Navigating Ambiguity and Charting a Course for Success Carolyn Wilson, MBA, RN Executive Vice President & Chief Operating Officer Beaumont Health Disclosure In accordance with the ACPE s and ACCME s Standards for Commercial Support, anyone in a position to control the content of an educational activity is required to disclose their relevant financial relationships. In accordance with these Standards, ASHP is required to resolve potential conflicts of interest and disclose relevant financial relationships of presenters. In this session: All planners, presenters, reviewers, and ASHP staff report no financial relationships relevant to this activity. About Beaumont Health Not for profit organization based in southeastern Michigan formed in September 2014 Eight hospitals with 3,429 beds 187 outpatient sites 5,000 physicians, 38,000 employees and 3,500 volunteers 2017 total net revenue: $4.4 billion Page 1 of 11
Our learning objectives today Discuss leadership skills for personal and organizational success. Identify disruptive forces impacting health systems. Describe insights on what strategic effectiveness and nimbleness means in today s health care market. Disruptive forces within health care: national trends Disruption 1: New expectations for clinical care delivery Shift to outpatient care Procedures that used to only be available in hospitals such as joint replacements and cardiac caths are moving to the outpatient setting. Increased accountability Insurers are holding physicians and health systems accountable to deliver high quality care at a reasonable cost. Patients/ Consumers being held more accountable with high deductible co pays Employer benefits Employers are looking for new ways to improve employee health and wellness while reducing their health care costs. Page 2 of 11
Disruption 2: Growth in consumerism 93% of consumers prefer same day appointments to walking in and waiting one hour 66% of Millennials and Gen Xers would switch providers for the ability to book online 56% of consumers would consider using retail clinics Sources: State level trends in employer sponsored health insurance 2012 2016, State Health Access Data Assistance Center, August 2017 Five Ways Tech Savvy Millennials Alter Health Care Landscape, PNC Healthcare, March 23, 2015 Jones, Liz, What Do Consumers Want from Primary Care?, The Advisory Board, October 26, 2016 ~50% of Millennials and Gen Xers use online reviews when shopping for a health care provider 63% of Yelp reviews ranked US News and World Report top 20 hospitals only 1 3 stars out of a possible 5 Hospital mergers & acquisitions Health care organizations continue to merge, creating large regional and national organizations: Advocate Health Care + Aurora Health Care Beth Israel Deaconess Medical Center + Lahey Health Dignity Health + Catholic Health Initiatives Partners HealthCare + Care New England Health System Disruption 3: Consolidation Physician aggregation Following national trends, some physicians are pursuing employment or forming super groups to achieve economies of scale. Disruption 4: Marketplace changes Pharma integrating with payors Payors offering everything but hospital care Health systems entering pharma Employers entering health care Page 3 of 11
Disruptions for pharmacy professionals within a health care system National concerns Drug shortages Escalating pharmaceutical costs Opioid and prescription medication addiction Workforce shortages and burnout Patient facing issues Reducing and preventing errors Patient compliance Routine tasks vs. those requiring greater expertise Which of these concerns are highest priorities for American Healthcare? 1. Drug shortages 2. Escalating pharmaceutical costs 3. Opioid and prescription medication addiction 4. Workforce shortages and burnout 5. Reducing and preventing errors 6. Patient compliance C Suite areas of focus CEO: inspire organization to live our Mission and achieve our Vision COO: achieve our Vision through setting expectations for hospitals, service lines, ambulatory expansion CFO: balance future plans with current financial pressures CMO and CNO: partner with physicians and nurses and intra professional team to create best place to practice medicine CIO: ensure IT systems make it easier to provide high quality patient care all while being secure CHRO: create a workplace of choice Page 4 of 11
In the midst of all this, senior leaders must decide how to move the organization forward Bridge between current and future business models (World A to World B) Partner with third parties who offer expertise and breadth of services Gain input from physicians, leaders and employees to shape strategy before it is set in stone Retain, recruit and train top talent Evaluate all decisions against our Mission and Vision Navigating the changes impacting pharmacy Addressing shortages and increasing costs Artificial intelligence anticipates drug demand to minimize disruptions in care. Formulary management is even more important in an environment of rising costs. Creating a system wide central pharmacy saves costs and improves access and distribution as needs change. Page 5 of 11
Preventing and treating addiction Pharmacists at the bedside to confirm dosages, address patient concerns and offer alternative options Partnering with patients and families to manage pain effectively Workplace programs to care for health care workers with addiction issues Preventing errors on all fronts Patient and family centered care encourages partnership with patients and families as full members of the care team Programs, policies and procedures including: Just Culture Speak Up programs Compliance hotlines Huddles Technology For most organizations, improving non punitive responses to errors remains difficult Page 6 of 11
However, Beaumont has improved almost 70 percent At your organization, do you feel comfortable speaking up about errors? 1. Always 2. Most of the time 3. Sometimes 4. Never 5. N/A or don t know Efficiency ensures we work at the top of license Pharmacy technician workforce analysis Examining warehouse management Researching opportunities for robotic delivery Page 7 of 11
Improving patient compliance Meds to Beds The first fill of pharmaceutical medications is a big indicator for ongoing compliance, recovery and wellness. Beaumont is considering paying for first prescriptions at discharge. Partnerships with major pharmacies in addition to in house resources may ensure the best care. Claims data review Pharmacists can better advise and partner with patients based on history of refilling medications. Strategic effectiveness and nimbleness: Leading the future of health care What makes an organization nimble? Efficient approvals Aligned goals Effective delegation Clear direction Trust and openness Resilient workforce Future focus Customer driven decisions Learning from mistakes Dynamic leadership Three way communication Page 8 of 11
Embedding strategic effectiveness and nimbleness throughout the organization Who does Pharmacy report to in your organization? 1. CEO 2. COO 3. CFO 4. Other Are you engaged in cross functional teams and projects in your organization? 1. Service lines 2. Ambulatory teams 3. Multidisciplinary rounds with patients and families Page 9 of 11
Pharmacy Core Operations Q3 2018 2020 Pharmacy & Therapeutics Committee Medication Use Committees (site) Clinical Subcommittees Medication Safety Subcommittee Drug Utilization & Expense Management Subcommittee Formulary Oversight Subcommittee Carolyn Wilson EVP & COO *Administrator Kathy Pawlicki Rx Core Operations Steering Committee David Wood, MD EVP & CMO Medical Director Donna Hoban, MD 340B Governance Oversight Standing Subcommittees Antimicrobial Stewardship Pharmacy Compliance Oversight IT Stakeholder Pharmacy Practice Council * = denotes accountable executive Priority Subcommittees Q3 2018 2019 12 18 month initiatives Population Health support BH population health strategies through amb/specialty/mtm practices Rx Supply Chain central distribution assessment Drug Diversion & Security monitoring software, external audit Med History standardize practice Workforce Planning tech training program, shared resources (pool) Outpatient Pharmacy expand discharge med program Priority Subcommittees 2019 2020 12 18 month initiatives Population Health ambulatory practice model; pharmacy resource center Rx Supply Chain design and implement central distribution facility Outpatient Pharmacy expansion of pharmacies/services Residency Training expanded residency program, leveraging economies of scale for training and shared precepting Work Teams 90 day projects 2018 USP 800 (BH standard against NIOSH list) Controlled Substance Audit Ethical Drug Rationing Career Ladder USP 800 (with nursing for PPE evaluation & budgeting) Mass Casualty Plan 2019 Critical leadership skills and attributes Openness Anticipate and embrace change Flexibility in style, approach, roles Attitude No one can do everything, but we can all do something Don t let perfection be the enemy of good Team Hire strong, be strong Leverage diversity of talent Passion Find it and feed it Health care isn t for the faint of heart! Where do you have the most expertise and success? 1. Openness 2. Attitude 3. Team building 4. Passion Page 10 of 11
What makes a good leader great in the eyes of the C Suite Align your work with your organization s values, strategies and goals Vet the facts and popular assumptions Engage feedback from multiple disciplines at all stages Present solutions, not problems Advocate for your patients and your team s ability to help them Demonstrate measurable results and key learnings for the future Be confident in your expertise and humble in your authority Key takeaways 1) Disruptive forces will always be rampant. 2) Strategic effectiveness and nimbleness are possible even in health care. 3) The right leadership skills enable success in any environment. Thank you! Carolyn Wilson, MBA, RN Executive Vice President & Chief Operating Officer Beaumont Health Page 11 of 11