Technical Difficulties: Challenges and Strategies to ... · Technical Difficulties: Challenges and Strategies to Address Pharmacy Technician Turnover OSHP 77thAnnual Meeting Thursday,

Technical Difficulties: Challenges and Strategies

to Address Pharmacy Technician Turnover

OSHP 77th Annual MeetingThursday, April 21, 2016

Tyler A. Vest, Pharm.D. Candidate 2016University of Cincinnati James L. Winkle College of Pharmacy

Katie Clark McKinney, Pharm.D., M.S., BCPSDirector, Pharmacy Services, University of Cincinnati Medical Center

Thursday, April 21, 2016 | Technical Difficulties: Challenges and Strategies to Address Pharmacy Technician Turnover Slide 2

Pharmacist Learning Objectives

• Review pharmacy technician turnover metrics at the University of Cincinnati Medical Center

• Recognize the impact and costs associated with pharmacy technician turnover

• Discuss ways to decrease pharmacy technician turnover

• Assess directions to increase pharmacy technician engagement


Technician Learning Objectives

• Identify how pharmacy technician turnover can affect the department of pharmacy

• Evaluate the importance of pharmacy technician engagement


Introduction To UC Health – University of Cincinnati Medical Center (UCMC)


Practice Advancement Initiative (PAI)

The consensus of the Pharmacy Practice Model Summit. Am J Health Syst Pharm. 2011;68(12):1148-52.


PAI (continued)


PAI (Continued)


Impact of Technician Turnover

• Replacing an employee is 1.5 times annual salary

• UCMC wants to decrease technician turnover

• Increased turnover results from• Low engagement

• Wage disparities

• Poor working conditions

• Conflict

• Poor communication

Mueller A. The Cost Of Hiring A New Employee. Investopedia, 2015. Available at: http://www.investopedia.com/financial-edge/0711/the-cost-of-hiring-a-new-

employee.aspx. Accessed August 13, 2015.

Waldman JD, Kelly F, Arora S, Smith HL. The shocking cost of turnover in health care. Health Care Manage Rev. 2004;29(1):2-7.


Impact of Technician Turnover (Continued)

• Pharmacy technician turnover results in• Decreased morale

• Loss of productivity

• Less training for positions

• Overtime

• Open FTEs

• Engagement of technicians is crucial for practice advancement

Desselle SP. Job turnover intentions among Certified Pharmacy Technicians. J Am Pharm Assoc (2003). 2005;45(6):676-83.


UCMC Case Study

• Purpose• Assess estimated costs of replacing pharmacy

technicians

• Goals/Objectives• Estimate the cost of pharmacy technician turnover at

UCMC

• Evaluate relationship between overtime and open positions

• Identify opportunities to increase engagement


Methods

• Retrospective analysis of FY15

• Data points• Pharmacy technician/intern overtime hours by week

• Pharmacy technician/intern open FTEs by week

• Assumptions made• Average rate of pay for pharmacy technicians

• Costs associated with hiring, training, and replacing

• Center for Law and Social Policy and Center for Economic and Policy Research (CLASP-CEPR) Turnover Calculator

• Actual overtime spend is in dollars


UCMC Technician Overtime (FY15)

Characteristic Hours Amount

Weekly Inpatient Pharmacy

Technician Overtime (Average)77 $1,363

Weekly Outpatient Pharmacy

Technician Overtime (Average)4 $71

Total Inpatient Pharmacy

Technician Overtime 3,904 $69,101

Total Outpatient Pharmacy

Technician Overtime219 $3,876

Inpatient and Outpatient Total

Pharmacy Technician Overtime4,123 $72,977


UCMC Technician Open FTEs (FY15)

Characteristic FTEs

Weekly Inpatient Pharmacy Technician 5.23

Weekly Outpatient Pharmacy Technician 2.75

Total Pharmacy Technician 7.98

Weekly Inpatient Pharmacy Intern 2.21

Weekly Outpatient Pharmacy Intern 0.27

Total Pharmacy Intern 2.48

Total Inpatient 7.44

Total Outpatient 3.02

Inpatient and Outpatient Total Open FTEs 10.46


Overtime Expense VS. Open FTEs (FY15)

0

2

4

6

8

10

12

14

16

18

0

500

1000

1500

2000

2500

3000

3500

4000

0 10 20 30 40 50

Op

en

FT

Es

Ov

ert

ime

Ex

pe

nse

s

FY15 Week

Overtime Expenses Open FTEs


Observations Noted

• Technician positions are• Difficult to fill

• Difficult to retain

• Open FTEs through the entirety of FY15

• Open positions result in overtime expense

• Costs associated with recruitment, replacement, and training were included


Methodology: Turnover Calculator

Rosnick D. CLASP-CEPR Turnover Calculator. Available at: http://cepr.net/calculators/turnover_calc.html. Accessed August 13, 2015.


Methodology: Turnover Calculator (Continued)



Methodology: Turnover Calculator (Continued)



UCMC Turnover Costs

Characteristic Amount

CLASP-CEPR Turnover Cost Estimate Per

1.0 Technician FTE$18,006

Pharmacy Technician Annual Salary $36,816

Estimated Cost To Replace 1.0 FTE of

Pharmacy Technician$54,822

Total Average Open FTE 10.46

Total Turnover Cost, FY15 $573,437


UCMC Technician Turnover (FY16)

FY16(July 1 – February 22)

Open FTEs,

Average

Technician

Vacancy Rate

FTEs Turned Over

(Associate Count)

Inpatient/Infusion

Pharmacy3.0 22.3% 8.04 (12)

Outpatient/

Ambulatory Clinic

Pharmacies

4.2 23% 0 (0)*

*Attrition, FY15


UCMC’s Retention Challenges

• Natural turnover due to student associates• Academic Medical Center

• Our Mission Is To:• Provide life changing, patient centered medical care

• Drive innovation through groundbreaking research

• Educate and inspire the next generation of healthcare professionals

• Other healthcare careers

• Environmental influences• Complex system

• Challenging to navigate

• Fast-paced

• Communication


Human Resources (HR) Recruitment Strategies

• External recruitment• Purposeful to get the right “fit”

• Relationship development• Local colleges

• Technician training programs

• Conversed regarding technician qualifications upon hire• One year from date of hire to receive technician

certification


Pharmacy Recruitment Strategies

• Identified contacts for technician training programs• Program coordinator and placement specialist

• Extended opportunity to post to online job boards

• Receive candidate referrals from network

• Invited to participate in Advisory Boards

• Considering affiliation agreements as experiential sites


UCMC PAI Dashboard

Goal 1 Goal 2 Goal 3 Goal 4 Goal 5

Pharmacist roles,

practices, and

activities will improve

medication use and

optimize medication

related outcomes.

Pharmacy technicians

will prepare and

distribute

medications and

perform other

functions that do not

require a

pharmacist's

professional

judgment.

Pharmacists and

pharmacy technicians

will have appropriate

training and

credentials for the

activities performed

within their scope of

practice.

Pharmacy

departments utilize

available automation

and technology to

improve patient

safety and improve

efficiency.

Pharmacists will

demonstrate

leadership in

exercising their

responsibility for

medication use

systems and will be

accountable for

medication related

patient outcomes.

2016 UCMC 80% 67% 62% 52% 77%

2015 UCMC 72% 55% 60% 55% 67%

2014 UCMC 71% 58% 60% 66% 77%

2013 UCMC 74% 51% 59% 59% 67%

2012 UCMC 72% 56% 55% 44% 67%


Pharmacy Technician Engagement: Current Associates

• Professional development• Meeting and travel support

• Career ladder (I, II, III)

• Organizational culture• Identify meaningful roles

• Coordinator opportunities

• Retain talent within the health-system


Novel Roles For Pharmacy Technicians

• Expanding the role of the Pharmacy Technician• Practice Advancement Initiative (PAI)

• Creation of novel roles• Support development of pharmacy services

• Extending pharmacist’s practice (PAI)

• Expansion to technician-led initiatives


UCMC Technician Training Program

• 1.0 FTE requested for FY17

• Create and implement ASHP-accredited technician training program

• Based at UCMC

• Estimate 33% rate of hire following program completion


Future Directions

• Opportunity for an ASHP-accredited technician training school

• Assess the time to fill vacancies

• Evaluate strategies for pharmacy technician engagement

• Measuring future success:• Turnover

• Retention

• Morale


Conclusions

• Technician overtime relates to staffing vacancies

• Pharmacy technician turnover expenses exceed projected salary adjustments

• Adjustments in technician wages must be considered to contend with attrition

• PAI offers unique opportunities for technician career development


References

• The consensus of the Pharmacy Practice Model Summit. Am J Health Syst Pharm. 2011;68(12):1148-52.

• Mueller A. The Cost Of Hiring A New Employee. Investopedia, 2015. Available at: http://www.investopedia.com/financial-edge/0711/the-cost-of-hiring-a-new-employee.aspx. Accessed August 13, 2015.

• Waldman JD, Kelly F, Arora S, Smith HL. The shocking cost of turnover in health care. Health Care Manage Rev. 2004;29(1):2-7.

• Desselle SP. Job turnover intentions among Certified Pharmacy Technicians. J Am Pharm Assoc (2003). 2005;45(6):676-83.

• Rosnick D. CLASP-CEPR Turnover Calculator. Available at: http://cepr.net/calculators/turnover_calc.html. Accessed August 13, 2015.

Technical Difficulties: Challenges and Strategies

to Address Pharmacy Technician Turnover

OSHP 77th Annual MeetingThursday, April 21, 2016

Tyler A. Vest, Pharm.D. Candidate 2016University of Cincinnati James L. Winkle College of Pharmacy

Katie Clark McKinney, Pharm.D., M.S., BCPSDirector, Pharmacy Services, University of Cincinnati Medical Center

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Technical Difficulties: Challenges and Strategies to ... · Technical Difficulties: Challenges and Strategies to Address Pharmacy Technician Turnover OSHP 77thAnnual Meeting Thursday,