Nimble in the Face of Change

Director of Pharmacy Perspective

Strategic planning has never been more important for a pharmacy department. For the department to maintain services and continue to have growth potential, the directors of pharmacy need to know how the organization works and reacts to financial change and must have a place at the executive table, even if by proxy. Directors of pharmacy need to understand where health care reform is in the state and determine how their pharmacy can be part of the discussion for the inevitable evolution under way. They should know where pharmacy services can help close a performance gap tied to Medicare reimbursement and be ready to mobilize pharmacy staff to help the organization impact a specific metric. They also should consider taking ownership of Core Measure and Meaningful Use outcomes that relate to medication use, reallocating resources as necessary.

Middle Manager Perspective

Middle managers should understand what the Director of Pharmacy needs to successfully justify pharmacy services. Reviewing and revising workload statistics, expanding documentation of clinical activities, and even auditing position descriptions to identify areas of improvement from a perspective outside the department will be beneficial. If a position has a primary responsibility in gathering or reporting regulatory data for Core Measure or Meaningful Use attestation, that responsibility should be identified clearly. As budget information becomes available, middle managers can devise a strategy for communicating with the team. Cuts that are publicized in the local newspaper can quickly raise staff anxiety levels; there is almost always more to the story from the organization that middle managers can share with individual employees. They should be as transparent as possible with providing timelines for cuts and outlining the realistic impact to the department or work unit.

Individual Pharmacist or Pharmacy Technician

It is helpful for individual pharmacists or pharmacy technicians to understand the local marketplace and how their hospital or health system fits in the area. Even in a city or town with a single hospital or health system, the health organization may not be immune to the impact of changing reimbursement strategies from state and federal funding sources. Pharmacists should open the line of communication with their supervisor or manager to better understand the financial health of the organization and how the department of pharmacy fits within the organizational structure. Knowledge about the organization's patient population (Medicare, Medicaid, or charity percentage) compared to others in the market may help predict impending changes in reimbursement strategies.

Most pharmacy staff members are unprepared to leave a position. Mentors and educators emphasize the strategies that are needed to obtain an interview for residency positions or to seek a new opportunity on a personal timeline, but they rarely discuss how to handle a layoff or forced job change.

Regardless of the financial situation of the organization, prepare for the unknown. Take the time to update your resume or curriculum vitae (CV). Dust off the document with each performance review, detail accomplishments of the past year, and add place holders for projects in process or on the horizon. If the rumor mill starts churning with possibility of job changes, you need to be ready to react; having a current CV on file will be one less thing to worry about during a stressful time.

Maintain your professional network. These individuals will be your first contact as you start to look for another position. Take the time to attend a professional meeting or get involved in the local pharmacy school to refresh relationships and associations. Network within your specialty at the local, regional, or state and national levels, if possible.

As you take the time to update your CV and network professionally, consider your credentials. Are you working at the top of your current position? Could you be doing more to advance clinical practice within the hospital? Would achieving board certification in pharmacotherapy or your specialty area help secure the position you currently hold? For hospital practitioners without a PharmD degree or residency training, seek out new experiences in your current environment. Do you have 20 years of experience or have you worked 1 year 20 times? Attempt to position yourself closer to the patient, making your services indispensible to physicians, nurses, and patients.

Assess personal finances with your spouse and family. Evaluate monthly expenses to identify areas that can be reduced or eliminated and channel those savings into the family emergency fund. Having an emergency fund provides peace of mind as the organization starts to vocalize concerns with reimbursement rates or changes in the area's health care market.

Facing a Layoff

Even with being proactive in understanding the organization, updating your CV, and networking, the day may come when you are laid off. Keep your support team involved during the process – communicate with your spouse, a friend, or extended family to help you move through this emotional time. Don't take a layoff personally – the vast majority of the positions eliminated during a workforce reduction are just that, positions. People are impacted when those positions are removed from the books, but it is rarely about job performance or work ethic.

Take advantage of the services offered by the organization if you are laid off. Often a severance package will provide time to transition into another position with a number of weeks of pay and coverage of benefits. Meet with the organization's human resources department early in the process to identify ways to maintain health care coverage and navigate the process for unemployment filing, if necessary. If you can manage the time, evaluate the next step in your career. This unexpected change may be an opportunity to work for another health system, a manager that you admire, or even stretch into a new practice area.