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The Pharmaceutical Journal Vol 265 No 7114 September 16, 2000
Pharmacy Practice Research
Papers presented at the British Pharmaceutical Conference, Birmingham, September 10 to 13, 2000 pR66

Evaluation of the impact an automated dispensing service has on prescription turn-around time and staff work patterns

By P. M. Rutter

Introduction The core role of community pharmacist practice in Great Britain is still the supply and sale of medicines.1 However, dispensing of medicines over the past 20 years has radically changed. Extemporaneous dispensing has fallen to an almost negligible level2 and the introduction of computer labelling and original and patient pack dispensing has deskilled the assembly part of the dispensing process to a technical task.
The aim of this study was to determine whether original and patient pack dispensing could be automated and to determine the effect this has on dispensary staff work patterns and prescription turn-around time. This paper reports the findings from baseline data collection prior to the installation of the automated dispensing system.

Method The work-study technique of work sampling was employed to determine the work patterns of each member of staff working in the dispensary. Sixteen previously defined activity categories were utilised to categorise their work.1 Observations were made by the author at one-minute intervals over three consecutive days. A rotating sampling frame was employed to ensure that only one member of staff's activity was recorded at any given observation as it was not possible to record the activities of several people simultaneously.
To determine prescription turn-around time, members of staff who received prescriptions from patients at the pharmacy counter were asked to note on the prescription the time at which it was handed in to the dispensary. Likewise, dispensary staff were asked to note the time at which the prescription was handed back to the patient underneath the time at which it was handed into the dispensary. Prescription turn-around time could then be calculated.

Focal points

  • The physical aspects of dispensing (labelling, lick, stick and pour) occupied all dispensary staff for the greatest proportion of their time
  • Pharmacists spent the greatest proportion of this time on labelling compared with dispensers, who spent the greatest proportion of their time assembling the prescriptions
  • From prescription receipt to handing the patient the dispensed medicine took an average of two minutes per item

Results Over 27 hours, 1,310 observations were made on five dispensary-based staff (pharmacist A, 437; pharmacist B, 55; dispenser C, 422; dispenser D, 340; dispenser E 56). The low number of observations attributable to pharmacist B and dispenser E was due to both staff only working for four hours during the period of observation.
Activities associated with the physical dispensing of prescriptions occupied all dispensary staff for the greatest proportion of their time. However, pharmacist activity centred on the use of the computer to label prescriptions, whereas dispenser activity centred on the assembly of prescriptions. It was noted that the additional four hours of pharmacy cover did not substantially affect the pharmacy manager's activities. Only health-related clerical work significantly increased (P<0.001, Chi-squared test).
The number of prescription items presented for dispensing over the three days was 336, and took 682 minutes to dispense, an average of 122 seconds per item. Original-pack dispensing was found to be significantly quicker than items that required counting, pouring or cutting (P<0.001, Chi-squared test).

Discussion Staff work patterns and prescription turn-around times have been established for the pharmacy under study. The next stage of the study will involve collecting the same data but after installation of the automated dispensing system. It is hypothesised that installation of such a system will speed up the dispensing process and so decrease prescription turn-around time.
In addition, it is hypothesised that time dispensers spend on the assembly of prescriptions will decrease, allowing them to perform duties currently performed by pharmacists such as labelling. This will potentially free pharmacists from the physical dispensing process and allow them to interact with patients more often and for longer periods of time.

Pharmacy practice department, University of Portsmouth

References

1. Rutter PM, Hunt AJ, Darracott R, Jones IF. A subjective study of how community pharmacists in Great Britain spend their time. J Soc Admin Pharm 1998;15:252-61.
2. Macarthur D. The growing influence of the pharmacist in Europe: opportunities in a changing market. London: Pearson Professional Ltd; 1995.