LeeAnn Miller wants to put pharmacists at the center of patient care. She’s not looking to oust other clinicians. To the contrary, she hopes to build fully integrated teams that generate the best possible outcomes—together.
At some hospitals or health systems, pharmacy remains an unseen department lurking below the surface—sometimes quite literally in the basement. Its professionals are summoned only if and when unexpected problems arise. But that’s not the case at Yale New Haven Health System (YNHH). As vice president and chief pharmacy officer, Miller embeds her teams at every stage of the care continuum. “Pharmacists can make a huge difference, and we need to participate anytime medication is involved,” she says. The approach gives patients at Connecticut’s largest healthcare system the best path toward healing and wellness.
LeeAnn Miller’s crusade to get pharmacists on the front lines of care hits close to home. The doctor of pharmacy (who also has a master’s of science in pharmaceutical systems and policy) was still early in her academic career at West Virginia University when her mother was diagnosed with diabetes. Unfortunately, disjointed care and poor support contributed to complications. Miller’s mother had a massive heart attack and passed away in a hospital setting. “A more team-based care approach in helping my own mother likely would have prevented her death,” Miller reflects.
Yale New Haven Health provides Miller the opportunity, freedom, and support to develop and implement her unique approach. “I’ve been able to get involved across the entire health system organization, and in doing so, my eyes were opened to the full potential of what we can accomplish as a pharmacy profession,” Miller says.
With more than twenty years at the system, and experience in several senior roles, LeeAnn Miller has influenced formulary policies, managed procurement, built relationships with physician and nurse leaders, and led various teams. She also helped create repeatable structures and standardize governance models as YNHH opened new facilities and acquired others over the years.
Today, the health system encompasses five hospitals inclusive of Yale New Haven—the academic medical center, which has two main campuse—and boasts multiple specialties in cancer, children’s and women’s health, and psychiatry to name a few. New Haven Hospital’s staff of nearly thirteen thousand treats over seventy-five thousand patients per year, and Yale’s comprehensive, multidisciplinary team has earned a stellar reputation for top programs in endocrinology, neurology, and cardiovascular surgery.
Bringing new hospitals, teams, and systems online helped Miller discover and hone new strategies for integrating services, optimizing best practices, eliminating redundancies, and efficiently delivering the best service possible, all with the goal of creating an initiative called Pharmacy Care Signature. In her current role, Miller identifies new ways for pharmacy to drive the strategic priorities of YNHH forward. Those priorities include continuing to provide high-value patient-centered care focused on quality, safety, and optimal patient outcomes, not to mention growing clinical services, ensuring financial strength, and maintaining employer of choice status.
Care teams with embedded pharmacists and pharmacy technicians create a culture where pharmacists, doctors, nurses, and the entire care team want to stay and work. “Our model allows each person on the care team to practice at the top of their license,” LeeAnn Miller says. Administrative tasks such as insurance authorizations can be transferred to the pharmacy technicians so the physicians can see more patients and so decisions regarding medications, and the responsibilities around educating patients on medication complexities, are left in the hands of an expert.
“Protenus is proud to partner with LeeAnn and Yale New Haven Hospital, supporting their proactive efforts with drug diversion surveillance and empowering pharmacists to eliminate risk and generate the best possible outcomes,” says Michelle Del Guercio, chief marketing officer at Protenus.
Other steps help YNHH attract and retain employees in the midst of the Great Resignation. LeeAnn Miller and her peers are continuing to grow services in unique areas, like establishing the first health system-integrated home infusion service in Connecticut. They are increasing work flexibility by offering remote and work-from-home options for certain roles and have maintained a very robust career ladder for both technicians and pharmacists to provide sequenced opportunities for career growth.
According to CarepathRx Chief Strategy Officer Keith Crawford, “CarepathRx is excited to partner with LeeAnn to expand Yale New Haven’s pharmacy capabilities to provide home infusion to the communities they serve. This infusion program will enhance patient care and positively impact patients’ lives through expanded services from a provider they know and trust. Home infusion creates significant community value while improving hospital financial performance.”
Those who make their way onto Miller’s teams are certain to have access to strong mentors. The pharmacy team is developing robust mentoring programs for employees at all levels—something Miller takes seriously. “We have to network to do our jobs well. That means being a mentor, finding a mentor, and creating relationships across the entire organization,” she says.
Strong relationships yield creative solutions in times of crisis. At the onset of the COVID-19 pandemic, leaders across YNHH came together to form an incident management structure to best serve their community, patients, and staff. Miller formed an incident command structure in the pharmacy to enable fast, system-wide decisions and strengthen communication.
All leaders took on new roles outside of their traditional functional areas. Administrators held employee town hall meetings and press conferences, clinicians opened drive-through testing sites and mobile testing units, new telehealth options expanded care, and HR increased access to mental health and other support benefits. YNHH even opened, staffed, and operated a COVID-19 call center that once handled 4,426 calls in a single day and 494,785 in its first year.
Employees have volunteered to cover extra shifts, work at other facilities, and assume new roles and duties. They’ve administered hundreds of thousands of COVID tests and vaccine doses, all while continuing to care for patients like they have since the General Hospital Society of Connecticut first opened its doors in 1826. Then, YNHH was the first hospital in the state. Nearly one hundred years later, it still provides world-class care, with pharmacists and pharmacy technicians on the front lines.