Numbers show Walgreens workloads exceed safety threshold

NAPERVILLE—Walgreen Co.’s own numbers show that its pharmacies routinely go beyond the widely accepted safety threshold for numbers of prescriptions filled per hour, according to documents released July 13 by the National Pharmacists Association.

Leading pharmacy researchers have placed the safe average workload at 20 prescriptions filled an hour by pharmacists, documenting that anything beyond that drastically increases the risk for errors.

According to Walgreens’ own numbers from monthly store productivity reports, 58 Walgreens pharmacies in northern Illinois and northwest Indiana, including the pharmacies in Rockford and Loves Park, have exceeded the 20-prescriptions-per-hour-per-pharmacist threshold so far in 2005—nearly one in five pharmacies for which records are available. Another 130 pharmacies are in the gray zone between 15 and 20 prescriptions per pharmacist hour, meaning they likely exceed the safety threshold at peak hours.

“Walgreens is caught in its own web of mistruths,” said Chuck Sauer, executive director of the national Pharmacists Association. “The bottom line is that many pharmacists are too rushed to make sure patients go home with the right prescription. We’re not willing to put up with that level of risk. Walgreens seems to be.

“This is the direct result of Walgreens’ systematic implementation of its assembly-line philosophy, under which pharmacists are made to work at ever-increasing speeds, compromising patient safety.”

The company’s numbers and its own pharmacists contradict the company’s repeated claims that its pharmacies are adequately staffed and that pharmacists are never pushed to go beyond what they considered is safe.

“One night I noticed an error and told everyone working with me to slow the pace down, because we did not want anyone dying under our watch,” said Joan Schwimmer, a Walgreens pharmacist in Northbrook. “The next day, I was reprimanded and told not to do it again.”

Pharmacists at Schwimmer’s pharmacy averaged 24 prescriptions filled per hour in January 2005, Walgreens records show. The busiest Walgreens pharmacy in the region for 2005 is Western Springs, where pharmacists fill an average of nearly 27 prescriptions an hour. The pharmacies in Rockford and Loves Park had averages of 22 and 23, company records show.

The National Association of Boards of Pharmacy is on record stating that “workload conditions… impact the public health and safety,” and leading medical studies at major pharmacy and medical schools, including Auburn and Texas Tech, document that the risk of error rises along with the number of prescriptions filled per hour.

A landmark Auburn University study demonstrated that “the number of errors increases significantly” between 20 and 24 prescriptions filled per hour, and that any hourly average over 23.5 creates a “high risk of making errors.”

“Pharmacists are in the business of making people healthy and keeping them safe,” Sauer said. “We are on record with Walgreens that a workload over 20 per hour creates an unacceptable risk for patients, but have been ignored,” said Sauer. “Even pharmacies that on average don’t break the safety threshold routinely exceed it at peak hours. This problem affects every patient at every Walgreens.”

Some states have set workload standards to help curb prescription errors. Based on available research, North Carolina’s Board of Pharmacy set a 150-prescription-per-shift threshold (or 18.75 for an eight-hour shift). In 1994, the Iowa Board of Pharmacy Examiners set a quota of 14 prescriptions per hour per pharmacist.

“Not only does the pace itself increase the chance for misfilled prescriptions, but it also leaves pharmacists no time to counsel the patient, which is usually when you might catch a mistake,” said Sauer. “We can’t provide the level of personal service that Walgreens has made the cornerstone of its marketing.”

Studies have shown that adequate time to counsel patients can curb the risk of them going home with the wrong drug by as much as 90 percent.

“We hoped Walgreens would start putting patients ahead of profits,” Sauer said. “Instead, their response has been to intimidate our members and try to break this union so that there is no one left to call attention to them jeopardizing patient safety.”

Walgreens pharmacies in this area with workloads more than 20 Rx per hour are: 3325 N. Main, 1603 N. Alpine and 3929 N. Mulford in Rockford; 5900 N. 2nd St. in Loves Park; and 5065 Hononegah in Roscoe.

From the July 27-Aug. 2, 2005

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