Pharmacy's goals should include these seven areas of accountability
Pharmacy's goals should include these seven areas of accountability
Expert outlines plan of action
When the economy is challenging, it's more important than ever for hospital pharmacy leaders to show how their department creates value in safety, quality, and the bottom line.
It will take a comprehensive and authentic leadership plan to meet any hospital resource crisis head-on, says Billy W. Woodward, BS, RPh, executive director of Renaissance Innovative Pharmacy Services in Temple, TX. Woodward has more than 35 years of experience in hospital pharmacy work and consulting, including having worked as a corporate director in two large academic health systems.
"Many times people react to a crisis without an overall strategy," Woodward notes. "They go from one set of challenges to another."
But the most effective pharmacy leaders have a strong, proactive plan that includes seven areas of accountability, he says.
"Anyone of these spheres of accountability can become so big that it dominates the entire strategy, and that's the hazard of it," Woodward adds.
Here are the seven areas of accountability:
• People sphere: This should be pharmacy directors' top priority, Woodward says.
"If you don't have a strong people-centered team, none of the other accountabilities get done," he says.
There is more to managing staff than hiring, training, and firing, he adds.
New employees quickly should be brought into the hospital pharmacy's culture of leadership, which demonstrates how every person in an organization is an important part of the overall group, he advises.
"If they're treated that way while in training and retraining, and if they're allowed to participate and be involved in the decision-making process, then they can become team members who feel they know what the purpose of the department is," Woodward says.
"Everyone in the department should understand who they are, what they're supposed to do, what their role is, and how it fits into the organization."
Strategies for achieving this include these:
- Motivate staff to work independently and to become self-sufficient, even while keeping in mind that they're part of a team;
- Instill in employees the belief that they can always make things better; and
- Maintain training and career development resources even during challenging economic times.
"You need to maintain a pipeline of staff so you can groom people to move into positions of leadership," Woodward says.
• Business accountability: Pharmacy directors need to keep the business aspects of a pharmacy on their radar screens.
"You need to make sure you're getting the best prices, and you should have clinical programs in place that force your formulary decisions," Woodward says.
"Do you have a clinical team that interacts with the prescriber in a way that affects outcomes?" he says.
"Think about the fundamental business processes of a large, multimillion-dollar operation and what the C-fleet expects you to be doing," Woodward suggests. "Pharmacy people sometimes let this fall through the cracks."
The business equation is a critical piece, and it includes entrepreneurial activities, Woodward says.
"Pharmacy has a tremendous potential to be an entrepreneur among the health system," he adds.
• Operational accountability: This sphere includes drug distribution, packaging, paperwork, and process mechanics in the drug operations.
"This is a sphere that tends to get so big that it takes over all of your time and attention," Woodward says. "And it's so important that you as a leader among pharmacy staff should be careful to not get lost in that sphere."
If the operations sphere becomes so big that other spheres of accountability are ignored, then the pharmacy fails, he adds.
• Clinical care accountability: "This runs parallel with the operational piece," Woodward says. "I've seen examples where operations get out of whack and bigger than life, and clinical care monitoring and even cost monitoring do not get done."
There also have been a few cases where a hospital becomes so progressive clinically that pharmacy leaders forgot the operational piece, he notes.
"Those situations ended up with major patient care issues, as well as creating a financial disaster for the institution," Woodward adds. "So any one of these spheres can become bigger than life and take over, and all have to be addressed in their own right."
• Medication safety and quality improvement: "To appropriately address these you have to have a focused initiative that stands aside and looks objectively at the whole process, including safety and improvement issues," Woodward says.
"I've seen operational folks who've done a great job of mechanics, but who didn't take the additional perspective and ended up with medication safety issues," he adds.
• Regulatory compliance: "Legal, regulatory, and compliance issues are a three-pronged sphere," Woodward says. "These include accreditation rules and Medicare regulations."
Pharmacy leaders should focus on corporate compliance, he suggests.
"If they can't address it then they could have serious legal and ethical challenges," Woodward says.
If there are problems in this area, the fall-out can dominate a pharmacy department because of the incredible pressure to resolve all concerns, whether they're regulatory or the result of a survey by the Joint Commission of Oakbrook Terrace, IL.
• Integration of pharmacy across the continuum: "The seventh accountability is extremely important, but it's not one that people think of," Woodward says.
Pharmacy departments need to be integrated across the health care continuum.
"Pharmacies tend to get caught in one piece of the puzzle," Woodward says. "We don't transfer services across the continuum, so we may do well in the hospital, but we do a terrible job of discharge planning."
It's important for hospital pharmacists to be included in making certain patients receive the correct medication information and are prepared to contact a retail pharmacy when they are discharged home, he adds.
Hospital pharmacies that are well integrated have staff that get along well with clinical staff, Woodward says.
Sometimes it's a challenge to integrate the pharmacy's clinical team with its operational team.
"If you have a great clinical team, but the operational team thinks they're doing all the grunt work, then you have the makings of potential problems within the department," Woodward explains.
"Also, nurses and physicians are critical to the ultimate success of the pharmacy system," he adds. "Again, all of these integration principles aren't talked about much, and, unfortunately, they often are not done very well."
Pharmacy leaders should keep their eye on the seven spheres of accountability to ensure their department maintains balance and focus on its goals.
"All of these spheres become overwhelming," Woodward says. "But my message isn't to say it's easy, but that it can be done, and I've seen good examples of hospital pharmacies that have these elements in place and did a good job most of the time."
When the economy is challenging, it's more important than ever for hospital pharmacy leaders to show how their department creates value in safety, quality, and the bottom line.Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.