Impact of a performance management system in a South African retail pharmacy on the provision of pharmaceutical care to patients

Abstract

Background: An investigation was undertaken to determine whether pharmacists at one independently owned retail pharmacy were compliant with Good Pharmacy Practice (GPP) standards for the provision of pharmaceutical care to patients. It was hypothesised that the pharmacy's performance management system (PMS) undermines compliance with these standards, and thus the provision of pharmaceutical care. Method: A triangulation approach was used. The quantitative research method involved 200 patients who completed a questionnaire. The qualitative research method involved conducting individual, semi-structured interviews with all four dispensary employees. Results: At least 50% of patients perceived that only two out of 10 pharmaceutical care services were always provided. All pharmacists agreed that the provision of pharmaceutical care was a key performance area, and there were several commendable aspects of the PMS. However, nine key weaknesses in the PMS were identified. These included inadequacies relating to the pharmacy's vision and mission statement; poor awareness of GPP standards; the absence of fundamental documentation, such as job descriptions, and performance appraisals; confusion regarding performance objectives; inadequate training and development; and misunderstandings regarding remuneration. Prominent findings are that time pressures contributed to difficulties in providing pharmaceutical care, and that a key performance target was to serve customers as quickly and efficiently as possible. Conclusion: These weaknesses in the PMS may have undermined compliance with GPP standards. Non-compliance increased the potential for patient harm, and posed operational risks that could have undermined the business's financial performance.