Pharmacy Leadership

Sculpting the Pharmacy Leaders of Tomorrow Introduction Leadership has so much influence in our lives because so often it determines whether we enjoy a particular activity. Life is short – so why participate in an activity if we don’t enjoy it, and if we do participate, why not do so with all of our energy? Therefore, having an understanding of leadership and acknowledging its significance is vital within our day-to-day lives.Leadership can be described by many, â€Å"as the process by which a leader imaginatively directs, guides and influences the work of others in choosing and attaining specified goals by  mediating between the individuals and the organization in such a manner, that both will obtain maximum satisfaction. †1 Leadership is about building teams and communicating so that everyone works together. The importance of leadership is a key ingredient to all successful businesses and championship teams around the world. Teams that have this synergy tend to thrive and be the ones on top.Thus, leadership is dynamic in all aspects of life. At the forefront of any successful business or team is the leader. A leader is anyone who inspires and influences people to accomplish organizational goals. They motivate others to pursue actions, focus thinking, and shape decisions for the greater good of the organization. A leader is also a knowledgeable and trustworthy individual that communicates effectively and sets an example by living the corporate values everyone is expected to follow. Often times many contemplate whether leaders are born or made.Effective leaders are not simply born or made; yet they are born with some leadership ability and develop it over time. 1 Legendary collegiate football coach Vince Lombardi once said, â€Å"Contrary to the opinion of many people, leaders are not born, leaders are made, and they are made by effort and hard work. †1 Thus, we are all leaders, and all individuals have potential leadership skills, which stresses the importance of leadership development. Anyone can have the fundamental requirements necessary for the leadership role, but it’s how they develop them that matters.Leadership development is defined as an effort to enhance a learner’s ability to lead, an endeavor focused on developing the leadership abilities and attitudes of the individuals sitting at the top of the chain of command. Successful leadership development requires a lot more than the ability to give orders. It also requires diplomacy, top of the line people skills, and a certain level of ruthlessness. Leadership within Pharmacy These leadership attributes and skills pertain to all professions, regardless of the career path chosen for each individual.In the pharmacy profession, transition into a leadership role often happens serendipitously, resulting in what is sometimes referred to as accidental leadership. Today’s pharmacy students receive very little exposure to pharmacy administ rative career options and administrative leaders throughout the curriculum. Thus, they are often unaware of many leadership opportunities available to them upon graduation. Furthermore, those who do develop an interest in advanced administrative training often do so after they have already committed to a post-graduate staff position or a clinical training program without an emphasis on administrative practice.By not exposing students to administratively focused career options during their impressionable clerkship years, we are losing many potential future leaders. 5 We need to spark their interest in administrative practice earlier, while they are still in pharmacy school, and introduce them to a career that focuses on leadership and creating innovative pharmacy services and practice models that improve patient care. 5 Pharmacy school provides future health care professionals with the knowledge and skills of pharmaceutical therapies in order to deliver adequate, high-quality patient care to those with health illnesses or diseases.As society becomes more and more saturated with clinical drug experts, there soon will be a higher demand for some of these individuals to lead and operate pharmacy departments. With many students having very little to no experience in leadership or managerial roles, how will these future health care providers of future generations become equipped with the essential leadership skills and attributes to successfully operate a pharmacy?A high-performance pharmacy department is one that aspires to maximize its contributions to the clinical outcomes of patients and financial position of its health system by functioning at the highest levels of effectiveness and efficiency. Achieving a high-performance pharmacy practice requires leaders committed to a clear vision for excellent practice. These pharmacy leaders must continuously enhance their team’s commitment to that vision, using recognized benchmarks of best practice to extend phar macy’s influence across the continuum of care. Do Residencies Promote Effective Pharmacy Leadership? Within pharmacy curricula, students are required to perform in various academic rotations in order to gain further knowledge of the profession in diverse areas of the field. Upon graduation from a graduate program such as pharmacy school, students also have the option of applying for a residency, or post-graduate training, to enhance their pharmacy learning and provide more experience within the profession. According to many, residencies are categorized as clinical and general.Current American Society of Health-System Pharmacists (ASHP) accreditation standards state that the purpose of a post-graduate year 1 (PGY1) residency is â€Å"to accelerate growth beyond entry-level professional competence in patient-centered care and in pharmacy operational services, and to further the development of leadership skills. †2 Therefore, the main purpose of a PGY1 residency is to inc rease the competency of pharmacists in the clinical environment and that PGY1 training should focus on effectiveness, efficiency, and competence in the clinical environment reinforced by experience in a strong pharmacy operations environment. In the desire to be recognized as a clinical profession, pharmacy-training programs have devoted the vast majority of resources to patient care and clinical activities. This is done at the expense of training practitioners who are not knowledgeable about the operations of a pharmacy department and have difficulty integrating clinical expertise and patient care with the skills necessary to navigate complex organizations.While operations and management expertise can be obtained through completing a post-graduate year 2 (PGY2) residency in health-system pharmacy administration, many believe the emphasis on the interconnectedness of operational knowledge and clinical practice success should be a solid part of PGY1 residencies. 2 The core experience s required in a PGY1 residency program include acute care, ambulatory care, drug-use policy, and practice management.An evaluation of various training programs revealed that approximately 80% of residency training time is directed toward acute and ambulatory care experiences, with the remaining time divided among orientation, drug-use policy, and administrative experiences. 2 Ironically, in an era of a leadership crisis within the pharmacy profession, the primary individuals responsible for the training and nurturing of young leaders are preceptors with expertise in clinical specialties that do not always have an understanding of the importance of the infrastructure that supports their work.The profession has made significant progress in training highly skilled, knowledgeable patient care specialists, some of whom now direct residency programs and profoundly influence training. While this is exemplary practice, it is also essential that the new generation of drug-specialists be fami liar with the operational aspects of a pharmacy department (e. g. , be able to create a budgetary impact proposal to justify an anticoagulation clinic or defend the purchase of smart pumps for a health system for safer delivery of I. V. medications). While completion of a PGY1 residency by itself cannot create a well-rounded, clinically competent practitioner who is well versed in organizational abilities, it is noted that residency training is the ideal starting point to establish the concept. 2 Residents are the future of the pharmacy profession, and it is imperative that they recognize, have experience in, and respect the critical role and linkages of the clinical pharmacy expert to pharmacy management and to the health system. 2 What Are the Essential Skills of a Pharmacy Leader?In December 2004, an article was published in American Journal Of Health-System Pharmacy by five authors who had over 140 combined years of experience in health-system pharmacy leadership positions. 4 Tw o of the five authors were past pharmacy directors at University of Wisconsin Hospital and Clinics (UWHC), where the combined master of science (M. S. ) in hospital pharmacy and administrative residency program was started. These experienced administrative leaders described the leadership skills they believed were ssential for a high performance pharmacy practice, noting that there was documented synergy between great leadership and high-performance pharmacy practice. The skills described included the following:4 * Creation of a vision that is adopted by all department personnel * Core personal values that extend to an individual’s professional life * Ability to develop relationships across the organization * Lifelong learning * Develop spheres of influence across the organization * Ability to take risks and be an opportunist Transferring knowledge across the department and the hospital * Successful work–life balance * Succession planning Specifically for patients, the y also believed that pharmacy leaders and managers should hire the best pharmacists possible, provide the best tools for pharmacists to do their work (e. g. , automation, information resources), have adequate pharmacy staff, and ensure a culture of medication safety. 4 All of these leadership skills and attributes are thus part of the manager and residency training program at UWHC.I believe that similar skills and goals should also be applied to pharmacy student rotations, and therefore students must be provided options for selecting clerkship rotations specialized in health-system pharmacy administration. Even if those who participate in such clerkship experiences decide to pursue a clinical rather than administrative career path, they will be more effective clinicians as a result of their broadened view of the profession and their understanding of the challenges of pharmacy management. They will no longer be the clinical practitioner telling our future students that administration is unrewarding â€Å"busy work. Practitioners will be more able and willing to articulate the impact pharmacy administrators can have on advancing pharmacist-led patient services and will discuss this career option with students in a more favorable light. Expanding the availability of administrative clerkships is a win–win proposition for students and the profession. 5 Delivering Leadership Skills Via Dual-Degree Programs An additional opportunity for pharmacy students to acquire fundamental leadership skills and attributes is in the pursuit of an advanced degree in business.Many pharmacy schools across the nation, including Sullivan University College of Pharmacy (SUCOP), are implementing dual degrees for those ambitious students that seek these administrative positions within the pharmacy profession. The dual PharmD/MBA degree will provide students with clinical health care expertise along with a business background and skills that are necessary to enter managerial positi ons within pharmacy. University of Arizona College of Pharmacy PharmD/MBA student Elizabeth Munch states â€Å"business pervades every facet of health care, now more than ever.And an understanding of the business aspects of pharmacy is crucial no matter which aspect of pharmacy is considered. Business training will only serve to increase the competence and effectiveness of today’s health care providers. †6 These intensive dual-degree programs provide students a way to hone problem-solving, leadership, and communication skills while engaging with students and mentors in other disciplines. Pharmacy schools that offer these programs do so to â€Å"prepare graduates for alternative non-academic pharmacy careers† as leaders in for-profit, nonprofit, and government health organizations. In particular, a leader within the pharmacy profession needs pharmacy-specific knowledge and skills for ensuring consistency and credibility within and outside the department, recruiti ng and retaining the right team members, establishing the pharmacy team’s value beyond a traditional role, becoming a more influential player within the health system, identifying challenges as opportunities, creating passion for change, and thoughtfully making difficult decisions. Having better pharmacy leaders results in better patient care, improved medication safety, and enhanced pharmacy productivity, all of which usually lead to better medication use within health systems. Conclusion It is critical that today’s leaders take steps to ensure that pharmacy maintains a strong pool of managers to continue the important work of guiding the profession. Starting an administrative clerkship rotation is an easy way to expose students to the rewards of leadership and the satisfaction of teaching and mentoring.Pharmacists are becoming increasingly involved in managing patients with chronic conditions, while also collaborating more with physicians and other health care provid ers in a multidisciplinary team. Therefore, balance and retention of important skills that enable and leverage these new opportunities are what we need. We must also encourage residency program directors and preceptors to convey the importance of and provide excellent training in clinical care and disease management, as well as operations infrastructure, logistics, and leadership.References 1. Lussier, R. N. , & Achua, C. F. (2007). Leadership: theory, application, skill development (3rd ed. ). Mason, Ohio: Thomson/SouthWestern. 2. Ivey, M. , & Farber, M. (2011). Pharmacy residency training and pharmacy leadership: an important relationship. American Journal Of Health-System Pharmacy, 68(1), 73-76. doi:10. 2146/ajhp100051 3. Thielke, T. (2010). Synergistic relationship between pharmacy leadership development and pharmacy service innovation.American Journal Of Health-System Pharmacy, 67(10), 815-820. doi:10. 2146/ajhp090445 4. Zilz, D. , Woodward, B. , Thielke, T. , Shane, R. , & Sco tt, B. (2004). Leadership skills for a high-performance pharmacy practice. American Journal Of Health-System Pharmacy, 61(23), 2562-2574. 5. Knoer, S. , Rough, S. , & Gouveia, W. (2005). Student rotations in health-system pharmacy management and leadership. American Journal Of Health-System Pharmacy, 62(23), 2539-2541. oi:10. 2146/ajhp050226 6. Enderle, L. (2011). Dual degrees: full speed ahead. Pharmacy Times. Retrieved from http://www. pharmacytimes. com/publications/career/2011/PharmacyCareers_Fall2011/Dual-Degrees-Full-Speed-Ahead 7. Johnson, T. J. , & Teeters, J. L. (2011). Pharmacy residency and the medical training model: Is pharmacy at a tipping point?. American Journal Of Health-System Pharmacy, 68(16), 1542-1549. doi:10. 2146/ajhp100483