Application of work study techniques to quantify the work of community pharmacists.
The way in which British community pharmacists work has been much talked about but,
until now, not quantified. A review of work study techniques within the field of
pharmacy revealed that community pharmacy had been largely neglected. In the light of
recommendations to extend the community pharmacists' role to provide non-traditional
services it was necessary to examine community pharmacy practice to investigate the
feasibility of diversifying pharmacy roles.
Utilising the technique of subjective evaluation, pharmacy managers from a national
multiple chain were asked to estimate how much time they spent on each of sixteen
activity categories that had been devised by the author to represent their work. Three
hundred and twenty three managers replied to the study generating 1,084 usable
responses. The findings showed that seven categories accounted for almost 80% of their
time, of which dispensing [as defined in this thesis] occupied proportionally the greatest
amount of time of any category [37%]. However, subjective evaluation relies on
estimation and has been previously criticised as being imprecise. A further work study
technique, work sampling, was chosen as the most appropriate validation tool to
determine the accuracy of the subjective evaluation findings. Five pre-registration
pharmacists recorded the work of five pharmacy managers, generating 2,682
observations. The results from the observed data set were compared with those from
subjective evaluation. Only two categories were found to be significantly different,
lending weight to the assumption that the results obtained from the subjective evaluation
study were an accurate record of how community pharmacists spent their time.
These results demonstrated that the work patterns of community pharmacists mainly
centre on the supply of medicines. The final stage of the research programme attempted
to alter pharmacist work patterns via a skill mix programme in an attempt to limit
pharmacist involvement in technical tasks such as dispensing. A `pre-test post-test'
design was employed to determine the success of the study on three outcome measuresthe change in work patterns after skill mix implementation; non-pharmacist acceptance of
altering their way of working; the perceptions held by the pharmacists also on the new
way of working.
The results showed that pharmacists' work patterns were altered, although changes could
not be directly attributable to the intervention. In addition, the principal aim of
substantially reducing the time they spent dispensing was not achieved. Non-pharmacist
staff, on the whole, accepted or preferred the change to work practice as too did
pharmacists. However, barriers to change were identified which needed to be rectified
before skill mixing can have a significant impact on freeing pharmacist time away from