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Fridays with Ambulatory Care: How to build a highly functioning Ambulatory Practice Site
How to build a highly functioning Ambulatory Practice Site... In 4 easy steps. ;+)

I wish it was that easy. Clearly, there are several keys to building a well-coordinated Ambulatory Practice.

The first is to put in the work personally to understand your strengths and build a strong ambulatory care knowledge base. There is no short cut to this expertise. Whether you go the residency route or start from the ground up in an organization with multiple mentors, you have to put in many hours to achieve your goals. In his book Outliers, Malcolm Gladwell makes a solid argument for 10,000 hours being a threshold for mastery in an discipline.

Once you have the clinical knowledge that allows you to communicate patient information with providers, you also need to understand something about business. Whether this is learned in parallel or in series with your clinical knowledge, you need to understand what drives the decision makers at your institution or business. This will enable you to do the functions that matter and collect the data that prove your worth.

Drs. Kliethermes and Brown's book, Building a Successful Ambulatory Care Practice; (ASHP 2012) is a great resource for pharmacists to learn and practice the critical skills to achieve success.

Finally, developing your emotional/spiritual intelligences (S.Covey. 8th habit. 2012) along the way is a piece that is frequently neglected by pharmacists as they negotiate the science and math heavy curricula of pharmacy school, residencies and practice. In highly technical disciplines like pharmacy, these intelligences have been shown to be the factor that elevates the best practitioners from the good ones.

Chapter two of the Kliethermes/Brown book talks about identifying partners, stakeholders and the needs of the site. My experience over the last 13 years has shown me that the emotional/spiritual intelligences of passion, empathy and communication are the most helpful as you seek to build long-term relationships.

What have you found to be the most important skill/technique when identifying and building relationships with stakeholders?

Kliethermes, Mary Ann, and Tim Brown. Building a Successful Ambulatory Care Practice. A complete Guide for Pharmacists. Bethesda: ASHP, 2012. Print

Gladwell, Malcolm. Outliers. The Story of Success. New York: Little Brown and Company, 2008. Print.

Covey, Stephen. The 7 Habits of Highly Effective People. Powerful Lessons in Personal Change. New York: Free Press Trade, 2004. Print.
Created By: Jeffrey Brewer On: Fri, Mar 01, 2013 01:44 PM

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Steven Riddle March 01, 2013 8:19 pm
I think the most important step in building relationships with stakeholders is to assume their perspective. As a pharmacist that is perhaps pushing a new service, it is very easy to see the value you believe you will be providing. However, there are great variances in perspective between departments, positions and roles in the health-system. Think about what the concerns of the stakeholder are...what problems are they trying to solve? How will your service impact them?
Having clear 'value messages' for different stakeholders is smart. Your CFO would likely be more concerned about how your going to impact revenue than how many patients will now have their glucose in target range. If you can draw the connection from the clinical/patient outcome to a financial outcome, such as better quality measure compliance and increased reimbursement or a decrease in readmissions for poorly controlled diabetes, then you will likely get further.
A good way to approach this is to do a bit of research and ask questions of your stakeholders to understand their current goals and pressures before you make the pitch. This helps build the relationship and provides you valuable insights to get your service and the related messaging finely tuned.
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