By Ms. Stacy M Sanning (Regional Health Command Europe)November 1, 2018
Quality and safety are the highest priorities for the Wiesbaden Army Health Clinic pharmacy team, which provides over 100,000 prescriptions annually and clinical pharmacy services to improve medication therapy for eligible beneficiaries in the area. The pharmacy team regularly reviews their operations to improve efficiency and reduce wait times for patients.
After joining the Wiesbaden Army Health Clinic nearly 90 days ago as the new Chief of Pharmacy, Maj. Jason Kim and the pharmacy team have been working hard to decrease wait times while they maintain the high level of quality and safe services patients deserve.
Many patients noticed the first big change in July, when the pharmacy began closing their prescription pick-up windows during the lunch hour, from 12:30 to 1:30 p.m.
Kim explained that the pharmacy team was previously using a staggered lunch schedule for staff, which reduced the number of staff available to serve patients for a larger portion of the mid-morning and afternoon.
"With fewer staff in the middle of the day, our patients were waiting longer for each prescription," said Kim. "We made this change to ensure that when patients come to see us, we have a robust staff ready to take care of their medication prescription needs."
The one-hour closure allows the pharmacy team to take their lunch break as well as catch up with refills and hard copy prescriptions that would normally take additional time during regular hours.
"Being able to complete these duties during a dedicated hour rather than throughout the day has added up to time saved for our patients. Now the average wait time is 5-7 minutes less," said Kim.
In addition, the Army Medical Command determined the right size for military treatment facilities across the entire organization earlier this year, which adjusted the total staffing levels at the Wiesbaden Army Health Clinic to meet the core mission of caring for active duty and their families.
The pharmacy team saw a reduction in staff and are using this change as an opportunity to find ways to streamline their workflow.
Pharmacy operations behind the scenes can be complex, as prescriptions move through several steps to ensure safety and accuracy.
The staff verify each patient's identification and then reviews the prescriptions a medical provider ordered. A pharmacy tech and a pharmacist each screen the prescriptions to prevent potential interactions with other medications, ensure appropriate dosage for the patients' age, weight and medical concerns then perform other clinical interventions. Then the team fills the prescription by pulling prepackaged medication from a shelf, filling a pill bottle from large robotic machines, or even carefully combining two or more drugs to compound a prescription for a patient's individual needs. Finally, the pharmacy staff prints labels and ensures the patients understand how to take the medication and any associated risks.
"We are doing a deep dive to really look at every step in the process to see if there are ways we can save time, better ensure safety and improve customer service," said Kim.
At times, the pharmacy may not have a medication available due to a national backorder, such as the widely reported EpiPen shortage, or because medications going through German customs can take longer to arrive. The pharmacy team works diligently to anticipate medication needs far enough in advance to prevent delays as much as possible.
When a patient's medication is not available, a clinical pharmacist will typically work closely with the prescribing provider to find an equivalent substitute, change the prescription or explore options on the German economy for some patients.
German prescriptions are accepted at military pharmacies when they include U.S.-standard prescription information, such as drug name, strength, quantity, directions and refill numbers. German prescriptions are traditionally written differently than U.S. prescriptions, however many host nation providers in the TRICARE network follow the U.S. standard for their American patients. The pharmacy staff will often contact local German providers for clarification as needed.
"At the end of the day, the pharmacy team's goal is to take care of our patients as quickly, safely and compassionately as possible," said Kim. "We will always take the extra time needed to meet a patient's specific needs, which is why we look for ways to be more efficient so we can keep the average wait times short and let our patients get back to their day."