Link to the University of Pittsburgh Homepage
Link to the University Library System Homepage Link to the Contact Us Form

Understanding the dispensary workflow at the Birmingham Free Clinic: A proposed framework for an informatics intervention

Fisher, AM and Herbert, MI and Douglas, GP (2016) Understanding the dispensary workflow at the Birmingham Free Clinic: A proposed framework for an informatics intervention. BMC Health Services Research, 16 (1).

[img]
Preview
PDF
Published Version
Available under License : See the attached license file.

Download (1MB) | Preview
[img] Plain Text (licence)
Available under License : See the attached license file.

Download (1kB)

Abstract

© 2016 Fisher et al. Background: The Birmingham Free Clinic (BFC) in Pittsburgh, Pennsylvania, USA is a free, walk-in clinic that serves medically uninsured populations through the use of volunteer health care providers and an on-site medication dispensary. The introduction of an electronic medical record (EMR) has improved several aspects of clinic workflow. However, pharmacists' tasks involving medication management and dispensing have become more challenging since EMR implementation due to its inability to support workflows between the medical and pharmaceutical services. To inform the design of a systematic intervention, we conducted a needs assessment study to identify workflow challenges and process inefficiencies in the dispensary. Methods: We used contextual inquiry to document the dispensary workflow and facilitate identification of critical aspects of intervention design specific to the user. Pharmacists were observed according to contextual inquiry guidelines. Graphical models were produced to aid data and process visualization. We created a list of themes describing workflow challenges and asked the pharmacists to rank them in order of significance to narrow the scope of intervention design. Results: Three pharmacists were observed at the BFC. Observer notes were documented and analyzed to produce 13 themes outlining the primary challenges pharmacists encounter during dispensation at the BFC. The dispensary workflow is labor intensive, redundant, and inefficient when integrated with the clinical service. Observations identified inefficiencies that may benefit from the introduction of informatics interventions including: medication labeling, insufficient process notification, triple documentation, and inventory control. Conclusions: We propose a system for Prescription Management and General Inventory Control (RxMAGIC). RxMAGIC is a framework designed to mitigate workflow challenges and improve the processes of medication management and inventory control. While RxMAGIC is described in the context of the BFC dispensary, we believe it will be generalizable to pharmacies in other low-resource settings, both domestically and internationally.


Share

Citation/Export:
Social Networking:
Share |

Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Fisher, AMarf56@pitt.eduARF56
Herbert, MIphcup@pitt.eduPHCUP
Douglas, GPgpd6@pitt.eduGPD6
Date: 19 February 2016
Date Type: Publication
Journal or Publication Title: BMC Health Services Research
Volume: 16
Number: 1
DOI or Unique Handle: 10.1186/s12913-016-1308-7
Schools and Programs: School of Medicine > Biomedical Informatics
Refereed: Yes
Date Deposited: 22 Aug 2016 18:41
Last Modified: 02 Feb 2019 16:56
URI: http://d-scholarship.pitt.edu/id/eprint/28733

Metrics

Monthly Views for the past 3 years

Plum Analytics

Altmetric.com


Actions (login required)

View Item View Item