In a competitive environment, it’s more important than ever for independent pharmacies to increase patient care and decrease costs. They cannot afford high overhead costs or inefficiencies behind the counter.
“Today, pharmacies have to be at the top of their game,” says Ryan Summers, PharmD, owner of Summers Pharmacy in Clinton, MO.
At the same time, patients expect more from their pharmacies. “Patients don’t just compare pharmacies to other pharmacies,” Summers says. “They compare us to nonpharmacy organizations that have a high level of customer satisfaction.”
One important way to improve customer service and staff efficiencies is to incorporate a workflow management process. The pharmacy will be more organized. Prescriptions will be filled by priority. Technicians and clerks will have a better sense of their individual responsibilities.
From the patient perspective, workflow management helps improve medication safety since there is an orderliness to filling prescriptions. The pharmacist, because he or she is less involved in the filling of prescriptions, has more time to counsel patients about their medications, which can lead to improved adherence and less side effects.
“Workflow management is important to both the pharmacy staff and patients,” says Stephen A. Brown, JD, PharmD, adjunct professor in the Department of Pharmaceutical, Social, and Administrative Sciences at Samford University in Birmingham, AL. “With the correct workflow management process, pharmacists and nonpharmacist personnel can operate at the top of their abilities. There is a sense of well-being among the staff.”
Many software programs are available to help independent retail pharmacies implement a workflow management system—each distinct in their own way. But they have a number of common traits:
- Each system clearly orders and prioritizes the tasks at hand, from the time the prescription comes into the pharmacy through to checkout.
- Employees, whether they are pharmacists, technicians, or clerks, know their individual responsibilities during their shifts.
- Prescriptions are prioritized so the pharmacist knows which ones to verify immediately and which can wait.
- There are checks and rechecks to ensure the proper medication is getting to the right patient.
“The main objective of workflow management is to align the team,” says Ghada Abukuwaik, RPh, president and head pharmacist of CureMed Pharmacy in Clifton, NJ. Employees better understand what they’re doing and the tasks they are expected to perform. “It’s essential to running a successful pharmacy.”
A successful pharmacy breeds customer trust. “The last thing you want as a pharmacist is to have customers watching as the staff tries to locate their prescriptions,” says Michael Fapore, RPh, owner of The Medicine Shoppe in Somerset, PA. “Workflow builds patient confidence.”
Before Implementing Workflow, Do Your Homework
When Michael Fapore, RPh, decided to implement a new workflow management system in his pharmacy, The Medicine Shoppe, in Somerset, PA, he stressed patience with his staff. “I’m glad I did because we had some rough times at first,” he says.
Part of those rough times stemmed from the fact that his old software program could not support the improvements in the pharmacy’s workflow that Fapore wanted, despite assurances from the developer that it could.
The results were not pretty.
“The day we opened, we had a mess,” Fapore says. “The system wouldn’t work as we wanted.”
Fapore and his staff were able to muddle through on a temporary fix for several months before he purchased a new software program that could accomplish everything he wanted.
Once the new system was implemented, Fapore began to see the changes in patient safety and staff efficiencies he had envisioned through workflow management.
While it was a tough lesson, Fapore learned that there must be demonstrable proof that a software program can handle the type of workflow management system the pharmacist wants.
“The first thing I would tell [pharmacists] is before they start, make sure their software can support the objectives,” he says. “Demand a demo to make sure it will work the way they want it to work. We did not do this, and it made it a lot tougher for us in the beginning.
“We found out the hard way that not all computer systems are set up to manage workflow,” Fapore maintains.
Greater Confidence in Patient Safety
Patient safety was the No. 1 issue that prompted Fapore to implement a new workflow management system.
In the old workflow system at his pharmacy, the pharmacist would enter all data into the computer, and the technicians would count, fill, and place the prescription at the end of the counter for the pharmacist to check. With a large amount of prescriptions coming in at any one time, Fapore wasn’t always sure at the end of the day that everything was done correctly. “It was hectic,” he says.
In the new system, the process of filling prescriptions is broken down into various subsets. Technicians, working at their own workstations, know their individual responsibilities—entering prescription information, assembling the prescription or troubleshooting insurance questions.
There are several safety checks before the prescription gets to the pharmacist for a final check. For example, the technician filling the prescription identifies the medication by bar code. The system prevents the prescription from being filled if the incorrect bar code is scanned.
When the medication gets to the pharmacist for the final check, its image appears on a computer screen, along with its drug utilization review data. “This is something the old system did not have,” Fapore notes. “It’s a big plus for patient safety.”
Repetitive mistakes are less common with the new workflow management system. That’s not to say mistakes are a thing of the past.
“We usually catch something every day, and although 99% are minor errors, we are able to correct them and educate our staff to reduce these errors in the future,” Fapore says.
When there is a mistake, Fapore can see where it occurs, and he can discuss the steps to take to avoid similar errors in the future with the responsible employee.
The new system gives Fapore peace of mind. “I want to be confident that all prescriptions are correct,” he says. “I know there is no guarantee we will be mistake-free. However, our new workflow management system gives us the best opportunity to safely deliver prescriptions to our patients.”