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Challenges and facilitators to implementing a Veterans Affairs-wide pharmacy call center: A qualitative study of
Background:
Virtual pharmacy contact centers represent an innovative approach for improving health care access across the U.S. Department of Veterans Affairs (VA). While these services have the potential to enhance care quality and expand patient reach, there remains a limited understanding of the experiences faced by the frontline personnel responsible for implementing this initiative.
Objective:
To explore frontline staff and supervisor experiences within a VA-wide pharmacy contact center modernization.
Methods:
From May to September 2023, we conducted semi-structured qualitative interviews with 14 contact center pharmacy technicians, 3 lead technicians, 6 supervisors, and one clinical pharmacist from 6 VA regional sites. Qualitative themes were organized within the Theoretical Domains Framework (TDF) to identify salient domains related to the grounded experiences of delivering virtual pharmacy care to Veterans.
Results:
Eight TDF domains surfaced from interviews: (1) Social/Professional Role and Identity, (2) Reinforcement, (3) Beliefs About Capabilities, (4) Beliefs About Consequences, (5) Memory, Attention, and Decision Processes, (6) Emotion, (7) Knowledge, and (8) Social Influences. Within these domains, we identified 21 themes related to facilitators and challenges described by staff. Facilitators include technicians' intrinsic motivation to support Veterans, effective interprofessional collaboration, positive team dynamics, and well-structured remote work arrangements. Conversely, challenges involve role ambiguity, perceived pressure from performance metrics, training gaps, and the strain from emotionally taxing calls.
Conclusion:
Pharmacy staff's commitment to Veterans and professional collegiality provide a strong foundation for VA pharmacy contact center services. Clarifying roles, refining training and respite opportunities, and balancing performance expectations with patient-centered care may further strengthen implementation and help ensure sustainable, high-quality service delivery.
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