Return to stock (RTS) is an extremely labor-intensive undertaking where unclaimed prescriptions that have reached a pre-determined number of days in will call are searched, retrieved and returned to inventory.
There are two major methodologies used in RTS workflows. The clerk either uses a list of aged prescriptions generated from the PMS or individually examines all bags for a targeted (or earlier-in-time) date. There are also other variations where bags get sub-filed chronologically so the valid RTS candidates are already grouped together.
The following table examines how the level of ‘saturation’ (i.e. the percentage of bags in will call that have exceeded their ‘pull dates’ compared to the total number of bags in will call. In a manual methodology that examines all bags for their fill dates, the more ‘saturated’ the will call, the more efficient this methodology appears. However, keeping the will call area saturated creates a negative impact by increasing filing times and regular customer search times due to the increased number of total bags cluttering up will call. The amount of impact to these other areas of workflow due to keeping the will call area ‘saturated’ was not studied in this white paper.
The pharmacy studied had a saturation level of 61% in the measured RTS event. This may be higher than the average saturation level for other pharmacies. As a result, we calculated other, lower saturation levels. The ‘20% and 5% of Total RTS candidates’ rows are calculated estimates in order to examine lower saturation levels in the ‘before automation’ pharmacy RTS candidates in will call. This number was calculated assuming that the clerk still had to examine all bags in will call (following the RTS methodology already being used in the ‘before automation’ will call environment).
An automated will call system outperforms a manual system across varying levels of ‘saturation.’ Performing RTS at lower ‘saturation’ levels in the scripClip system provides the greater percentage improvement (78% faster than manual). As mentioned earlier, regardless the level of saturation, the will call automation system eliminates slower filing and customer search times that occur in manual methodologies due to the clutter of bags exceeding their pull dates.
Table 5. Return to Stock (RTS) Performance
|Return to Stock|
|Percentage of RTS bags in Will Call||Will Call Without Automation||Will Call Using scripClip Automation|
|61%||92 min1||59 min2|
|20%3||51 min||19 min|
|5%||43 min||9.5 min|
|RTS Time Measurement Criteria4||Measured from start to completion clock time of RTS task in video||Measured from clicking “Search” to when the Clip is “checked out by pressing scripClip button.|
Note: The ‘before automation’ data collected is limited.
1The pharmacy in this study used a RTS methodology of examining each bag in will call for the RTS trigger date. The total time spent for the RTS was 92 minutes over three RTS sessions (during one work day) to completely examine the will call inventory. The search time for a RTS bag using the ‘examine all bags for an expiration date’ approach produces large search times since every bag in will call gets examined when using this approach. Thus, the more expired bags in will call, the lower the ‘search time’ per bag. This study found 306 bags that qualified, making the search time appear low (approximately 18 sec/bag).
2 After implementing scripClip will call automation for RTS, the pharmacy started to run more frequent RTS searches and stopped spending long dedicated blocks of time for RTS. The time in column 3 represents the individual RTS bag retrieval times multiplied by the number of retrievals obtained via RTS search without automation (column 1). The calculated times of 59, 19 and 9.5 minutes were determined by multiplying the average automated retrieval time of 11.4 seconds by the number of RTS bags in each table row.
3 In the 20% calculation, 100 bags were calculated as valid bags to be removed and 400 remained as active bags. An estimated value of 4 seconds was assigned to be the time required to examine each active (not a RTS candidate) bag. In the video study, the actual time to examine an active bag varied due to the visibility of the Rx date appearing through the hanging bag. In some cases, the bag had to be taken off the hanging rod, and its contents removed in order to view the Rx date.
4 Neither ‘with’ or ‘without automation’ RTS processes included billing reversal times to the pharmacy management system. Also, some of the ‘without will call automation’ bags were emptied as they were taken off the shelf.