Tct Property Management Reviews

Tct Property Management Reviews – 2 Disclosures Drs. Cynthia Boyle, Kayla McFeely, and Kristopher Rusinko have no relevant financial relationship with any commercial interest in the content of this presentation.

3 Objectives By the end of this presentation, the participant should be able to: 1. Describe at least 3 recent advances/initiatives for education/training of pharmacy technicians 2. Describe the Maryland Acute Care TCT process Society of Health-System Pharmacy (MSHP) and proposal highlights presented to Maryland Board of Pharmacy

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3. Describe the successes and challenges of an optimized community pharmacy care model that enhances the role of trained pharmacy technicians to reinvest pharmacists’ time to provide patient care services 4. Discuss the steps, Scope and Limits of a Potential Tech-Check-Tech in Maryland

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Moderated Discussion on Optimizing Care in the Community Pharmacy – Challenges and Opportunities for TCT in Maryland (audience input to Maryland Stakeholder Conference)

6 Objective 1: Describe at least 3 recent advances/initiatives for the education/training of pharmacy technicians. Cynthia J. Boyle, PharmD, FAPhA Professor, University of Maryland School of Pharmacy MPhA Past President

7 Survey participants State boards of pharmacy should require new pharmacy technicians to obtain national certification for registration or licensure (75/15/5/5) Bridging programs should be developed and proposed to build the skills of pharmacy technicians who are currently in the workforce and would like to advance their skills (56/40/3/1) Planners should build a coalition with broad representation for PTSCC recommendations (77 /23/0/0) Zellmer WA, McAllister EB, Silvester JA, Vlasses PH. Towards uniform standards for pharmacy technicians: summary of the 2017 consensus pharmacy technician stakeholder conference. JAPhA 57(2017)e1-e14.

Quality of Pharmacy Technician Education/Training Programs Program Accreditation Pharmacy Technician Accreditation Pharmacy Technician Regulation Role of Academic Institutions in Pharmacy Technician Education, Training and Certification Collaborations Mobley Smith MA, Boyle CJ, Keresztes JM, Liles J, Garrelts MacLean L, McAllister EB, Silvester J, Williams NT, Bradley-Baker LR. Advancing the pharmacy profession together through partnerships between pharmacy technicians and pharmacy education. Report of the Standing Committee on Professional Affairs. Am J Pharm Educ. 2014 ; 78(10): Section S22.

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9 “The ability of pharmacists to successfully fulfill patient care provider roles depends on how well pharmacy technicians are prepared to perform their role as pharmacy support personnel. »

All sectors of pharmacy participated, including a pre-conference survey of JCPP member organizations. State variability in regulations presents risks for patients and the profession. Job analysis should be the basis for accredited technician training, technician certification and national regulations. Participants recognized generalist knowledge/skills/abilities regardless of practice and the need for additional programs beyond entry level (advanced).

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PTCB – founded in 1995 by APhA, ASHP, Illinois Council of Health-System Pharmacists, and Michigan Pharmacists Association, and joined by NABP in 2001. PTCB advocates for a single national standard for pharmacy technician certification recognized and supported by the profession. The PTCB advances medication safety by certifying qualified technicians to support pharmacists and patient care teams in all practice settings. New PTCB Executive Director, William Schimmel

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Exam Content Areas (9-4) as of 2016 Job Analysis, Entry Degree Medical Safety/Patient Care Focus Training – PTCB or equivalent experience Effective January 1, 2020 90 Day Comments Staff Sgt Mary Johnson PTCB CPhT of the Year 2017

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13 Active Learning The statement that best describes the results of the Pharmacy Technician Stakeholder Consensus Conference (PTSCC) is: By 2020, all pharmacy technicians should be licensed. By 2020, all pharmacy technicians may be eligible for certification through PTCB coursework or experience. By 2020, all states should adopt comparable regulations for technicians. By 2020, all schools/colleges should offer technician education/training.

15 Objective #2 Describe the Maryland Society of Health-System Pharmacy (MSHP) Acute Care Tech-Check-Tech (TCT) process and the highlights of the proposal submitted to the Maryland Board of Pharmacy

16 TCT – Background Specially trained and validated pharmacy technicians (VPT) verify the accuracy of medications filled by another technician No clinical judgment required Studies show that technicians are at least as accurate as pharmacists Code reading technology bars provides protection against dispensing the wrong medication Pharmacist’s time reassigned to patient care tasks

University of Wisconsin Health and University of Iowa Health Conference Calls UW Health/ Pharmacy Examination Board Toolkit Conversations with other states (student project) Retreats and breakout groups to update materials and discuss roles of TVPs

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Barcode scanning required Filling the Automated Dispensing Cabinet (ADC)

Appendix B – Waiver Request Cover Letter Appendix C – Waiver Request Form Appendix D – Sample Policy Appendix E/F – Additional Examples Appendix G – Practical Training Checklist Appendix H – Application Checklist Competency Assessment Appendix I – TCT Overview for Technicians Appendix J – Training and Self-Learning Package Appendix K – Written Exam Appendix L – Competency Validation Process Guidelines Appendix M – Initial Validation Error Log Form Appendix N – Quality Assurance Process Guidelines

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Appendix T – Initial Technology Validation Log Appendix U – QA Monitor Report to Board Appendix V – TCT Implementation Checklist Appendix O – QA Error Log Sheet Appendix P – Report Tip Spread Appendix Q – Artificial Error Log Appendix R – Examples of Artificial Errors Appendix S – Examples of Artificial Basket Fill Errors

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MDBOP has created a working group of its members to review the framework, if any Training and requirements Authorized activities Monitoring and reporting Lifebridge, Medstar, JHBMC and JHH Peds

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24 Active Learning Which of the following were suggested as items to check in an acute care setting TCT program: Product check before restocking Automated dispensing cabinet (ADC) Batch assay preparation for loading into ADCs Filling trays /code boxes Preparing manufacturer’s oral doses liquid medication bulk vials All of the above

Objective #3: Describe the successes and challenges of an optimized care model within the community pharmacy setting Kayla M. McFeely, PharmD Executive Fellow National Association of Chain Drug Stores

“Change is a common thread that runs through all businesses, regardless of size, industry, and age. Our world is changing fast, and organizations must change fast too. Organizations that manage change well thrive, while that those that don’t may struggle to survive The “Why” Quick introduction to the dynamic industry and the need to improve patient care Brief introduction to how optimizing care is a strategy enabling pharmacies to provide more efficient and better patient care *Omit if others go over their time*

27 Optimizing care Strengthens the role of qualified pharmacy technicians to reinvest pharmacists’ time to provide patient care services Improve patient access and health care outcomes Harness the full potential of pharmacists’ clinical expertise pharmacists and technician skills Iowa, Wisconsin, Tennessee Definition and objectives. Optimization of care is the model, and product verification by the technician is an action within the model.

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Will verbally indicate Iowa’s progress from Phase 1 participation to Phase 3 participation as shown on the slide. FYI – IA understands the final phase of the project, but I can verbally say that it started with independent pharmacies.

Transitioning to Dissemination Phase Sharing Experiences and Ideas Webinar Series – Upcoming 2. Wisconsin Conclusion of Data Collection Upcoming Data Analysis 3. Tennessee Recruitment Baseline Data Collection 4. Qualitative Analysis – All 3 Projects

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Patient Safety Verified RPh (Baseline) Verified by Technician (Pilot) Total 5,565 5,950 Wrong Medication 1 Wrong Dosage 2 Safety Cap Error 8 19 Wrong # 3 Other Error 4 Total Errors 15 33 Rate of accuracy 99.73%* 99.445%* * not significantly different Published on the web: Iowa Optimizing Care Pilot – Phase 1

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Challenges Pre-Implementation Phase Implementation Phase Pharmacy Board Approval Pharmacy Recruitment IT Redesign Separate Distinction for Control Technicians Workflow Redesign Plan Perceptions and Myths Technician Verification Process – takes time Want to check on more technicians – coverage Staff turnover Takes time to adjust to new responsibilities Perceptions and myths Time consuming, especially for low volume stores Now that the stage is set regarding the definitions, objectives and context of the projects, transition to the challenges and successes encountered so far

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RPh time spent on dispensing 67.3% to 48.58% (p=0.004) Decrease This is available on the web: RPh time spent on patient care activities 15.9% to 35.08% (p=0.002 ) Augmentation Augmentation Iowa Optimizing Care Pilot – Phase 1

Increased number of services provided Identification of drug therapy issues Immunizations and non-vaccination injections MTM services – disease management, adherence monitoring, medication synchronization, compliance conditioning

“Instead of having baskets piled up every time I was busy with other tasks, I now know that my verification technician will take care of it.” “By allowing me to thoroughly check a patient’s medication list and perform medication utilization reviews before any medications are filled at the pharmacy, I am able to provide better patient outcomes. while spending more time with each patient. “Overall it’s been going very well and I’ve noticed a significant reduction in my stress levels and the stress of my colleagues.” “Patients don’t have to wait for counseling or vaccinations. Patients get the care they deserve while spending less time sitting in the pharmacy waiting room. “After double-checking the verification technician’s initial checks, the results for me were very clear: she does her job of verifying prescriptions just as well as I or any pharmacist.” “Release

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