A Model for Staffing and Scheduling at Emergency Center Pharmacies

Abstract

Optimization of staffing and scheduling is critical for maximizing efficiency and providing safe patient care. The Emergency Center (EC) at The University of Texas MD Anderson Cancer Center treats 60 to 80 patients per day. The EC pharmacy processes and fills medication orders for EC patients 24 hours a day and fills medication orders for other clinics as needed after other pharmacies close. To identify ways to improve staffing and scheduling, we assessed needs for pharmacists and technicians in the pharmacy at different times of day and on different days of the week. All work activities done in the pharmacy were tabulated and then evaluated using time-motion analysis to determine standard times for each activity. Data were then analyzed from multiple institutional sources to determine the frequency of each activity by hour of day for weekdays and weekends. We developed Microsoft Excel macros to calculate recommended staffing for each position under baseline conditions and with changes in patient volume and work distribution. A scheduling tool was programmed to allow comparison of current staff schedules with staffing needs. Shift start times and shift lengths can be modified in the tool to change the number of staff at each hour of the day. These changes automatically update graphs that display recommended staffing and proposed staffing. This tool allows leadership to experiment with new staffing schedules in order to determine optimal coverage. The staffing model and scheduling tool can be used by the EC pharmacy to ensure appropriate staffing, create a safer environment in the EC, and provide the best care for patients.