1. THE CHANGING DEMOGRAPHICS IN PHARMACY, YES, MORE CHANGE! Lynnae Mahaney MBA, RPh, FASHP New York State Council of Health-System Pharmacists May 2009

2. Disclosure I have no actual or potential conflict of interest in relation to this program.

3. OVERVIEW STATISTICS STATISTICS MULTIGENERATIONAL WORKFORCE MULTIGENERATIONAL WORKFORCE WORKFORCE CRISIS WORKFORCE CRISIS LEADERSHIP CRISIS LEADERSHIP CRISIS

4. PHARMACY WORKFORCE DEMOGRAPHIC STATISTICS AGE AND GENDER TECHNICIAN DIVERSITY

5. Pharmacy Demographics 86% of licensed pharmacists actively practicing 86% of licensed pharmacists actively practicing – 230,000 total; 200,000 FTE – 30% in hospital, health-systems, LTC Increase in part-time workers Increase in part-time workers – 2000: 23.4% of females, 11.6% of males – 2004: 26.8% of females, 15.4% of males

6. Work Status of Licensed Pharmacists

7. ASHP SURVEY 2008

8. Proportion of Active Women Pharmacists in the U.S. by Year Source: HRSA Study on Supply and Demand for Pharmacists 2000

9. Pharmacy Technicians Statistics 284,000 Pharmacy Technicians in the U.S. 284,000 Pharmacy Technicians in the U.S. 189,000 Active, PTCB certified Jan 2007 189,000 Active, PTCB certified Jan 2007 310,873 PTCB certified June 2008 310,873 PTCB certified June 2008 Sources: PTCB National Statistics https://www.ptcb.org/AM/Template.cfm?Section=National_Statistics&Templ ate=/CM/HTMLDisplay.cfm&ContentID=2432 Paul, R. Technician numbers on the rise nationwide, Drug Topics, March 10, 2007.

10. Pharmacy Technician Certification PTCB Certified Pharmacy Technicians [16] PHARMACY TECHNICIAN CERTIFICATION BOARD (PTCB) STATISTICS EXAM DATE # WHO SAT FORPTCE # WHO PASSED PTCE % PASSED 1995-2000 Exams 91,741 73,705 80% 2001 Exams 31,107 24,269 78% 2002 Exams 33,794 26,917 80% 2003 Exams 39,710 32,232 81% 2004 Exams 41,245 32,114 78% 2005 Exams 45,991 35,838 78% 2006 Exams 49,689 32,319 65% 2007 Exams 45,045 31,490 70% 2008 Feb-Mar 7,547 5,165 68% 2008 Apr-Jun 14,291 10,155 71% TOTAL 400,160 304,204 76% TOTAL # WHO PASSED PTCE 304,204 TOTAL # WHO COMPLETED TRANSFER PROCESS 6,670 TOTAL # OF CERTIFIED PHARMACY TECHNICIANS (CPhTs) 310,874 [16] PTCB Website Statistics, Sept, 2008.

11. Age Distribution of Pharmacists Card A55+ Card A55+ Card B45-54 Card B45-54 Card C<45 Card C<45

12. Age Distribution of Pharmacists 17%55+ 17%55+ 24%45-54 24%45-54 59%<45 59%<45

13. FTE by Gender and Age - 2004

14. Gender Statistics Not actively working – primary reason Not actively working – primary reason – Men – retirement 10.9% – Women – not working 4.3% Pharmacists practicing in hospitals Pharmacists practicing in hospitals – Women 30.7% vs. men 22.3%

15. Diversity Statistics Female >65% pharmacy students Female >65% pharmacy students Asian Americans 23.4% of Pharm.D degrees Asian Americans 23.4% of Pharm.D degrees Underrepresented minorities 11.8% of Pharm.D. degrees Underrepresented minorities 11.8% of Pharm.D. degrees Applicants > 68% had 3 or more years of postsecondary education Applicants > 68% had 3 or more years of postsecondary education

16. Workforce Diversity Racial and ethnic minorities comprise 1/3 US population Racial and ethnic minorities comprise 1/3 US population African Americans, Asians, and Hispanics will outnumber Whites in the 21st Century African Americans, Asians, and Hispanics will outnumber Whites in the 21st Century

17. MULTIGENERATIONAL WORKFORCE For the first time in history, four generations are present in the workforce.

18. ALSO KNOWN AS THE GENERATIONAL TSUNAMI

19. Traditionalist Black and white TV Black and white TV ‘stretch a buck nine ways to Sunday’ ‘stretch a buck nine ways to Sunday’ Ballroom dancing Ballroom dancing Push mower – not motorized Push mower – not motorized

20. Traditional 1930 – 1945 The "silent generation“ The "silent generation“ Value loyalty, sacrifice, discipline Value loyalty, sacrifice, discipline Respect authority, rules, and hierarchy Respect authority, rules, and hierarchy Delayed reward Delayed reward Duty before pleasure Duty before pleasure

21. Pharmacist -Traditionalists (over 62 yrs) 17% of the nation’s Pharmacist workforce 17% of the nation’s Pharmacist workforce CARD A

22. Baby Boomers Elvis before sequins Elvis before sequins Typewriter Typewriter World’s first trip to the moon World’s first trip to the moon Woodstock, hippie Woodstock, hippie ‘Generation Gap’ ‘Generation Gap’

23. Baby Boomers 1946 – 1964 Loyal Loyal Live to work – largest group of workaholics in history Live to work – largest group of workaholics in history Driven by personal success Driven by personal success Spenders Spenders Excellent Mentors, experienced Excellent Mentors, experienced Politically active Politically active Want or need to work longer Want or need to work longer

24. Pharmacist - Baby Boomers (44-62 yr olds) 24% of the nation’s Pharmacist workforce 24% of the nation’s Pharmacist workforce CARD B

25. Generation Xers Prince and 1999 Prince and 1999 Road trips in the station wagon Road trips in the station wagon Know who shot JR Know who shot JR Know rotary phone Know rotary phone Term papers on word processor Term papers on word processor

26. Generation X 1965 – 1980 Latchkey kids, watched parents overworked/lose jobs, distrustful Latchkey kids, watched parents overworked/lose jobs, distrustful Best academic training and internatl. experience in history Best academic training and internatl. experience in history Demand work life balance,work to live Demand work life balance,work to live Technology experts Technology experts Need positive reinforcement and communication Need positive reinforcement and communication Desire stimulation and growth in work Desire stimulation and growth in work

27. Pharmacist - Generation Xers (28-45 yr olds) 59% of the nation’s Pharmacists <45 59% of the nation’s Pharmacists <45 CARD C

28. Millennials Term paper typed on computer Term paper typed on computer Always had answering machine and voicemail Always had answering machine and voicemail Always had cable TV with remote control Always had cable TV with remote control Popcorn in the microwave only Popcorn in the microwave only

29. Millennials /Gen Y 1981 + grew up in groups grew up in groups volunteers, joiners volunteers, joiners close to family, trusting, value relationships close to family, trusting, value relationships technology experts – lived entire lives with information technology technology experts – lived entire lives with information technology excellent multi-taskers excellent multi-taskers after BB’s next dominant generation to influence health care after BB’s next dominant generation to influence health care

30. 59% of nation’s Pharmacists <45 59% of nation’s Pharmacists <45 CARDs C and D Pharmacist - Millennials (18-27 yr olds)

31. Tomorrow’s Pharmacist

32. Generational Commonalities Common life experiences more clearly define each generation group Common life experiences more clearly define each generation group Trad – environment of scarcity, value austerity Trad – environment of scarcity, value austerity Boomers – spawned social phenomena (hippie, feminism, divorce) Boomers – spawned social phenomena (hippie, feminism, divorce) X, Y – less social impact due to recent emergence X, Y – less social impact due to recent emergence

33. From AARP report: The Business Case for Workers Age 50 + (http://research.arp.org). “Cohort of workers >55 will grow significantly and opt for second and third careers or downsize work roles rather than fully retire.” “Cohort of workers >55 will grow significantly and opt for second and third careers or downsize work roles rather than fully retire.” This report makes a great case for keeping people longer in the work place. This report makes a great case for keeping people longer in the work place. RETIREMENT

34. Many cannot afford to retire early – children/stocks Many cannot afford to retire early – children/stocks 2007 survey, nearly 1/3 over-65 workforce will delay retirement 2007 survey, nearly 1/3 over-65 workforce will delay retirement AARP 2006 survey, 70% Americans want to work as long as able AARP 2006 survey, 70% Americans want to work as long as able Copeland, Craig. “Employment status of workers ages 55 or older.” Employee Benefit Research Institute, Notes, Vol 28, No. 8. August 2007, p. 2. Copeland, Craig. “Employment status of workers ages 55 or older.” Employee Benefit Research Institute, Notes, Vol 28, No. 8. August 2007, p. 2.

35. WORK-LIFE BALANCE Not a gender or generation issue today. Boomers Boomers – Sandwich generation – Personal health issues – Approaching retirement Generation X Generation X – Dual working couples – Single parents – Outside interests – Household responsibilities – Community involvement Generation Y Generation Y – Community involvement – Volunteers

36. Overall healthcare environment is changing - permanently. Overall healthcare environment is changing - permanently. The Baby Boomers - dominant generation to influence health care. The Baby Boomers - dominant generation to influence health care. Baby boomers retirement, beginning 2011, will be overwhelming and will dramatically affect the health care system. Baby boomers retirement, beginning 2011, will be overwhelming and will dramatically affect the health care system. GLOBAL CHANGES

37. HEALTHCARE CHANGES 50% of US population has at least one chronic condition* 50% of US population has at least one chronic condition* – 36% over 65yo have 3 or more – By 2025, 25% will have multiple chronic conditions – Increase in cancer, cardiovascular disease, and type II diabetes (due to obesity) Medicare to consume more of the national budget and give the federal government more direct control over health care dollars. Medicare to consume more of the national budget and give the federal government more direct control over health care dollars. – MC $ were 3% GDP in 2006, 8.8% in 2030 Baby boomers will unify and become more responsible elders about the expense of end-of-life care. Baby boomers will unify and become more responsible elders about the expense of end-of-life care. *Wye River Group on Healthcare 2008

38. Global Demographic Statistics (WSJ Demographic Bomb Ticks On 6/6/06) 200516.7% US population 60 years and older 200516.7% US population 60 years and older 205026.4% US population 60 years and older 205026.4% US population 60 years and older US is relatively young….as compared to Japan, Germany, and China. By 2040, these nations face even more peril.

39. Population of the Oldest Old age 85 or older Will grow 377% by 2050

40. IMPENDING WORKFORCE CRISIS 76m Boomers will retire in the next 15 years 76m Boomers will retire in the next 15 years – 46% of current workforce 45m Gen X’ers available to replace 45m Gen X’ers available to replace – 29% of current workforce 14m skilled worker shortage predicted by 2020 14m skilled worker shortage predicted by 2020 80% of Pharmacy directors and 77% of middle managers plan to resign in the next 10 years 80% of Pharmacy directors and 77% of middle managers plan to resign in the next 10 years

41. Healthcare Worker Shortage 5.3m new Healthcare Workers needed by 2010 5.3m new Healthcare Workers needed by 2010 Pharmacist shortage will be 157,000 by 2020 Pharmacist shortage will be 157,000 by 2020

42. Pharmacy Workforce Changes Multigenerational work place Multigenerational work place Desire for balance of values to the workforce Desire for balance of values to the workforce Increasing the demand for alternatives to traditional work norms Increasing the demand for alternatives to traditional work norms Increasing ethnic diversity Increasing ethnic diversity Job satisfaction does not change across the generations and indicates pharmacists are generally satisfied

43. WHAT CAN WE DO ? Teach four generations to work together as a team Teach four generations to work together as a team Flexible work schedules Flexible work schedules Restructure work Restructure work Invest in the 50+ worker Invest in the 50+ worker Facilitate pharmacist re-entry Facilitate pharmacist re-entry

44. Tips for Bridging the Gap: (Mayoclinic.com) Challenge them with important work that matters and reward them for success. Don’t micromanage and give them space. Challenge them with important work that matters and reward them for success. Don’t micromanage and give them space. Ask for their opinion so they feel part of a team. Try to avoid the strict chain of command style of management. Ask for their opinion so they feel part of a team. Try to avoid the strict chain of command style of management. Provide frequent feedback; they are used to quick and direct criticisms and compliments. Provide frequent feedback; they are used to quick and direct criticisms and compliments. Use e-mail and avoid frequent meetings on menial topics. Use e-mail and avoid frequent meetings on menial topics. For the Older working with Younger

45. Tips for Bridging the Gap: (Mayoclinic.com) Show respect and acknowledge your lack of experience and need to learn. Show respect and acknowledge your lack of experience and need to learn. Avoid using solely e-mail and voicemail communications; many baby boomers prefer face to face communications. Avoid using solely e-mail and voicemail communications; many baby boomers prefer face to face communications. Learn about the department/company history, what has gone wrong and what has worked BEFORE trying to actively change something. Learn about the department/company history, what has gone wrong and what has worked BEFORE trying to actively change something. Play the game of seniors in the office even if you are turned off by traditional workplace politics. Play the game of seniors in the office even if you are turned off by traditional workplace politics. For the Younger working with Older

46. Tips for Bridging the Gap: (Mayoclinic.com) Avoid stereotyping. Avoid stereotyping. Realize that no generational characteristics apply to everyone, and Realize that no generational characteristics apply to everyone, and Remember: everyone’s personality is unique. Remember: everyone’s personality is unique. For All Generations

47. WHAT CAN WE DO? Flexible Scheduling Demand for greater work-life balance Gen X, Y Demand for greater work-life balance Gen X, Y Role reversals Role reversals Boomer needs Boomer needs

48. Flexible Work Schedules Develop multiple schedules/hour/days of the week Develop multiple schedules/hour/days of the week Engage staff in work schedule development to meet organizational and staff needs Engage staff in work schedule development to meet organizational and staff needs Obtain regular feedback on schedules and activity preference Obtain regular feedback on schedules and activity preference Develop attractive incentives for undesirable work shifts Develop attractive incentives for undesirable work shifts *ASHP Task Force on Pharmacy’s Changing Demographics

49. Flexible Schedules create perceptions: Viewed as unfair, favoritism Viewed as unfair, favoritism Workers not seen as valuable contributors Workers not seen as valuable contributors Part time staff viewed as competent and informed Part time staff viewed as competent and informed Pharmacy managers lack understanding of the differences among generations in attitudes toward work Pharmacy managers lack understanding of the differences among generations in attitudes toward work

50. Potential negative implications of alternative work schedules Scheduling challenges Scheduling challenges Resentment from full-time staff about flexible schedules for certain workers Resentment from full-time staff about flexible schedules for certain workers Difficulty filling part-time vacancies Difficulty filling part-time vacancies Challenges training part-time workers Challenges training part-time workers Part-time workers lacking connection to overall health system because of limited work hours Part-time workers lacking connection to overall health system because of limited work hours Lack of availability of part-time workers with desired skill set Lack of availability of part-time workers with desired skill set *ASHP Task Force on Pharmacy’s Changing Demographics

51. Positive implications of alternative work schedules A pool of extra staff to cover time off A pool of extra staff to cover time off More uncompensated hours from a larger number of workers More uncompensated hours from a larger number of workers More flexibility in covering schedules with several part-time workers More flexibility in covering schedules with several part-time workers Management does not have to provide benefits for some part-time workers Management does not have to provide benefits for some part-time workers Access to qualified pharmacists that would not otherwise be available for full-time work Access to qualified pharmacists that would not otherwise be available for full-time work Flexible hours can be used as a recruitment tool Flexible hours can be used as a recruitment tool Flexible scheduling allows for re-entry into the profession Flexible scheduling allows for re-entry into the profession *ASHP Task Force on Pharmacy’s Changing Demographics

52. WHAT CAN WE DO Restructure the Work Phase out purely distributive roles and replace with more integrated roles Phase out purely distributive roles and replace with more integrated roles Find responsibilities that can be share Find responsibilities that can be share Leverage technology to increase schedule flexibility Leverage technology to increase schedule flexibility – Dispensing and cart fill robotics – Work that can be done from home, long distance e.g. VA computer system enables work from home very well *ASHP Task Force on Pharmacy’s Changing Demographics

53. ASHP Position on Pharmacy Technicians Evolving role of technicians is key to advancing what pharmacists do Evolving role of technicians is key to advancing what pharmacists do Developing well-qualified pharmacy technician workforce, with defined skills and competencies, is essential to the success of this role Developing well-qualified pharmacy technician workforce, with defined skills and competencies, is essential to the success of this role Support uniform training – ASHP-accredited Support uniform training – ASHP-accredited Support certification through PTCB Support certification through PTCB Support registration through state boards Support registration through state boards

54. A well-qualified pharmacy technician workforce is critical to our future Growing complexity of medication use Growing complexity of medication use Continued focus on medication safety, quality Continued focus on medication safety, quality Increased public visibility, accountability Increased public visibility, accountability Described in the ASHP Long-Range Vision for the Pharmacy Workforce in Hospitals and Health- Systems Described in the ASHP Long-Range Vision for the Pharmacy Workforce in Hospitals and Health- Systems Supports goals described in the JCPP Future Vision for Pharmacy Practice 2015 Supports goals described in the JCPP Future Vision for Pharmacy Practice 2015 Objective within the ASHP 2015 Initiative Objective within the ASHP 2015 Initiative

55. Definitions Registration is the process of making a list or being enrolled in an existing list; registration should be used to help safeguard the public through interstate and intrastate tracking of the technician work force and preventing individuals with documented problems from serving as pharmacy technicians. Registration is the process of making a list or being enrolled in an existing list; registration should be used to help safeguard the public through interstate and intrastate tracking of the technician work force and preventing individuals with documented problems from serving as pharmacy technicians. Certification is the process by which a nongovernmental agency or association grants recognition to an individual who has met certain predetermined qualifications specified by that agency or association. Certification is the process by which a nongovernmental agency or association grants recognition to an individual who has met certain predetermined qualifications specified by that agency or association. Licensure is the process by which an agency of government grants permission to an individual to engage in a given occupation upon finding that the applicant has attained the minimal degree of competency necessary to ensure that the public health, safety and welfare will be reasonably well protected. Licensure is the process by which an agency of government grants permission to an individual to engage in a given occupation upon finding that the applicant has attained the minimal degree of competency necessary to ensure that the public health, safety and welfare will be reasonably well protected.

56. Accredited Training Program Statistics 112 programs in 32 states (TX = 24, CA = 23) 6,400 graduates in 2006 (5,000 78% are related to chains) < 10%of all technicians completed an accredited program

57. Status of State Regulation of Pharmacy Technicians (NABP Survey of Pharmacy Law-2007) Regulations on REGISTRATION : 34 states require registration 34 states require registration 5 states require licensure 5 states require licensure 11 states have no registration or licensure requirements 11 states have no registration or licensure requirements Regulations on CERTIFICATION PTCB Recognition in 30 states as one option for registration or for expanded tech responsibilities PTCB Recognition in 30 states as one option for registration or for expanded tech responsibilities - MT only state that requires PTCB - MT only state that requires PTCB 310,873 CPhT’s Nationwide 310,873 CPhT’s Nationwide Regulations on TRAINING 29 states require education and training (non-accredited) 29 states require education and training (non-accredited) (ND and NV specifically recognize ASHP accreditation in some form) (ND and NV specifically recognize ASHP accreditation in some form)

58. ASHP Pharmacy Technician Initiative What: Advocacy partnership with goal of developing an educated, trained, certified and registered pharmacy technician workforce. What: Advocacy partnership with goal of developing an educated, trained, certified and registered pharmacy technician workforce. Who: ASHP and individual state affiliates. Who: ASHP and individual state affiliates. How: Joint advocacy to promote a qualified technician workforce, with strategies and tactics unique to each state. How: Joint advocacy to promote a qualified technician workforce, with strategies and tactics unique to each state. When: Seeking affiliate sign-on starting January 1, 2008. When: Seeking affiliate sign-on starting January 1, 2008.

59. What can we do? Invest in the 50+ Worker They represent a solid and sound investment proposition. They represent a solid and sound investment proposition. Promote Mentoring: From the AARP report: “Mentoring can invigorate middle and older workers, creating challenges, conveying critical knowledge and sharing institutional history.” Promote Mentoring: From the AARP report: “Mentoring can invigorate middle and older workers, creating challenges, conveying critical knowledge and sharing institutional history.”

60. What Can We Do? Re-entry Programs Severe problem existing in all health professions. Severe problem existing in all health professions. How do we ensure competency prior to return to work? How do we ensure competency prior to return to work? It is not a question of expense for the re- entry program, we NEED pharmacists. It is not a question of expense for the re- entry program, we NEED pharmacists.

61. Why do Pharmacists Leave the Workforce? Caretaking issues Caretaking issues Personal illness Personal illness Dissatisfaction Dissatisfaction Pursue alternative careers Pursue alternative careers

62. The National Task Force on Re-entry into Clinical Practice identified several barriers to funding of re-entry programs: Limited public information regarding programs Limited public information regarding programs Resource-intensive Resource-intensive Lack of standardized curricula and no officially recognized national accreditation Lack of standardized curricula and no officially recognized national accreditation Key factors for success include Key factors for success include – Absolute commitment from the highest level of the organization – Excellent examples exist from successful business re-entry programs.

63. Pharmacist Re-entry Develop innovative programs to recruit community Pharmacists to transition to Health-system positions Develop innovative programs to recruit community Pharmacists to transition to Health-system positions Develop competitive recruitment packages Develop competitive recruitment packages

64. THE FACTS? True or False Card A or B Women and both sexes of Generation X bring a desire for balance of values to the workforce Women and both sexes of Generation X bring a desire for balance of values to the workforce Generational differences are increasing the demand for alternatives to traditional work norms Generational differences are increasing the demand for alternatives to traditional work norms Job satisfaction does not change across the generations and indicates pharmacists are generally satisfied Job satisfaction does not change across the generations and indicates pharmacists are generally satisfied

65. THE LEADERSHIP CRISIS Part-time pharmacists CAN move into leadership roles.

66. THE FACTS? True or False Card A or B Many Pharmacy leaders are reaching retirement and will be leaving in the next 5 to 10 years, e.g. VA. Many Pharmacy leaders are reaching retirement and will be leaving in the next 5 to 10 years, e.g. VA. “In a survey of 290 current pharmacy practitioners, only 30% wanted a leadership or managerial position during their career.” “In a survey of 290 current pharmacy practitioners, only 30% wanted a leadership or managerial position during their career.” Male or female want leadership responsibilities, but are not willing to work the long hours as their bosses. Male or female want leadership responsibilities, but are not willing to work the long hours as their bosses. There is an ample supply of senior mentors. There is an ample supply of senior mentors.

67. Women are still under-represented in leadership positions In academia - higher administrative position and tenured faculty In academia - higher administrative position and tenured faculty In the corporate sector executive leadership and board membership In the corporate sector executive leadership and board membership In leadership positions in the healthcare industry In leadership positions in the healthcare industry There are a lack of nontraditional role models and job structures for leaders and managers.

68. Can we reconcile the impending crisis of a leadership shortage and the increasing number of women in the profession with the lack of alternative ways to be a manager or leader in health-systems? Yes or No Card A or B

69. Reconciliation Develop leadership skills in all Pharmacy staff members Develop leadership skills in all Pharmacy staff members Combine clinical and management functions into the responsibilities of specific positions Combine clinical and management functions into the responsibilities of specific positions Recognize and reward staff with the goal of fostering interest in leadership Recognize and reward staff with the goal of fostering interest in leadership Educate students, residents, and staff about importance of their leadership role in daily practice Educate students, residents, and staff about importance of their leadership role in daily practice *ASHP Task Force on Pharmacy’s Changing Demographics

70. There is nothing we can do within an organization to affect the change in the demographics. FACT OR MYTH

71. TRUE! BUT WE CAN AFFECT WHAT WE DO ABOUT THE CHANGING DEMOGRAPHICS!

72. From the ASHP Task Force on Pharmacy’s Changing Demographics Final Report The profession of pharmacy needs to respond quickly to these demographic changes and create a workplace that engages and retains a diverse multigenerational workforce that can make many unique contributions to improve patient care. The profession of pharmacy needs to respond quickly to these demographic changes and create a workplace that engages and retains a diverse multigenerational workforce that can make many unique contributions to improve patient care. Educate leaders and pharmacy directors about generational differences and the need for greater options in the workplace. Educate leaders and pharmacy directors about generational differences and the need for greater options in the workplace.

73. Alternative methods must be developed to cultivate leaders and opportunities in nontraditional programs. Consider alternatives to current norms so that diverse ways of working are recognized and rewarded and that people have opportunities to fully contribute to the success of the organization Consider alternatives to current norms so that diverse ways of working are recognized and rewarded and that people have opportunities to fully contribute to the success of the organization Formal mentoring programs that address the business imperatives for leadership, skilled workforce, diverse workforce Formal mentoring programs that address the business imperatives for leadership, skilled workforce, diverse workforce

74. Leadership track programs for talented and committed workers Leadership track programs for talented and committed workers Create formal “off ramp” and “on ramp” programs that make it possible to leave and re-enter an organization Create formal “off ramp” and “on ramp” programs that make it possible to leave and re-enter an organization Alternative methods must be developed to cultivate leaders and opportunities in nontraditional programs.

75. THANK YOU! Lynnae Mahaney MBA, RPh, FASHP Chief, Pharmacy Services Wm. S. Middleton Memorial Veterans Hospital Madison, WI 608-256-1901 x11028 Lynnae.Mahaney@va.gov