Ipc -IPC -exam 1 - community pharmacy Flashcards
Medication Use Process: Workflow
The sequence of industrial, administrative, or other processes through which a piece of work passes from initiation to completion
Workflow
Important to manage in various settings
Organization and communication are key
Workflow
Proper workflow helps to ensure prescriptions are filled accurately, safely, efficiently, _timely____________
A well-established workflow keeps the pharmacy organized, sets an appropriate pace, and can maximize quality patient care
It is the pharmacist’s responsibility to ensure the process runs smoothly
Pharmacists’ Responsibilities
Prescription accuracy and safety
Overall workflow
- Triage and prioritization, this fits in with the assess portion of PPCP
- Task delegation
- Time management
Be honest and realistic with patients, do not say 10 minutes when it is not
Make sure technicians and interns work within their scope of practice
Pharmacy Stations
Drop off*
Prescription / Data Entry*
Filling / Production*
Verification*
Pickup*
Consultation Area
Compounding area
Reconstitution area
Counseling / Vaccination room
Flow of the pharmacy
Prescription received by pharmacy
- E-prescriptions
- in-person drop-off
Data / Prescription Entry
- Insurance billing
- Resolving issues
The prescription order is filled
- NDC matched via scan
- Pills counted
- Bottle is labeled
Prescription Verification
Order entry verification
Product Verification
Prescription dispensing
Pickup
Consultation
Patient Counseling
Drop Off
Most prescriptions are “dropped off” electronically
In some situations, prescriptions may be dropped off in person
- Patients or their agents - make sure all of the info is obtained
Accepted by technicians, interns, or pharmacists
Information obtained from patients
- Name and DOB
- Update:
Demographic info
Insurance info
Allergies and health conditions
- Plans for pickup
Drop Off
Receive the prescription
Identify the class or type of medication
Ensure the prescription has all the required items
Do you have any questions or concerns for the prescriber or patient?
Drop Off: Special Considerations
Prescription preferences
- language
- text messages
- easy off caps
Controlled Substances
- Patient ID
- Good faith dispensing (GFD) process
- Check the Prescription Drug Monitoring Program (PDMP) and/or refill history
- Prescriber notes
“Do not dispense until…” or “Do not dispense before…”
- Contact the prescriber for verification or validation of prescription PRN
“Drop Off”
what else happens
vaccination check-in
What percentage of prescriptions are physically dropped off to community pharmacies?
5%
Prescription (or Data) Entry
E-prescriptions are matched to the corresponding patient
- Scan dropped-off prescriptions into the computer system
Prescription information is entered/updated
- Date
- Patient name
- Drug name, strength, dosage form
- SIG
- Quantity, refills, days’ supply
- Prescriber
- DAW
Submit claim to insurance, resolve 3rd party issues
Third-Party Billing
Refill too soon
Prior Authorization required
Patient no longer eligible
Drug not covered
Plan limits exceeded
Invalid/missing days supply
Insurance limitations/contractual issues
Filling / Production
Patient monograph/leaflet prints
Find stock bottle/product
Match and scan leaflet and stock bottle(s)
Count medication and label vial
Image capture?
Attach any additional instructions and/or MedGuide
Filling / Production
Patient monograph/leaflet prints
Find automation-filled bottle
Match and scan leaflet to bottle
Image capture?
Attach any additional instructions and/or MedGuide
Filling / Production
Med bottles w/ leaflets placed into baskets or totes
Often color-coded
Sent to pharmacist for visual product verification
Or – the prescription is bagged and ready for pickup
- RPh can verify remotely
Verification Flow of the Pharmacy
receiving rx to
rx entry to
order verification to
filling meds to
product verification to
dispensing
Verification Flow of the Pharmacy
receiving rx to
rx entry to
filling meds to
rx verification:
- order verification
- product verification
dispensing
When considering pharmacy workflow, Which type(s) of verification can be done remotely by a community pharmacist?
A
Order Verification
B
Product Verification
C
Both
D
Neither
C
Both due to image capture and scanning into the computer
I pray lord that you help me to work remotely after I graduate from this program in Jesus’ name amen
Order Entry Verification
Verify entered information is correct and matches the original prescription
Look-alike, sound alike
Allergies
Dosing
- Unusual dosing
- Pediatric dosing
Dosage forms
Special requests from prescriber or patient
If controlled substances
- Review history
- Prescription Drug Monitoring Program (PDMP)
Good Faith Dispensing (GFD)
Used when dispensing C2 substances
- Oxycodone, hydromorphone, methadone
- Should always be using GFD when dispensing C2s
Review patient comments
Check diagnosis code
GFD
Check PDMP (MassPAT/ NH PDMP)
- Verify geographical proximity
- Multiple prescribers and scope of practice
Payment type
Pharmacists actions:
- Dispense – valid and meets requirements
- Refusal – determines elements of GFD are not present
Drug Utilization Review (DUR)
Unnecessary drug therapy
Drug selection not optimal
Clinical significant drug interaction
Medication dosing regimen not optimal
Adverse drug reaction
Needs additional drug therapy
Failure to receive drug therapy appropriately
Needs additional follow-up
DUR in community pharmacy
Dosing regimen not optimal or appropriate
Allergies/Health conditions
Drug-drug interactions
Duplication of therapy
Adverse drug reaction
