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Presidents Message
Working Smarter Not Harder

by Charlene Hope, PharmD, MS, BCPS, ICHP President

I was cleaning out my office the other day and found a company newsletter from Esso Resources that my Dad gave me sometime last year. It was published back in 1988. He was about the same age I am now and one of several employees interviewed and featured in the newsletter. My favorite part of the column was the conclusion: “A large company is not unlike a community in that everyone has to learn to work together,” says Selwyn. “There’s a lot more to success than just working hard. To survive in any organization you not only have to work harder and smarter, you have to be a team player and that means working with a lot of different people. Sometimes it isn’t easy but I look at it as a challenge.”

It is one of my favorite ‘ah ha’ moments, because it's the moment you realize that you are probably much more like your parent than you care to admit.

As far as I can remember, starting early in my pharmacy career, I have always held close, and shared with numerous co-workers, the mantra: "Come on you guys, we just have to learn how to work smarter, not harder." Throughout my career, I have always been driven by looking at processes and creatively thinking of ways to improve them, to lessen the workload or to create time for clinical pharmacy activities. Those experiences have now led me to my career interest in healthcare quality and patient safety.

So when I recently saw an editorial published in the BMJ Quality and Safety Journal, entitled, A ‘work smarter, not harder’ approach to improving healthcare quality, I was very interested in what it had to say.¹ The authors illustrated our current state of healthcare today, which at times can be best summarized in a word – overwhelming. Responsibilities include everything from implementation of healthcare technology, meeting regulatory standards, and initiating or expanding current services to maximize reimbursement from insurers.

The issue for us in healthcare right now is that more and more is getting added to everyone's plate, but the plate is not getting any larger. We are often relegated to telling our staff to work harder. And naturally, working harder does not always get you the results you hope for. The authors offer the alternative approach of working smarter.

Smarter takes patience – it is taking the time to consider the impact of implementing a new initiative on current staff workload and involving the front-line caregivers in designing and testing alternative ways of incorporating the new work. The benefits include increased staff engagement, increased sustainability of the practice change and hopefully better outcomes. Naturally, there are often numerous forces within an organization that make "working smarter" easier said than done. It isn’t easy, but I look on it as a challenge. Opportunities are everywhere for working smarter – we just need to look for them!

For example, promoting a work smarter not harder mindset occurred most recently working with my pharmacy team on automated dispensing cabinet restocking practices and delivery times. Two technicians were assigned to pull and prepare the medications for different nursing areas and then deliver them at later times in the morning. Issues often ensued depending on the teams of technicians that were scheduled together (some working together better than others) and there was a lack of consistency or agreed upon standard of restocking practices for the department. After reviewing the current workflow and discussing the goal of becoming more efficient, it was decided that the two technicians would work together to pull the medications for all the assigned nursing areas together, and then they would both deliver the medications at the same time.

The result? Enhanced teamwork among the technicians. In addition, the positive comments from the technicians regarding the new process were numerous, and the time to complete the restocking was reduced such that there was an hour gained in time before the next tasks were due. The technicians were wondering what they should do with the extra time they had. Albeit a simple example, it was a great short term win for the pharmacy department.

We all have opportunities to work smarter if we take the time to look around us, reflect on what is working and what isn’t, make the necessary adjustments, and then watch the resulting enhanced teamwork and better, more effective patient care. What needs adjusting at your work site?

Reference

1. Hayes CW, Batalden PB, Goldmann D. A ‘work smarter, not harder’ approach to improving healthcare quality BMJ Qual Saf Published Online First: 17 December 2014. doi: 10.1136/bmjqs-2014-003673