In any health care setting, leadership sets the tone for the level of emphasis placed on effective and safe patient care. Leaders can make it a priority to encourage teamwork, open and honest feedback, and continuous improvement. Conversely, leadership can set a tone of panic, punishment, and penalty. The latter has been proven by the Joint Commission, along with many other patient safety groups, to negatively impact communication and patient care. The highest performing organizations have employees that follow their leaders’ example, working relentlessly to improve the care provided to patients across all health settings.

 

So, you may be wondering, how do we get to this place?  If today’s culture does not necessarily set an expectation of teamwork and patient-centered best practices, what can be done? The answer may lie in the principles of followership and how they can be directly applied to the pharmacy profession.

 

In his 1988 Harvard Business Review article, “In praise of followers,” Robert E. Kelley described how corporate success is due to practicing good followership rather than good leadership. Translating good followership principles to the practice of pharmacy by empowering yourself and your colleagues to lead change can set the tone for better care.

 

Kelley described the following essential qualities of effective followers: they manage themselves well; they are committed to the organization and to a purpose, principle, or person outside of themselves; they build their competence and focus their efforts for maximum impact; and they are courageous, honest, and credible.

These principles originated in Fortune 500 companies, not in health care. Organizations that adopted these principles may argue that followership is actually more important than the leadership at an organization. This is based on the observation that even those high-performing teams that lost their leader still performed better than those groups who were not practicing followership, yet still have their leader in place. Followership was subsequently adapted to other industries, including health care, to empower all members of the health care team to participate in the best possible medication-related care for patients.

 

How can pharmacists exhibit these qualities to improve patient care? Due to the nature of the work, pharmacists first need to engage in self-management. Often, pharmacists work with little direct supervision to protect and improve the lives of patients. This leads to the second characteristic: the best followers are those who believe in a cause greater than themselves. The most successful practitioners are those who make every decision with the patient in mind. The patient is the purpose, principle, and person that pharmacists are committed to as practicing members of a multidisciplinary care team. Third, pharmacists must continue a commitment to lifelong learning. Good followers are dedicated to continuing education, always seeking better ways to achieve outcomes more quickly, with less cost, and more effectively. Finally, the best followers are those who hold themselves to the highest of expectations. Pharmacists should strive to always act professionally through the honest and ethical decisions and recommendations they make.

 

In my 2010 American Journal of Health-System Pharmacy article, “Followership: Nontraditional leadership roles for new practitioners,” I outlined seven steps that can serve as a guide:

Not everyone can hold traditional leadership positions but pharmacists can take charge of their own practice and become effective pharmacy followers, exhibiting key leadership characteristics while assuming a supporting role. Incorporating good followership into daily practice has great potential to advance the pharmacy profession and improve patient care.