“We knew that key to making the change was our relationship with the reception team at the facility. My pharmacy team works in collaboration with reception. We ensure that we get reception to pre-draw folders two days in advance, depending where the team is with their processing," he says.
In this way, the pharmacy is able to pre-determine which folders are for repeat-chronic-medicine and which are the booked-for-doctor folders. A newly set-up scripting process has been implemented where the folders for booked appointments are sent to the facility’s doctors and clinical nurse practitioners in order to re-board medication for patients in advance. This prevents the processing of folders taking place on the day that patients arrive, resulting in patients spending less time at the facility. After scripting, the folders are then sent back to pharmacy and kept there until the appointment day when the patients arrive. If no consultation with a healthcare worker is needed, and patients report that they are healthy during screening, pharmacy is able to access the prepared folder immediately, select the medication needed and dispense to patients immediately.
The unstable chronic patients need to visit the facility to have their chronic ailments monitored before dispensing their repeat medication. The folders for these patients’ repeat medication get drawn in advance as well, as reception can allocate lists of patients scheduled to visit, which the pharmacy will require. This ensures pharmacy can capture the folders, keep the stickers inside the folder and set it up the folders according to time slots so that they will be easy to find when the patient arrives.
“We have drawn in the community-based services to handle Chronic Dispensing Unit (CDU) queries and facilitate a home-delivery service with community-based services and Uber,” says Wajoodien .
He took the time to ensure that community health workers (CHWs) were trained up and kept abreast of everything needed to ensure they could run the process independently under his guidance. Parcels are packed two days ahead of schedule and dropped at the CDU drop-off sites so that CHWs collecting from those sites can have them ready. Each day, Uber collects the prepared parcels at 7.30am and proceeds to deliver these to the drop off sites.
“We have also offered our unstable chronic patients the opportunity to call in and arrange the delivery of their medication, especially as they are elderly and frail, and we mitigate the risk of infection by not having them visit the facility.”
He adds that because these patients need to be monitored, questions are first asked when they call in to ensure that they are stable and not in need of a doctor’s visit before arranging for delivery.
All patients are screened while waiting outside the facility. In addition to the screening process, staff are present to answer queries, ensure that patients adhere to social distancing norms and draw cards to take through to pharmacy so that medication can be dispensed as efficiently as possible - ultimately saving the patients hours of waiting. Collected cards are then taken to the pharmacy where the community health workers collect patients packs and then dispense to patients still outside the facility because of the short waiting period, ensuring no unnecessary entry.
For the balance of patients who couldn’t be verified for home delivery, they will come to the facility to collect on their set date. These patients are called out in small groups to follow a member of the team into the facility so that social distancing is maintained. Once they enter medication that has been prepared is then dispensed accordingly.
This process has ensured that by 11am most days our facility is empty and all patients have been attended to.
“Our whole team has embraced the implementation. We can’t do it without each other. What we do is for the benefit of the patient and we are determined to do what needs to be done to ensure we can work to the best of our ability," Wajoodien says.
