A blueprint for success: Using an implementation framework to create a medication history technician pilot program

Abstract

BackgroundMedication discrepancies at transitions of care may compromise patient safety. Trained pharmacy technicians can reduce harmful medication discrepancies at transitions of care by collecting medication histories. ObjectiveWe describe how to create a program integrating medication history technicians (MHTs) into the hospital discharge process using implementation science. Practice descriptionWe created our MHT program at a Veterans Affairs (VA) hospital. Practice innovationWe used an evidence-based framework and implementation science to tailor our MHT program to meet local stakeholder needs. Evaluation methodsWe completed a literature review and review of current discharge practices. Then, we completed a workflow pilot, a needs assessment, and semistructured interviews with pharmacy technicians and pharmacists. We integrated these findings to identify barriers of MHT program implementation. Finally, we mapped these barriers to implementation strategies to create an MHT program implementation blueprint. ResultsThe literature review and review of current discharge practices revealed opportunities for our program to reduce medication discrepancies. We applied these findings to our proof-of-concept workflow pilot, which reduced medication discrepancy rates at discharge. When we explored barriers in the needs assessment, we learned that 4 of 6 pharmacy technicians had some training conducting medication histories, but 5 of 6 requested additional training for the new MHT role. We explored these and additional barriers in semistructured interviews. Four themes emerged: elements of pharmacy technician training, challenges to implementation, program logistics and workflow, and pharmacy technician self-efficacy. We mapped barriers to implementation strategies to create an MHT program implementation blueprint, including developing pharmacy technician training materials, modifying our workflow, creating program evaluation materials, and strategizing how to overcome anticipated and current implementation barriers. ConclusionsWe used implementation science to create a tailored MHT program. Others may adapt our implementation blueprint to fit local stakeholder needs.