As healthcare reimbursement has changed over time, Providence has also had to evolve to keep up with the various payer models. Providence is a non-profit entity, and as such, does not operate like a highly competitive insurer or for-profit entity. Instead, our decision models are based on the mission and quadruple aim

Problem

On any given day, a single buyer in a facility may have to address a time-consuming drug shortage while also ensuring they are buying the most cost-effective medication that complies with regulatory and safety requirements. It became readily apparent that we need a centralized procurement support team that is supported by a standardized inventory management tool that is specific to pharmacy during the onset of the COVID-19 crisis. In huddle after huddle, each region would have to report their obsolete inventory based on the last time they walked the shelves and manually aggregate the data via spreadsheets. We have been asked to envision by leadership where we can continue the gains and changes in practice that we have realized from COVID-19, and this is the number one strategy the pharmacy teams have requested to help them do their jobs more effectively and, in turn, help our patients and caregivers.

These are the primary problems we face:

1. No centralized inventory system. Consider the way in which supply chain can manage their inventory centrally. We need a different tool to do that for pharmacy, given the complexities of our regulations. But with these tools, we can transform our pharmacy procurement systems to allow for the right balance between system coordination and regional oversight.
2. Buyer knowledge is learned on the job by walking the shelves. It is currently a manual art form rather than a rigorous data-driven process. The process involves repetitive walking the shelves, a very inefficient process because of the limited tools.
3. We have significant opportunity to reduce our pharmaceutical waste.

Currently, our ordering processes are fragmented and disconnected. We use spreadsheets to keep ourselves organized. With over 50 locations and significant levels of complexity, things do inherently unwind if the time-consuming manual oversight process is not applied. This is a major rate-limiting factor in our ability to search for new savings opportunities.

Transformation opportunity

We realized our ability to continue to generate savings would diminish significantly if we did not have automated tools to assist us. By using technology that can provide us with a virtual view of all inventories across the entire system, we would address drug shortages and maintain pharmaceutical inventory levels that match anticipated utilization. The implementation of hardware and software from two vendors will help us coordinate our complex work in much more efficient ways.

By implementing the two-vendor solution, our system has an opportunity to address the quadruple aim through one project. Starting with lower costs, the conservative estimates by finance have estimated significant savings over seven years. The patient experience will be improved by ensuring we have the necessary medications via better drug shortage management practices and perpetual inventory management. The caregiver will experience optimized workflows and elimination of manual processes. Lastly, by having better oversight of our perpetual inventory, we anticipate improved outcomes because we will reduce the need for workarounds or alternative therapies due to medications in short supply.

Henceforth, this software will aggregate our purchases and evaluate savings opportunities, while also evaluating the complex landscape associated with regulatory requirements. This system will evaluate our external spend to significantly higher levels and allow us to orchestrate coordinated savings opportunities in a effective way than our current manual methods.

The complex implementation plan occurs over two years with staging in over 50 locations. The plan was designed around pre-existing projects for known EMR go-lives or other IS conversions that could bring additional risk or complexity to the project.

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In January 2020,  the center for disease control (CDC) reported the first case of the novel coronavirus. Over the next several weeks, it would become evident that this virus was spreading quickly across the country and would need to be managed by many health care systems. We have been here before with wide-scale events from infectious diseases such as H1N1 influenza in 2009 to a supply chain crisis with IV Fluids when Hurricane Maria hit Puerto Rico in 2018. The problem or challenge was large enough to align all stakeholders to work together, collaborate and identify shared goals. 

The COVID-19 pandemic is a strong example where all priorities shifted to focus on the response plan.

As pharmacy leaders, most of the challenges we will need to manage will be less clear about the end result or alignment of stakeholders. Therefore, it would be prudent to look at the tactics and tools that were successful during the COVID-19 pandemic and apply these to future events. Looking forward, we are in a challenging position across the country as health system pharmacy leaders will need to manage an unprecedented supply chain challenge, with record-level inflation prices and hospital and health-system financial shortfalls. It will be critical to lead our teams through these uncertain challenges and help them identify how we can work together to accomplish shared goals.

Strategic planning is key

We must plan if we do not want to leave the results or outcome to chance. This can be a formal process with a strategic retreat or informal in smaller team meetings. The important point is that you must define for your team what is important to work on over the next 9-12 months based on the challenges that you and your leadership team see ahead. There will be a strong influence from your organizational strategic goals; however, pharmacy department-specific goals will come from the pharmacy management team. In addition, many strategic plans will need to be extended to 2-3 years at a minimum to forecast reimbursement changes, regulatory updates and capital projects.

Within your strategic plan process, the team should consider elements of strength where your team is performing well and areas needed for improvement. After defining these internal factors, consider external to your department and organization opportunities to grow your services and business while considering threats to your pharmacy services. An example of a threat listed above is how your team will prepare for the current supply chain challenges. This tool, referred to as SWOT analysis, assists the team in formally evaluating the areas of strengths, weaknesses, opportunities and threats. This is necessary for leading your team through challenging times and incorporating it into the strategic planning process.

Communication, communication, communication

Once you have developed a strategy and vision, it is essential to communicate this plan to your team. During the height of the COVID-19 pandemic, many leaders used virtual town halls to connect with their large teams and remote teams. Consider the tools you will need to spread the information in your strategic plan including emails, town hall, staff meetings, 1:1 meetings, dashboards and reports. By sharing the department goals, you will empower your team members to participate in meeting these goals and ultimately, celebrate your successes together. This process will also allow emerging leaders to shine by taking on projects that may not be directly in their day-to-day work. Finally, for future challenges, it will be important to identify these emerging leaders and incorporate them into succession planning.

“Catchball”

The lean concept of information sharing between leaders and team members in a continuous cycle can help be an early signal of both success and new challenges that need to be managed.  Ensure in the process of managing challenging times at all levels of management, there are established recurring team and individual meetings to allow for information sharing both to the team members and the managers. This catchball system will be beneficial for all aspects of the strategic plan.

One common tool in catchball systems is establishing a dashboard that tracks key performance metrics. The performance of the metrics can be incorporated into meetings as a talking point and then discussions on why these are either performing to plan or additional focus need to be provided.

Expect new challenges

Healthcare is an ever-changing environment with many stakeholders, suppliers, inputs and beyond. While pharmacy leaders must navigate challenging times with a robust strategic plan and communication platform, expect new challenges to arise that may not fit into the original plan. As leaders, we must evaluate the situation and determine if this new challenge requires an identified owner or resource on your team to manage or if you will need to shift your priorities to manage this new challenge. The COVID-19 pandemic is a strong example where all priorities shifted to focus on the response plan. Teams canceled all non-essential meetings and staff assisted in non-traditional roles to manage the priority of response. The path forward will not always be direct.

Strategic goals and results will be top of mind during challenging times, but as a final note, it is essential to connect back to your management team and front-line staff to ensure they have the resources and support to be successful. Recognizing that stressful times impact team members differently and personal challenges outside work can be an additive effect to performance and stress. As mentioned in the communication plan, incorporating wellness checks into 1:1 meetings with team members can be useful in navigating team resilience and wellness.

Communicate frequently, be organized and support your teams knowing that together you can navigate any challenging times as a team.

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Automation has been a part of pharmacy practice for decades. However, complex compounding robotics are less common and under continuous development to meet pharmacy demands. Reasons for lower adoption rates include high cost, product complexity, speed and product limitations. Before considering the purchase of a robot, the pharmacy should have thorough knowledge of product functionality and comfort with outcomes. I’m highlighting these expectations for improved decision-making.

Personnel

Pharmacy staff working directly with high-level robotics must develop technology skills to be successful. These skills are most often taught during an onsite training session. Training sessions require the pharmacy workforce to be off the line. The more complex the robot, the longer the expected training. For example, when working with complex intravenous sterile compounding robots, the minimum expected training time is 40 hours per person. There is a temptation to reduce or omit training; however, lost training upfront generally leads to additional time and expense post implementation. Therefore, it is essential that pharmacies create time for key staff to be off the line to train on the robot.   

In addition, pharmacies should target robotic training to a selected number of staff with an affinity for technology. The benefit of a small number of operators is increased interface time with the robot, which in turn sharpens skills and expands capability. The limitation of a small subset of trained robotic operators is a limited labor pool. Therefore, utilizing an untrained staff member to operate a robot places an expensive piece of equipment in jeopardy of misuse or damage. 

Compounding robots are often suggested to reduce personnel labor requirements in pharmacy operations. In reality, the more complex the robot, the more time staff will be required to operate, troubleshoot and manage.

Automation Time

Robotic automation can be sold with the promise of reduced time required to prepare the end product. Depending on the end product, the robot may be faster than the manual process; however, robots require upfront prep time which is not always factored into the equation.  Achieving the expected production speed can also take time as staff adapt and learn the capability of the automation. In addition, robots require intricate cleaning time between batches adding to production time. Finally, staff may be somewhat freed up to move on to other tasks when operating automation; however, the robot will require continuous oversight requiring the staff to remain in close proximity.

Supervision and Human touchpoints

Pharmacy robotics require a surprising number of human interaction touch points during the completion of a task. There is a need to feed and change consumables, troubleshoot errors, and intervene when the robot is producing an unexpected outcome. Before purchasing a robot, ensure the company has provided a clear expectation for the number of expected human touch points in a given period of time. 

Pharmacy robotics has its own set of challenges, but incorporating this technology into the pharmacy is important for the development of safer and high-quality end products.

Consumables

Robotics are generally inflexible when it comes to medical consumables such as medications, syringes, caps, diluent tubing, etc. Typically robots are limited to one or two specific consumables. When backorders or shortages occur, robots can become obsolete until the correct parts or calibrations occur to return the machine to operate. To best avoid this scenario, the pharmacy should target procuring and storing a 3 to 6 month supply of all consumables. When a backorder occurs, the pharmacy will have the time to work directly with the robotic company to program the robot with the new consumable, thus ensuring continued operation of the robots. 

Application

Unfortunately, not all robots are capable of universally completing all tasks related to an item or a process. In addition, there will be medications that cannot be prepared by the robot. Therefore if robotics are implemented, pharmacies will need to retain standard operating procedures (SOP) for manual processes. Product line limitations should be discussed and measured against the pharmacy’s goal prior to consideration. 

Safety/Quality

Despite the complexities mentioned above, robots are designed with many safeguards to reduce and or eliminate medication errors. Bar code scanning, photography, graviments, and in processes where measurements make automation superior to the manual process. Robots are also able to deliver the same outcome regardless of the size of the batch. With challenges in the labor market, automation can serve as a valuable member of the team, augmenting the labor that is available. 

Conclusion

Pharmacy robotics has its own set of challenges, but incorporating this technology into the pharmacy is important for the development of safer and high-quality end products. The key to successful automation integration is to partner with companies who are willing to make frequent and timely modifications based on customer feedback and for end users to challenge the automation for continued improvements.

The post Analyzing Compounding Pharmacy Robotics: What to Expect appeared first on HealthTech Magazines.

Pharmacy is one of the most highly regulated professions in the US and its management is complex. Pharmacy’s impact on public health and safety is vast as the profession includes professional/clinical practice standards in addition to pharmacy facility and product standards.

There are many different types of pharmacies that vary widely in their operations. Some different types of pharmacies include community (outpatient), hospital (inpatient), specialty, nuclear, infusion, and compounding. Across all pharmacy practice settings, there are key aspects for effective management.

REGULATORY COMPLIANCE

Many federal and state laws impact pharmacy operations and professional practice, with wide variations between states. Pharmacy crosses a multitude of disciplines that are regulated – facility standards, professional standards, controlled substances, insurance billing – to name a few.

A 2019 RSAP study found that pharmacy laws had 105.8% more word count than medicine and 97.5% more word count than nursing. Pharmacy laws are amended more frequently and have more restrictions when compared to medicine and nursing.

Effective pharmacy management requires compliance with all the regulations pertaining to the practice setting. Pharmacy practice settings that perform compounding of sterile pharmaceuticals have an even higher burden of regulatory oversight as the risk to public health and safety with sterile compounding is heightened. There are significant civil and administrative penalties for noncompliance.

An oversimplification of drivers of pharmacy success is payer mix and therapy mix.

PHARMACY OPERATIONS

Pharmacy workflow process design and optimization is critical to improve efficiencies and reduce medication errors. Utilizing pharmacy technicians to conduct non-clinical tasks such as data entry, retrieval and filling of medications, compounding of medication, and transactions at point-of-sale has been demonstrated to free pharmacists for clinical operations, providing more patient-centered care. There is an ongoing paradigm shift of pharmacists practicing at the top of their education, focusing on the direct clinical care of patients and improving clinical outcomes and patient satisfaction. 

Advances in technology such as robotics, pill counters, and pharmacy management systems have helped streamline workflow in pharmacies. These technologies have been shown to reduce medication errors and assist with regulatory compliance through inventory management, acceptance of e-prescriptions, customization of federal/state regulatory requirements on quantity limits, refills, prescription monitoring program (PMP) reporting, and more.

LEADERSHIP AND HUMAN CAPITAL

It is well established that any organization’s greatest asset is its employees, and this holds true in pharmacy. Aside from the general assets of education, training, intelligence, and skills a pharmacy’s employees bring to the organization, they build relationships and trust with their patients, improving patient satisfaction and clinical outcomes.

Employee engagement and overall well-being has been a top priority for most healthcare organizations since the COVID-19 pandemic. Burnout of pharmacy workers was exacerbated for a multitude of reasons, including but not limited to supply chain issues, drug shortages, increased workload, staffing shortages, and increased responsibilities.

A recent HBR article identified three ways healthcare leaders can boost employee engagement: by prioritizing patient and staff safety, building a culture of accountability, and providing proof that new practices will be worthwhile.

The impact of pharmacist turnover is not only financial, there are more important impacts on the quality of pharmaceutical care services and patient safety. Engaging with your employees and creating a strong organizational culture improves overall job satisfaction and well-being is crucial.

THE BUSINESS OF PHARMACY

Business metrics and key performance indicators (KPIs) for pharmacy operations vary between the different pharmacy types. Fixed costs and variable costs follow general business management principles of controlling labor expenses in correlation to production – prescriptions dispensed and clinical services provided. Organizations lower dispense costs through implementing technology (automation, robotics, communications, etc.) and workflow optimization. Pharmacy technician-driven models, utilize technicians to perform nonclinical tasks, lowering labor expenses, and freeing up pharmacists to focus on clinical tasks such as verification and patient care. Some states have pharmacist-to-technician ratio regulations which can affect an organization’s ability to control labor expenses through technician-driven models.

Outpatient pharmacy (community/retail, specialty, infusion) typically operate as profit centers with revenue collected for the prescription dispensed. With 95% of US prescriptions dispensed being billed to pharmacy benefit managers (PBMs), pharmacies contract with PBMs to join their networks and accept their negotiated reimbursement rates. An oversimplification of drivers of pharmacy success is payer mix and therapy mix. Payer mix refers to the percentage of commercial vs. government payers (reimbursement rates) and therapy mix refers to the different drug therapies dispensed and the availability of generic alternatives within the therapeutic class (generic alternatives and biosimilars are generally more profitable than brand name medications).

Inpatient pharmacies (hospitals) are generally treated as cost centers (expense). This is because many medical insurers reimburse hospitals on a per diem rate based on a disease-related-group (DRG) system – if a patient requires less or lower cost prescription therapy – the hospital retains more of the revenue reimbursed on their inpatient stay. An inpatient pharmacy’s financial performance has a high focus on controlling costs – drug spend. This is generally achieved through formulary and utilization management. Hospitals, through group purchasing organizations (GPOs) and directly, contract with pharmaceutical manufacturers for discounted prices on drugs. Within therapeutic categories that have multiple therapeutically equivalent alternatives, there is leverage with the manufacturers for a discounted price in exchange for including their drug on the hospital’s formulary. Additional focuses for inpatient pharmacy managers include controlling the cost to dispense in relation to financial stewardship.

This is a high-level view from 30,000 feet – there are many variables and exceptions to the above generalizations of outpatient and inpatient pharmacy including: implications of the 340b program for covered entities, hospital outpatient departments (HOPD), investigational drug services, medication therapy management (MTM) services, pharmacy administered immunizations, and the expanding clinical roles of pharmacists and growing adaptation of pharmacist provider status.

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Today’s health system pharmacy leaders face a myriad of challenges related to using technology in pharmacy practice. Strategic planning for capital support for larger systems has become a part of long-term financial planning as lead times for capital acquisition to support technology replacement on a ten to fifteen-year life cycle is required to maintain effective systems.

Electronic healthcare record (EHR) vendors are advancing in their support of pharmacy, but key areas such as sterile products compounding, pharmacokinetic dosing of medications to support personalized therapies, and lack of linkages between contracted payor reimbursement requirements and continued modifications of payment tactics between medical and pharmacy benefit in the ambulatory space offer areas for third party vendors to fill these gaps.

Human resources to manage these systems may or may not be located within the oversight of the health system pharmacy leader. Many organizations have created health informatics departments to support build for systems, but project management for large system implementations may need to be resourced, managed by the pharmacy operations team, or managed by the vendor. These scenarios create opportunities for governance as mergers and acquisitions occur to maintain standardization between EHRs, disparate pharmacy storage and dispensing systems, and various third-party vendor systems being used. Standardization efforts remain a focus as staff may need to rotate between facilities and efficiencies gained by having systems implemented in a standard fashion supports safe use and staff satisfaction. Other systems such as smart pumps may be purchased by Supply Chain leadership, maintained by Clinical Engineering, used by Nurses and Anesthesia, and have drug files maintained by Pharmacy or Health IT staff. These type of scenarios require multidisciplinary governance oversight to support change to drug libraries and maintain technology currency.

For health system pharmacy leaders who are supported by other departments from a systems perspective, maintenance of effective working relationships with health informatics departments, clinical engineering departments, nursing, anesthesia, respiratory therapy and other professions engaged in the medication management process are key to day to day as well as strategic planning for maintenance of these systems. Challenges in larger systems arise when lack of alignment in medication management-related initiatives arises. One part of the system may be advocating for expansion of bar code medication administration into ambulatory areas due to fatigue with manual documentation of vaccines during the pandemic, while the pharmacy may be advocating for implementation of image capture/gravimetrics to advance safety in sterile products operations, while others in the system focused on personalized medicine may be advocating for implementation of third-party vendors to support optimization of pharmacokinetics software. Division of focus may result in extended or inefficient implementation processes and when multiple vendors are introducing new products that require additional modification for optimization, getting systems to optimal operation may appear to be a never-ending process.

A new development for pharmacy leaders is the introduction of various interest groups to drive improvements in the healthcare automation space.

A new development for pharmacy leaders is the introduction of various interest groups to drive improvements in the healthcare automation space. Standardization of basic systems continues to be a need in the industry. Multiple platforms that do not interface in this age of health systems technology need to be mitigated. For example, this scenario currently exists in the RFID space. The UnitVis Alliance has been formed to advocate for industry standards in the RFID space to advance the use of this technology for tracking doses dispensed, managing inventory of high-cost medications, tracking temperature and humidity for medication storage and sterile products preparation areas and tracking equipment within health systems such as pumps, wheelchairs, beds and other durable medical equipment.

Another example in this space is the Autonomous Pharmacy concept being advocated by a cabinet vendor to address existing gaps in systems that require manual manipulation that result in inefficient systems and increased error. This group has published severalpeer-reviewed articles to support this advocacy and has launched a survey tool to help systems evaluate objectively where they are on the journey to fully automated systems. Expansion of efforts such as these to engage other vendors is complicated by concerns over competitive issues in the industry, but accomplishment of these long-term visions of fully automated systems with ISO 9000 levels of accuracy will require engagement across the industry to be successful.

Another approach in this space are institution-led grassroots efforts. Colleagues in Houston have recently launched the Boots and Roots Rx collaborative to bring together pharmacists, analytics, compliance specialists, project managers, health informaticists, and others to problem solve in this space.  

While these efforts are laudable to advance technology and practice, focusing on pharmacy informatics education and developing next generation of experts in this space remains a challenge for the health system pharmacy leader. Pharmacy informatics residency programs struggle to place residents and develop future practitioners in this space. Vendors have recently realized the dearth of training opportunities in this space and have funded fellowship programs to expose recent college graduates to various aspects of pharmacy informatics and industry-based informatics, along with graduate-level education in this space to support future iterations of leaps in pharmacy technology.

After thirty to forty years of EHR /cabinet/carousel/IV robotics/smart pump/, data visualization and analytics, health system pharmacy leaders must advocate for their systems with vendors and industry standard-setting organizations to vision the next generation of systems that fully interface throughout the medication use system from patient assessment to medication intervention via prescribing, through dispensing, to administration, and monitoring followed by assessment of contracting and reimbursement to support sustainable revenue cycles that support patient adherence and meet desired clinical treatment goals to improve patient quality of life must enter the broader conversation in this space. Without this focus, we are bound to continue limited improvement in these systems and will miss the opportunity for “moon shot” level initiatives that yield the technological advancements we need for our patients.

The post Perspective on Medication Management Technology: An Imperative for Advancement appeared first on HealthTech Magazines.

Artificial intelligence (AI) is the development of computer systems to perform tasks that typically require human intelligence, using various inputs of data and generally involving deep learning, decision-making, visual perception, and natural language processing (NLP). Healthcare is one of the largest industries using AI, with many new companies starting or shifting to focus on this space. Some benefits of integrating AI into workflows include decreasing time and costs to deliver value, supporting and enhancing the expertise of healthcare professionals, and linking complex processes and multiple disciplines for better decision-making.

Some healthcare professionals have concerns that AI may result in overall job loss. Considering the current state of understaffing across healthcare, this could be a benefit of AI. Additionally, the use of AI does not replace healthcare professionals; it enhances their performance and allows increased patient interactions that have been lost over the last decade from the increasing digitization of healthcare. Pharmacists have been more conditioned to sit behind a computer than most, but it would be very freeing to focus on spending time with patients and families, improving education and transition plans, and ensuring safety and understanding of medications.

AI is integrated into pharmacy today, but the rates and recognition of the technology are variable. Some examples include the use of AI in drug shortage management, the detection of certain conditions to predict adverse drug events, the prediction of drug levels based on patient characteristics, and the identification of clinically beneficial pharmaceuticals.

In addition to identifying future drugs, AI has other implications in pharmaceutical research. It can be used to succinctly summarize published literature, which is doubling at a rate faster than ever imagined. AI can identify patients appropriate for clinical trials and make recruiting faster than ever. Pharmacists could benefit from practicing with patterns provided by AI technology, allowing them time to provide personalized care with the efficiency gained. AI can also produce algorithms to determine patients who could benefit most from a pharmacist’s care. Another benefit is integrating workflows to quickly summarize lab data and problem lists to eliminate manual chart review. These are just few benefits of integrating AI in pharmacist workflows; many more will be identified in the near future. 

Pharmacy leaders must be open and prepare pharmacy teams for the future, including discussion on how AI can improve their work, not replace it.

Implementing AI brings many benefits to the pharmacy and some new challenges, including the impact on policy and laws for pharmacy practice. Legally, there is a requirement for pharmacists to approve medication orders. With the implementation of AI, this requirement could be challenged, which could negatively impact ensuring pharmacist involvement in patient care. Another potential concern with integrating AI is ensuring pharmacists and technicians understand the technology, what it is trying to convey to the end user, and how to act on the information. If there is not enough time spent focusing on integration into workflows and making it easy and understandable for the end user, it is not likely to be successful. It may also result in increased costs, with wasted money spent on the tool and the time lost with teams developing, training, and employing the technology.

Are pharmacy teams prepared to understand and integrate AI in their processes? AI is not part of most pharmacy schools or leadership curriculums, so it is critical that information and knowledge sharing on AI in healthcare and pharmacy be discussed and published. In the most recent ASHP Pharmacy Forecast, pharmacy leaders responded to questions regarding AI in drug dosing optimization and drug utilization patterns. Most pharmacy leaders felt it was at least somewhat likely that AI would be part of pharmacist work by 2025, which is quickly approaching.

So, where do we go from here? Pharmacy leaders must be open and prepare pharmacy teams for the future, including discussion on how AI can improve their work, not replace it. We have to continue to think about current pain points and opportunities where AI could improve performance, increase patient interaction, and improve patient outcomes. There are numerous use case examples to enhance pharmacy services with AI. The technology can be used for pharmacogenomics and eliminate the manual work for pharmacists to search for genetic testing results and review guidelines and published literature to modify drug therapy. AI makes the next iteration of personalized medicine possible. Another use case is improving transitions of care by determining who is at risk for adherence issues. AI could analyze drug interaction alerts to minimize the clinically irrelevant ones for pharmacists to reduce alert fatigue. If AI is utilized in the future for better diagnostic methods, pharmacists could fill gaps for provider shortages by stepping in to prescribe necessary medications based on diagnosis. AI could be used to monitor pharmacy technician work for compounding or packaging with specialized cameras to recognize the work technicians are doing.

Overall, AI can impact pharmacy, unlike anything we have ever seen. It can improve costs, care, safety, value, and satisfaction and move the pharmacist closer to the patient, where the significant benefit can be seen. It can free pharmacists from lower-level, technical work and focus their work on the highest-risk patients. In the future, AI can allow pharmacists to support ongoing provider shortages. Patients may receive the safest, most efficient, and most personalized medication therapy in the healthcare history with the integration of AI in pharmacy.

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An IT infrastructure build and integrity strategy; a favorable quantifiable clinical outcome strategy; a new business opportunity for considerable growth strategy; etc., no matter the area of focus, they all have the same intent and purpose as any well thought-out strategy; to take action on a conceived idea or initiative and charge established work streams to develop and execute a specific defined plan towards a desired favorable outcome.

A pharmacy management strategy is no different. There are few recommendations of best practices that I have come to appreciate and embrace consistently to increase the odds of a successful management strategy—no surprises here but always good practice to review.

No matter the area of pharmacy practice, a successful pharmacy management strategy starts with a firm grasp and a clear understanding of the organization’s strategic long and short-term goals that define success.

Once known and clearly understood, you tie them to how pharmacy contributes and the weighted level of importance towards achieving organizational success. This, in turn, will help create pharmacy goals in order of priority.

Communicate clearly why changes are needed and be sure to convey what’s behind changes with supportive examples.

A good way to think critically when structuring future pharmacy goals is to reflect and ask tough questions with honest answers towards previous goal performance. Questions like:

• How successful in the past has pharmacy been at meeting it’s goals?
• What worked well and should we do more of? Why did it go well?
• What goals did we not achieve and why?
• How do we now refocus to improve the odds of success moving forward?

The answers to these questions will well position you to start listing out the pharmacy’s short and long-term strategic goals in order of importance, being sure to note odds of success, threats to success and what specific work streams are needed to work towards success. Framing of:

• What are the work areas of focus for us?
• What timelines do these areas work and do they align with FY goals or beyond?
• What tactics will be deployed within each area of work?
• Perform a gap or SWAT analysis to understand where these areas of work are and what will be needed.
• Establish, assign, or identify as needed teams and individual member contributors who will have a specific area of focus; noting strengths and areas of support that will be needed. For the latter, identify ways to offer support by providing additional assets, e.g., analytics, clinical, strategy, etc., to close these gaps.

Once the teams have been established and their charge assigned, it is critical to provide clear and concise communication. There is an abundance of information on ways to effectively communicate, so I will not go into specifics here. However, I have found that when a project or initiative does not go as expected, invariably the reason is a breakdown in communication. As a leader, please be mindful of this and the adage, “It’s not what you say, but how you say it.” Effective communication establishes clear boundaries relative to area of focus, with pointed expectations delivered tactfully. Communicate to the team:

• Why this project/work/initiative is important,
• Get specific on details such as who will do what and by when.

Set the team in action towards a common primary objective and speak crisply to

• How will we measure progress?
• How will we address challenges/barriers? And,
• What does success look like?

All while keeping the teams motivated and engaged by providing positive feedback often.

Arguably of equal importance as a firm emphasis on effective communication, is empowering your teams to own and lead the work. Empowering your team is an invaluable asset that will reward everyone and make the work more cohesive, increasing the odds of success.

You have invested time and effort in creating and developing effective teams. Have worked closely with them on projects. No one is better positioned to know how prepared they are to take on and lead a specific project to a successful outcome than you. As such, you are encouraged to trust your teams to own and lead the work. Empower them to hold themselves accountable after communicating clear objectives and expectations. Expect them manage themselves while making progress with a fair degree of autonomy. While mission-critical initiatives and projects may require more touchpoints from you, be careful and resist the urge to micro or over-manage. This can manifest in many ways and inadvertently look like asking for intimate project-specific details/updates, or busy work that redirects focus towards achieving a certain level of quality for the details/updates, thereby acting more of a distraction to the team than actual value add.

As an effective manager, you must be prepared to make tough decisions when goals are not progressing according to plan. As such, you are to make changes to the strategic approach or team early and as often if needed to ensure the goals do not get sidetracked and risk failure. Communicate clearly why changes are needed and be sure to convey what’s behind changes with supportive examples. Take note to frame missteps as growth opportunities and are fine as long as the team learns and improves. This will ensure continued buy-in as changes are made.

Finally, because there are a seemingly incessant number of projects and initiatives to take on, we tend to close out one project to only then move onto the next without any notice or review. It is important to celebrate milestones and “wins”, giving thanks and taking the appropriate time to acknowledge all involved in a job well done. This is also a good opportunity to reflect on what went well and could have gone better.

These basic yet important management strategies will set you and your team up for continued success when addressing the next challenge.

The post How to Build a Successful Pharmacy Management Strategy? appeared first on HealthTech Magazines.

“Lead by example” is one of the most widely known leadership styles adopted by leaders across industries. However, very few leaders effectively use it in their daily operations, worse yet; many leaders don’t even understand the true meaning of leading by example and thus struggle to do the job they are supposed to manage.  

One of the most valuable lessons this pandemic has taught me is how to fill in for someone during a staffing crisis. If I am unable to do the job that I expect my staff to do, I would be doing an injustice to them if I had to lead them in any way. Staffing shortage is a true testimony of us leaders on how we can pivot, adapt and reevaluate our leadership style. It has allowed us to revisit our personal deficits on how we manage our staff, processes, and our policies like never before.  

Why take on a leadership role? 

This is one of the most challenging questions one must answer before taking on a leadership role. Leadership roles are rarely cookie-cutter positions with a traditional forty-hour work week. It takes time, dedication and around-the-clock commitment to serve such an impactful role. Everyone has their reasons as to why they want to be a leader. My reason was simple; to promote personal growth and inspire others along the way. I enjoy dealing with complex and challenging issues, getting out of my comfort zone and pushing myself to higher limits. I enjoy working with people, empowering them, and ultimately cultivating a culture that makes extraordinary contributions to patient care.  

I have been fortunate to have a list of great bosses who have inspired me, motivated me and invested a lot of time in me to instill a sense of purpose in what I want to achieve in my career. I didn’t want to just become a leader; I wanted to become an effective leader that positivity impacts the employees and the organization as a whole. I learned very quickly that I have the knowledge, skills and ability to make the right decisions about myself and others. When all the puzzle came together, I knew I was ready to take on the leadership position. At the same time, I was very practical and realistic with myself; I knew I wouldn’t attain success immediately. I realized I would make some rookie mistakes along the way. However, I never doubted my ability to correct and learn from those mistakes. I keep at it, work through challenges every day and believe in myself that I know; eventually, I will get better at it.  

Non-Traditional approach 

I have seen many managers in my career who have transitioned directly from a classroom setting into a leadership role without ever working the bench. Don’t get me wrong; there is nothing wrong with that method. Many have turned out to be highly effective and are leading the department very successfully. However, I knew this route would not work for me. I needed hands-on experience and thus I started from the bottom, moved around in various settings, served on multiple different shifts and learned from a variety of highly experienced colleagues. I listened, observed, took notes, and absorbed as much as possible to get a deep understanding of the industry. So I created a timeline, set high goals and then made strategic career moves to set me up for success. This non-traditional approach worked for me and helped me tremendously in transitioning from staffing to a director role. 

Making sure I “Walk the Walk” 

Often leaders say one thing and do another, and then they ask their staff to do as they say, not as they do. When I took on a leadership role, I set clear expectations and promises to be true to my words through my actions. I never intended to take the easy way out or expected my staff to treat me any differently because of my position. Instead, I am committed to walk the hard walk and talk the hard talk to get the desired outcome. If I expect my staff to follow a set of rules, I am ready to follow them myself every time. When your employees see you truly lead by example, it builds a strong trust amongst the department which, in turn, increases employee satisfaction.

I have just talked about how powerful it is to lead your department with an example but what happens when you don’t follow what you preach? Employees get disengaged, creativity decreases, and productivity comes to a halt. Eventually, the job becomes a means to an end rather than an end to a means. When I feel a sense of disconnect between I and my staff, I reflect on my behavior, realign my focus and try again to regain their trust in my ability to lead them effectively. I love having a team that I can help guide and enjoy watching them grow to their full potential. My non-traditional route of becoming a leader in today’s world has been one of the most challenging yet, one of the most rewarding positions in my career. 

The post <strong>Non-Traditional Route to Pharmacy Leadership</strong> appeared first on HealthTech Magazines.

Pandemics, shortages, and change, oh my! As everyone has realized over the past few years, healthcare is at a pivotal point of change and must adjust accordingly. We have seen and normalized many things we never thought we would. We have stretched our teams to their limits and there doesn’t seem to be an end.

All this being said, we as leaders have an opportunity to make meaningful changes impacting how we take care of the people who take care of our communities. We have the chance to re-write how we lead teams, though to do so, it is going to take some change in mindset. As leaders, we must work with our frontline teams to better understand their struggles and act on them. Gone are the days of leaders being able to stay in their offices. It is time to get back to hands-on work and a genuine desire to learn what our people need.

This sounds like a lofty goal, maybe even unrealistic. The burden on leadership is tremendous. We are consistently being asked to complete any number of projects and tasks…how can we fit everything into a 40, 50, 60 (or more) hour work week? If we start with maybe one focused project and utilize existing resources within your organization, we can start to approach the unthinkable and make it happen. We can leverage the feedback of our teams, bring them into the decision-making process and develop programs that will be meaningful and impactful.

As leaders, we are challenged to adapt, adjust and inspire in a rapidly changing industry. We must ensure that we care for those who care for patients…our frontline workforce.

Recognizing good work

As leaders, one of the most basic needs of our team members is to recognize their work. I believe that organizations often miss or don’t focus enough on is the power of peer recognition. Since I was in my first leadership role, I have made it a requirement that we don’t end our team huddles without peer recognition. We usually have a few people speak up, but often, there are awkward moments of silence until a member of the leadership team recognizes someone. So I started asking what we could do to better facilitate recognition amongst peers and how could we get people to speak up? I quickly received some crucial pieces of feedback 1) people don’t feel comfortable speaking in front of a large group, 2) throughout the week, great work can get forgotten/lost in the busyness of the day, 3) if we change how we recognize people, it needs to be easy and convenient. Though much of this was not unexpected, determining the “how” required our leadership team to get creative and innovate.  Ultimately, we came up with a program we affectionately call “Real-Time Recognition”. We utilize REDCap, a survey and project management tool already in use in several other areas within our organization. Our program is a few simple questions and allows the recognizer to fill it out, on their phone (utilizing a QR code) or computer, in less than a minute.

At the end of our weekly full team huddle, leadership will share the shout-outs submitted for the week with the team. We have heard great things from our team and have tremendously increased peer recognition.

Diversity, Equity and Inclusion (DEI)

One of the most important topics of our times is the development of DEI programming within organizations. As a pharmacy leadership group at our organization, we recognized that we had a significant opportunity to support our teams in creating environments where they felt safe, listened to and celebrated. Our first piece of development was to train our leaders to better understand what DEI is and why it must become enculturated within our departments. To accomplish this, every pharmacy leader within our organization attended training led by the DEI Office leadership. After completion, we quickly recognized that we needed to do more with our frontline team members to increase engagement and ensure that DEI training did not stop with our leadership team. Partnering with the DEI Office, we developed a program where leadership is provided with resources (videos, articles, posters, etc.) to discuss each week at their team meetings. Our team members have the chance to contribute to the conversation and discuss any thoughts they have, moments of realization, or what they learned from that week. We allow our team members time to provide feedback on how the program is going and what we can do to improve. We have learned more about each other, how we can foster welcoming and safe environments, and the world around us from people who may not look and think like us.

Bringing it all together

Change is hard…really hard. We have all been abruptly placed into an environment that looks different than it was prior to the pandemic. Maybe it even looks so different that you are questioning if it is still what you are called to do. There is still so much unknown about how healthcare will look in the future. What we know is that the only constant is change. As leaders, we are challenged to adapt, adjust and inspire in a rapidly changing industry. We must ensure that we care for those care for patients…our frontline workforce. My hope is that you all start to shift the lens in how you look at leadership. How can you better engage? How can you better listen and hear? How can you better support and inspire the teams you are entrusted with? One of my favorite quotes is from Teddy Roosevelt which says, “The greatest gift life has to offer is the opportunity to work hard at work worth doing” the work of healthcare, for us, is the work worth doing…let’s inspire others to feel the same.

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What could be worse than 2020? No, really? How about 2025? Don’t believe me? A recent survey by Elsevier Health, called “Clinician of the Future,” found that 47% of clinicians in the US reported they were planning to leave their role in the next 2 – 3 years. Of those planning to leave their role, 39% considered leaving the profession entirely. 1 in 5 healthcare workers quit their jobs in the first 18 months of the pandemic, with another half million workers (and counting) having been laid off. Even hospital closures reached a record pace in 2020 due in part to many familiar pressures such as rising costs for labor, drugs, supplies, and equipment.

These aren’t new issues. In fact, these issues have essentially defined the last 2 to 3 years in healthcare. Burnout, resiliency, health & wellness programs are persistent requirements for healthcare leaders. In short, we know this is an issue and you’ll find no shortage of articles detailing strategies to mitigate these risks for your team and organization. Instead, let’s discuss the generational shift happening each day in this country—one more statistic; 27% by 2025. Gen Z, those born between 1997 and 2012, will represent 27% of the US workforce by 2025, and with them, we will redefine our collective definition of work, balance, and life.

As leaders, we must assess the key pillars of where, when, and how we work to maximize engagement, collaboration, and productivity.

Fundamentally, very little separates us when it comes to basic needs and desires. Happiness, fulfillment, appreciation, and securityare universal goals that we all share, regardless of generation.

Create an Authentic Culture

As healthcare still reels from the Great Resignation, workplace culture continues to be a determinant in employee recruitment and retention. Although salary remains a top priority across all generations, Gen Z places company values higher than any other generation when deciding on a job. To attract and retain this influential generation, companies and employers must not only produce a good product but be good citizens. Companies must demonstrate their commitment to a broader set of societal challenges such as sustainability, climate change, and efforts to address diversity, equity, and inclusion.

How will this manifest in healthcare? First, assess ways your organization can build a workforce that reflects the increasingly diverse population they serve. Be clear, this cannot and should not be done overnight. The pipeline of future pharmacists, physicians, and nurses isn’t as diverse as our population; therefore, we have clear gaps. Luckily, as potential future employers, we can influence colleges and universities to partner in our goals to create a more representative society. I should note, for Gen Z, diversity represents more than race and gender; it must also respect identity and orientation.

Flexibility and Autonomy

As we draw insights and preferences from their entry into the workforce, we will be forced to reflect on how ‘work’ is changing and evolving. Let’s face it. We’re in a digital age with rapidly developing technologies and interfaces that blend the human-machine connection. Though we use EMRs, advanced imaging and screening techniques, and new drugs that can target defective genes; the fundamental ‘work’ we do as healthcare professionals has been largely unchanged. How we approach the delivery of healthcare is rife for disruption.

No longer will being the smartest or most clinically savvy provider be a determinant of success. The future clinician will need to be a Renaissance figure who can leverage their talents, interests, and expertise in a rapidly shifting environment. Clinicians must be empathetic, technologically inclined, demonstrate high emotional intelligence, and possess the necessary business and financial acumen to boot.

As more is required, more must be given. For Gen Z, flexibility is imperative. That doesn’t translate to 100% remote working conditions. It does refer to flexible work schedules, hybrid work opportunities, and more influence on how and when work is completed.

Earlier in the pandemic, healthcare fully embraced this new flexibility. Virtual visits grew at unprecedented levels. We found innovative opportunities to connect with patients outside our four walls and move beyond the traditional provider-patient relationship. Yet now we all see this adoption dwindling; at my organization, virtual visits are a fraction of their pandemic highs. There is a merit that telehealth isn’t for everyone, however premature abandonment of the technology may hamper future opportunities for flexible working conditions.

As leaders, we should challenge our teams and organization to genuinely assess flexible work options. The return to ‘business as usual’ could be a critical mistake for those who refuse to learn the lessons of the last few years. The return to office debate illustrates a definite divide between management and worker perspectives. At the core of this debate are employees believing they are just as productive out of the office and managers being less convinced. As leaders, we must assess the key pillars of where, when, and how we work to maximize engagement, collaboration, and productivity.

Purposeful, Challenging, and Passion-Driven Work

By 2025 millennials and Gen Z will represent just under 70% (68.4%) of the workforce. One aspect that unites these two generations is their desire for work that they care about and that potentially makes a difference in the world. This relationship with work is unique,yet that ambition will lead to challenges for healthcare leaders.

On the surface, many of us would assume that healthcare invokes passion and purpose and that being challenging is a no-brainer! We’re all set then, right? Wrong! Gen Z has already proven to be uniquely productive; their ability to adapt at the speed of evolution is unmatched. This unique trait has a downside: they’re easily bored by menial and repetitive tasks.

Consider the roles and responsibilities of the future clinician. What will work look like with a skilled clinician who also understands data analytics. Could more clinical decisions be automated with real-world evidence? Possibilities are brimming, as long as we’re willing to take some risks.

Conclusion

The war for talent is already underway. Luckily, for those paying attention, Gen Z is already incredibly articulate about what they want and how they want it. Our opportunity is to cultivate the teams and cultures that deliver more of what young workers need to thrive. Will you be ready?

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