CPAP Module 21, Section 5: Reporting and Presenting Outcomes to Leadership
MODULE 21: METRICS, QUALITY & PERFORMANCE IMPROVEMENT

Section 5: Reporting and Presenting Outcomes to Leadership

From Specialist to Strategist: The Art of Executive Communication.

SECTION 21.5

Reporting and Presenting Outcomes to Leadership

Translating Your Department’s Work into the Language of Value.

21.5.1 The “Why”: Closing the Loop and Proving Your Worth

You have now built a world-class prior authorization program. You have defined the key metrics that matter. You have implemented rigorous QA processes to ensure every submission is of the highest quality. You have built dashboards that make your performance transparent and understandable. And you have embraced continuous improvement frameworks to systematically make your workflows better, faster, and more reliable. You have built a powerful, efficient engine. But there is one final, indispensable step. You must now prove to the organization that the engine you built is not just running efficiently, but is actively driving the entire institution toward its most important strategic goals.

Reporting and presenting to leadership is not an administrative chore; it is the final, crucial link in the value chain of your work. It is the formal process by which your department transforms from a “cost center” in the basement to a strategic asset in the boardroom. Excellent clinical work, high approval rates, and fast turnaround times are meaningless to the organization if their impact is not translated into the language that leadership understands: financial performance, patient safety, risk reduction, and competitive advantage. Your work does not end when a PA is approved; it ends when the value of that approval is successfully communicated to the people who control budgets, allocate resources, and make strategic decisions about the future of the hospital.

Failure at this final stage can be catastrophic for a PA department. A team that does outstanding work but cannot articulate its value will be the first to face budget cuts, hiring freezes, and a lack of investment in crucial technology. Conversely, a team that masters the art of executive communication—of storytelling with data—will secure the resources it needs to grow, innovate, and expand its positive impact on patient care. This section is designed to be your masterclass in that art. You will learn how to move beyond simply reporting data and learn to build a compelling narrative that demonstrates, with unassailable evidence, that your PA department is not a cost, but a powerful investment in the organization’s success.

Retail Pharmacist Analogy: The Pharmacy Manager’s Business Review

Imagine you are a successful pharmacy manager who has just had a phenomenal year. You have launched a new medication synchronization service, boosted your immunization rates by 50%, and implemented a new workflow that cut patient wait times in half. You are justifiably proud of your team’s hard work.

Now, it is time for your annual business review with your District Manager (DM). How do you present your success?

The Ineffective Approach: You walk into the meeting and say, “We worked really hard this year. We started a new Med Sync program, gave a lot of shots, and customers seem happier.” The DM, who is responsible for 15 other stores, nods politely, but this information is not actionable. It doesn’t tell a story of value.

The Strategic, Data-Driven Approach: You walk in with a one-page summary.

  • “Our new Med Sync program has enrolled 85 patients, increasing our adherence metrics (PDC scores) by an average of 12% for this group, which directly translates to higher Star Ratings and an estimated $25,000 in additional DIR fee reimbursement.“
  • “Our targeted flu and shingles vaccine campaign generated $150,000 in new revenue, a 52% increase over last year, making us the #1 immunization pharmacy in the district.”
  • “By implementing a new workflow, we reduced our average wait time from 18 minutes to 9 minutes. Our patient satisfaction scores have increased from 82% to 94%, and we have seen a 15% increase in new patient transfers from our competitors since we launched the program.”
  • The “Ask”: “Based on this success, I am requesting a budget for one additional technician, which will allow us to expand our Med Sync program to 200 patients and launch a new diabetes care service, projected to generate an additional $80,000 in revenue next year.”

Which manager is more likely to get the resources they need? The second one, of course. They did not just report activities; they reported outcomes. They translated operational improvements into the language of the business: revenue, reimbursement, patient retention, and competitive advantage. This is the exact translation you must perform with your PA department’s data for your organization’s leadership.

21.5.2 Know Your Audience: Speaking the Language of the C-Suite

The single biggest mistake in executive reporting is presenting the same data to every leader. The Chief Financial Officer (CFO) and the Chief Medical Officer (CMO) are driven by vastly different priorities and metrics. To be effective, you must tailor your message, your metrics, and your language to the specific concerns of each member of your audience. Your dashboard is your universal source of truth, but the story you tell with it must change for each listener.

Masterclass Table: Tailoring Your Message to Hospital Leadership
The Leader Their Primary Concern Key Metrics They Care About How to Frame Your Department’s Value
Chief Financial Officer (CFO) The bottom line: Revenue, cost, margin, and return on investment (ROI).
  • Drug Cost Savings: Dollars saved through non-formulary to formulary conversions.
  • Denial Write-Offs Avoided: Value of therapy secured through successful appeals.
  • Staff Productivity: PAs processed per FTE.
  • Length of Stay (LOS) Impact: Correlation between faster PA approvals and reduced hospital days.
 “Our team’s intervention on 50 cases last quarter to switch from IV Brand X to formulary IV Brand Y resulted in a direct drug cost avoidance of $120,000. Furthermore, by overturning 15 high-cost infusion denials, we prevented $250,000 in revenue write-offs.”
Chief Medical Officer (CMO) / Chief Quality Officer (CQO) Clinical outcomes, patient safety, quality of care, and evidence-based practice.
  • Turnaround Time (TAT): For time-sensitive therapies (e.g., oncology, cardiology).
  • Approval Rates: For key service lines.
  • Adherence to Clinical Pathways: How PAs support standardized care.
  • Patient Safety: PAs that prevent inappropriate medication use.
 “By implementing a streamlined workflow for cardiology PAs, we have reduced the average TAT for critical discharge medications from 72 hours to 24 hours, ensuring patients can start evidence-based therapies without delay. This directly supports the hospital’s goal of reducing 30-day readmissions for heart failure.”
Chief Nursing Officer (CNO) Nursing workflow efficiency, patient satisfaction (HCAHPS scores), and safe medication administration.
  • Reduced Rework for Nurses: Fewer clarification calls and follow-ups.
  • Timely Discharge Medication Access: Reducing discharge delays caused by pending PAs.
  • Clarity of Communication: How your team communicates PA status to floor nurses.
 “Our new automated PA status update system has reduced clarification calls from floor nurses by 60%, freeing up valuable nursing time to focus on direct patient care. This has been a key factor in improving our HCAHPS scores related to communication about medications.”
Director of Pharmacy Department budget, staff management, medication safety, and alignment with the hospital’s P&T committee decisions.
  • All of the above metrics.
  • Staffing Model Justification: Volume, complexity, and productivity data.
  • Formulary Adherence: How your team champions the use of preferred agents.
  • ROI of the PA Team: A summary of total cost savings vs. total department salary expense.
 “Last year, the PA team secured therapies valued at $15 million and achieved direct cost savings of $2.1 million through formulary management. With a total salary expense of $700,000, our department delivered a 3-to-1 return on investment, not including the significant downstream benefits to patient safety and length of stay.”

21.5.3 The Anatomy of a High-Impact Executive Report

Executives are busy. They do not have time to read a 20-page report or decipher a complex spreadsheet. Your report must be concise, visually appealing, and designed for rapid comprehension. The ideal report is a “one-pager” or a short slide deck that follows a clear, logical structure. The guiding principle is BLUF: Bottom Line Up Front.

The One-Page Executive Dashboard Template

Executive Summary (The “BLUF”)

Q3 Performance: The Prior Authorization Department exceeded all major goals in Q3, achieving a 92% overall approval rate and reducing average Turnaround Time by 15% to 2.1 days. Key Highlight: A PDSA-driven workflow redesign for oncology PAs cut TAT for this critical service line by 48% and is projected to reduce patient discharge delays. Financial Impact: The team secured $4.2M in therapy value and generated $550k in direct cost savings. Recommendation: Approve budget for one additional FTE to support expansion of these successful initiatives to the cardiology service line.

Key Performance Indicators (KPIs) – Q3
Overall Approval Rate: 92%
First-Touch Approval Rate: 78%
Average Turnaround Time (Days): 2.1
Denial Rate (Initial): 8%
Financial Impact – Q3
Drug Cost Savings: $550,000
Value of Therapy Secured: $4,200,000
Department ROI (YTD): 3.2 : 1
Revenue Write-Offs Avoided: $1,100,000
Continuous Improvement Spotlight: Oncology Workflow Redesign

A two-week PDSA cycle tested a new checklist and communication pathway for oncology PAs. The results were immediate and significant, demonstrating a scalable model for other service lines.

Oncology PA Turnaround Time (Before vs. After)

4.4 Days

Q2 Avg

2.3 Days

Q3 Avg

21.5.4 Presentation Skills: The “Last Mile” of Communication

A great report can fall flat if it is not presented effectively. Presenting to leadership is a specific skill that requires practice. Your goal is not to read your slides; it is to tell a compelling story, anticipate questions, and guide the conversation toward your desired outcome.

Common Pitfalls to Avoid: Death by PowerPoint
  • Too Much Text: Your slides are a backdrop, not a script. If your audience is reading your slides, they are not listening to you. Use visuals, large fonts, and minimal text.
  • Getting Lost in the Weeds: Do not try to explain the clinical nuances of every PA. The CFO does not care about the mechanism of action of a PCSK9 inhibitor; they care that you saved $5,000 by converting the patient to the formulary alternative.
  • No Clear “Ask”: A presentation that ends with “Any questions?” is a missed opportunity. Your final slide should be your recommendation or request. Be specific: “We are requesting a budget of $75,000 to hire one pharmacy technician FTE.”
  • Inability to Answer Financial Questions: Be prepared to answer the tough questions. If you claim $500,000 in cost savings, you must be able to explain exactly how you calculated that number.
The Pharmacist’s Playbook: The 3-Minute PA Update

Often, you won’t have a formal 30-minute presentation slot. You will have 3 minutes in a larger leadership meeting. You must be prepared to deliver a concise, high-impact update. Structure your update like this:

  1. The Headline (30 seconds): “Good morning. I have an update from the PA team. This past month, we processed 850 authorizations and achieved a 94% approval rate, ensuring timely access to care. Our two key highlights are a major cost-saving initiative and a significant improvement in patient discharge times.”
  2. The Data Point (60 seconds): “On the cost front, we collaborated with the cardiology team to implement a new step-therapy protocol for Factor Xa reversal agents. This initiative alone avoided $180,000 in drug spend in the last month by ensuring appropriate use.”
  3. The Clinical Impact (60 seconds): “On the patient care front, by embedding a specialist with the discharge planning team, we have reduced discharge delays due to pending PAs by over 70%. This means patients are getting home faster and starting their critical medications sooner, which we believe will positively impact our readmission rates.”
  4. The Next Step (30 seconds): “My full report has been distributed. We are continuing to monitor the impact of these initiatives and will be launching a similar project with the oncology team next quarter.”