CVS Readyfill smoothing/Double verification

[owlegrad]

Wow. This is all on your pharmacy manager. Sounds incompetent.

This was one of the many things I hated about working CVS. Maybe retail in general? The idea that if the PIC was just competent enough they could somehow make it work. No, it’s not the PICs fault that CVS sets them up to fail, and if you believe it is you are part of the problem.

If this PIC is as incompetent as you believe why does CVS tolerate them? And why are so many PICs this incompetent since it is such a wide spread problem?



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[Secret_Informant]

I don't blame them though, with this high stress/ non stop/ get **** on by entitled customers/barely get a break/ low pay/ "could give a **** about its employees" company environment, why would someone want to work here?

My answer to this question (without sarcasm or fluff):

Without a job as a pharmacist lined up after graduation, choices become very limited for recent pharmacy school graduates who need work, pharmacists that were terminated (justly or unjustly) from other positions, or left their previous job due to worse working conditions at another job than what CVS would provide them. It is fear like this that make people regret not pursuing a residency or alternative careers early enough or aggressively enough as compared to their peers who already achieved such positions. They feel stuck and the corporate system makes them feel they are stuck.

It is no wonder many "good" pharmacists leave after 10 years. They are fed up with it all and they feel unappreciated and unacknowledged for their efforts.

 

[Sine Cura]

Chains do not care but CVS cares the least, or maybe it is 1a CVS and 1b Walgreens.

I met very few RPH that could verify 500+ a day as the solo RPH in 13 hours before double verification (and even then you cut massive corners when it comes to counseling) so there are even fewer than can do it with double verification

 

[mikejones123]

This was one of the many things I hated about working CVS. Maybe retail in general? The idea that if the PIC was just competent enough they could somehow make it work. No, it’s not the PICs fault that CVS sets them up to fail, and if you believe it is you are part of the problem.

If this PIC is as incompetent as you believe why does CVS tolerate them? And why are so many PICs this incompetent since it is such a wide spread problem?



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Does CVS not staff properly? Absolutely. It’s a horrible company. By no means am I defending the chain. But we are talking about a store with 80 pages in the que. The pharmacy manager should have some foresight and schedule techs overnight so they can knock it down. It’s a matter of 16 hours. I would usually side with the PIC over the chain in the majority of cases. But when you have 80 pages in the que the PIC needs to take initiative and have a plan to knock it down can’t just solely blame the chain on this one.

And why does CVS tolerate incompetent PICs. Because no one wants that ****ty position. That’s why all the experienced pharmacists are staff and the new grads are PICs.

 

[DrVader]

Every morning I open at CVS I have to go in to cvs and work an hour early unpaid to get the QV and QT cleared before the store opens - even volunteering that hour still is barely enough time to keep up with the daily onslaught of prescriptions. Techs and Pharmacists totally stressed out and overworked because never given enough tech hours - then I listen to continual customer complaints because CVS calls them too often. When will things get better?!?!?!

When someone dies, sues and it gets in the news. Only if all three.

 

[Secret_Informant]

For Your Information Only, published by Scott M. Mark, PharmD:

Things I Wish I Had Known Before Becoming a Pharmacy Leader

The hardest thing about being a Pharmacist in Charge (PIC) and being PICked for the job (whether you volunteer for it or not) is this: your success depends on your employee's contributions. That is not an easy thing to stomach, especially when first starting into the position.

Personally, I would never volunteer or volunteer myself to be a PIC, even as a new graduate. The salary increase is only $20K-$25K more than the average pharmacist for a huge difficulty-spike and possible disciplinary action if something is missed. It is not worth the aggravation right out of school.

To be a PIC, you need to be a pharmacist first. Some companies require you to be a pharmacist first so you are not thrust in without knowledge of pharmacy operations.

 

[maria1oh]

Im laughing when I read the suggestions about scheduling a tech to work overnight. It will be difficult to find a tech to work overnight. One time the cvs sup encouraged us to have full time overnight tech but we couldnt find anyone willing to do it. maybe with the holiday it will slow down and the 80 pages will go away. Rite aid switched to two step verify a couple years ago and it was bad at first now back to normal. Soon they will introduce shared qa and central fill. The readyfills will get qv1 by local rph but central fill will do the qv2 and mail the scripts.

 

[mikejones123]

Im laughing when I read the suggestions about scheduling a tech to work overnight. It will be difficult to find a tech to work overnight. One time the cvs sup encouraged us to have full time overnight tech but we couldnt find anyone willing to do it. maybe with the holiday it will slow down and the 80 pages will go away. Rite aid switched to two step verify a couple years ago and it was bad at first now back to normal. Soon they will introduce shared qa and central fill. The readyfills will get qv1 by local rph but central fill will do the qv2 and mail the scripts.

I work as a overnight pharmacist and have techs work overnight every week to put up truck/catch up. Not every night but when needed. I think most will welcome an overnight shift so they could escape the misery of the day. You just have to ask

 

[ericn2k3]

We are now over 80 pages of QP.

80.

WTF, corporate?

I feel terrible for your store situation. Now I don't feel as bad when I walk into my store everyday. When I think I've encountered the worst, either here or FB bring me down to earth. It's always worst elsewhere. The DL needs to take control here and send in help. All you/Pic needs to do is ask for help.

 

[WVUPharm2007]

I feel terrible for your store situation. Now I don't feel as bad when I walk into my store everyday. When I think I've encountered the worst, either here or FB bring me down to earth. It's always worst elsewhere. The DL needs to take control here and send in help. All you/Pic needs to do is ask for help.

The DL puts out an email telling everyone we need help and nobody responds. Nobody wants to go to the store that's at 91 pages of QP (when I left). It will likely go over 100 tonight.

 

[WVUPharm2007]

Wow. This is all on your pharmacy manager. Sounds incompetent. They should give you a couple techs overnight to catch up. It’s not the end of the world if you go over 10-16 hours. Especially in an extreme case like this

He's very competent. It isn't his fault, I'm telling you right now.

 

[maria1oh]

Is it still 15 scripts per page at cvs? So 91 pages woud be over 1,300 scripts to do?

 

[WVUPharm2007]

Is it still 15 scripts per page at cvs? So 91 pages woud be over 1,300 scripts to do?

Yes.

 

[puregoldenboy]

The DL puts out an email telling everyone we need help and nobody responds. Nobody wants to go to the store that's at 91 pages of QP (when I left). It will likely go over 100 tonight.

My old lead tech got called into a 24 hour store that had 60 pages of QP when she came in. We estimated she ended up doing the 60 pages plus maybe 5-10 pages more dropping during the day so roughly 1000 scripts with a scriptpro plus someone pulling for her constantly. Anyways hope they aren't wasting your guys time changing red times like my one of my old PIC used to make me do on weekly basis. 100 reds every Friday night.

 

[WVUPharm2007]

My old lead tech got called into a 24 hour store that had 60 pages of QP when she came in. We estimated she ended up doing the 60 pages plus maybe 5-10 pages more dropping during the day so roughly 1000 scripts with a scriptpro plus someone pulling for her constantly. Anyways hope they aren't wasting your guys time changing red times like my one of my old PIC used to make me do on weekly basis. 100 reds every Friday night.

If there was a scriptpro at my disposal, this would be much easier to pull off.

 

[browneyes021]

If there was a scriptpro at my disposal, this would be much easier to pull off.

You don't have a scriptpro?

 

[WVUPharm2007]

You don't have a scriptpro?

Negative. This store was doing less than 2000/week like 4-5 years ago. They didn't expect it to grow like it has. Do they even put new ScriptPros in stores anymore?

 

[WVUPharm2007]

Increased hours kicked in this week. Already down to 66 pages. Light at the end of the tunnel...maybe.

 

[owlegrad]

Increased hours kicked in this week. Already down to 66 pages. Light at the end of the tunnel...maybe.

Lol I bet you never thought you would say “already down to 66 pages”.


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[puregoldenboy]

Increased hours kicked in this week. Already down to 66 pages. Light at the end of the tunnel...maybe.

How much of it is red?

 

[meltyblend]

The only night shift I have ever done was a favor to a rxsup I liked. I thought it was the chillest gig in the world. Only a few phone calls here and there (probably less than 5), drive thru was closed from midnight to 8am, a script pro, maybe 2 narcs, and only 3 customers walked in that night. I actually thought it was amazing. Now that I'm reading all these horror stories, I'm starting to think that store is an outliers or I was really lucky that night.

I feel like absolutely dog **** for leaving behind 80+ red tonight. Ever since 2 step verification started the work load has become impossible. Every time we leave with a clean slate, a floater or my, slow as molasses, staff leaves a mess that requires 2+ days to clean up. Then the cycle repeats itself. This is why the store near me (not 24 hours) has 34 pages in QP. There's no point in catching up just to fall behind again.

 

[WVUPharm2007]

How much of it is red?

Not sure. It was about 80 of red when I left Monday AM.

 

[WVUPharm2007]

The only night shift I have ever done was a favor to a rxsup I liked. I thought it was the chillest gig in the world. Only a few phone calls here and there (probably less than 5), drive thru was closed from midnight to 8am, a script pro, maybe 2 narcs, and only 3 customers walked in that night. I actually thought it was amazing. Now that I'm reading all these horror stories, I'm starting to think that store is an outliers or I was really lucky that night.

Before 2016, it WAS the greatest job on Earth. Then they closed half of them in 2016. Then Walgreens closed most of their 24 hr stores last May. So now stores are getting between double and quadruple the old night time business due to late night urgent cares and EDs. So now it's a chaotic mess until 1AM most nights. Weekend nights when all of the other pharmacies close at 5 or 6PM are complete hellscapes. Most Saturday nights, my store does between 30-40 RXs between 8PM-10PM. And mySchedule allotts us 1 RPH and 1 tech. And typically, the patients are pre-grumpified people that have had to wait for hours at an urgent care. They flip out like you've never seen when we honestly have to tell them that it will be an hour wait.

For me, there are 3 EDs that my store is the closest 24Hr pharmacy to. And, what, maybe a dozen urgent care facilities that are open until 10-11PM...maybe more? It's completely nuts.

And they absolutely DO NOT let me close the drive thru. God, if they let me do that, it could be much more streamlines chaos.

 

[puregoldenboy]

Before 2016, it WAS the greatest job on Earth. Then they closed half of them in 2016. Then Walgreens closed most of their 24 hr stores last May. So now stores are getting between double and quadruple the old night time business due to late night urgent cares and EDs. So now it's a chaotic mess until 1AM most nights. Weekend nights when all of the other pharmacies close at 5 or 6PM are complete hellscapes. Most Saturday nights, my store does between 30-40 RXs between 8PM-10PM. And mySchedule allotts us 1 RPH and 1 tech. And typically, the patients are pre-grumpified people that have had to wait for hours at an urgent care. They flip out like you've never seen when we honestly have to tell them that it will be an hour wait.

For me, there are 3 EDs that my store is the closest 24Hr pharmacy to. And, what, maybe a dozen urgent care facilities that are open until 10-11PM...maybe more? It's completely nuts.

And they absolutely DO NOT let me close the drive thru. God, if they let me do that, it could be much more streamlines chaos.

I hear ya. I had to babysit a 24 hour CVS for 4 months last year. 4500-5000 scripts, 2 drive thru lanes, across the street from a major hospital. At least we had a script pro but no one ever filled it so it's always interrupting workflow. My lead technician only did drop off and pickup if you asked her to help, otherwise she'd sloth her way through the QT. It was so busy the store would buy 4 ounce ibuprofen boxes through Mckesson from Sunmark because every script from the children's hospital ED was 4oz ibuprofen, 30 mls zofran, 4oz APAP, and some abx suspension. Closing drive through overnight would probably help a bunch but again I don't see corporate allowing that. If only we could convince these guys to Escript everything.

 

[meltyblend]

Ah yes, my little stint was around 2016. I was probably only licensed for a few months at the point. Didn't really know what doing overnight entailed. I was surprised the store closes its drive thru at night. It didn't even register to me as a possibility. In fact, it was a passing remark the evening pharmacist and tech shared with me as they were walking out of the store. That's pretty much the only info they gave me besides how the script pro worked. I spent the night wondering how to fills controls and prayed no one came in for narcs since they didn't bother leaving me with the safe codes and I couldn't reach anyone until 6am.

With 2 step, the process of filling scripts takes almost double the time. Can't mass print QP to pull all at once until you finish QT and QV1. I've noticed that rebills don't always require QV1 anymore. But changing the NDC sure does...

 

[grumpyRph]

this thread has been so fascinating honestly reading as a wal/greenz rph. lol. i mean from what i gather "two step" means it's the same as how WAG has been doing it for a while..? type, data review, fill, product review. and at product review it's just product, no need to look at data again. i did a cvs rotation and hated that it WASN'T like Wag. do i have this wrong? it's such a better and more efficient system though.

 

[ldiot]

In regard to the smoothing crap...

You are still filling the same number of scripts per day. The workload is totally unchanged. If the workload is unchanged, there's no benefit. If there's no benefit, then the update is ****

IF they want to drop stuff in 4 days early instead of 3, why don't they just drop it all in 4 days early and make it due in 48 hours? Once the que is eventually cleared the pharmacy would be a day ahead and have that as a buffer

 

[RxPreceptor]

I swear to God, even when I do clear queue to create said buffer, the **** always hits the fan...(daytime people feel compelled to work less efficiently? Start working on QI, then get destroyed by QT, data entry bottle necks because RPh is taking care of all the insurance updates & customer issues because none of the technicians have adequate training, etc.). True story, cleared queue Monday morning, back to 13 pages QP @ 4am the next day = typical...(><).

If anything, this new update makes the system more prone to bottlenecking work flow in multiple queues now (easier to fall behind metrics despite best effort...not very encouraging). More queues to cover with more button mashing, same to fewer human work hours = more playing musical chairs

Can't wait until this "genius" numeric waiting bin idea...added fun in taking 3X as long to simply find a prescription to ring up. Not to mention taking 3X as long just to sort an Rx . Apparently someone thought this was a good idea because the alphabetic system is too complicated apparently & no one simply wants to acknowledge that most high volume stores could really use remodeling for more room. Numeric waiting bin idea = derived from King George III

 

[Dr Wario]

I think that numeric waiting bin could be good in a few ways. Firstly, that space could be used more efficiently, think of all the times when one bin is almost empty yet others are stuffed over the brim. Another thing is hopefully there will be fewer things misplaced (this is sadly a fairly common issue) since numbers have less look-alike problems vs letters. With all of that said, we all know how well CVS actually executes programs like this and a waiting for a real clusterF when the algorithm cannot judge large bags, and massive amounts of bugs.

 

[Sine Cura]

WM uses the Monaco bags. You can pull all the RTS faster and find Rx faster.

The downside is that each bag has a bar code corresponding to its number so that non-pharmacists can complete "bagging" (finalizing order completion after printing the paperwork) with a mandatory accuracy scan to finish an order.

 

[meltyblend]

So my DL paid a visit yesterday and mentioned that central verification is in the horizon for CVS. She said some areas are already piloting the change and should go live in our district it by next quarter. Basically, high/higher volume stores will be eligible for central verification where slower stores (mainly targets) will do data review for higher volume stores in their area during their down time. Essentially, QV1 will be in a pool and dispersed amongst the stores unless something gets rejected. If a rejection does occur, the store that has the script will have to data review it themselves so QT needs to be strong.

 

[dblock05]

How much help will the slower stores really provide though? CVS is very good at just giving you enough help to get what you need done. Will be interesting to see.

 

[Ra1nMak3r]

Basically, high/higher volume stores will be eligible for central verification where slower stores (mainly targets) will do data review for higher volume stores in their area during their down time.

The target stores in my area got their tech hours cut. I’m not sure if they are going to have much impact outside from their store duties

 

[meltyblend]

Not sure how it'll work but I sure hope it works. I don't want to walk into 17 pages in QV1 with half of them red anymore. The Target store near me opened less than a month ago so I'm hoping my store can offload to them. If not, people should start going to them (literally less than a 10 minute drive from my store) because I'm tired of doing 700+ a day.

 

[maria1oh]

It will be tough at first getting low volume stores to check for high volume stores. The target rph will reject for little reasons like missing "by mouth" on sig and not liking the interactions between flexeril and ssri. Also unlikely to work for controls (flexeril is now on state monitoring program). Also if target rph is swamped or lazy they will just reject everything to get it out of their queue. I have never heard of cvs punishing rph for rejecting too much.

 

[ericn2k3]

You can reject and have the option to edit it yourself. Grammar rejects are an easy fix. If it goes live, would that pharmacist make the MD call for DDIs, etc..

 

[WVUPharm2007]

QP is clear and we are out of the red. Yay, my store. Was 60 pages when I came in on Monday. The extra tech hours myschedule finally allotted us and the other overnight coming in for 20 hours over two nights is all it took.

 

[WVUPharm2007]

With the increase in hours, we are keeping up day after day.

It really was just myschedule's crap algorithm's fault.

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As far as two-step goes. I don't mind it as much as I thought I would, but only because I'm by myself. If gives you more control over everything.

If I was day shift, I'd probably hate it. I can't imagine how frustrating it must be. The problem is that there is only 1 RPH and way too many things have to go through them before the next step can occur. DE has to be done before any production. So if the RPH has to give a flu shot, pick up the phone, etc...it completely bottlenecks the process. It's to the point where the pharmacist has to be "protected" from the general public as much as possible because when they aren't on QV, nothing can get done.

 

[txpharmguy]

With the increase in hours, we are keeping up day after day.

It really was just myschedule's crap algorithm's fault.

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As far as two-step goes. I don't mind it as much as I thought I would, but only because I'm by myself. If gives you more control over everything.

If I was day shift, I'd probably hate it. I can't imagine how frustrating it must be. The problem is that there is only 1 RPH and way too many things have to go through them before the next step can occur. DE has to be done before any production. So if the RPH has to give a flu shot, pick up the phone, etc...it completely bottlenecks the process. It's to the point where the pharmacist has to be "protected" from the general public as much as possible because when they aren't on QV, nothing can get done.

I've been with WAG for 15 years and we started doing 2 step verification in 2005. At first it was a bit of culture shock from the old way of verifying prescriptions. However, I couldn't imagine not having it now. Our Phlomometer (little metric tool at the top typically) will tell us how many data reviews we have in the next 2 hours and if there are any waiters. Before I counsel, do immunizations, etc, I make sure that enough prescriptions are data reviewed so that the techs can fill so that when I get back, I just have to do a quick product review. Honestly, a pharmacist isn't necessary to compare pills vs images. This will eventually be a tech check tech task if the big boys have their way. (Obviously, controls should still be checked by the pharmacist). One other thing, after data review, DUR occurs so doing product review should be simple

 

[nextyearrx]

So my DL paid a visit yesterday and mentioned that central verification is in the horizon for CVS. She said some areas are already piloting the change and should go live in our district it by next quarter. Basically, high/higher volume stores will be eligible for central verification where slower stores (mainly targets) will do data review for higher volume stores in their area during their down time. Essentially, QV1 will be in a pool and dispersed amongst the stores unless something gets rejected. If a rejection does occur, the store that has the script will have to data review it themselves so QT needs to be strong.

Can’t wait to see this happen!!!

 

[WVUPharm2007]

In other words, expect to see fewer tech hours...and RPh hours...?

 

[lane one]

Can’t wait to see this happen!!!

As someone mentioned above, this sounds like a great idea in theory but I'm pretty sure the Target stores are running with 0-1 tech daily. CVS has probably leaned them out as much as they can. I know that wasn't the case initially, but at this point they're probably operating like all the low volume corner stores.

 

[meltyblend]

As someone mentioned above, this sounds like a great idea in theory but I'm pretty sure the Target stores are running with 0-1 tech daily. CVS has probably leaned them out as much as they can. I know that wasn't the case initially, but at this point they're probably operating like all the low volume corner stores.

Which really makes you wonder why they keep opening more. There's really no reason for new Target stores to have a pharmacy inside but the one near me that opened in December has one.

 

[APN-59 rph]

Which really makes you wonder why they keep opening more. There's really no reason for new Target stores to have a pharmacy inside but the one near me that opened in December has one.

Future video links? They are getting to be a thing. Some BOP's are running tests.

 

[Sine Cura]

Something something taking advantage of zoning laws something

 

[puregoldenboy]

With the increase in hours, we are keeping up day after day.

It really was just myschedule's crap algorithm's fault.

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As far as two-step goes. I don't mind it as much as I thought I would, but only because I'm by myself. If gives you more control over everything.

If I was day shift, I'd probably hate it. I can't imagine how frustrating it must be. The problem is that there is only 1 RPH and way too many things have to go through them before the next step can occur. DE has to be done before any production. So if the RPH has to give a flu shot, pick up the phone, etc...it completely bottlenecks the process. It's to the point where the pharmacist has to be "protected" from the general public as much as possible because when they aren't on QV, nothing can get done.

It's not that hard to train yourself to verify a waiter out of QV1 before walking out the pharmacy to give someone a flu shot. It's all about your ability to use the QV1 filters and N key to manage and navigate through QV1 efficiently. Personally I like swapping between screens after scanning my credential and that couple seconds it takes the computer to think and load the next script. Saves time and I get through stuff pretty quick. (Verify script/DUR -> Scan credentials -> alt+2 -> verify script/DUR -> scan credentials alt+1) Rinse and repeat.

 

[lane one]

Which really makes you wonder why they keep opening more. There's really no reason for new Target stores to have a pharmacy inside but the one near me that opened in December has one.

Possibly terms of the buyout deal. It's definitely a benefit for Target to have the pharmacy inside and collecting rent from CVS.

 

[nextyearrx]

Is that true that CVS will start delivering rxs to patient's home like independent pharmacies do?

 

[ericn2k3]

Is that true that CVS will start delivering rxs to patient's home like independent pharmacies do?

This is already live..at least in the big cities.

 

[maria1oh]

Cvs charges a fee to mail you the scripts but several independents do it for free. Also cvs will not send out control substances, refrigeration meds, or certain insurance plans (medicare part b is one).