Establishing A Pharmacy Productivity Model for Investigational Outpatient Infusions

Purpose. The purpose of this experimental study is to examine the relationship between pharmacy productivity and the quality of pharmacy services delivered to pharmacy customers within a health system outpatient infusion clinic. Productivity is defined as the amount of time utilized to execute pharmacy services. Quality pharmacy services are defined as efficient pharmacy practices that produce safe and accurate products and services to best optimize patient care. Methods. A preparation report of the investigational infusions was retrieved from the electronic health record that contained bar code scans at various time points, such as the start and stop times of the technicians. The time stamps were used to determine how long each investigational protocol took to prepare and created classification buckets of short, medium, and long. Percentages of each classification bucket were calculated by dividing the type of preparation to the total investigational preparations. The percentages were compared between two years to determine whether or not the classification percentages significantly changed from one year to the next. The median preparation times were calculated and associated with each of the classification buckets. The average technician preparation time as well as average turnaround time for each of the various classifications were calculated based off of the reports. The volume percentages, along with the median preparation time and outpatient infusion clinic’s schedule, were used to determine the full-time equivalent pharmacy technicians required to meet the demand on a day to day basis, as well as hour to hour in order to decrease pharmacy preparation time and overall turnaround time. Results. Data were summarized using frequencies for categorical variables; mean and median were computed for numeric variables. The comparison from year to year for each category was done using chi-squared tests which resulted in a non-significant change for the short and medium classification (p = .19, .41), while there was a significant change for the large classification (p < .0001). Two-sample assuming unequal variance t-tests were conducted to compare the number of required FTEs from one year to the next (p = .48), as well as used to determine if there was a significant change in preparation time and overall turnaround time. Each classification had a non-significant preparation time change from one year to the next, but overall there was an increase in time required (p = 3.31E-08). In addition, there was a significant decrease in the overall turnaround time (p = 1.15E-09). Conclusion. Historical classification percentages can be used with infusion clinic schedules to predict how much time will be required for the preparation of investigational infusions. Pharmacy technician FTEs should be scheduled appropriately based on historical trends in order to optimize production time as well as the overall production time.