Presentation on theme: "Green Square Consensus Team"— Presentation transcript:
1Green Square Consensus Team What management roles, skills, and abilities will be necessary for future pharmacy services?Green Square Consensus Team
2Flashback!11TH VA NATIONAL PHARMACY CONFERENCE “Aiming for Excellence” September 11-15, 2006
3The Initial 2006 Plan Question: Goal: End product: What management roles, skills, and abilities will be necessary for future pharmacy services?Goal:“Develop Super Hero Managers/Leaders with the skills & abilities necessary to thrive in EVOLVING pharmacy practice”End product:Cyber-based Leadership/Management training program for employees at ALL LEVELS
4Essential Management Roles necessary for future pharmacy services Essential Management Roles necessary for future pharmacy services. What Factors were essential for this decision?Proactive, adaptable and conducive to change both nationally and globallyTechnologicalStrategic PlanningMedical advancementsChanging pharmacy worldMentoring program (ongoing)Across PharmacyAcross DisciplinesAcross locationsPrivate sector/Outside organizationsCore competencies/Managerial developmentClinicalPharmacoeconomicsPersonnel managementAutomationAssessment/credentialingUnderstand and teach the VA systemMulti-culturalPolitical processesCommittee structureNetworkingPublic RelationsIncorporate Individual Facility and VISN practices into “One National VA”Measures/MonitorsCost containment strategyPatient focused care that is consistent, reliable, and accessible across VA facilities and partnersRecruitmentInternalSuper HeroExternalPharmacy residents/studentsEmergency Preparedness
5Essential Management skills and abilities necessary for future pharmacy services. What Factors were essential for this decision?InformaticsDecision makingPrioritization/JugglingReactiveClinicalCommunicationNegotiationMarketableDispensatoryPoliticalConfidenceLiaisonSalesLeadershipOpen mindedPatient focused
6More Roles, Skills, and Abilities…. Future pharmacy services:Fail-safe medication useQualified managers, RPh., TechnicianPractice/develop evidence based medicineAffordable and accessible pharmaceuticalsHealth executive (outside pharmacy) education and awarenessResearch and assessment of essential competenciesTraining opportunitiesVirtual Leadership developmentEducateFind more ways to build other things into pharmacy practiceLet executives know how pharmacy can helpBiomonitoring and therapeuticsNanotechnologyEMR & Risk simulationPre-clinical assessmentBiosystemsGenetic sequencesProteomicsGlobal health recordsGlobal drug discovery clerkshipTherapeutic imagingComputational Drug DesignOutcomes ResearchManage HCS resourcesPromote health improvement and disease preventionAuthority and automitityPharmacy is essential to the prevention health careDevelop a VA credentialEmbed pharmacists into leadership positionsProve more money spent on pharmacy decreases overall costsPatient centeredInterdisciplinaryQuality improvementMedical Informatics
7Post conference reality check: What can we realistically accomplish? Goal:“Develop Super Hero Managers/Leaders with skills & abilities necessary to thrive in EVOLVING pharmacy practice”Objectives:Further refine and define the list of Roles, Skills, and AbilitiesMUST BE USABLEExamine the options to develop these in all employeesVA and Non-VA sourcesRecommend a means to the goalEnd product:Cyber-based Leadership/Management training program for employees at ALL LEVELSWhat can we accomplish in our free time? Are we on the correct path to begin with?Step 1: Examine the roles, skills, and abilities more in depth.2. Define and Refine them into something we can use
8Defining and refining the list… Back to our roots! Informal survey within the squares and of VA pharmacy leadersReview of initial listEstablishment of new elementsReview of leadership and management literatureEstablishment and definition of elementsReview of established programsVA and Non-VA programsConcurrence with established ideasPotential Utility
9Key Concept“Develop Super Hero Managers/Leaders with skills & abilities necessary to thrive in evolving pharmacy practice”One of the big challenges in this process is that there are two critical elements.Two clearly different elementsLeadershipManagementNot every leader wants to manageVery different resources available
10Literature and other resources Nold EG, Sander WT. Role of the director of pharmacy: The first six months. Am J Health-Syst Pharm. 2004;61:Zilz DA, Woodward BW, Thomas ST, Shane RR, Scott B. Leadership skills for a high-performance pharmacy practice. Am J Health-Syst Pharm. 2004; 61:Center for Health-System Pharmacy Leadership Initiative: Management and Leadership CompetenciesVarious reference articles on LeadershipManaging & Leading: 44 Lessons Learned for PharmacistsStaff Development for Pharmacy PracticeHandbook of Institutional Pharmacy Practice 4th ed.Competence Assessment Tools for Health-System Pharmacies, 4th ed.Best Practices for Hospital and Health-System PharmacyAssuring Continuous Compliance with Joint Commission Standards, 7th ed.The University of Kansas: Department of Pharmacy Leadership Assessment FormGood to Great AND Good to Grear and the Social SectorsJim CollinsBreaking the rules…..Sharon Castle, never taught me during my residency NOT to be too wordy on my slides, so I blame this one on her.If anyone is evaluating me you can mark me NOT ADEQUATE for this Criteria Based Check list.
11VHA Workforce Development & Succession Model “VHA launched a complete leadership continuum and established programs to prepare employees at all levels of the organization for leadership positions.”
12New employee orientation HPDM awareness and development All EmployessNew employee orientationHPDM awareness and developmentVHA mentor and coach programCultural Health InitiativeFrontline EmployeesTCF programVAMC Leadership InstituteGraduate Health Admin. ProgramSupervisory/Team LeaderSupervisors TrainingVISN Leadership InstituteAdvanced TCF trainingNurse Manager DevelopmentMiddle ManagementECF Candidate DevelopmentService Line/Chief OrientationLVAExecutive Career FieldHCLIVA SES CDVSELISenior Executive OrientationNurse Executive OrientationSenior Leadership Academy (1-VA)Senior Management ConferenceELPProvided by Nancy Fadel in association with VA EES
13Other VA Opportunities Joint Medical Executive Skills Institute (Joint EES/DOD)Supervisors ToolboxPharmacy Mentor Certification ProgramVarious VA Pharmacy ConferencesUniversity of Wisconsin Federal Pharmacy ProgramsVA Clinical Pharmacy Programming ConferenceNational Pharmacy ConferenceVISN level confernecesLiterature resourcesInstitute for Management Studies Seminars
14Non-VA Programs ASHP Foundation Pharmacy Leadership Institute ASHP Foundation Pharmacy Leadership AcademyLatiolais Leadership InstituteUCSF Leadership InstituteAnnual ASHP Conference for Leaders in Health-System PharmacyVarious Administrative Residencies and Masters programsAmerican Mangement Association
15After all this, What roles, skill, and abilities are needed?
168 core competencies of the High Performance Development Model: http://vaww.va.gov/hpdm/
17Personal Mastery: Process of self-managed continuing professional development through setting of personal goals, self-assessment, and changeAccurate assessment of personal capabilities and appropriate reaction to strengths/weaknessesContinuously strive for personal developmentDefine realistic goals and accomplish them through self motivationAdvocate for growth of the profession and its professional associationsActively pursue balance of professional and personal lifeEfficiently prioritize duties through effective time managementStay abreast of new technology and advances in information technologyIdentify, recruit, coach, and transfer knowledge to potential future pharmacy leadersRoutinely participate in education & training opportunities to maintain/expand knowledge in pharmacy competenciesWell versed in VHA training portals and contributes to their developmentVolunteer in group activities as a consensus workgroup leader/facilitatorIdentify, research & conquer challenging areas in VHA; share success with others through poster presentationUse VHA employment as a means to expand leadership opportunity through collateral duties, federal scholarship programs, and affiliate/community relations
18Technical Knowledge and Skills: Maintains the knowledge and skills required to be effective in their roleProfessional knowledge in pharmacy operations, medication distribution systems, sterile preparations and mixturesProfit vs non-profit vs cost based health care systems and co-managed careVHA Policy and procedures* VHA Handbook Investigational Drugs and Supplies* VHA Handbook Outpatient Pharmacy Services* VHA Handbook Inpatient Pharmacy Services* VHA Handbook Controlled Substances (Pharmacy Stocks)* VHA Handbook Inspection of Controlled Substances* VHA Handbook Self Medication Program (SMP)Informatics/Software architecture (Vista, CPRS, BCMA, Microsoft - Office, ProClarity, SharePoint, LiveMeeting, VSSC)Legal aspects of pharmacy practiceProgram Management, Competency Assessment, Scope of Practice, Functional StatementInformation Security - cyber training, HIPAAPurchasing and Inventory ControlPharmacy layout and design, workflow analysisReporting systems and metricsHuman Resource (Title 5, Title 38, hybrid T-38)Health Care Recruitment and Retention Office (EDRP, EISP, VALOR, SEEP)VHA Service and Support Center (VSSC)
19Interpersonal Effectiveness: Ability to develop and maintain working relationships with everyone Build effective relationships with internal customers for mutual problem resolutionRespect differing philosophies and negotiate common ground between themShow appreciation to other services and consider what impact your actions have on themRealize everyone has a bad day now and then; put differences aside and move forwardIdentify mutual goals of pharmacy with other Service Chiefs, Chiefs of Medicine, Chief of StaffBe precise, articulate, and honest when selling your serviceLeadership coaching to build organizational talentExecutive presence and articulate communication (oral, written, listening)Foster team work and respect for all individualsEmpower employees/colleagues and appropriately delegate responsibilityServe as a role-model for others and lead through vision and valueHigh moral and ethical integrityRecognize achievement, celebrate success, and reward staffShare gratitude and be accountable for set-backsUnderstand Human Resource and Union philosophyCherish diversityMaintain composure and self-controlFrequently interview customers and listen to their perspectiveWilling to negotiate positions
20Customer Service: Maintains customer focus (patient, colleague, providers, etc.) in the appropriate elements of the serviceRecognize diverse group of costumers within VHA and understand their unique needsProvision of drug information with communication specific to customer's level of comprehensionFoster buy-in to formulary management through gold standard clinical pharmacy servicesMaximize employee satisfaction through development, coaching, recognitionChampion educational programs within department and beyondConduct quality improvement exercises targeting your costumers’ perspectiveUnderstand and facilitate cohesive business relationship with IndustrySet the bar, then aim to raise itListen to and treat all customers equally
21Flexibility/Adaptability: Ability to adapt quickly to change, handle multiple inputs and tasks, and accommodate new or emergent situationsAccept that unexpected things happen, usually at the most inopportune momentUnderstand that Emergency Preparedness, Joint Commission inspections, and staff shortages will occurExpect unforeseen incidents and cope with changes in daily routineManage urgent information requests and assemble response in short time frameContingency plans for loss of automation, printers, technologyManage scheduling changes due to staff illness/unexpected absencesWork well under pressure and able to resolve issues in a crisisHandle drug conversions secondary to shortages, formulary/contract changes, etc.
22Creative Thinking: Ability to develop innovative strategies, solutions, and plans Hold brainstorming sessions/focus groupsAnnual assessment of state of pharmacy serviceProblem Solving/Critical thinking workgroupsPromote and reward creative thinking from othersStrategic planning events for pharmacy services
23Systems Thinking: Ability to develop processes and solutions within your department that consider the impact on the entire system of your department and facilityBusiness Acumen: Ability to assess and improve a business modelChange Leadership: Promoting advances in practices and change from the status quoEstablish strategic direction that compliments medical center goalsConsider intentional and unintentional outcomes of changes or decisionsEvaluate new processes, their outcomes, and actions needed to improve serviceEstablish action plans to support to senior administration initiatives (Network Director ECF plan)Promote Residency training/teaching environmentMaximize efficiency in areas of automation, Computerized Physician Order Entry, Bar Code Med AdministrationDedication to processes of oversightControls over prescription drugs - controlled substance managementStaffing/Workload analysisOptimize fiscal resource management:* Understand pharmaceutical contracting (NAC, PBM, FSS, Big4, NC, BPA)* Pharmacy Budget, supplemental funds* PPV & Reverse Distributor* Account Level Budgeting (DSS cube)Role of pharmacy services in investigational drug usage and outcomes research
24Organizational Stewardship: Commitment to the VA/VHA mission and advocates as such and remembers this and places it in the context of their serviceComprehend VA & PBM organizational structure (President, Department, Secretary, PBM Service (Washington/Hines), CMOP, VISN, HCS, clinics, affiliations)Plan for workforce succession needs and identify innovative recruitment & retention strategiesAstute in committee functionalityContinuous readiness with oversight standards (JC, OIG, SOARS)Role of VA in Disaster planning/Emergency responseCommitment to patient/medication safetyConcerted effort to transfer knowledge and foster leadershipSupport VA mission, philosophy, and objectivesUnderstand significance of facility leadership goals and objectivesDevelop/expand student education/affiliationsGuidance in evidence based medicine, pharmacoeconomicsActively involved with creation and achievement of pharmacy measures & goalsEngage dialog with stake holders in cross-cutting issues
25THERE IS NO SINGLE PROGRAM THAT CAN MEET THE ENTIRE LOT! EvaluationPharmacy Directors/Managers/Leaders do A LOTWhen they are done with A LOT they still have more to doUltimately the job is never done!THERE IS NO SINGLE PROGRAM THAT CAN MEET THE ENTIRE LOT!
26Summary of observations Leadership trainingMuch of what is available in VA is non-pharmacy specificIs that critical?Pharmacy specific opportunitiesOften not completely focused but they clearly promoteImproving outside program availabilityASHP foundationGoal of 100 people trained per year in academyOther university programsCome with a costEvolving literature with potential crisis in pharmacyMay not need additional leadership programs if we can take advantage of what is availableStrong interest to assure broad availability
28Roles, Skills, and Abilities We’ve defined A LOT of roles, skills, and abilitiesThese are continuously evolving with pharmacy and will continue to do soCurrent list if utilized in some fashion would require periodic re-review and revision to keep current with practiceTo be further utilized by the Pharmacy Leadership/Administrative Training Committee
29Cyber-based Leadership/Management training program for employees at ALL LEVELS Still an idea with potential, HOWEVERTime intensive to developRequire extensive dedicated resourcesSimilar modules exist (EES/DOD, JMESI)Does their program work?Do people use it?No literature support that such a program will produce the desired resultsIf focused on the gaps in training, may be of benefit
30Final thoughts There are opportunities! There are some gaps Identification of personnel interested in leadership and management is CRITICALShould be done EARLY in careerOpportunities must be widely identified for these individualsCentral source of informationOpportunities should help to serve as qualifiers for promotionVA Pharmacy specific programs may help fill in the gapsNational, VISN conferencesWorkshopsSite VisitationMentoringTIME IS A MUST
31What else could be done?Organize an easy to use leadership/management resource guide that is specific for pharmacyDefine a method to identify those with interest in pursuing leadership and management positionsDefine a course for interested candidatesOpportunities needed from the front-line on upDevelopment of self-assessment tool for pharmacy managers/leaders to identify needed education
32Team Members and Special Contributions Bechdol, Ruth A.Brown, Jeanne BedfordEvans, FrankFriend, AmyGardner, Bryan J.Garza, ArnoldGray, David RHerr, Elizabeth AJohnson, Jill R.Koons, Kevin A.Larsen, Linda L.Leibfried, ElmarLopez, JulioMinard, PatrickPalkuti, MarisaSemla, ToddStein-Gocken, JulieSteinwandt, Stephan MStroup, TimYunker, Frank J