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Nicole Trischitti, pharmacy technician (back), checks medications in the Pediatric Intensive Care Unit Pyxis machine while Nicole Valeriano, RN, (left) and Nancy Hayes, PharmD, discuss patients' medication needs.

Yale New Haven Hospital pharmacy technicians are getting out a lot more these days.

Previously, technicians were based out of the central pharmacies at the York Street and Saint Raphael campuses, but as part of a Pharmacy Services Department practice advancement initiative, some are now based in the patient care units throughout each campus. There are three patient care unit-based technicians at the YSC and four at the SRC.

The initiative, which incorporates best practices from the American Society of Health-System Pharmacists (ASHP), also expands clinical pharmacist coverage. Both campuses already had patient care unit clinical pharmacists weekdays; a pharmacist recently began staffing the York Street Campus Pediatric Emergency Department. Pharmacist coverage has also been expanded to include evenings in other medicine and surgery specialty areas.

Decentralizing pharmacy services is just one component of the practice advancement initiative. "We have expanded pharmacists' and technicians' roles to ensure they're using their knowledge, skills and time more effectively to enhance patient care," said Janet Kozakiewicz, PharmD, director of Pharmacy Services, YNHH. "The ultimate goal is to improve efficiency, medication safety and patient outcomes."

As part of their expanded roles, patient care unit pharmacy technicians are responsible for the automated dispensing machines on the nursing units they cover, including regularly maintaining medication inventory and fixing technical problems. Technicians now handle most phone calls for missing medications or automated dispensing machine problems, which provides one direct point of contact for nurses and other unit staff.

"It's much faster with the technicians on the patient care units," said Nicole Valeriano, RN, Pediatric Intensive Care Unit. "If I have a problem or an urgent request for a medication, I can just call the technician or stop by and ask in person."

With technicians assuming missing medication and automated dispensing machine duties, pharmacists have more time for daily patient rounds with physicians, collaborating with nurses and other clinical staff and working with patients.

Pharmacists and technicians also have more time to devote to quality improvement efforts, thanks to increased automation in the Pharmacy — also part of the ASHP best practices. Pharmacy Services last year installed new automated carousels in the main pharmacies to assist with inventory control. One of the biggest benefits of the practice advancement initiative is enhanced pharmacist and technician collaboration, said Nancy Hayes, PharmD.

"We have better one-on-one communication," she said. "The initiative has taken the pharmacist-technician relationship to the next level."