Why Not?
How Pharmacy Techs Came to Give Vaccinations

By Dale Dauten, Syndicated Columnist

Curiosity at work isn’t a matter of style.
It’s much more powerful than that.
If you’re the boss and you manage by asking questions,
you’re laying the foundation for the culture of your group.
You’re letting people know the boss is willing to listen.
Brian Grazer

Why Not?

Like so many new ideas, the notion of pharmacy techs giving vaccinations was inspired by a question. Specifically, one born of frustration. That question came at a town hall-style meeting in Boise where the head of the Idaho Board of Pharmacy, Alex Adams, was out seeking input from pharmacists. It went something like this: “Why can’t my techs administer vaccines?”

The questioner added, “I have a tech who works in a medical office in the morning and she can give shots, but then she comes to the pharmacy to work for me in the afternoon and it’s illegal.”

Alex remembered thinking, “It had us scratching our heads – why not techs? After all, there are diabetics who are injecting themselves on a daily basis.”

So Alex and his team went to work and got approval for a pilot study that would become Idaho Rule 300.04, stating “An immunizing pharmacist may delegate the technical task of administering an immunization to a technician…” and then specified that the tech must be certified and have completed an accredited course on immunization technique. No such training existed, so a group at Washington State University developed one, headed by Kimberly McKeirnan, an Assistant Professor at the School of Pharmacy and a part-time pharmacist at an Albertsons store.

THE TEST

We’re coming up on the two-year anniversary of the first legal vaccination by a pharmacy tech – a pilot study undertaen in December of 2016. One of the people helping with that study was Davin Patel (that’s pronounced “DAY-vin”), a pharmacist who’s gone on to become the national Patient Care Services Coordinator with Albertsons Companies (2300 stores with 1700 pharmacies, headquartered in Boise). Davin says, “We’re an Idaho-based company so we wanted to be involved and were eager to be one of the first providers.”

Davin put out a call for techs to volunteer for the training. No problem. “We had plenty of techs who were honored to go through the training,” he recalled. So, with techs from Albertsons and Safeway, they underwent two hours of online training, followed by a two-hour in-person session that included vaccinating oranges and each other. The techs went on to administer nearly a thousand vaccinations during the pilot study with no accidental needle sticks or any other adverse events.

FROM “WHY NOT?” TO “HERE’S WHY”

After the pilot study, the decision was an easy one. Davin reported that the techs had increased job satisfaction, appreciated the diversity in tasks and had increased understanding of vaccinations, while the pharmacists appreciated the option of assigning the task to techs, and the public benefitted from a reduction in wait times. By March of last year, the Board and the Idaho legislature put the new law into effect.

Alex estimates that ‘techs have now given 25,000 vaccinations with zero complaints to the Board of Pharmacy.”

I wondered what he’d learned from the process and specifically, from opposition to the plan along the way. He said, “The arguments against involved the comfort level of pharmacists.” To that point, Davin said he’d encountered a pair of pharmacists who were uncertain about their technicians gving injections. That resistance melted away, however, after watching their techs in vax action. Alex added that “The more training that is built-in, the greater the comfort level.”

One change was made after the first run of the training process — the in-person session expanded from two hours to four. Why? As Davin put it, “We wanted to take time to review company-specific policies, including safety devices the technicians would be using in store.”

Davin also reports that his techs have been eager to get the additional training, and see it as part of career advancement. One outgrowth of the additional responsibilities is that “some techs have asked for additional compensation.” While there are managers who would see that as a negative outcome, others would take those requests as a positive, evidence that the techs see their increased value to the pharmacies and to their patients.

THE FUTURE

Alex offered his assessment of what happens next:

“I see this as expanding rapidly. Rhode Island has already joined in and Utah is close.”

WHY IDAHO?

This writer’s experience studying executives, working to understand how the good ones differ from the great ones, led to the conclusion that the best bosses often devise ways to dive through bureaucracy to hear suggestions at every level (suggestions usually disguised as complaints and criticisms). So I wasn’t surprised by Alex Adams’ answer to my question, “Why Idaho?” He said, referring to his town hall meetings, “I seek to err on the side of over-solicitation of opinions.” And when I asked Davin Patel the same question, he said, “Alex instituted a program of cutting out unnecessary regulation and that led to more authority for pharmacists. When it comes to pharmacies, Idaho is very progressive.” Given the continuing shortfall in adult vaccinations, and a drop in flu shot rates last year (see next article), having more personnel giving shots is one hope for reversing that trend. Thank you, Idaho.

A FINAL THOUGHT…

STC’s CEO, Mike Popovich, reacted to the discussion of the expanding role by pharmacy techs by saying,

“Who do we think of as experts?
Computer techs. Auto technicians. Now pharmacy techs.”

CDC RELEASES NEW FLU SHOT COVERAGE RATES…
AND IT’S BAD NEWS

Why Worry?

By Bill Davenhall

The CDC recently reported their coverage rate estimates for the 2017-2018 seasonal influenza campaign. Coverage rates for both Children and Adults declined, with Adult coverage experiencing a 6.2% decline over the previous flu season (2016-2017) and Children experiencing a 1.1 % decline.

Coverage rates also varied substantiality among various age groups as well as with racial and ethnic groups. The most likely population to receive a vaccination for the seasonal flu were Asians (62%), while those least likely to get a vaccination were Hispanics (28%).

Approximately 175 million persons are estimated to forgo a flu shot for the 2018-2019 flu season. More importantly, 80%, or about 140 million of these no-shot people (children and adults) reside in less than 18% (165) of all Metropolitan Statistical Area, or MSA’s.

(A Metropolitan Statistical Area, or MSA, is defined as those counties that have an economic dependence on the region’s major city or cities, a definition useful when looking at a geographically interdependent healthcare marketplace and where people of the densely populated region are more likely to be susceptible to circulating infectious diseases.)

The map below depicts those regional “markets” and their likelihood of people not receiving a flu shot during the 2018-2019 season. Looking at coverage rates for immunizations by MSA may offer some insights on how immunization programs might approach their work differently, at least in strategizing over approaches to “corral” a local outbreak or prepare a region for a possible aggressive flu strain.

To learn more about immunization coverage rates for the 2017-2018 flu season, see the following CDC publications regarding Children, and Adults. If you’re interested in learning what MSA’s we think will be least “covered” for this next flu season request our Top 100 Flu “Worry” MSA’s.

Link to Top 100 Flu “Worry” MSAs

Link to CDC publications with Estimates of Flu Vaccine Coverage

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