First Day at Polyclinic: Operational & Sustainability Flaws

There has been a lack of update as I have adventured out of pharmacy practice for a while despite still doing pharmacist locum work.

This week I started my new job at a Polyclinic and here are a few observations I’ve gathered so far regarding their work processes.

Environmental Concerns

• Excessive Ziplock Bag Usage: The polyclinic goes through a massive quantity of medium to A4-sized Ziplock bags every day. If a patient requires 10 different medications that come in quantities of two packs or more, each medication SKU is consolidated into its own Ziplock bag—resulting in 10 plastic bags for a single prescription. While using bags makes sense for hard-to-bundle items like lactulose syrup bottles, I don't see why boxed medications can't simply be bundled with rubber bands instead.
  (Side Fact: Did you know that clean plastic bags, Ziplock bags, and bubble wrap are recyclable and can be placed directly into blue recycling bins?)

• Paper Notifications: When a medication changes brand or packaging, colour print-outs are placed inside the Ziplock bags to inform patients. While a visual warning to elderly patients that their medication looks different (even though the active ingredient remains the same) is a great practice, it wastes a lot of paper. In the future—as patients become more tech-savvy—we could replace these paper slips with a simple sticker featuring a QR code and the caption "Change of Medicine Brand", allowing patients to simply view the update on their phones.

• A4 Pharmacy Receipts: I noticed some polyclinics and public hospitals print standard retail pharmacy receipts on full / half A4 sheets of paper. It is strange that their POS systems don't use standard receipt paper rolls. I applaud the SingPost's approach - where customers can opt for a digital e-receipt sent straight to their email.

Operational Workflow Issues

• Inflexible Kiosks: Our electronic self-service kiosks only handle ONE function: issuing queue numbers to patients collecting a full supply of polyclinic-prescribed medicines.
  Patients who need partial supplies, medication top-ups before their next appointment, or Pharmacy-Only purchases cannot use the kiosk. This bottlenecks everyone into a long physical queue at the pharmacy registration counter, which is manned by just a single staff member.

• Single-Person Picking and Checking: The picker and scanner/checker can be the exact same person. Having "ownself check ownself" is a risky practice that easily lead to confirmation and expectancy bias.

• Confusing Labeling: Unlike the ROWA item labels at my previous workplace—which clearly state box fractions like 1/4, 2/4, 3/4, 4/4 in the corner—our current labels display raw quantities spread across multiple stickers (e.g., 20/140, 30/140, 30/140, 30/140, 30/140 across 5 labels). This forces staff to mentally calculate or manually count labels to figure out that they need 4 boxes plus 20 loose tablets. Perhaps that's the limitation of old system, we can't fine-tune it,

• Discarded Rubber Bands Everywhere: Medications are pre-bundled in groups of 100 with rubber bands before being placed in storage bins. As a result, discarded rubber bands end up everywhere, and the small collection baskets on the shelves are always overflowing. Reusing these for patient bundling—rather than defaulting to Ziplock bags—would easily solve two problems at once!

The Bright Side

Credit where credit is due: the storage bins are logically organized by medical indication and labels are printed in sequence of the bin alphabet. This allows me to pick multiple medications on the same prescription without having to weave back and forth between different shelves.

That’s all the gripes I have for now! As I spend more time here at XX Polyclinic, I’m sure I’ll gain even deeper insights into our daily environmental impact and operational bottlenecks.

***