I have been reading Dennis Miller’s book PHARMACY EXPOSED … 1000 things that can go wrong at the drug store.
I have been “sitting” on the book for a couple of months now… because I wanted to take it to the beach to read.. which was suppose to be in Oct… but didn’t happen until about a week ago. This time of year at the beach… is wonderful… the temp is in the low-mid 70’s and sitting on the balcony.. hearing the small surf on the beach and my 50’s/60’s music playing in the background.. is my utopia/Xanadu !
I have only gotten thru about 1/3 of the book… apparently Dennis did a lot of “floating” in his career.. which exposed him to a lot of different RPH’s , their personalities and their individual quirks.
No matter what practice setting you are in… there seems to be a common underlying thread in all errors. I am a firm believer that all mistakes have a genesis in a system problem.. and in reading Dennis’ book… IMO.. there are two common system problems MONEY & TIME.
No matter if you are dealing with a prescriber’s office, pharmacy dept, or patients… we are all pressed for money & time.. because time is money. Under staffing, impatient patients that interrupt, DM’s that keep calling… bitching about metrics not met..as if spending time on the phone with the DM is going to improve the metrics.
For the last four + years, I can relate to Dennis because I have only temped. Everything from retail to LTC. I have elected to decline any hospital hours offered.. because I would probably be a lost ball in high weeds.
I have temped in a few “big box” stores and they all seem to have this same software system… that is a DOS system out of the 80’s.. I have programmed my own pharmacy/HME software in the late 70’s and have self taught myself on a number of other Rx software.. this particular software… seems to evade me…. IMO.. user friend it is not..
This system doesn’t provide for bar code scanning… which would – IMO – put another safety layer in the process. I guess that safety and reducing med errors is not a metric that is worth measuring.
Another thing that I find curious about retail pharmacy… is they spend the money on all kind of computers ( RX & POS), IVR’s , telephone system…etc..etc… and everywhere we are still using a plastic counting tray.. When I opened my pharmacy in 1976 one of the first things that I purchased was a electric tablet/capsule counter
some of these are very simple and very affordable around 2 K… when compared to the rest of the equipment that we use in the pharmacy. They can pick up a lot of slack when you get a rush..and they make double counting a snap… and when you are doing a C-II inventory count.. they are a real blessing. If you can push off hiring that addition tech for just a few weeks.. they can pay for themselves.
The last day that I worked in one of these big box stores.. I made a couple of mis-counts – in the store’s favor – and got a email from a RPH with the temp service.. three weeks after the fact …stating that I had made these mis-counts and the attached were the “error forms” that were documenting the “errors”… what is very ironic – IMO – the RPH FORGOT to attach the error forms to the email…I wonder if he had to fill out a form for this ERROR ?
It is unfortunate, that the healthcare system has to deal with imperfect human being the core of getting things done !
Filed under: General Problems
It is crazy…here we are after a 100 years of pharmacy, as we know it, and we are still counting pills! I know…it is absolutely astonishing! I will say that I do work for a company that has some excellent software. But, when it comes to counting pills, it is still spatula and counting tray.
I am also believe that mistakes are system failures. Whether you can classify every single mistake as a system failure, I am not sure. There are some people that can screw up something no matter how easy or how good the system. But, overall, it usually applies that a mistake is a systems mistake.