MIRROR TO HOSPITAL PHARMACY Experienced practice leader Bold goals for health-system pharmacy: Perspectives of an experienced practice leader JAMES G. STEVENSON Am J Health-Syst Pharm. 2014; 71:1958-9 A s we reflect on the Mirror to Hospital Pharmacy at the 50th anniversary of its publication, there are several contemporary goals for health-system pharmacy prac- tice that should be highlighted if an updated version of the Mirror were to be written today. These goals are critically important for the profes- sion of pharmacy to achieve its de- sired impact on producing positive patient outcomes. Efective and standard approach to the role of pharmacy technicians The first goal would be to establish an effective and standard approach to developing the role of pharmacy technicians within the pharmacy work force. This goal is not new. Donald Francke identified this as a critical action approximately 40 years ago. 1 Clearly, pharmacy technicians have been integrated within many pharmacies as critical participants in the pharmacy work force. They are widely involved in drug distribution activities, often in an attempt to real- locate pharmacist time to activities that require clinical judgment or to facilitate pharmacist involvement in direct patient care. Technicians have also been used in a variety of JAMES G. STEVENSON, PHARM.D., FASHP, is Chief Pharmacy Officer, University of Michigan Hospitals and Health Centers, Ann Arbor, and Professor and Associate Dean for Clinical Sciences, University of Michigan College of Pharmacy, Ann Arbor (jimsteve@umich.edu). Presented at the ASHP Midyear Clinical Meeting, Orlando, FL, December 10, 2013. The author has declared no potential conflicts of interest. Copyright © 2014, American Society of Health-System Pharma- cists, Inc. All rights reserved. 1079-2082/14/1102-1958. DOI 10.2146/ajhp140240 nondistribution-related activities. 2 Nevertheless, we still lack a standard national approach to the education, certification, and licensure of these individuals. Despite the critical and high-risk nature of technician activi- ties, some states still permit techni- cians to practice with no more than on-the-job training. Particularly with the advancement of technology, the education and roles of pharmacy technicians must be clearly defined and standardized to enable optimal integration into the pharmacy prac- tice model. Pharmacy as a profession cannot serve the public well unless technicians have adequate education and training and are driven by profes- sional values. In order to advance as a pharmacy profession and to meet the societal needs for safe drug distribu- tion, it is imperative that we move forward with the establishment of national standards in the education, certification, and licensure of these critical personnel. The stage has been set through vision statements that call for technicians to complete accred- ited training programs before taking their national certification examina- tion. 3,4 In addition, there is growing recognition of the need for advanced education and certification require- ments for pharmacy technicians who practice in areas that might require specialized skills (e.g., parenteral drug preparation, chemotherapy or haz- ardous drug handling). Enhanced utilization of informat- ics and automation A second important goal is related to capitalizing on health informatics and automation to advance qual- ity and safety in the use of medicines. Despite the significant investments in information systems in the United States, the anticipated benefits have not yet been realized. One of the key reasons for this is that there are signifi- cant deficiencies in the sophistication and use of these systems and in under- lying clinical decision-support rules to advance quality and safety. Often, these deficiencies lead health systems to either turn off or significantly limit the clinical decision-support func- tionality. When such functionality is used, alerts are often ignored (com- monly referred to as “alert fatigue”) due to the lack of context and sophis- tication in their presentation. 5,6 Part of the rationale for the sig- nificant investments in electronic health records (EHRs) and related technologies was the hope that we could improve the quality and safety of medication use by rapidly analyz- Layar ar 1958 Am J Health-Syst Pharm—Vol 71 Nov 15, 2014 Downloaded from https://academic.oup.com/ajhp/article/71/22/1958/5111058 by guest on 19 October 2021