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HOSPITAL AUTHORITY CONVENTION 2016  Service Enhancement Presentations

                                    F6.4  Managing Service Demands     10:45  Room 421

                                    Express Queue Under Express Dispensing System Cuts Pharmacy Waiting Time by 48-61% for Single-item
                                    Prescriptions at Peak Hours
                                    Lau LF, Au PW, Lam WH, Chiu SL, Shek WM, Leung WYS, Law KM
                                    Pharmacy Department, Queen Elizabeth Hospital, Hong Kong

                                    Introduction

                                    Express Dispensing System (EDS) has been in use in HA for many years. Despite continual refinements, EDS has reached its
                                    maximum effectiveness in coping with increasing workload and tidal wave pattern of service demand. Long waiting time and
                                    congestion at waiting hall during peak hours are common scenes across Specialist Outpatient Clinic pharmacies with poor
                                    patient experience ensued.

                                    Objectives

                                    To determine the effects of an Express Queue workflow model implemented under EDS on the pharmacy average waiting
                                    time (AWT) and degree of congestion at waiting hall.

Wednesday, 4 May                    Methodology

                                    The concept of Express Queue workflow was explored by a working group comprising members from major hospitals, Chief
                                    Pharmacist’s Office (CPO) and Information Technology and Health Informatics Division of HA Head Office (IT&HI). Data-
                                    mining reviewed that about 25% of daily prescriptions contained single item only. Workflow study was conducted and system
                                    enhancement areas were identified. Before a new corporate-wide system became available, QEH Ambulatory Care Centre
                                    Pharmacy simulated an express queue workflow for single-item prescription for two weeks from 30 November 2016 to 11
                                    December 2015 (study). The two-week period before study was taken as control. The hourly AWT during 09:00 to 19:00 was
                                    compared. Prescriptions not requiring patients to wait (CGAT and “keep-record only”) were excluded from analyses.

                                    Results

                                    The average number of “eligible” prescriptions dispensed daily was similar in the compared periods (all prescriptions, 881
                                    control vs 869 study; single-item 257 vs 256). The AWT (in minutes) for single-item prescription was remarkably reduced
                                    throughout and especially during peak hours (12:00 to 13:00, 49 control vs 23 study (53% decrease); 13:00 to 14:00, 48 vs
                                    25 (48%); 16:00 to 17:00, 37 vs 15 (59%); 17:00 to 18:00, 31 vs 12 (61%)). No adverse impact on prescriptions with >1 item
                                    was observed (maximum increase in AWT from 53 to 58 during 12:00 to 13:00). Improvement in percentage of prescriptions
                                    completed within 30 minutes was observed overall (42.8% vs 56.3%), for single-item prescriptions (50.3% vs 91.5%), and for
                                    >1-item prescriptions (39.8% vs 41.6%). The cumulative number of prescriptions received minus the number issued during
                                    each hourly period was decreased including peak hours (16:00 to 17:00, 148 control vs 119 study, 20% decrease), suggesting
                                    reduced waiting hall congestion.

                                    Conclusion

                                    This study demonstrated that the Express Queue workflow shortened the overall waiting time and for single-item prescription
                                    substantially, without adversely impacting the non-express queue patients. Waiting area congestion was also alleviated.

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