USPHS Pharmacist Readiness Training Program (PRTP)

11/24/08 USPHS Pharmacist Readiness Training Program (PRTP) CAPT Mike Montello CDR Laura Pincock

Background • Preparedness Training is a Requirement • Katrina After Action Report; S3678 Pandemic and All Health Hazards Preparedness Act; National Response Framework (NRF); National Incident Management System (NIMS) • HHS OIG Findings – Current readiness training insufficient • PPM 07-001, Extension of Manual Circular 377 • FY’07 - 87% of Pharmacists meet or exceed OFRD Basic Readiness standards • Questions • How to close the remaining gap? • Where do we go from here? (i.e. approach, format, resources, topics)

Proposal • Develop and Implement a Pharmacist Readiness Training Program (PRTP) consistent with: • OFRD & Transformation Life-Cycle training initiatives • NRF Requirements

Objective of Program • Increase and enhance the readiness and preparedness skills of all PHS pharmacists • By extension, improve readiness of PHS and our Nation • Balance requirements of • Federal guidelines for response training with • Unique requirements of Commissioned Corps • 24 of 27 missions NOT under ESF8 in FY’08 • Provide a model for other PHS categories and civilians • Consistent with OFRD, ASPR & Transformation training initiatives

OFRD Mega-Competencies • (4) Core Multi-disciplinary Mega-Competencies • Personal character; Communication; Mental agility; Cultural awareness. • (2) Category Specific Mega-Competencies • Preeminent Field Skills • Professional Astuteness • Mega-competencies include multi-tiered experience levels • Not demonstrated; Novice; Knowledgeable; Proficient; Expert

Initial PRTP Workgroup Approach • Curriculum Centric • Target OFRD Category Specific Mega-competencies • Preeminent Field Skills & Professional Astuteness • Identify/Develop • Basic Tenets of Program (Balanced, Comprehensive, Flexible, Incentives) • Nomenclature to describe curriculum • Challenges to implementation • General training categories & topics

Developed a solution without clearly identifying the need Skipped 1st step: Must identify Pharmacist Roles and Competencies before we build a Curriculum

Pharmacist Readiness RolesGeneral Concepts • Limited to Pharmacy Centric Roles • Did NOT include multi-disciplinary roles that pharmacists might have skills to fill • Developed Clinical and Non-clinical positions • Readiness roles often based on ‘traditional’ pharmacist roles (i.e. Ambulatory Care) • Some Readiness roles are truly unique • WMD/Pandemic Pharmacist

What’s the difference between a ‘Traditional’ and a ‘Readiness’ Pharmacist? • Readiness Pharmacists must consider ‘Crisis Factors’ (CF) such as: • Narrow and/or evolving formularies; • Exacerbation of adverse reaction risk; • Reduced patient compliance; • Limited access to diagnostic and monitoring tools; • Providers working out of area of expertise; • Prepare for the unexpected.

Pharmacist Readiness Clinical Roles • Types: • Ambulatory Care Readiness Pharmacist • Entry level – equivalent to National Response Framework (‘Pharmacist’) • Pharmacotherapy Readiness Pharmacist • Critical Care Readiness Pharmacist • Relationship between Pharmacist Readiness Clinical roles: • Natural progression between clinical roles but each role should be considered independently

Pharmacist Readiness ‘Other’ Roles • Types: • WMD/Pandemic Readiness Pharmacist • Pharmacy Readiness Logistician • Pharmacist Readiness Manager • No relationship between Pharmacist Readiness ‘Other’ roles. • Pharmacist Readiness Manager should have a general understanding of all Pharmacist Readiness roles

Each Pharmacist Readiness role includes: • Description of duties • Typical practice setting • Competencies necessary to fulfill role • Proficiency level required to be both minimally and fully qualified • Consider adding a mid-level proficiency (i.e. > minimal but < fully qualified)

Competency Categories • Clinical • Operations • Communication • Public Health • Management

Next Steps • Independent review of both: • Original ‘Curriculum Centric’ proposal • New ‘Roles and Competencies’ proposal • Link proposals. • Bridge curriculum to competencies (i.e., which training program is geared towards which competency) • Develop short and long range implementation plan • Develop transition plan (i.e., Rules to ‘Grandfather’ current officers) • Continue to collaborate with OFRD and Transformation • Identify new PRTP Champions

Questions/Comments? montellom@mail.nih.gov laura.pincock@fda.hhs.gov

USPHS Pharmacist Readiness Training Program (PRTP)