Over the years we have seen the world of pharmacy evolve from that of ‘Dispense and Supply’ to include an ever expanding range of clinical services, (medicines management, local enhanced services such as vascular checks, managing minor ailments and sexual healthcare amongst others). As the NHS in England adapts to new models of care under its ‘Five year forward view’ agenda[1], there is the promise of more to come. At the centre of all this change has always been the needs of the patient; and at the forefront of the pharmacist’s (and other healthcare professional’s) actions must be the intention to provide all services in a safe manner and to an acceptable quality.
According to the Health and Social care Information Centre the year 2014 saw an overwhelming 1,062.6 million prescription items dispensed, a 3.3% rise from the year before. Previous research has also shown that, (on average); between 0.04% to 3% of items dispensed by community pharmacies contained a dispensing error of some sort.[2] A staggering number for a growing prescription volume! Most of us already know the only way to meet the demand of a growing workload and an evolving profession is to change our practise.
So when I voiced my thoughts on how we should implement change, one can only imagine my surprise when I was faced with the statement, “this is how it’s always been done!” To which I duly answered, “Are you happy with the results?”
And if, my fellow pharmacists, the answer to that question is ‘NO’, then one must seriously consider the changes needed to attain the levels of excellence we strive for. Any pharmacist, who has experienced the anguish associated with having made a dispensing error, knows the unpleasantness involved. Most errors, however, can be avoided by investing in our work environment and workforce. Creating organisation in our work environment with the introduction of a proper work flow system, good lighting, sufficient counter space etc can make a huge amount of difference. People are creatures of habit. Therefore having an organised routine for staff is key to facilitating a smooth work flow. Providing adequate, effective training and empowering staff to make decisions will not only instil confidence in their own abilities but will also allow them to perform routine functions thereby reducing the need for the pharmacist to multitask and be prone to distractions, (a known leading cause of dispensing errors). If the pharmacist is able to share responsibilities by assigning duties to reliable staff, it would help tremendously with the workload and workflow. There isn’t much of a choice. To keep up with our changing environment we have to implement change.
The bottom line is this: ‘If you always do what you’ve always done, you’ll always get what you always got!’ – Henry Ford
[1] PJ, ‘Pharmacists must prepare for changing NHS, conference hears’, 19th September 2015
[2] Franklin BD, O’Grady K. Dispensing errors in community pharmacy: frequency, clinical significance and potential impact of authentication at the point of dispensing. International Journal of Pharmacy Practice 2007