Community Pharmacists and Productivity
I was looking through some old articles and found this one from 2013. Interestingly, 8 years later, it is as accurate a description of what we do now as it was then.
Owning a pharmacy can be an expensive proposition. I can only imagine what it might be like to own 1000 plus pharmacies and try to manage them. If I were a non-pharmacist and sitting in an office somewhere, I would want some sort of measurement to gauge how all of my pharmacies were running. Perhaps I would wonder what my pharmacists did all day with their tasks, so I may ask them to document each step of their day and enter it into flow charts. Then I would be in a position to measure each store to the other to see how productive one store was compared to the other.
Maybe, just maybe, I should visit each store and talk with the pharmacists that work at that site. Perhaps the pharmacists may have some input as to how the store may be staffed and worked to become more patient centered. The pharmacist may have this idea on how the pharmacy could become the medication education center for the town. Perhaps the pharmacist might have the opportunity to spend more time educating the patients on appropriate use and understanding of their medications, and less time filling out flow sheets that document how fast a prescription got filled and how long a patient had to wait for their prescription.
I would like to see a measurement system that records how well a pharmacist counsels their patient. A metric that looks at how well the patient understands what they are going to do with their medications and measures their outcome of therapy based upon the results of the counseling interaction they had with their community pharmacist.
Where I work, we have one measurement we document at the end of each day. We count the number of prescriptions filled during that day. This is by no means a perfect metric; however, the accountants need a number to gauge our productivity. On any given day, we usually meet our metric.
I am taking a moment to discuss this because for some reason this question has come up a few times recently, “What is it you do in the pharmacy anyway?”
The other day I took a few moments to try and document the activities of a normal day in the pharmacy.
- 24 times I met patients at the pharmacy counseling station to discuss their new medication with them, assuring that it did not interact inappropriately with their current medication profile and that they understood all the appropriate information about their new medications.
- 5 times doctors called to consult about medication regimens, 3 were for antibiotic therapy regimens and 2 were for pain medication regimens.
- 3 times I called doctors to discuss a potential drug interaction on a new medication order.
- 1 time I called a doctor back to clarify the dosing on a prescription written for injectable blood thinner medication. The dose was not appropriate for the patient's weight.
- 3 times I called doctors to clarify prescriptions because the dose that came through on the electronic prescription was different from the dose we had filled last time for the patient.
- 1 time I called a doctor in the Neonatal Intensive Care Unit to clarify the dose that he wanted us to compound for a newborn being discharged from the hospital.
- I participated in helping discharge 3 patients from the Behavior Health Unit, each of which had at least 5 prescription orders, and one of which had 13 prescription orders.
- I worked with a Social Worker at the Hospital to help discharge a patient that had no funds. We helped them receive 48 hours supply of discharge medications to hold them over until they are able to get to the county/state resource available to them to complete their prescription order.
- I participated in helping fill a Hospice Admission order which includes 9 emergency medications and then counsel the family member on the use of these medications.
- I worked with my partner in the store helping to implement a new “real time” computer narcotic inventory system.
- 14 times I consulted with patients on over the counter concerns relating to cough, congestion, diarrhea, constipation, itchy eyes, dry mouth and various other situations.
- Participated in helping to compound 3 different medications for pediatric patients.
I participated as a member of a team of 2 technicians, 1 pharmacist and 1 pharmacist manager. Together we exceeded our metric of how ever many prescriptions we needed to fill that day to stay positively productive. More than that, we worked as a team to assure that our patients received the best possible pharmacy care we could give them.
Community Pharmacists do fill prescriptions; however, they also know who you are, know your medication profiles, and work behind the scene all day to ensure that patients receive the best medication therapy. Until the point comes that we are able to measure the effectiveness of how a pharmacist provides pharmaceutical care, we will continue to count how many prescriptions we fill each day.