Wednesday, April 04, 2012

The measurement of quality makes the actual work less quality

In any given day in any given government pharmacy in Malaysia, this is what you will hear over the counter.

Puan Husnahkah? Selamat pagi. Apa khabar makcik?

Khabar baik.

Bagus. saya telah memeriksa semua ubat kamu, dan mendapati semua ubat adalah sama seperti kali yang lepas. Makcik ada makan dua jenis ubat untuk kencing manis, iaitu Gliclazide dan Metformin. Bolehkah makcik memberitahu saya macam mana biasanya makcik ambil ubat ini?

Yang putih besar besar ini makcik makan 2 biji 2 kali sehari, yang ini… makcik macam tidak pernak nampak..

Oh… lupa beritahu, ubat ini ada tukar baju sikit. sebelum ini, ia berbaju biru dan sekarang berbaju hijau. Ikut fesyen raya. Tetapi cara makan dan bilangan yang makan masih sama.

Oh…. patutlah..

Makcik, sekarang ini, kami tidak dapat memberi ubat kamu secara penuh. Hanya dapat bagi satu bulan sahaja, kerana kerajaan takut bazir duit. Perlu hutang ya… bila ubat makcik habis, boleh bawa preskripsi ini datang balik farmasi dan ambil ubat. Tarikh dia ada tulis di sini. Jika makcik ada ubat lebih di rumah tolong pulangkan juga. Jangan membazir ya. Makcik juga ada tengok tak tanda harga ini?  Sekarang semua ubat ada tanda harga supaya makcik tahu berapa nilai ubat-ubat yang makcik makan ini supaya makcik akan menghargainya...

Oh… perlu datang balik… bolehkah anak saya datang ambil?

Boleh..asalkan dia bawa preskripsi ini sahaja.. anak tahu SMS tak? Kalau tahu, kami ada satu sistem baru, di mana dia boleh SMS beritahu bila mahu datang ambil ubat. Dengan sistem ini, kami akan siap bungkus ubat dahulu sebelum dia datang. Dia hanya perlu datang pada masa yang ditetapkan sahaja dan tidak perlu beratur.

Tidak apa la…

Ada apa-apa lagi makcik?Jika tidak ada bolehkan makcik masuk sekejap? Kami sekarang sedang buat satu kajian kepuasan pelanggan. Tidak lama punya hanya lebih kurang 40 soalan dan 6 muka surat sahaja… lebih kurang 1 jam akan habislah. Kami amat perlukan maklum balas makcik supaya kami dapat tahu kelemahan diri sendiri dan memberi perkhidmatan yang lebih baik….

And poor illiterate makcik had to sit though the hour long session listening to a pissed off pharmacist rattling through survey questions and answering something she doesn’t care about. She cares more about having full supply of medications so that she doesn’t have to fork up RM30 more to come again just to take her meds than whether we have clean toilets or television set to keep her entertained.

Sometimes, I think its better we rebrand ourselves as Marketing Executives rather than Pharmacists.

In our quest to serve better, I think we had deviate too much from our core purpose. We had literally missed the forest for the trees.

We want to increase the quality of our service, which is good, but ironically, I think that the process to improve the service is hurting the service.

Nowadays we were squeezed and squashed in a pressure cooker, pressured by the waiting time KPI on one side (every patient to get their meds within 30 minutes) and promoting all the value-added services (which is also another KPI). Something gotta give. So what gives? The quality of the dispensing we provide to the patients. The time that we are supposed to put in to show empathy, to delve further and to understand the problems of our patients is sacrificed. For what? For better quality services.

May I ask: What is our core service again?

Haih. I hate to rant but enough is enough. Now we are supposed to measure the quality of our service with a six pages long standardised questionnaire. 400 of them by the middle of May. Personally, I like surveys and measurements, because as pharmacists, we are champions of evidenced based practice. But surveys should always adhere to the KISS principle, and not something so long worded and jargon loaded and so small font and so comprehensive.

The tool to measure whether we practice patient orientated care is so not patient orientated that I feel embarrassed to use it. And angry because it will further erode the time  I had to spend with my patients.

But well, as government servants usually say in the end, kami hanya menurut perintah…

1 comment:

phiklun said...

Being a youngsters like us, we always strive to our best, hopefully to make things better. but there are always certain things that we have to follow from the chief/boss. which made us quite frustrated sometimes when we notice the problems but it can't be fixed.
The only thing you can do is to reflect it to whom you can report to, so that he then reflect it to the bigger boss. hopefully by this, things will get better.