3. Pharmacist
versus
Practitioner
Pharmacist**
Practitioner*
ASHP Statement on Professionalism
10 Characteristics
1. *Knowledge and skills of the profession
2. *Commitment to self-improvement of skills
and knowledge
3. **Service orientation
4. **Pride in and service to the
profession
5. *Convenantal relationship with the patient
6. **Creativity and innovation
7. **Conscience and trustworthiness
8. **Accountability for his or her work
9. **Ethically sound decision-making;
and
10. **Leadership
4. An Array of Typical Management/Leadership
Principles and Lessons
• Dream big dreams (“BHAG”)
• Exploit your strengths
• See yourself as “self-employed”
• Never consider the possibility
of failure
• Manage your boss
• Be teachable
• Dedicate yourself to serving others
• Be impeccably honest
• Be responsive*
• Nurture key relationships
*”Whatever your boss wants done
takes top priority. Premise: the boss has good reasons for
wanting the job done now.”
• Think positive
• Make your moods
• Be generous
• Practice the Golden Rule
• Maintain your professional/
personal balance
• Be a mixer
• Listen, respond to employee
suggestions and problems
• Promote from within
• Manage your time (leave time
for important/non-urgent)
• Recognize employees formally
and informally
• Meet deadlines
• Seek other persons’ opinions
and recommendations
• Prioritize (do “first things first”)
6. Lesson 1: 1978
Change
"There is no squabbling so violent
as that between people who
accepted an idea yesterday and
those who will accept the same
idea tomorrow."
--Christopher Darlington Morley
7. Lesson 1: 1978
Change
“Men often oppose a thing because
they have had not agency in planning
it, or because it may have been planned
by those whom they dislike.”
--Alexander Hamilton
9. Lesson 2: 1979
Learn how to communicate
• Learn how to speak
• Learn how to write
“To communicate, put your thoughts in
order; give them a purpose; use them
to persuade, to instruct, to discover,
to seduce.”
--William Safire
10. Lesson 2: 1979
Learn how to communicate
• Learn how to speak
• Learn how to write
“The elaborate and technological civilization that we must operate
. . . requires millions of people able to construct and follow
discursive thought. It demands widespread competence in little
things as well as great, habits of precision, to be learned only
through a mastery of the symbol system of language. ”
“Ruly behavior expresses a ruly mind, and the
discipline of word and thought provides the discipline of deed.”
Less than Words Can Say Richard Mitchell
11. Lesson 3: 1980
Don’t be emotionally impulsive
or act foolishly
There are some things
at which you don’t get
a second chance.
Regarding e-mail:
the purpose is to transmit information—
not to transmit emotion.
Ask yourself if you will regret sending.
12. Be Careful what you Post
Lesson 3: 1980
Don’t be emotionally
impulsive or act foolishly
13. Lesson 4: 1981
Figure it out
Not everything
is in a textbook.
“The content of most textbooks is
perishable, but the tools of self-
directness serve one well over time.”
--Albert Bandura
14. Lesson 5: 1982
Enforce compliance/uniformity
This is not Burger King®.
You cannot do it your way.
Corollary: Eliminate excuses for
non-compliance and lack of uniformity.
”An important task of the manager
is to reduce his people’s excuses for failure.”
--Robert Townsend
“ . . . we couldn’t get to the highest level . . . if
everyone was doing his/her own thing.”
--Dan Wolterman (Memorial Herman—Houston)
15. “The first judgment
is whether to use
your judgment.”
Lesson 5: 1982
Enforce compliance/uniformity
This is not Burger King®.
You cannot do it your way.
16. Lesson 6: 1983
Hold people accountable
Definitions of accountability:
• Webster’s: “The property that ensures that the actions of
an individual or an institution may be traced uniquely to
that individual or institution.” “Being accountable.”
• Marc’s: “Responsibility with consequences”
“Holding accountable.”
Note: the consequences must be positive as well as
negative.
18. Lesson 7: 1984
Learn what to delegate
“As usually presented, delegation makes little
sense. If it means that somebody else ought to do
part of “my work,” it is wrong. One is paid for doing
one’s own work. And if it implies, as the usual
sermon does, that the laziest manager is the best
manager, it is not only nonsense; it is immoral.”
--Peter Drucker
“Chop your own wood.
It will warm you twice.”
--Henry Ford
20. Lesson 8: 1985
Inspect what you expect
“An inspection process
will make you aware
of performance gaps.”
--Gary Ryan Blair
“You get what you inspect,
not what you expect.”
--Patrick S. Dunn
Inspect/Monitor Feedback/Adjust
Improve/Sustain
Corollary: Understand the value of the checklists.
22. Lesson 9: 1986
Develop a model for progress
(focus on quadrant numbers 1 and 2)
“We’re spending
too much time
fetching balls in
the park.”
Which quadrant
is “fetching balls”
for dogs?
23. “Learn project management skills
and techniques, then apply them to the
activities that you manage.”
--W.J.King
Lesson 9: 1986
Develop a model for
progress
24. • Identify a problem or an opportunity for improvement.
• Identify alternatives.
• Select an alternative and establish a goal.
• Develop an action plan.
• Develop a policy and procedure (“document”).
• Inservice.
• Implement.
• Measure/Assess.
• Make adjustments.
• Ensure compliance.
10-Step Project Management
Approach
Lesson 9: 1986
Develop a model for progress
25. Ready-Fire-Aim1 (Or “Do it, Try it, Fix it)
• Ready: “Spectacular achievement is always preceded by spectacular
preparation.” --Dr. Robert Schuller
5 P’s: “Proper preparation prevents poor performance.”
• Fire: “There comes a moment when you have to stop revving
up the car and shove it into gear.”
--David Mahoney
• “Anything worth doing does not have to be done perfectly—at
first.” --Ken Blanchard
• Aim: “Good, better, best; Never let it rest; Until the good becomes
better and the better becomes best.”
-- Elementary School Rhyme
1. Peters and Waterman, In Search of Excellence, Harper & Row, 1982
Lesson 9: 1986
Develop a model
for progress
26. • Identify a problem or an opportunity for improvement.
• Identify alternatives.
• Select an alternative and establish a goal.
• Develop an action plan.
• Develop a policy and procedure (“document”).
• Inservice.
• Implement.
• Measure/Assess.
• Make adjustments.
• Ensure compliance (“monitor/enforce”).
10-Step Project Management
Approach
Lesson 9: 1986
Develop a model for progress
27. Lesson 10: 1987
Hire for character; Train for skill
“. . . a highly trained expert with a good
character and personality is a better, and a
great deal more valuable, employee than one
with the same technical training who lacks
basic social skills.”
-- W.J.King
NOT
28. Lesson 10: 1987
Hire for character; Train for
skill
”Character means having values. It means
having a moral compass that sets clear
parameters for what one will and will not
do.
Character is all about knowing right from
wrong and having worked these issues out
long before facing tough judgment calls.
Character also means putting the greater
good of the organization ahead of self-
interest.”
--Tichy and Bennis
29. Hire for character; Train for skill
Lesson 10: 1987
Values Inventory:
Attitude
Selflessness
Teamwork
Work ethic
Consideration of others
Ability to take direction
Enthusiasm/Optimism
“Our value is the sum of our values.” -- Joe Batten
30. Lesson 10: 1987
Hire for character; Train for
skill It requires incredible foresight
to remain faithful to an idea.
To ignore what your eyes and
ears tell you and imagine
better. One individual - Jack
Roosevelt "Jackie" Robinson
imagined better and ended
eighty years of baseball
segregation. He crossed the
color line and made his debut
with the Brooklyn Dodgers in
1947 as the first African
American in major league
baseball.
31. ”Hire for attitude and train
for skill.”
--Herb Kelleher—Nuts!
Lesson 10: 1987
Hire for character; Train for
skill
32. Lesson 11: 1988
Ready-Fire-Aim1 (Or “Do it, Try it, Fix it)
• Ready: “Spectacular achievement is always preceded by spectacular
preparation.” --Dr. Robert Schuller
5 P’s: “Proper preparation prevents poor performance.”
• Fire: “There comes a moment when you have to stop revving up the car
and shove it into gear.”
--David Mahoney
• “Anything worth doing does not have to be done perfectly—at first.”
--Ken Blanchard
• Aim: “Good, better, best; Never let it rest; Until the good becomes
better and the better becomes best.”
-- Elementary School Rhyme
1. Peters and Waterman, In Search of Excellence, Harper & Row, 1982
33. Lesson 12: 1989
Understand the “C’s”
of a healthy culture
Character; Courage; Confident; Can do; Capable;
Competence; Connection; Cohesion; Coordination;
Cooperation; Caring; Coaching; Consideration;
Conscience; Compromise, Courtesy; Constancy;
Clear; Calm/Cool/Collected; Communication;
Clarity; Consistency; Concentrate; Commitment;
Practice Core Values; Conviction; Comprehend;
Collaboration; Creativity; Consolation (“to allay
sorrow or grief”);
34. … “C’s” of a healthy
culture
Change; Camaraderie (“spirited goodwill
among friends”); Confrontation (“confront
problems, not people”); Clean; Confident;
Curious; Challenge; Call (rather than e-
mail); Conflict; Hold Crucial
Conversations; Conclude; Compliment;
Complement; Establish Sense of
Community; Clap; Celebrate;
Conscientious; Congruity
Lesson 12: 1989
35. Lesson 13: 1990
Read:
The Seven Habits of Highly
Effective People
• Be proactive
• Begin with the end in mind
• Put first things first
• Think Win/Win
• Seek first to understand, then to be understood
• Synergy
• Sharpen the Saw
36. Lesson 14: 1991
Set the bar high
(for others)
“It is the nature of man to rise
to greatness if greatness is
expected of him.”
-- John Steinbeck
37. Lesson 14: 1991
Set the bar high
(for others)
“My mother said to me, ‘If you become a soldier,
you’ll be a general; if you become a monk, you’ll
end up as the pope.’ Instead. I became a painter
and wound up as Picasso.”
-- Pablo Picasso
38. Lesson 14: 1991
Set the bar high
(for yourself)
“There is always some kid
who may be seeing me for
the first or last time--
I owe him my best."
-- Joe DiMaggio
39. Lesson 14: 1991
Set the bar high
(for yourself)
“One night we had a game that I didn’t think was that
big, and Jim Simpson said to me, ‘It’s a big game to
those kids and coaches who are playing.’ And I
always try to keep that in mind and make sure I make
every game special. That really came home when I
realized people were paying attention to what I was
saying."
-- Dick Vitale
40. Lesson 15: 1992
Work horizontally
“Whenever possible, information
should go directly from sender to receiver.”
--Donald L Kirkpatrick
“In the case of arguments with your colleagues,
it is usually better policy to settle your differences
‘out of court,’ rather than to take them higher
for arbitration.”
--W.J.King
41. “When you are dissatisfied with the service of
another department, make your complaint to the
individual most directly responsible for the
function involved. Complaints made to an
individual’s supervisors, over his or her head,
engender strong resentment and should be
resorted to only when direct appeal fails. In
many cases such complaints are made without
giving the individual a fair chance to correct the
grievance, or even before he or she is aware of
any dissatisfaction.”
--W.J.King
Lesson 15: 1992
Work horizontally
42. Lesson 16: 1993
Embrace diversity
“People may be said to resemble not the bricks of which
a
house is built, but the pieces of a picture puzzle, each
differing in shape, but matching the rest, and thus
bringing
out the picture.”
-- Felix Adler
“Diversity initially began as a topic of conversation that
focused heavily on race, gender, and ethnicity. Today, it
goes beyond those protected groups. Things like
diversity
in problem-solving, single versus married, children
versus
no children, high wealth and low wealth, political
43. Lesson 16: 1993
Embrace diversity
(with caveat—still
need to perform)
“I’m good with you
coming out of
the closet. It’s
your curveball
that I’m having
trouble accepting.”
44. Lesson 17: 1994
Measure of success:
Not fewer problems, but
are the problems getting
More sophisticated?
45. Lesson 18: 1995
Read inspirational quotations
You don’t have to be wise; you
just need to recognize wisdom.
“ I love quotations because it is a joy to find
thoughts one might have, beautifully expressed
with much authority by someone recognized
wiser than oneself.”
--Marlene Dietrich
"Be as smart as you can, but
remember that it is always
better to be wise than to be
smart."
-- Alan Alda
48. Lesson 19: 1996
Understand the Excellence Equation
PEOPLE + SYSTEMS
EXCELLENCE
“Give me Tiger Woods’
golf clubs, and I will play
crappy golf; give Tiger
Woods my golf clubs, and
he will play crappy golf.”
49. Lesson 20: 1997
Be guided by a definition
of leadership (first recognize the role)
Know the difference between “Leader” and
“leader” (Big “L” and little “l”)
“I want to know everything I can about leadership. Because I
don’t believe leaders are born. I don’t believe you spring
fully armored out of the head of Athena to slay Hector in
battle. I believe leaders choose to lead at some point in
their life. And it’s because they have a call to action. They
have a calling. They have something they want to make
happen. They choose to be part of a change that they want
to see in the world going around them, and they choose to
step forward, and they choose to take the risk of leadership.”
--A.G. Lafley Leadership is a choice, not a position.
50. “I always wondered why somebody
didn’t do something about that.
Then I realized I was somebody.”
--Lily Tomlin
“In 1918, Georges Clemenceau of France made the
observation that “War is too important to leave to the
Generals.”
Leadership is a choice, not a position.
Lesson 20: 1997
Be guided by a definition
of leadership (first recognize the role)
Know the difference between “Leader” and
“leader” (Big “L” and little “l”)
51. “Anyone, at any level has the opportunity to
influence the system. At Southwest Airlines, you
don’t have to hold the title of chairman or chief
executive officer to feel you can make a
difference.”
From the book Nuts!
Leadership is a choice, not a position.
Lesson 20: 1997
Be guided by a definition
of leadership (first recognize the role)
Know the difference between “Leader” and
“leader” (Big “L” and little “l”)
https://www.youtube.com/watch?v=731RSOJa1pc
52. “Leadership is taking people to places they've
never been before.”
--Marie Kane
“Leadership is the process of influencing the
activities of an organized group toward goal
achievement.”
--C.F. Rauch and O. Behling
“The leader is one who mobilizes others toward a
goal shared by leaders and followers.”
--Garry Wills
Lesson 20: 1997
Be guided by a definition of
leadership
Top definitions:
53. “The fundamental purpose of leadership is to
produce useful change, especially, non-
incremental change.”
--John Kotter
“Leadership is a process whereby an individual
influences a group of individuals to achieve a
common goal.”
-- Peter Northouse
“Leadership is action, not position.” - - Donald H.
McGannon
Lesson 20: 1997
Be guided by a definition of
leadership
Top definitions:
54. Lesson 20: 1997
Be guided by a definition of leadership
Leadership is:
“Making Things Better”
“If you have the
opportunity in life
to make things
better, and you don’t,
you are wasting your
Time on Earth.”
55. Lesson 20: 1997
Be guided by a definition of leadership.
Leadership is:
“Making Things Better”
57. Lesson 20: 1997
Be guided by a definition of leadership
How do you “make things better”?
Executing the Definition:
Vision
Confidence
Propensity to Act
58. Executing the Definition: Vision
“ The very essence of leadership is that
you have to have a vision. It’s got to be
a vision that you articulate clearly and
forcefully on every occasion. You can’t
blow an uncertain trumpet.”
--Theodore Hesburgh
“I have a dream that one
day this nation will rise
up and live out the true
meaning of its creed: "We
hold these truths to be
self-evident: that all men
are created equal."
60. Executing the Definition:
Confidence
“I have not yet begun to fight.”
--John Paul Jones
“If my mind can conceive
it,
My heart can believe it,
I know I can achieve it!”
--Jesse Jackson
61. “If you hear a voice within you say,
‘you cannot paint,’ then by all means
paint, and that voice will be silenced.”
-- Vincent Van Gogh
Executing the Definition:
Confidence
“Life is not easy for any of us. But
what of that? We must have
perseverance and above all
confidence in ourselves. We must
believe that we are gifted for
something and that this thing must be
attained.”
--Marie Curie
62. Executing the Definition:
Propensity to Act
“Nothing will ever be attempted if all possible
objections must be overcome first."
-- Samuel Johnson
“There is as much risk in doing nothing as doing
something.”
-- Trammel Crow
“A good plan, violently executed
now, is better than a perfect plan next week.”
--George S. Patton
“Never mistake motion for action.”
--Ernest Hemingway
“The vision must be followed by the venture. It is not
enough to stare up the steps - we must step up the
*Reversible vs. Irreversible Actions
64. Lesson 20: 1997
Axiom: Be a good follower:
Be the “First Follower”
CHANGECHANGE
https://www.youtube.com/watch?v=fW8amMCVAJQ
65. Lesson 21: 1998
Don’t remember
• Use forcing functions
• Use prompts
”There are two ways of securing cooperation in human
action. You get cooperation by controls or you can get it by
comprehension.”
--Winston Churchill
67. Lesson 23: 2000
Recognize the most important
element in a pharmacy’s
successThe most important element
determining a pharmacy
department’s success is
the ability of the leadership
team to work together.
68. Lesson 24: 2001
Be different
“Two roads diverged in a
wood and I—took the one
less traveled by. And that
has
made all the difference.”
--Robert Frost
"When you're always trying to conform to the norm, you lose
your uniqueness, which can be the foundation for your
greatness."
-- Dale Archer
69. Lesson 24: 2001
Be different
“You have to be willing to do
things the masses would
never do. That’s how you
separate yourself from the
masses.”
--Steve Bisciotti
70. Lesson 25: 2002
Practice “Persistence & Patience”
“Good ideas are not
adopted automatically.
They must be driven into
practice with courageous
patience."
--Hyman George
Rickover
Patience and perseverance have a
magical effect before which
difficulties disappear and obstacles
vanish.
--John Quincy Adams
71. Lesson 25: 2002
Practice “Persistence & Patience”
“In carrying out a project, do not wait passively for anyone—
suppliers, sales people, colleagues, supervisors—to make
good their delivery promises; go after them and keep
relentlessly after them.”
--W.J.King
72. “Nothing in the world can take the place
of Persistence.
Talent will not; nothing is more common than
unsuccessful men with talent.
Genius will not; unrewarded genius is almost
a proverb.
Education will not; the world is full of educated
derelicts. Persistence and determination alone are
omnipotent.
The slogan 'Press On' has solved and always
will solve the problems of the human race.”
--Calvin Coolidge
Lesson 25: 2002
Practice “Persistence & Patience”
73. "In the confrontation between the stream and
the rock, the stream always wins--not through
strength but by perseverance."
--H. Jackson Brown, Jr.
Lesson 25: 2002
Practice “Persistence & Patience”
74. Lesson 26: 2003
Form vendor partnerships
“I have found no greater
satisfaction than achieving
success through honest
dealing and strict
adherence to the view
that, for you to gain, those
you deal with should gain
as well.”
--Alan Greenspan
75. Lesson 27: 2004
Pay attention to the physical plant
“Administrators and pharmacists
can promote professionalism
by improving the pharmacy
practice area to reduce
environmental barriers to
professionalism (e.g., cluttered,
isolated, outdated, or cramped
working quarters).”
--ASHP Statement on
Professionalism, 2008
77. Lesson 29: 2006
Groom ‘em or broom ‘em
“Find your “Grant” : Irwin McDowell;
George McClellan; Ambrose Burnside;
Joseph Hooker; George G. Meade, then,
“. . . the boss has no excuse for
tolerating forever behaviors that erode
the morale of the overall organization.
Modern bosses are more often too slow
rather than quick to replace individuals who cannot
accommodate the legitimate needs of the group.”
--Walter F. Ulmer, Jr.
78. Lesson 30: 2007
Understand how complex systems fail or
succeed
• Make Systems Thinking the Prime Intervention
• Understand the Swiss-Cheese Model
of Medication Errors
• To Improve Efficiency and Effectiveness:
Centralize Support Processes
Eliminate the “Forks”
Eliminate the “Bottlenecks”
The Theory of Constraints states that "The throughput of any system is
determined by one constraint." Thus, if you want to increase throughput,
you should identify and improve the constraint (or bottleneck).
79. Lesson 30: 2007
Understand how complex systems fail or
succeed
Eliminate the “Bottlenecks”
“By the way,
while you
were off sick
we located
the bottle
neck.”
80. Lesson 31: 2008
Understand the definition
of customer service
“Customer service is doing everything
possible to satisfy our customers within
the confines of good (safe, ethical, legal)
pharmacy practice.”
84. Manage: Decide
Recognize one of the key roles of a manager: take
responsibility for making decisions
"It often happens that I wake
at night and begin to think
about a serious problem and
decide I must tell the Pope
about it. Then I wake up
completely and remember that
I am the Pope."
--Pope John XXIII
86. “You are not here merely to make a living.
You are here in order to enable the world to live
more amply, with greater vision, and with a finer
spirit of hope and achievement. You are here
to enrich the world, and you impoverish yourself
if
you forget the errand.”
--Woodrow Wilson
Practice: Serve
87. “You are not here merely to make a living.
You are here in order to enable the world to live more
amply, with greater vision, and with a finer spirit of
hope and achievement. You are here to enrich the
world, and you impoverish yourself if
you forget the errand.”
--Woodrow Wilson
Real meaning comes from committing
to something greater than oneself
that makes a lasting difference.
Practice: Serve
88. “You are not here merely to make a living.
You are here in order to enable the world to
live more amply, with greater vision, and with
a finer spirit of hope and achievement. You
are here to enrich the world, and you
impoverish yourself if
you forget the errand.”
--Woodrow Wilson
Practice: Serve
90. Lesson 35: 2012
Eliminate “We’s and They’s” at all levels—
stress unity of purpose
Pharmacists versus
Technicians
B.S. versus Pharm.D.’s
Pharmacists versus
Clinicians
Inpatient versus Outpatient
Management versus Staff
92. Be Tough on Principles/Issues;
Soft on People
Lesson 37: 2014
“And I like the idea of respecting
the sacred bond that exists
between musician and listener.”
--Moby
Enforce the PRINCIPLE
without violating the
PERSON.
dignity
generosity humanity
indispensable
93. “Regarding Dean Smith, the iconic coach of
North Carolina basketball who recently
passed away. One thing I noticed was that
Coach Smith taught his players to point to the
passer, person who made the assist – not the
one who made the basket. He had his team
notice the person usually left unnoticed.“
Lesson 38: 2015
Recognize the “Unnoticed”
Not only know how coumadin interacts with aspirin but how David should interact with Sally.
Not only know how coumadin interacts with aspirin but how David should interact with Sally.
Less Than Words Can Say p. 21 Ruly obedient; orderly
Conservative, traditional; Disciplined, Strong; Innovative, Aesthetic products, Visionary; Fun, Unorthodox, Customer-driven, Thrifty; Laid-back, Casual, nonconforming, comfortable.
One important element of any culture is its customs, stories, and idiosyncrasies.
From Those Guys Really do Have Fun: Inside the World of ESPN.
From 2500 Anecdotes.
From 2500 Anecdotes. Video From Charles Clark, Janitor, High School, Texas
See Hamilton Change Slide 5
More personal and grand. May 25, 1961, before a session of Congress.
Second quote from The Enlightened Leader Eric Lucas article in Leadership Essentials File
From Lynchpin Seth Godin pages 230 and 213
http://kalobgriffinband.com/2011/09/without-moby-or-moby-dick-it-would-just-be-another-common-story/