Sometimes success comes with a price. For Colorado's Westminster pharmacy manager Steve Bohn and supervisor Rodney Shull that sacrifice came in the form of their hair—all of it.

As a way to motivate the pharmacists and technicians to improve the department's historically lagging patient satisfaction scores—they'd never been higher that the low to mid-80s—and lengthy wait times, Bohn and Shull threw down a challenge: If the pharmacy reached 95% patient satisfaction they would shave their heads—completely.

The two supervisors made good on their word in early February, when the numbers showed the department had reached its goal. "I didn't think they would actually do it," Bohn joked.

What drives patient satisfaction?

With the highest patient volume in the Colorado region, the Westminster outpatient pharmacy serves nearly 800 members daily, filling 1,500 to 1,800 prescriptions in a day. Patient satisfaction is driven by four main factors—wait times, courtesy, consultation with a pharmacist, and whether or not the prescription is ready when the patient arrives.

"In years past, waits could be anywhere from a half-hour to 50 minutes, depending on the time of day," said technician Annette Mascarenas, SEIU Local 105, the pharmacy's unit-based team (UBT) sponsor and a member of the regional pharmacy unit-based team.

In the first quarter of 2008, the team was at 83% patient satisfaction, a number it has had a hard time surpassing. By the third quarter, it had hit 93%, and then stretched that satisfaction to 95% by the end of 2008.

Wait times cut by almost half

Much of the increased satisfaction, the team members say, is due to reducing the time members have to wait for prescriptions. Wait times went from 23 minutes in the first quarter of 2008 to 12 minutes by the end of 2008.

"We've had some great comments from patients," said pharmacist Heather Caryofilles, UFCW Local 7 co-lead for the UBT. "They walk in and a lot of time they're ready for a long line. I think we've shocked a lot of patients, because they're used to waiting 30 to 40 minutes for a prescription."

Westminster's unit-based team attributes its success to several key changes instituted by the team, including the creation of a "greeter" role for peak busy times. To minimize long lines, the greeter approaches arriving patients to get the prescription information and relays that information to the pharmacy techs to get the process started. The member is then free to sit down or wander around the pharmacy instead of standing in line.
"Standing in a long line can be so demoralizing," Mascarenas said.

Other crucial changes included:

• Additional computers and work stations for clerks to process more members
• Addition of four FTEs (full-time equivalents)
• Reworking the schedule for clerks and techs to better reflect the pharmacy's busy times
• Creation of the "High Team"—techs and pharmacists who process high priority prescriptions, ensuring they are filled and ready when a patient arrives at the pharmacy

Bohn, the now-bald department manager, is certain that having steadfast support and commitment from superiors was crucial, particularly when it came to securing funds for the additional computers and workers. It allowed him to give his team the tools they needed to do their work, he said.

That support has not only improved patient satisfaction—it has also transformed Westminster pharmacy into a place where both pharmacists and technicians enjoy working.

Work satisfaction up

Despite initial resistance from staff with some of the changes, Local 105 labor co-lead and pharmacy technician Chrissy Pena said one small change, which returned more of the prescription processing duties to technicians, dramatically increased their work satisfaction.

"A lot of people don't like change. When we told them we're going to have a greeter shift, they were like, 'What?!' We were all used to doing certain things during the day," Pena said. "But adding more jobs to the tech role has really made morale go up, especially now that we do more inputting…It helps because it can be repetitive work."

That tangible increase in morale is seen in pharmacists as well.

"People really like to work here now," Caryofilles said. "It's more organized. You never have to guess what you need to do…I remember when we would work and every single day the line would be out the door. It was just expected. Now, it's really nice to know we're filling things quickly. We're not used to exceeding people's expectations. The mindset of everyone has improved because we know we're not making everyone mad all the time."