Leading Yourself: Utilizing the Pearls from Stephen Covey to Improve Pharmacy Practice

1. Leading Yourself: Utilizing the Pearls from Stephen Covey to Improve Pharmacy Practice Pharmacy Managers Monthly Conference Call Michael P Reed Jr., PharmD, Clinical Pharmacist VA Western NY Healthcare System Rita Case, PharmD, Clinical Coordinator VA Hudson Valley Healthcare System

2. At the end of the presentation participants should: • Understand the 3 habits of interdependence and apply examples of pharmacy practice to each habit • Understand why win/win is the best habit when relationships are vital to success • Understand what empathic listening is and how to apply this skill to pharmacy practice • Explain how a team can outperform its individual members collectively and understand how synergize is successfully applied to pharmacy practice • Explain the dimensions used to sharpen the saw

3. PLA Overview • 9 modules, 6 weeks each – all online • Each module has a different theme • Discussion Thread • Personal Journal • Group Projects • Diverse Background of Participants & Faculty

4. Paradigms of Interdependence The Emotional Bank Account

5. Paradigms of Interdependence Emotional Bank

6. The Habits of Interdependence

7. Habit 4 – Think Win/Win Principles of Interpersonal Leadership

8. 6 Paradigms of Human Interaction Win Win Win Lose Human Interaction Lose Win Lose Lose No Deal Win When relationships are vital to your success, Win/Win is the solution

9. 5 Dimensions of Win/Win Model Character Relationship Agreement Supportive System & Process Covey, Steven R.  The 7 Habits of Highly Effective People: Powerful Lessons in Personal Change.  New York: Free Press, 2004

10. 4 Steps to Win/Win • See the problem from the other point of view; • Identify the key issues and concerns; • Determine what results would make an acceptable solution; • Identify options to achieve results. You can only achieve Win/Win solutions using Win/Win procedures

11. Scenario: Patient Satisfaction Patient satisfaction scores have decreased due to patients stating excessive wait times to receive chemotherapy.  Patients receiving 4 chemotherapy agents may spend 6 - 8 hours at the VA if they have labs drawn and visit the MD on the same day of treatment.  Patients feel the time spent is excessive because they wait to have labs drawn, wait to see the MD and wait for pharmacy to mix their medications. Turn this scenario into a Win/Win agreement.

12. Habit 5 – Seek First to Understand, Then to Be Understood Principles of Empathetic Communication

13. Habit 5 – Seek First to Understand, Then to Be Understood What is Empathetic Listening?

14. Habit 5 – Seek First to Understand, Then to Be Understood You Must Diagnose Before You Can Prescribe Seek to Understand

15. Habit 5 – Seek First to Understand, Then to Be Understood • Then Seek To Be Understood Character Empathy Logic

16. Habit 5 – Seek First to Understand, Then to Be Understood Keys To One On One Communication

17. Scenario: Empathetic Listening As a Clinical Pharmacy Specialist, you are providing an anticoagulation service for a patient who has not been compliant with her prescribed therapy. She is reluctant to talk and is apprehensive about allowing you to check her INR level. How can you use Empathic Listening to Improve Patient Outcomes?

18. Scenario: Staff Morale • How can we manage staff burnout? Photo from www.lancastergeneralhealth.org

19. Habit 6 – Synergize Principles of Creative Cooperation

20. Habit 6 – Synergize Synergy is when the total is greater than the individual parts

21. Scenario: Diabetic Education Clinic • The physician refers the patient for follow up • Patient is seen by the PACT Pharmacist and a Dietitian • Patient is provided with an initial assessment and a detailed plan to follow As a group more is accomplished including glucose monitoring, personal care, exercise, sick days, nutrition, and medication management.

22. Habit 6 – Synergize High Synergistic (Win/Win) Respectful (Compromise) Defensive (Win/Lose or Lose/Win) Low Low High

23. Habit 6 – Synergize • Pooling desires and seeking the third alternative is a major paradigm shift from the either/or mentality. • The outcome is greater than any option individually

24. Habit 6 – Synergize Realizing that the answer to a problem is not either one way or the other but can be an entirely new solution that accomplishes more

25. Scenario: Patient Care Rounds You are a member of the hospital’s Heart Failure pharmacy team. A new patient has been diagnosed, and your team has been consulted to provide education to this new patient on his medications and how they impact his condition. Using Habits 4, 5 & 6 how can you maximize patient care? Think Win/Win – Seek Understanding – Synergize…

26. Public Victory

27. Scenario: Missing Dose A nurse on the surgical care unit calls the pharmacy to inquire about the status of medications for her patient. She states that she has been waiting for an unacceptable amount of time and she wants to talk to you, the pharmacist in charge. The patient is severely nauseated, in pain, and the nurse is very frustrated. How can Habits 4, 5 & 6 be used to improve this interaction?

28. In summary: • THINK WIN/WIN – Vital for successful relationships • SEEK FIRST TO UNDERSTAND, THEN TO BE UNDERSTOOD – Listen with empathy • SYNERGIZE – The outcome is greater than any option individually • Applying these three habits in your daily pharmacy practice will lead to Successful Public Victory!!  

29. Sharpening Your Saw Social/Emotional Mental Spiritual Physical

30. The Physical Dimension “Physical fitness is not only one of the most important keys to a healthy body, it is the basis of dynamic and creative intellectual activity.” -John F. Kennedy

31. The Physical Dimension • Food, rest, relaxation, exercise regularly • Build body in 3 areas: • Endurance • Flexibility • Strength • Preserves and enhances capacity to work and adapt and enjoy • Not a quick fix…long term results • Personal vision

32. Physical – Exercise • Improves all areas of life • Neuron connections, increased energy, reduce stress, beat the disease, re-kindle relationships • Develops relationships • How to do it • Kids – take to park and walk with them • Walking • Pool • Weights • Stretching • Park farther away • Wii®

33. Physical – Nutrition • Lose weight • Eat smaller meals • Leave food on your plate • Types of food • Healthy snacks • Nuts • Fruit • Drink water • Helps you feel better

34. Physical – At Work • Role model for others • Decrease call-outs & sick days • Take the stairs • Schedule it! • More effective at work! • Increases your leadership courage • Leads to other spirituality, social/emotional, and mental improvements

35. The Social/Emotional Dimension “Comfort in expressing your emotions will allow you to share the best of yourself with others, but not being able to control your emotions will reveal your worst.” - Bryant H. McGill

36. Social/Emotional Dimension • This dimension differs from the other three dimensions in that they rely on interpersonal relationships versus relationships within yourself. • “If your emotional abilities aren't in hand, if you don't have self-awareness, if you are not able to manage your distressing emotions, if you can't have empathy and have effective relationships, then no matter how smart you are, you are not going to get very far.” - Daniel Goleman • You as a professional will not only be judged on your technical capabilities, but also on social/emotional qualities such as drive, empathy, communication, and adaptability.

37. Managing Emotions • “Emotional intelligence is managing feelings so that they are expressed appropriately and effectively, enabling people to work together smoothly toward their common goals.”- Daniel Goleman • Personal and Social attributes of emotional intelligence: • Self-awareness • Self-regulation • Self-motivation • Social Awareness • Social Skills

38. Sharpening the Emotional Saw • Renewal of the social/emotional dimension can be done through daily interactions • Interaction may be with your boss, your friend, your co-worker, your subordinate, your spouse, etc. • Overall social/emotional satisfaction comes from “helping others in a meaningful way” • Leads to mental acuity

39. The Mental Dimension “I put my heart and soul into my work, and have lost my mind in the process.” -Vincent Van Gogh

40. Learn and Teach • Publish a paper every few years and peer-review for a journal • Precept/mentor students and residents • Consider online courses that challenge your way of thinking • Continuing to learn can be a source of motivation, stimulation and job satisfaction http://www.humansolutions.org.uk. Accessed 3/2/12

41. Are You Too Comfortable? • Time to step out of your comfort zone • Make a fool of yourself • Face your fears • Become comfortable taking risks • Enjoy the unknown • Expand your mind and your abilities by looking for new and different challenges everyday www.wikihow.com/Step-Out-of-Your-Comfort-Zone. Accessed 3/2/12. www.studentbranding.com

42. Take the Time • Read a great book • Put a challenging puzzle together with your child • Take a vacation to a new destination and get lost in your curiosity • Take the time to relax your brain in creative and enjoyable ways

43. Mental Capacity • Cognitive • Focus, time management, positive and critical thinking skills • Meditation • Deep breathing • Visualization • Rituals • Coaching

44. The Spiritual Dimension of Self Renewal “I have so much to do today, I’ll need to spend another hour on my knees.” - Martin Luther King “The greatest battles of life are fought in the silent chambers of the soul.” - David O. McKay

45. Ways You Can Renew the Spiritual Dimension in Your Life • Daily prayerful meditation • Immersion in great literature or music • Communicate with nature/walking • The more you adopt spiritual principles in your life, the more life becomes an adventure rather than a struggle

46. How Then Do We Enhance Our Spiritual Dimension? • Every moment in our day-to-day interactions provides an opportunity to be more spiritual • We consciously improve our attitude and feelings • We live according to our highest ideals

47. The High Performance Pyramid Spiritual Capacity Rituals Mental Capacity Rituals Emotional Capacity Physical Capacity Adapted from: Loehr, J., Schwartz, T. “The Making of a Corporate Athlete.” HBR. January 2001.

48. “If I had 10 hours to chop down a tree, I’d spend 8 hours sharpening my axe.” -Abraham Lincoln

49. In Summary • Utilizing Habits 4, 5, & 6 can improve interactions within the work environment • Sharpening the saw is important to maintaining and preserving yourself • These habits can result in better leadership within the pharmacy department

50. Contact Information Rita Case, PharmD, ritalee.case@va.gov Michael Reed, PharmD, michael.reed5@va.gov