A simple yet impactful initiative is transforming how patient care is delivered in the inpatient respiratory unit at UK King's Daughters Medical Center in Ashland, Kentucky.
The hospital incorporated a pharmacy technician into the care team, enhancing communication between pharmacy and nursing staffs and improving the discharge process for patients recovering from serious respiratory conditions.
Now, even more nurses are requesting the support of pharmacy technicians, showing that sometimes, one change can make a big impact.
Team-based strategy for care
This collaborative approach began when Lori-belle Slone, clinical manager of pharmacy at UK King’s Daughters Medical Center, launched a pilot program in March 2024.
Certified pharmacy technician Matthew Elswick joined the hospital’s 26-bed respiratory unit, where he began working with patients admitted through the emergency department or recently transferred from the intensive care unit. These patients have pneumonia, acute respiratory failure, chronic obstructive pulmonary disease, and other chronic conditions that require multiple medications. Elswick ensured that staff took medication histories and offered patients enrollment in the hospital’s Meds-to-Beds program, which ensures they receive all medications and related education before discharge.
Since joining the team, Elswick has become a vital part of the unit, gaining the appreciation of his colleagues and leading other nurses to request their own pharmacy technicians. His strong connections with patients have made a noticeable difference, resulting in a dramatic increase in prescriptions filled through the Meds-to-Beds program—from 186 during October-December 2023 to 734 during the same period in 2024. This increase not only improves transitions of care for patients but also boosts the pharmacy’s revenue.
“The thing that I appreciate the most about this position is I truly feel like I’m making a difference,” added Elswick. “It’s not uncommon after a patient discharges — and after I’ve helped them get their medications in hand and as affordable as possible — for one of them to reach back out to me and ask to have all their prescriptions transferred from their home pharmacy.”
Aligning with broader goals
By increasing participation in UK King’s Daughters’ successful Meds-to-Beds program, the integration of a technician on the care team has helped the hospital hit several goals within ASHP’s Practice Advancement Initiative (PAI) 2030, including expanding roles for technicians, improving transitions of care, and optimizing comprehensive medication management.
PAI 2030 includes 59 recommendations to promote optimal, safe and effective medication use, expand pharmacist and technician roles, and implement the latest technologies. These recommendations served as a framework for implementing effective practices within UK King’s Daughters, providing a roadmap for Elswick to enhance patient care.
Elswick began by taking medication histories for each patient on the unit, signing patients up for Meds-to-Beds, and coordinating pharmacist-led medication education at discharge. Over time, he began picking up additional tasks, such as price-checking prescriptions for patients, joining the nurse practitioner on rounds to maximize enrollment in Meds-to-Beds, and working with the outpatient pharmacy’s 340B Drug Pricing Program to ensure as many patients as possible could get their medications affordably and in-hand at discharge.
“Matthew has made a big impact, especially when you’re talking about the affordability of medications in this area,” said ASHP member Amber Gross, a transitions of care pharmacy specialist with the hospital. “When you have to choose between food and medicine, that can be really hard for people.”
Bridging gaps in healthcare communication
“The thing that I appreciate the most about this position is I truly feel like I’m making a difference,” added Elswick. “It’s not uncommon after a patient discharges — and after I’ve helped them get their medications in hand and as affordable as possible — for one of them to reach back out to me and ask to have all their prescriptions transferred from their home pharmacy.”
The tasks that Elswick handles were previously done either by the nursing or outpatient pharmacy departments, but Gross said communication between the two wasn’t always thorough.
Since implementation, both nursing and pharmacy staff have reported significant improvements in communication. Gross is now working with a pharmacy resident to compare how the respiratory unit previously managed these pieces to how Elswick does now.
While taking medication histories, Elswick identifies patients who may need extra help or counseling and relays that information to Gross, who can consult with the patient. Elswick also acts as a bridge for the pharmacist who typically rounds on the unit, communicating any issues that pop up during discharge planning.
While some staff on the respiratory unit initially expressed doubt about incorporating a pharmacy technician, those were pretty quickly eliminated, said Slone, an ASHP member. “Part of it is, they don’t know how we can help them until we can show them,” she said. Slone, who teaches in the nurse residency program, emphasized the importance of taking a medication history and referring patients to the Meds-to-Beds program.
“We have some float nurses, and those that come to Matthew’s unit and then go to other units say, ‘Why can’t we have a Matthew on every unit?’” she said. “I honestly feel like it has bridged that gap we had experienced in communication and throughput with the medications, from the beginning to the end.”
“It says a lot that he works directly with the nurse practitioners and the providers as well. They trust him implicitly,” Gross added. “You don’t see a pharmacy technician as part of the multidisciplinary team ever, so I think that’s really nice and something to showcase.”
Plans for expansion
Based on this success, Slone said she hopes to add technicians to other inpatient units, starting with wards known to have barriers with transitions of care or not enrolling patients in Meds-to-Beds. A tube system is also being installed in the new outpatient pharmacy to increase efficiency in delivery.
The trio said getting buy-in from key stakeholders and having champions in place for the program helped it work. It also was imperative to have the right technician in place, Slone added. “Matthew has initiative. He’s going to be going to pharmacy school this fall,” she said.
Their success “didn’t happen overnight,” Slone said. She and Elswick maintained an open line of communication and met frequently to check in as the service was being built. “It took some time to build those relationships and build rapport with that unit,” she said. “Then we built the program to exactly what we envisioned.”
