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The pursuit of innovation is a process that pharmacists seem to have forgotten, if indeed, they ever embraced it.
As we move forward in the new millennium and seek a competitive advantage in the marketplace, we are finding it unsustainable to develop a competitive advantage in quality, cost, or speed of service.
This is because the gap between our rivals in quality, cost and speed has already closed, or is rapidly closing.
And by rivals, I don't mean just other pharmacists.
I mean every other organisation that competes with pharmacy services, in niche areas, or across the board, and can include major retailers, health food stores, naturopaths, other health professionals (including nurses and doctors), Internet pharmacies, integrated medical corporations-the list is ever widening.

For the consumer, the bulk of these entities appear indistinguishable in quality, cost and speed, for their specific need, and they will naturally choose the service that offers them the very best choice.
It is only the "stand out" entity that will attract.

So, the only sustainable organisation for the future is the one that relies on innovation as its point of difference, evoking sensory and emotional responses.
This is described as the "Ahhh" factor, which is that "look at this" experience that dazzles and captures a customer/patient's attention to win ultimate loyalty.

I once read a very interesting and well-known book about the history of pharmacy in Australia, where it was stated that in the roughly 200 plus years of development and growth, no single major initiative in pharmacy had ever occurred from within pharmacy ranks. It had always been foisted on pharmacy by governments, the medical profession, or other external organisations.
It was these external influences that shaped pharmacy of today.
Not very inspiring, is it?
And I remember mentally reacting against that image, but with considered reflection, and an experience acquired from the "school of hard knocks", I am now in total agreement with that point of view.
Why is it that over the years, we have had umpteen dozen reviews of pharmacy activities by government agencies, culminating in the Wilkinson Review of recent times, the CoAG Review etc ?
As they say, we have not learned the lessons of history.

Given the turmoil that is manifest in the community pharmacy of today, and the unsustainable workload that is upon us, where is the starting line to begin a new and sustainable process to ensure survival ?

Mindset is the starting point.
Forget about what you want, what wholesalers and manufacturers want, what your staff wants, what governments and official pharmacy organisations want.
Filter out all the noise created by these "wants".
The only opinion that matters is the opinion of the customer/patient; the ultimate consumer of your service offerings.
Have you ever asked your existing patient/customer base what it was that attracted them to your pharmacy, and if they had the opportunity, what they would like to see changed or added to your offerings?
When you think about it, it is a simple starting point.
What are the needs, lifestyles and the aspirations of your current (and potential) customers/patients.
What is the secret of having them say "Ahhh" to your most recent service offering?

Beware of initial consumer responses to your questions.
Initial reaction is not always a good guide to a product or service being successful, and consumers sometimes have to be led into the process in a carefully focussed and attentive manner. For example, when the computer mouse was first invented, most consumers reacted negatively, preferring to type in commands that they were previously used to doing.
When answering machines were introduced, they were felt to be disrespectful and impersonal to callers.
And so it may be with the new range of services being rolled out utilising consultant pharmacists.
There may be a million reasons why these services may not seem to be needed by our patients.
Just ask your local G.P.
The chances are he/she will trot out a litany of reasons, ranging from a questioning of your skill base to the mountains of paperwork you are generating for G.P's.
Do pharmacy patients (Yes, I said pharmacy patients - we do genuinely have them) need these new pharmacy services?
Well, the only way to find out is to ask patients, trial the services and continually innovate and focus, until we get a perfect "fit".
The "Ahhh" solution.
And what about the cost?
Well, cost is relative.
If the consumer genuinely desires and needs a service, the cost will be willingly met directly by the patient, or be subsidised by health insurers or governments in some way.
The need is the all-important, driving factor.
This is the reason, in my previous articles, I have encouraged pharmacists to be innovative and not be satisfied with government subsidised services, but to get out and develop a range of private activity to fill all those obvious gaps within pharmacy patient need.

There is a term for this approach in the commercial (generally IT) world, and it is called "expeditionary marketing".
Basically, it is a strategy involving a series of low cost and fast paced market incursions.
Instead of waiting for the market to reveal itself and unfold the perfect and financially safe (for a pharmacist) service model, an undeveloped product is brought to an ill-defined market.
Based only on previous experience, judgments on how to proceed are made.
The model might have to be scrapped entirely if it does not gain acceptance.
Most likely, it will be reconfigured and refined, and sent out for another foray.
This process is continually repeated, and with each experience (positive or negative), new insights are gained into what will be the ultimate "Ahhh-inspiring" model of service.
All the time you will be asking patients, actual or potential, what they need and like within your model.
The "bulls-eye" must eventually be hit, with practice.

To bring a new innovation on stream you will have to develop an organisation that is quick on its feet, so that development and delivery times for innovative new models of service can be reduced.
This is where the real level of competition exists.
Already, some of our competitors can deliver models of service with as short a lead time as 30 days, from conception to delivery.
To be able to compete into the future, we will have to get as close to a "zero lead time" as we can.
To enable this process we have to be up with the best in the Information Technology stakes, to ensure that we have access to information inputs, control of overheads (gateway purchasing technologies) and equally fast access to consumers with our outputs.
These outputs will rely more and more on Web-based systems.

To create the innovative pharmacy, traditional models of management will have to be changed. Teams of employees will have to be developed around major processes within a pharmacy, and be given access to information (traditionally guarded as being confidential), to enable them to produce a measurable result
What can be measured can be easily managed.
These workplace teams will need to be empowered to act on their own research and apply their findings in a decision making process normally reserved for a hierarchical middle-management structure.
This type of line management is now obsolete.
It is too slow, it is costly, and can be obstructive.
The entire line is replaced with a leader, who will have the capability of drawing the individual workplace teams into a cohesive unit, will give credit and value to each unit and will continually provide feedback between units.
Employees may belong to more than one workplace team, and non-employees may need to be co-opted at various times, to introduce skills not inherent within the existing groups. These co-opted people will be consultative-type persons who will be drafted for a short term, sharply focussed learning project, and then move out.
As the teams grow in productivity, these co-opted skills may need to be permanently employed to facilitate innovation and sustain growth.
The whole process is energised by encouraging "out of the box" thinking in all facets of daily work activity, and from all participants.

One of the major tasks of a workplace team is to identify activities that are not running smoothly, or processes that continually present frictions between employees, or worse, at the customer/patient interface.
In many instances, these problems have been inherent and traditional within the pharmacy workplace and have just been accepted e.g. the pharmacy may have the traditional system of borrowing between pharmacies-a scrap of paper on a bulldog clip, which may eventually be thrown away, because no one is sure that it has been redeemed by a return product.
Or the system for ordering individual special purchases for customers continually breaks down because no single person is responsible for the process. There is no ownership, and customers/patients are continually being disappointed.
The "Ahhhh" turns to "Ugh!"
Pharmacy is littered with these inefficient and outmoded methods of conducting a business.
The workplace team must design a system to eradicate these inefficiencies, which in turn, leads to errors and adverse events. Errors can be life threatening once they enter the professional area, and they are costly, because they should not be there in the first place.
They are a constant threat to customer/patient loyalty.
Innovation begins with these small events-the design of a simple system to eradicate a problem.
From small things, bigger things evolve and it just takes the spark of leadership to set it aflame.

We used to think of the marketplace as being a series of "market segments" and logically began to set about controlling as large a portion of that segment as possible.
Now there are only "fragments" - tiny "market fragments", which, if we take a systematic approach to, we can win.
Because these fragments are "bite-sized" they may represent a consumer need that other competitors have overlooked, or find too paltry for them to service.
Pick up on this process.
What have you done before that you are no longer doing?
Is there an obvious need that you can service that fits your scale of operation?
And look at modularity.
Can you build one market fragment in conjunction with another or as an extension?
Can a service be designed so that a consumer can select their own modules to suit their particular needs?
A "mix-and-match" approach can be an innovative process in itself and be an encouragement for your customer/patients to suggest ideas for future modules.
This can be an ongoing and innovative process once started.

Innovation is the constant search for the new, the different, the better value-adding product or service that creates the "Ahhh factor".
For pharmacies that embrace innovation as the primary basis for achieving a sustainable competitive advantage, it will mean that this pursuit becomes the quest for knowledge, and for mechanisms to translate knowledge into customer/patient benefit.
For the organisation itself, something positive begins to happen.
Gradually the old mechanistic ways of thinking about the organisation give way to newer and better concepts. The organisation itself becomes a living, learning and growing entity that processes knowledge and interacts continuously with its environment and its customers/patients.
This type of organisation is different, it is customer/patient sensitive, it is knowledge creating and it is totally agile.
The flexibility and adaptability generated, creates the ability to thrive on chaos, uncertainty, unpredictability and continuous change.
It is lean in its use of resources, it services small niche markets (sometimes as small as a single customer) and it delivers highly customised services (virtually on the spur of the moment).
Such organisations do exist, but are not very evident in pharmacy.
A pharmacy meeting the above specifications would be a highly sought after place to work in.
A profession built on the same platform, would be a prestigious one indeed.

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