So, you want to own a pharmacy, Part 4 – Workflow and process engineering

The workflow of a pharmacy is something that can have a huge impact on every aspect of your business from productivity and patient experience, to employee satisfaction. How does your pharmacy work? Is this something you’ve thought about or has it never crossed your mind?

This article will take the time to talk about workflow, some considerations for your business of what may or may not work.

Workflow in a pharmacy has a few components that traditionally have always been the same. An area where prescriptions are dropped off, an area where data is input into the pharmacy management system, a filling section to package medication, a POS station to cash customers out and will always have an area to counsel patients. Where are these located in your pharmacy? Do you feel these are the best locations for them in your pharmacy, and is it time to re-evaluate?

What determines your process efficiency?

How do you determine if your pharmacy is efficient? Often many managers and owners judge this by seeing if work is being done on time. However, this does not highlight where staff may be losing time due to cumbersome processes. The key indicator of process efficiency is the average amount of time it takes to perform a task, such as filling a prescription.

Some important questions to ask yourself about your practice:

• How many steps does each staff member need to take at each stage of the prescription filling processes?
•  Can you see any bottlenecks in this process?
• How long does each stage of the prescription filling process take?

 Streamlining movement

To ensure changes are improving your workflow, start by defining your current baseline. Understanding where you are currently can help start the journey of where you want to be. Once you see your current state, look for areas of improvement. Comparing yourself to industry standards or with other locations you know/own can show where your current store workflow ranks. It’s important to note that not all pharmacies are the same and cannot be directly compared. But this does give some general indication for potential to improve.

Streamlining movement can look at the number of steps and the location of items in your pharmacy, and it can look at the number of times you may have to re-do a task because of improper training.

Stations

Where your stations are located can have a big impact on your efficiency. Is the station at your prescription drop-off appropriate for all the tasks that staff members may have to do? Such as scanning in the prescriptions, having insurance quick references and details for patient data input? It is important to recognize where and when information and references are needed and arrange those accordingly.

Who is at each station is also a very important consideration. In theory, the pharmacist has the ability to do every role in the pharmacy. In reality, they may not be the best fit to be at any station. When designating stations, rather than highlighting them by staff members, designate staff to specific duties.

How do you handle out-of-flow tasks?

 An out-of-flow task is any one that does not fall within the regular prescription filling flow. This can be dosette/blister cards that are packaged a little differently and have a different timeline. It can be services such as vaccinations, OTC counselling, the need to contact an insurance company, etc. Out-of-flow tasks can also have their own workflow. Having a standardized operating procedure to offer vaccinations, or prompt in your pharmacy to signal counselling or further assistance can help ensure that prescription checking isn’t interrupted, but also that these tasks are addressed in a timely manner.  There are numerous small tasks that require cognitive workload, from fridge items, delivery notes, etc. Having a process can help anyone integrate into your pharmacy and also support your staff’s cognitive workload.

Transitioning to automation

Automation has become an integral part of workflow efficiency. All automation isn’t right for every pharmacy, but as a pharmacy naturally grows and staff roles change, automation can help your workflow become more efficient, ensuring your staff’s time is freed up to provide other services and build patient relationships. When investing in automation it’s important to understand what your workflow currently is, how this can support your current flow or work and what you will be doing with your time savings and how you will reinvest that time in your business.

What shape is your pharmacy?

When renovating or starting a new pharmacy, it’s important to ensure you take ownership of your pharmacy’s design. Ask yourself a few simple questions:

• Where are your patients entering and exiting?
• What are you looking to highlight and what do you want patients to see?
• How innovative do you hope to be and who is your target audience?

Traditionally, pharmacies have been linear. They are often a straight counter that gives full visibility to patients as to what is happening behind the dispensing bench. However, layouts are changing. Formats can be circular, triangular, have walls to cover where automation machines may be, integrate a more accessible layout to the pharmacist, etc. Understanding what you want in your pharmacy is the first step and then designing the format of your pharmacy around that can lead to efficiency. Layout is impacted by the sum of all the decisions mentioned previously.

Always re-evaluate

In pharmacy the workflow is affected by various factors. Always re-evaluate to see if your current workflow is still responsive to your business. As prescription volumes change, the way prescriptions get to the pharmacy change, the roles of pharmacists and pharmacy technicians change, and so much more, the pharmacy operating layout and workflow will also change. Start with a baseline and monitor the impact of changes made in the pharmacy. Not every new idea is a great idea and not every idea will work in your practice. Take the time to evaluate, innovate and optimize. You don’t always have to do this alone; there are experts who are able to support you in this process as well as great resources you can utilize to start the journey.

Pavithra Ravinatarajan RPh is the founder and principal consultant of Pavithra Consulting Inc and works for National Bank of Canada in the Pharmacy Specialization Group