Sunday, March 4, 2012

Prescription errors: Who is really to blame?

The recent dispensing error at a New Jersey CVS once again raises the awareness of everyone who works in a pharmacy. Fortunately, it appears at least initially that there was no serious harm brought by the error. This is a good thing, especially since it involves children. It does raise the question (as errors always do) of who is to blame?

Make no mistake, the error is ultimately the responsibility of those who filled and subsequently verified the prescriptions, namely the techs and the pharmacists. The alarming fact is that this was not isolated, it affected as many as 50 families, so this was an error that happened over and over again. I fully believe that when the facts come out we're going to find out this was a case of a script filling robot that was loaded with the incorrect med. The fact that the pills look very similar made it easier to overlook, and I'm guessing that on some level verifying pharmacists probably don't take quite the hard look at scripts that they know were dispensed by robot. It doesn't excuse it, but it might explain it.

While the techs and pharmacists in the store are ultimately responsible, however, there are many factors at play here and it should not be ignored that the corporate culture and indeed customer expectations are complicit to a certain degree with creating an atmosphere where errors are more likely to occur. Corporate culture pushes for more sales, more sales, more sales and safety and customer care are an afterthought. Increasing sales targets and shrinking hourly budgets force pharmacies to do more with less, and safety is the first thing to suffer. Fewer technician hours, coupled with pharmacists who regularly work 10 or 12 hour shifts without so much as a meal break are a formula for disaster and corporate just turns a blind eye. Unless someone dies as a result of an error (and even then I'm not 100% sure) they are not going to re-examine their policies and practices. Hell, these people will look you straight in the eye and tell you that they don't time their pharmacists, to which I call a hearty BULLSHIT!

This mindset has now translated into customer expectations about turnaround time that put added strain on pharmacy staffs. The "fastfood" mentality that was fostered by companies like CVS, Walgreen's, and the like has lead to the expectation that pharmacy should be instant, like ordering a Big Mac. No one thinks twice about walking in at 5pm on a Monday and insisting on waiting for a refill on the blood pressure medication that they've been taking everyday for 8 years and are suddenly out of. If you don't turn it around in 15 minutes you might get a bad SSS score and we know how corporate hates that. And God help you if you tell one of these refill waiters that it will be longer than 15 minutes, or suggest that they could have called in the script in advance, because they'll be on the phone to the corporate snitch line to complain. Oh, did I mention that you also show up on a report that shows that the pharmacist failed to fill that waiter in 15 minutes? So much for not timing pharmacists, right?

Bottom line is that there are multiple pressures being put on pharmacies to perform to higher and higher levels, all the while performing their jobs perfectly. Those pressures are going to be ignored when heads finally roll, and rest assured there are people who will lose their jobs over these errors. The problem is it will all be people in the store, with a blind eye being turned to the architects of the corporate business model that helped to lead to the errors becoming more likely to happen.

(Hey, if you like what I have to say spread the word. I'd love to get a loyal following in the blogosphere. And don't forget to bookmark the page. Thanks!)

No comments:

Post a Comment