Doing Right by the Frontline: Supporting Direct Support Professionals Through the Medication Pass

For providers supporting individuals with intellectual and developmental disabilities (I/DD), workforce retention is rarely about one factor. Compensation and scheduling matter, but so does the daily experience of doing the work itself. For direct support professionals (DSPs), few moments in a shift carry more responsibility than the medication pass.

When that process is organized, accurate, and supported, DSPs can focus on the individual in front of them. When questions arise during the pass, staff may need to clarify an order, confirm a medication change, check documentation, or seek clinical guidance while keeping the shift moving. Over time, repeated uncertainty can affect confidence, morale, and retention.

Doing right by individuals with I/DD begins with doing right by the people delivering their care every day. For providers, that means reducing avoidable confusion and giving DSPs the tools, information, and support they need to confidently perform their roles.

That support starts before administration begins. A safe and manageable medication pass depends on accurate information at the point of care. The 3-Way Match-Back process helps address this need by comparing three key elements: the prescriber’s order, the electronic medication administration record (eMAR), and the medications received from the pharmacy. When these elements are routinely checked against one another, discrepancies can be identified and resolved before a dose is due, rather than during the pass.

This is especially important in I/DD settings, where medication regimens are often individualized, complex, and subject to change. For example, a new order may follow a physician visit, a regimen may change after hospitalization, or a discontinued medication may need to be removed from active administration records. Each change can create confusion if the order, eMAR, and medications don’t match.

Clear packaging can also reduce friction for frontline staff. Pre-packaged medications organized by individual, date, and time give DSPs a more reliable path through the pass. Staff can easily confirm the right medication is administered to the right person at the right time. When packaging connects with an eMAR system, barcode scanning can help update documentation and reduce the need for separate notes or manual reconciliation later.

The Seven Rights of Medication Administration serve a similar purpose. The right patient, right drug, right dose, right time, right route, right reason, and right documentation give DSPs a dependable process to follow during busy shifts and after medication changes. These checks support safety, but they also support staff confidence by making the work more consistent and less dependent on guesswork.

Even strong processes cannot prevent every unexpected situation. A medication label may look unfamiliar, an order may need clarification after regular business hours, or a recent hospital discharge may require careful review before the next scheduled pass. In those moments, access to pharmacist support becomes a practical resource for frontline staff, not just a clinical safeguard.

A long-term care pharmacy partner with experience serving I/DD providers can help ensure DSPs have a place to turn when questions cannot wait. Around-the-clock pharmacist access reinforces that medication management is not the responsibility of one staff member working alone during a demanding shift. Accurate records, clear packaging, responsive communication, and clinical expertise all contribute to a more supported work environment.

For providers, this is a workforce issue as much as a safety issue. Medication errors must be prevented, and safety must remain central. However, the systems designed to support safety also affect whether DSPs feel equipped to do their jobs well. Unclear orders, missing information, manual workarounds, and limited after-hours support make difficult work harder. Reducing those barriers helps staff stay focused, confident, and engaged.

Retention is built through the daily realities of the job. The medication pass is one place where preparation, reliable tools, and timely support come together. Providers that invest in stronger medication processes send a clear message to their teams: we have thought carefully about what this work requires, and we have made sure you are not doing it alone. That investment supports safer care for individuals with I/DD and the DSPs who make that care possible every day.

Kyle Simmons is co-president of Guardian Pharmacy Services’ Boomer Solutions.