We continue this week to explore Pharmacy Workflow Magic with pharmacy entrepreneur and business owner Don Grove. If you missed the first couple posts, simply click HERE FOR PART I or click HERE FOR PART II of this series. Don, thanks for joining us again today as we follow up with a couple more important questions about workflow.
5) What are some of the big mistakes that pharmacy owners or businesses make with respect to work flow?
The chains are making this mistake by thinking walls are a barrier to the pharmacist and the patient. Patients want speed and accuracy and the option of counsel but on their terms. The chains want patients to hang around for 1-2 hours and buy more stuff and we don’t sell stuff normally.
Erect a POS bagging area as a privacy wall so patients don’t get to watch and listen and you can work faster with less interruptions leading to more accuracy. Pharmacies need to be closed more to the public rather than in talking distance to the patients. I call it the fish bowl effect where the pharmacist is behind a glass in a fish bowl. Patients hear and see everything going on behind the counter so there is no privacy and numerous patient interruptions during the filling process.
Can you imagine a physician wanting patients to hear his interaction with other physicians and patients and worse yet watch him or her operate? It is a bizarre concept independent pharmacists bought into in the 80’s and now successful Walgreens is pushing it even more, so their pharmacists are more accessible. It is crazy. We closed down our pharmacy and the only 2 areas the patients interact with us are at the drop off station and the counseling windows. The rest of the area is closed off by the POS sacking areas which has a closed wall. This has virtually eliminated errors caused by disruptions.
The other big mistake is pharmacist/owners try to function as technicians and do jobs a technician can actually do better and faster. With high wages and reduced 3rd party reimbursements every employee should function where they give the owner the highest ROI and maximize speed without compromising accuracy. Pharmacists should work in the areas in which they were trained and are meeting the Board of Pharmacy legal requirements. The pharmacist should never stop working to personally receive a prescription unless there is a request for the pharmacist.
Separate privacy tech filling stations should be clutter free and more horizontal counter space, headsets instead of phones, Rx bags instead of trays, close proximity to robotics to save steps. Inventory can be on vertical carousels within feet of the technicians so the techs move less. Every bag should be color coded so Rx’s move quickly according to urgency and pick up times to lessen stress on techs, pharmacists and OTC bagging clerks.
Use technology such as IVR’s to stay off the phone and robotics to help technicians work faster and more accurately. It is not unusual for us to verify 500-700 Rx’s with one and ½ pharmacists and still give vaccinations. This economy of time allows us to also do MTM and outside consulting.
6) What are some of the discoveries or innovations that you have implemented at J&D pharmacy to improve the work flow?
A customized work station for each technician and their touch screen computer holds multiple Rx bags that are all color coded. Circular, vertical inventory carousels close to techs with a small foot print carry most all the Rx inventory not contained in the Script Pro robot allowing us to remove the 50 year old antiquated metal fixtures.
A bagging carousel holds the recently filled color coded Rx’s by time received. Metal bundling clasps can double the volume of the bags should you have 20-30 Rx’s for one family or patient. Each transparent bag has easy access additional external pockets on both sides for Rx tickets and internal auxiliary house labels and notes from pharmacists.
Drawers for purses are within hand reach and out of sight of other workers and patients. Stations have drawers for tech’s purses, auxiliary labels and tickets. We use a profile analysis called the Winslow Report to help ensure higher paid employees are in the area or skill set they are most suited for which increases employee satisfaction and efficiency. A digital picture frame is provided for technicians so they can see pics of their family avoiding the 2 sided taped up pictures that make the \technician area more professional.
Special drawers keep used labels off the counters to avoid HIPAA problems, clutter and mistakes. The pharmacist work station has more clinical oriented materials for handouts but the same large horizontal counter with a touch screen computer and off counter counting tray.
Our Education Area has sit down kiosks with accessible iPad videos that further educate our patients on medications, devices and disease states and self-service BP kits. These 2 minute professionally produced videos counsel better than a pharmacist due to their clarity and consistency. These same videos are sent to smart phones, home computers and tablets for additional viewing by patients and family.
The pharmacy redesign as I said earlier makes the Rx preparation area not as accessible to patients as most pharmacies. Our POS clerk bagging area across the front affords us more privacy. This way our employees have more freedom to talk among themselves without violating HIPAA. The pharmacists have 2 counseling areas that are private and semi-private but we do not attempt to speak to every patient that walks in the pharmacy. This allows for more speed and accuracy.
Lastly we were one of the first pharmacists in the nation doing prescription synchronization with the Univ of Mississippi ground breaking studies. This program made us proactive rather than reactive each day in the way we respond to our walk-in patients which keeps our pharmacy running like NASCAR.
Please tune in tomorrow for PART IV and our final day with Don Grove and this series on Pharmacy Workflow.