HIGH PERFORMANCE PHARMACY SM The 8 Dimensions of the High Performance Pharmacy for High Performance SM Pharmacy Education Human Resources Management Leadership Medication Preparation and Delivery Performance Patient Care Services Medication Use Policy Medication Safety
8 Dimensions, Countless Benefits for Hospital Pharmacies. The is a groundbreaking initiative of McKesson and the Health Systems Pharmacy Executive Alliance, a group of well-known health system thought leaders. Based on a landmark study that identifies the core set of best practices for hospital pharmacy performance, the sets a new standard of excellence for hospital executives and pharmacy leaders. There are 8 dimensions of performance that serve as a roadmap in achieving the financial and clinical gains of a. By implementing the systems, programs and processes of each dimension, hospital pharmacies can gain a competitive advantage in today s health system environment. The 8 Dimensions of High Performance are: 1. Leadership 2. Medication Preparation and Delivery 3. Patient Care Services 4. Medication Safety 5. Medication Use Policy 6. Performance 7. Human Resources Management 8. Education About the Health Systems Pharmacy Executive Alliance: The Health Systems Pharmacy Executive Alliance is a collaboration of well-known leaders who are dedicated to advancing hospital pharmacy s contributions to patient safety, clinical quality, and financial performance through increased effectiveness and efficiencies. The Executive Alliance s vision is the advancement of the High Performance Pharmacy SM a concept that enhances and elevates the profession of health system pharmacy, as well as its practice and standing, within health care today and in the future. Active since 1998, the Executive Alliance maintains a strong and prestigious membership. McKesson is proud to sponsor this energetic group. The Executive Alliance, as a body, operates independently from McKesson and takes responsibility for the public positions and publications it issues. The Executive Alliance members include McKesson and non-mckesson customers, representing the entire health system continuum: from internationally known academic centers to community-based hospitals.
Assessing the value of implementing High Performance practices in your pharmacy. As the study was developed, the Executive Alliance recognized that hospital pharmacies needed guidelines to follow while implementing each element of the 8 Dimensions of High Performance. Each element was evaluated on three levels: 1. How many resources are needed and what is the level of investment needed to implement a particular element successfully? 2. on Investment What kind of financial returns can a hospital pharmacy expect to gain as a result of implementing a particular element? 3. Quality and Safety What kind of quality and safety gains can a hospital pharmacy expect to make as a result of implementing a particular element? Value Assessment Legend: The feasibility metric estimates the complexity and the level of effort required to implement an element within one of the 8 Dimensions of High Performance. Metric 3 1 Checkmark 33 2 Checkmarks 333 3 Checkmarks 3333 4 Checkmarks Definition A very simple element to implement, seldom (if ever) requiring financial investment or additional staff. A simple element to implement, requiring a labor investment of 0.5 full-time equivalent (FTE) and/or a minor amount of other direct expenses. A moderately complex element to implement, requiring a labor investment of between 0.5 and 1.0 FTE and/or a moderate amount of other direct expenses. A complex element to implement, requiring a labor investment of >1.0 FTEs and/or a substantial amount of other direct expenses. The financial return metric estimates the level of financial return on investment (ROI) expected from implementing an element within one of the 8 Dimensions of High Performance. Metric Definition No Dollar Signs Minimal ROI or cost-neutral. $ 1 Dollar Sign ROI = <25% of amount invested. $$ 2 Dollar Signs ROI = 25-50% of amount invested. $$$ 3 Dollar Signs ROI = 51-100% of amount invested. $$$$ 4 Dollar Signs ROI = >100% of amount invested. The quality/safety metric estimates the quality and safety benefits resulting from implementing an element within one of the 8 Dimensions of High Performance. This Value Assessment was developed to provide this guidance. Each element of the 8 Dimensions of High Performance is evaluated according to parameters in this assessment. Metric No Stars H 1 Star HH 2 Stars HHH 3 Stars HHHH 4 Stars Definition Implementing this element will yield no measurable improvement in quality or safety. Implementing this element will improve quality or safety slightly, but improvements may be too small to measure. Implementing this element will result in a small improvement in quality or safety. Implementing this element will result in a moderate improvement in quality or safety. Implementing this element will result in a substantial improvement in quality or safety and should be considered a best practice.
Dimension: 1. Leadership Description: Defines the skills required to effectively lead a pharmacy to achieve better outcomes for the entire health system Click on the links below to read more about each element 1. Synergy between leadership and High Performance Pharmacy SM practice 2. Definition of a pharmacy leader 3. Critical components of leadership 4. Assessing a leader s influence 5. Developing a vision 6. The budget 7. Pharmacy leaders as opportunists and risk-takers 8. Putting it all together For more information, please read Leadership Skills for a High-Performance Pharmacy Practice, Zilz et al, Am J Health-System Pharmacy, Vol. 61, December 1, 2004, pp. 2562-2574.
Dimension: 2. Medication Preparation and Delivery Description: Focuses on the safe, efficient delivery of all medications 1. Unit-dose distribution system $$$$ 3333 HHHH 2. Dispensing incorporates machine-readable coding $$$$ 3333 HHHH 3. Pharmacy oversight of medications in all care locations $$$$ 333 HHHH 4. Pharmacy management of investigational medication $$$$ 33 HHHH 5. Chemotherapy preparation in pharmacy $$$ 33 HHHH 6. Medications returns managed by pharmacy $$ 3 HHHH SKY PACMED PakPlus, Horizon Meds Manager, McKesson Connect Link Bar Code Packaging Robot-Rx, MedCarousel, PakPlus, SKY Acu-Dose-Rx Cabinets McKesson Pharmacy Asset Management Horizon Expert Documentation McKesson Specialty McKesson MedSource 7. Reconciliation of controlled substance waste $$ HHH McKesson NarcStation McKesson Electronic Data Translator McKesson Data Exchange McKesson s Electronic Controlled Substance Ordering System (CSOS) Acu-Dose-Rx Cabinets Continued
Dimension: 2. Medication Preparation and Delivery Description: Focuses on the safe, efficient delivery of all medications 8. Dose standardization $$ 333 HHHH 9. Compounding formulations and protocols $ 3 HH 10. Management of automated dispensing cabinets $$$ 33 HHHH 11. Appropriate label components and quality $$ 3 HHHH 12. Safe medication storage $$ 3 HHHH 13. Pharmacy control of medication transport to point of dispensing $$$$ 33 HHHH 14. Integration of distribution and clinical services $$$$ 3333 HHHH 15. Advanced technician roles $$$$ 3333 HHH Acu-Dose-Rx Cabinets MedCarousel Intellishelf-Rx ROBOT-Rx (pharmacy storage) Acu-Dose-Rx Cabinets (floorstock) Automation (ROBOT-Rx, MedCarousel, Acu-Dose-Rx)
Dimension: 3. Patient Care Services Description: Defines the elements of patient care services that can help your pharmacy improve patient care outcomes and deliver significant financial benefits to the entire health system 1. Pharmacist-performed medication histories and reconciliation $$$$ 3333 HHHH 2. Pharmacist role on the patient care team $$$$ 3333 HHHH 3. Discharge counseling and medication reconciliation $$$$ 3333 HHHH 4. Patient care rounding $$$$ 3333 HHHH Horizon Expert Documentation s Medication Reconciliation Module Horizon Physician Portal s Medication Reconciliation Module Horizon PatientVision (for education) Horizon Expert Documentation s Medication Reconciliation Module Horizon Physician Portal s Medication Reconciliation Module Intervention Rx Analytics 5. Mechanism to measure the impact of pharmacists $$$ 33 HHH Rx Analytics 6. Integration of documentation $$$$ 333 HHHH 7. Participation on resuscitation teams $$$$ 333 HHHH 8. Appropriate anti-infective care services $$ 33 HHHH 9. Focus on core quality performance measures $$$ 3333 HHHH 10. Standard medication administration times $$ 33 HHHH 11. Patient Satisfaction Surveys $ 333 HH Horizon Expert Documentation Horizon Physician Portal Horizon Health Summary Clinical Performance Analytics
Dimension: 4. Medication Safety Description: The policies, procedures, and system that ensures safe delivery of medication therapy 1. Bar Code Medication Administration $$$$ 3333 HHHH 2. Clinical decision support based infusion pump technology $$$$ 3333 HHHH 3. High-alert medication policy $$$ 33 HHHH McKesson Connect Link Horizon Care Alerts 4. Safe drug nomenclature $ 33 HHH Horizon Expert Documentation 5. Use of preprinted order sets $$$$ 333 HHH 6. Computerized prescriber order entry $$ 3333 HHHH 7. Computer decision support $$$ 3333 HHHH 8. Availability of patient information $$$ 33 HHHH 9. Pharmacy maintained medication administration record $$$ 333 HHHH 10. Elimination of color-coded systems $$ 3 HHHH $$$$ 333 HHHH 11. Education of allied health professionals on medication safety issues Horizon Care Alerts Horizon MobileCare Messaging Horizon Laboratory Horizon Expert Documentation Horizon Health Summary Horizon Physician Portal
Dimension: 5. Medication Use Policy Description: Identifies the elements your medication use policy should include to comply with various regulatory and statutory requirements and to instill a culture of performance 1. Effective formulary system $$$$ 333 HHHH McKesson High Performance Pharmacy Benchmarking 2. Active Pharmacy and Therapeutics committee $$$$ 333 HHHH 3. Drug shortage systems $$ 33 HHH 4. Effective industry representative policies $$$$ 33 HH 5. Non-Formulary Medication Review $$$$ 333 HHHH 6. Resource utilization management $$$$ 333 HHH McKesson High Performance Pharmacy Benchmarking Rx Analytics 7. Technology assessment services $$$$ 33 HH 8. Forecasting of financial performance $$$$ 333 HHH McKesson High Performance Pharmacy Benchmarking Rx Analytics 9. Medication prescribing policy tools $$$$ 3333 HHHH 10. Drug information services $$$ 333 HHH 11. Communication systems $$$ 333 HHHH 12. Dietary supplement (herbal and nutraceutical) policy $ 3 HHH 13. Medication use evaluation $$$ 333 HHHH 14. Medication samples 3 H
Dimension: 6. Performance Description: Outlines the key programs, systems, and processes that will help your pharmacy maximize its financial contribution to the entire organization 1. Budgeting of pharmaceuticals $$ 3333 HHH McKesson High Performance Pharmacy Benchmarking McKesson Quarterly Business Review 2. performance monitoring and reporting $$ 333 HH McKesson High Performance Pharmacy Benchmarking Rx Analytics McKesson Connect Link McKesson Quarterly Business Review 3. Billing and reimbursement monitoring $$$$ 3333 HH AccessHealth 4. Asset management $$$ 3333 HHH McKesson Pharmacy Asset Management Mobile Manager 100 McKesson Quarterly Business Review 5. Workload and productivity $$ 333 HHH McKesson Provider Technologies Automation Solutions McKesson Quarterly Business Review 6. Charge capture $$ 3333 H 7. Indigent care medication program $$$$ 3333 HHHH McKesson 340B Manager McKesson MedSource McKesson Easy340B
Dimension: 7. Human Resources Management Description: Focused on human resources and best practices for managing your pharmacy staff 1. Pharmacist recruitment $$ 333 HHH 2. Pharmacist orientation guidelines $ 33 HHH 3. Employee competency and concurrent evaluation $$ 33 HHHH 4. Social events, employee morale and recognition $ 33 HH 5. Pharmacist retention $$ 33 HHH
Dimension: 8. Education Description: Educating the future leaders of your pharmacy is crucial to ensuring that your pharmacy remains the standard of excellence and performance 1. Community educational seminars $ 3 HH 2. Interdisciplinary inservices $$ 33 HHH 3. Residency training program $$$$ 3333 HHHH 4. Student clerkship training $$$ 33 HHH 5. Pharmacy technician training and certification $$ 3333 HHHH 6. Pharmacist continuing education $$ 333 HHH
Learn More About the 8 Dimensions of High Performance. A is one that demonstrates the highest levels of patient safety, clinical quality, and financial performance. McKesson and the Health Systems Pharmacy Executive Alliance are committed to furthering the programs, services and practices of the. We hope you will utilize the following 8 dimensions as a critical tool in the success of your health system pharmacy: 1. Leadership 2. Medication Preparation and Delivery 3. Patient Care Services 4. Medication Safety 5. Medication Use Policy 6. Performance 7. Human Resources Management 8. Education Learn more. Visit www. to access all eight summary reports on the 8 Dimensions of.