Reflecting on our Pharmacy Service Improvement Project
At Project7, our mission is to drive meaningful change that enhances operational efficiency and delivers tangible results. One of our previous projects involved a significant transformation in the pharmacy department of a UK Learning NHS Trust. This reflection explores the challenges, solutions, and outcomes of this pharmacy service improvement initiative.
The UK Learning NHS Trust, serving areas such as East Surrey, North-East West Sussex, and South Croydon, was facing significant operational and financial pressures. With an annual budget of £300 million and a £20 million overspend, the trust needed to find ways to reduce overall costs while maintaining or improving service quality. The pharmacy department, in particular, was underperforming, with high levels of patients being discharged without their necessary medication. This issue led to increased costs, inefficiencies, and low staff morale.
The challenges in the pharmacy were multifaceted. There was difficulty in processing a high volume of prescriptions, especially those arriving late in the day after ward rounds. Often, medications were delivered to wards after patients had already been discharged, leading to unnecessary waste and storage issues. Additionally, the pharmacy operated without a “first in, first out” system, causing significant delays in processing prescriptions. There was also no tracking system in place, which meant that staff often had to search for prescriptions manually, leading to further inefficiencies.
To address these challenges, Project7 took a comprehensive approach. We began by reviewing the pharmacy’s staffing levels and competencies to ensure they were aligned with the volume of work required. Through process mapping with professional staff, we identified areas for improvement and implemented a range of solutions.
One of the most impactful changes was the introduction of a “first in, first out” processing system, which significantly reduced wait times and improved overall efficiency. We also implemented short interval control to manage the variation in demand throughout the day. Additionally, a Plan, Do, Check, Act (PDCA) confirmation system was introduced to ensure that medications were only delivered if the patient was present to receive them, thereby eliminating unnecessary storage on wards.
The results of these interventions were substantial. The pharmacy saw a 59% reduction in turnaround time, bringing it down from an average of 3.4 hours to within the trust’s target of 2 hours. The department’s establishment was redefined with a plan for implementation, leading to a reduction in headcount by three substantive posts and a 70% reduction in locum spend. Moreover, a tracker system was introduced, providing better oversight of prescription processing and ensuring a more efficient workflow. The standard delivery route and times for porters were also formalised, further streamlining the process.
Reflecting on this project, several key lessons stand out:
- Process Standardisation: Implementing a “first in, first out” system and standard delivery routes drastically improved efficiency and reduced turnaround times.
Effective Use of Resources: Aligning staffing levels with the required workload and reducing reliance on locums not only saved costs but also improved overall service delivery. - Continuous Improvement: The introduction of a PDCA confirmation system ensured that improvements were sustained and that medications were delivered only when needed, reducing waste and inefficiencies.
- Collaboration and Communication: Engaging staff in process mapping and decision-making fostered a sense of ownership and commitment to the improvements, leading to a more motivated and effective team.
This project demonstrates the transformative impact that targeted operational improvements can have on service delivery within a healthcare setting. At Project7 Consultancy, we remain committed to helping our clients achieve operational excellence through innovative solutions and continuous improvement strategies.
For more information on how Project7 Consultancy can help your organisation achieve similar success, contact us directly. We can help you maximise your business change potential.
Change: Victim or Participant?
A common belief in business is that “People do not like change.” However, our experience shows that people actually live in and understand the need for constant change. What they resist is the feeling of a lack of control, which can bring insecurity, confusion, and disorientation.
Change is a constant in life, driven by factors such as politics, economics, societal shifts, technological advancements, and environmental urgency. These changes profoundly influence individuals and businesses. What people struggle with is not change itself, but the way it is implemented, which significantly affects how they perceive and react to it.
In our experience, the success of change hinges on how it is implemented. The way people are involved determines whether they see themselves as participants in change or as victims of it. When people feel like they are part of the process, they are more likely to embrace change, rather than resist it.
The Dynamics of Successful Change
Successful change, characterised by inclusivity and collaboration, begins with engaging people in the initial planning and implementation stages. This early involvement is known as a business’s readiness for change and is critical for long-term success. When people and teams are engaged and empowered from the start, they are more likely to embrace change, adapt positively, and take ownership of its longevity.
This approach is grounded in principles such as psychological safety, emotional intelligence, authentic leadership, transparency, two-way communication, and focused empowerment. By involving those impacted by the change in the decision-making process, leaders can tap into innovative ideas and fresh perspectives, leading to more robust and acceptable solutions. Early engagement also helps prevent change fatigue, which arises from ongoing, relentless change without a clear understanding of its purpose or results.
A key element of participatory change is communication within a culture of psychological safety. Clear, honest, and ongoing communication builds trust and understanding. It allows individuals to voice their concerns, ask questions, and contribute ideas. This two-way interaction ensures that the change process is responsive to the needs and aspirations of those involved. When people feel heard and valued, they are more likely to support and drive the change.
True empowerment is key—not just the word “empowerment” used as a buzzword, but actual empowerment that involves providing individuals with the tools, resources, and authority to lead and influence change. Leaders must focus on removing barriers so their teams can succeed. This requires trust, training, opportunities for collaboration, coaching, and mechanisms for feedback. When people are truly empowered, they become active participants in the change process, contributing their skills and enthusiasm to achieve shared business goals.
The RESPECT Model of Change
A practical tool to guide people through change is the Project7 Consultancy RESPECT model:
- R: Realise that your business’s history, built by your people, has brought you to where you are today. Honour that history as you move forward. Take time to conduct a thorough diagnostic before implementing any change.
- E: End point. Clearly articulate your end goal so your people know when they have reached the destination of the change journey.
- S: Survey the road ahead. Work with your people to delineate milestones that track the progress of change and celebrate incremental achievements.
- P: Plan for ongoing change. Be open to adaptation as new data emerges. The path to or even the end point may change for the better as everyone contributes to the journey.
- E: Engage your people from the outset in communication about the ‘why’ of change. Engaged people will lead; disengaged people will become obstacles.
- C: Coach through the change process. Remember, “Coach, don’t tell.” Motivated people will find ways to overcome seemingly impossible obstacles.
- T: Set a timed goal to reach the end point of the change. Both business and individuals need to see an end on the horizon to measure success and avoid change fatigue.
The Pitfalls of Top-Down Change
Far too often, change is imposed from the top down in businesses without conversation or engagement, leaving individuals asking, “Why are we doing this?” and “What was wrong with the old way?” Top-down change often leads to feelings of disenfranchisement and victimhood, where decisions are made by those at the top with little or no input from those affected. This lack of involvement fosters resistance, apathy, and a sense of helplessness among those on the receiving end of change.
One of the primary consequences of top-down change is the erosion of trust. When change is imposed without explanation or consultation, it creates suspicion and fear. People may feel that their needs and opinions are being ignored, leading to resentment and opposition. This lack of trust undermines the effectiveness of the change and damages relationships within the organisation and its leadership.
The Importance of Participation
To transform potential victims of change into participants, it is essential to create an environment that fosters communication and collaboration. This begins with a shift in leadership mindset, from one of control to one of facilitation. Leaders must recognise the value of involving people at all levels in the change process and be willing to relinquish some power and responsibility. This approach not only leads to more effective and sustainable change but also builds a stronger, more resilient business. People who feel like active participants in the change process will be engaged, motivated, and committed to achieving business goals.
Wrapping Up
Change is an inevitable part of business life, but how it is experienced can vary dramatically. Successful change is a function of real empowerment, honest collaboration, open communication, and active participation, all of which foster a sense of ownership and control. In contrast, top-down change can leave people feeling like victims, disconnected from the process and its outcomes. By prioritising participation and inclusivity, leaders can transform change from a source of anxiety and resistance into an opportunity for business growth and innovation. Through effective communication, empowerment, and collaboration, leaders must ensure that people feel like participants in change, not victims of it.
If you are facing a change scenario, are unsure how to prepare for change, or are in an organisation suffering from change fatigue, contact us. We can help you maximise your business change potential.