Leadership and Growth Opportunities for Clinical Pharmacists

The role of lead pharmacist provides a pathway to leadership.

For almost a decade, the profession of pharmacy has been discussing and planning for a potential shortage in leadership. In 2005, the American Journal of Health-System Pharmacy published a survey summary assessing the current and future supply of candidates for leadership roles in pharmacy, defined as pharmacy directors and middle managers. Of the survey population, only 30% of current practitioners were interested in pursuing a leadership position in the future. The concerns regarding future leadership were raised in light of a projected vacancy of more than 70% of current leadership roles. Recruitment was singled out as one of the most challenging aspects of identifying future leaders. One recommendation of the report was that current practitioners pursue alternative leadership opportunities.¹

Why Lead Pharmacists?

One method that could be utilized to fill a potential gap in leadership is the implementation of a lead pharmacist role. The introduction of lead pharmacists is a single solution that can address multiple needs. In addition to serving as a way to identify and develop future leaders, the implementation of lead pharmacists can provide an immediate benefit to an organization. In coordination with their manager, the lead pharmacist can serve as an extension of their respective manager or assistant director, depending on the organization structure, thereby allowing for greater depth of influence and knowledge of a practice area. Additionally, these roles allow for more formal leadership training to occur in a supervised manner and can be a method of succession planning.

The department of pharmacy at the University of North Carolina Hospitals (UNCH) is one hospital that has implemented the lead pharmacist role. The current model of lead pharmacists at UNCH initiated from a requirement by the North Carolina Board of Pharmacy. The design and implementation of the position in the outpatient retail pharmacy setting produced benefits for the management structure within these areas and provided growth opportunities for staff. After this initial success, lead pharmacist positions were implemented in inpatient areas, both operational and clinical.

Ideally, the individual has practiced as a clinician or in an operational role prior to transitioning into a lead position and is typically informally recognized by colleagues as a leader. Extensive knowledge of an area of practice is vital to the success of a lead pharmacist position. Understanding the details of workflow and common issues encountered by the staff are valuable assets that can lead to

success in the position.

The complexity and size of

many health systems continue to expand as does the scope of many leadership positions. As a result, managers often find it challenging to maintain a consistent presence in their operational areas. Lead pharmacists can provide a more consistent day-to-day presence within the specific work

area and, as a result, can often troubleshoot issues in real time. Some organizations have seen expansion of pharmacy services into nontraditional practice sites or new facilities outside of the main organization. These areas may not be large enough to warrant an entire management structure but can be the perfect opportunity for appointing a lead pharmacist to serve as the site contact and lead day-to-day operations in an area. Additionally, the rapid growth

and change within health care requires extensive planning. Lead pharmacists can provide managers with additional time for planning functions and operational insights necessary for appropriate plans.

Role and Responsibilities

The specific duties and responsibilities of a lead pharmacist position should vary between practice settings and provide flexibility for the manager to align the position to fit their specific needs. Potential responsibilities or duties include:

• Day-to-day availability in the practice area
• Resolution of time-sensitive issues
• Vision planning/operational planning with manager
• Providing assistance with operational tasks
• Refinement or development of work flow
• Assistance with human resources tasks
• Leading and/or organizing team meetings
• Leading projects or initiatives for team
• Coordinating or tracking progress of ongoing projects and programs
• Manager back-up during vacancy

Initially, many of these roles will require the manager to invest time in training the lead pharmacist. Staff members also will need time to adjust to having a new leader involved in issue resolution and decision-making. For instance, the lead pharmacist and manager must focus on the development of trust in each other’s ability to determine which issues require intervention by a manager and which issues can be resolved by the lead pharmacist. Simultaneously, success is dependent upon the staff becoming comfortable with answers provided by the lead pharmacist and not the manager.

Human resources tasks can be some of the most time-consuming functions a manager is required to complete. Engaging a lead pharmacist in some of these roles can produce significant relief for the manager. For example, the lead pharmacist can conduct interviews for new staff, including candidate screening. Once the new staff member is on-site, the lead pharmacist can become an excellent point of contact for onboarding and training during the orientation period. The lead pharmacist could also assist with professional development plans, corrective action, and annual performance evaluations.

Challenges and Considerations

For all the potential benefits a lead pharmacist role can provide, it is not without its challenges. Involving staff members early as the position is developed and seeking their feedback regarding the selection can help promote support for the position. There is potential for flexibility in the design of these positions, with the most common being a continuation of clinical or operational practice with a minimum commitment of time for lead responsibilities. Dedicating time for new tasks and responsibilities will result in a need for coverage in the practice setting from other pharmacists.

The selection method will be organization-specific as some could require that a lead pharmacist be processed as an entirely new position while other organizations could consider it simply a change in a working title. Depending upon organizational policies, these positions may be permanent position changes or term-based appointments (eg, 12 months). Engagement with the human resources and compensation departments early in the process will ensure a more smooth transition for the position and that any change is in line with organizational policies.

Once the title and process have been arranged with human resources, engaging staff in the process of designing position responsibilities and selecting their leaders is an important step that can help affirm support for the position. Whenever possible, employees should be able to participate in the process. At minimum, their feedback should be solicited by the manager or a formal interview could be conducted for the selection.

After a lead pharmacist is selected, he or she will often need to undergo some form of leadership development training. Utilization of a departmental or organizational training program is an ideal place to start. National pharmacy organizations also have a variety of leadership training resources available, often at little or no cost. During the onboarding process it also will be important to outline specific responsibilities and establish a regular meeting time. It can take time to establish position responsibilities and for the candidate to develop proficiency. Often the new responsibilities can overlap with the manager’s former or current responsibilities. It is essential that this overlap is noted and discussed. Failure to specify responsibilities can result in significant frustration and incomplete tasks.

From this point forward, the manager and the lead pharmacist should do much of the vision planning and goal setting as a partnership. It will be important that the lead pharmacist is aware of the plans and vision so he or she can support and reinforce these with the rest of the staff.

Throughout this entire process, a significant amount of patience is necessary from all parties. Commitment to developing the team, including the new leader, must be modeled by the manager. The staff may need time to adjust to the new process and to having a new leader in the group. They will have to develop trust in the decision-making process. The manager must reinforce the role of the lead pharmacist and support their decisions. It is helpful if the manager and new leader establish a regular dialogue to review specific scenarios and potential solutions and debrief after decisions are made by the new leader.

The establishment of a lead pharmacist position can be a mutually beneficial endeavor for both the manager and the staff as a whole. Career advancement opportunities and professional development are long-term outcomes of a well-designed lead pharmacist position. Current leadership benefits greatly from additional leadership support and greater insight into the needs and expectations of the frontline staff. Lead pharmacist position descriptions must be designed with both the needs of the team and the manager in mind, and the leader selected should be able to meet both. Involvement and feedback from staff will help to ensure a smooth transition and a successful position in the long term.

Kayla M. Hansen, PharmD, MS, BCPS, where she previously served as a medication safety officer. She earned her doctor of pharmacy at Drake University and her master of science in health pharmacy administration fro the Ohio State University.