Millcroft Hospital Pharmacy Leadership Conference - June 1 - 3, 2007

Theme:Leading When the Future is Unknown

Introductions

Neil Johnson
Executive Editor
Hospital Pharmacy in Canada Report
London, ON

Conference chair Neil Johnson extended a welcome on behalf of colleagues at the Hospital Pharmacy in Canada Report Editorial Advisory Board. He encouraged participants to bring questions and comments about the survey and the conference to Board members and managing editors. He noted the attendance of Board Members Jean-François Bussières, Nancy Roberts, Patricia Lefebvre, Patricia Macgregor, Janet Harding and Michele Babich, as well as Managing Editors Chuck Wilgosh and Kevin Hall.

The conference agenda was designed to address emerging hospital pharmacy leadership issues, Johnson explained. The conference will provide insights into current practice, and takeaway messages participants can use locally, provincially, and nationally to move pharmacy practice forward.

Leading When the Future is Unknown

David Ricks
President & CEO
Eli Lilly Canada Inc.

David Ricks introduced himself as a student of leadership in a world where leadership is more of a journey than a destination. “Leadership is identifying the need for change and then driving change against adversity,” he said, quoting former US President Harry S. Truman.

“Identifying change is not about vision,” he continued. “Vision is more about courage and personal discipline.”

Leaders must have the courage to “buck the pundits” when necessary and reject advice that arises from popular assumptions, Ricks said. He provided a recent example. Pundits who were considered “consultants in the know” predicted a dramatic change in the pharmaceutical industry and recommended Eli Lilly acquire significant distribution networks. Eli Lilly followed this advice and spent $5 billion to acquire distribution networks, only to have to sell the networks three years later at a loss of $3 billion.

Leaders must also have the personal discipline to see a plan through. “As leaders we need to think about opportunistic changes as well as visionary changes,” Ricks said. An even greater challenge is to get people to take up the agenda for change. “People are creatures of habit; getting them to do things they don’t want to do is the crux of leadership.”

Eli Lilly’s leadership model was developed in conjunction with Brigham Young University, whose research revealed three principal reasons for failed change efforts. Change fails because people do not see it, do not understand the reasons behind it, or do not follow through.

The failure to identify change has the biggest impact, Ricks said. Part of a leader’s role is to alter the frame through which people examine changing practices and evolving environments. If people do not understand the context for change, they do not recognize why change is important. Reaching agreement about the need for change is not the end of the effort; there can still be fractious debate about what change is needed.

Communicating the chosen path is critical to successful change management, Ricks said. So too is the need to compromise. “Quite often commitment to the cause is more important than the fine details. It’s important to build broad coalitions and to be open to compromise.”

Failure to finish is often a fatal flaw in driving change, Ricks observed. “Smart people like change, and sometimes the temptation is to see the change, make it, then move on to the next change. It’s tempting to move on to the next shiny object.”

Ensuring that change is well embedded within a system or organizational culture is crucial, he said. All the hard work and concerted effort involved in identifying, contextualizing, and moving change is for naught if the change does not “stick.”

The last piece in the process is dealing with adversity. The most difficult component of leading change is coping with the necessary tradeoffs. The challenge is to maintain balance, such as the balance between short- and long-term wins, between what is right for the individual and what is right for the organization, and between listening to team members and knowing when to act.

Ricks said the Millcroft Hospital Pharmacy Leadership Conference was an exciting opportunity. Canadians should be proud of their health care system, while being cognizant of changing demographics. When the system was built, there were seven workers for every citizen over the age of 65. Today, there are four-and-a-half, and by 2025, there will be only two.

The needed changes are profound and fundamental, Ricks concluded.

 • The payer model must be changed.
 • The ratio of physicians to the population must improve.
 • Information and therapeutic technology must be seamlessly integrated into the health system.
 • The approach to chronic disease must change.

Most important, all of these changes must be viewed as investments in the future, rather than as expenditures. “Our role as leaders is to identify the issues, not to be afraid of change, and to be ready to face the adversity that may come in the face of it,” Ricks said.