Stress in pharmacies, filled up the papers

This spring, Dutch newspapers were filled with articles about aggression in pharmacies, due to regular medicine switches for patients. These switchers are caused by material shortages, poor deliverability or a change in preferential medicine of various health insurers, enforced by Dutch law. The switches stress out everyone involved, from the patients to the specialists and from pharmacists to the general practitioners (GPs). Healthcare provider VGZ and BENU - Netherlands’ largest chain of pharmacies - initiated a project to turn this unsustainable situation around. Empathizing with each party and visualizing needs, pains and frustrations has been the key in realizing change.

Stakeholders empathizing with each other turned out to be key. Some sessions were filled with 40 people, all wanting change. Understanding each others pains, gain and emotions was a real turning point.

— Joost van Leeuwen Koos

Stakeholder management: getting them all on board

The complexity of this project lies in the number of different stakeholders involved. ‘ Luckily’ the prominent dissatisfaction among patients,  pharmacists and GPs has positively influenced the willingness to contribute. During certain co-creative sessions the number of internal and external stakeholders even went up to 40 people. During these moments, stakeholders got to know each other and realised a greater understanding for each other’s perspective. These were vision changing moments. Looking back these turned out to be the biggest reason why the developed concepts  were accepted; it spoke to all stakeholders that the suggested change needed to have a positive impact on all.

Create understanding through visualizations 

When there are multiple stakeholders involved, it is important to show where their experiences meet. To get a full understanding of the issue at hand we interviewed patients, specialists, pharmacists and general practitioners. The insights that we gathered were visually communicated in a customer journey, in which all stakeholders could recognize their pains, gains, needs and emotions. By making it a multi-stakeholder customer journey, they could also see the pains, gains, needs and emotions of the other parties. This made it possible to create understanding for choosing certain elements for the ideation phase. 


Going for impact

Together with VGZ and BENU we set a strategy for change! We considered the ease and level of implementation (system, process, experience) as well as impact of implementation of the selected concepts. Based on these outcomes, several concepts were nominated for further development. To ensure progress we hosted an internal session inside VGZ concerning the realisation of next steps; teams were set up and responsibilities were divided. Everybody again joined in, motivated to get the job done. 

From the 7 concepts, VGZ selected 4 to carry out first. And they are currently running these 4 projects at the same time, and BENU is co-running one of them. We are glad to contribute as well, by leading the development, prototyping and testing of a toolkit for pharmacists that describes the best way to carry out the conversation at the counter: the first time it becomes clear for a patient that a medicine switch has occurred for him/her.

Holistic means taking it all into account

The added value of Koos in this project lies in several elements. Firstly, it’s the empathic way of finding and sharing the pains, gains, needs and emotions of all external stakeholders. We communicated these in such a way that they were adopted by all the other stakeholders, and we focused on making them pivotal throughout the entire project. This lead to the development of the concepts with most impact. Secondly, our contribution came from our ability to approach this problem holistically; taking into consideration all levels, from the systematic changes that need to be made on an organisational and policy level, down to the detailed changes in communication that will change the patient’s experience. We strongly believe this is the best way to realize positive results.

Finally, it lies in successfully bringing together various internal and external stakeholders, leading to common understanding and constructive cooperation during the development. This showed in a better outcome for all. 

Also in need of some serious stakeholder management?

The societal frustration really got to me

What makes this project special for me, personally, is the societal impact that it will have. Patients feel frustrated, angry, left in the dark, not in control, depressed or like lab rats. Pharmacists and general practitioners, on the other end, feel stressed about medicine switches, because of the time it takes and the negative impact it has on their daily lives: pharmacists spend about 1 hour a day explaining to patients what medicine switches entail. GPs spend a similar amount talking to patients that are unsatisfied with their medicine switch and that want them to solve it. The GPs and pharmacists have indicated that due to medicine switches their job has become less pleasant and more stressful. Some employees of pharmacies have even said that they go to work reluctantly. I’m really glad that we are going to make a change for them. So I am proud of the role we play in minimising these negative feelings and making life a bit less stressful for all involved parties.



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