FORT HUACHUCA, Ariz. – The Raymond W. Bliss Army Health Center’s pharmacy is the core of the medical treatment facility, MTF. The pharmacy itself is literally the center of the main clinic spaces, and is one of the most-used sections within the MTF.
The pharmacists and pharmacy technicians fill, on average, 750 prescriptions per day, even with the COVID-19 pandemic restrictions in place. Dr. Melissa D. Rife, RWBAHC Chief of Pharmacy, praised her team’s efforts to keep the patients and team members safe.
Rife said, “One of our pharmacists, Michelle Molinares, was key in implementing plexi-glass at the [pharmacy] windows in March, getting us ahead of the curve early on in the pandemic. Rebekka Edwards and Vinnie Cannady, two of our amazing pharmacy technicians, could be found disinfecting the lobby several times a day, wiping down chairs, ledges, computer screens, all in an effort to look out for the health and well-being of our patients.”
However, because of the limited space and continuous crowds in the pharmacy waiting room, the command started looking for better ways to prevent the congestion within the building.
Rife said, “Our primary objective was to implement a process to ensure the health and safety of our patients, one that prevents patients from having to physically enter the facility and wait in a crowded waiting room for their prescriptions, as quickly as possible.”
After approximately one week of brainstorming various options and ways forward with various section leaders throughout the RWBAHC facility, the Curbside Pharmacy came to fruition Friday, April 3, 2020.
Rife said, “The curbside pharmacy process implementation was a huge team effort that was made successful by the contributions of many departments within the RWBAHC facility. Our head of Security, Brad Powell, identified and ran through several risk models to identify the best area to be utilized for the process. Our head of Safety and Facilities, Terry Jones and his team, made quick use of resources and time to get posts set up in the parking lot and removed physical barriers in the parking lot in a matter of days. Our head of Logistics, Ray Bragdon, coordinated moving a building physically from a separate location to provide an area with shade and air conditioning for the soldiers to utilize, and provided pharmacy with tools necessary for organizing the prescriptions to be dropped off. Rachel Williams, our PAO, had signs made for every parking spot, maps and patient education printed and distributed via every outlet that you can imagine in a matter of days. Our NCOIC of Pharmacy Services, Staff Sgt. Imelda Rincon, coordinated with our Clinical NCO, Sgt. 1st Class Abram Umphrey, to identify Soldiers within various units that could be detailed to direct the traffic in the parking lot itself as well as help in the pharmacy to answer patient phone calls and retrieve medication orders. Barry Smith, in our IMD department, printed thousands of brochures, signs, and documents in a matter of days to ensure we had the tools in place to help patients through this process. Several members of our RWBAHC team, to include the Command team led by our Commander, Lt. Col. Gray, have volunteered their time to deliver medications from the pharmacy to the patients. So many people coming together to get this process in place to ensure our patients are treated with the best care possible during this crisis is a testament to the amazing team we have here.”
Six months later, the pharmacy has not slowed and they continue to find ways to improve the patient experience.
Rife said, “We continue to learn, grow, and adjust as the pandemic continues in order to strive to take the best care of our patients. We will be implementing a text messaging service next month that will allow patients to drop their prescriptions off, then return to the pharmacy when they receive a text message that their prescription is ready. Additionally we have purchased two new GSL cabinets to allow for more storage space, which we hope will allow us to prefill medications prior to the patient’s contacting the pharmacy, as this continues to be a source of confusion and frustration for some.”
The GSL cabinets allow for better safety and security within the pharmacy. According to the company’s website, the cabinets are designed increase “safety, accountability, efficiency and compliance.” The website also states that the cabinet design “improves customer service through a decrease in wait time.”
The pharmacy team were excited to have the two new GSL cabinets installed Thursday, October 22, during Pharmacy Week.
Rife said, “Safety is our number one priority, so there are double checks as a prescription is entered into the system, to include a drug interaction check after the prescription is typed into the system, then another set of double checks as a prescription is filled utilizing bar code scanning technology. Finally, a pharmacist completes the final check on the prescription to ensure the drug, patient, directions and doctor were entered correctly, the medication that was filled is in fact the correct medication in the bottle/container, and utilizing their clinical knowledge ensures the dose and drug is correct and safe. Finally, the pharmacist places the finished prescription into a basket which contains a RFID chip, and the patient name, date of birth, and prescription number is now linked to that basket and placed in a special cabinet. When the patient arrives, the pharmacy team member enters the patient name and date of birth into a system, and the cabinet that houses the prescription lights up and only allows that team member to access the cabinet to retrieve the basket containing the items (if anybody else tries to open the cabinet, an alarm is triggered). The multiple checks do take time, which is why pharmacy should never be compared to a “fast food” type service, but it is all in the name of ensuring our patient’s receive the safest pharmaceutical care possible.”
This week, the pharmacy team received recognition from the rest of the RWBAHC team while also sharing some of their day-to-day experiences with those other team members. Shawna Crockett, RWBAHC Pharmacy Technician of the Year, gave tours to fellow employees, explaining some of the processes and requirements in the pharmacy, to include the differences between the responsibilities of a pharmacist versus a pharmacy technician.
Crockett said, “[Pharmacists] are looking out heavily for patient safety. They are reviewing all of the prescriptions making sure that nothing goes out that can harm any of the patients. The technicians, we do the initial data entry. We’re looking for patient safety as well. We do a lot more of the grunt work. We fill the prescriptions; we stock the shelves, fill the machines. Whatever the pharmacists need assistance with, we do.”
Rife said she’s extremely proud of her pharmacy team. “Every day our team members deal with extremely complex medication issues, and sometimes frustrated patients, but always maintain great attitudes and genuinely strive to provide the best care possible for our patients. In addition, our Pharmacists are so knowledgeable and literally save lives every day, it’s a tough profession and our team makes huge differences in the lives of our patients.”