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Understanding the dispensary workflow at the Birmingham Free Clinic: a proposed framework for an informatics intervention

Overview of attention for article published in BMC Health Services Research, February 2016
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  • Good Attention Score compared to outputs of the same age (71st percentile)
  • Above-average Attention Score compared to outputs of the same age and source (57th percentile)

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8 X users

Citations

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5 Dimensions

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Title
Understanding the dispensary workflow at the Birmingham Free Clinic: a proposed framework for an informatics intervention
Published in
BMC Health Services Research, February 2016
DOI 10.1186/s12913-016-1308-7
Pubmed ID
Authors

Arielle M. Fisher, Mary I. Herbert, Gerald P. Douglas

Abstract

The Birmingham Free Clinic (BFC) in Pittsburgh, Pennsylvania, USA is a free, walk-in clinic that serves medically uninsured populations through the use of volunteer health care providers and an on-site medication dispensary. The introduction of an electronic medical record (EMR) has improved several aspects of clinic workflow. However, pharmacists' tasks involving medication management and dispensing have become more challenging since EMR implementation due to its inability to support workflows between the medical and pharmaceutical services. To inform the design of a systematic intervention, we conducted a needs assessment study to identify workflow challenges and process inefficiencies in the dispensary. We used contextual inquiry to document the dispensary workflow and facilitate identification of critical aspects of intervention design specific to the user. Pharmacists were observed according to contextual inquiry guidelines. Graphical models were produced to aid data and process visualization. We created a list of themes describing workflow challenges and asked the pharmacists to rank them in order of significance to narrow the scope of intervention design. Three pharmacists were observed at the BFC. Observer notes were documented and analyzed to produce 13 themes outlining the primary challenges pharmacists encounter during dispensation at the BFC. The dispensary workflow is labor intensive, redundant, and inefficient when integrated with the clinical service. Observations identified inefficiencies that may benefit from the introduction of informatics interventions including: medication labeling, insufficient process notification, triple documentation, and inventory control. We propose a system for Prescription Management and General Inventory Control (RxMAGIC). RxMAGIC is a framework designed to mitigate workflow challenges and improve the processes of medication management and inventory control. While RxMAGIC is described in the context of the BFC dispensary, we believe it will be generalizable to pharmacies in other low-resource settings, both domestically and internationally.

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X Demographics

The data shown below were collected from the profiles of 8 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 83 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Spain 1 1%
Unknown 82 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 17 20%
Researcher 10 12%
Student > Ph. D. Student 8 10%
Student > Bachelor 6 7%
Student > Doctoral Student 5 6%
Other 13 16%
Unknown 24 29%
Readers by discipline Count As %
Nursing and Health Professions 16 19%
Medicine and Dentistry 11 13%
Pharmacology, Toxicology and Pharmaceutical Science 5 6%
Psychology 4 5%
Engineering 4 5%
Other 19 23%
Unknown 24 29%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 5. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 February 2017.
All research outputs
#6,113,582
of 22,849,304 outputs
Outputs from BMC Health Services Research
#2,840
of 7,644 outputs
Outputs of similar age
#84,729
of 297,895 outputs
Outputs of similar age from BMC Health Services Research
#38
of 89 outputs
Altmetric has tracked 22,849,304 research outputs across all sources so far. This one has received more attention than most of these and is in the 73rd percentile.
So far Altmetric has tracked 7,644 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 7.7. This one has gotten more attention than average, scoring higher than 62% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 297,895 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 71% of its contemporaries.
We're also able to compare this research output to 89 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 57% of its contemporaries.