Members' perception of the level of innovation in the drug dispensing
service provided by EPS Compensar at the CAF Nova Center.
..........................................
Percepción del nivel de innovación en el servicio de dispensación de medicamentos,
prestado por la EPS Compensar en el Centro CAF Nova, por parte de los afiliados
Álvaro Infante Rodríguez
1
Sebastián David Herrera López
2
Mauricio Charry Prada
3
ABSTRACT
Conceptually, innovation can be described as a
series of activities carried out in order to
change pre-existing elements, ideas or
protocols to improve them or create new ones
that have a positive effect on the market. The
objective was to establish the users' perception
of the drug distribution service provided by
EPS Compensar at the CAF Nova Center, the
methodology for the development of this study
had a quantitative approach, with a non-
experimental descriptive scope and
longitudinal design. The universal population
consisted of 3390 users of the center, from
which a sample of 345 users was obtained with
a confidence level of 95% and a margin of error
of 5%. The results obtained were the
characterization of the services provided in the
Greco and Nova centers in the years 2021 and
2022, as well as the evaluation of the
perception of innovation in the Nova
dispensing service as a result of the changes,
where it was possible to demonstrate the
existence of a positive difference compared to
Received: March 05, 2023
Approved: June 11, 2023
...........................................
1
Project Management Specialist
Minuto de Dios University Corporation
Bogotá, Colombia
Email: ainfanterod@uniminuto.edu.co
http://orcid.org/0000-0001-6774-7772
2
Specialist in Water Resources and Specialist in
Project Management
Minuto de Dios University Corporation
Bogotá, Colombia Email: sebastian.herrera
d@uniminuto.edu.co
http://orcid.org/0000-0002-6671-1484
3
Specialist in Project Management, Specialist in
Financial Management and Specialist in
Occupational Risk Management, Safety and
Health at Work.
Minuto de Dios University Corporation
Bogotá, Colombia
Email: mcharryp@uniminuto.edu.co
http://orcid.org/0000-0003-3464-9986
Members' perception of the level of innovation in the drug dispensing service provided by EPS Compensar at the CAF Nova
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the previous CAF and the CAF Nova, it is
concluded that thanks to the changes made,
the users had a positive perception of the
services provided by the CAF Nova.
Keywords: : organization, modernization,
organizational change, health service,
perception, perception
RESUMEN
Conceptualmente, la innovación puede
describirse como una serie de actividades
realizadas con el fin de cambiar elementos,
ideas o protocolos preexistentes para
mejorarlos o crear nuevos que tengan un efecto
positivo en el mercado, el objetivo a alcanzar
fue establecer que percepción tienen los
usuarios sobre el servicio de distribución de
medicamentos, prestado por la EPS
Compensar en el Centro CAF Nova, la
metodología para el desarrollo del presente
estudio tuvo un enfoque cuantitativo, con
alcance descriptivo de tipo no experimental y
diseño longitudinal. La población universal fue
de 3390 usuarios adscritos al centro, de la cual
se obtiene una muestra de 345 usuarios con un
nivel de confianza del 95% y un margen de
error del 5%. Los resultados obtenidos fue la
caracterización de los servicios prestados en el
centros Greco y Nova en los años 2021 y 2022,
como también se evaluó la percepción de la
innovación en el servicio dispensación de Nova
a raíz de los cambios, donde se logró evidenciar
la existencia de una diferencia positiva frente
al CAF anterior y el CAF Nova, se concluye que
gracias a los cambios efectuados se logró que
los usuarios tuvieran una percepción positiva
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frente a los servicios prestados por el CAF
Nova.
Palabras clave: : organización,
modernización, cambio organizacional,
servicio de salud, percepción
Introduction
Environmental pollution has been tried to be controlled and reduced in different ways.
From the social aspect, it has been intended that environmental management be
carried out through concerted actions among all those involved, such as individuals,
industry, local and national governments and international organizations (Valadez,
2003). This intention is approached from the political aspect through the creation of
institutions and the enactment of laws and from the economic aspect through the
implementation of market incentives. From the cultural aspect of the exposed
problem, the solutions are focused on strengthening Environmental Awareness, which
can be defined as "the system of experiences, knowledge and experiences that the
individual actively uses in his relationship with the environment" (Gomera, 2012, p.
214). According to the conception provided by Chuliá (1995), environmental
awareness is outlined around four dimensions: cognitive (information and
knowledge), affective (beliefs, values, feelings of concern), conative (attitudes) and
active (individual and collective behaviors). In response to this need, environmental
education emerges as the main actor. The concept of environmental education changes
with the idea of environment and with the socio-cultural, political and economic
dimensions (Bedoy, 2000), however, it can be stated that it is "the formative
orientation in harmonious attitudes towards the environment that achieves the
prevention, treatment and solution of environmental problems and with respect to the
sustainability of life" (Cuéllar & Méndez, 2006, p. 184). Consequently, Environmental
Education is a fundamental pillar in the strengthening of Environmental Awareness
through the development of pro-environmental competencies and attitudes.
The Ministries of National Education and of Environment, Housing and Territorial
Development offer environmental strategies for environmental education through the
definition and implementation of School Environmental Projects (PRAE) that "are
pedagogical projects that promote the analysis and understanding of local, regional
and national environmental problems and potentialities, and generate spaces for
participation to implement solutions in accordance with natural and socio-cultural
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dynamics" (Restrepo, 2018, p. 2). In other words, the PRAE is a transversal reference
that seeks the curricular inclusion of the environmental dimension from all
disciplines, including those that do not consider experimental processes as a teaching
method (Cortés & González, 2017).
Environmental education can be approached from an interdisciplinary and integrated
approach to develop environmental awareness. From this perspective, we start from
an action - reflection research design, which takes up the epistemological and
phenomenological paradigms, and which leads to a spiral reflective process that
addresses the relationship between the intentions proposed by the subject plan, the
basic standards of competence and the school environmental projects, and their
impact on the dimensions developed by the students of tenth and eleventh grade, in
their teaching - learning process, facing the environmental problems within the
Ciudad de Ipiales Educational Institution.
Initially, in the first loop of the research spiral, this work addresses the construction
of a profile that evidences the interpretation of environmental problems by students
in tenth and eleventh grades. For this purpose, a strategy is structured that allows
interacting with the environmental phenomenon of the institution, in which the
participating students reflect on their educational progress regarding the dimensions
of environmental awareness, and such consolidation of perceptions allows the
research teachers to identify symbols and meanings that value different categories of
the system of beliefs, attitudes and knowledge of the students regarding their
environment. This makes it possible to fill with meaning the second level of the spiral
that supports the design of the research route.
With the assessment of the categorization of environmental awareness, the research
focused on analyzing the quality of the articulation of the environmental policies of the
educational system as proposed by the curricular guidelines and basic standards of
competence with the institutional environmental policies as proposed by the school
environmental project and the subject plans. This reflection allowed assessing the
practice inherent to the teaching and learning of the different areas regarding
environmental education, evidencing the cohesion and vertical and horizontal
coherence of the educational process oriented by the tenth and eleventh grade
curriculum, and finally, identifying the categories that such curriculum has to
enhance, improve or implement the integration of an interdisciplinary environmental
education that characterizes the Ciudad de Ipiales Educational Institution in the
management of development and social change within its community. These reflective
actions guide the route towards the following research spiral.
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With the identification of the potentialities, risks, challenges and limitations of the
subject plans, a possible space was created for discussion and reflection on the
meaning of environmental education that should be established from the subject plans
with the perspective and expertise of the institution's teachers, This reflection is active
and propositive to the extent that the conceptions that the teaching staff has about
environmental education are studied, key concepts of the curricular structuring
proposed are unified and oriented, and possible educational practices of
environmental approach are opened, which from the interdisciplinary transform the
comprehensions about the framework of knowledge applied to the environmental
context of the Ciudad de Ipiales Educational Institution.
Materials and methods
The IA model established in this research is based on Whitehead's research cycle as it
allows improving the relationship between environmental education and the
development of environmental awareness through a cyclical process of research that
includes the reflection of the relationship between the environmental awareness of
students and the subject plans of the different areas in order to integrate
environmental education in an interdisciplinary way. According to Poveda, et al.
(2018). Social appropriation is a mechanism of social interaction with the results.
Initially, the reflection is focused on understanding the nature of the environmental
awareness of this population through its categorization. The instrument proposed by
Gomera, designed under Chuliá's model of environmental awareness, was coupled and
optimized within the context of the Ciudad de Ipiales Educational Institution. The
optimization lies in the elimination of items that do not present a desirable internal or
global correlation for the functioning of the questionnaire, since these can provide a
non-assertive description of the phenomenon and inadequately focus the reflection on
environmental awareness. To this end, the results are initially coded according to the
indicators of the categories of each dimension of environmental awareness, the results
are collected and the value of the "Cronbach's Alpha" statistic is calculated and the best
items of the questionnaire are estimated to be used each year as an institutional tool
to guide the investigative spiral of the school environmental project and to orient the
environmental education strategies in the institution. Finally, descriptive statistics are
used to analyze the dimensions of environmental awareness that represent a more
considerable weight within the system of experiences, beliefs and attitudes that are
being built in the Ciudad de Ipiales Educational Institution and are evident in the
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profile of environmental awareness within the students, in order to reflect on where to
focus the educational practice established within the subject plans.
Next, the reflection focuses on relating the subject plans of the areas of Spanish,
mathematics, social sciences and natural sciences with the dimensions of
environmental awareness. A SWOT analysis of subject plans is carried out, a SWOT
strategy is developed and modifications to the plans are proposed to ensure the
integration of environmental education.
Based on this reflection, subject plans can be designed with an environmental focus
through a focus group with teachers. The proposals for modification identified for each
of the subject plans are presented. A focus group of teachers is opened for the design
of subject plans with an environmental approach for tenth and eleventh grades. At this
point, the investigative spiral of the present work is closed and the necessary tools are
left for the Ciudad de Ipiales Educational Institution to continue in a new investigative
spiral to improve environmental education within the institution.
Results
In order to achieve the objective of identifying the innovation that has created the drug
dispensing service provided by EPS Compensar in the CAF Nova center with respect
to the "El Greco" point of care, it was necessary to show the specifications of this center
as shown in Table 2. In the year 2021, in the month of November, an evaluation of the
services provided by Audifarma's CAF centers was carried out; this Firm is the one that
manages the different medicine dispensing points of EPS Compensar in the city of
Bogota. This study consisted in applying a structured survey, which was applied by
telephone between November 09 to 19, 2021, in order to determine the level of
satisfaction associated with the service provided by the CAF El Greco Center. The
population under study were active members of the Complementary Plan, Health
Benefits Plan and Subsidized Regime, women and men between 18 and 70 years of
age. The universal population was 4355, the sample was taken from 115 affiliates, with
a confidence level of 95%, standard error was 9%, the measurement scale was
represented in quantification from 1 to 5.
Taking into account the results, it was decided to expand the network of CAF Centers,
with the construction of the CAF Nova center located at Cra 57 No. 45-14 LC Norte,
Barrio El Salitre in an area of 600 m², where the CAF El Greco Center was moved in
its entirety, the new center was designed thinking about inclusion, exclusivity and the
needs of the users of the environment, in addition to complying with the regulations.
Members' perception of the level of innovation in the drug dispensing service provided by EPS Compensar at the CAF Nova
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The physical characteristics of the structure were evaluated taking into account
Resolution 10911 (Ministry of Health, 1992). (Ministry of Health, 1992) and Resolution
1403 of 2007 (Ministry of Social Protection, 2007)These include everything related to
care and administration areas, ceilings, walls, lighting, ventilation systems, electrical
infrastructure, as well as storage conditions and systems.
As for human resources, it was structured following the guidelines provided in Decree
780 of 2016. (Presidency of the Republic of Colombia, 2016).Resolution 1478 of 2006
(Ministry of Social Protection, 2006) and Resolution 1403 of 2007 (Ministry of Social
Protection, 2007).. The center has 27 Front and 10 work stations, where 40
collaborators rotate for the attention of the Caf and other tasks required by a drugstore,
from Monday to Friday from 7 am. to 7 pm. and Saturdays from 7 am. to 3 pm.
In terms of equipment, functional, adequate and inclusive equipment was installed,
including special shelves for handling quantities and quality, properly calibrated
thermohygrometers with their corresponding records, and of course refrigeration
systems for items that require a cold chain, etc.
Table 1. Comparison of CAF El Greco Vs CAF Nova Centers
Comparison between Audifarma's CAF Greco and Nova Centers
El Greco
Nova
Area
The CAF Greco center was built on an
area of 260 m², consisting of only one
floor with 60 m² for the waiting room
and 200 m² for medicine storage.
The CAF Nova center is built on an area
of 600 m², with two floors, 200 m² of
which are used as a waiting room and
400 m² for medicine storage.
Human Talent
The staff consisted of an Administrative
Coordinator (Pharmacy Regent) and 12
assistants.
The staff is composed of an
Administrative Coordinator (Pharmacy
Regent), 1 Administrative Assistant
(Pharmacy Regency Assistant), 22
assistants, 1 service counselor, 1 general
services assistant and 1 security guard.
Flow of attention
Entering the pharmacy and taking the
ticket at the dispenser took 4 minutes,
then waiting in the room and calling the
shift 45 minutes and finally calling the
Entering the pharmacy and taking the
ticket at the dispenser takes 1 min., then
waiting in the room and calling the shift
12 min. and finally calling the cashier
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cashier and dispensing the medication
11 minutes, for a total of 60 minutes for
the dispensing of the medication.
and dispensing the medication 7 min.
for a total of 20 minutes for the
dispensing of the medication.
Personnel characteristics
The personnel selected for employment
had to meet criteria such as being
pharmacy registry assistants and
nursing assistants.
The personnel selected to work had to
meet criteria such as being pharmacy
assistants and nursing assistants, as well
as special characteristics such as
efficiency, speed, personal presentation
and customer service.
Comfort in the facilities
General waiting room with an area of 60
m².
An area of 200m² with a general,
preferential and VIP lounges.
Cleanliness and order in the facilities
There were no general services
personnel; the same auxiliary personnel
were responsible for cleaning the
facilities.
There is a general services person who is
responsible only for cleaning the
facilities.
The center did not have restrooms for
the public.
The center has a men's restroom, a
women's restroom and a restroom for
the disabled.
It had an area of 200 m² with 11 double
top shelves for storing dry cargo and 6
industrial shelves for storing food
products.
It has an area of 400 m² with 24 double
top shelves that allow the storage of dry
cargo and 18 industrial shelves that
allow the storage of food products.
Signage inside the pharmacy
The headquarters had basic signage
demarcating the various sections
The headquarters has special signage in
Spanish and Braille for the blind, and
each area is marked so that users can
find their way around.
Note: Information provided by A. Infante (Personal communication, October 15,
2022).
The above table shows a comparison between the two centers. Table 3 shows the
differences between each of the centers, the area in m² is increased by 2.3 times in the
CAF Nova center compared to the CAF El Greco center, which allows users to enjoy
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more space, equipment, comfort and better access routes for the provision of services.
The aim was to speed up access to users and serve them as quickly as possible. The
novelty of the Nova Center was its ample spaces, which allow users to manage their
time and find what they need easily and quickly, something that cannot be seen in the
CAF El Greco center due to its reduced space.
In terms of human resources, CAF El Greco had a formulation indicator of 400 units
per day, while CAF Nova 1200 units per day, with a projection of 2500. These
productivity results are due to the work distribution of the team. At El Greco, the
workers had to perform different activities, from cleaning the facilities and their
workstations to guiding the users, making their formulation productivity low, since
the 12 assistants produced 400 formulas per day, which means that each one produced
33.3 formulas per day.
Meanwhile, at the CAF Nova, the formulation indicator is currently 1200 units per day,
which means that each of the 22 assistants produce 54.5 formulas per day. The above
result is due to the distribution of activities, since each auxiliary is dedicated to the
formulation process, the center now has an administrative assistant who is in charge
of managing the backlog and ensuring delivery of medicines within 48 hours, a
security guard, who is attentive to any situation that affects the service, a person in
charge of cleaning the facilities, as well as a service counselor who is responsible for
guiding the user to the use of the service; innovate the distribution of activities in a
work team, through a leadership that changes the characteristics of the activities, as a
result will improve satisfaction, empathy among the team and therefore productivity
and performance.
The flow of attention in El Greco was 60 minutes, while in the Nova Center it is now
20 minutes as can be seen in Table 2, these results were achieved thanks to the changes
made in the work team. Thinking that the services provided by the CAF Nova must be
of the highest quality, a work team had to be formed, therefore it was established that
to belong to this team at the time of selection and recruitment of each of its members
had to meet special criteria, such as a high service attitude, high knowledge and
experience in the field, agility and efficiency, another criterion that was taken into
account was personal presentation, the previous set was essential on the one hand in
productivity and on the other hand the empathy with users.
Regarding the comfort of the facilities of the CAF El Greco Center, it had a 60 m² room
where 6 X 4 tandems were located, in the CAF Nova it became a 200 m² space where
the general room was installed with 12 X 4, a preferential room with 4 X 3 tandems
and a VIP room with armchairs and armchairs. In this new design, comfort and
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decoration were taken into account to create a more welcoming environment for users.
In addition to these improvements, three sanitary units were installed, one for men,
one for women and one for people with reduced mobility, with inclusiveness in mind.
The cleanliness of the pharmacy is vital, since the purpose is to project an image of
neatness, asepsis, cleanliness, sanitation and professionalism. To this end, the CAF
Nova center currently has a person who is responsible for ensuring that the facilities
are clean and tidy, thus guaranteeing that the environment of the facilities is safe and
healthy. On the other hand, the medicines and other items dispensed must meet strict
cleanliness and maintenance requirements. It should be clarified that the CAF El
Greco center did not have this position in its work team.
In terms of organization, the El Greco CAF had an area of 200 m² with 11 double
shelves for storing dry cargo and 6 industrial shelves for storing food products; due to
the small size of the facilities, it was prone to overcrowding. The Nova CAF has an
area of 400 m² with 24 double shelves for storing dry cargo and 18 industrial shelves
for storing food products. Medicines are organized alphabetically, this classification
model happens to be one of the oldest and most used, medicines are sorted by name
without taking into account any other specification of the medicines, it is the oldest
and most used classification, it is sorted alphabetically from A to Z, without taking into
account any classification of the medicine only its name. On the other hand, the
medicines that require refrigeration at the CAF El Greco had only one refrigerator; at
the CAF Nova there are 3 refrigerators and a freezer in order to guarantee the cold
chain for medicines that require a cold chain.
The population of Compensar EPS has between 7% to 9% of people with disabilities,
so the CAF Nova center was built with inclusiveness in mind and thus reduce
inequality gaps. Users with this type of conditions will be able to be autonomous
because the facilities allow it due to their signage. The CAF Greco did not have this
type of signage, as the small size of the facilities prevented it. With these changes, the
CAF Nova Center became one of the most exclusive and unique in the city of Bogota
and even in Colombia.
When comparing the measurement results for the years 2021 and 2022, it was evident
that in question 1 the CAF El Greco obtained an overall rating of 66.2%, while in the
CAF Nova it was 81.9%, which shows progress in improvement, as shown in table 12.
In item number 2, concerning friendliness, 80.6% was obtained in the first and in the
second and 80.9%, where there was also improvement; in item 3 it can be evidenced
that there was 76.9% while in the second the results were 81.2% where progress is
presented; in question 4, in the year 2021 it was found that the results showed 86.1%
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and in the year 2022 80.0%, which represents a decrease in the process. In question 5
it was found that in the year 2021 the result was 73.2% while in the year 2022 it was
81.7%, which means that there was a representative improvement. In item 6 for the
year 2021 it was found that in the CAF El Greco Center it was 85.3% and in the year
2021 the CAF Nova was 80.9% where there was regression, as well as in question 7 in
the year 2021 of 82.6% while in the year 2022 it was 80.9%. The comparative results
show a predominant improvement in the two results, see Table 2.
Table 2. Measuring CAF El Greco CAF Center 2021 and Nova 2022
El Greco 2021
Nova 2022
Value
Responses
Rating
by
factor
Overall
appraisal
Responses
Rating
by
factor
Overall
appraisal
1. Waiting
time in the
pharmacy
from the
time of
admission to
the delivery
of
medications.
2.
1
0
0
66,2%
0
0
81,9%
2
2
80
0
0
3
77
60
0
0
4
34
144
312
1248
5
2
100
33
165
2.
Kindness in
the attention
1
0
0
80,7%
0
0
80,9%
2
0
0
0
0
3
34
102
15
45
4
43
172
300
1200
5
38
190
30
150
3.
Empathy on
the part of
the
pharmacy
staff
(understood
as: greeting,
looking you
in the eye
while
1
0
0
76,9%
0
0
81,2%
2
0
0
0
0
3
40
120
4
12
4
53
212
317
1268
5
22
110
24
120
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El Greco 2021
Nova 2022
talking to
you, and
giving a
warm
farewell).
4. Clarity
in the
information
on the
medicines
delivered
with respect
to name,
quantities
according to
formulation
1
0
0
86,1%
0
0
80,0%
2
2
4
0
0
3
27
81
0
0
4
20
80
345
1380
5
66
330
0
0
5. Comfort
of the
service area
1
0
0
73,2%
0
0
81,7%
2
34
68
0
0
3
15
45
0
0
4
22
88
315
1260
5
44
220
30
150
6.
Cleanliness
and order of
facilities
1
0
0
85,3%
0
0
80,9%
2
2
4
0
0
3
34
102
0
0
4
11
44
330
1320
5
69
345
15
75
7. Signage
inside the
pharmacy
1
0
0
82,6%
0
0
80,9%
2
0
0
0
0
3
10
30
0
0
4
80
320
330
1320
5
25
125
15
75
Note: Authors' own creation
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Taking into account the previous comparison, the global values in percentage of each
question were extracted from the results of El Greco year 2021 and Nova year 2022;
subsequently the difference between the two was found, these results were added and
then averaged and the result of this exercise was the global valuation of the service as
shown in table 5.
Table 5. Comparison of El Greco Vs Nova measurements and overall service rating
Applied questions
2021
2022
Difference
1. Waiting time in the pharmacy from the time of
admission to the delivery of medications. 2.
66,30%
81,90%
15,70%
2. Kindness in the attention
80,70%
80,90%
0,20%
3. Empathy on the part of the pharmacy staff
(understood as: greeting, looking you in the eye
while talking to you and giving a warm farewell).
76,90%
81,20%
4,30%
4. Clarity in the information on the medicines
delivered with respect to name, quantities
according to formulation
86,10%
80,00%
-6,10%
5. Comfort of the service area
73,20%
81,70%
8,50%
6. Cleanliness and order of facilities
85,20%
80,90%
-4,30%
7. Signage inside the pharmacy
82,60%
80,90%
-1,70%
Overall service rating
2,40%
Note: Authors' own creation
Conclusions
With regard to the general objective, which was to establish the users' perception of
the medicine distribution service provided by EPS Compensar at the CAF Nova Center,
the measurements taken in 2021 and 2022 were taken into account, and the difference
between one study and the other was subsequently found, In general terms, it was
found that the average user satisfaction for El Greco and Nova was 2.40%, which
means that there was progress in the process, but not significant, which should lead to
evaluate the real impact of the changes made in the process. This calculation was
determined through a simple average taking into account the results of each item
evaluated by the users.
To answer the research question, it can be said that after having carried out the
exercise, in general terms, it yields a result of improvement in perception (2.54%),
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which is not really significant, understanding that not all the items evaluated showed
an improvement in perception.
After the exercise it can be concluded that a company where innovation is promoted
will achieve a positive perception of its customers.(Lopez Rodriguez et al., 2021)This
is not only because they anticipate and adapt to changing market conditions, but also
because they attract and retain their customers and consumers.
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