Department of Pharmacotherapy, University of Utah, Salt Lake City, UT.
Clinical Coordinator, Pharmacy Services, University of Utah Health, Salt Lake City, UT.
Am J Health Syst Pharm. 2019 Feb 21;76(6):353-359. doi: 10.1093/ajhp/zxy068.
The process and methods used in an impact assessment of a centralized pharmacy call center on community pharmacy employee patient safety climate perceptions, telephone distractions/interruptions, and prescription filling efficiency are described.
A broad-based team designed a multi-faceted, pre-post call center implementation analysis that included multiple change assessment measures. First, yearly administration of the Agency for Healthcare Research and Quality Community Pharmacy Survey on Patient Safety Culture was used to assess patient safety climate based on employee perceptions of a safe working environment and potential for errors due to interruptions and distractions. Evaluative measures of staff workload that assessed telephone interference with prescription filling activities pre and 3 months post implementation included (1) the NASA Task Load Index, (2) multi-tasking observations through shadowing of pharmacists and technicians to count number of interruptions/distractions per prescription "touched," and (3) self-reported work sampling to assess proportional time estimates of clinical, professional, and technical activities. Finally, pharmacy efficiency and prescription filling capacity were assessed using operational measures (prescriptions filled, patients served, phone call volume changes, prescription rework counting). Data analysis included summary statistics, Student's t-test, and chi-square analysis, as appropriate, in addition to assessing convergence and agreement among measures. Every evaluative method showed a positive outcome from call center implementation, although individual pharmacies may have accrued greater benefit from call reduction than others.
Multiple analysis methods can be used to evaluate the impact of workflow changes.
描述了一项集中式药房呼叫中心对社区药房员工患者安全氛围感知、电话干扰/中断以及处方配药效率影响评估的过程和方法。
一个基础广泛的团队设计了一个多方面的、实施前和实施后呼叫中心的分析，包括多个变化评估措施。首先，利用医疗保健研究和质量社区药房患者安全文化调查的年度管理，根据员工对安全工作环境的感知以及由于中断和干扰导致潜在错误的可能性，评估患者安全氛围。评估员工工作量的评估措施，包括评估处方配药活动中电话干扰的情况，在实施前和 3 个月后进行，包括（1）美国国家航空航天局（NASA）任务负荷指数，（2）通过对药剂师和技术员进行观察，计算每个处方“经手”的中断/干扰次数，进行多任务观察，以及（3）自我报告的工作抽样，以评估临床、专业和技术活动的比例时间估计。最后，使用运营措施（配药量、服务患者人数、电话量变化、处方返工计数）评估药房效率和配药能力。数据分析包括汇总统计、学生 t 检验和卡方分析，以及评估措施之间的收敛和一致性。每一种评估方法都显示出呼叫中心实施的积极结果，尽管个别药房可能从呼叫减少中获得了比其他药房更大的收益。
可以使用多种分析方法来评估工作流程变化的影响。
