Pharmacy Staff Perceptions on Complementary Framework and Advanced Scope for Hospital Pharmacy Support Staff

Abstract

Pharmacy assistants and technicians, as pharmacy support staff, play an important role in hospital pharmacy departments by alleviating pharmacists’ time to concentrate on more clinically oriented tasks. Whilst organisations such as the Society of Hospital Pharmacists Australia (SHPA) have recognised the need to further integrate pharmacy assistants and technicians into more advanced roles, such as medication reconciliation, there is currently limited research on the availability of training and consistency in service delivery provided by these support staff in Australian hospital settings. As a result, hospitals/organisations around the country have implemented individualised in-house training suited to their respective needs and environment. In order for pharmacy support staff to be equipped to perform advanced roles, training frameworks and support from pharmacists are required. The aim of this study was to explore and compare the perceptions of roles and available training frameworks that support career advancement for pharmacy support staff, amongst pharmacists and support staff, in the hospital sector. A literature review was completed to inform international comparisons of roles, training frameworks and benefits of support staff advancement within the pharmacy profession. Semi-structured interviews were conducted with personnel from both private and public hospitals to explore key issues identified in the literature. A total of 25 participants consisting of ten pharmacists and 15 pharmacy support staff were recruited from a private (n=13) and a public (n=12) hospital in South East Queensland. Interviews were conducted either face-to-face or via telephone between October 2017 to August 2018 across both sites, with a mean duration of 39.85 minutes (range: of 20.08 to 60.04 minutes). All interviews were audio-recorded, transcribed verbatim, and quality checked by a second researcher prior to data analysis using the qualitative software NVivo® 11. The general inductive approach was used for thematic data analysis, which allowed for the emergence of new themes and sub-themes within the research topic. Findings from this research confirmed that the core duties of pharmacy support staff were dispensing and inventory management in both hospital settings, with greater clinical task involvement sought by participants. Tasks such as assisting with medication history taking, collating pathological results, research involvement, and discharge facilitation were considered as technical tasks within a clinical setting. Most participants supported the career advancement of pharmacy support staff irrespective of their own professional role, and believed that with appropriate training, this could include technical tasks in a clinical setting and administrative roles currently performed by pharmacists. Professional autonomy, time, and monetary incentives were commonly reported by participants as motivators, with lack of organisational support and course availability reported as common barriers for pharmacy support staff career progression. With some participants having international knowledge and experiences, emerging themes such as pharmacy technician registration and the need for governing bodies such as universities and registration boards were also expressed. Other emerging themes included the perception of hierarchy from inside and outside of the pharmacy profession by selected participants. This study also identified inconsistencies in the application of role titles used across both sites with pharmacy assistant and pharmacy technician used interchangeably, and differences in role expectations. For example, tasks such as supply of inpatient medication performed across both hospital environments had diverse processes with different levels of pharmacist involvement. As a result, this study highlighted the need for greater consistency in the definition and application of pharmacy support staff titles and roles. Additionally, participants revealed the need for governing bodies to streamline roles and training frameworks similar to the accreditation and registration processes seen internationally, as means of ensuring and maintaining the quality of service provided to stakeholders. This exploratory study provides valuable insight into the thoughts and motivation of pharmacy support staff and pharmacists that can inform the evolution of support staff career pathways. By documenting the accounts and views of pharmacists and pharmacy support staff in two different hospital environments, this study has added to existing research by being one of the first studies to obtain insight into the lived experience of pharmacy staff within the Australian hospital environment. This study has also identified potential areas for further research in the field of pharmacy support staff education and professional practice.