The Leader’s Personalized Pathway to the Autonomous Pharmacy

Episode Highlights

What did you learn in completing the self-assessment from a health system perspective?

Nilesh Desai: Being relatively new to Baptist Health, the self-assessment gave me an opportunity to see where the health system stands and where we should focus. I used it to collaborate with the pharmacy leadership and operational folks at each of the hospitals, and to get a better understanding of the strengths, the gaps, and the opportunities for improvement.

Drilling down into the actual findings, what did the self-assessment show you?

Nilesh Desai: We have a very strong IT infrastructure and we have a good amount of human resources, so we scored very well in both of those categories.

In the data intelligence category, we scored fairly well, because we do have a good database where we are able to bring data in and look at it from an overall enterprise perspective.

We also have some opportunities for improvement, such standardizing on a decentralized medication dispensing model across the hospitals, adding IV robotics to our sites, improving visibility into all medications across the enterprise, and adding automation storage in the outpatient pharmacies. These are some of the strategies that we need to work toward over the next few years.

Mike, you completed the self-assessment for Baptist Health Lexington. What did the findings reveal to you?

Mike Anderson: To me, the value is in having a framework for analysis. I sought input from a number of my teams, including our clinical, operations, IT, and purchasing folks. It was not an onerous process at all; I completed it within an hour. But it was very good in that it gave us ideas of what we were doing well, and ideas of potential gaps.

One of those strengths was standardizing on Epic across all nine hospitals. It’s a great resource for us, and having that common platform is invaluable from a system and hospital perspective. Other strengths include our decentralized medication distribution model and the processes that make that happen. And as we move into the ambulatory space, our pharmacy clinical activity certainly is a strength.

Some challenges for us: we’re still looking for that ultimate solution for a pharmacy-owned process for medication reconciliation; IV automation is an opportunity, because while we utilize Epic barcode scanning, we’d like to get to gravimetric technology; and managing shortages, that’s the Holy Grail. Finding better, more efficient ways to manage shortages and being proactive with that information flow is something we are looking toward.

How have you used the self-assessment findings for strategic planning purposes?

Nilesh Desai: The self-assessment and the Autonomous Pharmacy framework are helpful in strategic roadmap planning. As a health system pharmacy leader, the assessment data is helpful in informing the overall direction and what you want to achieve over a specified timeframe. It’s helpful in capital planning, in financial planning, and in human resources planning. Definitely it's a good way of starting your actual strategic plan.

Mike Anderson: The self-assessment results provide meaningful validation data that can be leveraged to put people in a position to be successful. By that, I mean you want pharmacists in the places where they can make the most impact, and not wasting their time doing non-value- added tasks.

Also, using the data for benchmarking purposes can be an interesting exercise. But I think you have to be really careful in benchmarking. Be sure it’s a like comparison. Even subdividing that out, maybe starting with products versus the entire enterprise. So, I think there’s a lot of power in the ability to use benchmarking when it’s done thoughtfully.

How else did you use your self-assessment findings?

Nilesh Desai: We looked at our leadership and management structure and set up a number of different work groups. We now have different committees and meetings where the teams are working on standardization and other new initiatives. There’s an operations group, an education and competency group, a policies and procedures group, and we created a number of ambulatory pharmacy groups. So, the self-assessment process has been very positive in that regard.

For example, previously, each hospital was running its own new hire and refresher training for Epic and for Omnicell technology. That was a lot of hours spent by every hospital on training. Mike’s team suggested centralizing our training and making it more virtual. Now, we’ve standardized our training on common policies and procedures, and each hospital takes a turn leading the training.

How does health system standardization relate to your organization at Baptist Health Lexington?

Mike Anderson: Well, that's been a primary initiative the past few months as we try to align the nine hospitals, and it can be a challenge. But certainly there are benefits to be gained in terms of efficiencies.

Among the more interesting aspects is sharing best practices among the hospitals. We each have different strengths. And if we can take the best of each of us and learn from one another, there’s just a lot of power in that capability.

Another key is to use standardization intelligently. For example, I don’t recommend starting out saying we’re going to standardize 100% on everything. A lot of times, it really isn’t practical to standardize on those last 10% to 20% of processes. And in the end, you can lose more than you gain by trying to force total standardization. But as long as standardization efforts are done intelligently and you really try to mirror around the best-practice concept, there's a lot of value to be gained.

DISCLAIMER

The Future of Pharmacy Podcast is produced and distributed by Pharmacy Podcast Network. The views and opinions expressed in this podcast are those of the authors and do not necessarily reflect the official policy or position of any other agency, organization, employer or company. Assumptions made in the analysis are not reflective of the position of any entity other than the author(s). These views are always subject to change, revision, and rethinking at any time and may not be held in perpetuity.