travis-wolff-pushback to pushing forward · •the 4 disciplines of execution: achieving your...
TRANSCRIPT
10/10/2017
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From Pushback to Pushing Forward: Successful Strategies for Engaging Your
Pharmacy StaffBack Office
Travis WolffPharmD, BCACP
10/10/2017
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Disclosure
Travis Wolff, PharmD, Med‐World Pharmacy, Inc. declares no conflicts of interest or financial interest in any product or service mentioned in this program, including grants, employment, gifts, stock holdings, and honoraria.
Learning Objectives
•Discuss successful methods for introducing new concepts to pharmacy staff to minimize pushback.
• Evaluate methods to improve pharmacy programs based on staff input and results.
•Describe your current culture and how it can adjust to align with changes.
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What this class will look like
• Why does it matter as an independent pharmacist now more than ever?
• Best strategies for changing process• Look at two actual examples from my pharmacy
• Learn to apply strategies with your examples
• Pearls for successful change in the workplace using helpful resources and recommended books
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New Strategies require CHANGE
•Can’t continue on current road, must exit to new pathways of profitability and patient care
•More successful when we engage our staff on this journey to success
Med‐World Pharmacy
•Purchased in 2011, at that time a standing retail pharmacy for 30 years
•Retained all staff at purchase, some had been there since day one
•No patient care services, 100‐120 Rx/day
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Changes 2011‐2014
New computer system
Immunizations
MTM
Hours of operation
Additional staff hired
Rx business grown (we are busier!)
Wouldn’t it be nice if there were an easy button for CHANGE?!?
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2015
•Purchased second store located two blocks from our location, so we combined new business and their staff under our roof
•Added additional drive through window
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2015
6 months of original pharmacy business
Plus
6 months of two businesses under same roof
= great year!
2016
Store profit not what we projected
Pharmacy profession is changing
I can’t succeed without you!
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What Happened?
•Payers are slowly starting to stop paying for dispensing, and while they are demanding additional quality measures (clinical services) but they don’t know how to pay us (yet!).
• Independent pharmacists have the advantage because we can make our path to creating payment models for these services (and our patients will be healthier for it!)
• THRIVE…..not just survive!
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2016‐Now
• DME
• Strep and Flu Tests• PCCA HRT Certified Pharmacist
• Patient Education Classes‐Smoke Cessation, Weight Loss, COPD/Asthma, Diabetes (and more)
• AADE Accredited for Diabetes Education• Cholesterol and A1C screening• Total Health Consultations• Any Ambulatory Care Opportunity
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What is the key to change?
• Identifying the problem?
•New ideas?•Goal setting?•Planning process?
What is the key to change?
• Identifying the problem?
•New ideas?•Goal setting?•Planning process?
•IMPLEMENTATION
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IMPLEMENTATION
• The 4 Disciplines of Execution: Achieving Your Wildly Important Goals by Chris McChesney, Sean Covey and Jim Huling
•We used these four steps at a retreat to plan each and every change we targeted
• You Can, Too!
Four Disciplines
•1. Wildly Important Goals (WIGs)
•2. Lead Measures
•3. Scoreboard•4. Accountability
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Four Disciplines
• 1. Wildly Important Goals (WIGs)• Broad company wide directive/initiative
• 2. Lead Measures• High‐impact actions your team must take to reach lag measures
• Lag measures are end results/measurements
• 3. Scoreboard• Simple, visible, updated often
• 4. Accountability• Who will report/monitor when and what needs to be done next
• Can be meetings or documentation strategy
Wildly Important (SMART) GOALs
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Lead vs Lag
• Most goals are lag measures (after the fact)
• Lag Measure ‐ I want to lose 20 pounds
• Lead Measure‐ steps taken to reach Lag Measure• Eat 1500 calories per day• Reduce carbs to 45 grams or less each meal
• Walk 3 miles four times per week
Scoreboard
• “Measurement drives the execution process….leading to informed decision making….feedback loop that lets you know if your actions are effective…”
• “Too many managers mistakenly think about measurement as accountability. This mind‐set creates all kinds of dysfunction and barriers to high performance. “
• Team will resist measurement –(should crave it=engagement?)
• ‐The 12 Week Year by Brian Moran and Michael Lennington
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Accountability
•Misunderstood
•Most equate it with bad behavior, poor performance, and negative consequences
•Accountability is not consequences, but ownership….a willingness to own your actions regardless of circumstances
• – The 12 Week Year by Brian Moran and Michael Lennington
Case Study #1
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WIG: Grow Sync program to 50% in 1 year
Lead Measures‐add patients to program
•50% would be 580 patients, currently 335pts•580‐335=245 patients / 12 months =20.41pt/mo
•20.41/4 weeks= 5.10 patients signed up each week
• Lead Measure‐ add 5 patients each week
WIG: Grow Sync to 50%
•Lead Measure 1‐ add 5 patients each week
•Lead Measure 2‐ identify patients•Expensive meds, Compounds, Star Rating Meds, birth control, high maintenance
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WIG: Grow Sync to 50%
•Scoreboard‐how will we track this?•Tally sheet for sign‐ups with patient name changed every week
•List Star Rating meds for staff•Update thermometer graph every month
WIG: Grow Sync to 50%
•Accountability•Score keeper is Larry •Callers are Jennifer and Angela•Can also assign by position but remember CPR
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Case Study #2
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WIG: Cost Containment/Inventory Management
•Lead Measures
•Scoreboard
•Accountability
WIG: Cost Containment/Inventory Management
• Lead Measures•COGs vs Wholesaler order +/‐ 10%
•Double check usage and que•Return to stock every 2 weeks on Fridays•Wholesaler return every weeks on Mondays
• Scoreboard
• Accountability
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WIG: Cost Containment/Inventory Management
• Lead Measures
• COGs vs Wholesaler order +/‐ 10%
• Double check usage and que
• Return to stock every 2 weeks on Fridays
• Wholesaler return every week on Mondays
• Scoreboard• Record wholesale bill and COGS at day’s end• Check list Y or N when will‐call bin returned• Check list Y or N when wholesale return done
• Accountability
WIG: Cost Containment/Inventory Management
• Accountability ‐ COGS vs Wholesale Bill
Mon‐ HillaryTues‐ SandiWed‐ ShawndaThur‐ AngelaSat‐ Pharmacist
• Return to stock – Sunni• Wholesale return‐ Hillary and Sandi
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Four Disciplines using your examples
• WIG
• Lead Measures
• Scoreboard
• Accountability
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Pearls for Change
•Don’t assume your staff knows what you know
• Emotion in change; Communication in change
• Small actions repeated can be HUGE
• Translate goals into behaviors
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Change is hard…..right?
•Switch: How to Change Things When Change Is Hardby Chip Heath & Dan Heath
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So what separates hard change from successful change?
•EMOTIONS
Why is change in business hard?
• We focus on the rational…..not the emotional
• Emotional…what?• What motivates your staff?• What is important to your workplace culture?• What information do they need to be successful?• Ambiguity is the ENEMY of CHANGE• Often what seems like resistance to change is actually lack of clarity
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Communication vs Ambiguity
• “If you want to create a company that is fun to work for, where productivity and creativity are high, and that you are actually glad to lead, you must create a culture of communication.” – Dave Ramsey
• Lack of communication ‐> frustration ‐> anger ‐> distrust ‐> fear
• “Mushroom communication” –keep them in the dark and feed them manure
Motivating Employee Engagement
•Motivation is the fuel to change•Not knowledge•Not information
•Consider change in cigarette ads
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Old way:Knowledge
New way:Motivation
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“Elephants don’t bite” – Joel Weldon
• Little things that go wrong = huge difficulties• Wrong DAW, stocked one too many Enbrel, out of stock, wrong bag
• Little things that are done right and consistently make the difference
• Rx ready, phone on second ring, ordering correct quantities, calling patients when ready
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Independent Pharmacy Thrives
• Leaders need to translate goals into behaviors• EntreLeadership by Dave Ramsey on delegation
•No brochure or policy needed
•Adapt work environment to make change the path of least resistance
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Independent Pharmacy Thrives
•Your success = My success•Let’s Thrive!
•“If you can’t fly, run. If you can’t run, walk. If you can’t walk, crawl. Just keep moving.” – Martin Luther King, Jr
Bibliography1. Change Next Exit photo: http://acmptoronto.org/ accessed 08/02/2017
2. Change button photo: https://www.professionalacademy.com/blogs‐and‐advice/hr‐advice‐‐‐how‐to‐change‐workplace‐culture accessed 08/02/2017
3. Change is process photo: http://www.gymmomentum.com/weekly‐momentum/is‐change‐possible/ accessed 08/02/2017
4. The secret of change photo: https://www.pinterest.com/explore/embrace‐change‐quotes/?lp=true accessed 08/02/2017
5. Small actions photo: https://aiacoloradoepblog.com/tag/change/ accessed 08/02/2017
6. One reason photo: https://www.pinterest.com/explore/embrace‐change‐quotes/?lp=true accessed 08/02/2017
7. Change is hard at first photo: https://www.pinterest.com/explore/embrace‐change‐quotes/?lp=true accessed 08/02/2017
8. ACT photo: http://dailypersonalitydevelopment.com/why‐you‐should‐not‐focus‐on‐things‐that‐you‐cannot‐change/ accessed 08/02/2017
9. Old way photo: http://www.bbc.com/news/av/business‐36668692/the‐importance‐of‐change‐in‐business accessed 08/02/2017
10. SMART photo: http://simonlovelock.com/using‐s‐m‐a‐r‐t‐goals‐in‐musical‐practice/ accessed 08/09/2017
11. Marriage photo: http://dailysignal.com/2014/07/31/marriage‐wont‐end‐poverty‐will‐help‐lot/ accessed 08/09/2017
12. Smart phone photo: http://www.bell.ca/Mobility/Products/Apple‐iPhone‐7 accessed 08/09/2017
13. New baby photo: http://congratulationsto.com/baby_congratulations/new_baby_cards.php accessed 08/09/2017
14. Tip from former smoker photo: https://www.pinterest.com/jlb143/quit‐smoking/?lp=true accessed 08/09/2017
15. Smoking stats photo: https://www.pinterest.com/pin/362610207478347448/ accessed 08/09/2017
16. Suicide smoke photo: http://www.boredpanda.com/top‐40‐cool‐creative‐antismoking‐ads/ accessed 08/09/2017
17. McChesney, C., Covey, S., & Huling, J. (2012). The 4 disciplines of execution: Achieving your wildly important goals. London: Simon & Schuster.
18. Heath, C., & Heath, D. (2010). Switch: How to change things when change is hard. New York: Broadway Books.
19. Thermometer goal photo: http://www.davincibg.com/progress‐monitors/white‐goal‐thermometer.aspx?source=google4&kwid=pla_goal_thermometer_chart_white&gclid=CjwKCAjw9O3NBRB3EiwAK6wPT‐q9Dzuo2tuG4tnnaIu0fbY3S8JuGV7PwJm0Ybs6tvYoAuMXv1lvoxoCCRQQAvD_BwE accessed 09/15/2017
20. Ramsey, D. (2011). Entreleadership: 20 years of practical business wisdom from the trenches. New York: Howard Books.
21. Moran, B., Lennington, M. (2013). The 12 Week Year: get more done in 12 weeks than others do in 12 months. New Jersey: Wiley
