Reducing after-hours prescription refill requests

Abstract

Background: It is not convenient or always possible to address parent requests for prescription refills after hours. The primary objective of this quality improvement study was to decrease the number of refill requests received outside of regular business hours. A secondary objective was to reduce the negative effects of call fatigue and related exhaustion for physicians taking calls.

Methods: Voluntary participation in this quality improvement project was solicited from the Child Neurology Division at a single academic, tertiary, metropolitan children's hospital. Study design was developed from a project charter, fishbone diagram, process map, driver diagram, and plan-do-study-act worksheet. A peer-reviewed letter was mailed to all clinic patient families and signs were displayed in the clinic space as notification of a policy change. A peer-reviewed script was provided to the Children's Mercy Contact Center triage personnel addressing after-hours refill requests. The number of refill requests received during each after-hours call shift was recorded from April 1, 2015, to March 31, 2016, with a primary outcome measure of the monthly number of refill requests.

Results: Postintervention, the average number of refill requests after hours decreased by 39% from 21 to 11 per month (p = 0.0055).

Conclusions: This simple intervention has promise to limit prescription refill requests made after hours and improve physician quality of life. Continued data collection will help establish the sustainability of the effect made by this intervention.

Figure. Prescription refill requests

Number of prescription refill requests received after hours during the study period. Time of intervention denoted by the arrow. Preintervention and postintervention averages of 21 and 11 requests per month, respectively, indicated by the solid lines (p = 0.0055).