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NSPG streamlines the prescription refill process

Over the course of a typical week, Jan LeClerc, R.N., and Marilyn Mayor, R.N., field hundreds of prescription refill requests for the North Shore Physicians Group (NSPG) practice at 331 Highland Avenue in Salem. Requests pour in by phone, fax and email and making sure they all get processed in a timely fashion places a heavy burden on an already busy staff. A similar scenario plays out at each of NSPG’s nine other primary care locations and physician practices across the country.

“Prescription refills are a huge challenge for all primary care practices and without even doing any formal research, we knew it was an area where we could make significant improvements,” says Lindsay Gainer, R.N., M.S.N., Clinical Best Practice Program Manager at NSPG. “It’s a time-consuming process for our staff and an inconvenience for patients. We knew there had to be a better way.”

Gainer, who is facilitating a number of clinical redesign projects at NSPG  to improve work flow and enhance the patient experience, put together a small team to delve deeper into the prescription refill process at NSPG using data collected at the 331 Highland Avenue practice.

“We analyzed one week’s worth of prescription refills at the practice,” explains Gainer. “We also had the nurses doing the refills track the amount of time they allocated for this task and then administered a patient survey.” The scope of the project was limited to refills for non-controlled medications.

What they found was that 46 percent of the total refill volume was for maintenance medications requested by patients who had visited the office within the last six months. “It was clear that we are missing a lot of opportunities to refill prescriptions in real-time when patients are in the office and that we aren’t issuing them sufficient refills of their maintenance medications,” says Gainer. It was also clear that processing refills wasn’t the best use of the nurses’ time.

Based on the outcome of the pilot program at the 331 Highland Avenue practice, Gainer and her team plan to collaborate with providers in the other NSPG offices to streamline therefill process with the goal of reducing refill request volume by 30 percent. Her focus will be on sending patients home with six to 12 months worth of refills on all maintenance medications while they are in the office for a regularly scheduled follow-up visit or physical. She also plans to expand the role of medical assistants in each practice to assist with refills.

“Not only would this new refill process ease the burden on patients, it would also help us to reallocate our clinical staff’s time from administrative to clinical functions,” says Sharon Lucie, Operations Manager at NSPG. “This would help us to better manage the care of our most medically-complex patients, contributing to better care and, ultimately, improving the overall affordability of healthcare.”

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