Technician Career Ladders Support Career Growth, Health System Success

In part 2 of an interview with Pharmacy Times, Julie Lanza, Director of Pharmacy Education and Training at Beth Israel Lahey Health in Massachusetts, discussed how the organization’s career ladders for pharmacy technicians not only support the staff themselves, but also the broader success of the health system.

Q: What do the career ladders look like at Beth Israel Lahey Health?

Julie Lanza: So, we are a newer health system. The health system itself is just 5 years old, so we have 14 hospitals. So, right now we're still in the process of streamlining all 14 hospitals to be the same policies and procedures, the same processes with everything. With that, we're trying to streamline job descriptions, the career ladders for everybody. Some hospitals didn't have career ladders, some had some in place, and we're trying to streamline that. We've implemented some career ladders already; we've tweaked some that already had some. What we'd like to do is we'd like to have everybody have the same career ladders. Not that it's a bad thing, but too many levels on a career ladder might kind of muddy the waters. So, what we're trying to do is system-wide, we'd like to see a 3-step career ladder, you know, a pharm tech 1 and pharm tech 2, a pharm tech 3. Not necessarily—and I don't mean it negatively—generic, but a very generic term of pharm tech 1, 2 and 3 across the system. You know, naming off the basic functions of a pharmacy tech is elevated in different settings, a retail pharmacy versus an institutional pharmacy. An institutional pharm tech 2 or 3 may handle hazardous medications. A retail pharmacy tech may handle, you know, more of the ordering or something or inventory, you know, and we have the local level managers and directors get involved on that end. We do actually keep some outside of the career ladder. Some of our advancements with some of our advanced certifications and our compensation or increased compensation for advanced certifications, we keep that out of the career ladder, because we keep a lot of training, mentoring, [standards of practice], policies and procedure writing in the career ladder. So, if you're a pharm tech 3, we expect you to write policies and procedures, we expect you to write trainings, we expect you to be an advanced trainer.

Now that said, someone who may want to go and be an advanced pharmacy technician and get 3 or 4 advanced certifications to advance their education may not be someone who is a great policy writer, or may not be a great trainer, or may not have the patience to be a great trainer, but they're very educated in this 1 subject matter. So, we want to reward them for taking the time and taking the initiative to go get their advanced certification, so we keep them kind of separate. But, you know, if you're an Advanced Certified Pharmacy Technician, you would obviously qualify as a tech 3, but just because you're advanced, you don't elevate to a pharm tech 3, so we separate the 2 to not muddy that. But in the health system, what we're aiming for and what we've implemented thus far, is across the board a pharm tech 1, 2, and 3. Beyond that, if the budget allows, what we're exploring would be a lead of a certain area. Some would have a sterile products lead, a central pharmacy lead, an oncology lead, whatever it would be, and beyond that would be supervisor, then manager, and then director from there.

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Q: Are there any challenges to implementing career ladders for technicians?

Lanza: I would think that the only challenges are going to be the same no matter what. It would be staffing and budgets, like when you do a career ladder, implementing a career ladder at any employer across the country would involve company-wide compensation. And it would have to be separating where they were and where they are. And I think it's just seeing where you are now and who's going to go where, and I think it's just the discussion of placement and new things. And I also think, depending on the size of the place you're talking about, some of our hospitals or community hospitals are very small. You know, you're talking 6, 7, 8 technicians total, versus the bigger hospitals that have 90. So, you know, I think there's challenges anywhere for implementing. I don't think anything's impossible. I think that challenges are put there to overcome and I think there's always a way around the challenge, but I think that they're just there and you find a way to make it work.

Q: How do career ladders also benefit the organization as a whole?

Lanza: We talk about this a lot in our article with PTCB, and I think that it’s in our title. You know, technicians are technical, and I think that’s been more prevalent in the world of pharmacy over the past 5 years. In my first 10 to 15 years in pharmacy, you know, all I knew was clinical, clinical, clinical, clinical. And I think what we've seen, or what I've seen in the past 10 years, is there's an entire technical, operational side of pharmacy, you know, a business side of pharmacy, a behind-the-scenes side of pharmacy, that's just as relevant as the clinical side of pharmacy. And I think that when you talk about technicians and the technical side of pharmacy, I think that deep down inside, people have to understand and admit that pharmacies aren't going to run without pharmacy technicians. You know, there's work to be done in every setting of pharmacy that pharmacists do not want to do. Pharmacists go to school for 6 years to do what some technicians may not want to do, and that's why they're pharmacists, and that's why technicians are technicians. And I think that when you talk about technicians wanting to do what they're doing, I think it then allows the pharmacists to do what they were meant to do.

I think for our organization, what [career ladders] have allowed us to do is take pharmacists and put them in positions that we may not have allowed them to do before. You know, we have technicians doing a lot of prior authorization roles and things that then allow pharmacists to meet with patients. We have pharmacists that are doing specialty pharmacy work, and we have technicians doing these roles that then allow our organization to expand service lines. And I think when you put technicians within their scope of practice, as long as they're working within their scope of practice, it allows our organization to expand more services. We have a technician that's in a specific system-wide drug diversion role and she does drug diversion surveillance. So, she looks at surveillance software for the entire system. She's a technician, she's working within her scope of practice, but it allows us to have that extra level of someone looking at the surveillance software. So, I think that's a service line that as a health system, we may not have. And we're talking about the USP that just went live in November, and having technicians look at like the data and making sure all 14 hospitals have their environmental monitoring, and we have technicians that are taking care of all that. So, I think that it benefits the organization because you're talking about the different regulatory aspects of pharmacy. There's a lot of regulatory aspects of pharmacy that a pharmacist does not need to oversee, and I think that when you're talking about the day-to-day aspects of things that can be maintained and the things that need to be looked at, these are things technicians can do and it has allowed us to stay all within our regulatory bases of how we can monitor things.