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Three decades of excellence

COMMENTARY

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Celebrating three decades of excellence in pharmacy management: The John W. Webb Lecture award John R. Reynolds, William A. Gouveia, and Alessandra Lyman Am J Health-Syst Pharm. 2014; 71:1227-30

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weeping and profound changes in any profession do not come easily; they require thoughtful, focused, and persistent leadership. Over many years, key leaders and managers in the profession of pharmacy have set bold and exciting directions that have enabled health systems to better serve the needs of specific patients while improving overall quality and safety across systems and populations. In this respect, review and analysis of the many aspects of a remarkable evolution of health-system pharmacy, as well as key contributions of individual leaders, become instructive as we prepare ourselves for the many changes and uncertainties that lie ahead for our profession and health care in general. Through this article, we will describe a program that has for nearly 30 years identified, acknowledged, and celebrated the accomplishments of distinguished leaders and managers and identify and explore their collective wisdom and contributions. Most pharmacy leaders are recognized for their willingness to place service to others, particularly patients, at the center of all that they do. These leaders are known for their personal integrity, strategic thinking, system approaches, and thoughtful mentoring. Such is the basis for recognition in our profession

through the John W. Webb Lecture Award program. The Webb Lecture, established in 1985 as the John W. Webb Visiting Professorship in Hospital Pharmacy by Northeastern University College of Pharmacy, recognizes annually one health-system pharmacy practitioner or educator who has distinguished herself or himself through extraordinary dedication to fostering excellence in pharmacy management. The award honors John W. Webb, director of pharmacy at Massachusetts General Hospital from 1959 to 1983 and director of the graduate program in hospital pharmacy at Northeastern University from 1964 to 1983. Mr. Webb had a distinguished career in hospital pharmacy management and was an exemplary leader and innovator who always placed patients first, and he expected the same of his colleagues. In 2006, a memorandum of understanding between ASHP and Northeastern University transferred responsibility for the award to ASHP. John R. Reynolds, Pharm.D., is Dean and Professor, School of Pharmacy; William A. Gouveia, M.S., FASHP, is Adjunct Clinical Professor; and Alessandra Lyman, B.S., is a student pharmacist, Bouvé College of Health Sciences, Northeastern University, Boston, MA. Address correspondence to Mr. Gouveia ([email protected]).

The ASHP Section of Pharmacy Practice Managers began administering the annual selection process in 2007. Most Webb Lectures have been published in the American Journal of Health-System Pharmacy (Appendix A). The complete list of past Webb Lecture Award recipients is presented in Appendix B. Throughout the history of the Webb Lecture series, recognized leaders in health-system pharmacy have shared their wisdom and vision while describing specific paths to successful leadership and management in the form of practical, instructive, and inspiring lectures. Since the Webb Lecture’s founding in 1985, the profession of pharmacy and those who comprise it have evolved to become increasingly dynamic and essential parts of the health care system. Thoughtful and focused leadership has always been at the foundation of quality patient care services. During the Webb Lecture series, we have observed leaders who are confident, yet humble; demanding, yet encouraging; motivated, yet strategic; and innovative, yet mindful of tradition. With unwavering commitment to the profession, Webb Lecture recipients have historically distinguished themselves in ever-changing workplaces and health care systems through thoughtful vision, quality education and training, and well-organized teamwork empowerment. The authors have declared no potential conflicts of interest. Copyright © 2014, American Society of Health-System Pharmacists, Inc. All rights reserved. 1079-2082/14/0702-1227$06.00. DOI 10.2146/ajhp140063

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Three decades of excellence

Specific actions described in Webb Lectures that stimulated and resulted in growth and improvements in patient care services include planning, challenging, adapting, and growing, while using critical knowledge and skills enabling pharmacists to assume unique responsibilities as drug experts in the health care system. The dynamic evolution of the profession that accompanied and, at times, was driven by educational and practice initiatives has placed pharmacists in critical roles assuming quality medication-use oversight designed to ensure optimal patient outcomes. Throughout these transformations in the profession, three strong principles, or pillars, have remained constant and of critical importance. We use the analogy of pillars as a symbol of how the many tenets of effective leadership and management hold up and otherwise allow us to systematically build layers of excellence into our profession’s structure. The first pillar is the continued advancement of the profession of pharmacy within the health care system due to the expansion of clinical practice and the sharing of this progress. The second pillar, quality patient care, including safe and effective medication use, is often analyzed, scrutinized, and improved by pharmacists themselves and professional organizations. The third pillar, the impact that pharmacists have on the health care delivery system, continues to be shaped by both the clinical and professional actions of those in our profession and, increasingly, in an interprofessional manner. The first pillar, advancement of the profession of pharmacy, highlights the important functions of pharmacists within the health care system. Advances in education and training, expansion of innovative practice models, and effective internal and external advocacy have resulted in a larger scope of practice and improved quality of patient care services. Pharmacists as 1228

professionals are increasingly recognized as medication-use experts and essential members of the health care team and less so as primarily distributors of medications. Direct involvement in patient care and associated responsibilities are major components of contemporary pharmacists’ work in health systems. Major contributors to improved and more effective integration of operationsbased and clinical services include focused leadership and vision, changes in education and training, quality improvement in response to seminal events related to medication misadventures, and advocacy at the local and national levels. The second pillar denotes the importance of quality care and medication safety. This responsibility undergoes continuous scrutiny by internal systems, regulators, and accreditors and focuses on methods by which pharmacists provide valuable clinical services at the bedside. In this age of evidence-based medicine, carefully constructed models and systems to measure and assess patients’ medication-use outcomes have come to the forefront of effective practice. Applications of technology in the medication distribution and use system are critical components of this pillar. Notably, technological advances have helped the profession implement important system checkpoints in the process of ordering, dispensing, and administering medications and reducing errors. The use of sophisticated technologies enables pharmacists to perform patient care services such as developing individualized therapeutic plans and monitoring; providing medication reconciliation; improving patient understanding and adherence to medication therapy through effective counseling, thereby reducing medication errors; and managing adverse effects. Pharmacists’ roles in patient care are solidified as they become primary providers of health care services that focus on achieving

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intended pharmacotherapeutic benefits with reduced likelihoods of adverse effects. A discussion about the evolution of pharmacy would not be complete without addressing the final pillar: the impact that pharmacists have on health care organizations. The duty and commitment that pharmacists have to patients and the profession are attributes that are not only embedded in the minds of pharmacists but also signified by the letters “R.Ph.” on our white coats and name badges. Leaders in pharmacy have demonstrated this commitment by shaping and adopting quality standards in patient care and exhibiting vision and perseverance while pursuing and achieving ambitious goals for themselves, their colleagues, and the profession. It is through the leadership of many, especially recipients of the John Webb Lecture Award, that the impact pharmacists have on patient outcomes has been recognized within and among the health professions. Throughout the Webb Lecture series, leadership in pharmacy has often been a topic of discussion and debate. Methods to motivate pharmacists to strive toward common goals may differ among leaders, but they always center around the core attributes of being industrious, determined, critical, motivated, and compassionate. In this lecture series, we have observed that leaders are faithful in their commitment to the important goal of improving patient care. Pharmacy continues to evolve as a knowledge-based profession where pharmacists need to be conscientious and critical of the environment they work in to make improvements in the quality of care patients receive. Technology has played a vital role in preventing medication errors with the implementation of barcode scanning, robotics, and medication evaluation reviews, but the systems can go only so far, and it is at this point that pharmacists need to put their

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education, knowledge, and skills fully into action. With the demand for pharmacists and their services at an all-time high in the early 2000s, the doctor of pharmacy degree became the entry-level degree. This prompted an even more intense focus on the clinical education and training of all new pharmacists. More recently, demand for residency programs has increased greatly as new graduates seek to further develop their practice knowledge and skills. It is with this in mind that leaders who have participated in the Webb Lecture program remind us of the importance of our work. We recognize through these leaders and our own experiences how each patient is our priority and how, as practitioners, managers, and educators, we must be mindful of our history, driven by the need for improvement, adaptable to current and emerging technology, and always compelled to put quality first. The legacy of the Webb lecturers lies in the wisdom they offer to the next generation of leaders who will apply their knowledge and skills to accelerate the advancement of our profession. Appendix A—Published Webb Lectures 1. Williams RB. Achieving excellence. Am J Hosp Pharm. 1986; 43:617-24. 2. Pierpaoli PG. Management diplomacy: myths and methods. Am J Hosp Pharm. 1987; 44:297-304. 3. Smith WE. Excellence in the management of clinical pharmacy services. Am J Hosp Pharm. 1988; 45:319-25. 4. Smith JE. Leadership in a clinical profession. Am J Hosp Pharm. 1988; 45:1675-81. 5. Gouveia WA. Turbulence and tranquility in the new decade: pharmacy leader– managers in patient care. Am J Hosp Pharm. 1990; 47:311-9. 6. Mehl B. Defining excellence. Am J Hosp Pharm. 1993; 50:921-8. 7. Lazarus H, Duncan WJ. Restructuring pharmacy departments for survival. Am J Hosp Pharm. 1994; 51:2827-31. 8. Shane RR. Pharmacy without walls. Am J Health-Syst Pharm. 1996; 53:418-25. 9. Woodward BW. The journey to professional excellence: a matter of priorities. Am J Health-Syst Pharm. 1998; 55:7829. 10. Ray MD. Shared borders: achieving the goals of interdisciplinary patient care. Am J Health-Syst Pharm. 1998; 55:1369-74.

11. Abramowitz PW. Nurturing relationships: an essential ingredient of leadership. Am J Health-Syst Pharm. 2001; 58:479-84. 12. Anderson RW. Health-system pharmacy: new practice framework and leadership model. Am J Health-Syst Pharm. 2002; 59:1163-72. 13. Wollenburg KG. Leadership with conscience, compassion, and commitment. Am J Health-Syst Pharm. 2004; 61:1785-90. 14. Zellmer WA. Reason and history as guides for hospital pharmacy practice leaders. Am J Health-Syst Pharm. 2005; 62:838-44. 15. Kvancz DA. A distinctive competency. Am J Health-Syst Pharm. 2006; 63:819-28. 16. Breland BD. Believing what we know: pharmacy provides value. Am J HealthSyst Pharm. 2007; 64:1284-91. 17. Ivey MF. Expanding the pharmacy enterprise: leadership needed. Am J HealthSyst Pharm. 2009; 66:1652-9. 18. Thielke TS. Synergistic relationship between pharmacy leadership development and pharmacy service innovation. Am J Health-Syst Pharm. 2010; 67:815-20. 19. Stevenson JG. Overcoming inertia: achieving more-rapid transformation of pharmacy practice. Am J Health-Syst Pharm. 2011; 68:604-12. 20. Bush PW. Leadership at all levels. Am J Health-Syst Pharm. 2012; 69:1326-30. 21. Clark T. Leading healers to exceed. Am J Health-Syst Pharm. 2013; 70:625-31. 22. Maddox RR. The essence of leadership. Am J Health-Syst Pharm. 2014; 71:662-8.

Appendix B—Webb Lecture Award recipients, 1985–2013a 1985 Robert B. Williams, M.S. Shands University Hospital Gainesville, FL

Three decades of excellence 1992 Bernard Mehl, D.P.S. The Mount Sinai Medical Center New York, NY 1993 Herman L. Lazarus, M.S. University of Alabama at Birmingham Birmingham, AL 1994 Richard F. de Leon, Pharm.D. University Hospitals Ann Arbor, MI 1995 Rita Shane, Pharm.D. Cedars Sinai Medical Center Los Angeles, CA 1996 Billy W. Woodward, R.Ph. Scott and White Hospital and Clinics Temple, TX 1997 Max D. Ray, M.S., Pharm.D. Western University of Health Sciences Pomona, CA 1998 Bruce E. Scott, M.S. Allina Health System St. Paul, MN 1999 Harold N. Godwin, M.S. The University of Kansas Hospital Kansas City, KS 2000 Paul W. Abramowitz, Pharm.D. University of Iowa Hospital & Clinics Iowa City, IA 2001 Roger W. Anderson, Ph.D. Anderson Cancer Center Houston, TX

1986 Paul G. Pierpaoli, M.S. Rush Presbyterian Hospital Chicago, IL

2002 Harold Kornfuhrer, R.Ph. North Mississippi Medical Center Tupelo, MS

1987 William E. Smith, Ph.D. Long Beach Memorial Hospital Long Beach, CA 1988 Joseph E. Smith, Pharm.D. Thomas Jefferson University Hospital Philadelphia, PA

2003 Karol G. Wollenburg, M.S. The University Hospitals of Columbia   and Cornell New York, NY

1989 William A. Gouveia, M.S. Tufts–New England Medical Center Boston, MA

2004 William A. Zellmer, B.S.Pharm., M.P.H. American Society of Health-System Pharmacists Bethesda, MD

1990 David A. Zilz, M.S. University of Wisconsin Hospital and Clinics Madison, WI

2005 David Kvancz, M.S. The Cleveland Clinic Foundation Cleveland, OH

1991 Sara J. White, M.S. Stanford Health Services Stanford, CA

2006 Burnis D. Breland, M.S., Pharm.D. Columbus Regional Healthcare System Columbus, GA

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2007 Marianne F. Ivey, Pharm.D., M.P.H. Health Alliance of Greater Cincinnati Cincinnati, OH 2008 Thomas S. Thielke, M.S., R.Ph. University of Wisconsin Hospital and Clinics Madison, WI 2009 William W. Churchill, M.S., R.Ph. Brigham and Women’s Hospital Boston, MA 2010 James G. Stevenson, Pharm.D., FASHP University of Michigan Health System University of Michigan College of Pharmacy Ann Arbor, MI 2011 Paul W. Bush, Pharm.D., M.B.A., FASHP Duke University Hospital Durham, NC 2012 Toby Clark, R.Ph., M.Sc., FASHP Medication Systems Consultant Charleston, SC 2013 Ray R. Maddox, B.S., Pharm.D., FASHP St. Joseph’s Chandler Health System Savannah, GA a Practice sites are those at the time of award recognition.

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Celebrating three decades of excellence in pharmacy management: the John W. Webb Lecture award.

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