Impact of value added services on patient waiting time at the ambulatory pharmacy Queen Elizabeth Hospital
Background: Value added services (VAS) are an innovative dispensing system created to provide an alternative means of collecting partial drug supply from our hospital. This in turn was projected to reduce the necessity for patient to visit pharmacy counter and thus reduce the burden of prescription handling.
Objective: To evaluate the impact of increased VAS uptake following promotional campaign towards patient waiting time and to explore factors that may affect patient waiting time at the Ambulatory Pharmacy, Queen Elizabeth Hospital.
Methods: A quasi experimental study design was conducted from September 2014 till June 2015 at the Ambulatory Pharmacy. During pre-intervention phase, baseline parameters were collected retrospectively. Then, VAS promotional campaign was carried out for six months and whilst this was done, the primary outcome of patient waiting time was measured by percentage of prescription served less than 30 minutes. A linear regression analysis was used to determine the impact of increased VAS uptake towards patient waiting time.
Results: An increased in percentage of VAS registration (20.9% vs 35.7%, p<0.001) was observed after the promotional campaign. The mean percentage of prescription served less than 30 minutes increased from 83.2% SD=15.9 to 90.3% SD=11.5, p=0.001. After controlling for covariates, it was found that patient waiting time was affected by number of pharmacy technicians (b=-0.0349, 95%CI-0.0548 : -0.0150, p=0.001), number of pharmacy counters (b=0.1125, 95%CI 0.0631 : 0.1620, p<0.001), number of prescriptions (b=0.0008, 95%CI 0.0004 : 0.0011, p<0.001), and number of refill prescriptions (b=0.0004, 95%CI 0.0002 : 0.0007, p<0.001). The increased in percentage of VAS registration was associated with reduction in number of refill prescription (b=-2.9838, 95%CI -4.2289 : -1.7388, p<0.001).
Conclusions: Patient waiting time at the Ambulatory Pharmacy improved with the increased in VAS registration. The impact of increased VAS uptake on patient waiting time resulted from reduction in refill prescriptions. Patient waiting time is influenced by number of pharmacy technicians, number of pharmacy counters, number of prescriptions and number of refill prescriptions.
2. Rahman DEA. Why Medications Given on Monthly Basis. Malaysia: The Star Online; 2011. Available from: http://www.mps.org.my/newsmaster.cfm?&menuid=36&action=view&retrieveid=3465 (accesed 2011 21 July).
3. Ahmad A, Hassan Y, Aziz N, Hashim R, Bahrin NLZ. Pharmacy dispensing value-added services: determination of patients enrolment rate and factors influencing. 4th International Conference on Pharmaceuticals, Nutraceuticals and Cosmetic Science. Selangor (Malaysia), Jul 1, 2015. doi: 10.13140/RG.2.1.4748.1689
4. Bahadori M, Mohammadnejhad SM, Ravangard R, Teymourzadeh E. Using queuing theory and simulation model to optimize hospital pharmacy performance. Iran Red Crescent Med J. 2014;16(3):e16807. doi: 10.5812/ircmj
5. Tan WS, Chua SL, Yong KW, Wu TS. Impact of pharmacy automation on patient waiting time: an application of computer simulation. Ann Acad Med Singapore. 2009;38(6):501-507.
6. Choon OH, Leng CW, Ai WJ, Chai TM. Evaluation of manpower scheduling strategies at outpatient pharmacy with discrete-event simulation. OR Insight. 2013;26(1):71-84. doi:10.1057/ori.2012.9
7. Fernando TJ, Nguyen DD, Baraff LJ. Effect of electronically delivered prescriptions on compliance and pharmacy wait time among emergency department patients. Acad Emerg Med. 2012;19(1):102-105. doi: 10.1111/j.1553-2712.2011.01249.x
8. Pierce R, Rogers E, Sharp M, Musulin M. Outpatient pharmacy redesign to improve work flow, waiting time, and patient satisfaction. Am J Hosp Pharm. 1990;47(2):351-356.
9. Othman MI, Huzaifah A, Zaini N, Nordini W, Ismail HW, Sulaiman S, Razali WN, Isa H. Comparison of Patients' Waiting Time between SMS (Short Message Service) and Conventional Methods in an Out-patient Pharmacy. ASEAN Conference on Scientific and Social Science Research 2011. Penang, Malaysia, 22 - 23 June 2011
10. Lin YF, Lin YM, Sheng LH, Chien HY, Chang TJ, Zheng CM, Lu HP. First drive-through pharmacy services in Taiwan. J Chin Med Assoc. 2013;76(1):37-41. doi: 10.1016/j.jcma.2012.10.001
11. Tan CLH, Hassali MA, Saleem F, Shafie AA, Aljadhay H, Gan VB. Building intentions with the theory of planned behaviour: a qualitative assessment of salient beliefs about pharmacy value added services in Malaysia. Health Expect. 2016;19(6):1215-1225. doi: 10.1111/hex.12416
12. Tan CL, Hassali MA, Saleem F, Shafie AA, Aljadhey H, Gan VB. Development, test-retest reliability and validity of the Pharmacy Value-Added Services Questionnaire (PVASQ). Pharm Pract (Granada). 2015;13(3):598. doi: 10.18549/PharmPract.2015.03.598
13. Chou YC, Chen BY, Tang YY, Qiu ZJ, Wu MF, Wang SC, Lin HS, Chuang WC. Prescription-filling process reengineering of an outpatient pharmacy. J Med Syst. 2012;36(2):893-902. doi: 10.1007/s10916-010-9553-5
14. Shaat M. Improving pharmacy dispensing performance through time management. [Masters thesis] Royal College of Surgeons in Ireland, 2011.
The authors hereby transfer, assign, or otherwise convey to Pharmacy Practice: (1) the right to grant permission to republish or reprint the stated material, in whole or in part, without a fee; (2) the right to print pr epublish copies for free distribution or sale; and (3) the right to republish the stated material in any format (electronic or printed). In addition, the undersigned affirms that the article described above has not previously been published, in whole or part, is not subject to copyright or other rights except by the author(s), and has not been submitted for publication elsewhere, except as communicated in writing to Pharmacy Practice with this document.
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC-BY-NC-ND) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.