Teamwork in Busy Pharmacies

We all face days at work when the intensity and flow feels busier than ever. Whether it is an independent community pharmacy, a large chain store, or a pharmacy in an institution, busy is busy!

The store where I practice is an outpatient clinic pharmacy for a local community hospital. It is located on the first floor of a 4-story medical office clinic and serves discharge patients, the campus, and the community at large.

When it gets busy, we call it "being backed up to the elevator." When the line behind the counter gets to about 4 or 5 customers, it begins to go out the door. At 7 or 8 customers, the line appears to continue out the door, across the hallway, and into the elevator on the other side of the hall.

This past Friday, we were backed up to the elevator for most of the afternoon. That is not to say we are more or less busy than any other pharmacy; it is just our internal, subjective way of commenting on how busy we may be on any given day.

Whether we are practicing in a community pharmacy serving the public or an institutional setting serving the hospital, pharmacists are all part of a team. A slow day may feel fantastically busy or a busy day may run incredibly smooth depending on how that team operates.

This past Friday, our team ran beautifully well together. The technician running the front counter was attentive to customers in line, recognizing and addressing them as they entered the store while also keeping an eye on who was sitting in the waiting area. She kept track of who was dropping off and who was picking up, while efficiently notifying the pharmacist of who would be waiting for their prescriptions.

As customers finished their transactions at the register, I would regularly hear the technician say, "Please step over to your right to the counseling area so the pharmacist may discuss your medication with you." At that point, either myself or the other pharmacist would acknowledge that we had heard her and then meet with the patient at the counseling area.

At the same time, the technician running the order entry terminal triaged dozens at a time, keeping our wait time down to 15 minutes for most of the day. Swiftly and methodically, she organized and processed discharge orders from the hospital, e-scripts, computer voicemail prescriptions, patient drop offs, and faxed and telephone orders. Of course, this was completed while answering phone calls, calling insurance companies, and assuring all of the afternoon deliveries were prepared and ready.

The pharmacist whom I have worked with for the past 15 years shares all of the duties of the pharmacy. Just as a well-trained musician may pick up any instrument in the band and play it fluently, pharmacists need to maintain proficiency in every aspect of the pharmacy in order to step in and handle any situation that may arise, from a jammed printer, to a prescription insurance rebill, to a neonatal liquid morphine compound, to a disgruntled customer, to a corporate-wide audit.

As pharmacists, we oversee the entire operation, fill and verify the prescriptions, and assure that each medication order is appropriate for the patient who is receiving it. Pharmacists are not dispensing, but also counseling and communicating with each patient, assuring to the best of our abilities that the patient understands a medication treatment regimen.

In addition to our technical and clinical duties as pharmacists, we are responsible for assuring that the pharmacy runs smoothly. We are constantly observing the work of our technicians in order to assess their progress of moving through the tasks at hand. We adjust and adapt the work flow to allow for breaks and lunches, no matter how busy it gets. We keep an attentive eye to any situation that may require our intervention, while at the same time allowing our technicians to maintain ownership of their positions.

Teamwork involves communication. This past Friday, my pharmacy team's communication was excellent, and all patients were served well.