1. Getting Noticed: Establishing Strategy and Defining Success Joyce A. Tipton, RPh, MBA, FASHP Director of Pharmacy Memorial Hermann Memorial City Houston, Texas

2. Objectives  Apply methods for aligning the goals of the Department of Pharmacy with the priorities of the health system  Define steps for a robust annual strategic operational planning process  Identify key performance indicators that support the impact of pharmacy within the organization

3. Annual Strategic Operational Planning – Marketing the Impact  Demonstrates thorough planning prior to annual budget process  Provides a consistent and systematic approach that supports success worth sharing  Achieves buy-in by key stakeholders  Leaders and staff within pharmacy  Opportunity for mutually agreed upon priorities with organization leadership  Sets clearly defined goals and targets  Sets accountability for pharmacy leadership and staff  Objective measures for upline reporting structure

4. Annual Strategic Operational Planning – Marketing the Impact  Establishes measurable evidence of success  Objective measures that open the door for highlighting quality contributions  Facilitates alignment with organizational priorities  Clear and visual confirmation of the value of pharmacy supporting goals of the organization  Supports a structured format for marketing pharmacy contributions  Readily available information for promoting value of pharmacy at every opportunity

5. Annual Strategic Operational Planning – Plan the Planning  Two to three months in advance  Schedule two sessions (full day and half day or two half days) and reserve room  Send written notice to participants outlining attendance expectations  Invite your VP or COO to bring greetings at the retreat  Invite Organizational Development to conduct a developmental session during the retreat (team building, time management, etc.)  Make assignments to managers and residents (let residents learn as they do)

6. Annual Strategic Operational Planning – Plan the Planning  Two to three weeks in advance  Notify your internal public relations department and invite them to cover the event  Send agenda to participants, including brief thought-provoking questions they should answer prior to the retreat  Make arrangements for meals and snacks  Assign a photographer

7. Steps in the Strategic Operational Planning Cycle The Planning – Phase 1  Customer identification  Mission and Vision SWOT Analysis – Strengths, Weaknesses, Opportunities, and Threats  Prioritizing issues  Establishing goals and initial strategies  Identifying accountability  Further defining strategies for each goal using SMART criteria

8.  Specific – the objective should state exactly what is to be achieved  Measurable – an objective should be capable of measurement – so that it is possible to determine whether it has been achieved  Achievable – the objective should be realistic given the circumstances in which it is set and the resources available to the business  Relevant – objectives should be relevant to the people responsible for achieving them  Time Bound – objectives should be set with a time frame in mind. These deadlines also need to be realistic SMART Criteria

9. Steps in the Strategic Operational Planning Cycle The Planning - Phase 2  Establish metrics that will be used for outcomes measures  Establish firm target dates  Develop written action plans with timelines  Identify resources needed (important for budget planning)  Identify accountability and target date for each action

10.  Commit the plan to writing in three versions – Detailed, Outline, and Matrix  Share with VP, CEO, and provide with budget documents  Share excerpts via hospital newsletter, etc.  Share with all members of the Department  Town hall meetings  Staff meetings  Individual copies Sharing the Plan

11. Example of Matrix Goal and Strategy Employee Engagement ExcellenceEfficiency Core Measure NPSG Med Safety Compliance Hospital of Physician Choice Goal I: Improve patients medication therapy outcomes, optimizing quality / cost Antimicrobial Stewardship XX X X X Anticoagulation management XX XXX X Provide quality pharmacy services in the Emergency Department XXXXXX X Enhance compliance with Medication Reconciliation XXX XX Implement technician order entry XXX XX Oncology Services X X X Goal II: Maximize efficiency, quality, and safety in the medication use process. Continual maintenance of basic QA XX XX Pyxis fill accuracy X XX Missing doses X XX Timely med delivery XX XX X MedCarousel and PacMed X X X Goal III: Promote a culture of engagement and accountability. Staff development, orientation, training XX X Improve effectiveness of communication X X Improve leadership goal execution XXX Employee recognition XX Incredible Website X Goal IV: Achieve financial budget plan for FY 08 Decrease cost of wasted drugs X Clinical Initiatives with cost savings/avoidance X

12. Reporting  Require at least quarterly reports from each person accountable including specific metrics  Create Dashboards or Scorecards for visual reporting  Provide quarterly reports/presentation to VP/COO.  Volunteer to present pharmacy updates for any appropriate committee  Provide updates to staff at Town Halls or staff meetings  Share the Dashboards in visible places  Bulletin boards  Published in newsletter

13. Example of Dashboard

14. Example of Metric Detail

15. Dashboard Metrics  Highlight the metrics from Strategic Planning goals  Don’t confuse what you need to know with what your CEO needs to know  May need two Dashboards  Align the metrics with your organization’s strategies  Typically will align with the functional areas of operational, clinical, and financial

16. Wake Up – It’s your turn…  Organize discussion groups of 4 to 5 people around you  Identify a recorder and a spokesperson  Spend five minutes identifying metrics and how you have used them  The recorder will write down all the metrics mentioned  The spokesperson will be prepared to share with the large group

17. Metric Examples  Financial  Drug spend ▪Drug cost per APD ▪Trended drug cost by DRG  Personnel Expense ▪Salary cost per APD ▪Work hours per RVU  Clinical  Clinical Interventions ▪Trend by volume ▪Trend by assigned dollar value  Medication Reconciliation ▪Percent completed  Core Measures  Operational  Turnaround Time  Missing Doses as percent of doses dispensed  Percent doses from ADC  Order entry turnaround time  Percent CPOE

18. Metrics and the Whole Story  Grab attention with the metric snapshot  Be prepared to tell the quality story  Why is the metric meaningful  How does it impact quality and the patient experience  Have a real patient example  Metrics and ROI are only part of the story  Quality is meeting and exceeding the customer’s needs and expectations for what they consider a reasonable price

19. Where does the Pharmacist Add Value? Value = Outcomes + Customer Experience (+/-) ____________ Cost Paint the picture of Pharmacist value

20. And if needed… put on your cowboy hat and dance!