Optimizing Outpatient Pharmacy Workflow to Enhance Efficiency with Dispensing Without Counselling (DWC)
Care Process & Redesign
National University Health System Quality Improvement
National University Health System
25 March 2025
To reduce the average queue time and improve service efficiency for patients at NTFGH by implementing a Dispensing Without. Process Consistency: Standardized scripts and procedures are crucial for ensuring all eligible patients are consistently offered the.
Year Submitted: 2025
Published Date: 25 March 2025
Tags: Outpatient Care, Care Process ＆ Redesign, Access To Care, Waiting Time, Operational Management, Resource Allocation, Productivity, Time Saving
About this Content
Aims
To reduce the average queue time and improve service efficiency for patients at NTFGH by implementing a Dispensing Without Counselling (DWC) workflow for eligible patients while maintaining patient safety and satisfaction. The goal is to achieve a DWC adoption rate of at least 30%, reduction of average wait time of 70th percentile by 10% and average serving time by 20% before end 2025.
Background
In 2024, Ng Teng Fong General Hospital (NTFGH) Outpatient Pharmacy (OP) serves approximately 600-700 patients daily. All patients were given medication counselling, even when not needed, resulting in long queues, inefficient Pharmacy resource allocation, and reduced patient satisfaction. This also contributed to lowered patient compliance and limiting time for patients with complex medication needs.
Methods
Root cause analysis using fishbone diagram and 5-Whys analysis, development of DWC eligibility criteria, staff training on new process and eligibility screening, PDSA cycles with two main phases, standardized scripts and visual aids development, patient publicity posters, interviews with pharmacy technicians for feedback, and frequent updates on uptake rates to team.
Results
DWC adoption rate achieved 16.8% in first cycle, 12.3% in second cycle (below target of 30%)
DWC patients had significantly shorter average serving time of about half a minute compared to general patient group
Average serving time reduced from 2.35 minutes to 2.27 minutes (3.5% reduction)
Time savings from DWC implementation were redirected to patients needing more in-depth counselling
No significant improvement in overall patient queue time due to confounding factors (increased patient load, training requirements, staff turnover)
Lessons Learnt
Process Consistency: Standardized scripts and procedures are crucial for ensuring all eligible patients are consistently offered the DWC option. Staff Engagement: Regular feedback sessions and involvement in refinement processes enhance staff buy-in and improve implementation. Adaptive Implementation: Continuous monitoring and willingness to adjust processes based on timely feedback leads to better outcomes.
Keywords
dispensing without counselling, outpatient pharmacy, queue time, workflow optimization, patient safety
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National University Health System |
Organization(s) Involved | National University Health System |
Platform(s) | National University Health System Quality Improvement |
Healthcare Professional Group(s) | Healthcare Administration, Pharmacy |
Applicable Specialty or Discipline | Healthcare Administrators, Operations, Pharmacy |
Project Lead(s) | Goh Shixu |
Project Member(s) | Teoh Wen Ting |
Connect with this contributor!
Goh Shixu - shixu_goh@nuhs.edu.sg
Project Attachment
OPTIMIZING OUTPATIENT PHARMACY WORKFLOW TO ENHANCE EFFICIENCY WITH DISPENSING WITHOUT CO.pdf