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Published on Monday, October 30, 2023

APhA and NASPA release seventh PWWR report and learnings

WASHINGTON, DC—Today, the American Pharmacists Association (APhA) and the National Alliance of State Pharmacy Associations (NASPA) released the seventh installment of the Pharmacy Workplace and Well-being Reporting (PWWR) trends and learnings report series.1

Launched in October 2021, PWWR serves as a safe space to submit both positive and negative pharmacy workplace experiences in a confidential and anonymous manner. The goal of PWWR is to tell the stories of those who submit their experiences so that the profession may begin to act on the findings and learnings.

To date, more than 1,800 reports have been submitted to PWWR by pharmacy supervisors to pharmacy support personnel in nearly every state, the District of Columbia, and Puerto Rico.

The learnings from this cycle’s analysis provide a roadmap for pharmacy personnel, employers, and the profession at large to address patient/consumer/coworker harassment concerns and barriers to staff–management communication. In addition, it is important for local pharmacies and national organizations to celebrate and give voice to positive experiences that are often on the backburner to the negative ones.

“While few in numbers, positive experiences continue to tell us that changes in the pharmacy do not have to be large scale to affect pharmacy personnel’s well-being. Experiences such as actions taken to keep patients safe by helping a patient understand their medication and supervisors consulting personnel about potential changes in the pharmacy before they are implemented have greatly contributed to a positive effect on the staff member’s well-being,” said Michael D. Hogue, PharmD, FAPhA, FNAP, FFIP, executive vice president and CEO of APhA.

In this reporting cycle (July through September 2023), 378 reports were received. Positive experiences that were reported ranged from working with a patient to find alternatives to medication that was not available due to shortages, being asked for an opinion about a change in the pharmacy before it was implemented, having a supervisor willing to listen, and using clinical medication treatment knowledge to help medical staff. Unlike in past cycles, those who submitted positive experiences indicated that their experiences would have a temporary effect rather than a long-term effect on their well-being.

While workplace conditions—specifically workload/volume mismatched to hours/staff available—continue to be one of the primary reasons cited in the experience reports submitted to PWWR, verbal harassment from patients/caregivers and pharmacy managers continues to be reported this cycle. Reporters in this cycle identified a number of root causes that triggered the negative experiences. The top three root causes were inadequate staffing, metrics, and workflow design/policies.

There were three primary learnings this quarter:

  • The stories and details in experience reports vary; however, each report further amplifies the observation that frontline pharmacists and technicians lack the autonomy to protect themselves and their patients. The pharmacy professionals reporting are working in failed organizational structures and unsafe cultures. While several reporters noted their resignations, in many of the stories the reporter does not quit and continues to provide patient care as best they can. While care is provided, often under quasi-heroic conditions, the experience stories tell of the emotional and psychological toll inflicted by these environments.
  • The PWWR data are not able to make any conclusions as to the appropriateness of the reporters’ specific recommendations or whether these suggestions were effectively communicated to management. However, the relatively high percentage of reporters that did not know if action would be taken on their recommendation suggests that failed communications are prevalent and present an opportunity for improved trust between management and the frontline workforce.
  • One reporter astutely stated “I didn’t tell others about this [positive experience]. We don't really celebrate wins like we emphasize errors and near-misses.” This comment suggests that comprehensive local and national campaigns to enhance working conditions and well-being should include a component that provides tools and strategies to amplify the positive stories that otherwise go unreported or unappreciated.

“Reading each report brings a sense of trepidation—what will this quarter bring? The percentages and numbers calculated in the report fluctuate, highlighting improvements and declines. Yet, it continues to provide pharmacy staff with a safe outlet and a constructive tool to bring concerns forward. Though positive stories remain low, each is an opportunity to celebrate even the smallest step and to stimulate additional actions toward meaningful change. It is possible to make impactful change, and it is possible to improve well-being. Peeling back layers of a systemic problem requires perseverance, and pharmacy staff continue to display their dedication and professionalism in uncertainty,” said NASPA President Elise M. Barry, MS, CFRE.

PWWR is an ongoing online confidential and anonymous service for pharmacy personnel to report positive and negative experiences across all pharmacy practices. Pharmacists, pharmacy technicians, and student pharmacists are encouraged to submit positive and negative experience reports as often as they would like. In-depth analysis reports with trends and learnings will be periodically issued. A short snapshot of submissions will be issued each month. To submit an experience and read PWWR Reports, visit www.pharmacist.com/pwwr.

The Alliance for Patient Medication Safety, a federally listed patient safety organization, analyzes the reports submitted to PWWR. Reports are protected by the confidentiality and privilege provisions of the Patient Safety and Quality Improvement Act of 2005. Actual submitted experience reports to PWWR cannot be disclosed or subpoenaed and are not subject to discovery in a legal proceeding.

1 PWWR Reports I through VI and monthly snapshot reports can be found at www.pharmacist.com/pwwr.

About APhA

APhA is the only organization advancing the entire pharmacy profession. Our expert staff and strong volunteer leadership, including many experienced pharmacists, allow us to deliver vital leadership to help pharmacists, pharmaceutical scientists, student pharmacists, and pharmacy technicians find success and satisfaction in their work and advocate for changes that benefit them, their patients, and their communities. For more information, please visit www.pharmacist.com.

About NASPA

NASPA, founded in 1927 as the National Council of State Pharmacy Association Executives, is dedicated to enhancing the success of state pharmacy associations in their efforts to advance the profession of pharmacy. NASPA’s membership is comprised of state pharmacy associations and over 70 other stakeholder organizations. NASPA promotes leadership, sharing, learning, and policy exchange among its members and pharmacy leaders nationwide.

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