The Express Lane at the Pharmacy

How a simulation study at a VA hospital in the 1990s cut prescription waits from an hour to fifteen minutes, and what it tells us about how we get our medicines today

If you have ever waited for a prescription, you know the feeling. You hand over the paper or give your name at the counter, you are told it will be "a little while," and then you wait without any real idea of how long "a little while" is. In the early 1990s I spent time with a group of patients who knew that feeling better than most: veterans waiting in the cafeteria of the Little Rock VA hospital for their outpatient prescriptions to be filled.

I was consulting with the VA hospital system at the time, and the Pharmacy Service in Little Rock had asked for help. The hospital provided both inpatient and outpatient care, and the outpatient pharmacy had a waiting-time problem that everyone could see and nobody had been able to fix. This is the story of how we fixed it, and of how the same thinking eventually helped change the way millions of Americans receive their medications.