Every business needs a clear-eyed evaluation every few years. Systems that worked well initially seldom continue to produce outstanding results as the environment around them changes. Clearly defined roles and designated locations give way to old habits or incorporate new adaptations. Operational efficiency drifts downward. Even if you think your pharmacy operates at peak performance, a quick evaluation could provide validation—or a few surprises.

1. Establish goals and metrics: Exactly how productive do you want to be? Know what you want to achieve. If you want all prescriptions filled within 10 minutes of drop-off, set up a system to measure the time taken at each step for each medication. If you want employees to dispense a certain number of prescriptions per hour, employ a software program that tracks performance by person. Compare your results to industry standards.

2. Dig into the data: If the fill time exceeds your goal, identify the sticking points. Is there a bottleneck where multiple scripts are waiting for one person to take action? Are illegible scripts causing delays while staff members contact physician offices? Your reports may reveal that some employees appear much more productive than others. That presents opportunities to better understand the differences. Are the employees who fill fewer scripts actually slower or are they more engaged with patients? If they are advising patients or cross-selling products, do you want them to stop that to increase their speed? Are they splitting their time between fills and answering the phone?

3. Follow the path: Watch how a script flows through the pharmacy. Does it travel across the room a few times or move in a relatively straight line from drop-off to register? Do pharmacy technicians have the equipment and materials needed at their stations, or do they need to retrieve materials from other locations? If you see a lot of movement within the pharmacy, track the number of steps your staff take every day. A few cheap pedometers will be accurate enough. While 10,000 steps may be a fitness goal for some staff members, if they are literally walking miles just filling prescriptions, some streamlining is in order.

4. Designate responsibilities: While smaller pharmacies may need employees to handle multiple roles, assigning primary responsibility for key tasks provides accountability. To the extent possible, clarify who should follow up with physician offices and insurers, answer the phone, pull medications, handle fills, label bottles, and return unclaimed “will call” prescriptions to inventory. The fewer tasks each person has, the more efficient the process will be as less time will be lost in the transition from task to task, and the individual will develop a natural flow to the work as it becomes increasingly familiar. Keep in mind the personalities and skills of your staff as you divvy up responsibilities. If you have someone who hates to be on the phone, don’t ask them to work with physicians’ offices or handle the register. Keep your higher skilled and higher paid employees focused on tasks that need their expertise.

5. Communicate the new structure: Diagram the work flow and write up responsibilities in an operating manual or at least a PowerPoint presentation. Review it with employees and solicit their comments. Make any tweaks or revisions needed to rationalize the process given the staff and environment you have. Then implement the changes one step at a time to ensure that unexpected consequences do not cascade into major problems. “You don’t want to do a thousand things at once,” according to Jack Galdo, PharmD, BCPS, CGP, clinical assistant professor at Samford University in Birmingham, Alabama. “You want to do one thing at a time, and look at the impact of that one thing.”

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