Are chain pharmacy work system characteristics associated with work-life outcomes? A national study

Pharmacists in chain and mass merchandiser pharmacies practice in standardized, corporate-driven environments where performance metrics and workload expectations often dictate daily activities. Few studies have systematically examined how specific work system characteristics such as autonomy, staffing, and feeling heard relate to pharmacists' perceptions of work-life outcomes in these pharmacies. Understanding relationships is critical as pharmacy organizations and pharmacists seek to address workplace issues magnified by COVID-19 and improve pharmacist retention and recruitment.

To examine the prevalence of work system characteristics across chain and mass merchandiser pharmacies, test associations between work system characteristics and pharmacists' perceptions of burnout (BO) and job turnover intention, and explore organizational strategies to improve pharmacist work-life.

Data were obtained from the 2022 National Pharmacist Workforce Study, a cross-sectional online survey of U.S. pharmacists. The Systems Engineering Initiative for Patient Safety 2.0 model guided the survey's domain content. Respondents practicing in large chain and mass merchandiser pharmacies (n = 662) responded to survey items about 6 work system characteristics, professional fulfillment (PF), BO, and turnover intention. Descriptive statistics and multivariate regression models were used to assess associations.

Nearly 88% of pharmacists reported engaging in more work activities than when hired, 85% reported that workload metrics compromised safety, and 73% felt their organization did not listen to pharmacists' patient medication safety concerns. Regression models showed that autonomy and feeling heard about safety issues were the strongest predictors of PF and BO.

Pharmacists' perceptions of not having control of how work is done in large chain and mass merchandiser pharmacies likely stem from how hierarchical organizations make decisions. Organizational strategies that increase local decision-making, reduce reliance on workload metrics, and provide autonomy to pharmacists are needed for workforce sustainability.