Clear roles and job aids keep work flowing in your pharmacy
Hesston Pharmacy and Harvey Drug have had policies and procedures in place for years, but the pandemic proved the value of well-crafted job aids too.
Usually, owners Sandie and Adam Kueker each lead one store, and employees might work at both locations, which are only about 8 miles apart, near Wichita, Kansas.
However, in 2020, having employees work at both stores created risk because if someone had COVID-19, everyone would have to quarantine. So, they separated their employees into two groups, until vaccines were available.
“We completely segregated our team,” Sandie explained. “It was a lot different managing our staff without working with everyone.”
At the same time, the work that had to be done was changing, as each store had to develop new cleaning routines and offer COVID-19 tests.
In summer 2021, seven staff members left for various reasons, ranging from college graduations to caring for family. This situation forced the Kuekers to rethink their staffing and operations. Knowing what skills the pharmacy needed and how to train new employees made all the difference.
Define tech levels
At Hesston Pharmacy and Harvey Drug, the technicians have different knowledge and skill levels, and they have different job roles, which are clearly spelled out.
| Base technicians | Mid-level technicians | Advanced technicians |
|---|---|---|
Licensed with the state board of pharmacy, are proficient in basic data entry and filling, and can oversee or run one program, such as medication synchronization. They must become nationally certified within two years, but most move up in three to six months. | Must be nationally certified as a tech and may become certified in another area, such as immunization or hypertension monitoring. They are proficient with the complete system of at least one advanced program, such as compliance packaging. Most pharmacy programs rely on mid-level techs. | Are proficient with all the pharmacies’ advanced programs, are able to train or oversee other staff, and are responsible for communicating and coordinating care with health care team members inside and outside the pharmacy. Advanced techs allow the pharmacy to add new services. They led the way with new COVID-19 services and were eager to become immunizers when allowed, Kueker said. |
With this system, Sandie knows when she has the staff to add a new service, and techs know they have room to advance. Plus, everyone knows what it takes to earn a raise. Kueker admits that she likes to give employees more money simply for doing a good job, and that having defined steps for advancing actually keep the payroll in check.
Defined roles also help the pharmacists know when they can delegate and when they need to slow down and explain something to a tech.
The Kuekers ensure the pharmacists are doing the work that requires judgment, and the techs handle routine tasks. In their pharmacies, the techs no longer send prior authorizations requests. They print rejections for pharmacists to review.
“There’s a lot of times that we don’t send anything to the physician’s office,” because the pharmacist sees another solution, Sandie said. “The clinics in our area usually answer our prior authorizations right away, because they know if we send one it’s truly something they should look at.”
Learn about learning to teach effectively
“If a pharmacist walked into our Harvey Drug store and they never worked in our pharmacy before they would be able to read the instructions for everything we do,” Kueker said. “That took some discipline…You want to just go in and do your work. But it’s huge, because then you can actually have someone come and help you.”
Sandie used to write all the pharmacy job aids—instructions or other tools that explain how to do a task—but her daughter’s interest in teaching led her to discover more about learning styles.
She noted that when you think about that, it’s easy to see the difference in employees. “You just assume that other people learn the same way you do, but they don’t,” she said. “[one employee] just wants to hear, and she wants to watch me do it, and if she watches and hears it, she’s got it, whereas [another employee] wants to write everything down.”
To meet those needs, Hesston Pharmacy and Harvey Drug take multiple approaches that they have summarized into four learning categories.
- Make it visual. The pharmacy color codes work, from the daily schedule to baskets.
- Discuss it. Telling a story is a powerful way to explain to techs why they can’t skip any step in a process. The Kuekers’ techs know that just counting untaken medications in compliance packaging is important work. When a provider planned to increase one patient’s dosage, the pharmacy had the notes showing that this patient often had skipped a noontime dose. The solution was as simple as the patient taking her pill in the morning, instead of midday, when she often wasn’t home.
- Let them write it. Job aids evolve over time, with new employees contributing. Recently Sandie gave one tech a few hours to update an aid and add screenshots to a document, which also helped the tech better understand the process. “She learned a ton that day,” Sandie said.
- Do it. Practical exercises are great for kinesthetic learners. For example, set up a sample patient for them to follow through the system.
With well-defined roles and workflows, the Hesston and Harvey staff know what to do every day and what needs the pharmacists’ attention.
“Our technicians literally run our stores,” Sandie said.
Hesston Pharmacy and Harvey Drug aren’t done with training staff. They are looking to techs as diabetes self-management educators. Sandie is also considering formal training for delivery drivers to serve as community health workers who can recognize when a patient needs someone to check on them.
“We’re utilizing everyone’s strengths,” she said.
Watch the video below to learn more about Hesston Pharmacy and their initiatives to certify their team for community health care worker roles.