*Dr. Khatri is serving in her personal capacity.

What are you doing now and how did you get there? What is your vision for the future?

I started my pharmacy career at Kaiser Permanente, where I served as the Mid-Atlantic Area Clinical Coordinator for the Kaiser Permanente’s Mid Atlantic Anticoagulation Clinic (serving Maryland, Virginia and DC residents). During my tenure (2000-2007) at Kaiser, I managed Kaiser’s Anticoagulation Clinic, achieving Kaiser’s recognition and best pharmacist award for best clinical practices by dramatically reducing hospitalizations and patient care costs. I supervised, developed guidelines, monitored, and mentored staff and clinical pharmacists. During my clinical practice, I came across inter-clinic variability among provider’s treatment and how they targeted the excessively narrow INR target ranges and patient variability. This led me to establish a viable and efficient workflow and process across Clinical Pharmacy Services and physicians. I collaborated with the Kaiser Physician group and developed and successfully launched a new Health System application (EPIC). This resulted in better clinical decisions and a transparent new workflow for the clinical services which Kaiser is currently using.

My increasing passion for patient safety cultivated a desire for me to join the National Action Plan for Adverse Drug Event Prevention, of which I am currently a member. Being part of this group has not only provided me with an opportunity to connect and learn from health care leaders in other agencies at both national and local levels, but this unique educational experience has strengthened my understanding of tracking and monitoring surveillance as well as creating policies intended to serve the public at large. Through this program-specific framework, I believe that I can provide a bridge between the fundamental scientific explorations that are conducted to improve public health and the communities they are intended to serve.

Later in my career in 2007, I moved from private sector to the U.S. Food and Drug Administration, where I served as the Director of the FDA Pharmacy Student Experiential Program (2007-2015). Under my leadership, I conceptualized, initiated and implemented measures which significantly improved the visibility and involvement of FDA Pharmacy Student Program across the Agency and nation’s academia. I expanded the effectiveness and outreach of the Program throughout the nation’s academia, expanded FDA’s preceptor cadre, introduced office collaborations and exponentially increased student participation contributing to their understanding of FDA’s role in protecting the public health. The Program grew exponentially under my leadership from 70 student applications to approximately 700—a 900% increase. I collaborated with other FDA Centers and offered FDA employees throughout the Agency the opportunity to mentor student pharmacists. I created and launched an electronic resource library for preceptors to assist them with necessary steps in on-boarding students. This dramatically increased preceptor participation and created more opportunities for students at the FDA. I also, assisted in developing an online pharmacy student application system, which eliminated the need for paper application, making the entire application process efficient. I received a PHS Commendation Medal for recognition of my leadership and sustained performance.

I currently serve (2015-present) as a Regulatory Officer at the US Food and Drug Administration (FDA) in the Center for Drug Evaluation and Research (CDER)’s Office of Center Director at the Professional Affairs and Stakeholder Engagement (PASE) group. I apply my extensive knowledge of public health and communications to improve our stakeholder’s drug regulatory insight and understanding. This enriches the experience of patients, advocacy groups, health care professionals and public health agencies in further engaging with the Center for Drug Evaluation and Research. This not only promotes a broader understanding of FDA’s critical-mission initiatives among stakeholders, but also promotes stronger professional networks within federal health care sectors. In my current position, I implement teambuilding exercises and organize teambuilding training sessions to improve morale and to eliminate management and staff conflict, Equal Employment Opportunity complaints and minimize resistance to change.

As part of PASE, I contribute to FDA’s mission by providing systematic and coordinated engagement with stakeholders to develop complementary, collaborative actions that will improve medication use and increase awareness of regulatory activities. This includes meeting with and responding to advocacy groups and professional organizations about drug development, drug review, and drug safety. I also respond to public inquiries by phone and email, provide mentorship to onboarding students and employees and perform quality control on the responses we issue. Finally, I trust that in being an effective leader, I will foster leadership in others and, in turn, leave a legacy that will positively impact the agency.

I also established collaboration between the American Medical Association (AMA) and the FDA and successfully created and launched a FDA-AMA medical student/resident Experiential program. This is the only experiential program at the FDA which allows the young medical doctors to experience the FDA at its best and gives them a unique opportunity to learn firsthand how CDER serves the public. In 2015, there were 27 applicants from top notch medical schools such as Harvard, Brown and Dartmouth University. CDER leadership has shown strong support for this medical internship and recognizes the benefits for both the FDA and academia. I introduced and presented the program agency wide in the CDER town hall meeting. As a leader of our FDA Medical Student and Resident Experiential Program, I have a vision to grow the program by increasing the awareness of the non-traditional roles of medical doctors in FDA. There is room for improvement to cultivate and enhance this program, target appropriate audiences and provide the leadership and guidance that they need.

As a collateral duty, I also serve as a pharmacist representative for the FDA on the prestigious Human Health Services (HHS) Medical Claims Review Panel (MCRP) and assist the Department in meeting responsibility to provide quality health care in its facilities and by its providers. Collectively the panel is responsible to review and evaluate analysis performed by HHS or consultant physicians and other health care professionals on paid claims for damage, injury, or death filed under the Federal Tort Claims Act (FTCA) against a DHHS facility or healthcare practitioner covered under the FTCA. As a pharmacist, I apply my clinical knowledge and expertise and am responsible for identifying clinician(s) who provide the necessary treatment and give rise to the claim to determine whether the standard of care was breached. The activity occurs after a claim has been paid pursuant to a settlement or adverse judgment. I provide professional recommendations to HHS clinical programs and personal systems on matters of quality assurance and risk management activities within the context of the cases reviewed. The MCRP determines if the standard of care was breached which determines if the practitioner will be named in the National Practitioner Data Bank (NPDB). Being on this prestigious panel has enabled me to better understand the policies surrounding various federal health facilities and how they secure and efficiently exchange information between the health care facilities and MCRP. This experience has enhanced my current understanding of the quality improvements at the DHHS healthcare facilities that will help promote excellence in patient care.

WMSHP Engagement
I have performed at an executive level in WMSHP during my career at Kaiser Permanente and at the U.S. Food and Drug Administration. Currently, I am serving as a board member of WMSHP. The USPHS officers who have served on leadership roles at WMSHP speak very positively of their experiences. The transferable skills acquired are now reflected in their leadership approach. WMSHP provides an opportunity to meet other influential leaders in various pharmacy practice settings. Each practice setting and different organizations possess their individual visions and dynamics, and thus it is critical to learn from the experiences of different pharmacy leaders with varying perspectives. I am particularly interested in applying such leadership in the day to day managerial and leadership opportunities within my office. Through an array of diverse, inclusive, and supportive group of pharmacists, I will be better equipped and motivated to explore innovative health education initiatives that target various pharmacy settings and public health policies that will continue in promoting patient safety and care. This has been a great experience with the interaction of members helping me understand what is going on in pharmacy outside my work environment. It has also been a delightful experience.

Advice for new practitioners
Pharmacy has evolved dramatically in the last generation and will continue to do so. Continue to train yourself to meet the changing demands. Be ready for the change and be creative and think strategically to achieve your goal. Now pharmacists have much more varied positions. They combine their pharmacy education with advanced clinical training, and go back to school to study something outside of medicine that can be applied to the pharmacy profession. In the end, I would like to say for the next generation of pharmacists, “Never follow your passion, but always bring it with you,” -- Mike Rowe.

I would like to take this opportunity to express my gratitude to the entire WMSHP leadership and especially to Dr. Vaiyapuri Subramaniam, CAPT John Quinn and Dr. Justin Sebakijje for nominating me. It has been a great experience working alongside these versatile leaders.

Sadhna Khatri, MS, MEd, PharmD, MPH