Is Our Pharmacy Meeting Patients' Needs? (continued)

Part II: Survey of Pharmacy Staff

About the Pharmacy Staff Survey

Pharmacy staff members help create the environment within the pharmacy, and their choices and interactions with patients determine the health literacy friendliness of the pharmacy environment. They have a unique perspective on the strengths and weaknesses of the pharmacy in serving patients with limited health literacy that may or may not be consistent with the viewpoints of objective auditors and patients.

The second part of the Pharmacy Health Literacy Assessment is a staff survey entitled "How Health Literacy Friendly Are We?" (Appendix 3). The pharmacy staff survey is divided into the following our sections:

• Print Materials.
• Clear Verbal Communication.
• Sensitivity to Literacy.
• Personal Information.

The survey assesses the pharmacy's overall sensitivity to the needs of patients with limited health literacy skills, and it should take approximately 20 minutes for respondents to complete.

Who Should Complete the Pharmacy Staff Survey?

Ideally, all pharmacy staff, including supervisors, pharmacists, pharmacy technicians, and pharmacy administrators should complete the survey. This can be accomplished if the pharmacy has a small staff.

If the staff is large, it may be more practical to distribute the survey to a random sample of staff. If you decide to sample, make sure to get a sample that is representative of all types of staff members. Staff should be divided into groups by job title (i.e., supervisor, pharmacist, pharmacy technician, administrator), and a random sample of staff in each group should be surveyed to form a representative sample.

Tips on Getting a Good Response Rate

You want as many of the pharmacy staff in your sample to complete the survey as possible. In many pharmacies, staff members are busy and overworked. Make staff aware of the importance of conducting the assessment and addressing health literacy issues in order to ensure their cooperation in completing the survey carefully and thoroughly.

• Offer an incentive for completing the survey, such as cash or a gift card.
• Distribute the survey at a meeting of pharmacy staff, where many staff members can be reached at one time.
• Provide staff with time away from their normal job responsibilities to complete the survey.
• Solicit the cooperation of staff supervisors, who can encourage their staff to complete the survey and provide them with time away from their responsibilities to complete it if necessary.
• Emphasize that you want honest responses. Assure staff that responses are anonymous and that no action will be taken against employees who identify problems. If there are few members of the pharmacy staff, this may require dropping the demographic portion of the survey.

Analyzing Pharmacy Staff Survey Results

Results of the Pharmacy Staff Survey can be analyzed using a spreadsheet (e.g., Microsoft Excel) or a statistical software program such as SPSS (SPSS Inc., Chicago, IL) or SAS® software (The SAS System for Windows, SAS Institute, Cary, NC). Table 4 indicates how responses should be entered into the spreadsheet or statistical package.

Table 4: Coding of Responses for Pharmacy Staff Survey

Coding Pharmacy Assessment Tour Results
Response Option for Items 1-30	Code
1. This is something that the pharmacy does not appear to be doing.	1
2. The pharmacy is doing this but could make some improvements.	2
3. The pharmacy is doing this well.	3
4. Not applicable (N/A)	Spreadsheet: Leave blank and do not include item in calculations. Statistical software code: 7
5. Blank (No box checked)	Spreadsheet: Leave blank and do not include item in calculations. Statistical software code: 7

Spreadsheet. Each item or sub-item should be a separate line, and each pharmacy staff member should be a separate column. For each item or sub-item, calculate the frequencies of each response (e.g., how many people chose 1, how many chose 2). Then calculate percentages of the total responses to that item for each response option (e.g., 10 out of 40 respondents to a particular item chose response option 1 ["This is something our pharmacy is not doing"] = 25 percent). Do not calculate means for this section, as frequencies and percentages will provide a more informative description of results.

Statistical software. Create a variable for each item or sub-item. Calculate frequencies for each variable and percentages of the total for responses to each item.

Missing responses. Some pharmacy staff members may not answer all of the questions on the survey. You should report the percentage of respondents with missing values separately.

Demographic differences. It may also be useful to determine whether certain demographic characteristics (e.g., job title, education level) are associated with certain perspectives on the different health literacy variables. With spreadsheets, you will have to create summary columns that tally the responses of respondents with the same characteristic. With statistical software, you can calculate cross-tabulations between variables in the first three sections and variables in the personal information section in order to assess associations.

Interpreting and Reporting Pharmacy Staff Survey Results

Examine percentages and frequencies to determine areas of strength and weakness. High percentages of responses of "Our pharmacy is doing this well" indicate areas in which the pharmacy staff members feel that the pharmacy is meeting the needs of patients with limited health literacy. High percentages of responses of "This is something our pharmacy is not doing" indicate areas in which the pharmacy is not addressing the needs of limited-literacy patients.

Frequent responses of "Our pharmacy is doing this but could make some improvements" indicate areas in which the pharmacy could make some improvements in addressing the needs of their patients with limited health literacy skills. This response should not be taken to mean that the pharmacy is performing adequately in that area, but rather as an indication that there is room to do better. Refer to Appendix 4 for more information and examples.

It will be useful to compare the results by section to determine whether a certain area—print materials, clear verbal communication, or sensitivity to literacy—is stronger or weaker than another area.

A report of the Pharmacy Staff Survey results should do the following:

• Provide a description of the sample, using information gathered in Section D—Personal Information.
• Identify areas of strength and weakness, as indicated by pharmacy staff.
• Include a discussion that provides an overall impression of the pharmacy's status in meeting the needs of patients with limited health literacy. This discussion should also:
• provide suggestions for how the pharmacy can improve its services to better meet patient needs, and
• identify any problems or limitations encountered in obtaining survey responses from a representative sample.

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