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March 8, 2019

North Dakota Technician Champions National Certification

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

 

Diane Halvorson, CPh.T.

AS A YOUNG ADULT, Diane Halvorson, CPh.T., never intended to become a pharmacy technician. But now, more than 25 years later, she has a gratifying career and is an influential figure in the field. As Lead Pharmacy Technician at Vibra Hospital Pharmacy in Fargo, N.D., Halvorson is a staunch advocate for improving technician certification and education programs.

Successful Technician
Halvorson began working at a hospital pharmacy more than two decades ago. As a single mother, she needed to find a way to support her son. Halvorson was lucky enough to learn the pharmacy technician trade on the job. She didn’t have any experience, but back then the job of a pharmacy technician was “very basic,” she said. She mostly managed the prescription medication stock.

Over time, her boss (the pharmacy director) took notice of her attention to detail and ability to manage her time and work efficiently. “As pharmacy evolved, I evolved along with it,” she said. “I became a sponge and started attending conventions, conferences, and any continuing education I could to expand my knowledge. The support of my peers and leaders gave me the confidence to excel.” When she began serving on the North Dakota Board of Pharmacy in 2011, she realized it was time to become certified.

“I have taken every opportunity to gain the knowledge and understanding of pharmacy and have evolved into the person I am today,” she said

National Standards for Techs
As a member of ASHP and other national and state pharmacy organizations, Halvorson was appointed by the governor of North Dakota to serve a second term on the North Dakota State Board of Pharmacy, with a goal of implementing education and certification programs in the state. The position has provided a forum to speak out about the need for standardizing pharmacy technician training across the nation.

Currently, there is no standard training or certification on a national level to become a pharmacy technician. Education and certification requirements to earn a CPh.T. degree vary by state. Some states may require more training than others, additional exams, or recertification.

But standardization in the profession is needed now more than ever. Pharmacists are now working in more clinical roles, but prescriptions still need to be filled. “Pharmacy technicians should have the credentials and knowledge to fulfill this role safely and accurately,” said Halvorson.

Expanding Tech Education
Halvorson and many of her colleagues would like to see pharmacy technicians undergo the same rigors of training that pharmacists face. “I feel we should have a national standard that establishes a way to ensure all pharmacy technicians have a baseline knowledge when entering the profession,” said Halvorson. “While our education would not be as detailed as the pharmacist, our process should mirror the process of the pharmacist.” The process would include the completion of an exam that verifies the baseline knowledge, she added.

Halvorson is an advocate for improving technician certification and education programs.

Some of the strictest requirements in her field exist in her home state of North Dakota, where pharmacy technicians are required to receive their education from an ASHP/ACPE accredited program. They must take a national certification exam to demonstrate their knowledge of the field, and they may only earn their certification in the state after meeting those requirements.

Hospital pharmacies in North Dakota are also required to have a quality assurance program to track prescription errors. “If you have a near-miss or a mistake that reaches the patient, you need to document it,” said Halvorson. “Was this an isolated incident? Was there a product problem or process problem or personnel problem?”

Technician Advocacy
Donna Kisse, CPh.T., is a pharmacy technician who has gotten to know Halvorson through their service together in North Dakota’s Northland Association for Pharmacy Technicians. Kisse and other colleagues admire Halvorson for the advocacy work she’s taken on toward a goal of consistent, national certification requirements for pharmacy technicians.

“Since pharmacists are taking the lead in clinical patient care roles, pharmacy technicians must be leaders in supporting standardized qualifications to ensure pharmacies are safe, efficient, and have productive work environments,” said Kisse.

Halvorson became involved with ASHP through the Pharmacy Technicians Stakeholders Consensus Conference steering and advisory committee. “For me, being a member of ASHP has elevated my overall knowledge and fundamental understanding of the opportunities of expansion of the scope of practice that a pharmacy technician can achieve,” she said.

The ASHP Pharmacy Technician Forum, which launched last year, has also been integral to her efforts. She currently serves on the forum’s Patient Care Quality Advisory Group committee.

Halvorson began her technician career more than two decades ago and currently serves as the Lead Pharmacy Technician at Vibra Hospital Pharmacy.

Reducing Prescription Errors
Halvorson hopes that all states will move toward following strict training guidelines like those in North Dakota. By not standardizing pharmacy technician training, Halvorson said the profession is putting the safety of patients in jeopardy. “The consumer believes that any person behind the pharmacy counter has education, that those people know what they’re doing, and that they have a minimum education.”

She recalled an incident that made headlines years ago. It involved Emily Jerry, a three-year-old girl in Ohio who died in 2006 as a result of a hospital pharmacy technician error. At the time of the toddler’s death, Ohio didn’t register pharmacy technicians or require any training or licensing to do the job. In 2009, Emily’s Act was signed into law. The legislation requires that pharmacy technicians be at least 18 years of age, register with the State Board of Pharmacy, and pass a Board-approved competency exam. It also includes requirements related to technician training.

“Humans make errors, and that’s why in a pharmacy you have a check and balance,” Halvorson said. That safety net wouldn’t exist without Halvorson and other passionate pharmacy technicians.

By Jessica Firger

 

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December 17, 2018

ASHP Continues to Lead on Pharmacy Workforce Well-Being & Resilience

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

I am pleased to share with you that over the last year ASHP has continued to increase our efforts to support the well-being and resiliency of the pharmacy workforce. ASHP is an original sponsor of the National Academy of Medicine (NAM) Action Collaborative on Clinician Well-Being and Resilience and is honored to support the pharmacy profession on this important patient care and workforce issue. As the NAM Action Collaborative on Clinician Well-Being and Resilience approaches the two-year mark, I would like to share some updates with you on our efforts to help address this important issue facing pharmacists, pharmacy residents, student pharmacists, and pharmacy technicians.

These past 15 months, through the NAM Action Collaborative and ASHP’s own organizational efforts, we have raised the visibility of clinician burnout, depression, stress, and suicide. Over that time, ASHP has developed resources, educational programming at our national meetings, and community connections for members to learn more about the issue. Former U.S. Surgeon General Vivek Murthy kicked off our 2018 ASHP Summer Meetings by challenging attendees to include well-being as the core of what we do as healthcare workers.

Summer Meetings attendees also heard about some of the science behind resilience and were introduced to interventions for building individual and team resilience through two interactive presentations by Dr. Bryan Sexton, Director of the Duke Patient Safety Center. Conversations on the topic continued in the ASHP House of Delegates, where delegates approved an ASHP policy on Clinician Well-Being and Resilience. We are very pleased to have an official professional policy for members to reference as they begin and continue discussions at their institutions. Efforts by the ASHP House of Delegates also helped form a joint ASHP Council and Commission session on the pharmacists’ role in suicide prevention during the 2018 ASHP Policy Week.

We know that burnout is associated with compromised patient safety and a loss of productivity in the healthcare workforce. As such, we continue to help advance pharmacy-specific research on resilience and well-being. ASHP recently partnered with the Pharmacy Technician Certification Board (PTCB) and Duke University Health to study the prevalence of burnout in pharmacy technicians and identify resources to support this important and growing segment of ASHP’s membership. While both NAM and ASHP are improving baseline understanding of challenges to clinician well-being, we are reminded that this is a local issue that requires local solutions to address it. ASHP members continue to share their strategies on how to foster the creation of resilience in clinical learning and managing preceptor burnout. If you traveled to Anaheim for the recent Midyear Clinical Meeting, there were multiple educational sessions on workforce well-being. Many of these sessions were recorded and will be available on ASHP eLearning in early 2019.

NAM recently kicked off a consensus study to examine systems approaches to improve patient care by supporting clinician well-being. ASHP nominated M. Lynn Crismon, Dean, University of Texas, College of Pharmacy, to serve on this committee, which will issue a report with recommendations for system changes to streamline processes and manage complexity, minimize the burden of documentation requirements, and enhance workflow and teamwork to support the well-being of all clinicians and trainees. In the meantime, the NAM clinician well-being knowledge hub continues to grow with solution strategies for leaders, organizations, and individuals, including ASHP contributions to a discussion paper on implementing optimal team-based care to reduce clinician burnout. ASHP state affiliates are also an important part of the conversation, and ASHP has created a state affiliate toolkit on well-being and resilience to assist them in their state-level efforts.

Our continued work in advancing workforce well-being and resilience is ultimately growing a foundation for long-term culture change. We have enhanced our SSHP Recognition Program for the 2018–2019 academic year to encourage our students to address the issue. We know that many of you are working on well-being and resilience within your organizations, and we would appreciate hearing 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 on resilience and supporting a healthy and engaged workforce. If so, we encourage you to fill out this brief survey so that we can create case studies others can learn from.

I hope you share our enthusiasm about this very important work to support the resilience and well-being of the entire pharmacy workforce and about the impact this work will have on improving patient care.

Thanks so much for being an ASHP member and for everything you do for your patients and pharmacy teams. I look forward to sharing more with you in the future as ASHP’s efforts continue in this important area. Have a safe holiday season.

Sincerely,

Paul

February 15, 2018

AJHP’s Top 25 Articles Address Critical Practice Issues

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

WITH A CIRCULATION OF 45,000, ASHP’s peer-reviewed scientific journal, AJHP, is the most widely recognized and respected pharmacy journal in the world. As part of our year-end review in late 2017, the editors of AJHP assembled a list of the Top 25 most frequently accessed articles on www.ajhp.org. What they found was compelling: The articles read most by you and your colleagues address some of the most critical issues facing the profession and healthcare at large. This connection is no accident. From its early days as The Bulletin to its current iteration, AJHP has sought to provide pharmacists with the latest, most relevant practice information available.

AJHP has undergone a comprehensive transformation in recent years in both design and content, including a new approach to cutting-edge clinical topics and an enhanced digital experience. These changes represent a continuation of the journal’s vital role in equipping pharmacists to guide medication-use and healthcare delivery at the patient, population, and policy levels.

A look at the most-accessed content clearly illustrates this principle. The Top 25 list includes articles that predict future directions for practice, offer guidance for strategic planning, and examine the challenges faced by women seeking greater leadership opportunities. Also featured are discussions about the training needs of pharmacy technicians, guidelines on preventing diversion of controlled substances, and approaches for caring for diverse patient populations. The Top 25 list also contains several articles that address important clinical practice issues related to the care of the critically ill as well as patients with cancer, diabetes, infectious diseases, pulmonary hypertension, and thrombotic disorders. This collection of most frequently accessed AJHP content addresses pressing issues for our patients, for our profession, and for our times.

AJHP’s mission to advance science, pharmacy practice, and health outcomes can be realized only when pharmacists take what they’ve learned and apply those findings in their practices. The Top 25 articles, and all of AJHP’s content, can be used to:

  1. Advance ASHP members’ approaches to patient care.
  2. Support pharmacists’ and pharmacy technicians’ professional development activities and approaches to delivering patient care.
  3. Inform proposals for educational offerings at ASHP’s meetings as well as state affiliate-based educational programs.
  4. Supplement educational initiatives with students and residents in the classroom, at the bedside, and through journal clubs and seminars.
  5. Prepare for policy discussions with legislators and other policymakers at the local, state, and federal levels.

I encourage you to take some time to read or revisit the findings in these valuable articles and consider how you can use AJHP to impact patient care at your organization. The full list of the Top 25 most-accessed articles is available as a collection on www.ajhp.org.

Thank you for all that you do on behalf of your patients, and for being a member of ASHP.

Paul

October 19, 2017

The New ASHP Pharmacy Technician Forum

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

I AM VERY HAPPY TO INFORM YOU of the recent unanimous decision by the ASHP Board of Directors to create a new ASHP Pharmacy Technician Forum! ASHP has always had a pharmacy technician membership category, and we currently have many pharmacy technician members. However, our goal for the Pharmacy Technician Forum is to create a much more well-defined membership home for pharmacy technicians, which provides enhanced educational, training, and career opportunities for a very important segment of our pharmacy workforce.

I think we all agree that pharmacy technicians are one of the cornerstones supporting the advancement of pharmacy practice and the safe use of medications. With a pharmacy technician workforce that has accredited training and is certified, pharmacists will be able to spend the majority of their time providing direct patient care. Pharmacy technicians are extremely well-positioned to manage the vast majority of medication preparation and distributive activities in pharmacies, along with other advanced technician functions on patient care units and in clinics. ASHP wants to do everything it can to help pharmacy technicians assume these important roles.

ASHP has been a leader in advancing the roles of pharmacy technicians for decades, and we are eager to take things to the next level with the new ASHP Pharmacy Technician Forum. We want to engage our technician colleagues in meaningful ways, hear their needs, and design services that help them elevate their careers. A consistently educated, certified, and eventually licensed pharmacy technician workforce benefits the public and patients, other providers, healthcare organizations, and the entire pharmacy profession. It also helps create a clear pathway for individuals who wish to make being a pharmacy technician a career.

We plan to have the new Pharmacy Technician Forum up and running in early 2018. We will be reaching out to pharmacy technicians and encouraging them to become members of ASHP, which will include a wide array of opportunities to grow personally and professionally. All current pharmacy technician members of ASHP will automatically be members of the new forum, and others will be invited to join and become part of something that seeks to further elevate the role of the pharmacy technician to new heights.

I hope everyone shares our excitement about the new ASHP Pharmacy Technician Forum. It is noteworthy that it is happening now at the conclusion of our 75th anniversary year, the tagline of which is “Creating the Future.”

Thanks for being a member of the fastest-growing and most forward-looking organization in pharmacy, and for everything you do for your patients and our profession.

Sincerely,

Paul

March 27, 2017

ASHP’s 75th Anniversary: Celebrating the Past, Creating the Future

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

ASHP TURNS 75 THIS YEAR, and we have a yearlong campaign filled with surprises and exciting events for our members to celebrate this significant milestone. The last 75 years have been marked by so many ASHP-led advances in pharmacy practice, including: the creation of postgraduate residency training, clinical pharmacy, enhanced recognition of pharmacists as vital members of the interprofessional team, the largest gathering of pharmacists in the world — the ASHP Midyear Clinical Meeting — and so many more.

Although much has been accomplished over the last 75 years, our focus remains on the future, and ensuring that more and more people have access to the direct patient care services of pharmacists. Therefore, the theme of our yearlong celebration is Celebrating the Past, Creating the Future.

The founders of ASHP were visionaries who understood and learned from the past but realized that pharmacists must transform their practices. They worked hard to create a practice future designed to dramatically improve the care of their patients. These leaders included legends such as Gloria Niemeyer Francke, ASHP’s first CEO; Harvey A.K. Whitney, ASHP’s first president; and Donald Francke, ASHP’s second president; and, of course, Joseph A. Oddis, ASHP’s CEO for over 37 years. These are just a few of the great leaders who realized very early that pharmacists must do so much more than dispense drugs, and that ASHP should be the organization that makes it happen on behalf of patients.

Prior to the 1920s, hospital pharmacy was not a strong, well-organized component of the profession. In 1936, a subsection of hospital pharmacists in APhA was formed and, for the first time, hospital pharmacists had a voice on the national pharmacy stage. In 1942, the American Society of Hospital Pharmacists was formed with 153 charter members who worked exclusively in hospital settings.

Today ASHP has nearly 45,000 members who treat patients in every healthcare setting, including in ambulatory clinics, hospitals, and throughout the entire continuum of patient care. ASHP members are involved in all facets of pharmacy practice and include inpatient pharmacists, ambulatory care pharmacists, clinical specialists and scientists, informatics experts, practice managers, student pharmacists, residents, new practitioners, pharmacy technicians, and others.

We owe our success to our dedicated members, which is why we would like you to help us celebrate our diamond anniversary. We have a number of special activities scheduled throughout the year, culminating in a grand finale celebration at the Midyear Clinical Meeting in Orlando in December. We also are planning significant activities for key ASHP events including the Summer Meetings in June, the Preceptors Conference in August, Policy Week in September, and the Leaders Conference in October.

Thank you so much for being a member of ASHP, and for everything you do for your patients. With your help, we can continue to improve patient care and support you in your professional endeavors.

Please join us in celebrating this important anniversary — and stay tuned for more details as we roll out our 75th anniversary celebration.

Sincerely,

Paul

March 28, 2011

ACOs in the Age of Health Care Reform

Multidisciplinary teamwork is a key feature of Accountable Care Organizations.

THE PATIENT PROTECTION AND AFFORDABLE CARE ACT OF 2010 provides a plethora of opportunities for pharmacists to optimize their patient-care services. As health systems and physicians, groups create accountable care organizations (Acos) to reach the performance measures laid out in the medicare Shared Savings Program, they are turning to pharmacists to fine-tune the management of chronic diseases, reduce hospital readmissions, and improve medication safety.

Med Management and the Medical Home

The medical home model can provide a foundation for an ACO. In this model, pharmacists, working as members of the interdisciplinary care team, concentrate on medication management as a way of not only improving patient care but also curtailing costs.

For example, Baylor Health Care System in Dallas is creating an ACO in which chronic disease management is a core competency. Pharmacists will be involved in several key areas: medication compliance, polypharmacy management, and reduction of unnecessary medication. Baylor is integrating hospital electronic health records with outpatient electronic health records to facilitate medication reconciliation, as well.

Baylor also operates a medication assistance program for indigent patients at high risk for hospital readmission. Pharmacists help patients in the program apply for free medications from pharmaceutical manufacturers.

“We started that many years ago, and originally focused on the transplant patient population to help them get medications to prevent organ rejection, but the program has been so successful in realizing savings that we plan to use it heavily in our ACO,” said Michael D. Sanborn, vice president, cardiovascular services. “If we are able to get high-risk patients free or reduced medications, we can reduce hospital admissions and reduce overall cost.”

At four clinics, Fairview Health Services, an eight-hospital health system in Minnesota, is also incorporating the medical home model into its ACO. Fairview is establishing medical homes in which the goals are to reduce costs, increase patient satisfaction, place 50 percent more patients under a clinic physician’s care, and improve quality-of-care measures.

Efficient work flow is a cornerstone of Fairview’s efforts, said Scott Knoer, Pharm.D., M.S., director of pharmacy at the University of Minnesota Medical Center. “We want to have the right people doing the right thing. Anything with medication should involve the pharmacy, either pharmacists or pharmacy technicians, as appropriate.”

For example, pharmacy technicians interview patients and enter patient histories into the electronic health record. Standardizing medical histories enhances medication reconciliation and can help smooth the transition from inpatient to ambulatory care. Meanwhile, pharmacists have more time for direct patient care and education, such as helping patients manage their blood pressure and control their diabetes. These efforts will combine to improve patient care and rein in costs, Knoer said.

Above, Kevin J. Colgan, M.A., FASHP

Waiting for Guidelines

The Department of Health and Human Services hasn’t yet laid out guidelines or rules governing ACOs. But there are several things to keep in mind as health systems forge ahead to provide higher quality while lowering costs, said former ASHP President Kevin J. Colgan, M.A., FASHP, corporate director of pharmacy at Rush University Medical Center in Chicago.

“It’s important to set parameters to determine risk for readmission or problems with adherence and incorporate pharmacy services as appropriate,” Colgan said, pointing to a study of 58 readmitted patients at the medical center that revealed each patient was taking, on average, 11 different medications.

“It’s obvious what the role of the pharmacist is there,” Colgan said. “Pharmacists should be providing medication education and assistance with managing therapy so that you get good outcomes.”

Health systems in the process of creating ACOs will also have to determine which patients should be enrolled, he added, noting that the opportunity to reduce overall cost shrinks for those at low risk who require fewer services.

Finally, ACOs will need to determine where to concentrate resources to provide the best care. “Theoretically, the idea would be to transition patients to prevent unnecessary hospital readmissions and lower costs that way,” said Colgan. “It may mean that you move some resources to an ambulatory setting to help patients avoid hospitalization.”

He added that overall, there is room for variation in ACO development. “There will be different forms and structures, with room to shape what the pharmacist’s role will be,” he said.

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