Saturday, February 22, 2014

It's Not The Way The Pharmacist Defended A Mistake By Saying "Well, You Know, They Both Begin With H." That Bothers Me The Most About This Story.

...even though that's bad enough. I'm ahead of myself here though, so let me back up a little.

The pharmacist really did say that. Through the magic of the internets, let's go to the entirely appropriately named town of Surprise, Arizona to get the whole story:

Sparling received a call from Walgreens to inform her that she was given the wrong medicine for one of her prescriptions. She was given blood pressure medication instead of the pills to treat her hives. "She goes, 'Well, we probably couldn't read the doctor's handwriting.' Then I said, 'Well, I know that that's not possible because the prescription was printed out,” Sparling recounted. “She kind of paused and said, 'Well, you know, they both begin with H.’"

Did you know that pharmacies used to file old prescriptions in big steel boxes? Seriously. I just bought a boatload of pharmacy antiques to decorate my store and the prescription file boxes that came probably could withstand a nuclear explosion. That's how seriously we used to take the responsibility of being trusted with the chemicals people needed to live. Now we just wrap a slightly thicker piece of paper around a bundle of a hundred prescriptions and throw them in a drawer. Some stores I've seen didn't even do that. And evidently still others feel getting the first letter of a drug name right counts as a good enough effort.

But that's not what bothers me most about this. Don't get me wrong, that was a dumbass thing to say and it bothers me, but not as much as this:

Phil Caruso, Walgreens spokesperson, issued a statement to KPHO that reads, "We're sorry this occurred and we apologized to the patient. We have a multistep prescription filling process with numerous safety checks in each step to reduce the chance of human error.

And I'm supposed to feel better about this now? Let me explain something to you Mr. Walgrrens hack, if you do indeed have a "multistep prescription filling process with numerous safety checks" you now look even STUPIDER. Because, and follow me here, a GOOD process with FUNCTIONAL safety checks would PREVENT someone only concerned about the first letter of a drug's name from getting prescriptions out the door.

Got me? I'll go over that again. The object of a safety check is to make a mistake less likely to happen. So, you see,  when a boneheaded move like this manages to get through your "multistep process"  that's maybe a sign your process sucks. Trying to impress us with the fact you have a process will not work, because the whole thing the process is designed to prevent  JUST HAPPENED.

Or you know what? Maybe it will work. Because people used to expect more from their drug store back in the age of the indestructible prescription file. I'm starting to get a feeling this night...that they probably expected more from corporate spokespeople as well.

15 comments:

Anonymous said...

"We have a multistep filling process" that has replaced those pesky, experienced techs and pharmacists with minimum wage yahoos off of the street.

Anonymous said...

Come on. Hydroxyzine vs. hydralazine is very common. I can't believe that you are ragging on them for a comment reported second-hand. Seriously, the amazing thing is that someone caught it after the drug left the pharmacy without the patient reporting the error. You are better than this.

DrugMonkey, Master of Pharmacy said...

I understand that errors happen in a pharmacy, and yes, hydroxyzine vs. hydralazine is asking for trouble, but to tell the person who just got the wrong med "they both start with an H" is boneheaded, tonedeaf, and unacceptable.

And unfortunately, only mildly surprising in today's chain environment. The fact people like you are enabling them just contributes to the downward slide in standards.

And to brag about your quality control immediately afterwards is even stupider. That is the point of this post. Your reading comprehension... should be better than this.

Anonymous said...

I'm a pharmacist for WAG and the computer alerts you to be careful in filling these two medications. A pop up box says something to the effect that hydralazine is for hypertension and hydroxyzine is for itching/allergies. The process works. It wasn't followed. Counseling would have caught it. Cudos to the pharmacist for owning up to the error and contacting the patient, albeit her response was certainly less than stellar. As for corporate response, did you really expect anything different?

Anonymous said...

There is so much that can be written about Walgreens. The company that I've worked for almost 20 years. It's not the same company now that it used to be. I have become an active anti-Walgreens recruiter: no pharmacist I know would want to work for this awful company after speaking with me. And I've worked here for almost 20 years.

No excusing errors - or the moron who replies "well, they both start with H", or the bigger moron that talks about a "multi-step process". You know who's checking those prescription? A pharmacist who is being bombarded left and right with questions from management, techs, and customers. Have to acknowledge every customer, "Welcome to Walgreens!", between answering doctor calls. Catch an error? Hell, I'm lucky to catch a bathroom break. I'm usually crossing my legs - it definitely makes it hard to think when you've had to pee for 3 hours.

My techs won't ever get paid what they're worth. They won't ever have enough time to get trained. Up in volume? Okay, great! Oh - we're going to cut your budget for next month since you're doing so well...

"Do more with less" has become "do more and more and more with less and less and less". My staffing level is about to reach an all-time low, and there's nobody on the floor we can reach out to for help. Did you know that all front end personnel used to be technicians? Might not mean much, but at least they could ask "did you have any questions for the pharmacist" legally. Now my tech has to do it between ringing the other two customers he or she is ringing up. And answering the phone. And typing. And filling. And fixing the printer.

Free blood pressure checks! Vaccines! MTM's!

And, I kid you not, daily we have 20-30 phone calls to make for late refills, late pick ups, new to therapy... yeah, right. Are you frigging kidding me?

I seriously have never been so disenfranchised with a company and worried about the future of it. I honestly feel they're trying to see just how far they can take it before the cost of the errors exceeds the costs they are cutting with staffing, technology, etc.

How low can Walgreens go? I guess we all have to wait and see...

Lexi said...

A friend of mine just got out of the hospital, brought her prescriptions to CVS...and was given Aricept instead of Abilify. The directions on the script, which was dutifully copied onto the label, said "take daily for depression." my friend is 28. What kind of idiot dispenses Aricept to a 28 year old to treat depression?

His response when she went back? "I'm sorry, we were really busy that day."

*head->wall*

Anonymous said...

Unfortunately all the chains (CVS, Walgreens, Kroger, Walmart, etc) are all doing the same thing - push the pharmacy to do more, more, more with less, less, less.

Anonymous said...

This shows the POWER of Centralization, script typed off-site, reviewed somewhere else off site, in store RPH just checking product against leaflet and hopefully counseling

Anonymous said...

Mail order pharm that my insurance insists on using for my more expensive meds sent me cyclophosphamide instead if cyclosporine. When I called to report the mistake they tried to talk me into taking it anyhow, since 100 of one is as good as 100 of the other! The next person I talked to lied about having talked to my doc to approve the change, apparently the girl that waters the plants when my doc is out of town "agrees that it's probably ok" to take the pills.

Anonymous said...

I did seven years as a tech at WAG before I managed to find my out. Everything you said is resonating so hard inside my skull that it feels like I'm back in the store taking more and more crap from corporate.

Hired in '06, I distinctly remember a far different company culture. The emphasis was customer service. Being good people. Being knowledgeable, helpful. They say it's what differentiated them from the others. And you know what? It worked. Our loyal customer base was large, friendly, and they bought things by the cartloads and got all their friends and family in on it. We had five permanent techs and 3 pharmacists as part of our rotation, and at 1900 scripts a week, we were comfortable and quite profitable in our district.

I don't know what happened in the ensuing 5 years. Before we knew what happened we were down to 2 permanent techs and 1 pharmacist. There were no more than 2 techs scheduled at any time. Gone was the customer service focus, instead forcing us to shove upsellables at any Rx customer regardless of how long that tied things up. I think the biggest surprise was right near the end of my tenure in march or april last year where flu shot quotas were being discussed. No more PMs. I only realized the truth behind what was happening when I started jumping on those like a hobo on a ham sandwich, finally realizing I'd fallen into the corporate soul-sucking vacuum.

I hope you find the change you're looking for in the end. Whether Walgreens gets its act together or you ship out, godspeed.

bcmigal said...

We all have to admit that every chain is the same. No mention of patient care, only the "scores". We all rush to beat the clock and hope and pray that we have not harmed anyone. There but for the grace of God…...

Anonymous said...

I used to work for WAG and as previously said,"it is not the same company." After 26 years, I quit because what I see to be happening in that company. They are turning into a CVS wannabe, or maybe they are already there. There is no way to be a responsible pharmacist with all the "programs" they are involved in. Answer the phones, greet customers, answer the questions about sale items on the floor, fill Rxs, oh yeah, don't forget the guy at the end of the counter waiting for his cholesterol check during the 5PM rush. Soooo happy I'm gone. Oh yeah, forgot about being robbed 3 times in 2 months!

Anonymous said...

On a more important clinical note:
Last week, our CVS District Manager sent out a mass e-mail to pharmacists admonishing that we don't smile enough. Those observed not smiling when engaging customers will be coached and counseled (we ain't talking' therapy here). I am at a distinct disadvantage here as my pharmacy school of 22 years ago did not yet have a Smiling Lab. Perhaps a pertinent live CE class?

Anonymous said...

Only coached and counseled? Favorite word for the DM here is "retrained". Maybe a Learnet course on smiling is next?

Alice said...

Wow I saw someone catch the hydr mistake a few years back and saw the cyclo mistake too, scary!

Smiling: yeah that's the reaction sick people want when they're discussing their misery. Why not grin at the old guy who's asking about the gawdawful side effects of his chemo and smirk at the lady who's describing her hemorrhoids in excruciating detail? I'm sure that'll go over well.

If they're gonna mandate a facial expression they ought to go with Bill Clinton's famous I-feel-your-pain concerned frown. I'm imaging training classes and step-by-step instruction: first you lower your eyebrows.... finish with a slight nod. Think I can sell it?