Leveraging the roles of the technicians

and assistants in your pharmacy

Rachelle Rocha RPh

Ruth-Ann Plaxton RTech

Disclosures

Rachelle Rocha

• No conflicts to disclose

• Works for Loblaw

B

Disclosures

Ruth-Ann Plaxton

• No conflicts to disclose

• Works for Loblaw

B

Goals and objectives

• Maximizing workplace efficiency to deliver optimal

patient care

• Understanding roles of pharmacists, technicians,

assistants and clerks

• Effective task assignment and scheduling

• Case study

RAP

RAP

State of the nation

Total licensed pharmacists 38,737

Total licensed pharmacy technicians 4,349

Pharmacies*:

Community pharmacies 9,558

In-patient hospital pharmacies, if licensed by regulatory authority.

285

Total licensed pharmacies 9,843

RAP

State of the nation

Jurisdiction Total licensed pharmacy

technicians Alberta 457

British Columbia 915

Manitoba 0

New Brunswick 1

Newfoundland and Labrador 0

Northwest Territories 0

Nova Scotia 44

Nunavut 0

Ontario 2,927

Prince Edward Island 5

Quebec 0

Saskatchewan 0 Yukon 0

CANADA 4,349 RAP

RR

RR

Sustainable pharmacy practice

Increase revenue

Fill MORE RX for

less unit profit

PLUS

Build NEW

revenue streams

Decrease cost

Delegate ALL tasks

to the lowest paid,

qualified person

RR

B

Right person

Right task

Right time

Right place

Right equipment

Right technology

RAP

Production line

technical

Patient care

responsibility and

decision-making

Right person, right Task

Ph

arm

acis

t • Evaluating therapeutics of each Rx

• Assessments

• Prescribing

• Extend/renew

• Adapting

• Supervising

• Injecting

• Medication Reviews

• Minor ailment prescribing

• Taking responsibility for patient care

Tech

nic

ian

• Checking Compliance Packs

• Checking “in-line”

• v/o prescriptions

• Direct workflow in dispensary

• Write schedules

• Inventory

• Transfers

• Troubleshooting inventory/drug plans

Ass

ista

nt • Order Entry

• Billing for professional services

• Collecting information (flu shot screening)

• Placing the order

• Identifying opportunities for pharmacist intervention

• Faxing doctors

• Mixtures

• Pushing compliance packs at computer

• Device training

C

lerk

• Packaging

• Phone

• Triage

• Cleaning

• Cash

• Put the order away

• Filing

• Filling compliance packs

• “in training to be an assistant”

B

RAP

Pharmacists need to pick up

• As many professional services that they can

– Refilling or adapting prescriptions

– Medication reviews

– Injections

– OTC recommendations

– Minor ailment prescribing

– Professional opinions

– Assessing EVERY prescription that gets filled for

therapeutic appropriateness

RR

RR

Pharmacists need to give up

• Checking the contents of the vial

• Answering questions about drug plans

• Answering questions about inventory

• Checking compliance packs

• Order entry

• Answering the phone

• Cashing out prescriptions

RR

Techs need to pick up

• Checking all prescriptions – compliance pack and inline

• Training assistants

• Answering all questions related to billing, inventory,

supply chain issues

• Leading the assistants and clerks during busy times

• Organizing the pharmacist with respect to identifying

opportunities for professional activities and directing the

pharmacists next tasks

• Ensuring that all prescriptions have a therapeutic check

before leaving the dispensary RAP

Compliance packs

• OVERSEES the entire program

• Check the completed packs

• Ensure that the pharmacists has completed the therapeutic

review as required

• Assigns and oversees the assistants and clerks billing and

filling the packs

• Troubleshoots all problems related to compliance packs

• Looks for opportunities for expanded professional activities

• NEVER checks his/her own work

RAP

RAP

Techs need to give up

• Order entry

• Answering the phone first

• Filling prescriptions

• Filling bubble packs

• Putting away stock bottles

• Placing the order

• Putting away the order

RAP

We may need to stretch ourselves…

Sometimes to get something really good…

RAP

Train

RR

Trust

RAP

Empower

RR

Evaluate and provide feedback

RAP

Right place

Drop-off Pickup

Counseling spaces

Packaging and Checking

Compliance pack area Inventory management

RAP

Right place

RAP

Right equipment, right technology

RAP

Right person, right time

RR

Scheduling

Pharmacist Pharmacist Pharmacist Pharmacist

Assistant

Assistant Assistant

Assistant Assistant

Clerk

ZERO volume VERY high volume

RR

Scheduling

Pharmacist Pharmacist

Assistant Assistant

Assistant Assistant

Clerk

Clerk Clerk

Technician

Technician

Technician

ZERO volume VERY high volume RR

Scheduling

Pharmacist Pharmacist

Pharmacist

Assistant Assistant

Assistant Assistant

Clerk

Clerk Clerk

Technician

Technician

Technician

ZERO volume VERY high volume RR

Scheduling

Pharmacist Pharmacist

Pharmacist

Assistant Assistant

Assistant Assistant

Clerk

Clerk Clerk

Technician

Technician

Technician

ZERO volume VERY high volume

Robot

RR

Scheduling

Pharmacist Pharmacist Pharmacist Pharmacist

Assistant

Assistant Assistant

Assistant Assistant

Clerk

Shared technician

ZERO volume VERY high volume RR

High volume - scheduling for a week day

Opening About one hour after opening

Evening

Technician

Closing

Pharmacist

Assistants

Clerk(s)

Pharmacist

RR

Low volume shared tech

Pharmacist Pharmacist Pharmacist Pharmacist Pharmacist Pharmacist Pharmacist

Assistant Assistant Assistant Assistant Assistant Assistant

Technician

Sunday Tuesday Monday Thursday Wednesday

Friday Saturday

Technician

RR

Right time

• Who covers breaks and lunches?

• Who covers during busy times?

• What happens when your tech goes on vacation or has

an extended illness?

RR

Case study

Sally, the technician, arrives in the pharmacy at 9:30 on a Monday morning and the staff is hard at

work. Tom, the pharmacy manager, is in the counseling room and there are three people waiting

in line for a flu shot. Sally overhears patients in the waiting area commenting on how great it is

that they don’t have to waste so much time at the doctor’s office for their annual flu shot. (How

wonderful!) The main assistant, Jane, is inputting this morning and the new part time clerk, Joan,

is filling. Sally is relatively new to this pharmacy. She is the first ever registered technician and

has been with the store about two months. She is excited to finally find such an amazing,

progressive pharmacy, (especially when her former employer of 15 years would not let her work

as a technician after she got licensed!)

The day starts off well with everyone working together and Sally spends the first 15 minutes at the

dispensary counter, checking the technical component of the prescription (contents of the vial).

Suddenly, the phone rings and rings and rings, and finally she picks it up. As she is answering

the caller’s question, an elderly woman approaches the cash to pick up her prescription. After a

minute or two Sally finishes on the phone and runs over to the cash to serve her. Returning to

her workstation, the phone rings again. She waits, but at last answers it again. This scenario

repeats itself over and over again, leaving Sally little time to check any baskets. Finally, she gets

back to her workstation and begins checking the stack of baskets that have accumulated. When

Tom arrives on the scene, he blurts, “Hey…I thought you technicians would be able to keep things

going, so I could do other things!” How could the day start off so great, and end up like this?

B

D

# D

esi

red

act

ivit

ies

Time

Supporting change

RR

RAP

References

• Our experience

• Trust In the workplace articles and books

– Bowman, Dave, Human Resource Expert TTG

Consultants; The Five Best Ways to Build - and lose –

Trust in the Workplace, article found on internet

– Reina, Dennis S and Reina, Michael L, (2015) Trust

and Betrayal in the Workplace, Oakdale California,

Berrett-Koehler Publishers Inc