An evaluation of the Hines Consolidated Mail Outpatient Pharmacy

Weaver FM, Hynes D, Kubal J, Ippolito D, Kerr M. An evaluation of the Hines Consolidated Mail Outpatient Pharmacy. Paper presented at: American Evaluation Association Annual Conference; 1998 Nov 1; Chicago, IL.

The Department of Veterans Affairs is in the process of streamlining workload in its pharmacies by shifting outpatient prescription refills and mail work from local VA medical centers (VAMCs) to centralized locations called Consolidated Mail Outpatient Pharmacies (CMOPs). The purpose of this evaluation is to assess the impact of using a CMOP on local VAMC pharmacy costs, quality, and satisfaction with care. Questionnaire data have shown that there are, indeed, some benefits derived from employing a CMOP for outpatient prescription distribution. Patients = use of outpatient window prescription pick-up decreased (82% to 74%; p < .001). Patient satisfaction with mailed prescriptions increased (83% pre and 86% post; p < .016). However, some perceived benefits, such as an increase in time spent by VAMC pharmacists on patient counseling were not realized (14%; pre and post CMOP). The financial impact of CMOP on individual VAMCs will not be known until postCMOP data are analyzed over the next few months.Evaluation of a major system change requires assessment of the impact of this change from the perspective of all the major stakeholders. The evaluation is using a pretest/posttest design and data are being collected through several mechanisms. First, data on satisfaction, quality, perceptions, etc. regarding the CMOP are being collected using mail questionnaires sent to patients, outpatient pharmacists and technicians, and chiefs of pharmacy. Second, CMOP and VAMC administrative data are being examined to analyze the effects of CMOP on cost and workload. Third, site inventories are being conducted pre and post implementation to assess change in the volume of pharmaceuticals instock at local VAMCs. Finally, site visits have been conducted to obtain qualitative data on CMOP operations. By measuring these multiple dimensions, we are able to assess the impact of using a CMOP from various perspectives. In this way, policy makers can make a more informed decision about the future of VA CMOPs.This presentation will introduce the study methodology utilized in the evaluation. It will also include a discussion of the obstacles and changes that occurred in conducting the evaluation that resulted in modifications to the original design and methodology. Finally, we will discuss the validity of the results given the changes that occurred over the course of the evaluation.