John is currently Director of Pharmacy Operations within Resource Optimization and Innovation’s (ROi’s) Performance Consulting Division.

ROi is a wholly-owned subsidiary of the Sisters of Mercy Health System based in St. Louis, Missouri. Mercy is an integrated delivery system (IDN) residing within seven states, comprised of twenty-six acute care facilities, three heart hospitals and one rehabilitation hospital. Managing more than 4,000 licensed beds, Mercy performs over 300,000 surgical procedures annually. John will be sharing his thoughts with a presentation titled:  The New iTeam – Collaboration Outside of Pharmacy on Crossover Products and Practices at the 2010 Fall IDN Summit.

IDN Summit (IDN): Outline a couple of recent ROi initiatives you have implemented that have effectively reduced costs while maintaining effectiveness across your organization.

John Kleiss (JK): A couple of recent initiatives have been work on a standardized formulary process and an antibiotic stewardship program.  These programs combined have brought over 6 million dollars in savings for Mercy facilities while improving safety and improving patient care with in the first year of implementation. 

IDN: Patient safety is an issue that concerns all of us. What initiatives have you had success with that have improved patient safety within the Sisters of Mercy system? 

JK:   Both standardized formulary and antibiotic stewardship have provided for improved patient safety and, in the end, Mercy also realized financial benefit.  The standardized formulary allowed us to identify the best medications and practices through white-paper research and discussions with advisory groups, then drive increased compliance toward these findings.

IDN: How did you develop buy-in among the various groups for these initiatives?

JK: A key elements for both initiatives was strong support from senior leadership.  Our senior leadership was quite vocal in their support and adamant that they expected positive results.  This resonated with the staff throughout the Mercy facilities.  Pharmacy staff throughout Mercy was excited to have the opportunity to engage in a new way and make a demonstrable difference in improving patient safety outcomes.

We also facilitated physician group discussions to learn what our physician experts saw as success.  Some of these discussions were heated and required follow-up meetings. Nonetheless, in the end all parties were able to come to consensus and agree on priorities, planning and execution.  I truly believe that people just need a chance to voice their opinion and have it heard.  Once that is done and all scenarios have been discussed, the best choice rises to the top and becomes obvious. 

IDN: What are the two issues that have you most concerned during the next few years and what should we be doing to address those issues?

JK: In my mind medication errors and inappropriate therapies are negatively affecting patients every day.  Medication errors are still occurring even after focusing on this topic for years.   Although the reporting of errors is improving, and yielding local process improvements, these error findings and process changes are infrequently shared throughout our community. This lack of effectively coordinating and disseminating this information allows these errors to occur in other facilities.  With the changing face of healthcare, it is imperative that best practices and error prevention activities become readily available and widely distributed. 

Additionally, there is a common misperception that at times can thwart the beginning stages of our initiatives: the misperception that these initiatives are solely targeting financial gain. It is an understandable misperception, given our nationwide financial crisis in healthcare coupled with our tough macro economic conditions. As I mentioned earlier, once our clinical staff has the opportunity to express their insights, experiences and opinions, and know that they are being heard with an open mind and willingness on all sides to adapt to needed change, full staff engagement and very real, demonstrable advancement in patient care is the obvious and most rewarding outcome.

An example of this phenomenon is our effort to enhance our antibiotic stewardship, an effort barely begun. Through this work, we have made a huge leap forward.  We have educated physicians, pharmacists and nurses on appropriate use of medications and development of protocols and algorithms to improve job performance, which directly enhances patient care and outcomes. This is merely the tip of the iceberg for these types of programs. As we turn our focus in this manner toward particular disease states to identify and implement best practices, we benefit everyone in the healthcare value stream, most specifically, the patients. The key word as we move ahead is collaboration.  Collaboration among our healthcare providers – our physicians, nurses, pharmacists and others – with our senior leadership and our suppliers are the partnerships crucial to identifying opportunities that will best serve our patients and our communities.

IDN: Thank you John, are there any other items you’d like to share with us?

JK:  ROi extends an invitation to all who would improve healthcare delivery and patient outcomes to share their singular experiences, challenges and successes as we at ROi have shared our unique strategies and initiatives.  I would hope that other innovators would embark on this journey with us so that patients all over the country can benefit from our collective success. 

Full Bio:

John is currently Director of pharmacy, lab and imagining sourcing within the Integrated Sourcing Solutions group of Resource Optimization and Innovation (ROi). ROi is a subsidiary of Sisters of Mercy Health System based in St. Louis, Missouri.  Mercy is an integrated delivery system across seven states with twenty-six acute care facilities, three heart hospitals and one rehabilitation hospital. The system possesses more than 4,000 licensed beds, and performs over 300,000 surgical annual procedures.  The Sisters of Mercy Health System is the eighth largest Catholic health system and the twenty-fifth largest among all healthcare systems in the U.S., based on net patient revenue.  As of June 30, 2009, Mercy invested more than $208 million comprised of unpaid Medicaid cost, charity care and other services, education and ministry to help those less fortunate in our communities. ROi is Mercy’s centralized supply chain function, which includes an Integrated Sourcing Solutions Group for contracting, consulting and clinical integration, and a Consolidated Services Center, which provides warehouse and distribution functions, as well as providing the site for ROi’s sterile Custom Pack Solutions (CPS) manufacturing operation.

John is focused on working collaboratively with clinical coordinators and pharmacy directors to improve processes, and implement savings and safety initiatives along with regulatory compliance. Recently John worked to develop a standardized formulary for the system involving clinical reviews of each class of drug. 

Previously, John was involved in formulary development and implemented a Medication Therapy Management program for Express Scripts.  John worked to develop third party formularies for insurance plans, including Medicare Part D plans.

Before joining Express Scripts, John was Director of Pharmacy at small–to–medium—sized facilities.  Most recently John was executive leader at North Hawaii Community Hospital in Waimea, Hawaii.
 
John is a registered pharmacist with a Bachelor of Science degree in pharmacy from St. Louis College of Pharmacy in St. Louis, Missouri.  John also earned a Doctor of Pharmacy degree from Midwestern University, Chicago College of Pharmacy, in Downers Grove, Illinois.