Analysis of Perceived Barriers Encountered by Management within Pharmacy Workflow due to Intermittent Family and Medical Leave Act (FMLA) Leave at a Governmental Teaching Hospital

Objective: The primary objective of the study is to determine what the perceived barriers are to pharmacy workflow as experienced by management. Specific aims include determining the specific barriers as deemed by Pharmacy Supervisors and the commonality between different facilities when an employee is on intermittent Family and Medical Leave Act (FMLA) leave.

Methods: This qualitative study was submitted prior to commencement to the institutional review boards (IRB) at both the University of Houston and the Harris County Hospital District (HCHD). Inclusion criteria include employees of HCHD who currently hold a title of Pharmacy Supervisor in any of the 15 ambulatory pharmacies. Identified Pharmacy Supervisors were approached at their Ambulatory Pharmacy Services meeting and informed about the study. Once written informed consent was obtained, face-to-face interviews comprising of only the Pharmacy Supervisor and principal investigator were conducted. Subjects were asked to answer approximately 15 questions from a semi-structured questionnaire that was designed to elicit information on barriers to workflow they may have experienced due to employees being on intermittent FMLA leave. Interviews were audio recorded for manual transcription and subsequent data analysis. Grounded Theory approach was utilized for data coding and analysis to determine perceived barriers experienced by Pharmacy Supervisors.

Results: The study sample included 15 Pharmacy Supervisors. Approximately 33.3% of the subjects were male and 66.7% female. The mean years of experience as a Pharmacy Supervisor were 6.6 ± 2.6 years for males and 5.3 ± 4.1 years for females. The data presented four common barrier themes in which each was discussed by at least 3 of the Pharmacy Supervisors. These themes included the inability to find replacement staff, reduction of patient satisfaction, the decline of morale of staff not on intermittent FMLA and the increased workload despite the outsourcing of FMLA.

Conclusions: Evaluation of the results indicates that there may not be optimal usage of the pool of replacement staff intended for employees out on leave. Unstandardized pharmacy workflows may significantly contribute to the workflow barriers, including reduction of patient satisfaction and decline of morale of staff not on intermittent FMLA. Although the outsourcing of FMLA may improve overall monitoring of FMLA usage, the study suggests that the workload has increased for the Pharmacy Supervisor. Thus, there is a need that may suggest reevaluation of the outsourcing process.