One of the features of the 2010 McKesson Trade Show in Las Vegas was a
continuing education presentation give by industrial engineer Robin Gensler,
and sponsored by Parata Systems. Gensler came to talk with independent
pharmacists about how they can best analyze their operations, and develop
methods for making educated decisions about workflows, staffing, and
technology. Gensler made several interesting observations about what you can
learn using the right methods. For example, Gensler mentioned studies that
showed that the conventional wisdom that new prescriptions take much longer
than refills to process isn't necessarily true. Such a discovery can help you
develop a clearer, better understanding of your pharmacy operations, which can
then form the basis for creating growth plans, adjusting staffing, better using
your available physical space, and deploying technology intelligently.
Keith Overfield, who manages Parata Consulting (a newly formed service offering that leverages industrial engineering principles to achieve metric driven results in pharmacies), also has a good deal of experience
with applying industrial engineering (IE) concepts and methods to pharmacy
operations. Following Gensler's presentation, Overfield answered a few
questions for ComputerTalk senior editor Will Lockwood about how
pharmacists can bring an IE approach to their pharmacies.
CT: Keith, IE isn't necessarily new to pharmacy. What's the take for
pharmacists who may feel as if they've gone this route before?
Overfield: Well, Robin made a really good point that IE isn't just time
and motion and direct observation studies. In fact, these probably aren't going
to be very useful in most pharmacies. Where you'll find real value is when you
start to think along the lines of humanizing the IE approach, and seeing how it
can help you understand the human capital that makes pharmacies run. We need to
see it as a set of methods that can support change management by helping you
understand what you can do to empower your staff and get the most out of your
CT: So what will pharmacists who want to use IE methods being doing?
Overfield: In my experience, when you look at all the activities, beginning
when a prescription is received and ending with the pick-up transaction, there
are probably 15 activities that will cover 99% of the activities that happen
behind the counter, and these tend to be common to most pharmacies. How you
accomplish these activities can vary, but what you need to do doesn't.
So the interesting part comes when you then ask: "What are the problems
I'm trying to address?" The answers here depend on what you want to
achieve, and having a clear idea of what that is. Once you've defined your
problems, the next question is how do you quantify it? You will need to find
out what the key metrics are for understanding how your pharmacy is performing.
The challenge is that when you are observing your business
from inside your operation, it can be tough to see the forest for the trees.
For example, in the CE, Robin asked how many pharmacists agreed that refills take
much less time than new prescriptions. Most did.
In fact, an IE-based evaluation reveals that while some
time is saved with refills because you don't have to enter the script into the
system and engage with the customer at the counter, there's not that much
difference in time required because most of the other steps are the same,
whether it's a refill or a new script.
CT: So the conventional wisdom isn't
right in this case. Are there other good examples?
Sure. Another example
that illustrates this point is will call. Many pharmacies have identified will
call as a major pain point in their operations. While that may be true, will
call represents just 4 percent of total pharmacy work, and less than 20 percent
of customer service time. So an investment to improve the efficiency of will
call will have only a marginal impact on customer service.
Of course, the pressure of locating a prescription for a waiting
customer can skew your perception. An objective look at your processes can help
you clarify priorities and make investments in areas of your workflow that will
yield the greatest return against your goals.
CT: OK, so benchmarking is very important. What are some resources for
Overfield: The first place most will look is the NCPA Cardinal Digest,
which will tell you how the top-performing pharmacies are doing in terms of
metrics such as labor dollars/rx, how many rx/total hours staffed, and a lot of
good measures of operational efficiency against which you can benchmark
Then you've got to step outside your operation, and take
an objective look at how your processes work and the time it is really taking
to perform various functions.
CT: Keith, incidentally, the
American Society of Consultant Pharmacists has just published the results of an
operational benchmarking survey for long-term care pharmacies, which is
available from ASCP's Web site at www.ascp.com/business.
So then, once you've reviewed the studies, how do you put this into action?
Overfield: This is when your vendors can come into play. They can help
you deploy solutions that will expedite progress toward the goals you've identified.
What's critical is that you are armed with your own
metrics for evaluating technology and understanding the potential of a given
solution to help achieve your goals. In short, you'll
be able to evaluate which technology investments will deliver the biggest bang
for your buck.
CT: It certainly is ideal to be able to have a plan for your pharmacy
that's based on solid research. But to make the effort and investment
worthwhile, you really need to be ready to make changes in how your pharmacy
operates day-to-day. That's usually easier said than done, right?
Overfield: Change management, it's not free, it's not easy. There's a
statistic out there that says that 70% of management teams that have deployed
change management processes say that they haven't gotten the value out of it
they expected. There are huge rewards for change management, but it's a tough
task to succeed at.
CT: Exactly. So offer busy pharmacists out there some advice.
Overfield: You need to ask yourself some hard questions. For example,
how do you know you are open to change? Are you very clear about what you are
trying to achieve? And then it comes down to having a specific business plan
that is designed to take advantage of the changes you make. If you have a goal
of freeing up a certain amount of time, know what tasks you'll assign that time
to and who will do them. If you are looking for growth, then you have to have a
plan and benchmark against which to measure growth and determine your return on
your efforts. You'll want to be able to benchmark internally so that you can
see in a year, say, how your investment has affected a few key metrics.
CT: There's a lot of work here, but really a lot of opportunity for
pharmacists as well.
Overfield: Yes. And to be fair this whole process of change management
isn't something that most pharmacists necessarily have any training in. It's
not likely to have been a major component of their pharmacy education, if it's
part at all. So if you can find the resources to educate yourself about
creating change and identify the people who can help you do it, then you will
distinguish yourselves from your competition by better managing the change you