Closing the Pharmacy Sector’s Skills Gap: The Solutions Training and Teamwork (STAT) Program’s Approach to Workforce Development and Diversity Enhancement

Abstract

Purpose:

Ongoing national and local pharmacy technician shortages are significantly impacting healthcare organizations prompting the development and implementation of the Solutions Training and Teamwork (STAT) program, a state-funded initiative aimed at bridging the skills gap in the pharmacy sector. This program was specifically designed primarily to train unemployed individuals in Rhode Island, equipping them with the necessary skills to become well-qualified pharmacy technicians. As a secondary outcome, STAT endeavored to enhance workforce diversity and cultural competence, aligning the demographic characteristics of pharmacy technician staff with the diverse population served, thus reducing workforce disparities. We employed a mixed-methods approach to evaluate its outcomes.

Summary:

The STAT program emerged from a collaborative effort by Lifespan, the Rhode Island Department of Labor, and the Community College of Rhode Island. Spanning sixteen weeks, the program combined 180 hours of didactic learning, 120 hours of unpaid practical experience, and 42 hours of workplace readiness and leadership skills training. Supported by the Governor’s Workforce Investment Board and the CARES Act, the program removed financial barriers. Outcomes were promising, with a 66.8% graduation rate, 70.5% achieving national certification, and 60% of the graduates were extended job offers by Lifespan. Significant increases in workforce diversity were also observed.

Conclusion:

The STAT program provides an effective approach to workforce development, addressing the persistent skills gap and underrepresentation of minority groups in the pharmacy sector. It provides a replicable model for other healthcare systems facing similar challenges, potentially revolutionizing the way healthcare organizations can implement training programs to enhance diversity, employee retention, and team engagement.

PROBLEM

The United States currently faces a paradox of high job vacancies, with 9 million openings as of December 2023, juxtaposed against a backdrop of persistent unemployment and underemployment. ¹ This scenario is exacerbated in sectors requiring specialized skills, where the gap between job requirements and workforce capabilities is pronounced. The pharmacy sector, both in hospital and community settings, exemplifies this challenge. A national survey conducted by the American Society of Health-System Pharmacists in 2022 highlighted this issue, with 74% of hospitals reporting a shortage of entry-level pharmacy technicians, 91.8% hospitals reporting shortages with experienced pharmacy technicians and 93.4% reporting shortages with pharmacy technicians skilled in sterile compounding. ² Similarly, a 2021 survey by the National Community Pharmacists Association underscored the difficulty in filling technician roles, with 90% of respondents identifying it as their most challenging position to staff. ³

The ramifications of this skills gap are multifaceted, impacting not just the efficiency and quality of healthcare delivery, but also the diversity and inclusivity of the pharmacy workforce. The underrepresentation of minority groups among pharmacy technicians is a pressing concern, as it may limit the sector’s ability to serve increasingly diverse patient populations effectively and with cultural competence. The lack of diversity within the workforce may also hamper efforts to reduce health disparities and improve patient outcomes through more nuanced and culturally sensitive care, though more empirical evidence on this topic is necessary. Rhode Island’s population is predominantly White, comprising of 69.2% of the total population; the Black community represents 9.3%, while Asians account for 3.7% and Hispanic or Latino make up 18%.⁴ Prior to the implementation of our pharmacy technician training program, the demographics of our pharmacy technician team were predominantly White with the Black or African American community representing 1.3%, Asians representing 7.9% and Hispanic or Latino making up 5.3% (Figure 1).

Figure 1.

Given the projected 7% growth in pharmacy technician jobs from 2023 to 2033, alongside the ongoing challenge of high unemployment rates, there is a critical need to bridge these gaps through innovative workforce development strategies. ⁵ This case study describes the successful development and implementation of the Solutions Training and Teamwork (STAT) program, a novel pharmacy technician externship initiative in a health-system’s inpatient and outpatient settings aimed at addressing these challenges.

The STAT program was designed with four key objectives:

1. To train unemployed individuals, equipping them with the skills needed to serve as a well-qualified pharmacy technician workforce, thereby addressing the sector’s skills gap.

2. To increase the diversity of our team, better aligning the demographic characteristics of our pharmacy technician staff with those of the Rhode Island population our health-system serves, thereby reducing healthcare disparities.

3. To resolve recruitment challenges by directly creating a pipeline of individuals who could be recruited, streamlining the hiring process and reducing the time and financial costs associated with staffing vacancies.

4. To increase current employee engagement by empowering the existing team to act as mentors and actively participate in the recruitment process, fostering a more collaborative and committed workforce.

In detailing the STAT program and its outcomes, this case study aims to provide a template for other health-systems to develop similar subsidized pharmacy technician training programs. Such initiatives can address recruitment challenges while simultaneously enhancing team engagement, increasing retention, and improving diversity within the pharmacy sector.

ANALYSIS AND RESOLUTION

Approach to Evaluation

Our study employed a mixed-methods approach, integrating qualitative feedback from program participants obtained through surveys with quantitative data regarding participation and outcomes.

Program Development and Partnerships

Conducted at Lifespan, a comprehensive academic health system comprising six suborganizations across Rhode Island, an initiative was spearheaded by Pharmacy Services in collaboration with the Lifespan Workforce Development Department. Lifespan Workforce Development serves unemployed and underemployed adults by offering them access to job training and sustainable employment opportunities.

Together with key stakeholders, we created the Solutions Training and Teamwork (STAT) program, a state-funded pharmacy technician extern training initiative, supported by four key pillar entities: the Rhode Island Department of Labor, Lifespan Workforce Development, the Community College of Rhode Island, and the Lifespan Health System. Each pillar plays a significant role in the program’s success, creating a synergistic effect that bolsters its impact. This program is designed to strengthen both inpatient and outpatient pharmacy technician labor forces by focusing on recruiting individuals with high potential and retraining an engaged workforce for new roles.

Training Program Structure

Spanning sixteen weeks (Figure 2), the pre-employment boot camp encompasses 180 hours of didactic learning, 120 hours of unpaid practical experience at a Lifespan location, and 42 hours focused on workplace readiness and leadership skills. Our program aligns with the entry-level accreditation competency standards set by the American Society of Health-System Pharmacists (ASHP) for pharmacy technician education and training programs, with the exception of sterile and non-sterile compounding. These compounding elements are excluded because State licensing regulations mandate that pharmacy technicians must hold national certification to perform these tasks. This comprehensive approach aimed to equip participants for successful employment and career advancement.

Figure 2.

Funding from the Rhode Island Department of Labor and the Governor’s Workforce Investment Board through Real Jobs Rhode Island, along with the Coronavirus Aid, Relief, and Economic Security (CARES) Act via Back to Work Rhode Island, covers all aspects of training, removing financial barriers and ensuring equitable access for all Rhode Islanders (Table 1). The funding covers all of the following: obtaining state pharmacy technician licensure and national certification; technology needs (e.g., laptops); textbooks; uniforms; and support services, such as childcare, transportation, and assistance with paying rent and utilities. These resources were designed to address obstacles and enhance the likelihood of student success in completing the training program. Eligibility for the STAT program is detailed in Table 2.

Table 1.

Attributes of the STAT Program.

Building the Right Team: Technician Workforce Pipeline
RI Department of Labor	Lifespan Workforce Development	Community College of Rhode Island	Lifespan Pharmacy Services
State Grant Funding: • Real Jobs RI • Back to Work RI • Financial & Support Services	• Workforce Solutions Training & Teamwork • 42 Hours Workforce Readiness & Leadership Training	• Academic Training • 180 Hours of Didactic Learning	• Inpatient & Outpatient Settings • 120 Hours of Hands-on Pharmacy Experience

Table 2.

Program Requirements.

Program Requirements
18 years or older	Rhode Island resident
High school diploma or equivalent	Eligible to work in the United States
Unemployed or underemployed	Willing to comply with policies
Pass a criminal background check	Willing to complete the entire program, attendance is mandatory
Pass a tenth-grade level math assessment	Motivated to learn new skills and work full-time upon completion of program
Pass a screening interview	Open to receiving feedback and incorporating recommendations

The Community College of Rhode Island delivers didactic learning through virtual and in-person formats, covering a wide range of pharmacy-related topics. Topics include pharmacy law and regulations, healthcare law and ethics, pharmacology for technicians, brand and generic medication names, patient safety and quality assurance, compounded sterile products, math calculations and order entry and processing. Tutoring is also offered to all pharmacy externs to help strengthen skills where needed. Lifespan Workforce Development offers job readiness training, mentorship, case management, and career coaching, emphasizing essential soft skills and professional development. Workforce Development also provides one-on-one counseling.

Lifespan inpatient hospitals and outpatient retail locations (e.g., Rhode Island Hospital, The Miriam Hospital, Newport Hospital, Lifespan Pharmacy) are utilized for the experiential learning. Externs work alongside pharmacy technician team members and gain hands-on experience with day-to-day pharmacy operations. The pharmacy externs are able to request which practice setting (inpatient versus outpatient pharmacy) they want to experience, and every attempt is made to match them based on their preferences. Most of the extern hours are completed at the assigned primary Lifespan location, but each extern has the option to visit other Lifespan locations. At the end of the training program, Lifespan has the discretion to offer jobs to successful graduates as they deem appropriate.

Regular virtual check-ins with the program coordinator ensures continuous engagement, with the program culminating in national certification exams for the externs. Individuals hired by our health system are required to become nationally certified within one year of hire and maintain employment for a minimum of one year.

Outcomes and Workforce Impact

From program implementation through 2023, a total of 259 extern students were accepted into the pharmacy technician training program, divided across the 10 completed cohorts (average of 26 students per cohort) with 173 students successfully completing the program. Contributing factors that led to individuals not completing the training program include not being able to successfully pass the didactic exams, attendance concerns, and some dropping out of the program due to not being able to keep up with the workload or program schedule. The available demographic data (2021–2023 years) for the accepted students in this program revealed that 78% (153/196) of the students were female, 21% (41/196) were male, 1% (2/196) were gender non-binary, 22% (43/196) were Black or African American, 35% (68/196) were Hispanic or Latino, 27% (53/196) were White, and 9% (18/196) were Asian (Table 3). Recruitment strategies utilized included advertising the training program across all four key pillars of the program, leveraging various social media platforms and our Human Resources Recruiter reaching out to individuals on a one to one basis to people who had jobs that had transferable skills or qualities that we look for in pharmacy technicians such as attention to detail, multi-tasking, and customer service (e.g., individuals with fast food service jobs).

Table 3.

Cohort Statistics

Cohort #	Number Accepted	Ethnicity Asian	Ethnicity Hispanic	Ethnicity Black	Ethnicity White	Number Graduated	Percentage Graduated Per Cohort	Number Passed National Certification Exam	Offered Jobs at Lifespan
1	21	NR	NR	NR	NR	17	80.9	12	9
2	16	NR	NR	NR	NR	9	56.3	8	9
3	26	NR	NR	NR	NR	21	80.8	15	9
4	32	3	10	7	8	25	78.1	16	12
5	31	3	8	5	14	17	54.8	12	13
6	30	5	9	6	9	18	60	14	12
7	30	3	5	5	9	14	46.7	12	13
8	30	2	11	8	9	19	63.3	10	13
9	18	0	10	5	3	16	88.8	12	9
10	25	2	15	7	1	17	68	11	5

Abbreviations: NR, not reported.

Among individuals accepted into the STAT program, the outcomes were highly encouraging. Specifically, 66.8% of enrollees graduated, 70.5% achieved national certification, and 60% of the graduates were extended job offers by Lifespan (Table 3). Of the individuals extended Lifespan job offers, 89% were subsequently hired, of which 77% achieved national certification within the one-year requirement and 74% maintained employment for the minimum one-year commitment. Concurrently, the program significantly enhanced workforce diversity. The proportion of Black or African American pharmacy technicians increased from 1.3% (2/152) in September 2018 (pre-STAT program implementation) to 10.7% (18/169) in September 2023 (post-implementation), and Hispanic or Latino representation rose from 5.3% (8/152) to 27.8% (47/169) (Figure 1), which more closely matches the diversity of Rhode Island’s population. These increases were statistically significant (Fisher’s exact test p=0.00038 for Black/African American and p=3.72×10⁻⁸ for Hispanic/Latino), whereas the proportion of Asian technicians remained statistically unchanged (7.9% in 2018 vs. 8.3% in 2023; p=1.0). Moreover, there was a significant association between the evaluation year and the overall racial/ethnic distribution (chi-square test p=0.002).

Feedback from Program Graduates

Individuals who graduated from our training program and were working at Lifespan in 2023 were offered the opportunity to complete an anonymous survey to assess the value of our program on their well-being and impact on their career. The survey was completed by 30.4% (14/46) of the individuals and provided feedback that underscores the positive impact, with 86% strongly agreeing it benefited their well-being and 93% confirming a positive effect on their career paths, highlighting the STAT program’s comprehensive benefits. Table 4 and Table 5 provide qualitative feedback from the program graduates organized into key themes. The themes showcase how passion and fulfillment contribute to personal growth and well-being, as well as how transformative experiences and newfound clarity of purpose foster both personal and professional development. Furthermore, they demonstrate the link between career advancement, skill development, increased confidence, job satisfaction, and opportunities for financial stability, all stemming from a dedication to continuous learning and the provision of quality care within our program.

Table 4.

Representative Quotations for Program Value.

Themes	Quotations
Theme 1: Passion and fulfillment in one’s work led to personal growth and improved well-being.	“I love my job!” “I get to do something I love and am very passionate about.” “Completing the pharmacy extern program improved my life and well-being on a personal level by helping me get out of my comfort zone.”
Theme 2: Personal and professional growth through transformative experiences and newfound clarity of purpose.	“Completing the program helped me to find my drive again and helped me realize that I do indeed want to work in healthcare for the rest of my life.” “I have a better perspective on my personal life and goals.” “The opportunity I was waiting for.” “I feel like it has improved my decisions in my life career…stability and a more hands on environment.”
Theme 3: Career advancement and skill development leading to increased confidence, job satisfaction, and opportunities for financial stability.	“Completing the program provided me with job security and health benefits.” “It has taught me new work-social skills and helped me reach that desired experience I’ve aspired for.” “This extern program helped me become more confident and allowed me the chance to obtain a more reliable, better paying job.”
Theme 4: Commitment to professional growth and dedication to providing quality care through continuous learning and skill development.	“I pride myself in what I do and try to better myself for the hospital I work for. Makes me happy to know the impact I get to make daily for the patients we care for.” “In this program, I got practical experience, and they were so willing to help me learn new things I didn’t know before.”

Table 5.

Representative Quotations for Program Enhancement Opportunities.

Themes	Quotations
Theme 1: Additional support for exam preparation to foster collaborative learning.	“If the program implemented a group study for the national exam, it would increase the program’s value.”
Theme 2: Expand program to provide well-rounded experience and practical skills in various healthcare settings.	“Allow pharmacy externs to split their externship hours between inpatient and outpatient settings.” “One thing that could be implemented to increase the program’s value would be adding more IV related labs.”

DISCUSSION

Despite the nationwide shortage of pharmacy technician training programs, few existing initiatives offer the same level of state-funded financial support as the STAT program, which was specifically designed to reduce economic barriers for participants. Unlike other training programs, our program leverages state funding not only to cover operational costs but also to actively remove barriers that may impede students’ success. By addressing challenges such as financial constraints, childcare needs, and transportation issues, we significantly enhance the likelihood of our students successfully completing the program. This proactive approach underscores our commitment to fostering an inclusive and supportive learning environment, ensuring that all aspiring pharmacy technicians have equitable opportunities to thrive and excel in their education. Furthermore, our program offers the unique advantage of retaining the freedom to selectively hire graduates upon completion of the training program. Unlike some other training programs, we are not bound by the requirement to employ all individuals, affording us the flexibility to assess candidates based on their alignment with our mission and values. This discretion ensures that our team comprises individuals who not only possess the necessary skills but also embody the ethos of excellence and dedication central to our health system.

In this study, we developed a novel state-funded sixteen-week comprehensive pharmacy technician extern training program (the STAT program) encompassing didactic learning, soft skill training, and hands-on experience, in collaboration with Lifespan Workforce Development, Community College of Rhode Island and the Rhode Island Department of Labor. We discovered that through a thorough training regimen, individuals previously unable to sustain employment or find roles utilizing their skills can successfully transition into gainfully employed positions, such as those requiring nationally certified pharmacy technicians. Our STAT program bolstered team involvement in recruitment efforts, cultivated mentorship opportunities, and enriched team diversity.

Our STAT pharmacy technician extern program could offer employers a risk-free opportunity with minimal financial obligation (i.e., limited to time spent training) to observe key qualities (e.g., work ethic, dependability, communication, critical thinking, etc.) of potential employee candidates (i.e., externs) and provides current frontline team members a pronounced voice in the recruitment process. Frontline team members who are graduates from previous cohorts of the STAT program inherently have an increased vested interest in mentoring subsequent cohort externs through the training program, as newly hired team members. Previous graduates and current technician externs develop a strong connection, fostering team mentoring, collaboration, and lasting friendships. Motivated, engaged team members who feel ownership of their job and a sense of real community can ultimately produce increased employee retention and productivity.

Implementing an innovative, demand-driven solution, such as an employer-led workforce pipeline that connects the employer’s needs with education/training programs, can yield a stronger, more diverse pharmacy technician workforce. For the pipeline to be successful, educational partners (e.g., community colleges) must have a profound understanding of pharmacy, a strong education record, soft skills training, and a flexible, evolving curriculum to match the employer’s changing needs due to advancements in technology and/or the role of the pharmacy technician.

Our STAT pharmacy extern training program can be successfully revised to fit the needs of other healthcare disciplines (e.g., nursing, physical therapy, etc.) and other geographic areas experiencing similar healthcare recruitment challenges. Early in the discovery phase of project planning, it is essential to engage with the state Department of Labor to explore available state funding options, articulate the program’s vision, and identify target populations for the program. The next step should entail reaching out to educational institutions to establish partnerships.

When developing a comprehensive pharmacy technician workforce pipeline, incorporating weekly check-in calls with program partners to triage challenges, monitor outstanding issues, and discuss priorities enhances the success of the program. Additionally, frequent, consistent feedback improves extern engagement, elevates performance, and strengthens the program.

Our STAT pharmacy extern training program faces some constraints. Shortly after the implementation of our pharmacy technician training program, there was a Coronavirus (COVID-19) pandemic that impacted our employee retention due to some employees being afraid to continue working in an acute care inpatient hospital setting and some employees not wanting to comply with the mandated COVID-19 vaccine requirement. Additionally, our capacity to accommodate externs at various Lifespan hospitals and retail pharmacies is limited, restricting the number of applicants we can accept per cohort. Further, our survey response rate to assess the value of our pharmacy technician training program on well-being and impact on career status was lower than we had hoped. We recommend incorporating the survey as a required component of the program post-graduation. Lastly, securing state funding for healthcare training programs may pose a challenge in certain states due to a lack of funds or established legislation. Building strategic alliances with governmental agencies, such as the Department of Labor, advocating for the program’s alignment with state healthcare priorities, and actively participating in legislative discussions are effective ways to collaborate with the state and secure funding for training programs. Moreover, implementing the program in regions with homogeneous populations could hinder the ability of recruitment efforts to enhance diversity, as diversity within the pool of potential candidates may be lacking. Therefore, the program is most likely to be effectively implemented in urban or suburban areas, or in rural areas with a diverse population, to achieve optimal outcomes related to increasing a diverse workforce. Potential future program enhancements worth considering include expanding the scope of the program to include high school students and considering sponsoring work visas for immigrants who legally reside in the state.

CONCLUSION

The STAT program represents a significant advancement in pharmacy technician training, addressing critical workforce needs while enhancing diversity and inclusion within the sector. The program’s success demonstrates the potential for innovative training initiatives to impact healthcare delivery positively. Other health systems and their partners might consider implementing the STAT program or a similar career training program that can create a workforce pipeline to fill staffing gaps by leveraging available labor resources in their respective states while simultaneously decreasing the unemployment rate. Future efforts should focus on expanding the program’s reach, ensuring its sustainability, and exploring new opportunities to further enhance the pharmacy workforce. This program serves as a model for other healthcare disciplines and geographic areas facing similar challenges, offering a blueprint for leveraging training initiatives to address complex workforce development needs. Establishing a pharmacy technician workforce pipeline with minimal financial obligation is an innovative solution that healthcare organizations, regardless of their size, can implement to resolve recruitment challenges, intensify team engagement, increase employee retention, and broaden team diversity, potentially diminishing disparities between healthcare workers and the patient population they serve by tapping into the unemployed/underemployed populations within their state.

KEY POINTS:

• The Solutions Training and Teamwork (STAT) program successfully addressed the skills gap in pharmacy technician roles, achieving a graduation rate of 66.8% and offering 60% of the graduates’ jobs.

• State funding and strategic partnerships facilitated the removal of financial barriers within the STAT program, contributing to an increased diversity of the pharmacy workforce.

• The STAT program’s model of integrating didactic learning with practical experience can serve as a blueprint for similar initiatives in healthcare systems nationwide, enhancing workforce development and employee engagement.

Data Availability

The data underlying this article will be shared on reasonable request to the corresponding author.