What if your Income was based on your Outcome?
I just returned from an energizing ASHP Summer meeting in Denver, Colorado. The keynote speaker, Jay Kaplan, MD, FACEP, presented strategies to inspire transformational change as it relates to the Pharmacy Practice Model Initiative. The pharmacy practice model initiative, better known as PPMI, involves hospital and health-systems that will involve: 1) pharmacists providing direct patient care, 2) expanding the role of a qualified technician workforce and the use of technology, 3) ensuring that pharmacy departments are responsible for the provision of safe, effective, and efficient medication use policy, and 4) working to assure pharmacists are accountable for patient outcomes.
Based on the PPMI, one of the questions Dr. Kaplan posed to the audience was, “What if you were paid based on your performance? Essentially, what if your income equaled your outcome?” As the profession of pharmacy continues to evolve, the career of providing excellent service and patient care will also extend into quality clinical services. If that is the case, are we ready for that change? Ways in which to achieve value based performance is to create memorable experiences for patients. This may be difficult in our hectic workday, but without challenge, there is no change.
Dr. Kaplan provided some steps to help guide the process. First, ask yourself, “What do you want to be known for?” Let that be your aim or vision. Once decided, you will also need to determine your biggest obstacle and take necessary steps to overcome it in order to progress. Second, define your standards and ensure that they are specific, observable and measurable. He used a great line concerning standards and accepting anything less from your organization,”If you permit it, you promote it.” Third, staff needs to be engaged in the process. Ways to engage your staff should be to focus on the positive while still identifying areas for process improvement. By focusing on the positive, it is hopeful that you are coaching new behaviors. Fourth, focus on the 4 F’s: find, focus, fix and then follow-up. Whether it is your specific aim or objective, an issue or a problem, the 4 f’s should be implemented. Also, follow-up is stressed to ensure that strategies or solutions that you have developed are effective. Fifth, create a team. Transformation cannot be done in a silo. A dedicated, enthusiastic team will help support and encourage change. Sixth, memorable experiences should not be made just for patients but also for colleagues with whom you work. What can you do to make it a great day for your colleagues? Can you remember the last time you left work and said, “Wow, it’s been a great day!” versus “Wow, I am so glad this day is over!” I immediately thought that was much easier said than done. Dr. Kaplan posed my same thought but followed up by asking us to think about bowling. You shoot for something, meaning the bowling pins, correct? If you didn’t hit the pocket the first time, do you go and throw your second ball the same way or do you change your approach? Immediate feedback is given on the first ball thrown and with that is a scorecard. Basically, if we don’t like the way our day has gone or the feedback that we have been given, shouldn’t we attempt to make it different? Good point.
All of these points are valid and will take much effort, so he recommends starting with one or two strategies and proceeding from there. Trying to implement a number of ideas at one time is overwhelming and may be discouraging if unsuccessful. However, with continued growth in our profession, we can advance from a career focused on product to one of service that is valued and expected. If we are always in our comfort zone, we are not where we need to be.