Introduce PDSA cycle

Discuss common processes and problems

Decide on a small, actionable quality improvement you can implement in your current workflow and test before next session

How are referrals to your pharmacy services typically generated (e.g., EMR orders, warm handoffs, informal communication)?

What barriers do you encounter in getting consistent referrals from providers?

How have you approached educating providers and clinic staff about when to refer patients to you?

How do you handle referral tracking and follow-up to ensure patients are actually seen or contacted? How do you handle no-shows?

What are your interactions with care coordinators, specialists, or community resources?

Where do you typically see patients — exam room, your own office, consult room, shared space?

What are the logistical challenges around room availability or scheduling?

Are MA’s, nurses, or technicians involved in your clinical workflow?

Have you worked with your clinic to reserve space for pharmacy services, and how was that conversation approached?

What tips or creative solutions have you used when space is limited?

How does your billing process currently work for Medicaid and private payers? Are you submitting claims yourself, working through clinic billing, or a combination?

How do you document visits — EMR note, separate system, both?

What challenges have you run into when trying to get paid (denials, incorrect codes, incomplete notes)?

Have you found certain visit types or services that are easier to bill successfully?

For those billing from a community pharmacy base — what is working or not working when trying to bill in that setting?

How are you notified of labs you ordered? How are abnormal results escalated?

Do you have standing order privileges or delegated lab ordering authority?

What is your process for lab result follow-up — direct patient contact, through PCP, documented plan?

Have you experienced challenges with labs ordered by pharmacy not showing up correctly in EMR or not being recognized by payers?

How do you manage EMR inbox messages — dedicated pharmacy pool, personal inbox, team-based?

What types of messages are you responsible for (refill requests, lab follow-up, clinical questions)?

What inbox pain points are you seeing?

Have you found any strategies or tools that help you manage inbox volume efficiently?

Are you currently providing any services via telehealth? If so, what is working well?

What barriers have you faced with telehealth implementation — technology, scheduling, reimbursement?

For those working in community pharmacy — are there models where you’ve incorporated telehealth into that setting?

How do you handle documentation and billing for telehealth encounters?

For those launching new services or adding new patient populations — what steps did you take to plan your workflow?

Were there unexpected workflow challenges after go-live?

How did you engage other team members (MA, RN, front desk, providers) to support the new service?

What part of your workflow has changed the most in the past year?

What is the most inefficient or frustrating part of your current workflow?

What is one workflow adaptation that has really helped your practice run more smoothly?

If you could fix just one system/process in your clinic to make pharmacy services more efficient, what would it be?

Which of these issues do you think is most ripe for improvement or standardization?

Are there any that you think would really benefit from us taking it through a PDSA cycle together?