Joyce A. Tipton, RPh, MBA, FASHP Director of Pharmacy Memorial Hermann Memorial City Houston, Texas

   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

    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   Opportunity for mutually agreed upon priorities with organization leadership Sets clearly defined goals and targets  Leaders and staff within pharmacy Sets accountability for pharmacy leadership and staff  Objective measures for upline reporting structure

   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

 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)

 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

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



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

circumstances in which it is set and the resources available to the business – the objective should be realistic given the 

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

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

    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

Goal and Strategy Employee Engagement Excellence Efficiency Core Measure NPSG Med Safety Hospital of Compliance Physician Choice Goal I: Improve patients medication therapy outcomes, optimizing quality / cost

Antimicrobial Stewardship Anticoagulation management X X X X X X X X X X X X Provide quality pharmacy services in the Emergency Department Enhance compliance with Medication Reconciliation Implement technician order entry Oncology Services X X X X X X X X X X X X X X X X X X X

Goal II: Maximize efficiency, quality, and safety in the medication use process.

Continual maintenance of basic QA X Pyxis fill accuracy Missing doses X X Timely med delivery MedCarousel and PacMed X

Goal III: Promote a culture of engagement and accountability.

Staff development, orientation, training Improve effectiveness of communication Improve leadership goal execution Employee recognition Incredible Website

Goal IV: Achieve financial budget plan for FY 08

Decrease cost of wasted drugs Clinical Initiatives with cost savings/avoidance X X X X X X X X X X X X X X X X X X X X X X X X X X X

      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

Clinical Intervention Summary

$1 000 000 4 500 $900 000 $800 000 4 000 3 500 $700 000 $600 000 3 000 2 500 $500 000 $400 000 2 000 1 500 $300 000 $200 000 1 000 $100 000 500 $0 Total $ Total Interventions Aug-07 Sep-07 Oct-07 Nov-07 дек.07

янв.08

фев.08

мар.08

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Jun-08 Jul-08 Aug-08 Sep-08 Oct-08 Nov-08 Dec-08 Jan-09 $647 199 $699 908 $594 602 $867 376 $675 865 $950 643 $919 907 $884 555 $735 318 $866 197 $692 267 $624 802 $680 847 $792 542 $695 749 $661 341 $768 822 $936 237 2 441 2 203 2 577 3 056 3 333 3 835 3 686 3 556 3 368 3 428 2 923 2 794 3 174 2 958 3 310 2 967 2 811 3 137 0

Month - Year

  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

     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

  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

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

Outcomes + Customer Value = Cost

Paint the picture of Pharmacist value