After nearly three decades at University of Toledo Medical Center, from inpatient pharmacist to hospital executive, Russell Smith, PharmD, is now applying his extensive clinical background to lead hospital operations as the new chief operating officer.
Question: You began your career at the University of Toledo Medical Center as an inpatient pharmacist in 1995. How did that experience lay the foundation for your path into hospital administration and your current role as COO?
Russell Smith: I graduated from the University of Toledo in 1995 and joined the Medical College of Ohio (MCO). MCO merged with the University of Toledo in 2006. So, I’ve been with the combined entity for 36 years.
Early in my career, I had the benefit of an outstanding internship where I learned clinical functions that you may not typically be exposed to as a student such as how to dose theophylline, heparin, PCAs, aminoglycosides, vancomycin and renal dosing of antibiotics at a progressive hospital pharmacy. We didn’t have any of those programs in place when I came to UTMC. I had an outstanding pharmacy leader here who encouraged me as a staff pharmacist to help develop these programs for the University of Toledo.
I worked with our physicians and pharmacists in creating our first IV to oral conversion program, aminoglycoside monitoring program, vancomycin dosing program, and renal dosing protocol. That was really the foundation of a clinical pharmacy model here run by staff pharmacists. Looking back, that’s really what set me on this path: seeing a need, finding a solution, and putting a program in place to fix it.
Q: At what point did you begin to see pharmacy as a launch pad into broader health system leadership? Did you always know you wanted to go into the COO role or something similar?
RS: Yes, I think I did. My first director of pharmacy at the University of Toledo was promoted into administration shortly after I started and this really resonated with me. He was a mentor, and I had the aspiration very early on that was a career path I was interested in taking.
Q: What are some of the skills from pharmacy practice that have been the most transferable or valuable in your executive role?
RS: When I look back over my pharmacy career, the strategic and operational skills I developed in pharmacy, supported by organizations like ASHP and Vizient and the outstanding pharmacy leaders in these organizations, translated well into working with other departments. Whether it’s inpatient, outpatient, or ambulatory services, pharmacists are trained to think critically, optimize outcomes and maintain fiscal stewardship.
Respiratory was one of my first areas outside of pharmacy, and very much like pharmacy, respiratory is traditionally seen as an ancillary service, as a cost center.
To overcome this, our strategy was to create evidence-based protocols allowing respiratory therapists to practice at the top of their license. We created an ambulatory strategy with a sleep lab, pulmonary function testing, outpatient EEG, and pulmonary rehab. We hired an outstanding pulmonary navigator who assists in the clinical management of complex patients working directly with the physicians across the continuum of care, much like a clinical pharmacist.
Q: What are some of your top goals for the COO role?
RS: One of the first things I did was put together my 90-day plan. Quality and Safety, patient experience, employee engagement, physician relationships, community outreach, and creating a position of financial strength for the institution are my top priorities.
Now is a very dynamic time in health care with potential changes at the state and federal level that will impact patients and healthcare systems. Placing UTMC in a position of success amid these changes is a top priority.
Q: How does your clinical understanding influence the ways you manage areas like radiology, lab services and cancer care operations?
RS: A perfect example is today. I do what I call a “day in the life,” where I spend a couple hours with each area so I can understand their work, advocate for them, and help remove barriers preventing them from reaching their goals.
Today was my first time working with MRI techs. We had great conversations about the inpatient versus outpatient balance. We talked about strategies in working with providers to make sure we are utilizing the MRIs in the most cost-efficient way that meets the needs of our patients.
The team shared frustrations with prior authorizations, and I was able to connect with them—clinically and operationally—because I’ve lived through similar barriers in pharmacy.
We talked about how, in pharmacy, we overcame a lot of those barriers by putting policies and procedures in place by collaborating with physicians and setting a standard approach across the board.
Q: What advice would you give to other pharmacists considering a move into executive leadership?
RS: Say yes to opportunities that are presented to you. Don’t let the fear of the unknown dissuade you. Go in with a positive attitude. Have confidence in your training and your expertise.
Pharmacists are among the most trusted healthcare professionals. Our skill set; evidence-based thinking, interdisciplinary collaboration, and systems management — translates exceptionally well into leadership. Other departments appreciate working with people who’ve been in their shoes.
