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Learning ObjectivesCompare and contrast the production line
approach and the empowerment approach to designing and managing pharmacy services.
Explain the concept of service scripts and their value in providing excellent pharmacy services.
List the steps involved in service recovery.Discuss the purpose of a service blueprint.
Identify the key components and the steps involved in building the blueprint.
Discuss the main elements of a service audit. Give examples of questions associated with each element.
Think about your last job. How would you characterize
the service provided?
World-class?Distinctive?
Journeyman?Available for
service?
Production lineTop-down designStandardize, simplify, clear division
of labor, substitute technology for employees, minimize independent decisions by employees, use employees as interchangeable parts
Increase efficiency and speed; lower cost/unit
EmpowermentBottom-up designGive employees power, flexibility,
and responsibility in their jobs. Give discretion and tools with minimal policies and rules.
EmpowermentBenefitsBenefitsAdaptableSpontaneousAbility to copeRecovery
CostsCostsHarder to manageLess efficient and
more expensivePotentially more
bad decisions
Better approach depends on
Basic business strategyNature of transactionNeed of patientsType of employees and managers
(see situational leadership)Trade-off between managerial control
and employee involvement
Service scriptsEstablish expected actions and
responsibilitiesStandardize proceduresAre based upon best methods availableCan be used for both production line
and empowerment approaches
Indian Health Service counseling guidelines
1. What did the doctor tell you the medicine is for?
2. How did the doctor tell you to take the medicine?
3. What did the doctor tell you to expect?
Examples of script situations Dispensing error Situation that requires a
physician to change a prescribed therapy
Nonformulary prescription
Prior authorization Nursing administration
error Patient complaint about
the price of a prescription
Hostile customer
Drug incompatibility (e.g., intravenous)
Physician prescribing error
Drug allergy Drug interaction Service mistake
(e.g.,overcharge) Negotiation with
co-workers Difficult counseling
situation Patient with renal/hepatic
insufficiency
Service recovery (example of a script)
Mistakes are inevitable. Mistakes present an opportunity to save
or even strengthen a relationship with a customer.Dissatisfied customers will tell between 9 and
16 people about a poor service experience.Repurchase intentions increase from 19% to
54% when complaints are satisfactorily addressed.
Steps to service recoverySearch out potential for service
failures and dissatisfaction.If a failure occurs
Apologize.Offer a remedy.Solve the problem immediately.If possible or necessary, offer
compensation to customers for their trouble.
Service blueprintsService blueprints are flowcharts used to
design service operations. They are maps of service processes that
permit pharmacists to better see and understand them.
They simultaneously depict the process, customer roles, service providers, and supporting services.
They break down the service into components and arrange them according to their purpose.
Gives Prescription (Rx)Gives Prescription (Rx)to Pharmacy Employeeto Pharmacy Employee
Fills OutFills OutPatient ProfilePatient Profile
Arrive at Arrive at PharmacyPharmacy
GreetsGreetsCustomerCustomer
(RPh/Tech)(RPh/Tech)
Receives &Receives &Checks RxChecks Rx(RPh/Tech)(RPh/Tech)
ComputerComputerEntry (Tech)Entry (Tech)
Fill RxFill Rx(Tech)(Tech)
Ok’d byRPhOk’d byRPh
Cus
tom
erC
usto
mer
Act
ions
Act
ions
Con
tact
Em
ploy
eeC
ont a
ct E
mpl
oyee
Invi
sibl
eIn
v isi
b le
Proc
e ss
Pro c
e ss
(Bac
kst a
g e)
(Ba c
kst a
ge)
(Ons
tage
)(O
nsta
ge)
Phys
ical
Phys
ical
Evi
denc
eE
vide
nce PharmacyPharmacy
ExteriorExteriorParkingParkingAppearanceAppearance of Non-pharmacyof Non-pharmacy DepartmentsDepartments
Employee Employee DressDressNon-prescriptionNon-prescription MerchandisingMerchandising
Waiting AreaWaiting AreaPatient InformationPatient Information BrochuresBrochuresSignsSigns
Line of InteractionLine of Interaction
Line of Internal InteractionLine of Internal Interaction
Line of VisibilityLine of Visibility
Clarification Needed?Clarification Needed?
YesYes NoNo
Calls MD’sCalls MD’sOffice(RPh)Office(RPh)
Drug Interaction orDrug Interaction orDUR Notification?DUR Notification?
Do not fillDo not fill
Insurance DUR Insurance DUR NotificationNotification
Check RxCheck Rx(RPh)(RPh)
Clarification or ChangeClarification or ChangeMade with Rx Made with Rx
Profile ReviewedProfile Reviewed(RPh)(RPh)
Picks UpPicks Up& Pays for Rx& Pays for Rx
Is CounseledIs CounseledAbout RxAbout Rx
AppearanceAppearance of Rx Labelsof Rx LabelsAppearance of Appearance of DrugDrugBillBill
Drug InformationDrug Information InsertInsert
Presents BillPresents Billfor Rx andfor Rx and
MerchandiseMerchandise(RPh/Tech)(RPh/Tech)
CounselsCounselsPatientPatient(RPh)(RPh)
Service Blueprint for Dispensing ServicesService Blueprint for Dispensing Services
Blueprint advantagesIncludes patient viewMakes process visually explicitPermits cost-benefit trade-offs
Service audit (see Table 5-2)
Systematic, critical review of the way services are marketed by organizations, examiningMarketing orientation New customer marketing Existing customer marketingInternal marketingService quality
ConclusionDesign can make the difference between
poor and excellent services. Production line and empowerment
approaches both can be useful frameworks for providing pharmaceutical services.
Service scripts, blueprints, and audits can each help improve the design of pharmacist services.