education, testing, accreditation, role definition etc. Pharmacy Workforce Cooperation Resource sharing and cooperation to help cope with labor force requirements and the needs of patients and clients Acknowledgement and support of all roles and contributions to the pharmacy workforce. Potential to create a common web-portal for information sharing and learning across jurisdictions Education and Training Supports Production and analysis of evidence that can facilitate more effective training and resource distribution for preceptors and students. Using data from enrollment, statistics, rotation timing, course timing, etc. Working with CPTEA to move collaboratively towards common educational goals 2008 Canadian Pharmacists Association 7

10 Implementation of bridging programs to help address the diversity in training, education, accreditation and clinical experiences of technicians. Public Education and Engagement Public education about pharmacy technicians role and training. Educate communities so that expectations are managed effectively. 8 National Dialogue on Pharmacy Technicians: Summary of Outcomes

11 SUFFICIENT NATIONAL FRAMEWORK /SUSTAINABILITY FACTORS: Participants were also asked whether there is a sufficient national framework to support the sustainable implementation of an enhanced role for pharmacy technicians. The general consensus from participants was that yes, the required national elements are in place. Implementation and sustainability however, depend upon the following key factors: National Standards Buy-in from pharmacy technicians, employers, the general public, government, pharmacists and other health providers Strong inter and intra professional communication and collaboration Consistent and sufficient financial model to support pharmacy technicians Research and evidence to support change management and best practices Clearly defined standard of practice, scope of practice and regulatory requirements Distinction between delegation and independent authority to perform activities Title protection An evaluation of options for a comprehensive regulatory framework (i.e.: two separate regulatory colleges or one college with two divisions) KEY PRIORITIES AND ACTIONS For the past thirty years, pharmacy technicians have effectively supported the pharmacist role; however, as pharmacists engage in role expansion to more effective utilization of their knowledge, skills, and abilities, so too will the role of pharmacy technicians need to change and expand. There was a fulsome discussion on the most critical priorities required to support the sustainable and effective expansion of the pharmacy technician role in order to address the health care needs of Canadians and respond to the greater complexity in the pharmacy practice environment and the changing roles of pharmacist and technicians. In the second breakout session, participants were asked to identify the five key priorities for change to support the effective and sustainable implementation of an enhanced role for pharmacy technicians and to identify which organization(s) should take the lead role and who should play a supporting role in delivering on/addressing this priority. Questions explored during this breakout session included: Determining Key Priorities: 1) What are the five key priorities for change to support the effective and sustainable implementation of an enhanced role for pharmacy technicians? 2) Who has a lead role and who should play a supporting role in delivering on/addressing this priority? From the list of numerous priorities identified by each breakout group (see consultation/breakout session notes in Appendix C) consensus was reached through a broader plenary discussion on the following five key priority areas and key leads: 2008 Canadian Pharmacists Association 9

12 1. National Standards The discussion focused on the need for national standards in key areas in order to respond to the need for a common standard of: - Education and accreditation, as well as registration - Experiential learning/clinical requirements - Role definition, scope and standards of practice - Mutual recognition agreements - Practice models: how pharmacy services are provided within scopes of practice - Legislation Key Leads - PRAs, NAPRA, technician groups - CCAPP in relation to accreditation 2. Communications Communications was viewed as critical to supporting role expansion on a number of fronts. To address this key priority, it was determined that there is a need to: - Define roles and ensure an understanding of those different roles and responsibilities for pharmacists, pharmacy technicians and pharmacy assistants - Tailor messages in order to develop buy-in from various stakeholders - Define the change management process and develop a transition plan; recognizing that the transition process needs to be managed with a targeted strategy and action plan to support it - Respond to the what s in it for me questions for pharmacy technicians, pharmacists, pharmacy employers and patients - Reach out to the grassroots of the profession to assure that pharmacy technicians are supported in their transition - Ensure that there is consistent messaging to policy makers and legislators. Decision makers must know that advancing the role of pharmacists requires supporting the changing role of pharmacy technicians Key Leads - CPhA - link to the Blueprint process - PRAs, CAPT, advocacy groups Key Commitment: - A portal of information is needed to share provincial information (post new updates, create a network to share information etc.) joint practice specialty network (web-based/ based) -- build on Canadian Foundation for Pharmacy s work. - Tasked: Bill Veniot, New Brunswick Pharmaceutical Society (NB) 3. Business Case: There was a strong sense among participants that the profession needs to develop a better business case to drive the change process. The business case is critical to demonstrate the evidence and value of the pharmacy technician and the need for role expansion both in order to deliver better and more efficient pharmacy services but also to help ensure patient safety. It was decided that there is a need to: - Address the value proposition including the economic/financial rationale as well as health and safety protection for patients 10 National Dialogue on Pharmacy Technicians: Summary of Outcomes

13 - Respond to the what s in it for me questions for pharmacy technicians, pharmacists, employers and the public - Establish a critical mass that supports acceptance of role expansion for the pharmacy technicians. It will be critical to reach technicians, pharmacists, employers and the public Key Leads - CPhA through the Blueprint Supports: - Ontario, BC and Alberta have already developed some concept and policy papers related to the business case for role expansion. 4. Bridging Mechanism Bridging mechanisms were viewed as critical to supporting expanded roles and scopes of practice for pharmacy technicians. This includes the undertaking of required programs and learning activities to develop and improve upon the necessary skills for the expanded regulated pharmacy technician role. To address this priority there is a need to: - Determine whether or not bridging processes will be mandatory, voluntary, and/or accredited - Approach program delivery differently depending on the province, territory or community - Create a transition plan to assist technicians who are at various stages of their careers Key Leads - Educators, faculties of pharmacy, CCAPP - PRAs, CAPT, CCCEP 5. Research, Performance Measurement, Evidence-Based Information to Demonstrate Results Discussion focused on the need for evidence-based research that demonstrates how the changing role for pharmacy technicians is unfolding in various contexts. This includes measures of success and lessons learned in the application of the new role. Discussion also highlighted the need to track the changing legislation and regulatory environment that will have a significant impact on role expansion. There is a need to: - Research and review of best practices - Develop performance measurements - Undertake monitoring - Demonstrate results - Provide evidence of health outcomes for patients Key Leads - PRAs, CPhA, CCAPP Critical Areas Upon further examination of the above-noted priority areas, participants identified the following as the critical areas to be addressed in order to ensure common understanding and standards to support role expansion: - National standards o will need to be addressed early in the transition process and be supported by effective communications - Communications o must remain a high priority throughout the change process and continue throughout the Blueprint process o this include common definitions, and a response to what s in it for me questions - Business case 2008 Canadian Pharmacists Association 11

14 o o o linked to all the other priority areas need to reach all the critical stakeholders particularly employers research is critical to making the business case 12 National Dialogue on Pharmacy Technicians: Summary of Outcomes

15 Next Steps Several next steps were identified at the consultation including: - Moving Forward: will produce a meeting report, which will feed into a National Dialogue meeting in the spring of Information from this consultation can be used in developing the final strategies and recommendations and may also require an update of the Environmental Scan for pharmacy technicians. - Blueprint: 1 The Blueprint document sets the groundwork for change in the profession and is still a working document in draft form. There is a need to look at the specific key priorities and actions in the draft and align them with key priorities and discussions from this consultation. This includes consideration of whether key priorities are being addressed, if there is anything missing, and the need for a strong pharmacy technician business case. Blueprint working groups will be responsible for moving these actions forward at the end of the Moving Forward project. - Of particular note coming from the consultation, is the importance of consistent communications, and the need for the evolution of the role of pharmacy technicians to move forward in step/alignment with the evolving role of pharmacists. - An immediate need was identified during the consultation for a web-portal of information to share provincial information and progress in the form of a joint practice specialty network (web-based/ based). Bill Veniot, New Brunswick Pharmaceutical Society has been tasked with this action. 1 note that CPhA leads, does not OWN the Blueprint initiative Canadian Pharmacists Association 13

16 FACILITATORS Jennifer Smith, JLS Management Consulting Inc. Julia Corneau, JLS Management Consulting Inc. Appendix A Participant List REGRETS 1. Janet Harding, Saskatoon Health Region (SK) 2. Moira Wilson, Atlantic Health Sciences Corporation (NB) 1. Sandra Aylward, Sobeys Pharmacy Group (NS) 2. Deb Barnhill, Nova Scotia Task Force on Pharmacy Technicians (NS) 3. Mary Bozoian, Canadian Association of Pharmacy Technicians (ON) 4. Deb Chartier, Canadian Association of Pharmacy Technicians (MB) 5. Cathy Comeau, Canadian Association of Pharmacy Technicians (NS) 6. Dale Cooney, Alberta College of Pharmacists (AB) 7. Virginia Crawley, Canadian Pharmacy Technician Educators Association 8. Marie Rocchi Dean, University of Toronto, Technician Pathway Initiative (ON) 9. Mark Dickson, Pharmasave Drugs (BC) 10. Dee Dee Drake, Canadian Association of Pharmacy Technicians (AB) 11. Jeanne Eriksen, Saskatchewan College of Pharmacists (SK) 12. Tim Fleming, Canadian Association of Pharmacy Technicians* 13. Bonnie Gardner, Pharmacy Technician Board of Canada (AB) 14. Michael Heffer, Toronto Western Hospital, University Health Network (ON) 15. David Hill, Canadian Council for Accreditation of Pharmacy Programs 16. Susan James, Ontario College of Pharmacists (ON) 17. Doreen Leong, College of Pharmacists of British Columbia (BC) 18. Allan Malek, Canadian Association of Chain Drug Stores* 19. Ryan Murphy, Murphy s Pharmacies (PE) 20. Colleen Norris, Glebe Pharmasave (ON) 21. John Pugsley, Pharmacy Examining Board of Canada 22. Nancy Roberts, South-East Regional Health Authority (NB) 23. Myrella Roy, Canadian Society of Hospital Pharmacists 24. Cheryl Russell-Julien, CDI College (ON) 25. Chris Schillemore, Ontario College of Pharmacists (ON) 26. Louise Senécal, Pharmacy Assistant, AQATP (QC) 27. Marie-Lyne Thériault, AQATP (QC) 28. Stephanie Varner Watt, Pharmasave Drugs (NS) 29. Bill Veniot, New Brunswick Pharmaceutical Society (NB) 30. Deanna Williams, Ontario College of Pharmacists (ON) 31. Karen Wolfe, National Association of Pharmacy Regulatory Authorities 32. Margaret Woodruff, Humber College, Pharmacy Technician Program (ON) PROJECT STAFF 1. Janet Cooper, Canadian Pharmacists Association* 2. Kelly Hogan, Research Coordinator, Moving Forward: Pharmacist Human Resources for the Future 3. Heather Mohr, Project Manager, Moving Forward: Pharmacist Human Resources for the Future * Members of the Moving Forward Management Committee 14 National Dialogue on Pharmacy Technicians: Summary of Outcomes

17 Appendix B As was said : Notes from Introduction & Panel Presentation Introduction -- Janet Cooper, Canadian Pharmacists Association Welcome on behalf of CPhA and the Moving Forward Management Committee express how pleased we are to have everyone attend, good balance of representatives Background in 2002, meeting of pharmacy technicians and stakeholders reached agreement on strategies needed for a national strategy to support the enhanced role of pharmacy technicians o Reached consensus on roles/ responsibilities, competency profile, national certification, accreditation, regulation Funding needed, proposal developed by CPhA and CAPT, submitted to HRSDC -- not approved progress made since then Another funding proposal to HRSDC on pharmacy HR needs this was funded Moving Forward $1.5 M first significant investment By the time proposal accepted & funded feasibility of pharmacy technician landscape changed enable role of pharmacy technician CPhA/Moving Forward teleconference in 2006 establish National Pharmacy Technician Task Force -- Moving Forward took on a number of research studies to look at pharmacy technician workforce End of 2005 Blueprint for Pharmacy initiative (David Hill chair of Task Force) Moving Forward strategically focused on strategic HR pharmacy tech/pharmacists training, skills etc. Blueprint broadly based future of Pharmacy profession in Canada -- strategic action which includes HR but also legislation, regulation, liability and information and communication technology Federal government funds Moving Forward Blueprint is more long term implementation plan will be achieved over the years Current state and future vision in Blueprint informed early work of Moving Forward Recommendations from Moving Forward will be communicated to Blueprint s HR working group Unofficial goal for the day share information and update everyone main objective set common priorities and map a way forward based on what has happened and what need to be done will inform Moving Forward consultation in the spring, 2008 Message from Tim Fleming, President of the Canadian Association of Pharmacy Technicians Exciting time for pharmacists and pharmacy technicians At CAPT proud to be part of this As an assoc. 25 th Anniversary as voice of pharmacy technicians large board membership 2008 Canadian Pharmacists Association 15

18 PROVINCIAL PANEL Deb Barnhill, Nova Scotia Task Force on Pharmacy Technicians The NSCP (Nova Scotia College of Pharmacists) Council is of the position that in order to optimally serve the public, pharmacists need to relinquish technical dispensing functions where appropriate and engage more fully in cognitive practice. --NSCP Annual Report, September 2007 On how we are planning on moving forward: NSCP Annual Report of the position that in order to optimally serve the public.. this is the guiding principal Challenges/Barriers to Implementation: Lack of legal accountability of pharmacy technician o Pharmacists still sign off on all activities not willing to relinquish responsibility Lack of established qualification process to ensure technician competency Addressing Current Lack of Availability: Numerous process required for registered technicians Need registration, continuing competence, quality assurance complaints and discipline Need to be parallel process / similar to pharmacists Many things need to happen to ensure the competency: Defining education standards National competencies/ scope of practice o NAPRA doc Uniformity Legislation Many things need to happen, government needs to sign off so trying to remain open-minded Goal is to regulate the practice Task force: Represents: o hospital and community techs o pharmacy technician educators o pharmacists Hoping to bring balanced perspective to table Framework to be developed o Keep within the colleges mandate/ protect public o Evidence-based o Financially viable and sustainable Want to ensure mutual recognition province to province for pharmacy technicians First access appoint pharmacy technician to council as non-voting but fully participating member pharmacists will also be represented 16 National Dialogue on Pharmacy Technicians: Summary of Outcomes

19 Marie-Lyne Thériault, L'Association québécoise des assistant(e)s-techniques en pharmacie In Quebec term is Pharmacy Assistant Technicians o not through college professional education program Are not technicians Role and Mission: Goal promotion of professional and regional provincial basis Continuing education Collaboration -- AQPP, APES, OPQ, MELS and ASSTSAS Link between pharmacy technicians Involved in committees -- Dangerous drugs manipulation (ASSTSAS), delegate task in hospital (APES), Table of dialogue (MELS) Obstacles: Language barriers between stakeholders inside and outside Quebec Pharmacist organizations hesitant to transfer responsibilities Lack of communication Disinterest from some of our own members and leaders Voluntary work Problem is to interest people in what we are doing Not paid for the work Education requirements are not consistent with the roles assigned to pharmacy assistants Successes: Invitation on committee Invitation to participate in some events usually reserved for pharmacists Recognition of the association by other associations We learned: To be patient Be there at the right time Be constant and well prepared Establish good communication o For us today to be part of this process is a another step to move our profession in Quebec o Pharmacy decision makers in Quebec are waiting for our work o Hoping to make a difference and start a wind of change Other notes: Education for this position Before CEGEP When you finish high school PEP formation Need to have 5th secondary to work in hospital Ministry is satisfied that current program is sufficient for current pharmacy needs. They are open to some change, but not necessarily enhancing current roles Education they have is not enough for what they are asking pharmacy technicians to do Exam and program the same as 20 years ago 2008 Canadian Pharmacists Association 17

20 Susan James, Ontario College of Pharmacists Legislation passed in June 2007 establishes regulation within OCP Certification in ON started in late 1990s Title protection for pharmacy technicians Legislation supports expanded role Programs and process to support entry-to-practice requirements under way A model for pharmacy technicians regulation through College Aim for 2010 implementation College council has been clear that pharmacy technicians are to be integrated into the College The legislation has allowed OCP to determine conditions of practices, ongoing flexibility of role within the College Focused on bridging education of current technicians to ensure prep for new role and as a regulated professional in ON Successes: Support to optimize role of all pharmacy personnel Demonstrated commitment o OCP certification program, competencies, standards o Support from pharmacists, pharmacy technicians and owner/ employers o Collaboration with stakeholders to develop consistent education programs, examination o Active involvement of pharmacy technicians (council observers, content experts) o Actively involvement of pharmacy technicians/pharmacists, continue to be the ones who establish and set the exam Close to 4000 have completed the certification exam Commitment has been tremendous to represent to government Survey strong support it is there, those people are supportive to work with OCP ON does have two pharmacy technicians on the council, will have elected positions once the legislation is implemented OCP working to allow more room for pharmacy technicians Lessons Learned: Recommendations to achieve success: define the need and public benefit define the new role o understand the practices beyond entry engage partners/ stakeholders share stories mobilize resources to respond quickly communicate clearly, honestly and often 18 National Dialogue on Pharmacy Technicians: Summary of Outcomes

21 Dale Cooney, Alberta College of Pharmacists Technician Registration Individual who has successfully completed pharmacy technician program recognized by the council and who is registered in the pharmacy technician register provided for in the bylaws (Pharmacist Profession Regulation, April 1, 2007) Status: Register established bylaws Criteria for recognition of pharmacy technician programs approved in May 2007 Registration begins : Jan 2008 Registration with ACP is voluntary Challenges: confusion between ACP register vs. other tech initiatives o program review and recognition criteria are provisional until CCAPP and PEBC initiatives are available o on the job trained techs o PTCB (PTeB) voluntary certification Grandfathering large part of way legislation is written Training disparities Did not want to have techs in position on register and changes made national decision made to focus on education program Hospitals: Duties that can be performed by techs vs. individuals o Many are functioning beyond what they are required to do Hospitals may require registration HR and labour relations concerns over this If someone qualifies for the register may be required to be registered $225 fee If the employer requires it than the fee could be reimbursed Regulation of Technicians in Alberta: have been working toward self regulation for several years applied to government to be self regulated no response to date we ll get to you when we can ACP council supports the regulation of techs (consensus April 2006) Pharmacy tech regulation working group established Recommendations due to ACP council April 2008 Other Notes: There is support and if an agreement can be reached, technicians will be regulated in province Definition: nothing protected Identified three possibilities, stand alone college, transition to college or regulation within the college In hospitals, pharmacist maintains full responsibility 2008 Canadian Pharmacists Association 19

22 Doreen Leong, College of Pharmacists of British Columbia Regulating pharmacy technicians: Steering committee 2005, whitepaper business case to move forward with regulation have pharmacy technicians to have regulated under college of pharmacists like ON plan to begin in 2010 need legislative changes (transitioning to Health Professions Act in 2008) take opportunity to include the regulated pharmacy technician role in this legislation much support from ministry and government held info sessions across the province for pharmacists, pharmacy technicians and educators o o Challenges: 600 attendees response and feedback overwhelming - Good step but needs to be a means to communicate info to pharmacy technicians - So many of them wanted to be involved with committees etc. What will the requirement be to qualify for exam Will there be bridging programs Trying to talk and collaborate for transition period and regulation People more interested in how do we get there rather than regulation, this will be one of the key message to communicate - what does it mean in terms of professional responsibility, liability Successes or Obstacles: Collaborating with other PRAs (OCP, ACP) and national organizations to establish national standards and requirements Need to determine transitioning requirements / timeframe Establish bridging programs What certification model will we have language, practical training model will be parallel to pharmacists model Opportunities for Collaboration: Bridging programs English language proficiency Practical training requirements for new graduates Looking at protecting the title In some provinces the perception is to regulate the process in hospital Looking at expanded role of pharmacists ie: Medication management at same time as regulation of pharmacy technician Model standards of practice delegation of tasks to pharmacy technicians Summary: Need Accountability Framework (pharmacists to give up role) Bridging Different approaches to regulation Title Protection Voluntary Registration 20 National Dialogue on Pharmacy Technicians: Summary of Outcomes

23 NATIONAL PANEL John Pugsley, Pharmacy Examining Board of Canada Developing/ Piloting National entry to practice qualifying exam Purpose of certification For those seeking to be regulated Collaborate with OCP, ACP, BC, Royal College for Pharmacists in the development of the examination Need rigorous process Exam will permit standardized and equitable recognition and transfer of pharmacy technician credentials among different jurisdictions Steering Committee. is overseeing exam development. (15 members rep of NAPRA and individual licensing bodies) and pilot project research Written (knowledge based) and performance based (more in terms of abilities, communication, decision making) Developing an evaluating exam for international pharmacy technicians and for Canadian pharmacy technicians not graduating from CCAPP accredited program Eligibility to move forward Blueprint workshop to look at actual competencies to be tested (both components) these competencies are the NAPRA entry to practice for pharmacy technicians Whole process for developing the exam in 2008 Initiatives: Conducting pilot in 2009 National certification exam in 2010 Issues/ Challenges: Do not know what numbers will be (expected high) which has implications for performance based exam Design of exam important Diverse educational backgrounds of pharmacy technicians Cost effective exam delivery Newly regulated professional and expanded scope of practice challenge in standard setting Opportunities for collaboration: Limited due to issues of exam security Collaboration in development but thereon opportunities limited 2008 Canadian Pharmacists Association 21

24 Karen Wolfe, National Association of Pharmacy Regulatory Authorities Discussion with OCP, PEBC, CAPT, ACP understanding and willingness to consider regulation and or certification Entry to Practice Competencies for pharmacy technicians: NAPRA worked with pharmacy technicians from across country (as well as national pharmacist stakeholders) in the development of national competencies for entry to practice Set the stage for agreement and move from jurisdiction with common set of standards Competencies were drafted during a workshop held in Toronto in June 2007/refined NAPRA Board adopted competencies September 2007 See transition to pharmacy technicians as parallel process, while thy will be regulated in diff ways across country, opportunities to develop a process similar to pharmacists so once they come from credited program complete competency exam Successes: Convening a group of pharmacy technicians from each province to participate Inclusion of national pharmacy stakeholders within the process Sometimes to get those across country is challenging Obstacles: Provinces are approaching the regulation of pharmacy technicians differently Some under college of pharmacists, some self regulated, some will be seen as having delegated functions from various Pharmacy Acts Opportunities for Collaboration: Current and Future: o PEBC, CCAPP, CPTEA, Regulatory bodies as everyone has a part to play in the process. o CAPT, government In future, when profession regulated and given importance for government to remove barriers to opportunities this would be a good opportunities for collaboration 22 National Dialogue on Pharmacy Technicians: Summary of Outcomes

25 Virginia Crawley, Canadian Pharmacy Technician Educators Association First meeting in 2002 Organizations contribution to: Development of educational outcomes for pharmacy technician programs across Canada Accreditation of pharmacy technician programs Standards are so different, and this will make it easier for employers to know what pharmacy technicians are capable of Mission: Support and promotion of excellence in pharmacy technology education What is the status of the initiative? Advisory committee is ongoing Successes: Accreditation application in process CPTEA by- laws complete, incorporation in process National stakeholder CPTEA website Obstacles: Identifying all pharmacy technician programs across Canada (especially small, private schools) Membership Differences in provincial regulatory authorities Opportunities for Collaboration: Established the first CPTEA meeting in 2002 and remains ongoing CPhA, CSHP, NAPRA, CAPT, CCAPP, PEBC, provincial regulatory bodies 2008 Canadian Pharmacists Association 23

26 David Hill, Canadian Council for Accreditation of Pharmacy Programs Development of accreditation programs for pharmacy technicians at community, regional and career colleges in Canada. Organization s Contribution to implementing/ encouraging new role of pharmacy technicians: June 2006 board passed resolution to conduct a feasibility study and mandate of CCAPP developing an accreditation process for pharmacy technicians in Canada. Process would provide a measure of assurance that accredited programs meet nationally accepted standards for organization, structure & mission, teaching resources, curriculum content, student admissions eligibility, and program evaluation. September 2007 board approved launch of an accreditation service for pharmacy technician programs at community, regional and career colleges in Canada. Continuing for education for technicians/ graduates; is there a possibility that course work would be credible at degree program level? Success: Accreditation standards have been drafted (based on CPTEA educational outcomes/ NAPRA entry to practice competency profile for pharmacy technicians in Canada) Applications from programs for accreditation by CCAPP opened November 1, 2007 Info workshop about accreditation For ON programs held in Toronto on November 3 rd, 2007 (other regional information workshops being planned) Initial site visits to be conducted Feb-Apr 2008 leading to provisions regarding provisional accreditation of successful program in June 2008 Obstacles: Capacity of CCAPP resources (personnel) to carry out the process/ accreditation system for 30 to 40 college pharmacy technician programs in Canada. Uncertain (or undeclared) direction of PRAs of several provinces regarding timeline for registration and regulation of pharmacy technicians within their jurisdiction Typically add someone from PRA on site visits Different approaches from those that do not have expectations for regulation and do those that do have regulation Lack of receptiveness/ willingness of the hospital pharmacy sector to make their facilities available for experiential placements to the pharmacy technician students of the colleges in their region pursuing CCAPP accreditation (appears to be an issue of greater relevance to the private career college programs) Private career colleges Collaboration: NAPRA, CPTEA, PEBC, OCP, ACP, CPBC, other PRAs ACCC, NACC CPhA, CSHP, CACDS, CAPT, CCCEP Faculties of Pharmacy in Canada (i.e. bridges to degree programs) Strong relation with ACPE in US (ASHP had been working on role of pharmacy technicians) International programs one request 24 National Dialogue on Pharmacy Technicians: Summary of Outcomes

27 Myrella Roy, Canadian Society of Hospital Pharmacists Pharmacy technicians are critical to being able to fulfill mission Initiatives: Endorsing and supporting work others do (long tradition of this) Guidelines for delegation of functions of pharmacy technicians and others support personnel 1992 (withdrawn) CSHP guidelines for Hospital pharmacy technician training programs 1994 (withdrawn) CSHP position statement on the role of pharmacy technician 2001 (available publicly) CSHP guidelines for delegation (revised) of functions of pharmacy technicians 2007 o States that we are supporting and endorsing work others are doing o General principle, pharmacy technicians complete formal training/certification program o Have section on functions routinely performed o Define what functions may be delegated to pharmacy technicians Position statement 2001 on role of pharmacy technicians o Based on appropriate training, written guidelines on what pharmacy technicians do in hospital setting Obstacles: Task force on delegation of functions of pharmacy technicians 2007 Major challenge: reaching an agreement on the definition of a pharmacy technician o pharmacy technician vs. pharmacy assistant role o Formal education vs. on the job trainings o One year vs. two year variation across the country in how pharmacy technicians are defined, viewed and utilized by both regulatory bodies and hospitals Opportunities for Collaboration: CSHP, AGM 2004 Resolution: o That CSHP work collaboratively with pharmacy technician educators, CAPT, CCAPP and other stakeholder towards the establishment of an accreditation program for pharmacy technician educational programs May 1, 2006: Teleconference representing from OCP, CCAPP, CPhA, NAPRA, CAPT, CAPT, CACDS, BC Pharmacy Assoc. and 8 colleges w/ pharmacy technician programs Potential collaboration with PRAs and colleges with pharmacy technician programs to develop bridging for pharmacy technicians Other notes: CSHP embarked on major project CSHP project team challenging pharmacists across Canada to reach targets on 34 objectives o One under the goal of patient safety o One specific to pharmacy technicians 85 % certified by 2015 * Greatest example of collaboration is how far we have all come from 1996* 2008 Canadian Pharmacists Association 25