The Iowa new practice model: Advancing technician roles to increase pharmacists' time to provide patient care services

Objectives: Determine the effects of an 18-month pilot project using tech-check-tech in 7 community pharmacies on 1) rate of dispensing errors not identified during refill prescription final product verification; 2) pharmacist workday task composition; and 3) amount of patient care services provided and the reimbursement status of those services. Design: Pretesteposttest quasi-experimental study where baseline and study periods were compared. Setting and participants: Pharmacists and pharmacy technicians in 7 community pharmacies in Iowa. Outcome measures: The outcome measures were 1) percentage of technician verified refill prescriptions where dispensing errorswere not identified on final product verification; 2) percentage of time spent by pharmacists in dispensing, management, patient care, practice development, and other activities; 3) the number of pharmacist patient care services provided per pharmacist hours worked; and 4) percentage of time that technician product verification was used. Results: Therewas no significant difference in overall errors (0.2729% vs. 0.5124%, P = 0.513), patient safety errors (0.0525% vs. 0.0651%, P = 0.837), or administrative errors (0.2204% vs. 0.4784%, P = 0.411). Pharmacist's time in dispensing significantly decreased (67.3% vs. 49.06%, P = 0.005), and time in direct patient care (19.96% vs. 34.72%, P = 0.003), increased significantly. Time in other activities did not significantly change. Reimbursable services per pharmacist hour (0.11 vs. 0.30, P = 0.129), did not significantly change. Non-reimbursable services increased significantly (2.77 vs. 4.80, P = 0.042). Total services significantly increased (2.88 vs. 5.16, P = 0.044). Conclusion: Pharmacy technician product verification of refill prescriptions preserved dispensing safety while significantly increasing the time spent in delivery of pharmacist provided patient care services. The total number of pharmacist services provided per hour also increased significantly, driven primarily by a significant increase in the number of non-reimbursed services. Thiswas mostly likely due to the increased time available to provide patient care. Reimbursed services per hour did not increase significantly mostly likely due to lack of payers. (C) 2018 American Pharmacists Association (R). Published by Elsevier Inc. All rights reserved.