Performance metrics have caused a lot of drama in the pharmacy industry over the last decade. Pharmacists, particularly those who work at major retailers like Walgreens, CVS, and Rite Aid, are often evaluated on things such as how many prescriptions they dispense in a day and how many vaccinations they give each week. Some pharmacists have expressed concerns that the number of metrics they’re required to meet is contributing to burnout and a rise in medication errors.
In a major shift, Walgreens, the second-largest pharmacy chain in the US, said on Oct. 26 that it would eliminate task-based metrics in performance reviews for pharmacy staff members, effective immediately.
“Moving forward, pharmacy teams will be evaluated based solely on the behaviors that best support patient care and enhance the patient experience,” according to the company.
Walgreens said it made the decision “in response to feedback from our pharmacy team members.”
Erin Loverher, a Walgreens spokesperson, told Healthcare Brew via email that pharmacists will “continue to have visibility into” clinical and patient outcome metrics, but they won’t be “measured against any metrics as part of their annual performance reviews.”
Walgreens declined to say how the change would affect pharmacists’s daily workflow. It also declined to make any pharmacy staff available for an interview.
Unsustainable workloads?
The industry’s largest trade group, the American Pharmacists Association, has argued that the metrics pharmacists are required to keep up with are “unrealistic,” and pharmacists are burning out. And when pharmacists burn out, patient safety is at risk. Patients could be given the wrong medication, or a pharmacist may not catch that the two drugs they’re giving a patient might interact poorly.
A CVS pharmacy tech told NBC News in 2021 that they felt a “fatal error” was inevitable given their workload. The New York Times published a feature in early 2020 detailing several instances of serious dispensing errors—one reportedly fatal—made at popular retail pharmacies, including Walgreens and CVS, which some pharmacists said were a result of understaffing and unreasonable workloads.
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The trade group the National Association of Chain Drug stores told the New York Times that “pharmacies consider even one prescription error to be one too many” and “seek continuous improvement.” It also told the Times it was wrong to assume that errors have “direct cause-and-effect relationships” to pharmacists’ workload.
In 2019, 71% of full-time pharmacists said their workload was “high” or “excessively high,” in a study commissioned by the Pharmacy Workforce Center. The highest proportion (91%) of pharmacists who rated their workload as “high” or “excessively high” were those working full-time in chain pharmacies.
California Gov. Gavin Newsom signed a law in 2021 to prohibit pharmacies with 75 or more locations in the state from “establishing performance quotas related to the duties for which a pharmacist or pharmacy technician license is required.” The California Pharmacists Association, which cosponsored the bill, said such quotas are “intended to increase corporate profit margins on the backs of pharmacists and pharmacy technicians.”
Walgreens facing a staffing shortage
Walgreens’ metrics policy change might be related to the ongoing national pharmacy staff shortage that’s been hurting its prescription sales growth in 2022. Walgreens CEO Rosalind Brewer said on the company’s latest earnings call that it was working to return thousands of stores operating with reduced hours to “normal operating hours.”
In response, the company has been making several changes to try to attract more pharmacists. Besides getting rid of task-based metrics in performance reviews, it’s also opened robot-powered micro-fulfillment centers that will take some of the routine tasks, like filling prescriptions, out of the pharmacy.
“We’ve continued to make investments to elevate the role of our pharmacists and to foster an environment that enables them to best care for our patients and customers,” Holly May, Walgreens’s global chief human resources officer, said in a company press release.