title: SafeMed: Using pharmacy technicians in a novel role as community health workers to improve transitions of care.
abstract: OBJECTIVE
  To describe the design, implementation, and early experience of the SafeMed program, which uses certified pharmacy technicians in a novel expanded role as community health workers (CPhT-CHWs) to improve transitions of care.
  
  
  METHODS
  A large nonprofit health care system serving the major medically underserved areas and geographic hotspots for readmissions in Memphis, TN.
  
  
  METHODS
  The SafeMed program is a care transitions program with an emphasis on medication management designed to use low-cost health workers to improve transitions of care from hospital to home for superutilizing patients with multiple chronic conditions and polypharmacy.
  
  
  RESULTS
  CPhT-CHWs were given primary responsibility for patient outreach after hospital discharge with the use of home visits and telephone follow-up. SafeMed program CPhT-CHWs served as pharmacist extenders, obtaining medication histories, assisting in medication reconciliation and identification of potential drug therapy problems (DTPs), and reinforcing medication education previously provided by the pharmacist per protocol.
  
  
  RESULTS
  CPhT-CHW training included patient communication skills, motivational interviewing, medication history taking, teach-back techniques, drug disposal practices, and basic disease management. Some CPhT-CHWs experienced difficulties adjusting to an expanded scope of practice. Nonetheless, once the Tennessee Board of Pharmacy affirmed that envisioned SafeMed CPhT-CHW roles were consistent with Board rules, additional responsibilities were added for CPhT-CHWs to enhance their effectiveness. Patient outreach teams including CPhT-CHWs achieved increases in home visit and telephone follow-up rates and were successful in helping identify potential DTPs.
  
  
  CONCLUSIONS
  The early experience of the SafeMed program demonstrates that CPhT-CHWs are well suited for novel expanded roles to improve care transitions for superutilizing populations. CPhT-CHWs can identify and report potential DTPs to the pharmacist to help target medication therapy management. Critical success factors include strong CPhT-CHW patient-centered communication skills and strong pharmacist champions. In collaboration with state pharmacy boards and pharmacist associations, the SafeMed CPhT-CHW model can be successfully scaled to serve superutilizing patients throughout the country.
authors.forename: James E
authors.initials: JE
authors.lastname: Bailey
authors.forename: Satya
authors.initials: S
authors.lastname: Surbhi
authors.forename: Paula C
authors.initials: PC
authors.lastname: Bell
authors.forename: Angel M
authors.initials: AM
authors.lastname: Jones
authors.forename: Sahar
authors.initials: S
authors.lastname: Rashed
authors.forename: Michael O
authors.initials: MO
authors.lastname: Ugwueke
mesh_terms: D003150:Community Health Workers / Q000600:supply & distribution*; D003159:Community-Institutional Relations; D005260:Female; D006792:House Calls / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D010360:Patient Transfer / Q000379:methods*; D010596:Pharmacy Technicians / Q000193:education* / Q000706:statistics & numerical data*; D024382:Professional Role; D016730:Program Development; D013714:Tennessee