Re-engineering processes in an outpatients pharmacy area

Abstract

Background The Outpatient Pharmacy Area (OPA) has experienced an increase in patients and in the number and variety of medicines in recent years. Consequently new strategies are needed to ensure efficient OPA management that will bring benefits for both patients and hospital pharmacy. Purpose To describe the OPA re-engineering process. Its aim was to improve the activity flow of pharmaceutical care services so as to match individual patient needs with the services provided. Materials and methods A Standard Operating Procedure (SOP) was developed in 4 phases: OPA infrastructure was restructured. The Hospital Admissions Service set up an agenda for the OPA, to oversee appointments and collect data. Pharmaceutical and nursing staffs were appropriately trained in using the relevant software to use the agenda. Patients were gradually informed about the new procedures. Indicators were established to monitor the appointments system. Results OPA infrastructure comprises a pharmacists' office, a nurses' office and a waiting room. The SOP defines three types of consultation: a first consultation, a follow-up consultation and continuing-treatment consultations. First consultation: A hospital pharmacist interviews patients the first time they go to the outpatients area, initiates a drug treatment report and counsels on the treatment. Follow-up consultation: Patients are seen by a hospital pharmacist, who identifies and resolves medicines-related problems and monitors pharmacotherapy. Continuing-treatment consultation: Nursing staff dispense medicine every two months, unless the drug treatment is modified. Follow-up and continuing-treatment consultations require an advance appointment. These appointments are made and data is captured at each consultation by a pharmacist or nurse. Indicators: no. of appointments made, no. of patients seen at an appointment, no. of patients seen without an appointment and no. of patients that don't turn up. Conclusions The SOP has been able to minimise variation and promote quality during pharmacist counselling. The SOP has also improved patient flow, waiting times, medicines stock management. Further studies will be needed to evaluate the improvement of the pharmaceutical care services.