Getting Noticed:Establishing Strategy and Defining

Success

Joyce A. Tipton, RPh, MBA, FASHPDirector of Pharmacy

Memorial Hermann Memorial CityHouston, Texas

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

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

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

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)

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

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

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

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

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

Example of Matrix

Goal and Strategy Employee Engagement

Excellence EfficiencyCore

Measure NPSG

Med Safety

Compliance

Hospital of

Physician Choice

Goal I: Improve patients medication therapy outcomes, optimizing quality / cost          

Antimicrobial Stewardship X X   X   X   X

Anticoagulation management X X     X X X X

Provide quality pharmacy services in the Emergency Department   X X X X X XX

Enhance compliance with Medication Reconciliation X X X   X X    

Implement technician order entry X X X     X X  

Oncology Services   X       X   X

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

Continual maintenance of basic QA X X       X X  

Pyxis fill accuracy   X       X X  

Missing doses     X     X X  

Timely med delivery     X X   X X X

MedCarousel and PacMed X   X     X    

Goal III: Promote a culture of engagement and accountability.              

Staff development, orientation, training X X         X  

Improve effectiveness of communication X           X  

Improve leadership goal execution X X X          

Employee recognition X X            

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          

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

Example of Dashboard

Example of Metric Detail

Aug-07 Sep-07 Oct-07 Nov-07 Dec-07 Jan-08 Feb-08 Mar-08 Apr-08 May-08 Jun-08 Jul-08 Aug-08 Sep-08 Oct-08 Nov-08 Dec-08 Jan-09 Aug-07 Sep-07 Oct-07 Nov-07 Dec-07 Jan-08 Feb-08 Mar-08 Apr-08 May-08 Jun-08 Jul-08 Aug-08 Sep-08 Oct-08 Nov-08 Dec-08 Jan-09

Total $

647199 699908 594602 867376 675865 950643 919907 884555 735318 866197 692267 624802 680847 792542 695749 661341 768822 936237

Total Interventions

2441 2203 2577 3056 3333 3835 3686 3556 3368 3428 2923 2794 3174 2958 3310 2967 2811 3137

$50,000

$150,000

$250,000

$350,000

$450,000

$550,000

$650,000

$750,000

$850,000

$950,000

250

750

1,250

1,750

2,250

2,750

3,250

3,750

4,250

Clinical Intervention Summary

Month - Year

Inte

rven

tion

Cost

Avo

idan

ce

Num

ber o

f Clin

ical

Inte

rven

tions

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

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

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

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

Where does the Pharmacist Add Value?

Value =

Outcomes + Customer Experience (+/-)____________

Cost

Paint the picture of Pharmacist value

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