The last few Tips described various models of delivery value-added pharmacy services, some as a pilot or concept, and others as having carefully incorporated implementation science for sustainability. Technicians were mentioned at least indirectly and more often than not quite directly as integral to pharmacy achieving these new models of practice or improving upon existing models to provide more patient-centric care. If pharmacists are to take on new responsibilities, then technicians are the ones who must take on what the pharmacist previously was doing.
Technicians have not enjoyed the “scope of practice” that pharmacists do, nor should they. Their education and training are vastly different. However, they are knowledge workers and usually capable of performing more activities than they are assigned. Pharmacies have seldom re-engineered their workflows to optimize the practice of pharmacists and technicians. Exacerbating this problem is the fact that some state Boards of Pharmacy either don’t license and thus don’t really recognize technician practice or they narrowly confine it simply by listing a relatively small list of activities that can be undertaken by technicians. Adams, as the one-time head of the Idaho Board of Pharmacy describes how they expanded the scope of technician activities primarily under: medication dispensing support (eg, tech-check-tech) and technical support for clinical pharmacist services (eg, administering immunizations).1 While the state of Idaho approved technicians performing activities under these domains, Adams points out that the primary basis under which Idaho does so is to list the services that technicians CANNOT perform, rather than list the few that they can perform. This mindset allows the pharmacist to REALLY practice at the “top of their license” with greater autonomy and oversight of activities, thus having them perform those activities more central to direct patient care while delegating other activities to support personnel.
Pharmacy managers can support a culture of employee empowerment and optimal performance by allowing pharmacists to delegate to technicians to the extent possible all tasks that do not require clinical judgment, or at least those tasks which are not precluded by the state’s Board. Pharmacy managers must ensure effective hiring of both pharmacists (willing and able to delegate) and technicians (competent and mature enough to be deleted to) while having nothing short of 100% confidence that all operations are being conducted under the auspices of the state’s rules and regulations.
Additional information about Technicians and Compliance with Regulations and Regulatory Bodies can be found in Pharmacy Management: Essentials for All Practice Settings, 5e. If you or your institution subscribes to AccessPharmacy, use or create your MyAccess Profile to sign-in to Pharmacy Management: Essentials for All Practice Settings, 5e. If your institution does not provide access, ask your medical librarian about subscribing.
1Adams AJ. Advancing technician practice: Deliberations of a regulatory board. Res Social Adm Pharm. 2018;14:1-5.
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To what extent do you rely on pharmacy technicians? Does it feel empowering (in a good way) to delegate?