March 28, 2020
If Your Doors Are Still Open to Public,
YOU NEED TO CLOSE THEM IMMEDIATELY
As a pharmacist and pharmacy owner, you have four major responsibilities during the COVID-19 outbreak:
- Help minimize death & serious side effects among infected patients;
- Minimize transmission of the virus;
- Protect your pharmacy employees; and
- Ensure the continued operation and orderly functioning of your pharmacy.
NOW is the Time to Operate As a Closed-Door Pharmacy
We have previously urged our member pharmacies to close their doors to the public to protect staff and patients from the accelerating risk of infection and to enable the ongoing operation of your pharmacy. If you have not yet done so, YOU MUST IMMEDIATELY SWITCH TO CLOSED-DOOR MODE and provide only drive-through, curbside pickup and delivery options for patients. Infection hotspots are springing up in too many states now and the risk to your staff, patients and operations is far too serious to allow anyone other than carefully screened staff to enter the pharmacy.
- Lock all exterior doors and post signs at all entrances stating that your pharmacy is closed for in-store business. Instruct patients to use your mobile and/or online app for refills and direct pick-ups to the drive-through unless otherwise noted below. DOWNLOAD OUR EDITABLE SAMPLE SIGN. (MS Word file: document will not open, but will download -- look in your computer's Downloads folder.)
- If you reduce your operating hours to manage workload and stress, be sure to post your new hours on exterior doors as well.
- Require all employees to enter through the back door only and use our recommended health screening procedures.
- Continue to answer phones to the best of your ability & politely dismiss non-essential calls.
- Rotate employees between your drive-through and curbside pickup area throughout the day to reduce manage fear and burnout.
- The clerk/technician taking prescriptions to curbside patients will be the only person coming in and out of the pharmacy on a regular basis and will lock the door each time he/she exits. Otherwise, open the door only to accept essential deliveries or to allow employees to enter/exit at shift change.
- Keep sanitizing supplies by the front and back entrances to allow the disinfecting of doors, door handles, building keys, etc. after each store entry.
- Your designated curbside agent (employee) MUST wear a N95 mask while working with patients outside and must use hand sanitizer each time upon re-entering the pharmacy.
- Make sure your curbside or parking lot waiting area has a whiteboard or other sign where staff can post information identifying waiting patients via sticky note.
- Verify name and DOB for all patients before handing off prescription at drive-through or curbside.
- NO CASH OR CHECKS WILL BE ACCEPTED - CREDIT OR DEBIT/CREDIT CARDS ONLY.
- Ask all patients for permission to store credit card information in your pharmacy system and have two register screens open for saving time.
- Load credit card info into the POS by having the patient read it over drive-through speaker or hold it up at drive-through window.
- All patients will go through drive-through prior to being placed in a curbside spot unless told to go to a curbside spot because they have informed you that they are en-route to pick-up a prescription.
- Keep all drive-through lanes open to avoid excessively long lines. Be sure waiting cars do not impede the flow of traffic in adjacent streets.
- No paper scripts, vials, credit cards, cash or other materials will be taken at the drive-through.
- If a patient wants to drop off prescriptions at the drive-through, ask the patient to text an image of the script to the pharmacy text number, then call the prescribing MD to get a verbal order.
- If a patient's script is not ready, send them to curbside to wait (space #1, #2, "3 etc.)
- If the drive-through wait is too long, patients can call in scripts and wait at curbside.
- o Ask patients when they call in refills if you can pre-load their credit card info into your secure platform to speed up the drive-through/curbside service.
- If the drive-through clerk sends a patient to curbside:
- Get patient DOB, PHONE NUMBER, CAR TYPE/COLOR, & CURBSIDE NO.
- Place a sticky note on the curbside whiteboard next to the drive-through so everyone is aware of where the patient is parked.
- If the drive-through is empty or has a very short line, call the waiting patient at curbside and direct them to come back to the drive-through for pick-up.
- Remember to have an empathetic but firm mindset with patients at all times.They are fearful and stressed just like we are and they need our understanding. When asking for a credit card, use the following phrase: "To protect our staff and patients, we are not physically handling credit cards at our drive-through. Could you please hold your credit card up for me to see or read the number to me so I can load it in our secure system?"
- SIGNATURES: Do not require drive-through patients to sign for their prescriptions. Instead, document "CV 19 DT" on the signature capture pad.
- To improve workflow: when a patient calls in a prescription and informs you they are on the way to pick-up it up, instruct the patient to park in a curbside spot, then call you to confirm their arrival. This will keep them out of an already congested drive-through. Complete the transaction in the store as above and deliver to the patient.
- If a patient's prescription is not ready, take down the following information and keep it in a basket:
- NAME & DOB
- PHONE NUMBER
- CAR COLOR/TYPE & CURBSIDE SPOT LOCATION OR NUMBER
- Additionally, write the patient's NAME and CAR COLOR/TYPE on a sticky note and stick it on the whiteboard in the curbside/parking lot area.
- When the prescription is ready, call the patient to get CC info and load it into the patient's profile.
- If the prescription requires counseling, have the pharmacist counsel during this phone call.
- If the patient does not have a cellphone, bring your cordless phone with you when delivering the script and have the pharmacist on speaker to counsel (call xxx-xxx-xxxx).
- Process the payment in-store & sign "CV 19 curbside" on the signature pad for proof of pick-up.
- Take the prescription out to the patient and, before handing over the meds, verify the name and DOB one more time to ensure proper delivery
- OTC Purchases: if you have the staff and bandwidth to fill OTC orders, then do so, but strongly encourage all patents to text or fax in OTC orders ahead of time. If a patient gets to the head of the drive-though line and then asks for several OTC Items, send the person to wait curbside while you round up and bag the items or instruct them to return later if you don't have time to fill the order right away.
YOU MUST Keep Up Communications With Your Patients!
During this time of growing fear and contagion, it is imperative that you keep lines of communication open with your patients. We understand the growing strains under which you operate, but you must take time to tell your patients that you are still open and will take care of them to the best of your abilities. You must also instruct them how they can most efficiently and safely get their scripts filled under changed circumstances and operating procedures. We recommend that you take these steps to support effective patient communications:
Status of Operations | Hours | Script Fill Guidance
- Make sure your patients know that you're open and about any changes in your operating hours. Post procedures for getting scripts filled by each applicable method - delivery, drive-through or curbside - on your website and social media. Make sure they know about your mobile/online refill app. Post basic info in a sign on your front door (download our editable sign).
- Encourage patients with multiple scripts to refill them at one time. (Many health plans and PBMs are allowing overrides of early-refill prohibitions). It's a great time to push med synch.
- Let patients know as soon as they have prescriptions to pick up. Ask about their COVID-19/illness status and advise them on the best delivery or pickup option.
Status of Services | Consultations | Payment
- Let your patients that you have suspended services like immunizations, in-store testing, MTM, CRM, educational classes, etc.
- If you offer tele-consultations through a dedicated app, Skype, Facetime, etc., let patients know, provide a link to the app and give them the hours of availability.
- Make sure patients know that you no longer accept cash payments. (strongly advised)
Be a Calming Influence | Be a Reliable Source of Accurate, Vital Information
- Remember that many patients are afraid and some don't handle isolation well. Reassure them on your social channels that you are doing everything you can to stay open and meet their medication needs. Use social media posts & photos to keep them calm - a little humor or human interest will go a long way. This is also a great time to show the world with your posts that independent pharmacists are HANGING TOUGH in the midst of this crisis!
- Make sure patients understand that drug shortages will affect your ability to fill some scripts, or to refill in higher quantities on some others.
- Keep information on hand about drug assistance programs for those who need financial help. This will become more vital with the soaring job losses we're seeing:
- Be a reliable source of accurate information. There are many unfounded rumors and half facts circulating about COVID-19's symptoms and treatments. Caution your patients about anti-malarial drugs such as chloroquine purportedly being an effective treatment for the disease - there has so far been no large-scale, reputable trial showing any effectiveness.
- If patients are exhibiting known COVID-19 symptoms, know where to refer them to report the case. (See next article)
California Pharmacists Association is encouraging its member pharmacists & technicians to take selfies holding signs like those shown here, then post the photos on social media.
We think it's a great idea, but we want to take it a bit further. We've created some colorful signs of our own you can print out to use in your selfies, and we ask that you notify us if you've done this so we can view and share your posted photos. This is a warm and effective way to reach out to your patients to tell them you are still there for them!
You can find out signs online at:
If you'd rather make your own sign that's
more hand-written and authentic-looking, that's great, too. Just get a sheet of white copy paper and write a short phrase like
"WE'RE HANGING TOUGH!" or "STILL HERE TO SERVE YOU!"
or whatever you come up with. Take the selfie and post it, but be sure to share it with us on our FB page at American Pharmacies.
Social Media Resources
Reporting COVID-19 Cases
If you are concerned that a patient may have COVID-19, contact your local or state health department immediately for consultation and guidance. If you do not have a city or counbty health authority, report it to your state health department. Following are links to directories of both local and state health authorities for all 50 states and U.S. territories.
Resources & Important Information
It is important that you monitor the government health authorities who are coordinating the state and local response
to the virus outbreak in your area, most especially your state health department. These authorities will have vital information about the availability and location of screening/test kits/facilities, declarations of emergency conditions, emergency health-care or dispensing guidelines, and closings of businesses and governmental/educational institutions.