title: Proportion of work appropriate for pharmacy technicians in anticoagulation clinics.
abstract: OBJECTIVE
  Results of a two-part study to determine the proportion of anticoagulation clinic (AC) work that could potentially be shifted from a pharmacist to a clinical pharmacy technician (CPT) are presented.
  
  
  METHODS
  In part 1 of the study, a group of eight clinical pharmacists and four CPTs from Veterans Affairs (VA) ACs used a modified Delphi process to categorize AC tasks as appropriate or inappropriate for a fully trained, licensed CPT. In part 2, a three-day time study was conducted at an AC staffed by one clinical pharmacist to determine the amounts of pharmacist time spent performing the tasks delineated through the Delphi process. Based on the time study data and task appropriateness categorizations, the proportion of AC work that might be appropriate for a CPT was estimated.
  
  
  RESULTS
  Two levels of CPT-appropriate tasks were identified: those appropriate for any CPT and those appropriate only for an "advanced-practice CPT"; the latter category of tasks included conducting follow-up phone interviews with patients found to have in-range International Normalized Ratio values. The results of the time study indicated that 21% of the AC workload could be handled by a CPT and 41% could be handled by an advanced-practice CPT.
  
  
  CONCLUSIONS
  Investigation of AC roles within the VA system suggested that well-trained pharmacy technicians can perform a substantial proportion of work in an AC, including some tasks performed by pharmacists.
authors.affiliation: New England Veterans Engineering Resource Center, Jamaica Plain Veterans Affairs Medical Center, Boston, MA, and Northeastern University Bouvé College of Health Sciences School of Pharmacy, Boston, MA. hmkuhn715@gmail.com.
authors.forename: Hayden
authors.initials: H
authors.lastname: Kuhn
authors.affiliation: New England Veterans Engineering Resource Center, Jamaica Plain Veterans Affairs Medical Center, Boston, MA.
authors.forename: Angela
authors.initials: A
authors.lastname: Park
authors.affiliation: Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Affairs Hospital, Bedford, MA, and Department of Psychiatry, Harvard Medical School, Boston, MA.
authors.forename: Bo
authors.initials: B
authors.lastname: Kim
authors.affiliation: New England Veterans Engineering Resource Center, Jamaica Plain Veterans Affairs Medical Center, Boston, MA.
authors.forename: William
authors.initials: W
authors.lastname: Lukesh
authors.affiliation: Center for Healthcare Organization and Implementation Research, Edith Nourse Rogers Memorial Veterans Affairs Hospital, Bedford, MA, and Department of Medicine, Section of General Internal Medicine, Boston University School of Medicine, Boston, MA.
authors.forename: Adam
authors.initials: A
authors.lastname: Rose
mesh_terms: D000046:Academic Medical Centers / Q000379:methods / Q000592:standards; D000925:Anticoagulants / Q000008:administration & dosage*; D006801:Humans; D019934:International Normalized Ratio / Q000379:methods; D010044:Outpatient Clinics, Hospital / Q000592:standards; D010595:Pharmacists / Q000592:standards; D010607:Pharmacy Service, Hospital / Q000379:methods / Q000592:standards; D010596:Pharmacy Technicians / Q000592:standards; D016526:Workload / Q000592:standards
chemical_list: D000925:Anticoagulants