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IMPLEMENTATION OF BENCHMARKING GUIDELINES IN COMMUNITY PHARMACIES
WK Wong1, SS Chua1, JSH Tan2
1 Department of Pharmacy, Faculty of Medicine, University of Malaya
2 Malaysian Pharmaceutical Society, Kuala Lumpur
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CONTENTS
1. Introduction
2. Aim and Objectives
3. Methodology
4. Results and Discussion
5. Conclusions
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INTRODUCTION
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INTRODUCTION
BENCHMARKING GUIDELINES (BMGs):
Pharmaceutical Services Division of MOH has collaborated with the MPS to develop BMGsAdopted by all registered CPs by Jan 2006. Areas - premises, equipments, personnel, references and SOPs
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AIM & OBJECTIVES
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AIM & OBJECTIVESAIM
To determine the extent community pharmacies have
complied with the BMGs
OBJECTIVES1) To investigate the time frame required for community pharmacies to adopt the BMGs. 2) To identify problems associated with the implementation of BMGs
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METHODOLOGY
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METHODOLOGY
371 respondents (29.19%)
Exclusion:1.Ceased operation2.Shifted 3.Chain pharmacy with no pharmacist [ 1271 CPs]
Figure 1: Flowchart of Methodology
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RESULTS & DISCUSSION
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Particular of respondents Number of respondents(%)
Gender (n=370)
Female 212 ( 57.3%)
Male 158 ( 42.7 %)
Age (n=363)
21 – 30 99 ( 27.3%)
31 – 40 146 ( 40.2%)
41 – 50 81 ( 22.3% )
51 – 60 29 ( 8.0% )
>60 8 (2.2%)
Years as community pharmacists (n=362)
1 – 5 113 ( 31.2%)
6 – 10 116 ( 32.0% )
11 – 15 52( 14.4%)
16 – 20 47( 13.0%)
>20 34( 9.4%)
Types of employment (n=369)
Self-employment/ Share Holder 203 ( 55.0%)
Full time employee 160 ( 43.4% )
Part time/ Locum 6 ( 1.6% )
Table 1: Demographic Data of Respondents
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Figure 2 : Types of Ownership of CPs (n=370)
I – Independent C – Chain
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Figure 3: Types of services provided by CPs (n=371)
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Compliance to BMGs
51.0% of the respondents were aware of the BMGs
Mean + SD extent of compliance 62.55 + 21.1, median = 65%
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Figure 4:Percentage of Compliance with Premises Requirements in BMGs
42.1
50.555.8 57.5
64.3
75 75.1 75.3 75.6 78.484 86.1
89.295.7
0
20
40
60
80
100S
cree
ning
are
a w
ith "
Scr
eeni
ng t
est"
sig
n
Des
igna
ted
wai
ting
area
Ent
ranc
e ac
cess
ible
to
whe
elch
air
Dip
lay
nam
e of
pha
rmac
ist(
s) o
n du
ty
Hav
e ad
ditio
nal s
ecur
ity m
easu
re
Cle
an d
ispe
nsin
g ar
ea w
ith "
Pre
scrip
tion"
sign
Des
igna
ted
wet
com
poun
ding
are
a
Tot
al d
ispe
nsin
g ar
ea m
in 2
00 s
q ft
Des
igna
ted
priv
ate
coun
selli
ng a
rea
Dis
play
not
ices
of
serv
ices
pro
vide
d
"Pha
rmac
y" is
larg
er t
han
adve
rtis
emen
ton
sig
nboa
rd
Sep
arat
e di
spla
y ar
ea f
or in
tern
al &
exte
rnal
med
icin
es
Des
igna
ted
dry
com
poun
ding
are
a
Mer
chan
dise
are
arr
ange
d ac
cord
ing
toca
tego
ries
%
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BMGs Yes, n (%)
Types and ownership of CPs
P value
I, pharmacist
s, Yes/Total resp. (%)
I, non-pharmac
ist, Yes/Total
resp. (%)
C, group of
pharmacists,
Yes/Total resp. (%)
C, corporate body,
Yes/Total resp. (%)
Display name of pharmacist(s) on duty
212 (57.5)
116/219
(53.0%)
25/59
(42.4%
)
11/20
(55.0%)
60/70
(85.7%
)
0.000
*
Screening area with signage
155
(42.1)
82/218
(37.6%)
23/60
(38.3%
)
13/20
(65.0%)
37/69
(53.6%
)
0.017
Table 2: Percentage of compliance with premises requirement in BMGs and it’s association with
types of ownership
Table 2: Percentage of compliance with premises requirement in BMGs and it’s association with
types of ownership
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Figure 5:Percentage of Compliance with Equipments Requirement in BMGs
33.436 37.5
53.9 55.9
74.5
87.389.5
94.6 96.5 97.6
0
20
40
60
80
100M
easu
ring
cylin
ders
of v
ario
us s
izes
Com
pute
rs w
ithph
arm
acy
info
rmat
ion
soft
war
e
Com
pute
rs w
ithpa
tient
med
ical
reco
rds
Tile
/gla
ss s
labs
with
spat
ula
Prin
ters
for
labe
ls,
leaf
lets
or
prin
ted
mat
eria
ls
Com
pute
rs f
orin
vent
ory/
stoc
kco
ntro
l
Ava
ilabi
litie
s of
com
pute
r
Ref
riger
ator
mai
ntai
ned
at 2
-8C
Cab
inet
s fo
r st
orag
eof
doc
umen
t/re
cord
s
Pla
stic
bot
tles/
glas
sbo
ttle
s fo
rdi
spen
sing
Sui
tabl
e m
eans
of
coun
ting
tabl
ets/
caps
ules
%
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BMGsYes, n (%)
Types and ownership of CPs
P value
I, pharmacis
ts, Yes/Total resp. (%)
I, non-pharmac
ist, Yes/Total resp. (%)
C, group of
pharmacists,
Yes/Total resp. (%)
C, corporate
body, Yes/Total resp. (%)
Tile/ glass slabs with spatula
199
(53.9
)
133/219
(60.7%)
39/60
(65.0%
)
11/20
(55.0%)
16/69
(23.2%)
0.000
*
Measuring cylinders of various sizes
123
(33.4
)
95/219
(43.4%)
15/59
(25.4%
)
4/20
(20.0%)
9/69
(13.0%)
0.000
*
Computers - inventory/ stock control
275
(74.5
)
149/219
(68.0%)
42/59
(71.2%
)
18/20
(90.0%)
66/70
(94.3%)
0.000
*
Computers -pharmacy info. software
132
(36.0
)
85/218
(39.0%)
22/59
(37.3%
)
10/20
(50.0%)
14/69
(20.3%)0.019
Table 3: Percentage of compliance with equipments requirement in BMGs and it’s
association with types of ownership
Table 3: Percentage of compliance with equipments requirement in BMGs and it’s
association with types of ownership
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50.4 51.5
70.6
49.2
90.5
0
20
40
60
80
100
Formal training forpharmacy assistant(s)
Pharmacist(s) with nametag
Pharmacist(s) withprofessional dress code
Soft copies Hard copies
%Figure 6:Percentage of Compliance with Personnel
and References Requirement in BMGs
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BMGsYes, n (%)
Types and ownership of CPs
P value
I, pharmacis
ts, Yes/Total resp. (%)
I, non-pharmac
ist, Yes/Total resp. (%)
C, group of
pharmacists,
Yes/Total resp. (%)
C, corporate
body, Yes/Total resp. (%)
Pharmacist(s) with prof. dress code
259
(70.6
)
139/216
(64.4%)
41/60
(68.3%
)
13/20
(65.0%)
65/70
(92.9%)
0.000
*
Pharmacist(s) with name tag
190
(51.5
)
95/218
(43.6%)
21/60
(35.0%
)
11/20
(55.0%)
62/70
(88.6%)
0.000
*
Soft copies of references
175
(49.2
)
113/209
(54.1%)
31/58
(53.4%
)
10/19
(52.6%)
20/69
(29.0%)
0.003
*
Table 4: Percentage of compliance with personnel and references requirement in BMGs and it’s
association with types of ownership
Table 4: Percentage of compliance with personnel and references requirement in BMGs and it’s
association with types of ownership
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Figure 7:Percentage of Compliance with Written SOPs Requirements in BMGs
41.8
66.9
75.3 75.8
88.4
0
20
40
60
80
100
Extemporaneouspreparation
Monitoring and screeningtests
Supply of self-monitoringdevices
Response to minor healthproblems/ Sales ofpharmacy medicine
Supply of prescribedmedicines & record book
for group B and Cpoisons
%
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BMGsYes, n (%)
Types and ownership of CPs
P value
I, pharmacists, Yes/Total resp. (%)
I, non-pharmac
ist, Yes/Total resp.
(%)
C, group of
pharmacists,
Yes/Total resp. (%)
C, corporate
body, Yes/Total resp. (%)
Extemporaneous preparation
146
(41.8
)
101/206
(49.0%)
21/57
(36.8%
)
10/17
58.8%)
14/68
(20.6%)
0.000
*
Table 5: Percentage of compliance with Written Standard Operating Procedures (SOPs)
requirement in BMGs and it’s association with types of ownership
Table 5: Percentage of compliance with Written Standard Operating Procedures (SOPs)
requirement in BMGs and it’s association with types of ownership
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Figure 8: Reasons for not complying with BMGs(n=371)
0 20 40 60 80 100
%
Others
Space Constraint
Disagreement (partner/employer)
Guidelines not practical
Customer satisfaction
Time Constraint
Financial Constraint
Independent Pharmacy Chain Pharmacy
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Figure 9:Comparison of Reasons between Independent Pharmacy and Chain Pharmacy for not complying with BMGs
6.4
20
44.3
60.4
60.4
77.1
3.3
31.5
29.2
38.2
53.9
56.2
0 10 20 30 40 50 60 70 80 90
Space Constraint
Disagreement (partner/employer)
Guidelines not practical
Customer satisfaction
Time Constraint
Financial Constraint
%
Independent Pharmacy Chain Pharmacy
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CONCLUSION
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CONCLUSION Level of compliance with
benchmarking guidelines varied between CPs.
Need to review the guidelines before it is implemented fully.
Professional bodies and authorities concerned should identify problems for implementation and provide more information or assistance
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THANK YOU