Pharmacy call centers have been successfully implemented in outpatient and specialty pharmacy settings.1 A centralized pharmacy call center gives patients immediate access to a pharmacist who can view their health records to answer specific questions or fulfill medication renewal requests.2-4 Little literature exists to describe its use in an inpatient setting.
Inpatient pharmacies receive numerous calls from health care professionals and patients. Challenges related to phone calls in the inpatient pharmacy setting may include interruptions, distractions, low accountability, poor efficiency, lack of optimal resources, and staffing.5 An unequal distribution and lack of accountability may exist when answering phone calls for the inpatient pharmacy team, which may contribute to long hold times and call abandonment rates. Phone calls also may be directed inefficiently between clinical pharmacists (CPs) and pharmacy technicians. Team member time related to answering phone calls may not be captured or measured.
The Edward Hines, Jr. Veterans Affairs Hospital (EHJVAH) in Illinois offers primary, extended, and specialty care and is a tertiary care referral center. The facility operates 483 beds and serves 6 community-based outpatient clinics.
Implementation
A new inpatient pharmacy service phone line extension was implemented. Data used to report quality metrics were obtained from the Global Navigator (GNAV), an information system that records calls, tracks the performance of agents, and coordinates personnel scheduling. The effectiveness of the ACD system was evaluated by quality metric goals of mean speed to answer ≤ 30 seconds and mean abandonment rate ≤ 5%. This project was determined to be quality improvement and was not reviewed by the EHJVAH Institutional Review Board.
The ACD system was set up in December 2020. After a 1-month implementation period, metrics were reported to the inpatient pharmacy team and leadership. By January 2021, EHJVAH fully implemented an ACD phone system operated by inpatient pharmacy technicians and CPs. EHJVAH inpatient pharmacy includes CPs who practice without a scope of practice and board-certified pharmacy technicians in 3 shifts. The CPs and pharmacy technicians work in the central pharmacy (the main pharmacy and inpatient pharmacy vault) or are decentralized with responsibility for answering phone calls and making deliveries (pharmacy technicians).
The pharmacy leadership team decided to implement 1 phone line with 2 ACD splits. The first split was directed to pharmacy technicians and the second to CPs. The intention was to streamline calls to be directed to proper team members within the inpatient pharmacy. The CP line also was designed to back up the pharmacy technician line. These calls were equally distributed among staff based on a standard algorithm. The pharmacy greeting stated, “Thank you for contacting the inpatient pharmacy at Hines VA Hospital. For missing doses, unit stock requests, or to speak with a pharmacy technician, please press 1. For clinical questions, order verification, or to speak with a pharmacist, please press 2.” Each inpatient pharmacy team member had a unique system login.
Fourteen ACD phone stations were established in the main pharmacy and in decentralized locations for order verification. The stations were distributed across the pharmacy service to optimize workload, space, and resources.