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April 9, 2018

ASHP Leading the Way on Well-Being & Resilience

Paul W. Abramowitz, Pharm.D., Sc.D. (Hon.), FASHP

THE FOCUS ON CLINICIAN BURNOUT as a growing public health problem is gaining significant momentum. ASHP is an original sponsor of the National Academy of Medicine (NAM) Action Collaborative on Clinician Well-Being and Resilience and is honored to lead the pharmacy profession on this issue. We recognize that a healthy and thriving clinician workforce is essential to ensuring optimal patient health outcomes and safety. Therefore, ASHP is committed to fostering and sustaining the well-being, resilience, and professional engagement of pharmacists, pharmacy residents, student pharmacists, and pharmacy technicians. In his inaugural address, ASHP President Paul Bush called for a three-pronged approach to supporting the pharmacy workforce: building staff resilience, providing technician training and support, and encouraging clinicians to be leaders. ASHP’s commitment to improving pharmacy workforce well-being and resilience can be read here and is embedded within our recently revised Strategic Plan (Goal 4, Our Patients and Their Care).

Burnout is associated with a loss of productivity in the healthcare workforce. If you extrapolate this loss to a national level, it is equivalent to the elimination of seven graduating classes of medical schools. And healthcare worker burnout is not the only concern; a bidirectional relationship exists between burnout and medical error. For example, one study found that nursing burnout resulted in increased healthcare-associated infections. At the individual clinician level, burnout presents as emotional exhaustion (i.e., compassion fatigue), depersonalization and cynicism, and a low sense of accomplishment. At the healthcare-system or institution level, it is associated with medical errors, loss of productivity, added malpractice claims, and increased risk of patient harm. Currently, we don’t have a deep research portfolio specific to the pharmacy workforce, but we hear from you that it is an issue that needs to be addressed, and ASHP stands ready to help.

The Action Collaborative formally kicked off in January 2017 and has three goals related to increasing understanding of and identifying evidence-based solutions for clinician well-being and resilience. ASHP is actively contributing to discussions on individual and external factors that impact well-being and resilience as part of the conceptual model working group. Since the risk of clinician burnout spans all ages, stages, and career paths, this working group is tasked with identifying a model that captures the complexity of clinician well-being and resilience without oversimplifying the contributing factors. A new conceptual model was recently created to illustrate the interrelated and interlocking factors affecting clinician well-being and burnout while simultaneously conveying a vision and solutions. ASHP is a contributing author to the discussion paper that details the journey in constructing this new model.

In addition to our collaboration with NAM and contributions through the working group, ASHP is engaging our members on pharmacy well-being and resilience by:

If your organization has been working on resilience efforts to support wellness of its employees, we would love to hear from you. We encourage you to share your stories through our community on ASHP Connect. Or, maybe you know of an individual or an organization that is demonstrating positive progress to start the conversation on resilience and supporting a healthy and engaged workforce. If so, we encourage you to send us these ideas, and we can take these concepts back to the national conversation on this topic.

Thanks so much for being an ASHP member and for everything you do for your patients and pharmacy teams.



April 3, 2018

For Pharmacy Technician Krystal Green, the Sky’s the Limit

This is the first in a series of articles featuring ASHP’s pharmacy technician members and their valuable contributions to the profession. Check out ASHP’s new Pharmacy Technician Forum for more information about efforts to elevate and advance the pharmacy technician workforce, as well as ways for pharmacy technicians to become more involved in ASHP.

Krystal Green, CPh.T., M.B.A., explains how to hold a needle syringe unit to Kelsey McCulloch, a pharmacy technician student.

KRYSTAL GREEN, CPh.T., M.B.A., is not one to shy away from a challenge. In 2015, she set out to do nothing less than build the Piedmont Virginia Community College pharmacy technician program, located in Charlottesville. With only two other ASHP-accredited pharmacy technician programs in the state at the time, Green’s efforts filled an important need for robust technician training.

Standardized, high-level pharmacy technician training is critical to ensuring patient safety, since medication preparation is one of the highest-risk components of the medication-use process, according to an editorial published last year in AJHP. With highly qualified pharmacy technicians overseeing many aspects of the medication-use process, pharmacists can focus more of their time on providing direct patient care services.

Accredited Training Programs

More than 250 formal technician training programs are currently accredited by ASHP/ACPE (Accreditation Council for Pharmacy Education). “Accredited programs give future pharmacy technicians the opportunity to learn and practice hands-on skills that are vital to the position,” said Green. “The lab courses and the clinical rotation give students a chance to work through new technician jitters. After they complete the program, I believe graduates enter their new positions ready to work with confidence.”

Creating the Piedmont Virginia Community College pharmacy technician program was not Green’s first foray into building an accredited technician training program. In 2013, she helped gain accreditation for the Virginia College pharmacy technician program in Richmond. Prior to establishing the two programs, Green had practiced as a technician in a variety of settings, ranging from a Walgreens in Richmond to the Cardinal Health nuclear pharmacy in Richmond to the inpatient IV compounding room at CJW Medical Center’s Chippenham Campus. “I loved being in the IV room because it allowed me to use all of my skills,” she said. “I loved the calculations and creating special dilutions.”

Success with Students

Green currently serves as the director of the Piedmont training program. Perhaps part of the reason that Green has settled into this position is that the role allows her to nurture others. “I treat my students as I would my children,” said Green, who is currently the only instructor but hopes to grow the program and recruit one more colleague. “I absolutely love passing on my knowledge to help shape them into pharmacy technicians who have patients at the center of what they do. To see the students become professionals and enjoy their work is priceless.”

Green and McCulloch practice transferring tablets from the tray to the dram.

In addition to teaching technical skills such as medication distribution, dispensing, pharmacy calculations, sterile and nonsterile compounding, and processing insurance claims, Green emphasizes professionalism and treating each patient with respect. “When people come into the pharmacy, we don’t know what they’re going through. We can make at least five minutes of their day less stressful through a warm welcome, by being helpful and polite, and having empathy,” she said

Imparting a well-rounded body of knowledge to the 17 students who have gone through her program has paid off, with a 90% pass rate on the technician certification exams and full employment following graduation. With 17 unfilled technician positions in the Charlottesville area at Green’s last count, the six students currently enrolled in the program will be in high demand once they complete their studies.

“The word has gotten out that our graduates are very well prepared to work as pharmacy technicians, and pharmacies are coming to us to recruit them,” Green beamed, noting that, among other successes, one graduate now contributes to the University of Virginia’s meds-to-beds program and practices in a clinical environment. Another graduate was hired into the IV room setting straight out of the program — an achievement Green said typically requires at least a year of post-certification work. “I am extremely proud of my students,” said Green.

ASHP Membership

Krystal Green, CPh.T., M.B.A.

As an ASHP member since 2011, Green made use of the organization’s resources during her program accreditation process. She also finds sessions at the Midyear Clinical Meetings geared toward pharmacy technicians to be a wellspring of ideas for lectures and lab exercises. The Midyear Clinical Meeting offers her a way to become familiar with the structure of other academic programs. “Exhibit hall vendors give me an idea of what can be done in the lab and what the latest technology is, which helps me prepare students for what’s coming up ahead,” said Green.

Green is also involved with the Virginia Society of Health-System Pharmacists (VSHP), which named her Pharmacy Technician of the Year in 2013 for her role in gaining accreditation for the Virginia College program. “Through VSHP, I’ve found opportunities to network with other pharmacy technicians,” she said, adding that she is hoping to work with VSHP to deepen the organization’s engagement with pharmacy technicians.

Life at Home

Outside of work, Green enjoys spending time with her 11-year-old “four-legged child,” Mena, a Miniature Pinscher. “She loves riding in the car, and often when I’m leaving for work, she’ll run out and sit by the car tire,” Green said.

She also enjoys traveling, most recently to Cuba, and is planning to visit Thailand and Greece in the near future. “I love a good beach,” she said. “Give me blue water, hot weather, some nice scenery, and good food, and I’m happy.”

Future of Pharmacy Technicians

ASHP has supported the advancement of technician roles for decades and recently launched the Pharmacy Technician Forum. It will provide tools, education, and other resources to help pharmacy technicians expand their practice. “I think the forum is going to solidify the importance of pharmacy technician roles in all pharmacy settings and propel technicians into even more advanced roles,” said Green.

When asked to peer into her crystal ball and forecast the future of pharmacy technicians, Green said she thinks they may take on additional clinical roles in the future, including advanced medication therapy management tasks. “Pharmacy technicians are more than capable of assuming a lot of responsibility,” she said. “The sky’s the limit.”


By David Wild

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