Update on Pharmacy Technician Issues and ASHP Pharmacy Technician Initiative

Transcription

1 Update on Pharmacy Technician Issues and ASHP Pharmacy Technician Initiative

2 Current state of Pharmacy Technicians Estimated to be 450,000 or more Training varies greatly Certification requirements vary greatly Registration/licensure not required in all states Role continues to evolve Preparation of medications for dispensing Pharmacists shift to more direct patient care roles Impact of automation, IT, purchasing, other responsibilities

3 Why Pharmacy Technicians are so important There is growing complexity in medication use and a continued focus on medication safety and quality There is a need TODAY for well-qualified, competent pharmacy technicians for the safe provision of medications in all settings The existence of a competent pharmacy technicians will be fundamental to advancing the patient care role of pharmacists in the FUTURE

4 Yet, there is no defined standard We need a defined baseline of skills and competencies that can only be obtained through the standardized education, training, certification and registration/licensure of pharmacy technicians

5 Activities of Pharmacy Technicians Traditional activities Non-traditional activities Restocking floor stock and/or ADCs Replenishing unit dose carts Purchasing Packaging activities Compounding sterile preps Billing Quality Assurance act/unit inspections Compounding chemotherapy preps Controlled substance system mgmt IT system management Technician supervising other technicians Order entry (for pharmacist verification) Tech-check-tech Medication reconciliation (obtaining list) Medication assistance program mgmt Screening of medical records for MRPs Preparation of clinical monitoring information Dispensing with remote video supervision % Hospitals with technicians performing activity 27% 24% 17% 11% 11% 10% 6% 3% 40% 81% 80% 76% 66% 61% 97% 95% 94% 93% 0% 20% 40% 60% 80% 100% Source: 2012 ASHP National Survey

6 Pharmacy Technician Allocation of Time - CURRENT Nontraditional activities, 8% Administrative, 8% Other, 0% Traditional drug preparation and distribution, 79% Order processing, 5% Non-traditional activities: Initiating medication reconciliation IV/PO switch programs Dispensing via remote video supervision Criteria based screening of medical records Preparation of clinical monitoring information Managing pharmacy information systems Managing medication assistance programs Tech check tech Source: 2012 ASHP National Survey of Hospitals

7 Pharmacy Technician Allocation of Time - FUTURE Administrative, 9% Non- traditional activities, 18% Other, 0% Order processing, 6% Traditional drug preparation and distribution, 66% Non-traditional activities: Initiating medication reconciliation IV/PO switch programs Dispensing via remote video supervision Criteria based screening of medical records Preparation of clinical monitoring information Managing pharmacy information systems Managing medication assistance programs Tech check tech Source: 2012 ASHP National Survey of Hospitals

8 Technician Workforce Data Projected Change Occupation Employment Employment Title # % Pharmacy Aides 50,800 65,300 14, % Pharmacy Techs 334, , , % Combined* 384, , , % Pharmacists 274, ,600 69, % *U.S. Dept. of Labor, Bureau of Labor Statistics, March

9 ASHP Position on Pharmacy Technicians Well-qualified, competent pharmacy technicians are integral to the safe provision of medications in all settings. To achieve this, ASHP: Supports uniform training ASHP-accredited Support certification through PTCB Support licensure through state boards (Ideally should be completed in this sequence)

10 Pharmacy Technician Training, Competency, Practice (preferred state) Work as a Pharmacy Technician Start Process of Becoming a Pharmacy Technician ASHP Accredited Training Certification by PTCB Registration/Licensure by Board of Pharmacy Exit

11 Pharmacy Technician Training, Competency, Practice (current state) Become a Pharmacy Technician ASHP Accredited Training 7.5% Certification by PTCB Non- Accredited Training 9.2% 66% Work as a Pharmacy Technician Employer didactic training Exit 5.5% Registration by Board of Pharmacy 78% 80%* Employer on-the-job training

12 Positions of other Organizations American Pharmacists Association (APhA) supports nationally recognized standards and guidelines for the accreditation of training programs. supports the continued growth of accredited education and training programs supports the following minimum requirements for all new pharmacy technicians by the year 2015: Successful completion of an accredited education and training program Certification by the Pharmacy Technician Certification Board (PTCB) American College of Clinical Pharmacy (ACCP) Pharmacy technicians are authorized by both state regulation and employment status have successfully completed an education and training program that is accredited by a nationally recognized accrediting body; and are certified by the Pharmacy Technician Certification Board (PTCB)

13 Council on Credentialing in Pharmacy (CCP) - Pharmacy Technician Credentialing Framework Pharmacy profession recommendations regarding training and education for pharmacy technicians by 2015 (issued August 2009) CCP Members include: AACP, ACA, ACCP, ACPE, AMCP, APhA, ASCP, ASHP, BPS, CCGP, ICPT, PTEC Calls for Model curriculum for all technicians National, Programmatic Accreditation of Technician Education & Training Programs Competency Based Examination

14 Status of State Regulation of Pharmacy Technicians (NABP Survey of Pharmacy Law-2012) Regulations on TRAINING 33 states require education and training (non-accredited) (ND, SC and NV specifically recognize ASHP accreditation in some form) Regulations on CERTIFICATION PTCB Recognition in 30 states as one optionfor registration or for expanded tech responsibilities Regulations on REGISTRATION 33 states require registration 7 states require licensure 12 states have no registration or licensure requirements: Regulations on TECH-CHECK-TECH 13 states allow tech check tech

15 Education and Training of Pharmacy Technicians Currently no single standard for training every state is different some have no requirements, others vague 33 states require education and training (non-accredited) (ND, SC and NV recognize ASHP accreditation in some form) remaining 18 states have no requirement for training Currently there are 250 ASHP accredited training programs across the U.S., but many more are needed Three pharmacy chains have ASHP-accredited technician training programs (Walgreens, RiteAid, CVS) Theinsufficient number of training programs (accredited or non-accredited) is frequently cited as a reason for not mandating accredited training for technicians

16 ASHP Accreditation Standards for Pharmacy Technician Programs American Society of Health-System Pharmacists (ASHP) is the only accrediting body for Pharmacy Technician Programs Standards are set; can be found through the website Programs must follow the established Model Curriculum for Pharmacy Technicians.

17 Technician Credentials: ASHP-Accredited Training Completedan ASHP accredited training program Characteristic % Staffed beds < All hospitals All hospitals All hospitals All hospitals

18 Certification of Pharmacy Technicians Pharmacy Technician Certification Board started in 1995 Based on PTCE Job Analysis Tests on three subject categories: pharmacy practice, medication distribution/inventory control and administrative/management of pharmacy practice Psychometrically-Sound Exam; computer based testing ASHP recognizes PTCB certification as the standard for pharmacy technician certification New Job Analysis just completed Advanced/Specialty certification likely (e.g. medication safety, sterile compounding) Governed by: APhA, ASHP, MPA, ICHP, NABP

19 Certified Pharmacy Technicians Total certified: 444,000 Current/active: 262,000

20 C.R.E.S.T. Initiative Consumer Awareness Resources Education State Policy Testing Thought leaders included pharmacists, educators, federal pharmacy, major employers, state associations, State Boards of Pharmacy, and PTCB CPhTs.

21 C.R.E.S.T. Recommendations Summit recommendationspertaining to the PTCB Certification Program: By 2015, require a minimum period of practical experience By 2015, require mandatory criminal background checks By 2020, require completion of an accredited education program Accept only pharmacy technician-targeted CE credits. Require one of the 20 required CE credits to be medication or patient safety.

22 Technician Credentials: PTCB Certification PTCB Certified Characteristic % Staffed beds < All hospitals All hospitals All hospitals All hospitals

23 Registration or licensure ASHP current position is that technicians should be registered, but new proposed policy calling for licensure will be considered in June states require registration 7 states require licensure 12 states have no registration or licensure requirements Licensure requiresdemonstration of competence, registration just establishes a list

24 ASHP Pharmacy Technician Initiative Mission: to develop an educated, trained, certified and registered pharmacy technician workforce in every state in order to improve medication use safety and expand access to the patient care services of pharmacists. Goal: To establish a framework where state affiliate organizations partner with ASHP to advance the mission of the initiative.

25 ASHP Pharmacy Technician Initiative A partnership with ASHP affiliates Goal: to develop an educated, trained, certified and registered pharmacy technician workforce that will support the advancement of the pharmacist patient care role, promote safe medication systems, and improve patient care Supporting regulatory or legislative actions at the state level advancing pharmacy technicians Providing resources, education, information, web sites, to partners and members Promoting accreditation of training programs

26 Pharmacy Technician Initiative WA OR ID NV UT CA AZ AK MT WY CO NM HI ND MN WI NY SD MI IA NE IL IN OH PA WV KS MO VA KY NC TN OK AR SC LA MS GA AL TX FL Total 26 states NH VT ME MA RI CT NJ DE MD

27 Pharmacy Technician Initiative Progress and achievements to date: Education through webinars Meetings at SM and MCM to share challenges and solutions New Pharmacy Technician Information Center microsite Development of Pharmacy Technician Issue Briefs Specific outreach to unaccredited programs; tools for others Development of RU Ready Growth in accredited pharmacy technician training programs (142->222) Concurrence of PTI mission with CCP position ASHP REF Research grants focusing on research focused on technicians Advocacy support at state level as requested Significant recognition of technician role and recommendations from PPMI

28 Recommendations related Recommendations to Pharmacy Technicians from PPMI Pharmacy technicians who have appropriate education, training, and credentials could be used much more extensively to free pharmacists from drug distribution activities. [D1] Assigning medication distribution tasks to pharmacy technicians would make it possible to redeploy pharmacists time to drug therapy management activities. [D2] ASHP should define a scope of practice, including core competencies, for hospital and health-system pharmacy technicians. [D4] Uniform national standards should apply to the education and training of pharmacy technicians. [D5] To support optimal pharmacy practice models, technicians must be certified by the Pharmacy Technician Certification Board. [D6] By 2015, the Pharmacy Technician Certification Board should require completion of an accredited training program before an individual may take the certification examination. [D7] To support optimal pharmacy practice models, technicians must be licensedby state boards of pharmacy.[d8] All distributive functions that do not require clinical judgment should be assigned to technicians. [D9] Opportunities for technician specialization should be developed. [D10]

29 Recommendations from PPMI The following tasks can be assigned to pharmacy technicians who have appropriate education and training*: Initiation of medication reconciliation including obtaining and documenting patients medication information for pharmacists review. [D3a] Reviewing patient charts to identify medication allergies that require pharmacist follow up. [D3b] Checking dispensing by other technicians (i.e., tech-check-tech ). [D3c] Compounding routine sterile preparations in conformance with well-documented procedures. [D3d] Dispensing medications with remote video supervision by pharmacists. [D3e] Scheduling patient outpatient clinic drug therapy management visits. [D3f] Criteria-based screening of medical records to identify patients who may require pharmacist intervention. [D3g] Preparing clinical monitoring information (e.g., International Normalized Ratios) for pharmacist review. [D3h] Inspecting and replenishing medication storage devices. [D3i] Managing controlled substances systems. [D3j] Managing medication assistance programs. [D3k] Conducting aspects of quality improvement programs. [D3l] Managing pharmacy department information technology systems, including routine database management and billing systems. [D3m] Supervising other pharmacy technicians. [D3n] *defined as completion of ASHP accredited training program and PTCB certification

30 Definition of Pharmacy Technician: NABP Model State Pharmacy Act Pharmacy Technician means personnel registered with the Board who may, under the supervision of the pharmacist, assist in the pharmacy and perform such functions as: assisting in the Dispensing process; processing of medical coverage claims; stocking of medications; and Cashiering Certified Pharmacy Technician means personnel registered with the Board who have completed a certification program approved by the Board and may, under the supervision of a Pharmacist, perform certain activities involved in the Practice of Pharmacy, such as: receiving new Prescription Drug Orders; prescription transfer; compounding; and assisting in the Dispensing process 30

31 NABP Resolution No Whereas, new pharmacy technician education and training programs are being established in community colleges and trade schools across the country; and Whereas, no nationally recognized, uniform standards are currently in place in each state to guide the quality and appropriateness of the course curriculum of such programs; and Whereas, state boards of pharmacy have a responsibility to oversee the training and practice of pharmacy technicians in the interest of the public health and safety; THEREFORE BE IT RESOLVED that NABP continue to encourage states to adopt uniform standards for pharmacy technician education and training programs. Approved

32 NABP Task Force on Pharmacy Technician Education and Training Programs Recommendations NABP should encourage boards of pharmacy to require as an element of pharmacy technician certification completion of an education and training program that meets minimum standardized guidelines. NABP should encourage boards of pharmacy to require as an element of pharmacy technician certification completion of an accredited education and training program by NABP should assist in developing a national accreditation system for pharmacy technician education and training programs that is based within the profession of pharmacy and utilizes a single accrediting agency by NABP should encourage ACPE and ASHP to work collaboratively to develop an accreditation systemfor pharmacy technician education and training programs that reflects all pharmacy practice settings and, if feasible, to consolidate the activities into one accrediting body, preferably ACPE. Issued

33 NABP Task Force on Pharmacy Technician Education and Training Programs Recommendations NABP should encourage PTCB to change the process by which it determines who is qualified to sit for its examination to include completion of an accredited pharmacy technician education and training program and high school diploma or GED verification. NABP should encourage PTCB to provide NABP with information on its certified pharmacy technicians so that NABP may enhance the pharmacy technician data contained in the NABP clearinghouse to provide the information necessary for the state boards of pharmacy to protect the public health. NABP should encourage ASHP to revise its current accreditation standards for pharmacy technician education and training programs to require accredited providers to inform potential program applicants of applicable state requirements for registration or licensure. Issued

34 What s needed? Recognition of the role technicians play now and will play in future as pharmacists move to more direct patient care as use of automation/technology expands as medication use becomes even more complex Standards for education and training, certification Mechanism to demonstrate competency Scope of work/practice for technicians Expansion of Accredited Pharmacy Technician Training Programs Employers who seek trained and certified technicians 34

35 Ultimate Goal A better qualified and trained workforce Improved patient safety Greater consistency in technician workforce Greater ability to shift technical tasks Less turnover in pharmacy technician positions 35