Experience with a "tech-check-tech" program in an academic medical center

A "tech-check-tech" (TCT) program to support unit dose drug distribution at an academic medical center is described.

In April 2004, the University of Wisconsin Hospital and Clinics implemented a TCT program to provide validated pharmacy technicians with the opportunity to serve as the person checking unit dose medication cassettes that are filled during a 24-hour cart-fill process. This program required special authorization from the Wisconsin Pharmacy Examining Board and included detailed training and validation expectations of the pharmacy technicians, along with quality-assurance oversight by pharmacists who are completing a double check. For initial validation, the technician should attain a 99.8% accuracy rate for at least 2500 consecutive doses checked during at least five separate audits occurring over a minimum of five separate days. During the validation process, a pharmacist artificially introduces errors at a minimum rate of 0.2% (5 of every 2500 doses). A staff pharmacist performs a final check of the medications before releasing them to the inpatient units. The overall time for pharmacists spent on checking medication doses for cart fill was reduced from an average of 6 hours and 5 minutes per day to 20 minutes per day.

Through the implementation of a TCT program at a university hospital, specially trained pharmacy technicians safely and efficiently checked unit dose medication carts filled by other technicians. The program reduced interruptions in the pharmacists' daily workflow and allowed pharmacists to spend more time on patient care activities.