Lauren B Angelo1, Stefanie P Ferreri. 1. Department of Pharmacy Practice, Butler University College of Pharmacy and Health Sciences, 4600 Sunset Avenue, Indianapolis, IN 46208-3485, USA. langelo@butler.edu
Abstract
OBJECTIVE: To assess the effect that workflow enhancements have on dispensing responsibilities and pharmacist-patient interaction in the community pharmacy setting. DESIGN: Pre-post comparison. Pre-assessment data were obtained from a multisite observational study. SETTING: Pharmacy within a regional pharmacy chain. STUDY PARTICIPANTS: 3 pharmacists and 110 patients. INTERVENTION: The pharmacy was physically remodeled to enable workflow changes, including defining dispensing responsibilities with an emphasis on patient counseling, providing an additional 6 feet of counter space, upgrading technology, installing a third computer, implementing tools to augment the filling process, and requesting that cashiers rephrase the offer to counsel to encourage patient acceptance. Patients and pharmacists were surveyed about the experiences and beliefs, and pharmacy activities were observed directly. MAIN OUTCOME MEASURES: Patient counseling and prescription dispensing. activities. RESULTS: The number of pharmacists who perceived that they had adequate time to counsel patients increased as a result of the intervention (0 of 3 responding pharmacists before the intervention, compared with 2 of 2 afterward). Patient satisfaction scores both before and after the intervention were predominantly favorable and did not differ significantly. The most relevant change in dispensing activities was pharmacist involvement with data entry into the computer, which decreased from 61% to 10%. Oral counseling offers to patients increased significantly, from 5% to 85%, but counseling rates remained low throughout the study and were not measurably affected by workload. CONCLUSION: Workflow redesign has positively affected the dispensing activities at the study site. Technicians took more responsibility for dispensing tasks. Given the drastic increase in counseling offers but lack of effect on counseling rates, patient behavior and expectations with regard to counseling likely need to change to further improve dynamics in the community pharmacy.
OBJECTIVE: To assess the effect that workflow enhancements have on dispensing responsibilities and pharmacist-patient interaction in the community pharmacy setting. DESIGN: Pre-post comparison. Pre-assessment data were obtained from a multisite observational study. SETTING: Pharmacy within a regional pharmacy chain. STUDY PARTICIPANTS: 3 pharmacists and 110 patients. INTERVENTION: The pharmacy was physically remodeled to enable workflow changes, including defining dispensing responsibilities with an emphasis on patient counseling, providing an additional 6 feet of counter space, upgrading technology, installing a third computer, implementing tools to augment the filling process, and requesting that cashiers rephrase the offer to counsel to encourage patient acceptance. Patients and pharmacists were surveyed about the experiences and beliefs, and pharmacy activities were observed directly. MAIN OUTCOME MEASURES: Patient counseling and prescription dispensing. activities. RESULTS: The number of pharmacists who perceived that they had adequate time to counsel patients increased as a result of the intervention (0 of 3 responding pharmacists before the intervention, compared with 2 of 2 afterward). Patient satisfaction scores both before and after the intervention were predominantly favorable and did not differ significantly. The most relevant change in dispensing activities was pharmacist involvement with data entry into the computer, which decreased from 61% to 10%. Oral counseling offers to patients increased significantly, from 5% to 85%, but counseling rates remained low throughout the study and were not measurably affected by workload. CONCLUSION: Workflow redesign has positively affected the dispensing activities at the study site. Technicians took more responsibility for dispensing tasks. Given the drastic increase in counseling offers but lack of effect on counseling rates, patient behavior and expectations with regard to counseling likely need to change to further improve dynamics in the community pharmacy.
Authors: Richard J Holden; Neal R Patel; Matthew C Scanlon; Theresa M Shalaby; Judi M Arnold; Ben-Tzion Karsh Journal: Res Social Adm Pharm Date: 2010-02-11