Page 218 - HA Convention 2016 [Full Version]

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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