The drive-thru window… a genesis of medication errors?

According to this article, the addition of drive thru windows may not have been a good thing in regards to patient safety. A growing number of surveys/studies in various industry shows that fatigue and multi-tasking are causing errors and mistakes. The Oregon BOP recently did a study where ~ 75% of the chain pharmacists believed that their work environment did not encourage/support patient safety.

Almost universally, the BOP’s seem to fail to realize/understand that the typical work environment (long hours, no breaks, under staffing, etc ,etc ) can have a direct effect on med errors and patient safety.

A fellow Pharmacist The Redheaded Pharmacist recently blogged about how we should look at the potentially positive changes in our profession… He is right .. there are a lot of changes… he mentioned all the flu vaccinations that he has been able to provide… GREAT… did his employer allow him to do it via appointment or give him additional staffing during the peak season to help compensate for the added work load… he didn’t mention that…

Look at the new Walgreen’s Wellness Experience as it is outlined in this month’s edition of DRUG TOPICS. I have not been in one of these format stores, but according to the description, article and the picture provided.. the Pharmacist is verifying a filled Rx “electronically”, and being placed out in the “center of the action”.

How many times is HIPAA going to be violated from customer walking around that area of the pharmacy? Is Walgreens expanding their POWER SYSTEM.. remote call centers and or some variation that allows consulting “electronically” at the drive-thru window… or is the Pharmacist at the “front desk” going to  have to counsel “electronically” from the desk?

What happens when someone wants questioned answered at the drive thru window and he/she has someone at the desk asking a question… are they going to tie up one or both of the drive thru windows.. with a car(s) sitting there waiting to ask a question?

Is this system just re-enforcing that Pharmacist’s time/knowledge is worth nothing… Is this just several more multi-tasking that we are expected to do.

BTW… the 70 stores in Indiana that have this new format.. had to get a special permission from the BOP  to do this.. however… the President of the Indiana Board of Pharmacy is currently a Walgreen’s exec and this Indiana legislature this year… passed a bill that allows the BOP to increase RPH:tech ratio from 1:4 to 1:6

The article suggests that this “Pharmacist out front” is going to be the only RPH in the store and/or Rx dept.  When did “direct supervision of technicians” started to becoming more and more indirect?

I hope the PIC’s at these 70 stores have paid up their professional liability insurance… here is per the Indiana Practice Act

“Qualifying pharmacist” means the pharmacist who will qualify the pharmacy by being responsible to the board for the legal operations of the pharmacy under the permit.”

Notice that the Indiana Practice Act no longer states that there is a PIC (Pharmacist in Charge)… just a Pharmacist that “qualifies” the Rx dept and responsible for its legal operation. At least the BOP acknowledges that what was formally known as a PIC… is really no longer in charge.

To the best of my knowledge… Walgreens doesn’t set their “nurse in a box” in such a “gold fish bowl” setting. What other healthcare professional functions in such a setting?

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