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Pharmacy Management–Statements 309
ASHP Statement onthe Rolesand Responsibilities
of the Pharmacy Executive
Position
The American Society of Health-System Pharmacists(ASHP)believes that complex hospitals and health systems benefit from having a pharmacy executive responsible for the design, operation, and improvement of their organiza-tion‟s medication-use proce.This individual(sometimes referred to as the “chief pharmacy officer” but hereafter “the pharmacy executive”)must be properly positioned within the organization to ensure the best utilization of his or her expertise in all decisions regarding medication use.To pro-mote effective communication, collaboration, and teamwork with peers, the pharmacy executive should
the organization‟s strategic initiatives and addre system-wide iues regarding medications and medication use.Qualifications and Responsibilities of the
Pharmacy Executive
The pharmacy executive is a profeionally competent, le-gally qualified pharmacist.He or she must be thoroughly knowledgeable about and have experience in hospital phar-macy practice and management.Additional qualifications might include completion of a pharmacy residency program accredited by ASHP, an advanced management degree(e.g., M.B.A., M.H.A.), or an administrative specialty residency.What distinguishes the pharmacy executive from the established director of pharmacy position is a deeper knowl-edge of the organization‟s operations as well as a greater degree of involvement in the organization‟s strategic plan-ning and decision-making procees.The pharmacy ex-ecutive provides the organization with pharmacy‟s unique clinical and busine perspectives in discuions and deci-sions related to changes in medical and surgical practice and operational changes.3 He or she has experience leading evidence-based decision-making about drug use, controlling pharmaceutical expenses while maximizing patient benefit through the formulary system.The pharmacy executive has in-depth knowledge of the pharmaceutical supply chain, clinical therapeutics, physician prescribing habits, the med-ication-use proce, medication-use policy, and the technol-ogy used to deliver and support patient care and about how those iues affect the overall succe of the organization.The pharmacy executive understands the relationships be-tween third-party requirements, coding, documentation, bill-ing equations, pricing updates, and organizational resources and can provide quality aurance for all these functions, improving financial performance.4
The pharmacy executive‟s responsibilities include but are not limited to the following: strategic planning;design-ing, managing, and improving the medication-use system;ensuring quality outcomes through performance-improve-ment activities;leading drug-utilization efforts;optimizing use of information systems and technology;managing the pharmaceutical supply chain, pharmacy department finan-cial operations, and human resources;ensuring compliance
with regulatory and accreditation requirements;fulfilling the organization‟s research and educational miions;and pro-viding institutional representation and leadership.5 The phar-macy executive fulfills these responsibilities through his or her own actions, proper delegation to competent individuals on his or her staff, and collaborative efforts with other health care profeionals.•••••
Be involved in the organization‟s strategic planning regarding all components of the medication-use pro-ce,Report directly to the organization‟s principal execu-tive(e.g., chief executive officer [CEO], chief operat-ing officer [COO]),Have a title internally consistent with others reporting at that organizational level,Participate in regularly scheduled CEO-or COO-level meetings, and
Be a member of the medical executive committee(or its equivalent).Background
Hospitals and health systems are complex organizations.Executive-level decisions that affect the medication-use system are made at a rapid pace, often with profound im-plications for patient care, patient safety, and the health system‟s fiscal well-being.The pharmacy executive must be properly positioned within an organization to ensure the best utilization of his or her expertise in decision-making that affects the policies, procedures, and systems that support safe, effective, and efficient medication use.When pharmacy leadership reports directly to the principal executive rather than through multiple layers of manage-ment, the quality and timeline of information exchange improve significantly.Pharmacy leaders can more actively engage in critical decision-making and will be more effec-
tive in helping the health system anticipate and addre rapid change.Significant changes in pharmacy practice, health care, and health-system management over the past 20 years have dramatically transformed the traditional role of the pharmacy director.1 More widespread use of the title “chief pharmacy officer” was first proposed in 2000 in an attempt to enhance the contribution pharmacy makes to patient care by creating organizational parity between the pharmacy executive and other chief officers(e.g., chief nursing, medical, and infor-mation officers).2 When the pharmacy executive works col-laboratively with others at this executive level, the pharmacy department is better positioned to effectively contribute to
Strategic Planning.The pharmacy executive aees the health care environment, identifying opportunities to improve medication use and medication-use systems.In the organiza-tion‟s strategic planning, he or she provides pharmacy‟s per-spective on how changes in the use of pharmaceuticals and related technology may affect systems in the future.310
Pharmacy Management–Statements
ucts are safe, cost-effective, and timely.The pharmacy ex-ecutive is also responsible for emergency preparedne of the supply chain.Medication-Use System Management.The pharmacy exec-utive is responsible for overseeing the design, implementa-tion, and management of a safe and effective medication-use system.He or she ensures that systems are developed and improved based on evidence and best practices, operate ef-fectively and efficiently acro the continuum of care, and are continuously evaluated and improved using contempo-rary quality-improvement methods.The pharmacy executive is responsible for developing plans for the continued opera-tion of medication-use systems and for the provision of phar-maceutical services during emergencies and disasters.Financial Management.The pharmacy executive manages the health-system pharmacy‟s financial performance within the context of the broader health system.He or she develops budgets aligned with organizational and departmental ob-jectives and monitors financial performance appropriately, performing financial audits and analysis as needed to ensure accurate, appropriate, and timely recording and claifica-tion of actual revenue capture and expenses.Quality Outcomes and Performance Improvement.The pharmacy executive ensures that the medication-use system is continuously evaluated and improved using contemporary quality-improvement methods.The pharmacy executive pro-vides leadership at the organizational level to ensure that phar-macists are positioned to improve the quality and safety of medication use throughout the health system.The pharmacy executive(or his or her designee)should be a member of all of the institution‟s key committees responsible for performance-improvement activities related to medication use and patient safety.The pharmacy executive and his or her staff must be intimately involved in all improvement initiatives involving medication use.The pharmacy executive should give particu-lar attention to patients in high-risk areas(as identified by organizations such as the Centers for Medicare and Medicaid Services and the Joint Commiion)to ensure that pharmacy services meet patient care needs and that drug therapy is as safe, effective, and economical as poible.The pharmacy executive(or a designee)is a member and active participant of the infection control committee and ensures that infection control principles are applied to the prescribing, dispensing, and administration of antimicrobials.Human Resources Management.The pharmacy executive manages the health-system pharmacy‟s human resource ef-forts.These efforts include determining the appropriate num-bers and types of staff required to meet patient care needs, satisfy regulatory and accrediting requirements, and achieve the institution‟s miion.The pharmacy executive ensures effective and timely staff recruitment, orientation, training, education, mentoring, career development, performance re-view, and retention efforts.Regulatory and Accreditation Compliance.The pharmacy executive ensures continued compliance with all national, state, and local regulations related to medications and their use.He or she is responsible for the implementation of Joint Commiion medication management standards and National Patient Safety Goals related to medications;for maintaining ASHPaccreditation,whereapplicable(e.g., residency and technician training);and for the implementa-tion of best practices.Research and Educational Miions.The pharmacy ex-ecutive has an integral role in supporting the organization‟s research and educational miions by overseeing investiga-tional drug services, fostering staff and resident research, and managing student and residency educational programs.Drug-Utilization Management.The pharmacy executive collaborates with peers to develop drug-utilization and for-mulary initiatives that optimize therapeutic outcomes, reduce the risk of drug-related problems, and ensure the use of cost-effective pharmacotherapy throughout the health system.He or she identifies inappropriate utilization and leads efforts to modify practices to improve medication use.Institutional Representation and Leadership.The phar-macy executive demonstrates the personal leadership quali-ties and busine acumen eential to operate effectively withinthehealthsystemandtoadvancetheprofeion and practice of pharmacy.He or she serves as the primary pharmacy representative on relevant committees of the or-ganization‟s leaders to ensure that medication-use systems and pharmaceutical services meet the needs of patients and health care providers acro the continuum of care.The pharmacy executive aumes a leadership role withinthe profeion through active participation in local, state, and national profeional aociations.Informatics and Technology.The pharmacy executive lever-ages technology and automated systems to optimize the med-ication-use system.He or she has responsibility for ensuring that information systems and technology used in the pharmacy and patient care environments maximize the safety, effective-ne, and efficiency of medication prescribing, dispensing, and administration.The pharmacy executive provides leader-
ship at the organizational level regarding planning, purchas-ing, implementing, and maintaining information systems that support patient care(e.g., electronic health records, comput-erized prescriber-order-entry systems, smart pumps).Conclusion
Complex hospital and health systems should have a phar-macy executive responsible for the design, operation, and improvement of the organization‟s medication-use proce.This individual must be properly positioned within the orga-nization to ensure the best utilization of his or her expertise in all decisions regarding medication use.Supply Chain Management.The pharmacy executive is re-sponsible for all pharmaceutical contracting, procurement, receiving, security, inventory control, diversion prevention, and distribution policies, including reverse distribution and other methods of pharmaceutical waste disposal.He or she ensures that the methods used to contract and obtain prod-
Pharmacy Management–Statements 311
References
1.Nold EG, Sander WT.Role of the director of phar-
macy: the first six months.Am J Health-Syst Pharm.2004;61:2297–310.2.Godwin HN.Achieving best practices in health-system
pharmacy: eliminating the „practice gap.‟ Am J Health-Syst Pharm.2000;57:2212–3.3.Anderson RW.Health-system pharmacy: new practice
framework and leadership model.Am J Health-Syst Pharm.2002;59:1163–72.4.Mitchell CL, Anderson ER, Braun L.Billing for in-
patient hospital care.Am J Health-Syst Pharm.2003;60(suppl 6):8–11.5.Ivey MF.Rationale for having a chief pharmacy of-
ficer in a health care organization.Am J Health-Syst Pharm.2005;62:975–8.Developed through the ASHP Council on Pharmacy Management and approved by the ASHP Board of Directors on March 7, 2008, and by the ASHP House of Delegates on June 10, 2008.John E.Clark, Pharm.D., Rosario(Ru)J.Lazzaro, M.S., and Douglas A.Miller, Pharm.D., are gratefully acknowledged for draft-ing this statement.Copyright © 2009, American Society of Health-System Pharmacists, Inc.All rights reserved.The bibliographic citation for this document is as follows: American SocietyofHealth-SystemPharmacists.ASHPstatementonthe roles and responsibilities of the pharmacy executive.Am J Health-Syst Pharm.2009;66:499–502.
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