Meeting the Challenge of Employee Engagement in the Ever-Changing Specialty Pharmacy


Leaders in specialty pharmacy must work to improve employee engagement in order to boost the customer experience.

There are many daily conversations in our pharmacies about the importance of the stakeholder experience—patients, customers, physicians, and pharma—not to mention shareholders and wholesalers…the list goes on. These stakeholders all play a clear and vital role in the success of the business of specialty pharmacy.

However, there’s a key area missing from the above list. What about our internal teams? Doesn’t employee engagement impact our success as well?

Gallup’s “State of The American Workplace” survey from 2016 states that 51% of US employees are not engaged, and haven’t been in some time.1 This statistic shows that more than half of our workforce is not performing at their highest level.

Although the employee engagement numbers have grown throughout the years, this growth has been sluggish. In the past 5 years, employee engagement has grown a total of 4%, from 29% in 2012 to 33% in 2016.

As leaders, it is our job to develop strategies to drive the business forward, and in the world of specialty pharmacy, these strategies are constantly evolving. Due to the unpredictable nature of our current health care landscape, as well as the challenges that come with managing specialty drugs and therapies, leaders must be extremely creative and flexible when making daily decisions.

It seems that in specialty, we never fully get our footing from an operational change before another takes place. We all know that when we come back from vacation, it is not uncommon to return to our desks and have the business feel a bit different than it did when we left.

This begs the question: If we feel this way as leaders, how does this constant evolution and uncertainty affect our teams? How does this impact, in turn, affect our customers’ experience?

I’ve spent most of my specialty pharmacy career working on operational projects. Each time we roll out a large-scale project, we work very hard on the change management component.

We must ensure that our new initiatives are promoted and carried out by pharmacy teams who are informed and engaged. Without the team’s full engagement, our implementation will not be successful.

Our change management campaigns include a great deal of engaging communication. From posters to newsletters to games and prizes, we take every avenue possible to notify our teams of the upcoming changes and to be sure that they feel included throughout the process.

Through the development of internal change champions, we work with our teams to implement changes, rather than simply cascading the changes to them.

Why is it that we place such a large emphasis on change management when rolling out large-scale changes, but we don’t perform these activities with our smaller day-to-day changes? With our operations evolving daily, should we have more of a consistent focus on change management within pharmacy operations?

If we expect our teams to deliver efficient, quality care to our patients and physicians to execute on service goals that may be a moving target, how do we ensure they know exactly where this target currently is?

Employee Engagement in Healthcare

In researching employee engagement at a high level in the health care sector, and it’s clear that engagement is likely even lower in health care than in other segments of the market. According to Kristin Baird of Baird Group, a healthcare consulting firm, this is due to “the stress, angst, and pressure associated with delivering health care today.”2

This quote reflects the current atmosphere around working in health care, and the high-stress environment that currently exists in the segment.

I’d take this a step further, and suggest that engagement is even lower in specialty pharmacy than in other areas of health care. Why, you ask? The answer is simple.

When strategies must change as frequently as ours do, it is difficult to consistently communicate these changes, as well as the way that they’ve impacted our goals, to our teams. When the teams lack this information, it can be very difficult for them to understand their expectations.

Employees who are continually switching gears with a limited understanding of the “why” behind the changes will struggle with engagement; however, hope is not lost.

There are many things that we can do as specialty pharmacy leaders to improve employee engagement, and in discussing our employee engagement, we are already on the right track.

Acknowledging the Current State of Engagement

It was clear by researching engagement that the number one thing that leaders can do to improve employee engagement is to acknowledge the current state of engagement in their organization, and know that it can improve. This seems fairly straightforward, but it is easy to let our own experiences and biases fog up our view of the current state.

Let’s all take a step back and consider what it’s like to work on the front lines of today’s specialty pharmacy:

Back-to-back calls are coming in. My supervisor is likely in a meeting, but is managing to send me messages to try to take more calls. I am seeing emails coming in informing me of new specialty medications that are coming to market, and whether they may be handled by a separate team, or whether I need to learn specifics for helping patients taking these medications. As much as I love taking care of patients, this is becoming exhausting.

This is clearly an oversimplification, but I think we can all see where I’m going here. We’re busy. We’re scurrying around to help our extremely sick patients, and things are constantly changing. It’s exhausting for everyone involved.

Thankfully, once we acknowledge the current state of our employee engagement, there are steps that we can take to empower our teams to become more engaged.

Steps to Improve Engagement

There are many lists that detail potential steps to improve employee engagement. I’ve compiled a few, and provided some highlights through the lens of the specialty pharmacy experience.

1. Clarify expectations and relate them to your vision

A frequent complaint heard across specialty pharmacies is that things change so quickly that it’s hard to keep your eye on the ball, so to speak. In our fast-paced culture, it is easy to get bogged down in day-to-day stressors, and lose sight of the bigger picture. Every pharmacy has a vision for the future, and clarifying employee expectations to align with this vision is of the utmost importance. This helps employees to understand the “why” behind what they are doing, and helps them feel part of something bigger than just their piece of the process.

2. Ensure clear communication pathways so that all are informed

When there is constant change, there needs to be constant change management. As I discussed previously, we tend to focus on change management during times of large change, such as a shift in vision or rebranding of the business. However, if we are changing small processes and procedures on a weekly or daily basis, it is critical to engage the team in these changes. Simply getting the team together in a huddle to communicate the changes may work, or someone on the team could take charge of putting together a newsletter for communication. Simply making sure that each member of the team understands the changes that are occurring and what to expect next will greatly improve engagement.

3. Arrange teams so that each employee can do what they do best

I think all of us would say that we do our best when we feel motivated about our work, but I would turn this around and propose that we are the most motivated when we are able to demonstrate our best work. If there are 2 employees on a team, and 1 is best at resolving customer service issues and the other is best at drafting written communications, why not empower them to do these things if there is a need to do so? They will immediately feel more engaged in their work.

4. Provide positive and constructive feedback

When providing feedback to employees during monthly, quarterly, or yearly performance reviews, make sure that you include recognition for the things that the employee has done well, along with constructive feedback on ways that the employee can improve their performance. Many of the templates that we are given for feedback include the opportunities for improvement, but lack the recognition of accomplishments. It’s simple psychology and classical conditioning that we will do more of the things for which we receive praise, so this is a critical part of a performance review.

5. Make sure everyone has what they need to be successful

The foundation of our role as leaders is to provide our teams with the tools that they need for success. Whether this includes physical tools, such as access to software to perform job duties or assistance with learning a new task, it is critical that we are available to provide these things for our employees. As leaders in specialty pharmacy organizations, we wear multiple hats. Many of us are involved in a variety of projects and initiatives on top of our duties to our teams, but if we can facilitate the success of our teams by being available when they need us, they will be more engaged.

Once we acknowledge our current state of employee engagement and resolve to empower our teams to become more engaged in their roles in our pharmacies, we can begin to implement positive changes. These changes will enable our employees to provide a better customer experience for all specialty pharmacy stakeholders.




About the Author

Kimberly Firtz earned her Doctor of Pharmacy degree from Duquesne University and is currently enrolled in the Masters of Science in Pharmacy Business Administration (MSPBA) program at the University of Pittsburgh, a 12-month, executive-style graduate education program designed for working professionals striving to be tomorrow’s leaders in the business of medicines. Kimberly has spent the last 5 years working in Specialty Pharmacy, initially as a clinical pharmacist and most recently working on a variety of high profile Specialty Operations Projects. Her current role is working with the Process Innovation team on an effort to transform Specialty Operations and optimize the stakeholder experience.

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