designing pharmacy services
TRANSCRIPT
DESIGNINGPharmacy Services
David Holdford, RPh, MS, PhDProfessor, School of PharmacyVirginia Commonwealth University
Building Quality into the Design
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Slides to Accompany Chapter 9 of “Marketing for Pharmacists”
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Learning ObjectivesCompare and contrast the production line approach and the empowerment approach to designing and managing pharmacy services
Explain the concept of service scripts and their value in providing excellent pharmacy services
List the steps involved in service recovery
Describe tools for visualizing pharmacy services
Discuss the purpose and components of a service blueprint
Every system is perfectly designed to get the results it gets
― Donald Berwick
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Service design is increasingly important in personalizing care and conveying value and excellence to customers.
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Organizations can be divided into four categories according to the quality of services they provide
These categories indicate the importance they place on service
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1. “Available for service”
Services are necessary evils
Services are not important to business strategy
Service employees are an expense
The message from management -- “Don’t screw up!”
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2. “Journeyman”
Services should only meet that of competitors, but not necessarily meet customer needs
Services only need to be minimally competitive
Over time, these organizations resemble competitors
Employees are an expense, not an asset
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3. Distinctive competence
Service focused on customer needs
Service is integral part of strategy
Resources are committed to providing excellent service
Employees are considered assets because they generate revenue and value
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4. World-class service
Not only excellent but innovative
Set the standard for all others
Employees treated as assets and are a source of innovations
Employee performance standards are very demanding
Two broad approaches occur in the design & management of service
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Production Line Approach
Empowerment Approach
Pharmacy
A powerful illustration of an empowered employee
Ronald Ruiz has driven a New York City bus for 11 years. In that time, Ruiz, 58, has become one of the most beloved drivers in the Bronx, counting more than 100 regulars among his many passengers. But Ruiz, a single father with two daughters, says that one passenger, a woman from two years ago, sticks in his mind.
http://www.npr.org/templates/story/story.php?storyId=4755286
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Did Ronald Ruiz do the easy thing in serving this customer?
Did he take ownership & responsibility for serving her?
Did he likely break company policy?
If you were his boss, what would you say to him?
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Benefits & Costs of EmpowermentBenefits Costs
Better capacity to respond to the unique needs of customersMore individualized serviceBetter ability to quickly resolve problemsGreater sense of employee ownership about their jobsGreater employee acceptance of responsibility for service and outcomesLower turnover, absenteeism, presence of trade unionsMore employee warmth and enthusiasm in customer interactionsPositive customer word of mouth recommendations and loyalty
Slower servicePotentially higher labor costsEmployees cannot be easily interchangedLess easy to replace employees with part-timersTechnology is less able to replace empowered employees, because their output is less standardized (for technology to be used, standardization of tasks is necessary)Greater need for flexible and competent leadershipEmployers have to be willing to accept that empowered employees will sometimes make bad decisions
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The Better Approach Depends on:
Basic business strategy (e.g., low price versus personalized service)
Nature of transaction (e.g., dispensing a refill versus providing MTM)
Needs of patients (e.g., minor infection versus multiple chronic decisions)
Types of employees & managers working in a business
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INDUSTRIALIZED INTIMACYBlend technology with empowered workers to achieve a high level of contact, communication, & coordination with customers
Collecting data on customers and making it available at a touch to service workers can build a high level of customer intimacy
Easy access to information about patient therapy, service preferences, insurance coverage, & best practices
PLANNING FOR SERVICE PERFORMANCE
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QUALITY OF PHARMACY SERVICES CAN BE ENHANCED THROUGH BETTER PLANNING AND DESIGN
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Service Scripts
They are a script describing a service performance in a written list of actions
Similar to a script from a play or movie
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INDIAN HEALTH SERVICE COUNSELING GUIDELINES – 3 PRIME QUESTIONS
1. What ___________________________?
2. How____________________________?
3. What ___________________________?
SERVICE RECOVERY
Scripted response to a poor service experience
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Apologize Offer a Remedy
Fix the Problem Immediately
Consider Compensation
SERVICE RECOVERY STEPS
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Customer Journey Maps1. Identify everyone involved in the service experience
2. From the patient's viewpoint, list all of the steps that need to be completed to receive the service.
3. List all of the points of contact between the patient and specific employees
4. List the services that are provided in the pharmacy and a visible to the patient
5. List all of the support services provided to the frontline employees and the backstage people providing them
6. Now map the elements on the outline using a formal structure like flow charts, diagrams, or service blueprints
7. Identify moments of truth from the map
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VISUALIZING PHARMACIST SERVICES
Flowcharts
Supply Chain Diagrams
Tech ReceivesRx from Patient
PharmacistReviews Rx
Patient Goes toAnother Pharmacy
Drug in inventory?
Tech Fills Rx
PharmacistChecks Rx
PharmacistDispenses Rx
With Counseling
Patient Needs Counseling?
Tech Dispenses Rx Without Counseling
Patient LeavesPharmacy
No
Yes
Yes
No
Pharmaceutical Manufacturer Wholesaler Pharmacy Patient
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Give History-Medical-Medication-Smoking
Diagnostic Tests-Fagerstrom Test-BP/Pulse
Receive Instruction-NRT/ “Cold Turkey-Lifestyle/EnvironmentModifications
-Alternatives to Smoking-Personalized SmokingCessation Plan
Arrive atPharmacy
Greeted byPharmacyPersonnel
RecordHistory
AdministerDiagnostic Tests
Instruct Patient-NRT/ “Cold Turkey-Lifestyle/EnvironmentModifications
-Alternatives to Smoking-Personalized SmokingCessation Plan
Make Follow-upAppointment
Within One Week
Make Follow-upAppointment
Within One Week
SOAPNote
Check ForDrug Interactions
With Smoking Cessation
SelectTherapy
Stage theSmoker
PhysicianConsultation
InsuranceClaim Form
MDReferral
Line of Visibility
Line of Interaction
Line of Internal Interaction
Service Blueprints
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Service Blueprint for Appointment Based Medication Synchronization Program in a Community Pharmacy
Physical Evidence or Communication Channel
Line of CommunicationCustomer Actions
Line of InteractionOnstage Contact People
Front-line Service Personnel Actions (Onstage)
LinLine of VisibilityBackstage People
Behind-the-Scenes Personnel Actions (Backstage)
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Service Blueprint for Appointment Based Medication Synchronization Program in a Community Pharmacy
Physical Evidence or Communication Channel
Experience with basic dispensing process & other
services
Website POS signage and conversations with
techs & pharmacists
Word-of-mouth from customers &
health care professionals
Phone calls Social media
Line of CommunicationCustomer Actions Patient learns
details of ABM Program
Patient signs ABM contract
Patient brings new &/or refill
prescriptions to pharmacy to
choose synch date
Patient appointment
where adherence plan is established
Patient receives monthly call prior to picking up the
meds
Patient receives meds & discusses
any issues with adherence or
therapy
Line of InteractionOnstage Contact People Pharmacist, tech Pharmacist, tech Pharmacist, tech Pharmacist, tech Reminder phone
call peoplePharmacist, tech
Front-line Service Personnel Actions (Onstage)
Identifies & informs potential
candidates
Completes contract
Receives and counts meds,
identifies synch dates
Counts meds, co-creates adherence
plan (e.g., motivational
interview)
Makes call, resolves any issues
Medication picked up or delivered,
difficulties or issues solicited
LinLine of VisibilityBackstage People IT people,
marketingPhysician, insurance
company, business office
IT people Insurance company, business
office
Physician, IT people
Remote filling people, business
office
Behind-the-Scenes Personnel Actions (Backstage)
Website design & maintenance, Promotional messaging
Coordinating ABM with physician treatment plan and pharmacy benefits plan
Sets up and manages synch
system
Insurance company and
business office coordinate
financing and compensation
Physician communicates with pharmacy
about changes, IT maintains
automated call system
Meds filled and delivered to
patient's preferred location
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SummaryDesign can make the difference between
poor and excellent services
Production line & empowerment approaches both can be useful frameworks for providing pharmaceutical services
Service scripts and visualization can help improve the design of pharmacist services
SEE ‘MARKETING FOR
PHARMACISTS FOR
MORE DETAILS
D HOLDFORD