1. PHCL 472 Nouf Aloudah 1

2.  Mark Pillar story 2

3.  Change Is Necessary  Pharmacy managers and pharmacists are grappling with the many forces affecting today’s health care settings- cost containment, redefined role for health care professional, competitors with advanced technology – and trying not to compromise the quality of patient care  Must change if he wants to stay in business and keep serving his patients  Where to begin? 3

4.  Change Is Necessary  Try to respond productively but they often fail to consider a wide range of options  “One size that fits all” programs often will not works  Adding new program is a good business decision only if it reflects your individual stamp 4

5.  Change Is Necessary  Now after you know what you want your practice to look like and have identified the values important to you (previous lecture) 5

6.  Preparing for change  Why some pharmacies succeed and others fail?  “It is key to first establish your direction by developing your own vision of the desired future state” John Kotter  “without a sensible vision, a transformation efforts can easily dissolve into a list of confusing and incompatible projects that can take the organization in the wrong direction or nowhere at all” (previous lecture) 6

7.  Preparing for change  Pharmacy practice models  Total pharmaceutical care  Clinical pharmacy  Pharmaceutical care  Disease management  Integrated pharmaceutical care services 7

8.  Taking stock of your practice 8

9.  Values underlying change  To fully understand your practice you must explore the values and principles that underlie it  Are clear and consistent values at the foundation?  Assess your personal values and principles regarding your practice, as well as your staff  It is more difficult than you think!  Ask others to figure out what values you and your pharmacists are conveying 9

10.  Determining core motivators  Core factors that motivate your pharmacists and technicians in their daily tasks  Business and economics  Service  care 10

11.  Determining core motivators  Business and economics Cost containment, market share, revenue, profits  Service Drug information, PK dosing, drug distribution  Care Honoring patients, respecting their feelings, helping them to be heard 11

12.  Determining core motivators 1. What do you do when you provide service to a customer? 2. What do you do when you provide care to a customer? 3. How are these two activities different, and how are they similar? 12

13.  Determining core motivators  Difference is the degree to which you accept responsibilities … scary?!  The practice site dictate the amount of responsibility you can accept  Should include patients’ understanding of and adherence to drug therapy  You consciously decide to use services to move toward care 13

14.  Creating an image  In your mind from different prospective (visit sites, literature search) 14

15.  Implementing your new patient care program  Eight stages  Be patient, it may take years! 15

16. Implementing your new patient care program  Step 1:establish a sense of urgency  Do they feel urgency? No  “we’ve come through a difficult period and we’re tired, you want us to change again? No way!”  Ask how technology will affect the nature of their work 16

17. Implementing your new patient care program  Step 1:establish a sense of urgency  Creation of a knowledge based economy that needs workers with skills in collaborative problem solving, communication, teamwork, managing information, dealing with uncertainty 17

18. Implementing your new patient care program  Step 1:establish a sense of urgency  Consider your pharmacist satisfaction  Pharmacists’ sense of professionalism and social responsibility  Aware your staff of Patients’ problems with drug therapy statistics 18

19. Implementing your new patient care program  Step 2: create the guiding coalition  Combined efforts drive change … put a team  Owners and mangers should not be the sole driving force for change  Blends of leaders and managers 19

20. Implementing your new patient care program  Step 3: develop a vision and strategy  Leader types generally create the vision and some strategies for achieving  The manager types develop detailed plans and budgets to implement the strategy  Vision is an internal documents! (don’t share with public)  Short and easy to communicate 20

21. Implementing your new patient care program  Step 4: communicate the change vision  Keep the message simple “we will care for patients as if we were their mothers” !  Multiple ways, multiple days  Consider it when hiring new staff  You must demonstrate your commitment to the vision  Ask the staff for feedback 21

22. Implementing your new patient care program  Step 5: empower broad based action  Previous steps producing change in individuals this one examine the structural changes in the organization that allow staff to change 22

23. Implementing your new patient care program  Step 5: empower broad based action  Structural Barriers  Educational Barriers  System related barriers  Supervisory Barriers 23

24. Implementing your new patient care program  Step 6 : generate short term wins  Your first patient in asthma program  Missy but important  See that their works was worthwhile, pay attention to feedbacks, fine-tune your vision 24

25. Implementing your new patient care program  Step 7: consolidate gains and produce more change  You must maintain steady progress and prevent reversal of the chance everyone have worked hard for  Anticipate obstacles and plan solutions 25

26. Implementing your new patient care program  Step 8: anchor new approaches in the culture  Ensure that a patient care focus has become pat of your pharmacy’s culture 26

27. Implementing your new patient care program  Step 8: anchor new approaches in the culture  Keep the results in front of your staff  Get testimonies from patients, physicians  Continue to be supportive  Ensure that new people you hire share your culture 27

28.  Translating articles 28