The Importance of Pharmacy Checklists

Commercial airline travel remains the safest mode of transportation (motorcycles come in last). Despite the intricate task of lifting a heavy aircraft, navigating adverse weather conditions, and landing on modestly sized areas, commercial airplane accidents are such rare occurrences that they grab headlines when they do happen.

The commendable safety track record primarily stems from the advanced technology integrated into aircraft, complemented by the rigorous training undergone by flight crews. Pilots engage in recurrent training sessions and must pass evaluations every six months to be qualified for operating commercial airliners.

Integral to professional flight training is the reliance on checklists, which cover every stage of flight operation. From pre-engine startup to taxiing onto the runway and cruising at high altitudes, checklists ensure systematic adherence to safety protocols, even in the event of cockpit malfunctions.

In private aviation, checklists are indispensable both on the ground and in-flight. Neglecting to utilize a checklist almost inevitably results in a failed flight test for aspiring pilots seeking new ratings.

How About Pharmacy Work?

How does this relate to pharmacy work? Now moving to familiar territory, the reason you don't typically find prescription services at gas stations is the inherent risk associated with dispensing prescription drugs. State regulations mandate a high level of expertise and training before permitting establishments to engage in this practice.

Given the proven efficacy of checklists in averting accidents, the healthcare sector has also embraced their use to enhance safety during surgical procedures and general patient care. Dr. Atul Gawande, a prominent author and surgeon, has been an outspoken advocate for the lifesaving potential of checklists. His book, “The Checklist Manifesto,” is all about the surprising and unsurprising benefits of keeping a checklist.

Checklists prove most effective when tasks involve repetitive actions or are prone to oversight during time-pressured situations. Does this sound like your pharmacy? Although long-term care (LTC) pharmacies boast exceptional safety records, there's always room for enhancement. While not all scenarios are suitable for checklists, exploring processes that leverage this tool could mitigate potential mishaps.

What Exactly is a Checklist?

So, what precisely constitutes a checklist? It's a sequential list of actions necessary for achieving an optimal outcome. Ideally, checklists involve two individuals: one reads out the item, and the other confirms its completion. Picture a surgical team conducting an operation, with one member calling out checklist items and the surgeon or anesthesiologist affirming their completion.

Just like in aviation, checklists in healthcare settings play a crucial role in saving lives.

What Errors Can Be Prevented with Checklists?

Checklists can prevent all sorts of errors in your pharmacy. Medication errors come in many forms, sometimes originating from prescribers, such as prescribing the wrong medication or dosage, overlooking contraindications, or failing to ensure the correct formulation for the administration route. Pharmacy software serves as a valuable resource for minimizing errors and streamlining operations in busy pharmacies.

Fortunately, most LTC pharmacies incorporate measures to detect and rectify errors throughout the prescription fulfillment process. Despite these safeguards, errors can still occur. It’s like a surgeon posing this hypothetical question: would you prefer surgery performed by a skilled surgeon or a highly advanced robot?

The choice seemed obvious until he highlighted the human factors that can influence performance, underscoring the importance of checklists in maintaining attention to detail, especially during moments of fatigue or distraction.

The Limitations of Pharmacy Checklists

However, there are limitations to checklists. Going back to the aviation analogy, a pilot recounted an incident where, despite the copilot confirming the landing gear was down per the checklist, it hadn't been lowered, leading to a near-miss during landing. Checklists are only effective when adhered to diligently.

Do the following to harness the power of checklists in your pharmacy:

  • Identify processes prone to errors.
  • Develop and trial concise, user-friendly checklists.
  • Ensure your team uses checklists consistently post-implementation.

Check out the AmplifyLTC Podcast for more tips and tricks to streamline your long-term care pharmacy operations.

Written by:
Paul Baldwin
,
Baldwin Health Policy Group
Paul Baldwin

Paul’s pharmaceutical industry experience in public and government affairs led to becoming Executive Director of the Long Term Care Pharmacy Alliance, helping lead the industry through the Medicare Modernization Act and creation of the prescription drug benefit. Paul was VP of Public Affairs for Omnicare before founding Baldwin Health Policy Group.

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