The first thing Fapore did was shop for a robot, and shortly thereafter decided to bring in a ScriptPro unit. But, Fapore says, while looking at robots he read an article in a magazine produced by one of his buying groups. The article described how another PBA Health member had totally revamped his prescription filling process with a unique combination of specialized workstations, software, and “lazy Susan” type inventory carousels.
According to the article this “new way” of organizing workflow allows one pharmacist, working with a carefully trained team of technicians, to fill 700 or more prescriptions a day. Fapore contacted the subject of the article, Don Grove, R.Ph., owner of J&D Pharmacy in Warsaw, Mo. He liked what he heard, and became the first person to purchase the rights to install Grove’s SmartFlow Pharmacy Workflow System.
With a robot on order and a total revamp of the prescription area imminent, Fapore contracted with Crawford Designs, a Pennsylvania-based pharmacy design firm, to help organize, stage, and implement the changeover. Fapore says the project was done over a weekend and, after six months of adjustment, has worked even better than he had imagined. The heart of the SmartFlow process, Fapore says, “is a tastefully designed combination of individual workstations that totally rearrange the prescription filling process.”
Instead of a long counter with people, paper, computers, and printers that move prescriptions along the counter from person to person, he breaks the process into various subsets. Now the prescription data is routed to different staff members who handle the prescription in their own separate workstations, with the work being prioritized depending on what needs to be done and how urgently it needs to be handled.
Handling prescriptions in this manner required his former pharmacy management system vendor to make significant changes in its software. Unfortunately, after waiting several months for the necessary enhancements, Fapore made the difficult decision to bring in a new system. He went with Computer-Rx, as it had worked closely with Grove from the beginning and was able to deliver the software that was needed.
In working with Crawford Designs to install the SmartFlow workstations and his ScriptPro robot, Fapore also decided to totally update the entire front end, replacing carpet, installing new over-the-counter shelving, and modernizing his apothecary style of pharmacy.
The results, he says, have been nothing short of phenomenal. He says the reduction in wait time, along with comments from his customers, has been positive. And, he says, it has not been uncommon for a customer to simply utter, “Wow” when first entering the remodeled pharmacy.
The SmartFlow system has re-engineered the typical workflow from a linear process to one that routes prescriptions based on subsets and priority:
The new dispensing process goes like this. A patient brings in or calls in a script. A clerk at the intake desk has full access to the pharmacy management system and works with the patient on all details while entering in the necessary data. Simultaneously, the clerk also assesses the urgency of the transaction and notes any other unusual aspects of the prescription.
If the script is not going to the robot, the information is transmitted to a technician working at a freestanding workstation. These stations provide easy access to everything the technician needs: touchscreen monitor, printer, vials and labels, bags, etc. The workstations are positioned within a few feet of the specially designed inventory carousels. This special setup is the secret sauce of the system, and Fapore says it results in faster filling, increased accuracy, and improved worker satisfaction. In late 2015 the University of Illinois at Urbana/Champaign did a study of the system that verified increased employee satisfaction while growing productivity of techs and pharmacists by 184%.
Script information is prioritized, and scripts are processed in color-coded bags included as part of the system. Red bags indicate, “Hurry — the patient is waiting in the pharmacy.” Yellow bags mean handle in a normal fashion. Green bags mean the patient won’t be in until tomorrow, and purple bags indicate there is something unusual about the prescription that requires special attention — for example, the script might be very expensive or there may be an insurance issue.
Fapore has a couple of words of caution for anyone interested in exploring this new approach to workflow. First, he states, as logical as it seemed to bring in the robot and SmartFlow simultaneously, he advises others to break them into two separate projects. Fapore says the task of adjusting to them both at the same time was more difficult than he anticipated.
Second, start the process of working with your pharmacy management system vendor well before installing SmartFlow. The difference in programing is big enough that he doesn’t think it will be as easy for the system vendor to build as it appears at first blush.
He does suggest that if you elect to do something like this, that you also remodel, or at least make a meaningful upgrade to the physical appearance of your front end, to ensure it is in sync with the pharmacy work area. He says the fresh, modern look of his pharmacy also makes a big difference in how his employees feel about their job. And, he adds, another benefit of the new script-filling process is that he goes home at night more confident that they have dispensed everything accurately. That, he says, along with the dramatically improved productivity, has made this a truly worthwhile investment. CT
Bruce Kneeland is an industry consultant who helps retail pharmacies better serve their patients. He can be reached at firstname.lastname@example.org.