Decreasing Inefficiencies in the Community Pharmacy Setting: Addressing the Top Issues in Patient Centered Care




White, Annesha
Tran, Ngan
George, Emanuel
Butler, Michell


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Objective: The objective of this study was to review the literature in the last decade regarding inefficiencies in the community setting with respect to patient centered care. A 2013 study showed that 46.3% of 162 indemnity claims paid to patients due to a medication error were attributed to independent community pharmacies, while 34.6% from chain pharmacies. Additionally, 43.8% of all claims paid were a result of the patients’ injuries due to dispensing error. Sources for dispensing errors included: patient misidentification, improper computer coding, and nonadherence. Nonadherence is estimated at $300 billion annually. In contrast to the institutional setting, there is lack of literature emphasizing the inefficiencies in the community setting. Methods: Articles identified from electronic databases, Google Scholar, PubMed, and Scopus, from January 2006 to December 2016, were summarized in a table. A diagram and a visual display were created to represent an ideal community pharmacy of the future. Key search terms were “community pharmacy and efficiencies”, “community pharmacy and inefficiencies”, “retail pharmacy and efficiencies”, “retail pharmacy and inefficiencies”, “retail pharmacy workflow”, “retail pharmacy medical error”, “retail pharmacy dispensing error”, “dispensing error cost”, “patient centered care”, and “nonadherence”. Results: Seventeen articles and reports identified were categorized into inefficiencies associated with workflow and patient nonadherence. Inefficient workflow leads to prescription errors, time loss, and decrease in patient care. Moreover, the generic layout of the pharmacy creates a barrier in pharmacist-patient interaction. Also, prescription abandonment added unnecessary labor and resulted in poor patient outcome. Conclusions: A more efficient, patient centered care layout of the pharmacy is proposed utilizing the six-sigma tools to drive process improvement in the pharmacy. Although studies shows tools and technologies are available to increase efficiency, utilization remains low. This study highlights the benefits of incorporating technology to improve pharmacy operations. Maximizing technology may give pharmacists more time for patient-centered care service.