Pharmacist Role, Education & Training
Pharmacy Technician Role, Education & Training & Safety
Sub-Domain: Practice-Focused
Creation of a Pharmacy Professional Development Program at an Integrated Healthcare System
Submitted by Elizabeth Harthan, PharmD, BCPS; Jennifer Ellison, PharmD, BCPS; Miranda Chauncey, PharmD
Case Overview
The OSF HealthCare Advance program encourages and supports continuing professional development of pharmacists and pharmacy technicians. The program exists to promote and recognize clinical excellence through the continuous acquisition of clinical knowledge, professional development, and growth of our pharmacy employees. The objectives are to create highly engaged staff, as measured by increased employee engagement and retention, and to improve patient outcomes, including patient satisfaction and quality/safety metrics through staff development. OSF HealthCare is utilizing this program to support the OSF professional development model, which includes focusing on accomplishments and outcomes, measuring growth and development, and recognizing leadership, research, and education.
OSF HealthCare includes fifteen hospitals in urban and rural settings: one tertiary referral medical center with a children’s hospital, nine community hospitals, and five critical access hospitals. In addition, OSF HealthCare offers community pharmacy, a remote central verification pharmacy department, and home infusion pharmacy services. Pharmacists and pharmacy technicians in any of the settings mentioned above who have completed their orientation and onboarding process are eligible to participate in OSF Advance. Pharmacy employees may utilize the certification benefit to receive compensation for one certification and ongoing recertification. Pharmacy technicians may also utilize this benefit to complete certificate programs. Certificate programs must be relevant to the technician's role within the department and be approved by their manager. As pharmacy technician certificate programs continue to expand, this benefit has also expanded. The program does not limit the number of certificate programs a technician may complete.
In addition to supporting certification, pharmacists can participate in our Levels of Achievement program. By pursuing Levels of Achievement, pharmacists may earn professional development funds to use towards various professional development-related activities, including continuing education, maintenance fees, certificates, meeting attendance, and more. Various tiers of funds are offered based on the level of achievement. These levels include Elevate ($750), Achieve ($1,500), and Conquer ($3,000). At the end of each year, all pharmacists who wish to achieve a level present their accomplishments and career goals to the OSF Advance Committee and OSF Pharmacy Leadership.
The OSF Advance Committee currently has eight pharmacists who serve on the group. Of the members, four hold no formal leadership positions, and four are members of the management team. The participation is voluntary and full-time equivalent neutral. The role of the committee is to ensure the program components meet the needs of the pharmacy staff and to uphold the integrity of the program by ensuring the Levels of Achievement branch is fairly judged and awarded.
Through this program, OSF strives to provide opportunities for pharmacists and pharmacy technicians to achieve our mission to serve patients with the greatest care and love.
Key Elements
The OSF Advance program originally started as a nursing initiative in response to Organizational Engagement Survey Feedback regarding the provision of career development opportunities. The Pharmacy Department was invited to participate and modify the nursing program for pharmacy relevance to address similar feedback.
After obtaining financial support, the first step in developing the program was to create our Levels of Achievement program for pharmacists. The Levels of Achievement program requires pharmacists to create a presentation to describe the professional activities outside their defined job role they have pursued to achieve their professional development goals. This information is presented to the OSF Advance Committee and the pharmacy leadership team to determine the level of achievement. This presentation development allows pharmacists to reflect on their work over the year and share their achievements with others.
To develop the template for these presentations, the OSF Advance Committee needed to identify specific activities to be recognized as above and beyond. These activities were determined by benchmarking with nursing and incorporating the elements of the ASHP academic and professional record for residency preceptors. We also needed to determine a standard approach for how activities would be scored and the definition of “above and beyond.” The activities have a wide scope, including the development of monographs, volunteerism in the community, participation on health-system-wide committees, and many more. Currently, there are 29 different categories for activities.
The OSF Advance Committee and the pharmacy directors perform an annual program review. The review includes incentive allocation, the approval of certifications and pharmacy technician certificate programs, and the classification of newly identified “above and beyond” activities. The committee uses feedback from pharmacists and pharmacy technicians who participated last year to provide improvements to the program.
The OSF Advance program continues to expand based on feedback from pharmacists and pharmacy technicians, as well as the profession’s needs. Recently, reimbursement for pharmacy technician certificate exams and certificate training programs were added as opportunities for professional advancement specific to technicians. This aspect of the program has grown further with the initiation of a Pharmacy Technician Career Ladder, which requires the achievement of certificates or certifications to advance to higher levels.
Impact on Patient Outcomes
In 2022, 22% (42) of inpatient pharmacists across the health system achieved an OSF Advance Level of Achievement, with the following breakdown: Elevate (24), Achieve (14), Conquer (4). This was an increase of 13 pharmacists from the previous year. The program began in fiscal year 2020 with 21 pharmacist participants (11%) obtaining a level. Thus far, participants practice in the hospital setting and represent the tertiary medical center, community hospitals, remote verification pharmacy department, and critical access hospital environments. Since the program’s inception, 26 pharmacists have achieved certification or recertification. Six technicians have sought certificate or certification reimbursement.
Our annual staff opinion survey has reflected a continued increase in the belief that our organization supports career development opportunities. In 2018, 93% of our staff (283 pharmacy employees) participated in the Press Ganey survey. The survey results demonstrated a score of 3.68 for whether pharmacy team members agreed OSF provides career development opportunities. As the program was implemented and expanded, the score for the same question improved to 3.98 by 2022. This was a statistically significant improvement according to Press Ganey. Press Ganey considers any shift of 0.2 or greater in a response score to be significant (pharmacy technician 3.78 to 3.89 – same time frame); (pharmacists 3.51 to 3.99). This result was felt to be reflective of our staff’s opinions as that year 92% or 388 team members responded to the survey. Our score of 3.98 was also 0.3 points above the national healthcare average. This increase was most significantly recognized the year after implementation, but we continue to observe an increase in positivity towards this statement.
Pharmacy and Pharmacist Roles
We believe professional development and growth through the OSF Advance program is an individual choice of the pharmacy team member and a collaborative partnership between the pharmacy team member and the organization. Pharmacists and pharmacy technicians are responsible for choosing the technician certificates, certifications, or professional activities that best meet their professional goals. However, these activities need to be aligned with the employee’s role within the institution. Pharmacists and pharmacy technicians seeking to utilize the OSF Advance program are responsible for keeping track of their qualifying activities and presenting this data to the OSF Advance Committee. The employee’s supervisor is responsible for signing off on the activities and/or certifications to ensure they are relevant and appropriate for inclusion in the program.
For the certification branch, this program only provides reimbursement after successfully completing the exam. The reimbursement covers the cost of the certification testing fee and for approved technician certificate training programs. Pharmacists must use their own funds or funds earned through the levels of achievement to purchase preparatory materials. This reimbursement approach instills additional ownership to the pharmacy team member to ensure they are sufficiently prepared for the exam.
Professional development dollars earned through levels of achievement are utilized the following fiscal year on approved activities. Although activities are extremely varied, funds are different than a cash reward. Professional development funds encourage pharmacists to continue their professional development journey and set new goals each year. The program is intended as a means for individuals to invest in themselves.
One of the largest roles of the OSF Advance Committee members perform is to review and approve the levels of achievement presentations at the end of each fiscal year. This approval of the pharmacist presentations is crucial to the integrity of the program as it allows us to maintain consistency in our scoring. Also, the presentation review allows those most familiar with the program to help our participants obtain the highest level possible. Our goal as a committee is to ensure the program operates effectively and creates a positive interaction for our staff.
We have also developed a champion peer-mentor program to promote staff participation with OSF Advance. Each facility or region has a designated OSF Advance Champion. In this role, the champion acts as a point person for directing questions, forwarding monthly emails, encouraging co-worker participation, and sharing their experience with OSF Advance with their peers. Being a champion is considered an “above-and-beyond” activity for the individual’s own Levels of Achievement submission. We have found this additional role to help promote the professional development of pharmacists and technicians from a local perspective.
Lessons Learned
One of the key elements of our program is to support the workforce engagement of our pharmacy staff members. Supporting this effort has both been a large win, as well as a challenge. Providing our staff with an avenue to share their great work, receive recognition, and gain monetary benefits has improved staff morale. However, as committee members, keeping a balance between maintaining the integrity of the program in conjunction with being compassionate and understanding for compliance with program logistics, has been challenging. We want our staff members to positively associate with the program while creating fair and straightforward rules. As the program develops, the committee and staff members benefit from the lessons learned. The growth of the program creates new challenges and learning opportunities. Learning opportunities include how to support mission partners who missed a deadline or how to approach above-and-beyond activities not originally identified in our scoring tool. With each new encounter, our committee grows and adapts to a better approach to challenges our staff members present to us.
This outlook towards supporting workforce commitment has made the OSF Advance program a very personal experience to the committee members and its interactions with each participant. This personalization requires a significant time commitment and dedication from our committee members. Our nursing colleagues do not review the presentations prior to the final presentation date. This approach allows the committee to only focus on what was presented and how it matches up with the scoring tool. This lack of personalized support for the participants is an approach we considered. Only scoring the presentation in the moment would put a large focus on the rubric and more onus on the presenter to earn their level. Ultimately, we opted to utilize our committee resources to create a collaborative environment with our participants.
Our biggest champions of OSF Advance have been our local pharmacy managers and supervisors. They encourage the staff to participate, help them identify activities that will count towards earning a level, and champion our technicians to further their career development. Without their support, our program would not have the continued growth and success.
Budget & Resource Allocation
The OSF Advance Committee was established in September 2019, and the program rolled out in January 2020. Work in the initial months was primarily evaluating activities permitted for the Levels of Achievement branch and determining if they aligned with the above-and-beyond activities of our pharmacist staff. We also had to evaluate the certification benefit to ensure it met the need of our most common certification avenues. During our first year, we had a modest level of participation. Participation was appreciated as we quickly learned that the scoring tool lacked important elements that our pharmacists support. Also, our scoring tool benefited staff members working at large medical centers more compared to members in our smaller hospitals and remote verification pharmacy department. We made significant changes to our scoring tool after the first year to improve the balance of activities it supported, ensuring those activities aligned with the mission of our pharmacy department.
Future Goals
Our primary future goal is to continue growing the number of pharmacy staff members who choose to participate. In this most recent fiscal year, 22% of our inpatient pharmacist staff participated in the levels of achievement branch of the OSF Advance program. We aim to continue pushing that number to 40% involvement next year. We added the role of facility OSF Advance Champions to promote the advantages of participating in the program to their peers.
With the development of our pharmacy technician career ladder, we hope to improve communication about the technician benefits. Supporting our technicians’ professional development is essential to the quality and safety of our pharmacy department. Our last goal for the program’s future is to continue to encourage pharmacist participants to engage in goal-directed professional development activities. We plan to change our presentation format to give our pharmacists the tools to evaluate their goals and think about how the activities they choose to participate in support their future goals.