Hospital Pharmacy - July/August 2018 - 228

228

Pharmacy Organizational Change at
the OSUWMC
The OSUWMC pharmacy enterprise currently consists of 18
pharmacy locations, a staff of over 500 people, and expense
and revenues reaching $360M and $1.2B respectively. With
recent growth throughout the organization, it was critical for
an organizational restructure to better facilitate one unified
vision throughout the medical center and create an alignment
of the key pharmacy areas of patient care services, operations, quality and safety, business operation, informatics, and
academic integration.
The process to revise the net-neutral FTE (full-time
equivalent) pharmacy organizational structure began in
March 2016 with the appointment of a staff committee by the
OSUWMC senior leadership to spearhead the restructure,
organization, and timelines. The committee was comprised
of current associate pharmacy directors, nursing director,
pharmacy specialists, college of pharmacy department chair,
and human resource representative. The general operating
principles that guided the committee's work included (1)
think broadly about the department as a whole-one that
crosses over many service lines and departments; (2) foster
relationships among the members characterized by mutual
trust, responsiveness, flexibility, and open communication;
(3) do not place any names with any part of the organizational chart-think about the function and structure of our
department first, with specific names for positions being a
larger leadership decision; (4) commit to spend the time and
energy to carry out the committee's purpose; (5) be prepared
to listen intently to the concerns of others and identify with
the interests represented; (6) ask questions to seek clarification to understand fully the committee members views and
concerns; (7) regard disagreements as problems to be solved
rather than battles to be won; and (8) be prepared to think
differently and develop a creative solution to address the
many differences/needs within our pharmacy program.
In early September 2016, the new framework of the structure created by the committee was approved by the
OSUWMC senior leadership. The leadership also approved
the department to operate with an integrated administrative
structure divided into 5 broad areas: Patient Care Services,
Enterprise Operation Services, Safety and Quality, Pharmacy
Informatics, and Finance and Supply Chain. The patient care
services line focuses on patient care teams connected to various services lines; the enterprise operations line focuses on
the foundational aspects of pharmacy profession: dispensing
a pharmaceutically elegant product; the clinical education
and research line focuses on the valued relationship with the
College of Pharmacy and assuring competency of our entire
staff, residents, and students in all areas of practice; the
safety, quality, compliance, and policy line will focus on
integrating our medication safety program with other quality
programs (both internal and external) to the department; the
pharmacy informatics line will be integrated across all

Hospital Pharmacy 53(4)
business units to provide for a more united and standard
approach to technology management.
The next steps for the department included developing a
broad communication plan for steps moving and interviewing and hiring positions internally into the five new roles.
Once the 5 new director positions are filled, the department
will sequentially implement the rest of the structure until the
process is complete.

Leadership Strategies to Overcome
Potential Challenges of Organizational
Changes
Although change models have been used successfully by
many organizations, there are times that they do not succeed.
Aiken and Keller claim that most failures (ie, failure to
achieve the desired change or unsuccessful in sustaining the
change) result from a lack of understanding of certain predictable elements of human nature by leaders.4 One overwhelming topic surrounding structure reorganization is
change; people do not like change. As a leader, it is your job
to lead this change, and lead it with confidence and positivity
throughout the entire process.
Before the structure reorganization at the OSUWMC, the
pharmacy department struggled with fragmented communication and a disenfranchised feel from certain areas of the
department. There was not a standard approach to the pharmacy practice model or procedure. It was vital for the leadership team at the OSUWMC to be aware of the weakness of
the department before the restructure and use the restructure
as a way to better communication efforts and inspire a unified feel. The biggest undertaking for the department was
getting all staff to be open for the department to become a
shared services department. There have been many obstacles
along the way; however, with a structure plan, determined
focus, and support from senior leadership, we hope to elevate
the department beyond its current level of national
prominence.
Throughout any structure reorganization process, there
are many potential challenges that leaders may have to face.
These key findings and related challenges and strategies are
briefly summarized below:
1.

Timing: The timing of an organizational restructure
can be complicated. The first and foremost important
strategy is to make sure the timing of the restructure is
right-not just for the leaders but for the organization
and the staff. With organizations that have many layers
of managers, directors, and senior leaders, the timeline
may get lengthened, but it is important to make a timeline in the beginning and allow for changes. It is
important for not only the leaders to exhibit patience
but to ask of patience from the employees. The leadership team should portray the change and timeline with
an optimistic attitude at all times.



Table of Contents for the Digital Edition of Hospital Pharmacy - July/August 2018

Ed Board
TOC
Antibiotic Stewardship: The Health of the World Depends on It
ISMP Medication Error Report Analysis: CycloSPORINE Dispensing Errors
ISMP Adverse Drug Reactions
Summaries of Safety Labeling Changes Approved By FDA: Boxed Warnings Highlights January-March 2018
Restructuring a Pharmacy Department: Leadership Strategies for Managing Organizational Change
Angiotensin II
RxLegal: A Rapid Review of Right-To-Try
New Medications in the Treatment of Hereditary Transthyretin Amyloidosis
Significant Published Articles for Pharmacy Nutrition Support Practice in 2017
Utilization of Lean Techniques in Pharmacy Residency Training: Modifying the PGY1 Management and Leadership Experience
Impact of a Clinical Decision Support Tool on Cancer Pain Management in Opioid-Tolerant Inpatients
Lyme Carditis: A Case Report and Review of Management
Impact of the Implementation of Project Re-Engineered Discharge for Heart Failure patients at a Veterans Affairs Hospital at the Central Arkansas Veterans Healthcare System
Evaluation of Oritavancin Use at a Community Hospital
Hospital Pharmacy - July/August 2018 - Cover1
Hospital Pharmacy - July/August 2018 - Cover2
Hospital Pharmacy - July/August 2018 - 201
Hospital Pharmacy - July/August 2018 - 202
Hospital Pharmacy - July/August 2018 - 203
Hospital Pharmacy - July/August 2018 - 204
Hospital Pharmacy - July/August 2018 - 205
Hospital Pharmacy - July/August 2018 - Ed Board
Hospital Pharmacy - July/August 2018 - 207
Hospital Pharmacy - July/August 2018 - TOC
Hospital Pharmacy - July/August 2018 - 209
Hospital Pharmacy - July/August 2018 - 210
Hospital Pharmacy - July/August 2018 - 211
Hospital Pharmacy - July/August 2018 - 212
Hospital Pharmacy - July/August 2018 - 213
Hospital Pharmacy - July/August 2018 - Antibiotic Stewardship: The Health of the World Depends on It
Hospital Pharmacy - July/August 2018 - 215
Hospital Pharmacy - July/August 2018 - 216
Hospital Pharmacy - July/August 2018 - ISMP Medication Error Report Analysis: CycloSPORINE Dispensing Errors
Hospital Pharmacy - July/August 2018 - 218
Hospital Pharmacy - July/August 2018 - 219
Hospital Pharmacy - July/August 2018 - ISMP Adverse Drug Reactions
Hospital Pharmacy - July/August 2018 - 221
Hospital Pharmacy - July/August 2018 - 222
Hospital Pharmacy - July/August 2018 - Summaries of Safety Labeling Changes Approved By FDA: Boxed Warnings Highlights January-March 2018
Hospital Pharmacy - July/August 2018 - 224
Hospital Pharmacy - July/August 2018 - Restructuring a Pharmacy Department: Leadership Strategies for Managing Organizational Change
Hospital Pharmacy - July/August 2018 - 226
Hospital Pharmacy - July/August 2018 - 227
Hospital Pharmacy - July/August 2018 - 228
Hospital Pharmacy - July/August 2018 - 229
Hospital Pharmacy - July/August 2018 - Angiotensin II
Hospital Pharmacy - July/August 2018 - 231
Hospital Pharmacy - July/August 2018 - 232
Hospital Pharmacy - July/August 2018 - 233
Hospital Pharmacy - July/August 2018 - RxLegal: A Rapid Review of Right-To-Try
Hospital Pharmacy - July/August 2018 - 235
Hospital Pharmacy - July/August 2018 - New Medications in the Treatment of Hereditary Transthyretin Amyloidosis
Hospital Pharmacy - July/August 2018 - 237
Hospital Pharmacy - July/August 2018 - 238
Hospital Pharmacy - July/August 2018 - Significant Published Articles for Pharmacy Nutrition Support Practice in 2017
Hospital Pharmacy - July/August 2018 - 240
Hospital Pharmacy - July/August 2018 - 241
Hospital Pharmacy - July/August 2018 - 242
Hospital Pharmacy - July/August 2018 - 243
Hospital Pharmacy - July/August 2018 - 244
Hospital Pharmacy - July/August 2018 - 245
Hospital Pharmacy - July/August 2018 - 246
Hospital Pharmacy - July/August 2018 - Utilization of Lean Techniques in Pharmacy Residency Training: Modifying the PGY1 Management and Leadership Experience
Hospital Pharmacy - July/August 2018 - 248
Hospital Pharmacy - July/August 2018 - 249
Hospital Pharmacy - July/August 2018 - 250
Hospital Pharmacy - July/August 2018 - 251
Hospital Pharmacy - July/August 2018 - 252
Hospital Pharmacy - July/August 2018 - 253
Hospital Pharmacy - July/August 2018 - 254
Hospital Pharmacy - July/August 2018 - 255
Hospital Pharmacy - July/August 2018 - Impact of a Clinical Decision Support Tool on Cancer Pain Management in Opioid-Tolerant Inpatients
Hospital Pharmacy - July/August 2018 - 257
Hospital Pharmacy - July/August 2018 - 258
Hospital Pharmacy - July/August 2018 - 259
Hospital Pharmacy - July/August 2018 - 260
Hospital Pharmacy - July/August 2018 - 261
Hospital Pharmacy - July/August 2018 - 262
Hospital Pharmacy - July/August 2018 - Lyme Carditis: A Case Report and Review of Management
Hospital Pharmacy - July/August 2018 - 264
Hospital Pharmacy - July/August 2018 - 265
Hospital Pharmacy - July/August 2018 - Impact of the Implementation of Project Re-Engineered Discharge for Heart Failure patients at a Veterans Affairs Hospital at the Central Arkansas Veterans Healthcare System
Hospital Pharmacy - July/August 2018 - 267
Hospital Pharmacy - July/August 2018 - 268
Hospital Pharmacy - July/August 2018 - 269
Hospital Pharmacy - July/August 2018 - 270
Hospital Pharmacy - July/August 2018 - 271
Hospital Pharmacy - July/August 2018 - Evaluation of Oritavancin Use at a Community Hospital
Hospital Pharmacy - July/August 2018 - 273
Hospital Pharmacy - July/August 2018 - 274
Hospital Pharmacy - July/August 2018 - 275
Hospital Pharmacy - July/August 2018 - 276
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