Assessment of workflow redesign in community pharmacy.
OBJECTIVE
To assess the effect that workflow enhancements have on dispensing responsibilities and pharmacist-patient interaction in the community pharmacy setting.


METHODS
Pre-post comparison. Pre-assessment data were obtained from a multisite observational study.


METHODS
Pharmacy within a regional pharmacy chain.


METHODS
3 pharmacists and 110 patients.


METHODS
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.


METHODS
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.


CONCLUSIONS
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.
Angelo
Lauren B
LB
Department of Pharmacy Practice, Butler University College of Pharmacy and Health Sciences, 4600 Sunset Avenue, Indianapolis, IN 46208-3485, USA. langelo@butler.edu
Ferreri
Stefanie P
SP
D001107:Architectural Accessibility / Q000592:standards*; D003157:Community Pharmacy Services / Q000592:standards / Q000706:statistics & numerical data*; D017598:Efficiency, Organizational / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D010353:Patient Education as Topic / Q000379:methods / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010361:Patients / Q000523:psychology; D010595:Pharmacists / Q000523:psychology; D010596:Pharmacy Technicians / Q000592:standards / Q000706:statistics & numerical data; D011369:Professional-Patient Relations; D014941:Work Simplification; D016526:Workload / Q000706:statistics & numerical data