TY  - JOUR
T1  - When Dispensing Targets Compete with Patient Safety: A Normative Policy Framework for Pharmacy Performance Incentives, Professional Autonomy, and Organizational Accountability
A1  - Sarah Mitchell
A1  - David Thompson
A1  - Emma Wright
JF  - Annals of Pharmacy Education, Safety, and Public Health Advocacy
JO  - Ann Pharm Educ Saf Public Health Advocacy
SN  - 3108-4850
Y1  - 2026
VL  - 6
IS  - 2
DO  - 10.51847/dITM17FDLS
SP  - 178
EP  - 188
N2  - Performance incentives in community pharmacy can support timely dispensing, service availability, and organizational sustainability, yet their ethical acceptability depends on how performance expectations interact with pharmacists’ patient-safety obligations. This normative policy analysis examines the conditions under which dispensing targets and related productivity measures can coexist with independent clinical judgment. Drawing on evidence concerning pharmacy quality, dispensing safety, professional autonomy, organizational conditions, and incentive implementation, the analysis distinguishes legitimate performance coordination from arrangements that compromise essential clinical duties. It develops a framework grounded in proportionality, non-compensable safety obligations, effective professional discretion, institutional responsibility, and corrective accountability. The framework treats dispensing volume and service efficiency as permissible organizational objectives while requiring protected opportunities for clinical verification, patient counselling, justified interruption, and escalation of unsafe expectations. Organizational responsibility extends beyond setting targets to providing the resources, authority, and monitoring arrangements necessary for safe implementation. Incentive redesign must also distinguish reported safety concerns from measured harm and account for differences in pharmacy organization and regulatory jurisdiction. Performance incentives are ethically supportable when they remain subordinate to essential patient-safety duties, preserve meaningful clinical discretion, and incorporate enforceable mechanisms for identifying and correcting unsafe operational conditions.
UR  - https://smerpub.com/article/when-dispensing-targets-compete-with-patient-safety-a-normative-policy-framework-for-pharmacy-perfo-3y5zribf2d0ygpi
ER  -