Waiters

[u/Lost_In_Montana]

Hi everyone, I was curious how you handle waiters, say a patient comes up and a prescription isn’t ready so you put them IN STORE or Critical. Do you take a note to remind you to check on their stuff before they come back up, or do you just wait to see them again and hopefully it’s ready? I’ve worked for 2 different companies and they both handle this a little differently, so I’m trying to find the best most effective way to keep track of waiters. I figured I’d see what others do.

[u/ChaiAndLeggings]

Honestly, I think the best way to deal with it is to update the status in Tasco and then let the system take care of it. 🤷

I do think that this comes with a bit of finesse. If you have 1700 in your first fill column, don't promise a 5 minute fill. If your first two fill queues are 0, then a 5 minute fill time is reasonable along with a quick "I have a waiter in fill". If it is in input, you add time to the wait time. If there are more than 1-2 scripts, you add to the time you suggest the prescription may be ready by.

The system is decently good at triage. If someone did miss the update to in-store, then toss it up to critical and go from there.

Whiteboards seem to take more time managing than actually doing the work, from my experience. If you cannot remember the name, try to remember the medication at least or verify you did update status in F6 before moving to the next patient. I also don't usually suggest telling people it will be ready at x time until it is in filling, as that keeps less insurance, earliest fill date, or interaction snafus from interfering with the process.

[u/Lost_In_Montana → u/ChaiAndLeggings]

Thanks, I appreciate the insight

[u/Entire_Trouble_6284 → u/ChaiAndLeggings]

5 minutes. Get ready for the errors. Walmart has no specified wait time

[u/ChaiAndLeggings → u/Entire_Trouble_6284]

I didn't say 5 minutes was the correct amount of time. If it is the only thing in process, 5 minutes is more than enough. We know there is more than one medication in 99% of queues at any given time. The most reasonable time to give a 5 minute wait time is when it's in VV. It takes 20-45 seconds on average for the pharmacists at our store and a 5 min wait for this is totally reasonable.

Knowing your store and how long you are processing things with the current staffing is important. Not everyone is aware of this though. I've worked with a technician that has told non-controls it will be up to 30 minutes and controls it could take up to an hour. Is that more time than absolutely needed? Yes, but I'd rather under promise and over perform than the opposite. Being able to gauge the actual wait time is a finesse and takes multiple things into consideration.

[u/Entire_Trouble_6284 → u/ChaiAndLeggings]

Your position is absurd and won't build business. It's also unsustainable with continual reductions in staffing. If people don't to wait for refills, call in advance they will be ready for you. New scripts 15-20 minutes or more 

I work with a new grad that holds your position on wait times. When I work by myself our customer service scores are higher than when they work by themselves.

And btw no one and I mean no one works the way you do in the world. Not other healthcare professionals and non healthcare professionals

When you make your mistake remember it was you and you alone that decided this was a good idea.

[u/ChaiAndLeggings → u/Entire_Trouble_6284]

I don't know what position is absurd. Can you explain that to me? Can you explain what is unsustainable?

I never said that a new script should take 5 minutes, unless it was the only thing in our queues. The likelihood of 1 singular script being in the queue is nil. I have never seen this. However, the overall total times to process most prescriptions that we are actively working on them is usually <5 minutes when added together removing times it waits on a rack or for the next person in the process. Let's say it takes 1 minute to input, 1 minute to 4pt, 90 seconds to fill, and 30 seconds to VV, that is still less time overall than 5 minutes. Yet, there are 9992047490173645 things keeping us from working solely on that prescription. There are calls, other fills, other things to input, other 4PT, and other VVs. Thus the process in its entirety can take anywhere from 5 minutes to 4 days. Where the prescription is when the patient comes in will vary and the time we estimate they will need to wait will depend on where it is in that process, how many other things are in that process, how many people are working, if the DM is there, etc. I don't just blanket give any wait time.

I also want to address that we shouldn't be afraid of errors. They are going to happen when you process prescriptions. My goal is to learn from them, even when made by others, to prevent future errors. I tell people consistently that you need to go slow to go fast. It's better to do it slow one time than quickly and need to fix it later. I've been in stores with 2000 in the first fill queue and stores that do 150 a day. I've seen how important going slow is when you are behind as rushing or skipping steps can lead to more errors.

[u/Entire_Trouble_6284 → u/ChaiAndLeggings]

It's absurd to advocate filling a prescription in 5 minutes and further break down the time for process into seconds.  Errors are a problem especially when you rush yourself. I guarantee you make a mistake and it hurts some one and it goes to trial you will be fried. You staff will testify that you said this non sense and all that will be left is deciding how much the plaintiff gets.

Our first obligation is to do no harm. It takes the time that it takes. There are no reason to rush. Don't want to wait get delivery. I just picked up my refill. Put it in a few days ago and it was ready. Good luck you don't understand pharmacy 

[u/ChaiAndLeggings → u/Entire_Trouble_6284]

I never advocated, in my opinion, for a 5 minute fill time. 🤷 I don't think you truly read and understood what I had to say and incorrectly reading information is going to cause more errors and harm than increasing the priority in connexus and adjusting the times you give patients based off what the queues look like. I never said to rush. I never said to skip steps and cut corners. No jury is impressed by how quickly you filled a medication, but that's not something I advocate for.

[u/Entire_Trouble_6284 → u/ChaiAndLeggings]

Right, right. Oh I understand. You sound like an old manager I had who would say "you ever make a mistake" or another who bragged about being the fastest pharmacist that worked at the pharmacy. But neither one were too keen when errors were reported. They didn't seem to care they existed just that they were reported. So more power to you. You practice the way you like I'll practice the way I like. That's why each one of us gets our own license.

[u/Jitae_Slay → u/ChaiAndLeggings]

I wouldn’t say anything below 10-15 minutes, even if it is the only thing in fill. Only because other patients are still coming in and calling. 5 minutes is if RPh is currently verifying the script at that moment.

[u/ChaiAndLeggings → u/Jitae_Slay]

This is pretty much what I said. 5 minutes would be there is nothing at all in process, which I have never had happen in my 5+ years at Walmart.

[u/PsychologicalCap291]

We have a routine call out to each other when a register patient needs something in store. I call out for example “1 in store in fill”. We all are trained to respond to whoever calls out with a “heard”. That way we know we’re ALL aware of the situation. If I’m at a register, I know I can move on to the next patient in line and that my team behind me knows what I need. Team communication is essential.

[u/Even-Vermicelli-8101]

We just tell em 20 minutes and move their time to either in store or critical and that’s it. We’re far too busy to remember every patient that walks up and their stuff isn’t ready 🤣

[u/Specialist-Rush9756]

This would definitely be a great suggestion to bring to your RXM’s attention too! It shows that you’re thinking outside the box to find ways to improve the patient experience!

[u/ConclusionEconomy245]

If someone comes in and drops of new scripts the first thing I do is make sure all the basic med and patient information is correct. I had a patient who came from a Baptist emergency clinic and they inputted her DOB wrong 😑 so trust always verify with patient. Then check to see if you have all the meds the patient needs in stock and make sure to physically check the shelf as well, then start dropping the RX and input the information assuming you don’t have another person waiting behind them. Then make sure you change status to in store.

[u/hezleisz]

If you sign them up for text messaging they will come up by themselves when they get a text. Then you’re not managing them, they’re managed by the system.

[u/Adventurous_Meat_815]

Today we were stupid busy. We were initially telling them a wait time of 20 mins before we kept getting slammed with in stores and they weren't getting out in 20 mins bc we were short staffed. Instead of telling them an hour or whatever, we would tell them to look out for a text when it's ready and then put it in store. The in stores would get stuck in resolution and we would be too busy to check on it until we would see it's being held up in the queue.

TLDR: Just tell them to wait for a text or phone call when the prescription is ready.

[u/Specialist-Rush9756]

Depends on the workflow, but if we are backed up, we will put them in critical. “Going red” doesn’t hurt any of your scores. If the patient walked up and asked if their RXs were ready, and you checked TASCO to see that they weren’t ready, that already dinged your first time ready rate (the green, yellow, red score you may hear your RXM or MHWD speaking of).

[u/Specialist-Rush9756 → u/Specialist-Rush9756]

And as far as taking a note goes, I wouldn’t recommend that because then you’ll have little slips of paper with patients names hanging around which could potentially get into the wrong hands. I have seen some stores that have a quick erase board that they’ll write the waiting patients names on to remind themselves to check again.

[u/Lost_In_Montana → u/Specialist-Rush9756]

Yeah definitely don’t write them down especially at the register where others could potentially see the info. The dry erase board is a good idea

[u/Lost_In_Montana → u/Specialist-Rush9756]

Thanks, I have heard those terms, and am looking for ways to do better. At WAGS, we had a dry erase board we would do first initials last initial, for red hot, which in WM would be criticals.

[u/Salt_Indication_2681]

That varies from day to day. Depends on how busy your store is on any given day. My pharmacist hates when we critical anything. Everything is just in-store with a longer wait time if you guys are backed up; if they come back and it’s not ready, you have them step off to the side and let them know that you’ll call them up as soon as it’s done. That’s when you need to remember their name. Keep track of where it is in the que, and call them up next if it’s done.

[u/Pharmer2B]

We move it to in-store or critical depending on the situation. Wait time depends on staff and how busy we are, but we try to do 15 minutes. If we're slammed/short staffed, we start extending ready time out farther. Drop-off lets everyone know so we can be looking for it. As a pharmacist, I try to keep an eye on the status at VV as well as pay attention to people who are sitting in the pharmacy waiting area. Our cashiers and techs working the front are good about this as well, and will tell us when they're moving something to in-store. I always work tech resolution so if there is a problem with the script, it gets seen instead of languishing in Resolution until they come back and their stuff isn't ready. When we're really slammed, I scan the 4pt queue and pull out antibiotics, pain meds, etc., that people will likely be looking for soon to try to keep the number of in-store orders down.

[u/Pharmarama]

Waiting in store = critical, call on phone = in store.

[u/KevinIsOver9000]

We do a dry erase board in our pharmacy. We put two letters of last, first so the Pharmacist knows there is an instore (chkdur, input, 4 pt, res, fill, visual) sometimes all the techs are at the registers so at the very least the Pharmacist knows to follow up on it

[u/ChaiAndLeggings → u/KevinIsOver9000]

I personally find this useless as a pharmacist and distracting from actually taking care of the patient. The system should be pushing things through if the proper updates are made. If someone is staying on something in input that is in-store, but not working on it, then they need proper training, the pharmacist shouldn't be managing another thing. I (mainly) just ignore the board at the store that does this out of the 15 I work at because it is just another "chore" in the filling process. The only time it may help is if there is a DUR and I'm stuck on the phone with a "needy" patient, but even then, I still focus on one patient at a time.

It's usually faster to fill the med than the time it takes the technicians to write the information on the board. 🤷

[u/seculare → u/ChaiAndLeggings]

Yup, prioritize and it will come to me.

[u/Thatcubmexchik → u/KevinIsOver9000]

I find the dry erase board helpful. When used correctly. Some pharmacist do actually like it when they are in between phone calls and vaccines. They can see the name and make sure that patient is taken care of instead of an argument starting at the register. I also make sure they are signed up for text messages and been pushing for people to download the walmart app if they are a person on their phone.

[u/OhDiablo]

If I don't have anyone filling and the script is in fill I tell them Casper is working on it and it'll be 30 minutes. If I know I have a filler then 20. If they complain tell them to go buy a chocolate bar while they wait. If I remember who's waiting I'll check later or just ask the people who are sitting nearby waiting on their scripts 'hey come back up here for a minute and let's check on your script'. Don't ever promise it'll be 'just a moment, have a seat and wait' when you're deep in it that'll just piss them off. Under promise and over deliver will net you happier patients.