Editor ials

Executive leadership: Critical to developing clinical pharmacy programs and services

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ew clinical pharmacy service programs were ever “gifted” to any pharmacy department. In reality, each program was evaluated on its merits and costs. Ultimately, business cases were developed and justified before authorization was given. So, why are some departments seemingly better able than others to secure approval and funding to establish and expand such programs? Several successful programs highlighted in a series of Commentaries in this issue of AJHP (see pages 2087, 2092, 2098, and 2101) nicely illustrate the critical requirements: exceptional interpersonal communications, symbiotic partnerships at every level of management and leadership, and a bedrock foundation of mutual trust, accountability, and perseverance.1 Good executive leadership identifies opportunities, while great executive leadership capitalizes on opportunities to advance clinical pharmacy services with a clear value proposition—for the pharmacy department and the organization at large. Exceptional pharmacy leaders recognize program successes and challenges, freely impart both praise and guidance, and elevate those messages consistently to their organizational leaders. These pharmacy leaders anticipate needs and communicate with their organizational leaders on a routine basis to avoid blindsiding them with requests or challenges. Pharmacy executive leaders must always keep the patient at the center of their focus and never be perceived as doing what is best for pharmacy to the exclusion of what is best for the patient and the overarching organization. Gaining approval for initiatives and resources usually requires the assistance of key stakeholders and sponsors, including physicians and organizational leaders.2 While judicious use of anecdotes and testimonials is a persuasive technique to get the attention of decision-makers, ultimately pharmacy executive leaders must deliver what these stakeholders and sponsors need (oftentimes that means a solid return on investment). When senior organizational leaders trust pharmacy executive leaders, resource allocation for clinical pharmacy services often follows. In our experience, the reverse never happens. Few pharmacy executive leaders receive resources without earning them, but when resources are received it behooves the pharmacy executive to express gratitude and acknowledge organizational leaders’ trust in the pharmacy team. The pharmacy executive then must manage resources in a manner that is transparent and consistent with commitments, thereby building confidence in the organizational team to deliver judicious resource management, innovation, and Copyright © 2015, American Society of Health-System Pharmacists, Inc. All rights reserved. 1079-2082/15/1201-2060.

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openness to negotiation while consistently producing outcomes that exceed expectations. Although an understanding of these principles will not guarantee success every time, their ongoing application by pharmacy leaders builds a critical, trusting relationship with organizational leaders. In these challenging times, amid stormy seas of healthcare delivery and payment reform, pharmacy executive leadership is not for the faint of heart.3 It demands tenacity, passion for excellence, commitment to results, resiliency, and adaptability to respond to new opportunities and challenges. It is the pharmacy executive’s responsibility to consistently advocate for enhanced skills, competencies, credentials, and continuous professional development. That brings us to another aspect of leadership that is critical to organizational strength—and, indeed, the very future of our profession: the need for leadership succession planning. Effective pharmacy executives are pivotal in not only establishing clinical pharmacy programs such as those described in this issue of AJHP but also in ensuring ongoing program support. It is incumbent upon today’s leaders to commit themselves to developing and advancing clinical and administrative leaders who will one day assume the leadership mantle.4 The exceptional pharmacy executive must continually champion the value of clinical pharmacy services by aligning pharmacy department and organizational priorities, providing visionary leadership and execution, maximizing physician and sponsor trust, and cultivating capable leadership teams. Exceptional pharmacy executive leadership is about more than knowing what to do; it’s about knowing how to do it— with creativity, charisma, and courage. 1. Helling DK, Nelson KM. How to develop and implement a program to continuously demonstrate the value of clinical pharmacy services. Pharmacotherapy. 2000; 20(10, pt. 2):340S-344S. 2. Helling DK, Johnson SG. Defining and advancing ambulatory care pharmacy practice: it is time to lengthen our stride. Am J Health-Syst Pharm. 2014; 71:1348-56. 3. Helling DK. 2013 Remington Lecture: lengthen your stride. J Am Pharm Assoc. 2013; 53:359-61. 4. Helling DK, Johnson SG. The future of specialized pharmacy residencies: time for postgraduate year 3 subspecialty training. Am J Health-Syst Pharm. 2014; 71:1199-203.

Dennis K. Helling, Pharm.D., Sc.D. (Hon), FCCP, FASHP, FAPhA, Executive Director Emeritus, Pharmacy Kaiser Permanente Colorado (KPCO) Denver, CO Clinical Professor University of Colorado School of Pharmacy (CUSOP) Aurora, CO [email protected] Samuel G. Johnson, Pharm.D., BCPS, FCCP, Clinical Pharmacy Specialist, KPCO Clinical Assistant Professor, CUSOP The authors have declared no potential conflicts of interest. DOI 10.2146/ajhp150736

Executive leadership: Critical to developing clinical pharmacy programs and services.

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