Last week’s Tip discussed the value of effective cost accounting. Some of the same authors from the study cited in that Tip conducted a subsequent evaluation of pharmacy services. In this one, they employed a time-and-motion study to determine which activities are taking up the most time and to diagnose more specifically where efficiencies can be gained. These data are useful in cost-accounting and also operations management, including the design and implementation of services, along with consideration of workflow design and job descriptions of pharmacy staff.
Gregorio et al conducted this informative, observational time-and-motion study in 4 community pharmacies.1 They used prior literature to develop a reference list of activities to observe. Data from 8-hr shifts were collected on type and duration of the activity, who performed it, and where. To estimate the demand of the services, “thematic patient scenarios” were developed and based on the defined daily dose and package size of the most consumed medicines, combined with data obtained from the four pharmacies’ information systems on the day the observational study took place. Between 67.0% and 81.8% of the registered activities were pharmacist-patient interactions. These interactions had a mean duration of 3.98 min per interaction. On average, participant pharmacies’ professionals handled 4.2 prescription and 0.9 over-the-counter (OTC) consultations per hour. Approximately one third of the day was spent performing administrative and non-differentiated tasks. About 54.92 min were registered as free time, 50% of which were “micro pauses” of 1 min or less. The large amount of time a pharmacist has at the counter to interact with a patient makes disease or therapeutic management quite challenging. However, the perception of “lack of time”, often reported as a barrier for service provision, must be called into question, since substantial available time was found. However, to turn this available time into usable time, redesign of work processes and new role definitions are necessary. Better management and new communication channels should be developed to facilitate patient follow-up services.
Pharmacy managers might seldom have the wherewithal to conduct time-and-motion studies as formal as this one. They might seek help from academic researchers or even full-service wholesalers if unable to conduct one so formal. But even done informally, evaluations of time-and-motion can inform operations decisions, including the evaluation of downtime, which is seldom considered. Reductions in downtime don’t mean eliminating employee breaks; but rather, finding the optimal activities undertaken for employees while working and not on a work break.
Additional information about Time Management/Organizational Skills and Financial Reports and Operations Management in Pharmacy Management: Essentials for All Practice Settings, 5e. If you or your institution subscribes to AccessPharmacy, use or create your MyAccess Profile to sign-in to Pharmacy Management: Essentials for All Practice Settings, 5e. If your institution does not provide access, ask your medical librarian about subscribing.
1Gregorio J, Cavaco AM, Lapao LV. How to best manage time interaction with patients? Community pharmacist workload and service provision analysis. Res Social Adm Pharm. 2017;13:133-147.