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Pharmacist workload and time management


 

Continuing Education

Published through an educational grant from WYETH-AYERST LABORATORIES
TRENDS IN PHARMACY AND PHARMACEUTICAL CARE

An ongoing CE program of The University of Mississippi School of Pharmacy and DRUG TOPICS.
The University of Mississippi School of Pharmacy is approved by the American Council on Pharmaceutical
Education as a provider of continuing pharmaceutical education. Accredited in every state requiring CE. ACPE # 032-999-01-003-H04

This lesson is no longer valid for CE credit after 12/31/03.

CREDIT:

This lesson provides two hours of CE credit and requires a passing grade of 70%.

OBJECTIVES:

Upon completion of this article, the pharmacist should be able to:

  • Describe changes taking place in pharmacy practice
  • Summarize U.S. pharmacists' workload in terms of work characteristics and professional responsibilities
  • Integrate workload issues with the adoption of pharmaceutical care as a new practice philosophy
  • Discuss strategies for time management through the process of job redesign

GOAL:

  • To describe U.S. pharmacists' workload and review strategies for time management within pharmacists' work settings

Pharmacist workload and time management

By Jon C. Schommer, Ph.D.

Associate Professor University of Minnesota College of Pharmacy

Jump to:

During the past 50 years, health-care delivery in the United States has evolved from a cottage industry to one dominated by for-profit corporations, managed care processes, and government regulation. During this time, the pharmacy profession has undergone dramatic change as well. Some would argue that pharmacy is adopting a new philosophy in which the practitioner takes responsibility for all of a patient's drug-related needs and is held accountable for this commitment. Such a philosophy requires the establishment of a therapeutic relationship with the patient, an assessment, a care plan, an evaluation, and continuous follow-up. To put these steps into practice, R. W. Holland and C. M. Nimmo pointed out that practice environments, learning resources, and motivational strategies consistent with such a coordinated care plan need to be developed.

An important component of the Holland-Nimmo Practice Change Model is the environment in which the pharmacist works. Currently, within that environment, pharmacists provide services in drug information, self-care, clinical pharmacy, pharmaceutical care, and distributive practice. Interestingly, the evolution taking place in pharmacy practice is changing the environment in which pharmacists work. Conversely, practice environments can have an effect on the ability of pharmacists to make changes in their practice. The focus of this article is on the pharmacy practice environment, with emphasis on pharmacists' workload and strategies for optimizing time management.

Pharmacists' workload

Pharmacists' workload can be viewed in terms of work characteristics and of professional responsibilities. Work characteristics can include (1) hours worked per week, (2) the proportion of time a respondent worked as the only pharmacist in his or her pharmacy department, (3) the proportion of prescriptions dispensed at the site with which the respondent was involved personally, and (4) the number and types of interactions pharmacists have with others on a typical day. Professional responsibilities can include activities such as medication dispensing, consultation, business management, and drug use management (see Appendix A for definitions).

Work characteristics

Based on research conducted by the Midwest Pharmacy Workforce Research Consortium in 1999 and 2000, U.S. pharmacists work 44 hours during a typical week. Pharmacists holding management positions report working significantly more hours per week than staff pharmacists do (46 hours compared with 42 hours per week).

Very similar results are found when only community pharmacists are described. Overall, community pharmacists work 44 hours during a typical week, with community pharmacy managers working significantly more hours per week than staff pharmacists did (46 hours compared to 41 hours per week). Community pharmacists working in independent/ small chain settings work more hours in a typical week (47 hours) compared with pharmacists in large chain (43 hours), mass-merchandiser (43 hours), or supermarket pharmacies (42 hours).

Another component of work characteristics is the proportion of time a respondent works as the only pharmacist in his or her pharmacy department. Community pharmacists work as the only pharmacist in their pharmacy department 72% of the time compared with only 31% of the time for hospital inpatient pharmacists and 32% of the time for other noncommunity pharmacists (see Fig. 1). Pharmacists who practice in lower-volume pharmacies (< 175 prescriptions per day) work as the only pharmacist more than do those employed in higher-volume pharmacies (75% compared with 43% of the time). In community pharmacy settings, pharmacists who work in lower-volume pharmacies work as the only pharmacist 90% of their workday, on average.

 


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Another component of work characteristics is the proportion of prescriptions dispensed at the site with which the respondent was involved personally. For example, community pharmacists working in management positions reported a higher proportion of prescriptions with which they were involved personally (62%) compared with staff pharmacists who work in community settings (47%). Independent pharmacists reported the highest proportion (67%) compared with mass-merchandiser pharmacists (54%), supermarket pharmacists (49%), and large chain pharmacists (47%). Pharmacists in low-volume pharmacies reported personal involvement with 64% of the prescriptions dispensed at their site compared with 45% for pharmacists in high-volume pharmacies.

Work characteristics also can be described in terms of the number and types of interactions pharmacists have with others on a typical day. Overall, respondents to a 1999 study conducted by the University of Minnesota and Ohio State University reported 50 face-to-face interactions and 73 interactions via phone, e-mail, fax, or other communication medium on a typical day. Also, respondents reported 64 interactions with patients and 59 interactions with individuals other than patients (e.g., physicians, nurses, pharmacists outside their work area, third-party payers) on a typical day.

Respondents working in community pharmacies reported an average of 141 interactions with other individuals daily. Of these, 59 were face-to-face and 82 were through some other means. Out of the 141 interactions per day, 83 were with patients and 58 were with nonpatients. Respondents working in hospital inpatient pharmacies reported an average of 76 interactions with other individuals daily, of which 27 were face-to-face and 49 were through another medium. Fifteen of these 76 interactions were with patients and 61 were with nonpatients. Respondents working in other noncommunity-type pharmacies reported an average of 99 interactions per day. Of these, 38 were face-to-face and 61 were through another medium. Forty of the 99 interactions were with patients and 59 were with nonpatients.

Table 1 further summarizes pharmacists' interpersonal interactions by practice setting. For pharmacists working in community pharmacy settings, 40% of their 141 daily interactions were face-to-face with patients, 39% were via a medium other than face-to-face and with individuals who were not patients, 19% were with patients via a medium other than face-to-face, and the remaining 2% were face-to-face with nonpatients. For hospital inpatient pharmacy settings, 56% of the 76 interactions respondents had daily were with nonpatients via a medium other than face-to-face, 24% were face-to-face with nonpatients, 12% were face-to-face with patients, and the remaining 8% were with patients via a medium other than face-to-face. Respondents in other pharmacy settings reported that 49% of their 99 daily interactions were with nonpatients via a medium other than face-to-face, 27% were face-to-face with patients, 13% were with patients via a medium other than face-to-face, and the remaining 11% were face-to-face with nonpatients.

Table 1
Summary of pharmacists’ interpersonal interactionsa by practice setting

 
Community pharmacy settings
  With patients With individuals who are not patientsb Row totals

Face-to-face
56 (40% of total)
3 (2% of total)
59
(42% of total)

Other mediumc
27 (19% of total)
55 (39% of total)
82
(58% of total)

Column totals
83 (59% of total)
58 (41% of total)
141
(100% of total)

 
Hospital inpatient pharmacy settings
  With patients With individuals who are not patientsb Row totals

Face-to-face
9 (12% of total)
18 (24% of total)
27
(36% of total)

Other mediumc
6 (8% of total)
43 (56% of total)
49
(64% of total)

Column totals
15 (20% of total)
61 (80% of total)
76
(100% of total)

 
Other pharmacy settingsd
  With patients With individuals who are not patientsb Row totals

Face-to-face
27 (27% of total)
11 (11% of total)
38
(38% of total)

Other mediumc
13 (13% of total)
48 (49% of total)
61
(62% of total)

Column totals
40 (40% of total)
59 (60% of total)
99
(100% of total)

a Number of interactions on a typical day per respondent
b Includes prescribers, nurses, pharmacists in other pharmacies or work areas, third-party payers, other healthcare providers/practitioners
c Includes telephone, e-mail, fax, and other communication medium
d Includes HMO, clinic, mail service, hospital outpatient, nursing home/long-term care, home health/infusion, pharmaceutical industry, managed care organization/pharmacy benefit management organization, and other pharmacies
Source: Author’s research

 

Professional responsibilities

Based on research conducted in 1999 by researchers at the University of Minnesota and Ohio State University, 46% of pharmacists' time is spent in medication dispensing responsibilities, 29% is spent in consultation responsibilities, 16% is devoted to business management responsibilities, and 9% is spent in drug management responsibilities (see Fig. 2 and Appendix A).

 


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Appendix A
Professional responsibility categories

Medication dispensing
Preparing, dispensing, and distributing medications (traditional dispensing and medication distribution activities)
Consultation
Consulting and communicating with patients about prescription medications; interacting/communicating with other health professionals on patient’s behalf (via phone, face-to-face, etc.); patient/provider education
Business management
Managing pharmacy personnel, finances, and systems; processing and reconciling third-party claims; other business management activities
Drug use management
Assessing and evaluating patient medication-related needs; monitoring and adjusting treatment to attain desired outcomes

 

Pharmacists practicing in community settings spend similar proportions of time out of their workday in medication dispensing responsibilities regardless of position or daily prescription drug volume. Pharmacists practicing in hospital inpatient pharmacies and other types of noncommunity pharmacies do report differences in the amounts of time spent in dispensing responsibilities, depending upon position and daily prescription volume. In these settings, staff pharmacists and those in lower prescription-volume settings spent a greater proportion of time in dispensing activities.

For consultation, hospital inpatient pharmacists reported significantly lower proportions of time spent in consultation responsibilities (19%) compared with community pharmacists (31%).

Community pharmacists spend similar proportions of time out of their workday in business management activities regardless of position or daily prescription volume. Pharmacists practicing in hospital inpatient pharmacies and other types of noncommunity pharmacies report differences in the amount of time spent in business management responsibilities, depending upon position and daily prescription volume. In these settings, managers and those in higher prescription-volume settings spent a greater proportion of time in business management activities.

Community pharmacists spend a relatively small proportion of their workday on drug use management responsibilities (6%). Hospital inpatient pharmacists and other noncommunity pharmacists spend a significantly greater proportion of their workday in drug use management compared with community pharmacists (19% and 14%, respectively).

When pharmacist responsibilities are analyzed further, some interesting findings emerge. Pharmacists who work at least 30 hours per week spend relatively less time in medication dispensing responsibilities (50%) compared with part-time pharmacists (60% of their time is spent in medication dispensing). This difference is due to the fact that full-time pharmacists spend about 17% of their time in business management activities compared with just 7% for part-time pharmacists.

Some differences in professional responsibilities also emerge when experience is considered. For example, pharmacists with 10 years or less experience spend 47% of their time in medication dispensing compared with pharmacists with greater than 35 years of experience spending 64% of their time in medication dispensing responsibilities. Pharmacists with 11 to 35 years of experience spend 51% of their time in medication dispensing responsibilities.

In relation to the proportion of time pharmacists would like to spend in their professional responsibilities, community pharmacists report that they would like to spend an average of 37% of their time in medication dispensing, 34% in consultation, 19% in drug use management, and 9% in business management. Compared with what they do now, com-munity pharmacists would like to spend significantly more time in consultation and drug use management responsibilities and significantly less time in medication dis-pensing and business management responsibilities. Community pharmacist managers would like to spend less time in medication dispensing compared with what staff pharmacists would like (35% and 39%, respectively). In addition, community pharmacist managers would like to spend more time in business management compared with what staff pharmacists would like (12% and 7%, respectively). Community pharmacists working in chain or mass-merchandiser pharmacies would like to spend significantly less time in medication dispensing activities compared with what pharmacists in independent and supermarket pharmacies would like to do (36% for chain and 33% for mass-merchandiser compared with 41% for independent and 38% for supermarket). The opposite pattern is seen for consulta-tion activities (35% for chain and 37% for mass-merchandiser compared with 31% for independent and 34% for supermarket). Finally, community pharmacists working in high-volume pharmacies (weekly prescription volume at least 1,200) would like to spend significantly more time in consultation (35% of their time) compared with pharmacists working in lower- volume pharmacies (33%).

Workload and pharmaceutical care

For pharmacy practice to make the transition into the new philosophy of pharmaceutical care, a change from the current homogeneous focus on medication dispensing and associated consultation seems necessary. Research conducted by the Midwest Pharmacy Workforce Research Consortium in 2000 showed that pharmacists would like to spend more time in consultation and drug use management and less time in medication dispensing and business management. Thus, it appears that pharmacists do possess motivation for change into a type of practice that is more consistent with the philosophy of pharmaceutical care. However, with the projected growth in prescription drug use, the continued need for pharmacists in the dispensing process, and current strains on the pharmacist workforce, it appears that community pharmacists' work activities in the United States are not conducive to a rapid transition into the pharmaceutical care era.

Studies conducted at the University of Minnesota and Ohio State University also show that community pharmacists have very little division of labor for professional responsibilities, regardless of position or daily prescription volume. In community pharmacies, 48% of a pharmacist's time is devoted to dispensing responsibilities, 31% to consultation responsibilities, 15% to business management responsibilities, and 6% to drug use management responsibilities. This pattern of activity holds for both management and staff pharmacists, and it holds for pharmacists working in high-volume pharmacies as well as for those working in low-volume pharmacies. It appears that the majority of pharmacists in community pharmacy settings are being utilized primarily for the drug distribution process and associated consultation that is appropriate for using prescriptions.

Without division of labor for community pharmacists, it is unlikely that a pharmaceutical care practice can be realized in those practice settings. According to R. J. Cipolle, L. M. Strand, and P. C. Morley, pharmaceutical care practice follows a medical model that requires establishment of a therapeutic relationship with the patient, an assessment, a care plan, an evaluation, and continuous follow-up. For pharmacy practice to make the transition into the pharmaceutical care era, division of labor for pharmacists seems necessary. This might be extremely difficult to accomplish in light of the finding that community pharmacists working in pharmacies that dispense < 175 prescriptions daily spent over 90% of their workday as the only pharmacist in their pharmacy department. For those working in higher-volume community pharmacies, over 50% of their time was spent working as the only pharmacist.

In contrast to community pharmacy, division of labor exists for hospital inpatient pharmacy settings and for other noncommunity settings. The proportion of time spent in the professional responsibilities differs among pharmacists holding different positions and among pharmacists in high versus low prescription-volume settings. However, the division of labor appears to relate more to dispensing responsibilities, business management responsibilities, or drug management responsibilities for populations of patients rather than a division of labor that would support pharmaceutical care practice, which is individual-centered.

In the future, it is likely that dispensing will be accomplished through new distribution channels (e.g., wireless communication with home delivery of products), improved technology (e.g., e-commerce and automation), and regulatory change (e.g., centralized filling and expanded roles for technicians). As the channel of distribution for prescription drugs becomes more streamlined, with fewer firms comprising the channel, the opportunity for division of labor might become more likely for community pharmacists in some practice settings that no longer place distribution above other tasks in their practice model. It is at this time that a transition to the pharmaceutical care model might become more evident.

In addition, pharmacists' high number of interpersonal interactions on the job may limit practice-model change toward the pharmaceutical care practice. Presumably, community pharmacists are the most accessible pharmacy practitioners for ambula-tory patients. Table 1 shows that community pharmacists have an average of 141 interpersonal interactions per day, hospital inpatient pharmacists have an average of 76 per day, and pharmacists working in other noncommunity settings have 99 interactions per day.

Community staff pharmacists working in high-volume pharmacies report the highest average number of interactions per day at 161. These interactions were made up of 67 face-to-face interactions (65 of which were with patients) and 94 through another medium (32 of which were with patients). These findings reflect a heavy load of interpersonal interaction for community staff pharmacists working in high-volume pharmacies. For example, assuming a 10-hour workday with no breaks, these pharmacists had over 16 interactions per hour, or approximately one every four minutes. Assuming an eight-hour workday without breaks, the interaction rate is over 20 per hour, one every three minutes.

Sixty-seven face-to-face interactions translate into more than eight face-to-face interactions per hour over the span of an eight-hour day without breaks, or one every 7.5 minutes. Ninety-four interactions through another medium translate into almost 12 of these types of interactions per hour, or about one every five minutes.

Such findings highlight the challenges for pharmacist job design in high-volume community pharmacy settings. Without division of labor, these pharmacists very likely are responsible for all aspects of the pharmacy department and must answer patient phone calls, physician phone calls, and business-related phone calls. At the same time, pharmacists must supervise data entry, patient profile analysis, and drug preparation; double-check for safety; transfer the prescription to the patient; and provide appropriate consultation about the prescription. In between these activities, pharmacists also correspond via e-mail, fax, and other media with patients, nurses, physicians, pharmacists in other pharmacies, third-party payers, and representatives of other firms—not to mention the numerous requests from patients for consultation about over-the-counter medications or health in general. In addition to all of this, some community pharmacists also must deal with activities ranging from compounding special preparations to handling the sale of sundry items not associated with health care.

There is much to overcome in terms of community pharmacists' job design if there is to be a transition to the pharmaceutical care model. Even if pharmacists were relieved from all other duties, they could not effectively provide pharmaceutical care to patients if they still were engaged in one interpersonal interaction every three to four minutes as they are now. It appears that current job designs for pharmacists working in community pharmacies are not amenable to pharmaceutical care practice. Not only are many pharmacists solely responsible for all aspects of their pharmacy department, but also they may be interacting with other individuals outside their pharmacy department at the rate of one interaction every three to four minutes.

Strategies for time management

In light of pharmacists' workload and the effects that these workloads can have on pharmacy practice, it is important to consider both job stress and job design as they relate to time management for pharmacists. Job stress is a physiological reaction to job stressors in the work environment. Job design is concerned with the specific tasks a pharmacist performs, the techniques or processes used to perform these tasks, and the meaning of these tasks and processes. A key component for optimal time management is to identify relevant job stressors and then develop a job design model to help overcome job stressors and to help accomplish required job duties.

Job stressors

A stressor is any environmental factor that influences a person's stress level. Many stressors possess both psychological and physical components. It should be noted that more of a stressor does not always increase stress level, and less does not always decrease it. For most stressors, a curvilinear relationship exists such that understimulation and overstimulation both produce high stress (see Fig. 3).

 


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Work environment-related stressors can include such things as the amount of light or noise, ambient temperature, time pressures, and physical and intellectual demands. Organization role stressors include role conflict, role ambiguity, and decision-making responsibility. Career stressors involve job security, promotions, demotions, lack of promotions, barriers to ambitions, career uncertainty, and transfers. Career changes inconsistent with worker expectations may be particularly stressful. Organization climate stressors include organization politics, communication processes, and organization change.

Interpersonal relations can contribute to job stress. The most common interpersonal stressors involve relations with superiors, subordinates, peers, and clients/patients. Relationships involving low trust, low supportiveness, low interpersonal interest, functional dependence, and power imbalances increase stress. Finally, there are a tremendous number of stressors outside the workplace that can affect a pharmacist's stress level. Most of these center around family, friends, and economic and personal factors. Although these are extraorganizational factors, they should be of interest to organizations because of their impact on organizational members.

Job design

A useful strategy for optimal time management is to identify relevant job stressors and then develop a job design model to help overcome job stressors and to help accomplish required job duties. Periodic evaluation of job design also is a useful way to help expand and enrich the roles of pharmacists within organizations. In order to make effective changes that will help reduce job stress and improve time management, job redesign that involves a significant organizational change often is necessary.

The first step in job redesign is to recognize the need for change. This might be identified from many sources such as worker reactions, worker desires, or pharmacy practice evolution. The second step is to assess the key determinants of worker reactions. Although this can be done through personal observation techniques, more formal systematic techniques that take into consideration differing personalities and personal goals can be useful for this step. Third, it is useful to systematically assess existing levels of worker reactions such as satisfaction, attendance, motivation, and performance.

After the first three steps are completed, you can identify potential job changes based on your diagnosis of existing job design and its consequences. Opinions from workers and from individuals outside your organization or who had worked at your organization in the past can be helpful at this step. It is quite possible that a seemingly small change in job design could greatly affect time management and job stress. For example, changing the roles and activities of pharmacists and technicians in the dispensing process could allow both pharmacists and technicians the opportunity to engage in job activities that are meaningful and fulfilling. It might be as simple as asking them about a process that they would like to use and then taking some time to plan and implement it.

The fifth step is to project the probable benefits and costs of job redesign. Estimating benefits can be done in two ways. The first is to consult theory, research, and others' experience to help estimate the likely impact of job changes. The second approach is to build a predictive model based on assumptions and available data. In addition to estimating benefits, costs should be considered. For example, What are short- and long-term costs that will be associated with the job redesign? Are there equipment costs or downtime during the change?

Once the primary potential benefits and costs are identified and compared, a go/no-go decision must be made. This can be difficult, since most cost/benefit estimates are not totally quantifiable. This decision also will depend on your objectives for job redesign. Some organizations are willing to redesign to increase satisfaction as long as no performance decreases occur. Others are willing to make changes only if performance is likely to increase. Groups are often involved in this decision process to reflect diverse points of view.

Once you have decided to proceed with a promising set of job changes, you must develop a careful strategy for introducing change and carefully evaluate the effectiveness of the change. Many things can go wrong with job redesign. Redesign projects have failed to produce positive results, and some have produced unexpected negative effects. Common problems with job redesign include: (1) inadequate diagnosis of the work system, (2) planned job changes that are implemented in name only, without being fully used, (3) inadequate evaluations, thus preventing fine tuning, (4) managers and staff overwhelmed by the demands of job redesign in the early stages, and (5) organizational members' resistance to the introduction of job redesign.

There is no "one right way" to design a job. A wide range of factors, including environmental and worker characteristics, must be considered when designing jobs. Each pharmacy has unique characteristics, which makes job design for pharmacy personnel quite complex. However, in light of the changes in pharmacy practice under way and pharmacist workload characteristics outlined earlier in this lesson, it is important to consider job redesign for pharmacists and pharmacy technicians so that time management can be optimized, job satisfaction enhanced, and patient care improved.

Summary

Research suggests that pharmacist workload is focused primarily on prescription drug dispensing responsibilities and that many pharmacists (1) are responsible for all aspects of the pharmacy department, (2) have interpersonal interactions with others outside their pharmacy practice once every three minutes in some practice settings, and (3) do not have job designs that are conducive to a pharmaceutical care practice.

This article offers a method for developing a job design model to help overcome job stressors and to help optimize time management in pharmacy settings. It is likely, however, that some pharmacists will not have the authority to engage in extensive job redesign efforts. In other cases, even after job redesign, stressors may still be present and there will be a need for pharmacists to effectively manage their time within those situations. In those cases, some rules of thumb for time management can be helpful in the short term.

One rule of thumb is to work smart—think before you act. Some pharmacists carry such heavy workloads that they habitually plunge into one task after another with little thought as to how the tasks should best be handled—what work they should do immediately and what work can wait. Working harder and faster does not necessarily mean greater productivity. It is helpful to take a moment to plan, so less time is spent putting out fires and more time preventing them.

A second rule of thumb is to prioritize your tasks. From daily experience, pharmacists tend to prioritize tasks quite well. It should be remembered that priorities can change in organizations. It is helpful to talk periodically with supervisors and colleagues about priorities for the pharmacy department and organizations. For example, What is seen as the pharmacy department's key role in the organization? How can internal clients be better served?

A third rule of thumb is to know how to say No. Having your priorities straight makes it easier to deal with requests for help from a colleague or superior. That is because you know that you have to say No to any requests that will keep you from achieving the goals expected of you.

A fourth rule of thumb is to avoid traditional time wasters. It is not work that takes up the most time in a pharmacist's workday; it is the time wasters that have nothing to do with our jobs. One should not become a victim of paperwork or long-winded visitors. Delegating tasks to others can certainly help with paperwork or other tasks that are not part of a pharmacist's job description. Delegation requires trust and good communication to be successful. Also, when a visitor, or even a patient, needs your help, you may need to set a time limit on the interaction and then schedule an appointment if more time is needed to address the problem.

Finally, pace yourself to manage stress. No matter how well you manage your time, today's workplace is a stressful environment. Depending upon your personality traits, it might be useful to learn how to go on "superdrive" for a period, then slow down for a time, then speed up once more, and at the end of the day take a break. Relax with a hobby, exercise, a book, or a favorite television program. Also, it is important to maintain a healthful diet, good exercise habits, and good sleep patterns so stress can be managed at the workplace.

Sometimes stress is the result of a mismatch between an individual's career expectations and his or her job environment. Venting frustration and exercising may relieve some of the tension that comes from the situation, but the only real remedies are to seek advancement elsewhere or to learn to live within the situation. It is important to talk it out with friends and family and not to let the frustrations bottle up inside.

Working as a pharmacist can be particularly stressful as the profession makes the transformation into the pharmaceutical care era. In the short term, some useful time-management "rules of thumb" can be helpful for dealing with job stress. In the long term, however, job redesign that is consistent with pharmaceutical care practice could greatly increase job fulfillment for pharmacists and provide ways to optimize time management in the process.

References are available upon request.


TEST QUESTIONS

Write your answers on the answer form appearing below (photocopies of the answer form are acceptable) or on a separate sheet of paper. Mark only one correct answer.

1. During the past 50 years, health-care delivery in the United States has increased with respect to each of the following except:

a. For-profit corporations
b. Managed care processes
c. Government regulation
d. Cottage industries

2. Which of the following is not an important component of the Holland-Nimmo Practice Change Model?

a. Practice environment
b. Pharmacist salaries
c. Learning resources
d. Motivational strategies

3. The proportion of time a pharmacist works as the only pharmacist in his or her pharmacy department is a characteristic of:

a. Workload
b. Job redesign
c. Job satisfaction
d. Professional responsibility

4. U.S. pharmacists work an average of how many hours during a typical week?

a. 24 hours
b. 34 hours
c. 44 hours
d. 54 hours

5. Which type of pharmacist works as the only pharmacist 90% of the time in his or her pharmacy?

a. Higher-volume community pharmacy
b. Lower-volume community pharmacy
c. Higher-volume hospital pharmacy
d. Lower-volume hospital pharmacy

6. Overall, a community pharmacist works about what percentage of time as the only pharmacist in his or her pharmacy department?

a. 42%
b. 52%
c. 62%
d. 72%

7. Overall, how many face-to-face interactions do pharmacists reportedly have on a typical day?

a. Five
b. 10
c. 25
d. 50

8. For pharmacists working in community pharmacy settings, what percentage of their 141 daily interactions are face-to-face with patients?

a. 20%
b. 30%
c. 40%
d. 50%

9. For pharmacists working in hospital inpatient settings, what percentage of their 76 daily interactions are face-to-face with patients?

a. 12%
b. 22%
c. 32%
d. 42%

10. Overall, pharmacists spend 46% of their workday in which one of the following activities?

a. Medication dispensing
b. Consultation
c. Business management
d. Drug use management

11. Overall, pharmacists spend 29% of their workday in which one of the following activities?

a. Medication dispensing
b. Consultation
c. Business management
d. Drug use management

12. Overall, pharmacists spend 9% of their workday in which one of the following activities?

a. Medication dispensing
b. Consultation
c. Business management
d. Drug use management

13. Pharmacists would like to spend more time than they do now in which one of the following activities?

a. Medication dispensing
b. Consultation
c. Business management
d. Inventory control

14. Which one of the following describes a current workload characteristic for community pharmacists?

a. Division of labor
b. Rapid transition into the pharmaceutical care era
c. A relatively high number of interpersonal interactions
d. Work devoted mostly to drug use management

15. Community staff pharmacists working in high-volume pharmacies have an average of one interaction with another person outside of the pharmacy every:

a. Three to four minutes
b. 10-15 minutes
c. 30 minutes
d. 60 minutes

16. Which one of the following statements is false about job stressors?

a. A job stressor can have a psychological component.
b. A job stressor can have a physical component.
c. More of a job stressor always increases stress level.
d. Less of a job stressor can increase stress level.

17. Which one of the following is a career stressor?

a. Barriers to ambitions
b. Role conflict
c. Role ambiguity
d. Decision-making responsibility

18. The first step in job redesign is:

a. To assess the key determinants of worker reactions
b. To assess the existing levels of worker reactions
c. To identify the potential job changes that might be useful in job redesign
d. To recognize the need for change

19. Common problems with job redesign include all of the following except:

a. The work system is inadequately diagnosed.
b. Inadequate evaluations are conducted, preventing fine-tuning.
c. Managers and staff become bored with the job redesign in the early stages.
d. Organizational members resist the introduction of job redesign.

20. Time management can be optimized through:

a. Working longer hours
b. Hiring more people
c. Conducting job redesign
d. Leaving tasks unfinished

 


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Jon Schommer. Pharmacist workload and time management. Drug Topics 2001;4:45.

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