Are you considering starting up a travel clinic in community pharmacy? Community Pharmacist, Siân Humphreys, on behalf of ECG, takes a look at the organisation involved in setting up a travel service, and shares advice as to how you can make a success of your clinic without it having an adverse effect on your day-to-day community-focussed responsibilities.
We’re all under immense pressure to provide a sparkling service 100 per cent of the time – but how should we manage a situation when things go wrong? And what can we put in place to ensure that the same issue doesn’t reoccur?
Incorrect vaccine selection is a potential error that I’m very aware of. Many of the vaccines we offer are made by the same pharmaceutical company – and the cause of many dispensing errors is that the packaging is very similar. An example of this is Typhim Vi (typhoid vaccine) and Avaxim (hepatitis A vaccine). Both come in identical boxes of 10; and there are no distinguishing features apart from the name and a green stripe vs a pink stripe. Also amazingly similar are adult and child vaccines – such as Engerix B and Twinrix.
It’s very important to organise our fridge (and ourselves!) with the vaccine tasks ahead. We organise our dispensary alphabetically, so why not arrange the fridge in the same way? Limit staff access as you would the CD cabinet, and know your stock. It’s back-to-basics, but start this way and you will continue in this manner. It’s hard to put a process in place once a service has been running for six months, so instil the rules now and you won’t go far wrong.
Organisational Tips Which Need to be Set in Stone from Day One
Take Control of Your Stock
Know what you’re ordering, and from where. Do you have a vaccine quota? Do you need to set up an account with a supplier? If a patient enquires about a full course of hepatitis B vaccines, your answer needs to be, ‘Yes, we can offer that.’. If you can’t answer confidently and truthfully on the spot, then you’ll risk losing the custom.
At the point of agreeing to vaccinate (post-risk assessment etc.) make sure that you have the stock, or that you can easily obtain it within 48 hours. Often community pharmacies offer a discount if a full course is purchased – for example, typically 10 per cent discount is applied if all three vaccines are purchased at the point of dose one (hepatitis B, rabies etc.). If I don’t have the vaccines in stock, I always call the suppliers in front of the patient before taking payment. Supply of vaccines is sometimes troublesome, so don’t over-promise and under-achieve.
When a Patient Pays for a Course of Vaccines, Separate these Follow-up Doses
Store in a basket at the bottom of the fridge with the patient’s name and dose details, eg. Mr X, hepatitis B, dose two and three. I can’t stress how imperative this is! I always show the patient when I do this – it creates reassurance and trust that their follow-up dose is ready and waiting. Just remember to check the date if the vaccine is due in a couple of months.
This brings us on to schedules. Each of my patients has their own plastic wallet which contains:
• All consent forms – one needed per vaccine appointment, stating the correct date
• A downloaded ‘prescription’ – although you’re more than likely working from a PGD, you can usually print a list of vaccines to be administered which will help your vaccine plan. Like flu vaccines, travel vaccines have a peel-able sticker often with the vaccine name, expiry date, and batch number (I stick this on the print-out as a cross-reference and reassurance)
• Copies of till receipts – you will often see patients over a six-month period, so print a copy of each receipt at point of payment and write their name at the top. It’s so simple, but it has supported me greatly when a patient has queried remittance. It’s also hugely useful in keeping track if the patient prefers a pay-as-you-go approach
• Vaccine schedule planner – I fill this in as I go, and supply a copy to my patient so that we can work through the schedules together. My vaccine schedule planner is really useful, as I can see at a glance where I’m up to. Jane Chiodini’s schedule reference guide is updated regularly and is a great source. Visit www.janechiodini.co.uk
When running a travel clinic in community pharmacy, planning and organisation is paramount. Look after yourself, and work to your ability. If you start off organised and with a clear and achievable aim, the rest will fall into place – and in time you’ll be running a successful service.