Presented By: Shiona Davies

1
Community Pharmacy Pilot Feedback

• Presented By Shiona Davies
• Date 3rd May 2006

shiona.davies_at_continentalresearch.com
2
Todays presentation

• Todays presentation will cover the following
• Feedback on the pilot process and results
• Subsequent qualitative stage to explore other
  influences on patient satisfaction
• Recommendations for questionnaire design and
  methodology for the main survey

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Objectives

• The original objectives of this research were to
• Produce a template for the national patient
  satisfaction survey
• Design a spreadsheet to allow pharmacies to input
  their own data
• Provide advice on how to administer the survey,
  maximise response rates and achieve reliable
  results

4
The pilot process
5
Pilot methodology

• 25 pharmacies recruited mix of chains and
  independent pharmacies, and of smaller and larger
  pharmacies
• Questionnaires and reply paid envelopes sent out
  for distribution, together with an Urdu version
  where requested and full instructions
• Pilot sites asked to hand out questionnaires at
  various set times of day / day of week to ensure
  a spread of patients, and complete a respondent
  sheet (age, gender etc) with details of each
  person handed a questionnaire
• Regular contact with pilot sites to check
  activity underway and answer queries
• 150 incentive for taking part

6
The question areas

• The pilot questionnaire covered 4 sides of A4 and
  included questions on
• Purpose of visit
• Waiting time
• Satisfaction with visit
• Satisfaction with pharmacy (cleanliness, range of
  goods etc)
• Satisfaction with staff (helpful, taking time
  etc)
• Rating of services provided
• Rating of other information provided (opening
  hours etc)
• Rating of advice on other health issues such as
  smoking
• Contact with pharmacy by phone
• Frequency of visiting
• Overall satisfaction
• Demographics (including state of health)

7
Survey administration

• Questionnaires were distributed during December
  which was not ideal, as this is a busy time for
  pharmacies and did impact on the running of the
  pilot
• Pharmacies were provided with a range of ways of
  contacting Continental Research, but did not
  always advise of any problems such as non-receipt
  of questionnaires etc
• Despite agreeing to take part in the pilot, only
  a few pharmacies started handing out their
  questionnaires as soon as they received them, and
  completed all their tasks on time

8
Survey administration

• Most pharmacists claimed to have no problems
  mentioning the survey to patients, and were able
  to answer questions about the survey
• However, setting times for questionnaires to be
  distributed was unpopular and used as a reason
  for not having handed many out
• Completing respondent sheets was also unpopular
  because it was time consuming, and sheets were
  only returned from around half the pharmacies
• Only a minority of those on the pilot handed out
  sufficient questionnaires to meet their target
  for completed questionnaires returned

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Response rates - summary

• 8,500 were sent out, plus 100 Urdu questionnaires
  to each of the pharmacies that had requested them
• A total of just under 4,000 questionnaires were
  actually handed out (46)
• 1,510 questionnaires were returned by patients
  response rates varied widely between 5 and 60
  but most pharmacies achieved a response rate of
  between 20 and 50 and the average was 38
• Only 26 Urdu questionnaires were returned

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Response rates summary (2)

• With only a few exceptions, those who handed out
  more of their allocated questionnaires also got a
  higher proportion back suggesting that these
  pharmacies approached the matter more positively
  and this was perceived by patients.
• Patients had the choice of completing the survey
  and handing it in at the pharmacy or posting it
  back in a reply paid envelope. Most, 80, of
  returned questionnaires were posted back to
  Continental Research.
• Based on the respondent contact sheets provided,
  younger patients (under 35) were less likely to
  fill in a survey given to them, while those aged
  55 were more likely. There was no difference
  between men and women.

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Analysing the data

• Pilot pharmacies were provided with a spreadsheet
  where they could enter the answers given in a
  questionnaire
• They were provided with 5 dummy questionnaires
  to test the system with (their actual results
  were processed and analysed by Continental as
  part of the pilot)
• The instructions and the spreadsheet were clear,
  but respondents found it took time to enter all
  the data, and this was only for 5 respondents,
  rather than the 50-150 that will have to be
  processed at the main stage

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The results key highlights
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The questionnaireKey findings reason for visit
today
82 of respondents said that prescriptions were
dispensed very well Experience of other
services was more limited (to around half of
respondents) but those who had received these
services rated them highly
Base 1,510/409/1100
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The questionnaireKey findings satisfaction
with todays visit
98
96
98
Base 1,510 / 409 / 1,100
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The questionnaireKey findings rating of the
pharmacy

• Overall 80 of respondents rated their pharmacy
  as very good
• Highest ratings were for the pharmacy being
  clean, accessible and providing all the services
  needed all rated as very good by 70 of
  respondents
• Overall 83 of respondents rated the pharmacy
  staff as very good
• Highest ratings were for staff being helpful,
  taking time to listen and treating patients with
  respect all rated as very good by 79 of
  respondents

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The questionnaireKey findings information from
the pharmacy

• Many respondents said that they had not needed
  information from the pharmacy on opening hours,
  waiting times etc, but those who had wanted such
  information had found it easy to get
• Over 80 of respondents said that they did not
  need advice on smoking, healthy eating or
  exercise, but those who had received such advice
  had found it useful
• Two thirds of respondents had never tried to
  phone their pharmacy, but most of those who had
  were satisfied with the service they received

17
The questionnaireKey findings Overall rating
of the pharmacy and staff
75 of respondents visit the pharmacy at least
once a month and most questionnaires were handed
to regular customers
Base 1,510
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Key driver analysis

• Key driver analysis was used to identify how well
  the individual questions explain overall levels
  of satisfaction with the pharmacy
• The questions in the pilot questionnaire only
  explain 33 of the variance in levels of
  satisfaction, which means that there are other
  factors affecting overall satisfaction which are
  not currently being measured
• Not all of these will necessarily be within the
  remit of the pharmacy to change (cost of
  prescriptions, how safe the neighbourhood is) but
  a low score like this would typically suggest the
  need for qualitative research to understand what
  is missing

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The qualitative stage
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Qualitative researchBackground

• Before finalising the recommended patient
  satisfaction questionnaire, a series of group
  discussions were held to check all the key issues
  that the questionnaire should cover
• 4 groups were held
• Pre-family aged 18-30
• Families with dependent children
• Empty nesters
• Retired aged 60
• All groups were a mix of males and females, B /
  C1 / C2

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Qualitative researchUsage of pharmacies

• Younger respondents
• Go to pharmacies frequently for OTC, shampoo,
  film development etc
• Occasional visits for prescriptions, as required
• Use whichever pharmacy is most convenient near
  home, work or surgery
• Simple transactional relationship pharmacy is a
  pick up point
• Families
• Use of pharmacies increases when have children
• Convenience is still vital parking, opening
  hours etc
• Also looking for more of a relationship advice
  etc especially when it is difficult to see the
  doctor

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Qualitative researchUsage of pharmacies

• Older respondents
• Commonly go to a pharmacy once a week
• Loyal to the same pharmacy
• Know the pharmacist by name
• Pharmacy is seen as part of the community and
  feel protective towards it
• Less time pressured, more time to discuss /
  receive advice from pharmacist

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Qualitative researchUsage of pharmacies - summary

• Very different needs / expectations of pharmacies
  exist
• Key drivers of satisfaction therefore differ
  greatly

• Human interaction
• The pharmacist is knowledgeable / advises
• Ongoing relationship
• Patient has trust / confidence in pharmacist

• Speed
• Convenience
• One off transaction
• Personal interaction is not important

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Qualitative researchExpectation of pharmacies
COLLECTION POINT
DOCTOR PATIENT RELATIONSHIP
YOUNGER
OLDER
FAMILIES

• Expect the best of both worlds
• Speed / convenience on one occasion
• Advice if unable to get to the doctors

• Always appreciate a more personal service
• Either advice or social if no particular issues
• Less time-pressured

• Expect speed and convenience
• Dissatisfied if they do not get it
• Less aware of enhanced services

• Different lifestages have very different
  expectations from pharmacies, making it
  challenging for them to please all people all of
  the time

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Qualitative researchChoice of pharmacy

• Choice of pharmacy depends primarily upon two key
  factors
• Convenience for younger people (location,
  parking, speed of service etc.)
• Quality of service (helpfulness, level of
  knowledge, interest in patient etc.)
• Decision-making process
• Younger respondents chop and change the pharmacy
  they visit depending upon convenience and needs
  at the time
• Older respondents are likely to be very loyal to
  one particular pharmacy, and only change if
  forced to
• Families tend to have a repertoire of pharmacies
  that they visit for different needs, such as late
  night opening / parking etc

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Qualitative researchIdeal pharmacy experience

• Friendly, quick and efficient service
• Convenient location with ample parking and easy
  access
• Open 24 hours per day
• Spacious with wide aisles (plenty of room to
  navigate the shop)
• De-cluttered, clean and pleasant environment
  gives confidence
• Further health information available (e.g.
  leaflets in store)
• Create awareness of additional services available
• Prescription medicines always in stock
• Good range of general (non-medical) stock,
  including alternative medicines and bathroom
  products etc.
• Staff provide service according to needs (speed,
  advice, privacy etc)

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Implications for main survey
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Implications for main surveyThe questionnaire

• As a result of the qualitative stage, changes
  have been made to the suggested questions
• Satisfaction with, rather than actual, waiting
  times
• Satisfaction with parking and store layout
• Satisfaction with staff being quick and efficient
• Rating of advice received
• Way pharmacy is used (sole, suite, random)
• Responsibility for care of children

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Implications for main surveyThe process

• The pilot generally worked well average
  response rates were in line with expectations,
  and the profile of respondents was as expected
• A self completion questionnaire is a suitable
  vehicle for gathering information, but should be
  kept to a maximum of 4 sides of A4 (revised
  questions cover 3 sides, plus 1 side for
  introduction)
• However the pilot also highlighted various
  procedural changes that will need to be taken
  into account when this exercise is rolled out to
  all pharmacies

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Implications for main surveyGeneral learnings

• Support and encouragement
• These pharmacies had agreed to be on the pilot
  and were provided with everything they needed
  (questionnaires, envelopes etc)
• Despite this, work pressures and unfamiliarity
  with the process meant that the majority of them
  were slow to start handing out questionnaires,
  and did not report any problems such as
  non-receipt of questionnaires
• They will need support as provided on the pilot
  with
• Questionnaire design and printing
• Freepost for questionnaire return
• Processing and analysis of responses

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Implications for main surveyGeneral learnings

• Initial distribution of sufficient questionnaires
  is key
• Communication about the main survey should
  highlight likely response rates and the
  importance of handing out enough questionnaires
  initially
• A simplified admin process, and support to
  pharmacies taking part should help to improve the
  distribution rate
• The average response rate (38) was in line with
  predictions, but varied widely. Poor initial
  distribution meant small sample sizes for some
  pharmacies, below the numbers required

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Implications for main surveyKey points for
pharmacists

• Planning is key
• Dont choose your busiest month for this exercise
• Do plan when the questionnaires are going to be
  distributed, who by and how they will answer any
  patient queries
• Do think about the profile of your patients (age,
  gender etc) when handing questionnaires out
• Do hand out questionnaires at different times of
  day and days of week, even if no actual times are
  set, so you reach different types of patient

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Implications for main surveyKey points for
pharmacists (2)

• Distribute sufficient questionnaires
• Dont only ask your best patients to fill in a
  survey. It might provide good results but is it a
  true reflection of the service, and will it help
  you improve?
• Dont print and hand out just the number of
  questionnaires you want back. On average, you
  will need to hand out 3 times as many
  questionnaires as you want to get back (keep a
  tally so you can adjust for future waves) but you
  might need to hand out more
• Do approach this positively in the pilot it
  seemed to encourage patients to complete the
  survey

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Implications for main surveyKey points for
pharmacists (3)

• Some practical issues
• Do think about how completed questionnaires will
  come back to you, such as a box on the counter,
  and/or an envelope with a freepost address
• Do make sure that you / an agency can identify a
  questionnaire that has been handed out by your
  pharmacy, and any you have received by mistake
• Dont feel you have to do this all by yourself.
  Companies are available to help you print the
  questionnaires, analyse them and provide you with
  a summary of the findings allow time for their
  involvement

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Community Pharmacy Pilot Feedback

• Presented By Shiona Davies
• Date 3rd May 2006

shiona.davies_at_continentalresearch.com