The Drugs Are in
the Mail
Caremark Uses
Teaming, Career-Pathing, and Cross Training To Guarantee
Satisfied Customers
Phyllis Dale receives her
blood pressure medicine on the first of each month. While
mail order and mail fulfillment of prescriptions are a
relatively recent development in pharmaceutical care,
Phyllis is grateful that she has that option. What
Phyllis doesn’t realize is that a cross-functional
team made certain that her prescription arrived on time
and correctly. And it is quite likely that Caremark
fulfilled her prescription.
Caremark Rx, Inc. (formerly MedPartners
Inc.), a Delaware Corporation, is one of the largest
pharmaceutical services companies in the United States.
The company’s operations are conducted through
Caremark Inc., which provides pharmacy benefit management
services and therapeutic pharmaceutical services. These
services are sold separately and together to assist
corporations, insurance companies, unions, government
employee groups and managed care organizations throughout
the United States in delivering prescription drugs to
their members in a cost-effective
manner.
In 2000, Caremark provided these services to
more than 1,200 health plan sponsors, including some of
America’s leading corporations, managed care
organizations, insurance companies, government agencies,
and unions. More than 20 million plan participants will
receive over 70 million prescriptions through
Caremark’s retail, mail service, and specialized
home delivery options.
Caremark’s Florida offices decided to
move to a team environment last year, according to Lynn
Rose, training manager for Caremark Pharmaceutical Group,
Weston, Florida, with 500 employees on site. While
corporate-wide the company had benchmarked many
companies’ team environments, including Motorola,
the switch to a team environment in its mail-order
processing area presented some unique challenges.
“Previously, we were very
individualized in our job responsibilities,”
recalls Rose. “We had shippers, clerks,
pharmacists, and technicians each handling their own area
of responsibility. If someone called in sick, work would
slow down or stop. So we quickly saw the value of
cross-training. The natural environment for that seemed
to be in the establishment of teams.”
Implementation: One Team at a Time
However, Caremark did not suddenly institute teams across
the facility. Instead, they carefully selected upbeat and
positive individuals through supervisors and managers who
would comprise the first teams. These first teams would
then serve as internal cheerleaders for the establishment
of other teams across the facility.
An individual could be assigned to a
dispensing team consisting of a pharmacist, technician,
shipper, and clerk or an order processing team consisting
of several pharmacists, a technician, a shipper, and a
clerk. The team structure consisted of a team leader who
was always a pharmacist. The team leader’s
responsibility was to keep the workflow going and move
people to other areas. In addition, the team leader
promoted the team goals and tracked team processes.
Because of the governmental regulation of the industry,
the team leader had to be a pharmacist who could actually
sign off on orders. All of the individuals on the team
had to be cross-trained in other areas.
“Of course the biggest challenge was
managing the change,” recalls Rose. “We were
asking individuals to work with new people and learn new
skills which is outside many people’s comfort zone.
We also needed to work on getting everyone team
focused.”
Dealing with Change: A Slice of Cheese at a Time
Caremark met this challenge by embracing the concepts of
Who Moved My Cheese? Change can be a blessing or a
curse, depending on your perspective. The message of
Who Moved My Cheese? is that all can come to see
it as a blessing, if they understand the nature of cheese
and the role it plays in their lives. Who Moved My
Cheese? is a parable that takes place in a maze. Four
beings live in that maze: Sniff and Scurry are mice
— nonanalytical and nonjudgmental, they just want
cheese and are willing to do whatever it takes to get it.
Hem and Haw are “little people,” mouse-size
humans who have an entirely different relationship with
cheese. It’s not just sustenance to them;
it’s their self-image. Their lives and belief
systems are built around the cheese they’ve found.
Most of us reading the story will see the cheese as
something related to our livelihoods — our jobs,
our career paths, the industries we work in —
although it can stand for anything, from health to
relationships. The point of the story is that we have to
be alert to changes in the cheese, and be prepared to go
running off in search of new sources of cheese when the
cheese we have runs out.
“We distributed the book to all our
managers and supervisors. From there we trained all
employees in a mini-workshop around the video,”
recalls Tom Meyer, former senior organizational
development specialist for Caremark and current chair of
the ESL (English as a second language) and Foreign
Language program at Miami Dade Community College.
“It was critical that we carried out this training
before we moved to the team environment. Pharmacists
often had the biggest hurdle to embrace the change. They
generally did not view the works of others as important,
a sort of status and image scenario. After the training,
as we moved to the team environment, the pharmacists
began to view their co-workers as equal team members who
just mastered a different process.”
“I think people begin to realize that
things change as in Who Moved My Cheese?”
Meyer explains, “They always have changed and
always will change. And while there’s no single way
to deal with change, the consequence of pretending change
won’t happen is always the same: The cheese runs
out.”
Training Coaches and Those Being Coached
In addition all leaders were given coaching training.
“Because of the recursive nature of the process, we
realized we must keep training,” says Rose.
“We do monthly mini-camps where we retrain our
coaches. Every employee at Caremark has a coach and
because we are set up for double-loop learning we revisit
this training and see how we can improve it. We are also
planning to have all employees participate in the
coaching training. We want people who are being coached
to understand their role as well as those providing the
coaching.”
Coinciding with the move to the team
environment, Caremark also reviewed its career-pathing
environment. “What we found,” says Rose,
“is that many pharmacists really did not want to go
into management. So how could we help them? We are
approaching this situation by offering CEUs with
cross-training into other areas of the company. For our
technicians the challenge was a little easier. We are
able to offer them classes to receive their
certification. Florida is one state where they do not
need to be certified but it is a career enhancement. We
provide technicians who want the program with exam
materials and pay for them to take the classes and exam.
We cross-train our clerks and line staff for higher-level
jobs. Even our management team is involved. Every manager
must take a certain number of hours each year; for
example, they might take a course in financials for
nonfinancial managers.”
Training in an Academic Environment
Tom Meyer found the experience invaluable. Now in his
role of chair of a 25-professor community college
department, the value of cross-training and career
pathing is also apparent. “I suddenly realized that
even in the academic environment cross-training is
essential. College professors are educated and have a
sort of status just as pharmacists do. Given the events
of September 11, I now have some individuals called up
for reserve duty. With ESL education, students are taught
in components of reading, writing, or speaking. Many
professors only choose to teach one component. Given our
current staffing situation, this can create gaps. So now
I am encouraging professors to teach one other component
class and we are moving to a teaming environment where a
group of teachers will teach the same students in a block
of time.”
The advantage of cross-training, teaming, and
career pathing transcends all industries and job
classifications. Whether it is in a mailroom dispensing
prescriptions or a community college teaching immigrants
a new language, better service, better results can occur
when people work together.
The result — people like Phyllis Dale
get the prescriptions and products they need in a timely
fashion through the mail.
November 2001 News for a
Change Homepage
