PHARMACY EXECUTIVE OVERSIGHT OF AREAS OUTSIDE PHARMACY

To advocate for opportunities for pharmacy leaders to assume healthcare executive leadership roles outside the pharmacy department; further,

To urge pharmacy leaders to seek out formal and informal opportunities to provide such leadership; further,

To encourage pharmacy leaders to use tools, resources, and credentialing identified by national pharmacy and professional healthcare organizations to demonstrate competence and readiness for healthcare executive leadership; further,

To encourage pharmacy leaders to support development of leaders with a broader scope of executive responsibilities by balancing generalization and service-line specialization in their career development and the career development of rising pharmacy leaders; further,

To advocate for healthcare organization structures that provide pharmacy leaders with opportunities to assume leadership responsibilities outside the pharmacy department; further,

To promote continuing professional development opportunities in executive leadership to provide pharmacy leaders with evidence of a commitment to lifelong learning and leadership excellence.

Rationale

In health systems, pharmacy operations often span multiple practice settings, and pharmacists contribute to many different interdisciplinary teams. ASHP’s Statement on the Roles and Responsibilities of the Pharmacy Executive notes there is need for a “strategic and innovative pharmacy executive who plans and oversees the design and operation of the entire and complex medication-use process throughout the system.” As each health system is unique in the size and range of services offered to patients, there is significant variability of the scope for the pharmacy executive’s position. The role of the pharmacy executive, as it originated, was to provide cohesive oversight of the entirety of the medication-use process, including medication-use policy considerations. However, as practice has evolved, medication use and pharmaceutical management has as well. Recent areas of expansion related to medication management in health systems include drug shortages, medication safety and quality, 340B Drug Pricing Program oversight, investigational drugs, and patient assistance support. Some areas for which health systems have sought pharmacy executive oversight that are less directly related to medication management include compliance and regulatory assurance, transitions of care, supply chain, laboratory operations, and dietary services. Pharmacy executives also manage relationships with stakeholders, evaluate quality and outcome metrics, support medication access, and provide leadership in optimizing reimbursement.

Health-system pharmacy leaders possess skills that have often made them candidates for positions outside pharmacy. As senior leadership teams become smaller to reduce labor costs, pharmacy leaders may be asked to take on additional responsibilities. Over 70% of the 2020 ASHP Foundation Pharmacy Forecast panelists indicated this will be a likely occurrence in many organizations within five years. Adding to a pharmacy leader’s portfolio of responsibility creates opportunities for sharing experience and resources across multiple departments. Placing multiple departments under the leadership of one executive also makes it easier to reduce silo budgeting by identifying and implementing interventions that may increase cost in one department while reducing cost to a greater degree in another. Pharmacy leaders who accept responsibility for other service lines must exploit the strengths of their other departments, drive collaboration across all areas they lead, and avoid undermining authority entrusted to subordinate service-line leaders.

Pharmacy executive leaders should strive to demonstrate a commitment to achieving and maintaining excellence in pharmacy and healthcare leadership to communicate value to colleagues, healthcare administrators, and the public. This goal could be achieved by seeking national recognition of core competencies (e.g., leading people and processes, professionalism, financials) identified by national pharmacy and professional healthcare organizations (e.g., American College of Healthcare Executives fellowship program, 360 evaluations, career coaching, professional leadership certificates, ASHP Certified Pharmacy Executive Leader credential). Pharmacy executive leaders should continually seek opportunities for professional development to demonstrate their competence, leadership, and commitment to the profession and to enhance their essential executive knowledge, skills, and abilities in order to facilitate team success.

A key driver enabling a pharmacy executive leader the ability to devote the time and energy for expanded roles includes striking a balance with service-line personnel breadth and depth. This balance is of particular importance when establishing a talent pipeline of capable leaders that will keep the service lines running with little to no interruption. In some health systems, pharmacists hold roles such as chief executive officer, chief operating officer, and senior vice president. Some institutions include oversight of additional service lines within the purview of their highest-ranking pharmacist administrator, such as combining “Pharmaceutical and Nutrition Care,” or appointing a pharmacist to manage all “intravenous admixture services.”

To achieve maximum performance in an expanded leadership role, the conditions for success must exist. Organizational structure (e.g., hierarchal, matrix, divisional) aligns and defines the relationships of parts of an organization, and the structure chosen affects an organization's success in carrying out its strategy, goals, and objectives. Leadership should understand the characteristics, benefits, and limitations of various structures in aligning organizational structure with the enterprise's business strategy.