Evaluation of community pharmacy tech-check-tech as a strategy for practice advancement.

OBJECTIVE

The purpose of this study was to design, pilot, and evaluate a community "tech-check-tech" (TCT) program as a strategy for pharmacy practice advancement.

SETTING

Community pharmacy with both mail order and outpatient pharmacy services.

PRACTICE DESCRIPTION

The policies, technician training requirements, prescription eligibility requirements, and quality assurance measures necessary for the pilot were developed. The TCT workflows and procedures were integrated into the existing prescription dispensing framework at a pilot site. An analysis of pharmacist and technician checking accuracy was conducted with a 4-week data collection period for each role. To determine TCT technician accuracy, the TCT technician performed the first product verification check after the prescription was filled by a pharmacy staff member. If the TCT technician found an error, they documented the error and returned the prescription to the filling technician for correction. If the prescription was filled correctly, the TCT technician passed the prescription to a pharmacist for final verification. The pharmacist documented any incorrect prescriptions that the TCT technician verified. Pharmacist accuracy was measured through direct pharmacist observation. Direct observation was also used to measure and record pharmacist and technician prescription checking time. The data were then used to evaluate pharmacist time savings as a result of community TCT, while ensuring prescription dispensing accuracy.

PRACTICE INNOVATION

TCT was piloted in a community pharmacy.

EVALUATION

An analysis of pharmacist and technician checking accuracy was conducted with a 4-week data collection period for each role. To determine TCT technician accuracy, the TCT technician performed the first product verification check after the prescription was filled by pharmacy staff. If the TCT technician found an error, they documented the error and returned the prescription to the filling technician for correction. If filled correctly, the TCT technician passed the prescription to a pharmacist for final verification. The pharmacist documented any incorrect prescriptions that the TCT technician verified. Pharmacist accuracy was measured through direct pharmacist observation. Direct observation was also used to measure and record pharmacist and technician prescription checking time. This data was then used to evaluate pharmacist time savings as a result of community TCT, while ensuring prescription dispensing accuracy.

RESULTS

A TCT workflow was piloted successfully in the community pharmacy setting. Technicians were at least as accurate as pharmacists, as validated with statistical analysis (99.95% [95% CI 99.89%-99.99%] versus 99.74% [95% CI 99.61%-99.87%]), and patient safety was maintained. Time studies allowed for the quantification of potential pharmacist time savings (23 days per year) resulting from the implementation of a community TCT program.

CONCLUSION

This study demonstrates the feasibility of a TCT program in the community pharmacy setting.