1363 Are Chain Pharmacy Work System Characteristics Associated with Work and Work-Life Outcomes?: A National Study

S. Nadi; B. Bakken; C. Gaither; D. Kreling; D. Mott; J. Schommer; V. Arya; William Doucette

doi:10.1016/j.japh.2025.102819

Objectives The aims of this study were to explore the association of work system characteristics and pharmacists’ perceptions of patient medication safety and work-life outcomes for pharmacists practicing in large chain and mass merchandiser pharmacies. Pharmacists in community settings play a crucial role in maintaining patient medication safety by ensuring that drugs dispensed to patients are appropriate. However, research shows that chain pharmacists report that some aspects of their work setting may compromise patient care and safety. There is insufficient information about how specific characteristics of work systems affect pharmacists' perceptions of their work and work-life outcomes. Previous studies often fail to use a comprehensive framework to systematically analyze the effects of work system characteristics on pharmacists’ work outcomes. Methods A descriptive, cross-sectional, online survey research design was used to collect data from a random sample of 93,990 licensed pharmacists in the US. The Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 conceptual framework provided a basis for domains of the survey content. The survey contained items used in previous pharmacist workforce surveys and new items were developed from four focus groups of practicing pharmacists. Survey domains from the larger survey included work system characteristics, work-life outcomes, and demographic variables. Work system characteristics included the number of work activities that extend beyond what pharmacists were originally hired to do (Many activities), the adequacy of the number of pharmacists to meet patient care needs (Adequate pharmacists), the level of autonomy in how pharmacists accomplish their work (High autonomy), the organization’s focus on meeting workload metrics, which results in unsafe pharmacy practice (High metric focus), the organization’s failure to hire additional pharmacy staff when demand is high (Poor hiring practices), and whether the organization listens to pharmacists’ concerns regarding unsafe pharmacy practice (Pharmacists heard). A total of 4,947 usable responses were received between November 2022 and January 2023. Multivariate linear regression models were used to test for significant associations. Results A total of 1,201 respondents reported that they were actively practicing in a large chain or mass-merchandiser pharmacy. Most respondents were females (62.1%), were aged 46 to 55 years (27.7%), and were working full-time (84.7%). Regarding work system characteristics, over 85% of pharmacists reported having many activities, with nearly 80% noting inadequate pharmacist staffing. Almost one-half reported having low autonomy in accomplishing their work, and more than 80% cited high organizational focus on meeting workload metrics. Over 70% reported low levels of pharmacists being heard. The regression model results showed that while patient medication safety was significantly negatively associated with having many activities and a high metric focus, it was significantly positively associated with adequate pharmacists, high autonomy, and pharmacists being heard. Work exhaustion was positively associated with having many activities, a high metric focus, and poor hiring practices. Professional fulfillment was positively associated with adequate pharmacists, high autonomy, and pharmacists being heard. Job turnover intention was positively associated with having many activities and a high metric focus. Conclusions/Implications The results suggest the need for systemic changes and organizational improvements within chain and mass merchandiser pharmacy environments to ensure better work-life outcomes and improved medication safety. Improving pharmacist autonomy and pharmacist voice in decision making are critical aspects of keeping professionals happy. Efforts to include pharmacists’ ideas about improving work efficiency beyond solely focusing on workload metrics could improve work environments. Future studies could examine strategies utilized by pharmacies known to be successful in maintaining medication safety and work-life outcomes for pharmacists and study how to disseminate the strategies.

1363 Are Chain Pharmacy Work System Characteristics Associated with Work and Work-Life Outcomes?: A National Study

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