Dear CVS-
So you thought you needed a culture change? Good for you for having such self-awareness. So you thought the best way was to hire Senn Delaney at a cost of tens or hundreds of thousands of dollars to cheerlead and do their corporate motivation bullshit? So much for your self-awareness.
To put it bluntly, fuck you and fuck Senn Delaney and all their fucking "accountability ladders," and their fucking "mood elevators," and their motivational-poster-style catch phrases ("Be Here Now"?). You want to elevate my mood? How about giving your employees a raise that's not an insult. I just got my annual report in the mail. CVS Caremark had an increase in sales of nearly $12 billion last year compared to 2010. According to The Motley Fool investing website CVS is in prime position to take over RiteAid due to CVS having $700 million in free cash. Then you're going to tell me you can only afford a 1% raise? You've already raised expectations for your retail-level managers so high that there's no way they're going to bonus, so you're saving millions in that area too.
Want to elevate my mood? How about properly staffing your stores so we actually have time- between calling customers to tell them their meds are ready to calling customers if they'd like us to have their meds ready, to calling to see if they'd like us to get their doctors to refill those meds that they haven't refilled in 6 months to having to beg customers to "give us all 5s" on your bullshit Triple S surveys- to actually do patient care. We spend more time doing sales building in the guise of patient care that we do actually giving patient care. If you're going to insist that we pester these people relentlessly to refill their scripts you could at least give us the man-hours to make the fucking phone calls. And while you're at it how about putting pharmacy managers in place who actually know how to manage. Simply having a brand new pharmacist's license and the inability to say "no" to the district manager does not qualify someone to run a fucking pharmacy!
The whole problem with this current approach to corporate culture change is that culture change has to start from the top down, not from the bottom up. It's a bit like a psychiatrist treating a severely mentally ill patient by making sure his shoes are shined. Once again the powers that be in the Ivory Tower are going to put even more responsibility on the stores to improve on things over which the stores have little control (anyone seen the new Stores Own Sales?) and then getting all the managers to buy in by bringing on the Senn Delaneys of the world to "empower" them. It's a bunch of bullshit rah-rah that is intended to convince weak-minded managers that they are all able to impact their metrics.
So spare me the shit about how the stores are the ones who control everything, and if we fail it's because we weren't good enough. If the culture isn't going to change at upper corporate level then all the fancy little plaques with all the little catch phrases aren't going to mean shit. The company has more money than ever before, and the stores are getting shit upon more than ever. Wonder what Senn Delaney has to say about that.
Friday, April 13, 2012
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!)
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!)
Friday, January 6, 2012
Newsflash!! Obsession with Triple S Causes Brain Damage
OK, so I know I've written about Triple S before, and what utter bullshit it is, and wondered aloud why CVS' upper management team (AKA:The Ivory Tower Boys) put such stock in its questionable subjective results, but I just went through an incident that shows in a nutshell what happens when the ITB's obsession filters down to field management.
Anyone who works in a store knows what the first week of the year brings: insurance issues. Probably 25% of the scripts you process require new insurance cards, which make more work for us at store level because we have to call the customers to tell them we need their new insurance cards, then explain to half of them that we need to see the card instead of them reading random numbers over the phone. Then when they come in to pick up their scripts you have to enter the new insurance (which hopefully works and doesn't require an additional call to the insurance company) and then the pharmacist has to go through the entire verification process all over again, all while the customer is staring holes through you wondering what's taking so long. Add to that this year in that Monday was considered a holiday by most doctors, so all the rest of our work was condensed into fewer days. Oh, and let's not forget that now that Walgreen's doesn't contract with Express Scripts we are having to do dozens of transfers on a daily basis and those are also supposed to be our priority because as we all know CVS only wants to take care of NEW customers. They don't really care once you're in the stable. Just try getting a customer's name off the refill reminder call list and tell me that CVS gives a shit about existing customers.
So here I am, working on the first Thursday of the year (which was coincidentally the day we got our warehouse delivery) and doing it short-staffed because, of course, it was a holiday week so my pharmacy supervisor shorted us hours in our budget due to projected lower volume. Don't forget that although our volume may be lower we have way more work due to the aforementioned insurance issues and Walgreen's transfers. So at 5 PM when everyone is coming in to pick up their scripts and we have the insurance edits lining up like planes queueing up at the airport my district supervisor calls to (get this) TELL THE PHARMACY MANAGER TO PRINT DOWN THE TRIPLE S SCORES BECAUSE THEY NEED TO TALK ABOUT WHAT A BAD NUMBER WE HAD!!!! What kind of a fucking moron is this guy????? Even if our Triple S had totally tanked could you use the brain that God presumably gave you and call at a less busy time? By the way, our overall number was down by a whopping 3 points, meaning we missed our overall yearly target by 1 WHOLE POINT!! OH NO, WE"RE NOT AN 'EXCELLENT STORE' ANYMORE (whatever that means).
Look, I understand that this whole pressure for Triple S is a downward pressure from the ass-hats in the Tower, but that pressure seems to cause brain damage in the people on whom it is applied. At the root of the whole issue is that you have people who have been out of the stores (or in pharmacist-speak "off the bench") for so long they forget what it's like. Yeah, they cruise the stores once in a while and observe for a few minutes, or maybe even an hour or two and they think that qualifies them as having their fingers on the pulse, but that simply isn't true. I can deal with almost anything for 5 or 10 minutes. Try it when you're in hour number 8 of a 10 or 11 hour shift day after day and tell me it's the same thing!
And maybe, just maybe, our Triple S scores could be improved if we weren't having to stop in the middle of the busiest time of day during the busiest week of the year to run a report and take a call from the pharmacy supervisor telling us how much we suck. Oh and by the way, haven't seen the final figures for 2011, but the first 3 quarters of the year saw 'same store sales' increase for every quarter over the previous year. I'm guessing this trend to continue through the end of the year, meaning our sales are increasing although our hourly budgets are shrinking. Yeah, we suck. The survey may say one thing but peoples' pocketbooks say something else entirely.
Anyone who works in a store knows what the first week of the year brings: insurance issues. Probably 25% of the scripts you process require new insurance cards, which make more work for us at store level because we have to call the customers to tell them we need their new insurance cards, then explain to half of them that we need to see the card instead of them reading random numbers over the phone. Then when they come in to pick up their scripts you have to enter the new insurance (which hopefully works and doesn't require an additional call to the insurance company) and then the pharmacist has to go through the entire verification process all over again, all while the customer is staring holes through you wondering what's taking so long. Add to that this year in that Monday was considered a holiday by most doctors, so all the rest of our work was condensed into fewer days. Oh, and let's not forget that now that Walgreen's doesn't contract with Express Scripts we are having to do dozens of transfers on a daily basis and those are also supposed to be our priority because as we all know CVS only wants to take care of NEW customers. They don't really care once you're in the stable. Just try getting a customer's name off the refill reminder call list and tell me that CVS gives a shit about existing customers.
So here I am, working on the first Thursday of the year (which was coincidentally the day we got our warehouse delivery) and doing it short-staffed because, of course, it was a holiday week so my pharmacy supervisor shorted us hours in our budget due to projected lower volume. Don't forget that although our volume may be lower we have way more work due to the aforementioned insurance issues and Walgreen's transfers. So at 5 PM when everyone is coming in to pick up their scripts and we have the insurance edits lining up like planes queueing up at the airport my district supervisor calls to (get this) TELL THE PHARMACY MANAGER TO PRINT DOWN THE TRIPLE S SCORES BECAUSE THEY NEED TO TALK ABOUT WHAT A BAD NUMBER WE HAD!!!! What kind of a fucking moron is this guy????? Even if our Triple S had totally tanked could you use the brain that God presumably gave you and call at a less busy time? By the way, our overall number was down by a whopping 3 points, meaning we missed our overall yearly target by 1 WHOLE POINT!! OH NO, WE"RE NOT AN 'EXCELLENT STORE' ANYMORE (whatever that means).
Look, I understand that this whole pressure for Triple S is a downward pressure from the ass-hats in the Tower, but that pressure seems to cause brain damage in the people on whom it is applied. At the root of the whole issue is that you have people who have been out of the stores (or in pharmacist-speak "off the bench") for so long they forget what it's like. Yeah, they cruise the stores once in a while and observe for a few minutes, or maybe even an hour or two and they think that qualifies them as having their fingers on the pulse, but that simply isn't true. I can deal with almost anything for 5 or 10 minutes. Try it when you're in hour number 8 of a 10 or 11 hour shift day after day and tell me it's the same thing!
And maybe, just maybe, our Triple S scores could be improved if we weren't having to stop in the middle of the busiest time of day during the busiest week of the year to run a report and take a call from the pharmacy supervisor telling us how much we suck. Oh and by the way, haven't seen the final figures for 2011, but the first 3 quarters of the year saw 'same store sales' increase for every quarter over the previous year. I'm guessing this trend to continue through the end of the year, meaning our sales are increasing although our hourly budgets are shrinking. Yeah, we suck. The survey may say one thing but peoples' pocketbooks say something else entirely.
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