Engagement Result

Organization:    U.S. Air Force

Major Command:    Air Materiel Command

Numbered Force:    6th Air Mobility Wing

Unit:    6th Medical Group

Project:    PharmaCARE Center’s Prescription Drive-Thru Wait Times

Size:    3,000 personnel and over 50 mission partners

Location:    MacDill Air Force Base – Tampa, FL

Expertise:    Operational Assessment, Continuous Process Improvement, & IT Business Process Alignment

Assignment:    The 6th Medical Group (6th MDG) supports combat capability of the 6th Air Mobility Wing (6th AMW), USCENTCOM, USSOCOM, and over 50 tenant units by providing administrative, logistical, and ancillary medical support serving 106,000 beneficiaries in DoD's largest single catchment area. Under the charge of the 6th Medical Group, the PharmaCARE Center provides outpatient pharmaceutical care to all beneficiaries. The PharmaCARE Center serves as the central point for picking up all phoned in refill requests for prescription medications and the refill drive-thru service has been in operation at MacDill AFB since mid-2009. The drive-thru service area consists of three drive-thru stations and prescription medications w distributed to the customer through a tube device much like a drive-thru at a bank. 
Shortly after opening concerns were raised pertaining to long lines and excessive wait times with an average wait time of nine minutes during off peak times and 36 minutes during peak times. In addition, there was a growing concern being able to volume increases of 30-35% due to the annual winter retiree migration. MainStream GS was engaged to work with the Wing AFSO21 office to decrease the PharmaCARE Center’s prescription drive-thru wait times.

Actions:    Working with the support of Mainstream GS, the internal AFSO21 team conducted an operational assessment of the PharmaCARE Center’s prescription drive-thru processes and procedures. Five main contributors that unnecessarily increased cycle time were identified:

  • A Lack of Standard Work
  • Labor Intensive Process
  • Customer Confusion
  • Logistics Issues
  • Non-Value Added Activities

Due to the high number of process variables, such as the number of prescription medications available, controlled / non-controlled medications, refrigerated medications, and random customer arrival times, MainStream GS and AFSO21 team employed IT Business Process Alignment tools by utilizing a propriety computer simulation to evaluate the PharmaCARE Center’s complex prescription processing system. The simulation provided the AFSO21 team with a tool to quickly test, verify, and optimize the system before any change or expenditure was made, thereby avoiding the possibility of costly mistakes. The statistical output of the model also provided the AFSO21 team with insight as to where additional performance improvement areas of opportunity existed.
In addition, the AFSO21 team, supported by Mainstream GS, used a variety of Continuous Process Improvement, Lean, and problem solving tools to address the cycle time issues. The simulation model was used to “test drive” and optimize the various ideas. The model was also useful to show the effects of random customer arrivals and also to perform a volume sensitivity analysis.
The AFSO21 team focused on several initiatives critical to reducing cycle time and improving performance. This targeted focus resulted in key action items including:

  • Standard work was implemented to the PharmaCARE Center’s prescription processes and procedures
  • Drug storage filing system was modified for quick retrieval.
  • Visual aids were utilized throughout the PharmaCARE Center to communicate with the customers
  • See-thru packaging was utilized to reduce verification time
  • Cameras were installed at the customer drive-thru lanes which enabled the attendant to verify the IDs without having to send them through the tube
  • Window attendants were given headsets to communicate with the customers

Results:    In spite of a 31% increase in volume due to the winter migration, substantial improvement in wait times at the PharmaCARE Center have been realized, including reducing the average wait time by 35% from 9.0 to 5.9 min and reducing window cycle time by 40%. In addition, the maximum number of cars in line during peak times was reduced 44% from 25 to 14 cars and the maximum wait time during peak times was reduced from 64% from 36 to 13 minutes.