New pharmacy designs boost profits, patient care

Oluwole WilliamsPharmacy managers who are recruited for a new site are in an excellent position to develop pharmacy services that target the needs of the people in the community. In addition to the traditional dispensing of prescriptions typically remunerated through patient co-pays and reimbursements from PBMs, some services may be offered for a professional fee.

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Salable services

For example, consider the following:

1. Flavoring of liquid dosage forms, pill-splitting when needed, and weekly dose planners.

2. OTC recommendations from within the pharmacy. When the pharmacist prescribes or recommends a product, a standard pharmacists’ consultation fee may be added to the cost of the Rx.

3. Vaccines administration. A minimum occupational hazard fee may be added to the cost of the vaccine product, in addition to a fixed professional services fee.

See also: Managing vaccine inventories

4. A pharmacy section dedicated to OTC products, vitamins, and herbs, or an alternative medicine aisle may be manned by experienced part-time staff who can cater to the immediate needs of clients for advice or selection of vitamins/herbs and non-proprietary remedies.

5. A clearly demarcated area or unit may be set aside as the compounding area away from the normal dispensing table; for pharmacies offering sterile products, the sterile room can be planned into this same section.

6. A consultation room, complete with such equipment as a blood-pressure machine, weight scale, height measure, emergency kits, ophthalmoscope, glucometers, and other basic equipment, may be located near the consultation window for quick access by the clinical pharmacist on duty. Patients visiting the pharmacy for a physical check-up may be charged fixed consultation fees for the service provided.

7. Training sessions that introduce 12th grade students to the pharmacy profession may be marketed at a modest fee to area high schools as an annual career-counseling excursion.

Pharmacy design

The current layout in most community pharmacies and the design of contemporary retail pharmacies do not fully support extended clinical pharmacy services, though they present an opportunity for growth and development for new pharmacy sites. Every pharmacy location should observe a very high standard of hygiene, cleanliness, and professionalism, most especially in the handling of all connected with the vaccination process.

This brings to mind the important concept known as Total Quality Management. Beginning at the drop-off window all the way to the point of vaccine administration, patients must see and perceive a very high standard of hygiene, to ensure their confidence in the pharmacy’s standard of clinical practice.

Furthermore, employee productivity, job satisfaction, and delivery of services are all enhanced in a new pharmacy if space constraints and inhibitions are removed through proper store design and planning.

Clinic rooms

All new pharmacies should include a minimum of two additional rooms if they plan to provide clinical services, both because of the standard of care necessary to execute such provider services and to observe requirements pertaining to patient privacy. This is particularly important now that state boards of pharmacy have begun to approve child immunizations in community pharmacies.

Designing new pharmacies to provide demarcated clinic rooms will reduce risk of cross-infection, needle-stick injuries, accidental spillages, and contaminations arising from the handling of blood-stained cotton swabs used during vaccination processes.

Ideally, two pharmacists should be on hand, simultaneously offering a range of services that include dispensing, drug information, and clinical pharmacy provider services.

The big picture

In summary, the new pharmacy design takes into consideration service requirements; safety standards; public access, including wheel chair accessibility; minimum health department requirements; employee needs; business scope and objectives; training needs; and official uses.

Pharmacy planners should bear in mind requirements mandated for special services. In the state of California, for example, a pharmacy that desires to offer provider services must employ a pharmacist who holds the “Advanced Pharmacy Practitioner” license, issued by the board of pharmacy.

Similarly, the Centers for Medicare & Medicaid Services requires pharmacies offering point-of-care services - such as anticoagulation monitoring, diagnostic services, and clinical laboratory testing and interpretation - to obtain a Clinical Laboratory Improvement Amendments Waiver, known as a CLIA Certificate of Waiver.

A new pharmacy presents an opportunity to explore ideas in real terms. Beginning with the planning and design phase, the needs of community and the objectives of the business can be incorporated into the overall assessment of feasibility and profitability. This thoughtful approach is likely to produce a highly functional pharmacy that meets the needs of the business, the employees, and the community at large.

Oluwole Williamspractices pharmacy in the Philadelpha, Penn. area. Contact him at pharmwillie@yahoo.co.uk.