Abstract
Excessive patient waiting time at dispensing pharmacies is attributed to workflow inefficiencies that are difficult to isolate. The objectives of this study are to quantify current operational process and delay times and also to identify bottlenecks that lead to excessive waiting time at the pharmacy unit of primary health clinics in Temerloh district. A multicentre observational cohort study was conducted at a Pharmacy Unit of Bandar Mentakab Health Clinic (KKBM), Temerloh Health Clinic (KKT) and Tanjung Lalang Health Clinic (KKTL). Stopwatch technique was applied for all four operational procedures (greeting, data entry, filling and dispensing) based on workflow analysis. Data collection forms were used to identify factors and their impact on process time. Major components causing long waiting times were found in delay segments. Significant time delay occurred before greeting at KKT; before data entry at KKBM, KKT and KKTL; and before dispensing at KKTL. Among factors found affecting process segment in data entry include presence of intervention and psychotropic substances in the prescription. Filling process was found to be delayed by the presence of more than three items, cold items, intervention and psychotropic substances in the prescription. In addition, dispensing process was found to be delayed by errors in data entry and filling. This study identified several common bottlenecks and isolated issues specific to each pharmacy unit of three health clinics that lead to excessive operational process and delay times in pharmacy dispensing process. This approach laid a solid base to spearhead future optimisation strategies to improve efficiency and shorten waiting time.
Highlights
Patient waiting time in the health sector has been identified by the World Health Organization (WHO) as one of the key indicators of a good responsive health system (Valentine et al 2003)
In order to identify the bottlenecks in each segment that accumulates to excessive waiting time at pharmacy unit of all three study sites, this study has broken down the current operational procedure into four segments
This study successfully quantified the current operational dispensing process of pharmacy units in the three main health clinics in Temerloh Health Clinic which laid a solid baseline for comparisons to be made in future studies
Summary
Patient waiting time in the health sector has been identified by the World Health Organization (WHO) as one of the key indicators of a good responsive health system (Valentine et al 2003). In several countries including the United Kingdom and the United States, the government health care sector sets series of standards to provide timely care and to reduce harm as a result of delays (Bleustein et al 2014). Medical practices that are continually working to minimise wait time can expect to observe a significant improvement in the overall patient satisfaction as well as medical practice outcomes (Thompson and Yarnold 1995). Among them are the Key Performance Indicators (KPI) in the health sector introduced in 2009 that aims to improve healthcare services with regards to efficiency, effectiveness and customer satisfaction
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