IMPLEMENTATION OF BENCHMARKING GUIDELINES IN COMMUNITY PHARMACIES

WK Wong1, SS Chua1, JSH Tan2

 

1 Department of Pharmacy, Faculty of Medicine, University of Malaya

2 Malaysian Pharmaceutical Society, Kuala Lumpur

CONTENTS

1. Introduction

2. Aim and Objectives

3. Methodology

4. Results and Discussion

5. Conclusions

INTRODUCTION

INTRODUCTION

BENCHMARKING GUIDELINES (BMGs):

Pharmaceutical Services Division of MOH has collaborated with the MPS to develop BMGsAdopted by all registered CPs by Jan 2006. Areas - premises, equipments, personnel, references and SOPs

AIM & OBJECTIVES

AIM & OBJECTIVESAIM

To determine the extent community pharmacies have

complied with the BMGs

OBJECTIVES1) To investigate the time frame required for community pharmacies to adopt the BMGs. 2) To identify problems associated with the implementation of BMGs

METHODOLOGY

METHODOLOGY

371 respondents (29.19%)

Exclusion:1.Ceased operation2.Shifted 3.Chain pharmacy with no pharmacist [ 1271 CPs]

Figure 1: Flowchart of Methodology

RESULTS & DISCUSSION

Particular of respondents Number of respondents(%)

Gender (n=370)

Female 212 ( 57.3%)

Male 158 ( 42.7 %)

Age (n=363)

21 – 30 99 ( 27.3%)

31 – 40 146 ( 40.2%)

41 – 50 81 ( 22.3% )

51 – 60 29 ( 8.0% )

>60 8 (2.2%)

Years as community pharmacists (n=362)

1 – 5 113 ( 31.2%)

6 – 10 116 ( 32.0% )

11 – 15 52( 14.4%)

16 – 20 47( 13.0%)

>20 34( 9.4%)

Types of employment (n=369)

Self-employment/ Share Holder 203 ( 55.0%)

Full time employee 160 ( 43.4% )

Part time/ Locum 6 ( 1.6% )

Table 1: Demographic Data of Respondents

Figure 2 : Types of Ownership of CPs (n=370)

I – Independent C – Chain

Figure 3: Types of services provided by CPs (n=371)

Compliance to BMGs

51.0% of the respondents were aware of the BMGs

Mean + SD extent of compliance 62.55 + 21.1, median = 65%

Figure 4:Percentage of Compliance with Premises Requirements in BMGs

42.1

50.555.8 57.5

64.3

75 75.1 75.3 75.6 78.484 86.1

89.295.7

0

20

40

60

80

100S

cree

ning

are

a w

ith "

Scr

eeni

ng t

est"

sig

n

Des

igna

ted

wai

ting

area

Ent

ranc

e ac

cess

ible

to

whe

elch

air

Dip

lay

nam

e of

pha

rmac

ist(

s) o

n du

ty

Hav

e ad

ditio

nal s

ecur

ity m

easu

re

Cle

an d

ispe

nsin

g ar

ea w

ith "

Pre

scrip

tion"

sign

Des

igna

ted

wet

com

poun

ding

are

a

Tot

al d

ispe

nsin

g ar

ea m

in 2

00 s

q ft

Des

igna

ted

priv

ate

coun

selli

ng a

rea

Dis

play

not

ices

of

serv

ices

pro

vide

d

"Pha

rmac

y" is

larg

er t

han

adve

rtis

emen

ton

sig

nboa

rd

Sep

arat

e di

spla

y ar

ea f

or in

tern

al &

exte

rnal

med

icin

es

Des

igna

ted

dry

com

poun

ding

are

a

Mer

chan

dise

are

arr

ange

d ac

cord

ing

toca

tego

ries

%

BMGs Yes, n (%)

Types and ownership of CPs

P value

I, pharmacist

s, Yes/Total resp. (%)

I, non-pharmac

ist, Yes/Total

resp. (%)

C, group of

pharmacists,

Yes/Total resp. (%)

C, corporate body,

Yes/Total resp. (%)

Display name of pharmacist(s) on duty

212 (57.5)

116/219

(53.0%)

25/59

(42.4%

)

11/20

(55.0%)

60/70

(85.7%

)

0.000

*

Screening area with signage

155

(42.1)

82/218

(37.6%)

23/60

(38.3%

)

13/20

(65.0%)

37/69

(53.6%

)

0.017

Table 2: Percentage of compliance with premises requirement in BMGs and it’s association with

types of ownership

Table 2: Percentage of compliance with premises requirement in BMGs and it’s association with

types of ownership

Figure 5:Percentage of Compliance with Equipments Requirement in BMGs

33.436 37.5

53.9 55.9

74.5

87.389.5

94.6 96.5 97.6

0

20

40

60

80

100M

easu

ring

cylin

ders

of v

ario

us s

izes

Com

pute

rs w

ithph

arm

acy

info

rmat

ion

soft

war

e

Com

pute

rs w

ithpa

tient

med

ical

reco

rds

Tile

/gla

ss s

labs

with

spat

ula

Prin

ters

for

labe

ls,

leaf

lets

or

prin

ted

mat

eria

ls

Com

pute

rs f

orin

vent

ory/

stoc

kco

ntro

l

Ava

ilabi

litie

s of

com

pute

r

Ref

riger

ator

mai

ntai

ned

at 2

-8C

Cab

inet

s fo

r st

orag

eof

doc

umen

t/re

cord

s

Pla

stic

bot

tles/

glas

sbo

ttle

s fo

rdi

spen

sing

Sui

tabl

e m

eans

of

coun

ting

tabl

ets/

caps

ules

%

BMGsYes, n (%)

Types and ownership of CPs

P value

I, pharmacis

ts, Yes/Total resp. (%)

I, non-pharmac

ist, Yes/Total resp. (%)

C, group of

pharmacists,

Yes/Total resp. (%)

C, corporate

body, Yes/Total resp. (%)

Tile/ glass slabs with spatula

199

(53.9

)

133/219

(60.7%)

39/60

(65.0%

)

11/20

(55.0%)

16/69

(23.2%)

0.000

*

Measuring cylinders of various sizes

123

(33.4

)

95/219

(43.4%)

15/59

(25.4%

)

4/20

(20.0%)

9/69

(13.0%)

0.000

*

Computers - inventory/ stock control

275

(74.5

)

149/219

(68.0%)

42/59

(71.2%

)

18/20

(90.0%)

66/70

(94.3%)

0.000

*

Computers -pharmacy info. software

132

(36.0

)

85/218

(39.0%)

22/59

(37.3%

)

10/20

(50.0%)

14/69

(20.3%)0.019

Table 3: Percentage of compliance with equipments requirement in BMGs and it’s

association with types of ownership

Table 3: Percentage of compliance with equipments requirement in BMGs and it’s

association with types of ownership

50.4 51.5

70.6

49.2

90.5

0

20

40

60

80

100

Formal training forpharmacy assistant(s)

Pharmacist(s) with nametag

Pharmacist(s) withprofessional dress code

Soft copies Hard copies

%Figure 6:Percentage of Compliance with Personnel

and References Requirement in BMGs

BMGsYes, n (%)

Types and ownership of CPs

P value

I, pharmacis

ts, Yes/Total resp. (%)

I, non-pharmac

ist, Yes/Total resp. (%)

C, group of

pharmacists,

Yes/Total resp. (%)

C, corporate

body, Yes/Total resp. (%)

Pharmacist(s) with prof. dress code

259

(70.6

)

139/216

(64.4%)

41/60

(68.3%

)

13/20

(65.0%)

65/70

(92.9%)

0.000

*

Pharmacist(s) with name tag

190

(51.5

)

95/218

(43.6%)

21/60

(35.0%

)

11/20

(55.0%)

62/70

(88.6%)

0.000

*

Soft copies of references

175

(49.2

)

113/209

(54.1%)

31/58

(53.4%

)

10/19

(52.6%)

20/69

(29.0%)

0.003

*

Table 4: Percentage of compliance with personnel and references requirement in BMGs and it’s

association with types of ownership

Table 4: Percentage of compliance with personnel and references requirement in BMGs and it’s

association with types of ownership

Figure 7:Percentage of Compliance with Written SOPs Requirements in BMGs

41.8

66.9

75.3 75.8

88.4

0

20

40

60

80

100

Extemporaneouspreparation

Monitoring and screeningtests

Supply of self-monitoringdevices

Response to minor healthproblems/ Sales ofpharmacy medicine

Supply of prescribedmedicines & record book

for group B and Cpoisons

%

BMGsYes, n (%)

Types and ownership of CPs

P value

I, pharmacists, Yes/Total resp. (%)

I, non-pharmac

ist, Yes/Total resp.

(%)

C, group of

pharmacists,

Yes/Total resp. (%)

C, corporate

body, Yes/Total resp. (%)

Extemporaneous preparation

146

(41.8

)

101/206

(49.0%)

21/57

(36.8%

)

10/17

58.8%)

14/68

(20.6%)

0.000

*

Table 5: Percentage of compliance with Written Standard Operating Procedures (SOPs)

requirement in BMGs and it’s association with types of ownership

Table 5: Percentage of compliance with Written Standard Operating Procedures (SOPs)

requirement in BMGs and it’s association with types of ownership

Figure 8: Reasons for not complying with BMGs(n=371)

0 20 40 60 80 100

%

Others

Space Constraint

Disagreement (partner/employer)

Guidelines not practical

Customer satisfaction

Time Constraint

Financial Constraint

Independent Pharmacy Chain Pharmacy

Figure 9:Comparison of Reasons between Independent Pharmacy and Chain Pharmacy for not complying with BMGs

6.4

20

44.3

60.4

60.4

77.1

3.3

31.5

29.2

38.2

53.9

56.2

0 10 20 30 40 50 60 70 80 90

Space Constraint

Disagreement (partner/employer)

Guidelines not practical

Customer satisfaction

Time Constraint

Financial Constraint

%

Independent Pharmacy Chain Pharmacy

CONCLUSION

CONCLUSION Level of compliance with

benchmarking guidelines varied between CPs.

Need to review the guidelines before it is implemented fully.

Professional bodies and authorities concerned should identify problems for implementation and provide more information or assistance

THANK YOU