Working With USCF

statements of work

UCSF wasn’t immune to the cost and efficiency challenges found in many pharmacy operations. A one-size-fits-all solution would not work at an institution with more than 20 locations throughout San Francisco and beyond. UCSF is an industry of its own, contributing to the intellectual rigor and economic vitality of San Francisco.

The extensive offerings of UCSF’s therapeutics — medications, medical devices, and diagnostic tests reside across multiple specialty areas. Organizationally, the pharmacy structure needed to support and compliment the overall care delivery and complex patient populations served by UCSF.

UCSF leaders knew they had to question old processes and assumptions and exhaustively examine pharmacy positions and operations. At the time, job vacancies and standardizations needed focus to keep pace with UCSF’s new acquisitions and innovations. Drug pricing strategies and overall cost management needed assessment. And ambulatory staff required increased pharmacy support.

The pharmacy enterprise had devolved into an undervalued and underutilized asset. This status was not the norm for the over-achieving UCSF global enterprise.


UCSF’s response was to lead and provide solutions. As a result, they initiated an intensive planning effort to transform pharmacy operations to add value to care delivery and to improve financial contribution to the organization. The pharmacy value improvement initiative involved assessing organizational structure, operations, financial stability, compliance, and safety across all points in the organization.

The first move involved UCSF establishing a multidisciplinary steering committee to provide project oversight. The team members represented hospital senior leadership, finance, nursing, informatics, legal, compliance, and value improvement.

The committee decided that this wasn’t a minor redesign in one P&L center. This organizational change required big thinking and an outside perspective. The committee selected Visante to support UCSF in this initiative. This consulting company in addition to a national profile and deep pharmacy expertise had a history of several successful pharmacy projects with UCSF. The committee engaged Visante because they had demonstrated their capabilities time and again by moving to quickly identify and solve issues. Trust and results were the deciding factors in turning to Visante to help transform UCSF healthcare through pharmacy.

“Visante is known to accelerate the business of pharmacy and provide a sustainable proposition. This is a partnership like no other, and is an integral part of USCF in many ways,” said Sheila Antrum, Chief Operating Officer; Senior Vice President, UCSF Health.

Visante delivered 12 statements of work that detailed the rationale and approach to achieve UCSF’s strategic imperatives on pharmacy. Before developing these improvement initiatives, Visante conducted a comprehensive program assessment and gap analysis. Following the assessment, Visante defined a budget and created scorecards to track outcomes and financial performance, which the steering committee monitored monthly.

The decision on the statements of work reinforced the following four themes with clear deliverables:


This multi-year plan sets a trajectory to drive transformation while managing costs and increasing revenue. The initiatives involved intentional disruption in rethinking where and how UCSF operated all its pharmacy areas. The bottom line, the collaboration between UCSF and Visante built a more vital pharmacy platform by redesigning the organizational structure and instilling strong quality and value initiatives to guide the new team.

The enhanced interdisciplinary pharmacy support and interactions established financial performance exceeding targets with a 30:1 return on investment with Visante’s engagement and approach.

Specifically, at the conclusion of the initial 12-month engagement, the improvements to the University Medical Center’s net operating margin from pharmacy operations exceeded $80 million and the organization improved service delivery, safety and compliance around medication use.

The statements of work focused on righting the ship. There was also a financial component to this project. Our target was to produce, at a minimum, a 10:1 return on investment.

James Jorgenson, Chief Operating Officer
Visante, Inc.