Impact of an immunization platform in community pharmacies.

OBJECTIVES: To assess the impact of incorporating a bidirectional immunization forecasting and reporting platform in the workflow of a regional community pharmacy chain with the use of time and motion methodologies. SETTING: Six Bartell Drugs Pharmacies in Seattle, Washington. PRACTICE DESCRIPTION: Bartell Drugs is a 63-store family-owned regional community pharmacy chain that offers all routine vaccinations and travel vaccinations. PRACTICE INNOVATION: Six pharmacies were selected based on immunization performance the previous year. These pharmacies were divided into 3 immunization performance groups. Within each performance group, one store had implemented the bidirectional immunization forecasting and reporting platform (intervention) and the other had not (control). EVALUATION: Observations were conducted for 4 to 8 hours at each store to determine the time required for each immunization encounter. Each encounter was divided into 7 time subcategories, which were assigned to the pharmacist, technician, or patient. Time and motion methodologies were used to estimate total pharmacist and technician time and the number of immunizations administered per patient encounter. All data were analyzed with the use of descriptive statistics. RESULTS: Ten vaccinations were administered during 5 patient encounters in the intervention group compared with 8 vaccinations during 8 patient encounters in the control group. The average time spent on each patient encounter in the intervention group was 24.8 minutes, compared with 18.5 minutes in the control group. In the intervention group, pharmacists spent an average of 9.3 minutes per patient encounter compared with 7.6 minutes in the control group. In the intervention group, technicians spent an average of 10.8 minutes per encounter compared with 9.1 minutes in the control group. CONCLUSION: Incorporation of a bidirectional immunization platform into the workflow of a community pharmacy increased staff time but also resulted in a greater number of immunizations per patient, suggesting enhanced immunization care in the intervention pharmacies.

Comparison of two training methods in community pharmacy: Project VACCINATE.

OBJECTIVE: To compare the impact of a whole-staff training strategy with a train-the-trainer strategy on 1) the number of influenza, pneumococcal, herpes zoster, and pertussis vaccines administered by community pharmacists to adults; 2) staff confidence; and 3) fidelity to the intervention. SETTING: Eight Quality Food Centers (QFC) Pharmacies in Seattle, Washington. PRACTICE DESCRIPTION: QFC Pharmacy is a grocery store division of The Kroger Co. with 30 pharmacies located in Washington State. QFC provides all routine and travel vaccines to adolescents and adults and has a culture of improving vaccine access to its community. PRACTICE INNOVATION: Pharmacists and pharmacy technicians from 8 QFC pharmacies received training to enhance their immunization care for adults. The entire staff from 4 pharmacies received whole-staff training, and staff members from the other 4 pharmacies received a train-the-trainer approach. The whole-staff training group had all staff members attend a live, 2-hour training. The train-the-trainer group sent 1 pharmacist and 1 pharmacy technician champion to attend the live training and then return to their pharmacy to train the other staff members. EVALUATION: The number of immunizations administered, staff confidence, and self-reported fidelity to the intervention were measured before and after training. All data were analyzed using descriptive statistics. RESULTS: The number of total influenza, pneumococcal, herpes zoster, and pertussis vaccines administered increased 12.6% in the whole-staff training group and 15.2% in the train-the-trainer group. Both training strategies increased confidence in identifying patients eligible for vaccines, talking to patients about vaccine needs, and using the bidirectional immunization platform. Pharmacy staff members in both groups indicated fidelity to key steps in the intervention process. CONCLUSION: Both whole-staff training and train-the-trainer approaches were associated with an improvement in the number of vaccines administered, staff confidence, and fidelity to the intervention. Community pharmacy organizations could use either training strategy when implementing enhancements to an existing patient care service. The train-the-trainer strategy may be less resource intensive.