Reducing stress in pharmacies through smoother medicine switches.

During the spring of 2019 Dutch newspapers were filled with articles about stress 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 have been the key in realizing change.

Clients

VGZ and BENU

Challenge

Create a strategy for a change to reduce stress in pharmacies.

Award nomination

Service Design Award 2020 Finalist

Stress due to medicine switches.

During the spring of 2019 Dutch newspapers were filled with articles about stress 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).

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 of 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 visualisations.

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.

Achieving impact together.

Together with VGZ and BENU we set a strategy for a change! We considered the ease and level of implementation (system, process, experience) as well as the impact of the 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. These projects have been running at the same time, and BENU has co-run one of them. We are glad to have contributed 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. This toolkit is now in use in over 400 pharmacies in the Netherlands, improving the patient’s experiences every day.

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 led to the development of the concepts with the 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 a common understanding and constructive cooperation during the development. This showed a better outcome for all.

Motivated by the societal impact.

What makes this project special for me, personally, is the societal impact that it will have. Patients feel frustrated and not in control. Pharmacists and general practitioners feel stressed about the medicine switches, because of the time it takes: pharmacists spend about 1 hour a day explaining to patients what medicine switches entail.

GPs spend a similar amount talking to patients that have issues with their new medicine. I’m really glad that we are going to make a change for them. So I am proud of the role we play in improving the experience for all parties involved.

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