Three South Carolina programs show that putting pharmacists and technicians in advanced roles is paving the way for safer patient outcomes and enhanced care.
The pharmacist-directed medication management clinic at Self Regional Healthcare in Greenwood recently earned the prestigious Best Practice Award from the South Carolina affiliate of ASHP. Recognized for its exemplary commitment to the recommendations outlined in ASHP’s Practice Advancement Initiative (PAI) 2030, this clinic showcases the power of innovative pharmacy practices in promoting optimal and effective medication use.
Two other programs were also recognized for their efforts to advance pharmacy care: Prisma Health’s pharmacy technician certification program, and Tandem Health and the University of South Carolina’s (USC)expansion of clinical pharmacy services in the rural town of Sumter.
Championing the PAI recommendations is essential for addressing vital healthcare issues statewide, said Jennifer Bair, chair of the South Carolina affiliate’s professional affairs task force and chief pharmacy officer at Prisma Health, located in Columbia and Greenville.
Medication management
At Self Regional’s medication management clinic, pharmacists began collaborating with clinicians in 2021 under a collaborative practice agreement, allowing physicians to refer their patients to the pharmacists for comprehensive care.
In this setting, pharmacists take detailed medication histories and engage in clinical decision-making. This process amplifies pharmacy's role in patient care and diminishes barriers to effective medication management.
Although there was initially a learning curve among providers, integrating pharmacists into the healthcare team has yielded substantial benefits. “As we continued to grow, the wins became undeniable,” said ASHP member Nancy Goodbar, a clinical pharmacist who spearheaded the program’s launch. “Physicians have come to understand the critical role of a pharmacist within their ambulatory care team, while patients appreciate that they can now access their medications more affordably.”
Over time, the clinic, located just a mile from the main hospital, grew from a one-pharmacist operation to a robust team of four full-time clinical pharmacists, four full-time pharmacy technicians, an office manager, and two administrators managing a caseload of about 8,500 patients. Plans for the future include hiring two additional clinical pharmacists to ensure even greater capacity to serve their community.
The clinic helps all patients — adults and children — regardless of diagnosis, noted Goodbar. “If you’re having trouble obtaining a medication that is medically necessary, you let us know, and we will figure something out,” she said.
The clinic started out handling only those medications that qualify for the federal 340B Drug Pricing program. Now, clinic staff do much more, from filling out patient assistance program applications to running test claims to checking prior authorization.
“We are practicing at the top of our license, and the more that we do this and the more physicians recognize our ability, the more autonomy we truly are getting with chronic disease state management,” Goodbar said.
Going forward, Goodbar and her colleagues hope to expand into surrounding communities and be able to provide point-of-care testing.
Technician advancement at Prisma Health
Another project nominated for the Best Practice Award was Prisma Health’s pharmacy technician certification program.
To improve pharmacy technician retention rates and increase career development for technicians, the health system in 2023 created a program that requires its technicians to be at least state certified. In South Carolina, state certification means a technician has completed an accredited training program and passed a national certification exam.
The pharmacy team created a free, 12-week which is a Pharmacy Technician Certification Board (PTCB)-Recognized Education/Training Program, that includes synchronous and asynchronous virtual and in-person training classes, tests, and quizzes. Technicians who need access to technology can borrow a laptop computer or use a computer lab in the health system.
When technicians complete the program, which is offered twice a year, they receive a certificate and a voucher to sit for the national exam at no charge. The fifth cohort just started the program, Bair said.
Feedback has been positive, with about 95% of technicians staying with Prisma Health. The remaining 5% moved to technician roles outside the organization.
“We started celebrating the valedictorian and salutatorian of the classes, and we have a real graduation,” Bair said. “Families come and celebrate, our whole leadership team comes, so we make a big deal out of it. People feel very valued and excited about completing it.”
Bair noted that state certification allows technicians to complete more advanced duties, such as tech-check-tech in the acute care setting and prescription transfers in the retail setting.
“We have also seen this program allow technicians to move into advanced roles such as pharmacy buyers, pharmacy trainers, and specialty compounding roles (chemo, non-sterile compounding),” she said. “These all have added to job satisfaction for the team member, retention, and the ability to move up the career ladder.” In addition, Blair explained that some graduates have moved into medication history technician roles, which frees up time for some of the transitions of care pharmacists.
Expanding pharmacist services
The third project recognized was expanding pharmacy services at Tandem Health’s federally qualified health center in Sumter, in partnership with the USC College of Pharmacy. When they started a few years ago, Sumter had a shortage of healthcare providers. So, as experts discussed creating a family medicine residency program in the area, the USC staff thought of pairing it with a pharmacy residency program.
“Outpatient clinical pharmacy in Sumter was nonexistent at the time,” said ASHP member Brandon Bookstaver, professor of clinical pharmacy and outcomes and director of residency and fellowship training at the USC College of Pharmacy. “We really felt this was going to be an opportune time to capitalize on this and see if we can demonstrate benefit and the ability to expand pharmacy services using a residency [as the catalyst].”
Carrington Royals, now director of clinical pharmacy at the health center, was the inaugural resident. Coming from a small town and seeing the health system’s focus on ambulatory care drew her in. “The first day I stepped foot on the campus, I knew that I made the right decision because it just felt like a family,” said Royals, an ASHP member.
The training model successfully attracted multiple pharmacists to practice in Sumter, said Reagan Barfield, a clinical assistant professor at USC and director of Tandem Health-USC’s postgraduate year 1 residency program.
“We went from half of a full-time employee in 2019 to 2020 to eight pharmacists currently practicing in Sumter,” said Barfield, an ASHP member. Tandem Health now has multiple pharmacists in its adult medicine and family medicine clinics. Prisma Health, which had a location nearby, was inspired to hire ambulatory care pharmacists of its own in transitions of care, family medicine and cardiology.
Through a collaborative practice agreement, pharmacists at Tandem Health handle various tasks, from annual wellness visits to diabetes self-management and education, transitions of care visits with physicians, managing patients on anticoagulants, and overseeing technicians.
“Day to day, working with our providers, we are constantly being pulled for questions and consults,” Royals said. “Pharmacist presence also has led to a huge increase in available APPE rotations for pharmacy students interested in rural health, from three in 2020-2021 to 61 in 2023-2024,” Barfield said.
In addition, the work has incentivized some pharmacy students to pursue quality improvement and research projects in Sumter on such topics as hazardous drug labeling and implementation of a pediatric asthma clinic, Bookstaver said.
“There’s this nice cycle happening now where you have more opportunities and more classes. People are intrigued and curious, so they’re diving in. It’s also attracted and helped Tandem Health and Prisma recruit in Sumter,” Bookstaver said.
Barfield and others started the Southeastern Collaboration of Rural Health Research and Education, a networking opportunity for pharmacists at Tandem Health, Prisma Health, and other federally qualified health centers in the area to meet for dinner and build relationships “so that pharmacists practicing in rural South Carolina don’t feel as though they’re practicing on an island,” Barfield said. Drug manufacturers have provided educational talks to the group.
Barfield and Bookstaver are now looking to replicate the success of their “Sumter Model” in other sites in the state, including Florence and Greenwood.
Bair hopes the three projects highlighted by the Best Practice Award from the South Carolina affiliate of ASHP will inspire other organizations to embrace PAI 2030’s recommendations to improve care.
“It gives other people and other health systems and hospitals ideas of things they can implement, and it connects people to know who they can go to when they need a solution,” she said.
To learn more, visit the PAI 2030 web page and complete the self-assessment tool.
