Pharmacy Management PHCL-420

Pharmacy Management PHCL-420
Professor T. Al-Najjar Teacher & Coordinator Male & Female Campus Professor T . alnajjar PHCL Pharmacy Management

Professor T . alnajjar PHCL-420 - Pharmacy Management
Week # Teaching Faculty Lectures Date Lecture Topic 1 NA Mon 26 Jan Why study pharmacy management? Introduction: course objectives, course syllabus (expectations for the course, grade distribution, activities, attendance…etc). Wen 28 Jan 2 Mon 2 Feb Management functions Wen 4 Feb Planning in pharmacy operation 3 NA/LA Mon 9 Feb Wen 11 Feb Operational Management 4 LA Mon 16 Feb Wen 18 Feb 5 Mon 23 Feb Ensuring Quality in pharmacy operation Wen 25 Feb 6 Mon 2 Mar Midterm Exam 1 (Topics: management functions, Planning, & Quality) Wen 4 Mar Organizational structure and behavior 7 Mon 9 Mar Wen 11 Mar Human resources Management 8 Mon 16 Mar Leadership in pharmacy Wen 18 Mar 9 Mon 23 Mar Midterm Semester Break Wen 25 Mar 10 TA Mon 30 Apr Financial Reports Wen 1 Apr 11 TA/LA Mon 6 Apr Wen 8 Apr Purchasing and inventory management 12 Mon 13 Apr Wen 15 Apr 13 Mon 20 Apr Midterm Exam 2 (Financial Reports, Purchasing & Inventory) Wen 22 Apr Time Management 14 Mon 27 Apr Wen 29 Apr Management Skills: Team building 15 Mon 4 May Wen 6 May Professor T . alnajjar PHCL Pharmacy Management

activities/assignments/quizzes
Activity Points 2 Midterm exams 45 activities/assignments/quizzes 15 Final Exam 40 Total 100 Professor T . alnajjar PHCL Pharmacy Management

Pharmacy Management: Essentials for All Practice Settings‏.
By Shane P Desselle, David P. Zgarrick‏. McGraw-Hill Professional 3rd ed. Professor T . alnajjar PHCL Pharmacy Management

Why we study “Management”
Webster's Dictionary is : To control the movement or behavior To lead or direct To succeed in accomplishing task Need to be in control of our self & surroundings and successful in the tasks we performed Professor T . alnajjar PHCL Pharmacy Management

Is “a process which brings together resources and unites them in such a way that, collectively, they achieve goals or objectives in the most efficient manner possible. Need to use resources efficiently to perform their tasks. Thus all pharmacists should view themselves as managers. Leadership: ability to inspire or direct others (L. skills desirable for managers , but they do not necessarily go hand in hand) Professor T . alnajjar PHCL Pharmacy Management

Managers: Simply people who perform management activities Anyone who has a task to accomplish or a goal to achieve is also a manager Thus all pharmacists, regardless of their job responsibilities or position, should view themselves as managers! Professor T . alnajjar PHCL Pharmacy Management

Classical management theory F. W. Taylor, an executive with Bethlehem Steel. Published The Principles of Scientific Management in 1911 Five functions: Forecasting and planning, organizing, commanding, coordinating, and controlling Reduced to four Practice daily by each of us Professor T . alnajjar PHCL Pharmacy Management

M. Process Follow 3 dimensions: Activities that managers perform Resources that managers need Levels at which managers make decisions. Professor T . alnajjar PHCL Pharmacy Management

Management Process Professor T . alnajjar PHCL Pharmacy Management

Planning Planning is predetermining a course of action based on one's goals and objectives. Must consider many factors (internal and external E.)…. Future - proactive Formal: Plans of which drug products to carry or what professional services to offer. To strategic/ business plans for pharmacy Informal. A plan of how to get there (What time do I need to arrive? What form of transportation should I take? What route should I follow?). Professor T . alnajjar PHCL Pharmacy Management

Organizing Is the arrangement and relationship of activities and resources necessary for the effective accomplishment of a goal or objective. Next to which drug products or services should be offered. Resources (what-how and when) Weather, traffic reports, gas, car, childcare, etc Professor T . alnajjar PHCL Pharmacy Management

Leading or directing Fayal's command and coordinate Bringing about purposeful action toward some desired outcome. By yourself or working with others to lead them to where you want your organization to be. Orient, train, instruct, and order. Professor T . alnajjar PHCL Pharmacy Management

Control or evaluation Control or evaluation involves reviewing the progress that has been made toward the objectives that were set out in the plan. What actually happened but also why Quality-control (patients receive the desired medication in the appropriate manner) Goods & services met the goals in terms Clients ..high-quality patient care or improved clinical outcomes Provider .. job satisfaction? Did it improve the profitability of the pharmacy or organization?. If not arrived on time (traffic accident, Rd constructions, snooze etc.). Professor T . alnajjar PHCL Pharmacy Management

Management Activities
Plan Organize Lead Control Professor T . alnajjar PHCL Pharmacy Management

The Resources Money People Time Material information Professor T . alnajjar PHCL Pharmacy Management

M. activities Must be In order Cycle (Figure) Planning is required New Change Wrong Professor T . alnajjar PHCL Pharmacy Management

Levels of Management Self-management Pharmacist ensuring that every prescription is dispensed? Interpersonal management pharmacist counseling a patient about a medication? Organizational management Pharmacist planning to add a new service to his chain community pharmacy chains? Professor T . alnajjar PHCL Pharmacy Management

Modern Views Have a vision and ideas about what would like to see their organizations become in the future. Energize Provide the employees with training, resources, and advise and then let them get the job done Empower Letting their employees know when they have done a good job, as well as helping them to learn when things are not going well. Support The corner stone of communications is trust. Communicate Professor T . alnajjar PHCL Pharmacy Management

Energize. Today's managers need to have a vision of what they want to create and the energy to make it happen. When you think of good managers with whom you have worked with, Not those just want to keep doing the same thing every day for the rest of their lives. They have ideas about what they would like to see their organizations become in the future, and the energy and enthusiasm to attract others to want to join them in achieving their goals. They are always trying to make the best stressful situations, especially when the level of resources available may be less than they desire. In pharmacy today, good managers are often pharmacists who want to see the profession move forward by developing new goods and services, especially those that improve patient care. Their energy and enthusiasm attract motivated pharmacists and other personnel who share their vision and want to work with them. Find the resources they need to carry out their vision or make the most of what they already have. Not only does the power of energy and enthusiasm work for pharmacists, but it also benefits pharmacy students. Professor T . alnajjar PHCL Pharmacy Management

Empower. If you are a highly educated and skilled health professional, the last thing you want is to have an administrator questioning your decisions and telling you how you should do your job. In today's environment, managers should empower their employees to do what needs to be done. In many ways, today's manager is very much like the coach of a team. Coaches develop a game plan; select players; provide them with training, resources, and advice; and then step back and let the players execute the game plan. Good coaches empower their players to carry out the game plan. Managers who empower their employees provide them with training, resources, and advice and then let the employees get the job done. Professor T . alnajjar PHCL Pharmacy Management

Support. Next to empowerment , should not just leave them on their own, especially when things start to go wrong. Today, good managers need to be coaches, collaborators, and sometimes even cheerleaders for their employees. Support does not mean that managers should be willing to do their employees' work or always agree with the decisions employees make on the job. It does mean that managers need to provide employees with the training, resources, and authority needed to do their jobs. Managers also need to be good coaches, letting employees know when they have done a good job, as well as helping them learn when things are not going so well. Must also be mindful to balance the needs and resources of their organizations with what employees need. As much as a manager may wish to give a valued employee a big raise, the manager must also consider how much money is available for a raise amongst other potential uses of his organization's financial resources. Professor T . alnajjar PHCL Pharmacy Management

Communicate. In today's information-laden environment, communication between managers and employees is more important than ever. While managers can energize, empower, and support their employees, if they cannot communicate their messages, they will not be effective and their organizations will suffer. The cornerstone of communications in any environment is trust. If employees feel that they can bring up any question or concern to a manager, they will likely be more receptive to what the manager has to say. Vast number of ways in which they can communicate. Over the telephone, Via voice mail or , in a text message, or even through A social network such as Facebook or Twitter. Make it easier for managers and employees to communicate with each other, care must be taken in using these methods. Not every method of communication is appropriate (e.g., disciplining or firing an employee in a text message is not a good idea). Professor T . alnajjar PHCL Pharmacy Management

Why Should I Study Management? While there is certainly a role for applying self-management skills, most pharmacy managers agree that managing a pharmacy practice successfully requires a unique set of skills. Some of these skills can be quite technical [e.g., financial management , requiring a knowledge base that goes beyond what many pharmacists bring to their practices. These skills should be learned just as one would learn medicinal chemistry, pharmacology, or therapeutics. Something else to keep in mind is that in today's workplace, what might be common sense to you may not make sense at all to the other people you encounter. Pharmacists today work with employees, other health professionals, and especially patients who come from a wide variety of racial, ethnic, cultural, and educational backgrounds. People from diverse backgrounds bring with them an incredible amount of insight and experience. Pharmacists who do not take this diversity into account when working with people may find themselves frustrated and not able to achieve their goals and objectives effectively. This book presents material that is relevant to both pharmacy students and pharmacists. Pharmacy students who use this book will find that many of the scenarios that start each chapter are directed toward experiences to which they can relate. There may be some of you right now who think that your life has a lot in common with Krista Connelly's. We anticipate that this is the case. The information provided in each chapter not only will help students to better deal with management issues they are currently experiencing but will also help to prepare them for what to expect in the future as pharmacists. Pharmacists who use this book often have a good idea of why they need to have management skills. After all, they are living pharmacy practice management on a daily basis! The information provided in this book should help provide pharmacists with the skills they will need to better meet the challenges they face every day. In addition, the last six chapters of this book describe how pharmacists in a variety of practice settings apply management skills on a daily basis. Professor T . alnajjar PHCL Pharmacy Management

Chapter 4. Strategic Planning in Pharmacy Operations
Professor T. Alnajjar PHCL-420 Professor T . alnajjar PHCL Pharmacy Management

Learning Objectives Provide an overview of planning activities conducted by pharmacy and health care organizations. Describe the general process common to all types of planning. Describe the purpose of strategic planning, and illustrate the specific steps to develop a strategic plan. Differentiate a vision statement from a mission statement. Identify barriers and limitations to planning. Professor T . alnajjar PHCL Pharmacy Management

Planning Purposeful efforts taken by an organization to maximize its future success It is the process of attaining objectives. A management (manager) duty One of the four key functions Crucial because it supports the other three Involve more than just managers at high levels. Professor T . alnajjar PHCL Pharmacy Management

Planning activities Many different types . Business, Financial, Operational, Organizational , Resource, and Strategic planning. Differ in the purpose Resource planning (Human resources ,…..) Information technology planning which focuses specifically on the present and future I. needs and the technologies and systems to meet those needs) Professor T . alnajjar PHCL Pharmacy Management

Because S.P is important Many org. invest significant time and resources. Source of success Large companies delegated to a special depart.& often outside consultants. P. process may vary by the type of P. and the size of the org. or system. P. for H.P versus clinical pharm. services, or infor. management. Professor T . alnajjar PHCL Pharmacy Management

Planning (sophistication). Relatively simple and straightforward. Involve extensive analyses of data with complicated forecasting, decision-making models, and algorithms. Nevertheless, all planning processes s share a few basic characteristics: Eight steps in Table 4-2 May be expanded or condensed Key components: Understanding the purpose Assessing the situation Establishing goals, and Devising a method to accomplish those goals. Professor T . alnajjar PHCL Pharmacy Management

Steps in the Planning Process Define or orient the planning process to a singular purpose or a desired result (vision /mission). Assess the current situation. Establish goals. Identify strategies to reach those goals. Establish objectives that support progress toward those goals. Define responsibilities and timelines for each objective. Write and communicate the plan. Monitor progress toward meeting goals and objectives. Professor T . alnajjar PHCL Pharmacy Management

Steps in the Planning Process
Define the vision and mission Assess the current situation Establish goals Identify strategies to reach those goals Establish objectives that support progress toward those goals Define responsibilities and timelines for each objective Write and communicate the plan Monitor progress toward meeting goals and objectives As shown in the table, the planning process should begin with consideration of the purpose of the organization or system and of the planning effort, itself. This is followed by an analysis of the present situation or status of the system. Next, specific future goals are determined, and then a strategy for bridging the gap between the present and future is developed. Interim objectives that measure progress toward the goals are then identified, and responsibilities and timelines for each objective are assigned. The plan then needs to be communicated, implemented, and monitored. Professor T . alnajjar PHCL Pharmacy Management

Strategic Planning (S.P) Purpose: to ensure doing the right things now and in the future. Addresses: what ? business is in or ought to be in, and helps to determine long-term goals. Community pharmacy? “prescription business” or “health care business”?. Health system: “hospital business” or A “business that provides a continuum of care”? Answers may influence how it views itself and how it conducts its business Thus providing a framework for more detailed planning and day-to-day decisions. Professor T . alnajjar PHCL Pharmacy Management

S.P Defined as the process of selecting an organization's goals, determining the policies and programs (strategies) necessary to achieve specific objectives en route to those goals, and establishing methods necessary to ensure that the policies and strategic programs are implemented (Steiner et al., 1982). More broadly: an effort that enables the optimal deployment of all organizational resources within current and future environmental constraints. This results in to an increase the likelihood that an organization will survive, and preferably thrive, in the future. Professor T . alnajjar PHCL Pharmacy Management

S.P versus Business P. Most common types Differ in the purpose. S.P is about achieving a long-term vision and making sure the org. is doing the things necessary to ensure overall success, B.P focuses on a the feasibility of a specific program (usually a new initiative). B.P (and others) must occur within the context of the S.P of the org. S.P viewed as the overarching effort that should guide all other types of P. and even org. day-to-day activities. Professor T . alnajjar PHCL Pharmacy Management

S.P (history) Used in evaluating performance Companies that engage in long-range strategic planning are often more successful. Reactive S.P is not the ideal, but it is often necessary, especially in rapidly changing industries such as H.C . Preferably, proactive S.P enables to control environment instead of vice versa. Professor T . alnajjar PHCL Pharmacy Management

Provocative thinking In a position to control and recreate business environment. A type of strategic thinking (the pinnacle of planning efforts) — to be most competitive. An examples The evolution of electronic products and services of Apple, Inc., that respond to customer needs and reshape the digital environment, from the iMac and MacBook, to the iPod, iPhone, and now the iPad. Social networking Web site, Facebook, and the professional networking Web site, LinkedIn, and the group discount Web site, Groupon. Both developed a new markets for interaction via the Internet that did not exist previously. Professor T . alnajjar PHCL Pharmacy Management

S.P Distinguish from other types of planning. Time horizon Long-term planning. Actual timeline may vary or in some cases may not be known Because the future is unknown, it is difficult to predict with any accuracy the amount of time it will take to reach long-term goals. Nevertheless, a key component of strategic planning is to identify time periods (10 to 20 years) or as short as 2 years. In a survey by the Net Future Institute: 2 years (40.2 percent), 5 years (32.7 percent) and 1 year (17.9 percent). Many were high-tech industries (rapid change may impair longer-term planning). H.C is also an industry of rapid change, though the time horizon may be longer. Professor T . alnajjar PHCL Pharmacy Management

5-year time periods May not result in any truly sustainable competitive advantages or a significant org. metamorphosis. Goals that incorporate new paradoxes or visionary changes may be difficult for employees to believe if the time period for accomplishing those goals is too short. Nevertheless, this is the time period that must be congruent with these goals, not vice versa. The worst mistake would be to “dumb down” the goals to make them consistent with a shorter time period. Professor T . alnajjar PHCL Pharmacy Management

Vision and Mission Important part of the S.P process as it create momentum and to motivate personnel. S.P is all about creating a “story” about the org. Org. story is communicated through a number of different statements (products of S.P) Vision and mission are the most essential. Vision Is what the pharmacy org. wants to be at some future time point. May be complex and multidimensional, while at the same time it must be concise. It should make people think and motivate them, especially employees, to create a different and better future for the org. CVS Vision: is “to improve the quality of human life”. Is a lofty goal to inspire org. & employees. Professor T . alnajjar PHCL Pharmacy Management

Vision Used as beginning point and end point? Next how to reach such end point. Therefore it define the mission Mayo Clinic: Vision is to “provide an unparalleled experience as the most trusted partner for healthcare”. Such vision drives the mission including its values, and presumably, guide daily business . Professor T . alnajjar PHCL Pharmacy Management

Mission Is the purpose of the company. Defines what the company does or is. It is a statement of the present going ahead into the near future. It is a document written to create a sense of purpose for customers and employees. It should be short, usually no more than two sentences. Focus on the common purpose and may draw from its values or beliefs. Help to differentiate from others that provide the same products or services. Not only what the company does but also how it does it (essentially the differentiating point). Mayo Clinic's mission statement is “to inspire hope, and contribute to health and well-being by providing the best care to every patient through integrated clinical practice, education and research.” Professor T . alnajjar PHCL Pharmacy Management

Mission Elements (eg. community pharmacy ) The intended (or target) customers The core values of the pharmacy (such as compassion, respect, and confidentiality), The key services and products provided by the pharmacy, The benefits incurred by customers (such as improved health and improved safety), and The desired public image of the pharmacy. All pharmacy org. should have a mission statement. Kerr Drugs mission statement that focuses on the company's key priorities—“providing healthcare solutions with exceptional customer service”. CVS Caremark mission is to “…provide expert care and innovative solutions in pharmacy and health care that are effective and easy for our customers” Pfizer Inc. is to “apply science and our global resources to improve health and well-being at every stage of life.” Creates a sense of purpose (employees & customers) Kerr Drugs employee know that their customers will expect help with their medications and their health and they should strive to provide excellent service everyday. Professor T . alnajjar PHCL Pharmacy Management

Slogan Kerr Drugs' slogan is “For a Healthy Relationship. ” Pfizer's slogan is “Working Together for a Healthier World. Convey a message to customers about the organization. May be more marketing driven, or serves a similar role. Send a message to both customers and employees Must be congruent with actions or lost credibility. Nike: “Just Do It!”. Bring inspiration and innovation to every athlete in the world, also create a powerful image of what this company is all about ” Again, these slogans are brief yet convey meaningful messages. “I'm Loving It” for McDonalds, “It's the Real Thing,” for Coke,. Professor T . alnajjar PHCL Pharmacy Management

Vision, mission, (others) are Critical elements of S.P Established before S.P process (foundation). S.P process include Structuring Facilitating, and Implementing Process similar to other types of P. (steps Table 4-2) Each S followed by tactic (actions to achieve obj.). Tactical P. (1 year) is of a much short time frame/horizon than S.P. Professor T . alnajjar PHCL Pharmacy Management

Preplanning Phase (P. for the P.) It should not taken lightly because S.P Consumes much time and energy. Financial investment (personnel, consultant) Costs/ value analysis (perfectly versus superficially ) Preplanning This balance (cost/value) Define obj. of such efforts Procedures … Who should be involved depends Type of org. Level of S.P: key manager, important stakeholders, day to day operation, consultants, …. Where it will occur, and How much time Any political … Orient activity to the vision Professor T . alnajjar PHCL Pharmacy Management

Planning Phase Start with the destination in mind (vision) Once clear, find the starting point Next determine different routes to reach and the best within the constraints of limited resources. If speed is important, then one selects the quickest route. If scenery is important, then one selects the most scenic route. Mode of transportation Selects key milestones, or places to stop, along the way (to be on track). Group effort (all levels of the org.) Professor T . alnajjar PHCL Pharmacy Management

Destination Is the vision of the org. Identify where, what, and how the org. is in the present (situation analysis) Based on the past two, identify the goals for the org. Course is plotted to get from the present to the future. Last determine obj. that will help to reach the goals. Relationship between vision, goals, strategy, and objectives (Fig. 4-1). Professor T . alnajjar PHCL Pharmacy Management

Relationship between V, G,S, obj.
Vision Goal 1 Goal 2 Goal 3 Objective 1C Strategy #1 Objective 1B Objective 1A: Tasks Present Time

Relationship To reach a certain vision, or future state, the org. must set and reach one or more goals. Each goal is associated with a specific S. or method of reaching that goal. The S. can be defined by the obj. that are necessary intermediate accomplishments toward the goal. A set of tasks, or actions (tactics), may be associated with each obj. Professor T . alnajjar PHCL Pharmacy Management

Situation analysis (SWOT) Identify mission: analyze and define current situation (past performance) using all measures of performance (customer satisfaction, financial indicators,…). S. O: positive attributes (company- program – environment) that may bode well for the success of the business. W. T: negative attributes. Internal (S,W) or external (O,T) - (positive or negative) Professor T . alnajjar PHCL Pharmacy Management

Internal S & W Profitability Quality of pharmacy service Customer service Competence and ability of pharmacy staff Efficiency of the pharmacy operations. Professor T . alnajjar PHCL Pharmacy Management

External O & T Extent of competition from other Phar. org. The availability of technology, regulations that may help or hinder the business, Availability of reimbursement for services Costs incurred by the pharmacy organization, Political issues having an impact on health delivery, and Changes in the market & types of customers s. Professor T . alnajjar PHCL Pharmacy Management

Bridge the gap. The extent & nature of the gap between vision and current situation become clear S.P Vision Define goals that are consistent with the vision (capitalize goals on the org. S and O, and minimize the T and mitigate the W). Professor T . alnajjar PHCL Pharmacy Management

Organizing to operate S. Last part: Goals (3-5 years ) and vision (more) may be unachievable in the short term Therefore, intermediate obj. (1 year) help advance toward that target. Obj. (short term): budget, schedule, and responsibility assigned to each. Professor T . alnajjar PHCL Pharmacy Management

No common or standard Key elements: (1) the organization's vision, (2) strategies, (3) goals for each strategy, (4) objectives required to meet those goals, and (5) tasks or action plans to compete obj. Tasks listed (include date for completion, party responsible for each task). Professor T . alnajjar PHCL Pharmacy Management

S.P (example) S.: The department will align its pharmacy services to be consistent with the hospital's initiative to become part of an accountable care organization. G.: Develop and implement specific clinical pharmacy services that help to deliver care, improve patient outcomes, reduce spending, and/or generate revenue. Obj. Identify gaps in care delivery, quality, and spending where pharmacy services can lead to improvements - Select one clinical pharmacy service to implement in the short term. Professor T . alnajjar PHCL Pharmacy Management

Tasks/action plans: Perform a situation analysis of the hospital, accountable care organization, and pharmacy department, including a SWOT analysis. Prepare a list of clinical pharmacy services that can be developed and implemented to meet the needs of the organization, and compare the services on the basis of feasibility and impact. Select the most appropriate service and develop a business plan for the service. Professor T . alnajjar PHCL Pharmacy Management

Post planning Phase 3 steps: Written and communicated effectively. Implement the P., which requires to understand the long-range goals while at the same time determining and taking the steps necessary to accomplish the shorter-range obj. Monitor progress & assessing results This is O.P (day-to-day activities necessary to achieve the long-term goals) which differ from S.P that is about what to do (effectiveness) and not efficiency of O.P Professor T . alnajjar PHCL Pharmacy Management

O.P Is tactical activities or tasks Relationship between tasks or tactics and the key elements of S.P Managers focus on tactics, and periodically on big picture (vision, goals, and S) such as how this new service fits with vision, goals. Create monitoring plan (extent of implementation vs the planned schedule and the effectiveness in meeting its goals, especially in the deployment of limited resources). In other words, have both the plan and its implementation been effective? Possibility to change plan due to changes externally and internally. Professor T . alnajjar PHCL Pharmacy Management

S.P Plenty of published examples of S.P majority from the hospital practice Limited from community (do not fall into the hands of competitors). But general publications designed to assist community pharmacies in S.P Professor T . alnajjar PHCL Pharmacy Management

A survey 1,500 randomly selected C. pharmacies 30.8 % reported having conducted S.P For those that did conduct S.P 45.7% incorporated all seven steps Had significantly higher self-rated performance on clinical services, dispensing services, and financial performance—suggesting that strategic planning can improve organization success. Update of survey showed little change. Increased use of S.P was associated with improved performance. Managers who participated in a formal S.P education program more likely to conduct S.P, and had greater comprehension of it. Professor T . alnajjar PHCL Pharmacy Management

Steps used by C. pharmacies Step ..Percentage Develop mission statement Identify strengths and weaknesses Identify threats and opportunities …90.2 Formulate and select strategies …83.8 Review pharmacy structure and systems …60.1 Implement strategies Evaluate implemented strategies… 76.3 Professor T . alnajjar PHCL Pharmacy Management

Similar study H.P: 63 % of respondents conducted S.P and followed 4.7 (of 6) steps Belief that S.P within H.P is more commonplace In the H.P focused for clinical pharmacy services Professor T . alnajjar PHCL Pharmacy Management

S.P Merits Study includes pharmacy directors at (H., USA) to determine if more sophisticated P. resulted in improved outcomes. Levels of categories of S.P sophistication is based on different steps employed. Outcomes such as …. were rated higher for high level department by H. administrators Satisfaction Image among them # & quality of C. pharm. programs Improve performance and positive results reported in other industries using S.P. Professor T . alnajjar PHCL Pharmacy Management

S.P (changes practice E). Medicare Modernization Act (MMA) of 2003 is a good example of such a change. This legislation, which went into effect in 2006, created the Medicare prescription drug benefit (also known as Medicare Part D) and established the requirement that medication therapy management (MTM) be provided to high-risk Medicare beneficiaries. Successful pharmacies used S.P to predict the impact of the MMA and to develop practice plans for provision of MTM. Increased emphasis on Med. errors promoted by the Joint Commission (Give accreditation to Hosp. & H.C org.). Successful H.P departments (predict, developed and implemented P. ) to establish the technologic and human resources necessary to improve patient safety. Professor T . alnajjar PHCL Pharmacy Management

Barriers & Limitations Effective P. requires serious commitment of time and resources. Lack of success may stem from Failure to recognize and minimize common barriers Failure to understand limitations Professor T . alnajjar PHCL Pharmacy Management

Barriers Most serious: lack of endorsement by the top executive(s). Buy-in and participation is critical to S.P. Otherwise the whole P. effort could be a waste of time and resources. Professor T . alnajjar PHCL Pharmacy Management

Barriers Failure to commit sufficient time Interpersonal issues (struggles over power or politics and resistance to change) Lack of P. skills Failure to P. far enough into the future Constantly changing environment Failure to implement (owing to lack of time or lack of resources) Failure to monitor progress Lack of support of top (executive - board of directors) Professor T . alnajjar PHCL Pharmacy Management

Time Barrier Failure to commit sufficient time Creative P. should be accomplished during uninterrupted time (i.e. retreats), meet in a location outside the usual work E.). Because of the time and expense it require a huge commitment from both org. & personnel. Interpersonal issues (culture or struggles for power and politics), become barriers. Those involved may be resistant to change ( consciously or subconsciously sabotage effort) Personnel lack skills necessary to conduct P. Failure to plan far enough into the future (S.P intended to guide over long term). Professor T . alnajjar PHCL Pharmacy Management

E. Barrier H.C changing constantly or ambiguous. Changes in: Technology and automation New drugs and therapies Payment rates of Rx and availability of reimbursement for clinical services Regulations, and Labor market fluctuations Such changes may put off or avoid P. Failure to plan, even when it is difficult, may be more detrimental in long term. Professor T . alnajjar PHCL Pharmacy Management

Other Barrier Communication barriers Clarify jargon or terminology (P-speak) Use other forms such as V. presentation Implementation barriers (i.e. “analysis but no action.” The results of 3 causes: Unavailability of resources, Lack of time, and Failure to monitor progress. Management by crisis: Work is directed by problems than by goals. Long term, it may result in failure to meet goals. Professor T . alnajjar PHCL Pharmacy Management

Limitations: P. is not a magic bullet for the ills of org. (not cure) First: P. is to some degree, guesswork (but educated and experienced guesswork). Risk is still involved, and nothing is certain, even with good data and good S. (unpredictable and unavoidable negative things may happen) Second: poor data will result in poor S. (correlated to the degree of effort, creativity, time, and resources they put into it. Third: Two additional limitations (implementation) P. is not a substitute for action. P. should be a continuous process, and plans should change as the E. dictates. Professor T . alnajjar PHCL Pharmacy Management

Conclusion Professor T . alnajjar PHCL Pharmacy Management

General Operations Management
Professor T . alnajjar PHCL Pharmacy Management

General O.M Operations: All activities (work output) performed by the org. to transform resources into valued, profit-generating goods & services The management of such activities or the critical decisions that need to be made by O. managers is known to be O.M. Professor T . alnajjar PHCL Pharmacy Management

Pharmacy Outputs Tangible Goods (pharmaceuticals) Can be seen or touched and evaluate quality. Many intangible beside tangibles such as: Speed Proficiency Interaction with patients (assistance?) Both influence patient retaining for the future Professor T . alnajjar PHCL Pharmacy Management

Services In tangible For community Pharm. Packaging Adding information Billing insurance co. Add value to the product. Transferring resources to services is not easily understood To provide info. must recall info. or Look it up & apply info. to pt. or communicate info. clearly Professor T . alnajjar PHCL Pharmacy Management

Community Pharm. Practice: Rx filling based on Dr.s’ orders Compounding OTC meds (selection, referral) Nutritional supplements Offering & fitting durable medical equipment Info. about Rx , OTC meds. & nutritional supp. Health & beauty aids Disease-state mgt. DUR Counseling on drug use Adjudication of claims with insurance co. Screening for Dis Professor T . alnajjar PHCL Pharmacy Management

Institutional Pharmacy Services: Rx filling based on Dr.s’ orders Compounding IV meds. & solution preparation Meds delivery to floors Oversight & inventory of controlled substances Order collection from floors Drug event monitoring Formulary mgt. Therapeutic interchange Rx med counseling MUE Rx med carts filling DI to h/c providers TPN & PN Emergency crash carts stocking PK dosing Clinical drug trials Professor T . alnajjar PHCL Pharmacy Management

Business outputs Justify its existence. Categorize business (pharmacy provide safe, effective and economic medicine) Driven by decisions made by owners or managers taking into consideration: consumer opinion (need, want) - org. mission. Mission: defines the reason for its existence - communicates its advantages Owners or managers can: add, eliminate, enhance, and change S.P identify internal & external factors influence business Professor T . alnajjar PHCL Pharmacy Management

Resources (input) used to fill Rx: Rx meds Pharmacist who ordered Rx meds Delivery service provided by wholesaler Technician who stores meds Shelf where med. sat until used Vial used Computers used Service offered by insurance co. Label printed by comp. Software used by computer Phone line used Clerk who rung the Rx Register used Counter The pharmacy facility Electricity & other utilities used by pharmacy Professor T . alnajjar PHCL Pharmacy Management

Such resources Either Plays a critical role in filling Rx (dispensing process) Transparent (taken for granted) such as electricity Influences the efficiency & ability to perform activities in Rx filling ↑ efficiency & ultimately profitability of process i.e. shelving units Professor T . alnajjar PHCL Pharmacy Management

O.M Through the followings process Designing G & S Strategies processing Managing quality Location strategies Layout strategies Human resources Scheduling Supply chain-management (inputs) Inventory management Maintenance Professor T . alnajjar PHCL Pharmacy Management

Designing product (Goods & Services) Determined and developed by planning Requires internal & external analysis: Based on 1) market needs, 2) capabilities of the pharmacy. To be in line and consistent with consumers needs & wants:→↑chances of profitability Products either Goods: tangible (held & touched) Except for compounding, design is up to manufactures (separable, not influenced by C. ↑ Opportunities to design innovative & creative services to accomplish the goals Professor T . alnajjar PHCL Pharmacy Management

Services: intangible Experienced by consumer Offering of services will affect multiple aspects of pharmacy’s operations , i.e. marketing, production, delivery, internal communications (influence the day to day processes used to offer G & S to customers). Services can be designed in 3 different approaches: Customer Service (way C handled & treated) Product Services (S that add values to the product: way Rx introduced to patient) Service Product (MTM) Each always provide intangible Professor T . alnajjar PHCL Pharmacy Management

2) Process Strategies Operations process Involves many steps. Steps order is important Influence efficiency of operations Influence profitability (e.g. filling Rx drug not put on the shelf yet) Those used to create services influence by customer (waiting for Rx to be filled) Because it has specific capacity, resource imposes the greatest limitation on the process (Bottleneck) To increase capacity → Identify and eliminate bottleneck & other externals to avoid reducing quantity of goods created & services provided Professor T . alnajjar PHCL Pharmacy Management

Example: A pt. is waiting for a refill in a limited space of a crowded pharmacy. Solution: Line up each pt med. Refills so that pt can get all his meds once a month & contact every pt before Rx is due to be filled. This will allow for: Pt to discuss his med problems with pharmacist ↓the need to maintain a large inventory More control over the pace of filling Rxs ↑pharmacist contact with pt Significantly ↓ pt traffic in pharmacy Professor T . alnajjar PHCL Pharmacy Management

A flowchart Diagram of the steps involved in creating & offering G & S) → helpful in: Analyzing the resources used Designing the process Identifying & evaluating the capacities of each element of the process Identifying the areas that can be improved →improve efficiency manage the quality The more detailed the diagram is → the easier it is to evaluate the time & resources each step of the process (flowchart for filling Rx) Professor T . alnajjar PHCL Pharmacy Management

3) Managing Quality Measuring quality is very important & depends: Depend on kind of G & S provided. Quality of goods can be based on objective standards (i.e., quantity of active ingredient) Quality of services can be based on subjective standards (quality of DI provided) Services , although intangible → need to be evaluated Professor T . alnajjar PHCL Pharmacy Management

Costs associated with quality: The cost of maintaining quality: Prevention Cost: result from the use of resources ( time & personnel) to prevent errors from occurring e.g. training employees & use of technology Appraisal Cost: result from the use of resources to inspect, test & audit to identify a drop in quality of service or product. Professor T . alnajjar PHCL Pharmacy Management

2) Cost associated with poor service quality: a. Internal Failures: errors or defects that are identified & rectified before consumers receive the product or service (e.g., a mistake in labeling) b. External Failures: errors or defects in G or S that are actually delivered to the consumers & frequently identified by consumers (wrong med). Take much more time & money to correct Professor T . alnajjar PHCL Pharmacy Management

4) Location Can affect: How easily & efficiently the inputs for operations can be acquired How easily the outputs of operations can be transferred to consumers of these outputs Which outputs are chosen to be offered by a given business (designing of G & S ) Professor T . alnajjar PHCL Pharmacy Management

Examples: Conductive to attracting qualified pharmacists to work there Proximity to consumers (busy metrplex & requires public transportation → pharmacy has no stock → pt inconvenience → ? Return Large population that need drive-thru window (mothers with sick infants) If located near people who need its products → ↑chance of attracting them to the pharmacy ( dermatologic clinics ) Professor T . alnajjar PHCL Pharmacy Management

5) Pharmacy Layout Location of various G & S within the pharmacy Designed to maximize efficiency of processes conducted to create G & S Counseling area Patients’ movements through the pharmacy Professor T . alnajjar PHCL Pharmacy Management

6. Human Resources Examples of evaluating tools to determine HRs needed to accomplish the operations: job design job analysis to make good decisions about the HRs needs for specific operations Supply & demand → may prevent finding enough efficient pharmacists Environmental factors may cause higher pay, better working hrs, or better benefits Motivated, productive & competent pharmacists → greater profitability Training on their responsibilities is important (phone ring) HRs play a big role in transformation of inputs → outputs Professor T . alnajjar PHCL Pharmacy Management

7) Scheduling Regulations → licensed pharmacists present during pharmacy working hours Individual work preference Scheduling support staff ( chart demand) using computer system → most help needed with greatest Rx filling (careful planning, evaluation of sales, volume trends) Professor T . alnajjar PHCL Pharmacy Management

Chase strategy: Personnel available when predicted demand is greatest (after a weekend) Level Scheduling: to provide a level amount of production so that a constant workforce can be employed to handle the demand day after day & week after week (preparing IV solution) Forecasting Strategy: Forecasting demands for G&S requires use of info, mathematical functions & statistical analyses Scheduling the delivery of orders is important night or when closed or not busy) requires relationships with →suppliers Professor T . alnajjar PHCL Pharmacy Management

8) Supply-Chain Management Supply chain is the chain of business that supply the pharmacy with necessary inputs. Wholesalers: The primary vendors; they distribute the majority of prescription drugs in the USA. Should have relationships with reputable companies that provide reliable services. Some chain pharmacies receive goods from distributors they own + wholesalers Professor T . alnajjar PHCL Pharmacy Management

Services may include: Electronic order submission Next-day delivery service Private-label programs Advertising programs Special-handling services Pharmacy computer systems Pricing Store planning Professor T . alnajjar PHCL Pharmacy Management

Key elements in choosing suppliers: Timely delivery of needed & properly stored meds by licensed & reputable best price Wholesalers: (difference in services & authorization) Large full-service Regional Smaller Secondary Different types may be used to meet different needs Professor T . alnajjar PHCL Pharmacy Management

9) Inventory management Too much inventory: money sitting on the shelves Too little inventory: insufficiency in the system 10) Maintenance: Professor T . alnajjar PHCL Pharmacy Management

Pharmacy Management PHCL-420

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Pharmacy Management PHCL-420

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