My mechanic tells me the hardest part on an engine is the ignition. Like the work a cold engine needs to do to ignite a spark and release fuel into the combustion chamber, causing a reaction that generates energy for motion, pressing the mental START button is the hardest part of the job. Once the car is running, the engine puts in little work.
In pharmacy, the blister packs pile up and the pharmacist resists getting the checking started. The baskets of prescription to log grows and staff resist getting started. The medication review paperwork needing documentation to be completed actually falls off the shelf from being too heavy.
All these grinding tasks are doable, some even mind-numbingly simple, yet they pile up. They are not staff or patients demanding direct answers. There are no immediate consequences to leaving them for tomorrow.
We frequently remind ourselves of these to-do tasks needing completion and anxiety grows with each mental reminder. They grind away at our nerves until we either bite the bullet and get started, or kick the can so far down the road that the pile doubles, making starting seem futile.
We solve this problem by making it easy to start. Because once we start, we’re fine. If we could start less often, imagine how productive we would feel, and imagine how we would change our internal identities of ourselves from “I have no time” to “I get it done”.
In pharmacy, we can make it easy to start by first automating the repetitive. Identify tasks that need to occur like clockwork. Use a weekly task log with day of the week headings to list what you need done on each day. Ask the staff to add in their own or move items around until you have developed a perfect template. Our weekly log has all sorts of items like emailing reports, running computer back-ups, billing batches of Rxs, cleaning duties, topping up paper in printers, replenishing supplies like vials, preparing deliveries, ordering drugs, printing sales tags and a ton more.
The task log accomplishes a few things: it modifies the mental reminder from “I have to do that” to “that gets done on Mondays”, stopping the doom-gloom train before it leaves the station. It also reduces the chances of important tasks getting forgotten, which wake you up at night at a time when you cannot solve them.
I also use a monthly version of this called an ops calendar. These are the repetitive operational tasks that need to get done throughout the year like narcotic counts, inventory, paying bills, meetings, collecting annual compliance pack signatures, completing performance reviews and the list goes on.
These logs also serve as visuals for staff who automatically know what do to instead of asking. It provides direction without micromanaging and offers autonomy since they developed the list themselves. For me, it gives me a visual of what we are behind on, eliminating arguments of how ahead/behind we are on key tasks. The logs put everyone on the same page and indirectly acts as delegation tools, where great people feel empowered by getting things done, even when I’m not there.
Speaking of delegation, we can secondly make it easier to start by delegating the non-clinical. It takes a lot of steps done the right way to administer a vaccine. But only 1% of the process needs the Pharmacist to put the needle under the dermis.
Break down the components of your various patient care services and insert a non-Pharmacist for identifying clinical opportunities, triaging and bringing patients to the counseling room, printing paperwork, drawing up a vaccine, documenting the lot and expiry date, ordering supplies, running third party software under your supervision (e.g. Covax), billing/adjudicating and cashing out at the end. The Pharmacist (or Technician in some cases) steps into the workflow for the clinical piece, then steps out so the staff can run the show. An empowered staff, a patient taken care of and a clinician who has time to think, imagine! And guess what, the patient comes back because they had a great experience. Take care of people, who take care of customers, who take care of business.
I have put these tools together into an automation kit, where the formatting is already done, allowing us to type directly into the forms, print and post, offering endless updates as we navigate.
During a vaccine clinic this year I caught a patient who very suddenly and unexpectedly fainted. If I was focused on the other 99% of the process that needs to happen, stuck on the opposite side of my desk or managing the line-up outside the room, that patient hits his head. But because all the non-clinical steps in the process where taken care of by 2 different part-time staff who can given those tasks more attention and do a better job that I could, the patient came to conscious 60 seconds later, still in his chair with a juice box ready and a cool compress on his neck. He kept his dignity, his concussion-free brain and is returning to see me for his 3 travel vaccines tomorrow (He is bringing his wife and 4 kids for shots too).
The third way we make it easy to start is the prep tomorrow. Before leaving today, make a list of the important tasks that need to get done tomorrow. Exclude anything on the weekly task log and ops calendar since you already have a system that ensures those get done. Then list them in order of priority. Close the pharmacy knowing nothing will haunt you while you sleep and attack the list tomorrow, hitting one item off at a time. Avoid partially completing a task before moving on to the next. This means you will need to restart and risk a new start barrier. Finish one, go to two, then three. What doesn’t get done goes on tonight’s list and is re-prioritized accordingly.
Prevent developing an identity of a procrastinator. Prevent the mental torture of rehearsing a long list of tasks that won’t get done. Avoid wasting time saying you will do and instead of doing.
Instead, spend time designing your pharmacy to perform easy starts everywhere. Automate the repetitive, delegate the non-clinical and prep tomorrow.
If you liked this article, keep the fire burning.