Perceptions of working conditions and safety concerns in community pharmacy

Working conditions within community pharmacy can impact pharmacists and their ability to provide safe patient care. The objective of this study was to determine pharmacists’ perceptions of working conditions while controlling for respondent (years of experience, degree, work status) and workplace variables (prescription volume, type of community setting). This mixed-methods study used a cross-sectional survey to investigate community pharmacists’ perceptions of company climate (at the store level, corporate level, as well as fear of discipline), workflow issues, and career satisfaction. Items utilized a seven-point Likert-type response format (1 = strongly disagree to 7 = strongly agree). Linear regression was used to assess relationships between perceptions and years of experience, degree, work status, prescription volume, and type of community setting. A free-response question captured perceptions of safety concerns. An adapted version of the Agency for Healthcare Research and Quality integrative model of health care working conditions on organizational climate and safety was used as a framework for this analysis. Respondents working in national chains had significantly more fear of being disciplined for following policies to promote safety and addressing patient safety concerns than respondents in independent (P < 0.001) and grocery and big box stores (P < 0.001), when controlling for years of experience in community pharmacy, degree, and prescription volume. Most participants (n = 805, 96.9%) indicated organizational or company level factors were the most substantial threat to safety, with work design and quality emphasis being the second most frequently mentioned hazards. Company climate and workflow were perceived negatively in all community settings but were perceived the most negatively by those working in chain pharmacies. A majority of pharmacists feared being disciplined for addressing safety concerns with management, which may be detrimental to patient safety. Further research on how to improve working conditions is warranted.