The document discusses a pharmacy management case study involving a patient in an opioid maintenance treatment (MMT) program who is compliant with daily methadone doses but the pharmacy manager must determine how to address concerns from staff about increased loitering and drug-seeking behaviors from some MMT patients in the pharmacy. The case study aims to help students understand operational issues in pharmacy management and how to resolve common problems related to managing an MMT program.
The document discusses a pharmacy management case study involving a patient in an opioid maintenance treatment (MMT) program who is compliant with daily methadone doses but the pharmacy manager must determine how to address concerns from staff about increased loitering and drug-seeking behaviors from some MMT patients in the pharmacy. The case study aims to help students understand operational issues in pharmacy management and how to resolve common problems related to managing an MMT program.
The document discusses a pharmacy management case study involving a patient in an opioid maintenance treatment (MMT) program who is compliant with daily methadone doses but the pharmacy manager must determine how to address concerns from staff about increased loitering and drug-seeking behaviors from some MMT patients in the pharmacy. The case study aims to help students understand operational issues in pharmacy management and how to resolve common problems related to managing an MMT program.
The document discusses a pharmacy management case study involving a patient in an opioid maintenance treatment (MMT) program who is compliant with daily methadone doses but the pharmacy manager must determine how to address concerns from staff about increased loitering and drug-seeking behaviors from some MMT patients in the pharmacy. The case study aims to help students understand operational issues in pharmacy management and how to resolve common problems related to managing an MMT program.
Copyright:
Public Domain
Available Formats
Download as PDF, TXT or read online from Scribd
Download as pdf or txt
You are on page 1/ 41
Pharmacy
Management Case Studies PHM370
Muhammad Usama Arabi, BSc
PharmD Candidate, 2018 S A Bit About Myself
S Completed Honours BSc in Biochemistry from University of
Ottawa, 2012
S Completed APPE rotations at:
S St. Joseph’s Health Centre (SJHC) S Shoppers Drug Mart S Leslie Dan Faculty of Pharmacy S Canadian Armed Forces
S Currently employed as a Pharmacy Student at SJHC
Learning Objectives
S Understand how to use case studies as a learning tool
S Develop a process to resolve common operational issues
related to Pharmacy Management Why Case Studies?
S Case studies engage students to see practice from an action
perspective and develop their analytical skills to deal with ambiguous situations.
S Powerful cases are those that:
S Allow for several assessments of the same situation S Lead to equally plausible and compelling conclusions S Include information that is rich and makes the situation seem credible yet not so complete that it leaves no room for exploration S Have a clear problem statement
Case Learning: How does it work? Why is it effective?, Bonoma, V. T
Case Discussion: What is it like? What is its purpose?, Boehrer, J Teaching Methods for Case studies, Michelle Schwartz Questions to Consider
S What is the problem or decision?
S Who is the key decision-maker?
S Who are the other people involved?
S What caused the problem?
S What are some underlying assumptions or objectives?
S What decision needs to be made?
S Are there alternative responses?
Ideal Pharmacy Service Model
S Adhering to all legal requirements and Standards of Practice (DPRA,
Time Management Planning Commu Organizational nication Knowledge Planning Skills
Case: Compliance Management Case: Compliance
S Social History S TW - 60 year old male, NKDA, Unemployed S Restricted mobility using a walker S Patient has not been compliant with his medications for the past few months
S Past Medical History includes
S DVT S Hypercholesterolemia S Type II Diabetes S Hypertension S Osteoporosis Management Case: Compliance
S Current Medications S Amlodipine 10mg po daily S Fenofibrate 160mg po daily S Gliclazide MR 60mg po daily S Invokana 300mg po daily S Komboglyze 2.5/1000 mg po bid S Warfarin 12.5 mg po daily S Ramipril 5mg po daily S Fosavance 70mg/5600 IU once weekly Management Case: Compliance
S Approximate drug costs for 90 days supplies (including $11.99
dispensing fee) S Amlodipine - $44.28 S Fenofibrate - $45.64 S Gliclazide - $18.82 S Invokana - $320.47 S Komboglyze - $156.71 S Warfarin - $19.28 S Ramipril - $25.22 S Fosavance - $90 S Total cost = Approx. $720 Management Case: Compliance
S Physician is concerned about compliance
S Your staff pharmacist approaches you and offers to pay for
TW’s medication until he can afford it
S As the pharmacy manager what are your options to help
TW? Questions to Consider
S What is the problem or decision?
S Who is the key decision-maker?
S Who are the other people involved?
S What caused the problem?
S What are some underlying assumptions or objectives?
S Background S In preparation for the annual pharmacist performance reviews you obtain feedback from the techs they work with S You receive the following feedback for pharmacist, RZ: S Fast when he wants to be S Embraced professional services S Talks down to customers, gets into arguments with them causing transfers out S Staff is intimidated by him S You meet with RZ, and he indicates he wants a raise and eventually wants to become a manager as he feels things are going great Questions to Consider
S What is the problem or decision?
S Who is the key decision-maker?
S Who are the other people involved?
S What caused the problem?
S What are some underlying assumptions or objectives?
S Background S New manager in corporate chain pharmacy x 1 month S Unionized senior staff S Created a Whatsapp group for quick communication S You open the store on Saturday morning and dispensary is a mess S You take pictures and send to the Whatsapp group S Staff that worked Friday night leave the Whatsapp group S Staff complains to District Manager Questions to Consider
S What is the problem or decision?
S Who is the key decision-maker?
S Who are the other people involved?
S What caused the problem?
S What are some underlying assumptions or objectives?
S What decision needs to be made?
S Are there alternative responses?
Emotional Intelligence (EQ)
S Self-awareness
S Self-management/Managing emotions
S Self-motivation
S Empathy
S Social skills/Handling relationships
Conflict Management and Pharmacy
S Managing conflict among a variety of groups and people is a
necessary part of creating a high performance pharmacy
S It should be expected
S If conflict is avoided or mishandled, it can prove to be detrimental
to interprofessional collaboration and patient care
S A pharmacy managers’ success often depends on their conflict
management skills
Managing Conflict: A Guide for the Pharmacy Manager. Haumschild et al. 2015. Sources of Conflict
S There are 3 overarching categories conflict:
S Relationship conflicts: typically arise from personal incompatibilities though limited resources can also affect relationships and processes. S Task conflicts: disagreements that arise due to differing viewpoints and opinions about a particular task S Process conflicts: disagreements that arise due to differing opinions about how to approach a task or utilize a resource
Managing Conflict: A Guide for the Pharmacy Manager. Haumschild et al. 2015. Importance of Communication
S Consequences of Conflict S WHO and ISMP cite communication breakdown as one of the most common causes of medication related patient harm. S Data indicates that more than 60% of medication errors are caused by mistakes in interpersonal communication S Too often, well-intentioned professionals choose to not effectively communicate potential risks to optimal patient care
Managing Conflict: A Guide for the Pharmacy Manager. Haumschild et al. 2015. Conflict Resolution Strategies
S Competing S Resolution via exertion of formal positional power S Requires no further brainstorming on behalf of the manager but stifles outside viewpoints or collaborative feedback S Beneficial when individuals are unsure of how to respond and formal authority is needed
S Accommodating S The pharmacy manager satisfies the concerns of others while neglecting their own S If a manager is too accommodating then employees might push for agendas not beneficial to the organization S Alternatively if an outcome does not negatively effect operations or patient outcomes then accommodating will build team cohesion.
Managing Conflict: A Guide for the Pharmacy Manager. Haumschild et al. 2015. Conflict Resolution Strategies
S Avoiding S Employees avoid a manager if they disagree with their policies S Pro reduces escalation of conflict; S Con does not address the underlying issue
S Compromising S The solution is partially satisfactory to both parties S Helps settle the conflict though not necessarily the parties involved
Managing Conflict: A Guide for the Pharmacy Manager. Haumschild et al. 2015. Conflict Resolution Strategies
S Collaborating S Most successful approach as it involves the cooperation of both parties. S In the collaborative model the following steps should be taken S Identify the problem S Determine the Root Cause S Identify all possible solutions S Decide on the best solution S Implement the solution S Assess the outcome
Managing Conflict: A Guide for the Pharmacy Manager. Haumschild et al. 2015. Commu Organizational nication Knowledge Planning Skills
Case: MMT Program
Management Case: MMT Program
S FT is one of your MMT patients
S He rarely misses his daily methadone doses and is very polite to
the staff
S Recently, he started coming for his daily drink with a few of his friends who are not your patients
S After receiving his drink, FT and his friends tend to loiter outside the pharmacy, smoking and often keep returning to use the washroom Questions to Consider
S What is the problem or decision?
S Who is the key decision-maker?
S Who are the other people involved?
S What caused the problem?
S What are some underlying assumptions or objectives?
S What decision needs to be made?
S Are there alternative responses?
Management Case: MMT Program
S FT and his friends get into an altercation with one of your
other methadone patients RK.
S Though you have strictly prohibited FT from bringing his
friends to the pharmacy, FT and RK are still hostile towards each other. How do you resolve this issue? Commu Organizational Emotional Planning nication Knowledge Intelligence Skills
Case: Difficult Patient
Management Case: Difficult Patient
S PP is a patient at your pharmacy who comes in monthly to
pick up his prescriptions worth $1000.
S Unfortunately, he is quite aggressive and always belittles the
staff and sometimes yells at them
S It has gotten to a point where the staff no longer want to
provide care for him and hesitate to approach him at the pharmacy Management Case: Difficult Patient
S You are in the pharmacy when you hear a patient (PP)
yelling at your technician
S How do you approach this situation and resolve it? If not
resolved, can it be minimized?
S If PP refuses to come to an understanding would you ask
him to transfer to another pharmacy or ask your staff to put up with his behavior? Why? Commu Organizational Knowledge Planning nication HR Time Management Skills
Case: HR Planning Management Case: HR Planning
S Manager of a busy community pharmacy, approx. 300 scripts per day
+ 90 blister pack patients
S Full-time PA gives you 4 week notice that she is going to work for Central Fill site
S Full-time PA gives you 2 week notice that she is moving to another
province
S Full-time PA informs you that she’s pregnant will need go to on early
mat-leave in 6 months
S Flu season is 2 months away
Questions to Consider
S What is the problem or decision?
S Who is the key decision-maker?
S Who are the other people involved?
S What caused the problem?
S What are some underlying assumptions or objectives?
