Association News

Important Updates from the Tennessee Board of Pharmacy Meeting

IN THIS POST:

• TPA Community Pharmacy Transformation Pilot Project APPROVED by Tennessee Board of Pharmacy
• Adam Rodgers, PharmD, Selected by Governor Bill Haslam as Next Pharmacist Member of the Tennessee Board of Pharmacy
• Patient Safety and Pharmacy Staffing Concerns Raised in Complaint Filed with Board
• Board Rules Regarding “Pharmacist-In-Charge”

TPA Community Pharmacy Transformation Pilot Project APPROVED by Tennessee Board of Pharmacy

On September 13, 2017, the Tennessee Pharmacists Association (TPA) presented its Community Pharmacy Transformation Pilot Project proposal to the Tennessee Board of Pharmacy. After some discussion, the pilot project was approved by the Board. Interested TPA members can view TPA’s presentation of the pilot project proposal by CLICKING HERE and starting at the 2:05 mark. TPA greatly appreciates the ongoing support, engagement, and input from our TPA members, as well as the Tennessee Board of Pharmacy members and staff, regarding this pilot project. More information is provided below.

What is the Community Pharmacy Transformation Pilot Project?

The Community Pharmacy Transformation Pilot Project utilizes an emerging pharmacy practice model that leverages Technician Product Verification (TPV) and Collaborative Pharmacy Practice (CPP) to optimize the delivery of pharmacist-provided care and services in community pharmacy practice settings. Community pharmacists remain in the perfect position to transform our health care system and leverage patient access to create a new vision for delivery of patient care. TPV utilizes certified pharmacy technicians with advanced training to facilitate delivery of high-quality pharmacist-provided patient care that ensures patient safety and better health outcomes. TPV pilot programs in community pharmacies in Iowa and Wisconsin have demonstrated that advance trained, certified technician accuracy in performing final verification is comparable to pharmacist accuracy, and the use of TPV in these states has resulted in increased time for pharmacists to provide high-quality patient care leading to optimal health outcomes, while maintaining a high level of patient safety.

Tennessee Board of Pharmacy Rule 1140-02-.02 currently permits technician product verification for inpatient institution-based pharmacy practice settings where certified pharmacy technicians verify the contents of unit dose carts and automated dispensing systems prepared by other registered technicians using additional verification, by either barcode technology or a licensed health care professional, prior to administration to the patient. Additionally, seven other states allow the use of TPV in the community pharmacy practice setting. With the Tennessee Board of Pharmacy’s approval of TPA’s request for the temporary Community Pharmacy Transformation Pilot Project, Tennessee becomes the eighth state to implement this model of care in the community pharmacy practice setting.

Training Requirements and Pilot Project Goals:

With approval of the Community Pharmacy Transformation Pilot Project by the Tennessee Board of Pharmacy, TPA will move forward with site selection and training of independent and chain community pharmacists and certified pharmacy technicians, guide implementation of TPV and clinical services through Collaborative Pharmacy Practice, and track the results of this very important pilot project. Goals of the temporary pilot project include:

1. Evaluation of the impact of a community pharmacy-focused TPV program on patient safety measures
2. Examination of the impact of a TPV program relating to reallocating pharmacists’ time from technical duties to the delivery of patient-centered care
3. Assessment of the expansion of pharmacist-provided patient care in participating community pharmacy settings after implementation of a TPV program
4. Evaluation of the impact of this practice model change on the ability of pharmacists to achieve optimized patient-centered care through CPPAs

• Permit a certified pharmacy technician with advanced training in product verification to deliver the final verification of medication products (excluding compounds and controlled substances)
• Empower certified pharmacy technicians to screen patients and refer eligible patients to pharmacists for additional care and services
• Utilize a new pharmacy practice model to free up more time and increase patient access to pharmacist-provided services, such as those authorized by prescribers under CPPAs

• Change the pharmacist supervision requirements for pharmacy technicians
• Remove the pharmacist from the clinical decision-making process, Drug Utilization Review (DUR), or any other clinical component of the prescription dispensing process
• Diminish the importance of a pharmacist or the license they hold
• Replace pharmacists with pharmacy technicians

TPA member Dr. Adam Rodgers, of Brentwood, Tennessee, has been selected by Governor Bill Haslam to serve a 6-year term as a pharmacist member of the Tennessee Board of Pharmacy. A 2002 graduate of the University of Tennessee Health Science Center, Dr. Rodgers currently serves as a CVS Pharmacy Supervisor covering 28 Target Channel Pharmacies in Tennessee and Alabama. His previous work history includes service as a Target Healthcare Business Partner, Target Executive Team Leader for Pharmacy, Walgreens Pharmacy Manager, and Walgreens Pharmacist.

Adequate pharmacy staffing and maintaining patient safety remain a priority for the pharmacy profession. During its September meeting, the Tennessee Board of Pharmacy discussed a complaint filed with them regarding adequate pharmacy staffing and concerns about ongoing patient safety. As pharmacies look to maximize management of resources, decreasing pharmacy technician staffing hours has been one strategy deployed. Decreases in pharmacy technician hours, as well as increases in volume of prescriptions and immunizations, has raised concern among TPA members and the Tennessee Board of Pharmacy. Per the Board of Pharmacy, metrics to assist Board of Pharmacy investigators in determining patient safety within pharmacy practice sites do not exist, but observations of the workflow and workload have been used to measure patient safety. Complaints filed against pharmacies related to pharmacy staffing and patient safety are currently addressed through meetings between the Board of Pharmacy staff and upper-level pharmacy management. However, Board of Pharmacy members have asked for a more formal process to assess penalties related to patient safety and pharmacy staffing issues in the future. It is important to note that it is the opinion of the Board of Pharmacy that the pharmacist-in-charge is responsible for ensuring that the pharmacy practice site is safe. TPA encourages pharmacists who believe they are practicing in potentially unsafe work environments to discuss their concerns with pharmacy management and/or contact the Tennessee Board of Pharmacy. In the coming weeks, TPA will be sending a survey to members to determine current workplace issues and possible remedies. The following Board of Pharmacy rules address patient safety and pharmacy practice:

1140-02-.01 PHARMACISTS AND PHARMACY INTERNS.
(1) A pharmacist shall hold the health and safety of patients to be the first consideration and shall render to each patient the full measure of the pharmacist’s ability as an essential health practitioner.

(7) A pharmacist shall not agree to practice under terms or conditions which tend to interfere with or impair the proper exercise of professional judgment and skill, which tend to cause a deterioration of the quality of professional service and patient care, or which require the pharmacist to consent to unethical conduct. As a pharmacist, it is imperative to use your professional judgment to ensure the safety and welfare of your patients.

1140-03-.03 MEDICAL AND PRESCRIPTION ORDERS
(6) No pharmacist, or pharmacy intern or pharmacy technician under the supervision of a pharmacist, shall compound or dispense any medical or prescription order except upon the following conditions:
. . .
(e) At a rate, based on the actual number of medical and prescription orders compounded and dispensed per hour or per day, that does not pose a danger to the public health, safety or welfare.

During Board meetings, the Board routinely hears complaints filed against pharmacies, pharmacists, and pharmacy technicians. In many of these cases, the pharmacy and the pharmacy staff are listed in the complaint, but the Board also considers the responsibility of the pharmacist-in-charge when deliberating on these complaints. It is important for pharmacists serving as the pharmacist-in-charge of a pharmacy practice site to be aware of their additional responsibilities. Rules regarding the “pharmacist-in-charge” can be found in the Tennessee Board of Pharmacy Rules, and TPA reminds members serving as pharmacist-in-charge to review the Board rules and ensure that your pharmacy practice site maintains compliance.