Pharmacists may initially be daunted by the prospect of developing standard operating procedures (SOPs) but the experience of pharmacists in Wales reveals that the process need not be difficult.
The SWEEP programme developed by the Welsh Centre for Postgraduate Education offers guidance on writing and implementing SOPs. SWEEP is an acronym that summarises the aims of the programme:
S Standard setting made simple and effective
W With the aid of
E Education for both pharmacists and support staff
E Exemplars to give you an insight of what you can do
P Procedure writing which ensures that things are done the way you want by whom you want and when you want
SWEEP is used in pharmacies by both pharmacists and pharmacy staff. This staff input creats a better working relationship, according to Sheila Phillips, senior research associate, WCPPE. The programme uses a combination of written and on-screen resources to provide information and exercises. A training guide forms the written information source and a procedures manual is used to record actions taken. The on-screen part of the package consists of three CD-roms which refer people to the training manual when additional exercises or actions need to be taken. The package begins by covering the component parts of a generic procedure, including the objectives and scope of the procedure, how the task is to be carried out, who is responsible for doing it and how it will be reviewed.
SWEEP was important because it tackled clinical governance by addressing areas such as risk management and continuing professional development, Mrs Phillips said.
Feedback from pharmacists who had used SWEEP had been positive. They commented that it made them continuously think “is this the best way I can do this?”, she said. It also allowed effective delegation of jobs. When writing a SOP, it was best not to name individuals for responsibilites but rather to delegate them to a person with a specified level of competence, otherwise confusion could result if a staff member was absent. Other feedback had included comments such as “it helped me to manage time better”, “it encouraged me to be more organised” and “patients benefited from a better service”.
SWEEP provided benefits for pharmacists working in multiple pharmacies where SOPs were supplied by the chain’s head office. It helped pharmacists to understand the benefits of the SOPs supplied by head office and also allowed them to think of ways to tailor the SOP at an individual branch level, she added.
John Fletcher, pharmacist at JG Fletcher in Mid Glamorgan, said that his experience of SWEEP had been excellent. “I cannot praise it highly enough,” he said. The programme was easy to use and it had had a positive response from pharmacy staff. Mr Fletcher, and his staff, have used the programme to produce four SOPs, with another currently in development.
He recommended SWEEP to other pharmacists, particularly because of the fact that clinical governance was an area in which all pharmacists would have to participate and the programme provided a way to “take action now”. It had improved his pharmacy business in terms of both professional awareness and staff involvement and was also of financial benefit.
The programme provided suggestions which each pharmacy was able to individualise and include in its own SOP. It also gave examples to enable users to learn how to write a SOP. The four SOPs Mr Fletcher has produced cover emergency hormonal contraception (EHC), prescription reception, storage of prescriptions and counter sales (see panel). The programme was “straightforward to use”, he added.
Mr Fletcher recommended that each SOP should have specific aims and objectives. “It is no use producing 20-page procedures because no-one will read them,” he said. Instead, concise procedures that were a couple of pages long and tackled a bite-sized portion of the business were most effective.
Writing SOPs did not take a long time in terms of putting it on paper, he said, but did take longer to collect ideas. On average, it had taken Mr Fletcher’s pharmacy a week of discussions to plan each SOP.
Mr Fletcher said that he had encountered no problems with the programme. The only potential problem he could suggest was with computer access. The fact that he had been able to set up the programme on a laptop computer in the pharmacy so that it could be accessed at any point during the day had been useful to him and the pharmacy staff, but not everyone had the facility to do this. He added that the programme had been designed so that it could be started and stopped, and rewound if necessary, which was useful because it was difficult to dedicate a specific amount of time on it at once, because of the constraints of running a pharmacy business.
Phil Parry, pharmacist at The Pharmacy, Crymych, Dyfed, was one of 12 pharmacists involved in the pilot of SWEEP. All 12 had found that implementation of SOPs had benefits not only in the processes involved in the SOP but also increased efficiency in the business in general, he said.
Mr Parry had set up a SOP to deal with information flow in the pharmacy. A part of this had been to file information in folders corresponding to each chapter of the British National Formulary so that information was quickly retrievable.
Implementation of SOPs, and using the SWEEP package as a means to do this, was important, he said. It provided an opportunity to delegate responsibilities to staff and to develop the skills of staff. This enabled pharmacists to devote more time to areas such as medicines management, rather than devoting large amounts of time to mechanical processes, without compromising safety and ensuring that a high quality service was still delivered. Another long-term benefit of SOPs was a greater degree of continuity of pharmacy procedures. They were also useful for locum pharmacists. Mr Parry concluded that involvement in setting up SOPs was “key to the future of the profession”.
The SWEEP programme is available from the WCPPE free of charge for pharmacists in Wales and can be purchased by other UK pharmacists.
An example EHC
The aims of John Fletcher’s SOP for supply of EHC are:
- To enable rapid access to EHC
- To decide if EHC is necessary and safe
- To give professional advice
- To confirm that all legal requirements and protocols are followed
The scope of the SOP was the supply of EHC on request, and the responsibility fell with the pharmacist.
The process laid out a step-by-step procedure to be used following an initial request for EHC. In all cases, the client was referred to the pharmacist who would then interview the client in a consulting room. The SOP covered information the pharmacist had to obtain, such as, whether EHC was needed, whether supply could safely be made or if referral was necessary.
A pre-formulated questionnaire was used which covered areas such as the client’s menstruation history, criteria for supplying EHC or referral and counselling.