Centralized hospital pharmacy workflow

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farmadiazepine

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Hello,

I was wondering what your workflow is like if you work in a centralized hospital pharmacy? I work in a hospital pharmacy, and we are centralized. We usually have 5, 6, or 7 pharmacists working 2nd shift (4 to 1230am).

We really never had any assignments i.e. no particular employee was assigned any particular responsibility. Everybody went along as the night went on. People check orders for a bit, do the counter for a bit, check crash carts for a bit, etc.

Now, management created a new workflow. One pharmacist a remote verification pharmacist which checks all orders that don't have a problem, and tags the orders that do have a problem needing follow up by the clarification pharmacist. The other is an IV pharmacist. The other 3 pharmacists are clarification pharmacists who are left to clarify the problem orders, answer phone calls (we get a lot as we are a level 1 trauma center), check back counter, and check code carts.

What is the set up like in your centralized hospital pharmacy? We are looking for ideas to change our current workflow.

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How big is your hospital? I can only speak for 2nd shift (basically after 3p) we a IV RPh who does the TPNs and checking IVs but they have to make stuff when the only PM IV tech is on lunch break or out and about. Between 3pm and night shift there are 2-3 RPh doing order entry. 1 RPh dose vanc/whatever til a bit later in the evening, they can pitch in with the orders if things get too busy. The staffing RPhs don't really div up the entry/clarify/answer phone call... You verify, you clarify, inbetween phone calls and checking the counter once in awhile. <300 beds. scheduling wise everyone rotates between roles.

I've always heard in bigger institutions 'staffing' way less clinical can be literally staring at the screen all day or check all day... interested to hear how it works.
 
I am in a slightly large place than you probably - your method is likely not the best - just my opinion - it is way to easy for them to pass off work to the "clarification RPh" - and what happens when they don't feel it needs clarified? - I could see this setting up to cause issues.

You old method also sets is self up for problems unless you all get a long great - which hardly ever happens - it just takes one sour person to cause issues. We dd that, and there was also one or two Rph's who consistently took the easy orders and left anything with issues for other people. It created a state of distrust very quickly.

Now each centralized person has an assigned area - but everybody helps out every area - if there is a problem in that area - the assigned person gets it.

Not perfect, but it seems to work
 
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Both of those workflows (old and new) seem pretty strange. I'm at a large medical center and during the evenings there is 1 central pharmacist that handles all the checking and random phone calls. All the order entry, verification, vanc dosing, phone calls and clarification is done by the pharmacist assigned to the floor. Generally each pharmacist will have 3-5 floors they are responsible for in the evenings. This leaves no confusion on who is responsible for what, and you can't just skip easy orders. You have to take responsibility for your floors. Seems to work really well.
 
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