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  • Workflow

    I do about 12k items a month working for a multiple with (barely) the DT specified number of hours. It's busy, but manageable.

    Head Office, in their infinite wisdom, has decided that I should check all prescriptions in front of patients and bag them too.

    I can see how this would work well in some situations and for some pharmacists. But, I prefer to do the clinical check before starting the prescription and also prefer labelling so I can check the PMR for past uses, intereactions, notes, etc. This way I can see the patients who need my input, avoid the nutters and keep away from people who want me to scan their sandwiches.

    Should I:-

    A.Tell them to bugger off and continue working how I do. (Which presumably risks getting fired if they try and slip this way of dispensing into the SOPs.)
    B.Get used to checking on the counter and rely on my NVQ2 staff to point out any problems, interactions, etc.
    C. Go and work somewhere else with less micro-managing?

    I don't really want to be an awkward git. But I don't really want to miss a dose change and dispense an old RD the week later.

  • #2
    Re: Workflow

    Just my opinion...NEVER check and bag in front of a patient.
    Don't Stop Believing

    http://youtube.com/watch?v=rnT7nYbCSvM

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    • #3
      Re: Workflow

      Absolutely! I cant say this enough. You check where there are no distractions. Now showing the patient the contents before you seal the bag is a different matter, as this could help pick up a dispensing error, a bit like asking a patient to check their change before they leave the shop. But clinical and accuracy checking should be done in the dispensary. What idiots are you working for?
      MUR

      Major Underestimation of Resources

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      • #4
        Re: Workflow

        Don't your higher ups think that you check before the 'scripts go out? Maybe they should spend a day with you then decide on new crackpot safety measures. As an extra check whoever is giving out the 'scripts could check all the labels are on and the correct name is on them. Even the number of items can be counted quickly at the giving out stage, it only takes a glance at the 'script to do this. We tend to check and bag up large prescriptions in the dispensary checking the number of items as we go at the same time as normal prescription checking. Any interactions can be dealt with NVQ 2's and if necassary the pharmacist can intervene if he/she deems it relevent.
        Make some one smile today.

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        • #5
          Re: Workflow

          Originally posted by Hummer View Post
          I do about 12k items a month working for a multiple with (barely) the DT specified number of hours. It's busy, but manageable.

          Head Office, in their infinite wisdom, has decided that I should check all prescriptions in front of patients and bag them too.

          I can see how this would work well in some situations and for some pharmacists. But, I prefer to do the clinical check before starting the prescription and also prefer labelling so I can check the PMR for past uses, intereactions, notes, etc. This way I can see the patients who need my input, avoid the nutters and keep away from people who want me to scan their sandwiches.

          Should I:-

          A.Tell them to bugger off and continue working how I do. (Which presumably risks getting fired if they try and slip this way of dispensing into the SOPs.)
          B.Get used to checking on the counter and rely on my NVQ2 staff to point out any problems, interactions, etc.

          and to be honest with 12k items a month, i doubt that you'll be paid enough and I would in this scenario I would want a second pharmacist to work alongside me.
          C. Go and work somewhere else with less micro-managing?

          I don't really want to be an awkward git. But I don't really want to miss a dose change and dispense an old RD the week later.
          by head office, do you mean the superintendent, if so you're b%^$$red, i'd go for either 1 first but make sure if they sneak it into the SOP you are under no obligation to folow them as long as you provide your own version of the SOP that you will be following to the staff.

          If it's not the superintendent's office then call 'em and have a chat about how the "regional manager" is trying to interfere with your work. remember any error occuring while you're working, you're responsible for it, the head office have powerful lawyers to cover their backs.
          We are the music makers, We are the dreamers of dreams and God damn we are that good

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          • #6
            Re: Workflow

            Originally posted by Hummer View Post
            I do about 12k items a month working for a multiple with (barely) the DT specified number of hours. It's busy, but manageable.

            Head Office, in their infinite wisdom, has decided that I should check all prescriptions in front of patients and bag them too.

            I can see how this would work well in some situations and for some pharmacists. But, I prefer to do the clinical check before starting the prescription and also prefer labelling so I can check the PMR for past uses, intereactions, notes, etc. This way I can see the patients who need my input, avoid the nutters and keep away from people who want me to scan their sandwiches.

            Should I:-

            A.Tell them to bugger off and continue working how I do. (Which presumably risks getting fired if they try and slip this way of dispensing into the SOPs.)
            B.Get used to checking on the counter and rely on my NVQ2 staff to point out any problems, interactions, etc.
            C. Go and work somewhere else with less micro-managing?

            I don't really want to be an awkward git. But I don't really want to miss a dose change and dispense an old RD the week later.
            This is in the NPSA guidance on dispensing
            Design for patient safety
            See section 2.7 for some nice pictures.

            My view is that this is not the clinical check that you carry out as part of the dispensing process. It is an additional final check through with the patient. An analogy for the patient would be like they do in banks, they count the money, then check it again in your full view.
            47 BC : Julius Cesar : Veni Vidi Vici : I came, I saw I conquered.
            2018 AD : Modern Man : I shopped, I clicked, I collected.
            How times change.

            If you find you have read something that has upset or offended you an anyway please unread it at once.

            Comment


            • #7
              Re: Workflow

              Maybe so, but where is this final check and bagging operation to be carried out? The current layout and lack of facility which still exists in most pharmacies would suggest either on the counter in front of other customers, or in the dispensary, in front of staff. Unacceptable.

              If a private consultation room or "area" is available, then so be it, but I do not know one pharmacist who has time or inclination at present to personally discuss every item dispensed with every patient...further, there is a difference between counting banknotes in full-view, and supplying e.g. viagra or IVF preparations.
              Don't Stop Believing

              http://youtube.com/watch?v=rnT7nYbCSvM

              Comment


              • #8
                Re: Workflow

                I think it looks bad if you find an error and it has to go back to get fixed -- customers shouldn't see that bit !

                And what if you get a customer on 6x28 of drug a and 6x28 of drug b --are you going to open every packet to check the contents in front of the customer? If you don't then you aren't checking properly. If you do, the customer will spend the time telling you to just stick them in the bag regardless.

                not customer friendly either way.

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                • #9
                  Re: Workflow

                  Originally posted by lamzee View Post
                  I think it looks bad if you find an error and it has to go back to get fixed -- customers shouldn't see that bit !
                  It could be a lot worse if they find it at home!
                  MUR

                  Major Underestimation of Resources

                  Comment


                  • #10
                    Re: Workflow

                    Originally posted by Hummer View Post
                    Head Office, in their infinite wisdom, has decided that I should check all prescriptions in front of patients and bag them too.
                    It's how I'd prefer to work - PMR at the counter - to generate the label and do the checking and with the patient available to answer any questions.
                    Script assembled in the dispensary and then bagged in front of the customer.

                    However is the pharmacy built in such a way that can you do so without breaking patient confidentiality?

                    Jeff

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                    • #11
                      Re: Workflow

                      Originally posted by Jen the 3rd View Post
                      What idiots are you working for?
                      Rowlands have tried that one when i worked for them. I did it for a month then got frustrated and went back to checking in the dispensary, followed by a quick whizz through if the meds were for the person collecting the script. Might not have been SOPs but in my opinion it was a damn sight safer and less subject to litigation.

                      After a 'trial' in some stores they claimed it boosted turnover by an extra 4% or something - however i doubt it was down to the 'new concept' alone. This was then decided to be adopted as company policy - except in exeptional circumstances checking in front of the patient would be done in all newly refitted stores.

                      Get some PDA insurance and possibly think about writing your own SOP to cover your back in the event of any future trouble - complaints to head office / super's dept may well fall on deaf ears.

                      and to answer Jeff, rowly poly do install a glass screen wide enough for one patient to collect script at counter but it's nowhere near as private as it should be - always used to get my back up at the thought of counselling about a script there - and because the shop floor was so small it was a bloody nightmare to be in and out of the consultation room all the bloody time.
                      “It's not worth doing something unless you were doing something that someone, somewhere, would much rather you weren't doing.”

                      Terry Pratchett

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                      • #12
                        Re: Workflow

                        Originally posted by Jeff View Post
                        It's how I'd prefer to work - PMR at the counter - to generate the label and do the checking and with the patient available to answer any questions.
                        Script assembled in the dispensary and then bagged in front of the customer.

                        However is the pharmacy built in such a way that can you do so without breaking patient confidentiality?

                        Jeff
                        The NPSA do say a separate counter is required.
                        Otherwise you will have people "tutting" while waiting to pay for their sandwiches.

                        Current prescription numbers would in most pharmacies would stress the dispensary operation to much to do this routinely with every prescription. Optimum staffing is the answer rather than the bare minimum to scrape through with the goodwill of the staff to do without breaks or eat their lunch on the hoof.
                        47 BC : Julius Cesar : Veni Vidi Vici : I came, I saw I conquered.
                        2018 AD : Modern Man : I shopped, I clicked, I collected.
                        How times change.

                        If you find you have read something that has upset or offended you an anyway please unread it at once.

                        Comment


                        • #13
                          Re: Workflow

                          Originally posted by Sir_Dispensalot View Post
                          and to answer Jeff, rowly poly do install a glass screen wide enough for one patient to collect script at counter but it's nowhere near as private as it should be - always used to get my back up at the thought of counselling about a script there
                          AND the space there is used by all the people who think they're too special to queue at the till to hand their script in like everybody else (despite there being no member of staff to hand it to)

                          AND the people above (and a lot of others) hang around that bench destroying the little privacy it offers. Despite 5 people having handed in scripts in front of them also waiting, obviously theirs will be out first as they are special.


                          I used to manage for Rowlands and simply ignored this system.
                          Employed again... paid holidays! Yipee

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