PHARMACY MANAGEMENT:CONTEMPORARY WORKPLACE ISSUES

(12)

CUSTOMER SERVICE (11)

Christian B. Albano, PhD, MBA, MPH

OBJECTIVES:

Identify workplace/professional factors that

impact the effectiveness of organizations

Contemporary Workplace Issues & Cultural

Competency

Job Enrichment and Quality of Work Life

Work Safety Issues

Job Stress and Employee Impairment

Managing a Diverse Workforce

Career Planning

Managerial (Business) ethics

Customer Service2

JOB ENRICHMENT AND QUALITY OF WORK

Classical Pharmacy Job Design

Emphasizes standardization and segmentation

Requires accuracy, efficiency, and compliance – e.g.

community/retail pharmacist

Automations and technicians do more

Clinical Pharmacy Job Design

Pharmaceutical care that requires increased

professionalism, a different practice philosophy, and

enriched job environment to address ―higher order‖

pharmacist needs (i.e., MTM) – e.g. hospital pharmacist

Which do you prefer? Is there a movement? 3

MOTIVATION

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INTRINSIC MOTIVATION = QUALITY OF

WORK

Intrinsically motivating jobs and enriched job

environments increase satisfaction and

performance

Encourage 3 basic psychological states:

Experience meaningfulness of work

Knowledge of outcomes

Being responsible for outcomes5

INTRINSIC MOTIVATION = QUALITY OF

WORK

Do you have a strong need for growth, personal

accomplishment, self-direction, and learning?

Core job characteristics necessary to accomplish goals

(to what degree…):

Skill variety – demand greater skills

Task identity – complete the set of interventions or tasks

Task significance – impact for the well being of others

Autonomy – exercise independent judgment of the work

Feedback – feedback that is independent of supervisors &

co-workers

Academia example

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INTRINSIC MOTIVATION

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WORK SAFETY ISSUES

Organizations responsible for a safe environment

Managers in large organizations must interact with safety

staff, risk managers, and others to ensure the well-being of

their employees

May defer some responsibility to other areas

Hospital pharmacy

Managers in smaller organizations must take more

responsibility to be

familiar with rules and regulations

to ensure compliance with the law and a safe, productive

workforce

Community pharmacy 8

WORK SAFETY ISSUES

e.g., TOYOTA

This One You Oughta Tow Away

Organizational structure impacts

safety

Machine bureaucracy: formal, top-

down, dehumanizing, boring

(Mintzberg, Henry)

Formal safety rules & regulations

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http://www.newser.com/tag/17680/1/car-safety.html

WORK SAFETY ISSUES: OSHA

Occupational Safety and Health Act

Formed the Occupational Safety and Health Administration in

2003

Established the government’s role in promulgating and

enforcing safety and health standards for places of

employment

It is the responsibility of every employer to provide a

work environment that is free from recognized

hazards

Failure to comply with rules and regulations can result

in severe fines and penalties 10

WORK SAFETY ISSUES: NIOSH

National Institute for Occupational

Safety and Health

Conducts research on criteria for

specific functions and occupations Ergonomics and human factor

Publishes safety and health

standards related to workplace

hazards i.e, blood-borne

pathogens/chemical hazards Exposure plans/Post exposure follow up plans

http://www.swmedsource.com/p

harmacy_seating.htm

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es/ExerciseBallChairGirlSide.jpg11

JOB STRESS AND EMPLOYEE IMPAIRMENT

Recognize and identify stress

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JOB STRESS AND EMPLOYEE IMPAIRMENT

Long-term stagnation stress high turnover, absenteeism

and poor work performance

Function of demands, coping ability, skills, and supports

Function of Personality: Type A (coronary-prone behavioral pattern)

vs. Type B

Managerial and organizational duties:

To ↓ stress match the following with the demands/type of job

employee qualifications match tasks

skills match tasks

interest/personality mesh with the responsibilities

Awareness of employee behavior to observe symptoms of stress

reactions

Employee Assistance Program (EAP)

Mental health & substance abuse13

EMPLOYEE ASSISTANCE PROGRAM (EAP)

Voluntary and confidential Manager can suggest a referral based on poor work

performance or other related work problems

EAP professionals are licensed psychiatrists,

psychologists, addiction counselors, clinical social

workers Have to abide by HIPPA – employees can sign a releases to

share ―limited‖ information with employers

Training of managers in early identification and

referral improves EAP utilization 14

BENEFITS OF MANAGING STRESS

Lower turnover and absenteeism

Higher job satisfaction

Improvements in productivity and efficiency

Customer satisfaction

Physical and emotional health

Happiness15

DRUG/ALCOHOL ABUSE: MGMT INTERVENTION

Universal access + false sense of invulnerability substance abuse

Pharmacists and managers have responsibilities and obligations NOT to ―enable‖ another’s abuse

Pharmacy has taken a rehabilitative rather than a punitive stance towards impaired pharmacists State Board of Pharmacy

Pharmacy Assist Programs within each state16

DRUG/ALCOHOL ABUSE: MGMT INTERVENTION

Procedures for managing impaired pharmacist

1. Mandatory state board reporting requirements

2. Intervention by an organization, working closely with

the state board

3. Professional assessment

4. Treatment recommendations

5. After-care counseling and monitoring usually involving

Alcoholics Anonymous or Narcotics Anonymous

6. Random drug testing for a defined period

7. Reinstatement to practice contingent on successful

completion of treatment17

MANAGING A DIVERSE

WORKFORCE

DIVERSITY: DEFINITIONS

Diversity is all forms of individual differences, including culture, gender, age, ability, religion, personality, social status, and sexual orientation

The ability to value diversity and use these resources effectively, will be critical to the success of an organization

Managing diversity requires creating a workplace environment of quality of opportunity and respect for individual differences and capabilities

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DIVERSITY: BOTTOM-LINE

Managed improperly: (lack of) diversity tunnel

vision no creativity and no $

Managed properly: (more) Diversity escaping

tunnel vision innovations and $

Avoid “groupthink” : when a group makes faulty

decisions because group pressures lead to a

deterioration of “mental efficiency, reality testing,

and moral judgment”

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DIVERSITY: BOTTOM-LINE

“Good to Great” by Jim Collins

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DIVERSITY: BY THE YEAR 2020

More culturally diverse population

Minorities will constitute ½ of the new entrants in

the US workforce

White non-Hispanics will constitute 68% of the

workforce which was 76% in 1977

14% of the work force will be Hispanic, 11%

African American, 6% Asian

The same number of women as men will be

employed

More workers with disabilities will be employed

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DIVERSITY: MANAGEMENT AWARENESS

Managers need to be aware of general concepts

of discrimination:

Reasonable accommodation: making the

workplace both accessible and capable of use by

individuals with disabilities

Disparate treatment: different treatments and

opportunities are afforded to diverse individuals

Affirmative Action

Disparate impact: involves neutral employment

practices that lack apparent discrimination, but

exclude a group from opportunity

Highering based on a biased test23

DIVERSITY: MANAGEMENT INTERVENTIONS

Training programs that increase awareness/respect

for cultural pluralism

Educate people regarding practices that involve

negative stereotyping and negative impact on

minorities

Counseling when potential discriminatory practices

take place

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SEXUAL HARASSMENT

According to the Equal Employment Opportunity

Commission (EEOC), sexual harassment is unwelcome

sexual attention, whether verbal or physical, that affects

an employee’s job conditions or creates a hostile working

environment

Types:

Gender harassment includes crude comments or sexual jokes

and behaviors that disparage someone’s gender or convey

hostility toward a particular gender

Unwanted sexual attention involves unwanted touching or

repeated unwanted pressures for dates

Sexual coercion consists of implicit or explicit demands for

sexual favors by threatening negative job-related consequences

or the promise of job-related awards 25

SEXUAL HARASSMENT STATISTICS

In 2005, the EEOC received 12, 679 complaints at the federal level concerning sexual harassment. 14.3% of which were filed by males

Sexual harassment costs the typical Fortune 500company $6.7 million per year in absenteeism, turnover, and loss of productivity

Victims are prone to all of the results of extreme workplace conflict Poor mental health, symptoms of post-traumatic stress

disorder

Report of alcohol abuse, depression, headaches, and nausea 26

A DIVERSE WORKPLACE: BENEFITS

Bottom-line: creativity and $

Attract a larger talent pool

Enhanced knowledge of diverse markets

Increased probability of addressing unique customer

needs

Organizational agility in times of change

Problem solving and creativity are enhanced as a result of

diverse ―group think‖ capabilities

Promotes creativity and innovation

Remain competitive in a global market27

CAREER PLANNING

The active management of a career involves providing or attaining developmentally appropriate experience, education and training to decide, focus on, and nurture career progression

Career anchors:

technical/functional, managerial, security-oriented, autonomy-oriented, and creativity oriented

While managers can help choose the right fit between talents, interest, and job opportunities, the main responsibility for career management rests with the individual

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MANAGERIAL (BUSINESS) ETHICS

Healthcare is a moral enterprise – involving

issues of quality of life and suffering and

death

Pharmacist’s Code of Ethics:

is intended to publicly state the principles that

form the fundamental basis of the roles and

responsibilities of pharmacists

is established to guide pharmacist in relationships

with patients, health professionals, and society

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MANAGERIAL (BUSINESS) ETHICS

Pharmacist’s Code of Ethics

1. A pharmacist respects the covenantal relationship between the

patient and pharmacist.

2. A pharmacist promotes the good of every patient in a caring,

compassionate, and confidential manner.

3. A pharmacist respects the autonomy and dignity of each patient.

4. A pharmacist acts with honesty and integrity in professional

relationships.

5. A pharmacist maintains professional competence.

6. A pharmacist respects the values and abilities of colleagues and

other health professionals.

7. A pharmacist serves individual, community, and societal needs.

8. A pharmacist seeks justice in the distribution of health resources.

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MANAGERIAL (BUSINESS) ETHICS

Goals of Business ethics program:

Business ethics program must provide a code of

conduct that is short, specific, and easy to

understand for all employees

A business ethics program requires absolute

commitment from the top down in an organization

A business ethics program should provide guidelines

to help employees avoid doing something ―wrong‖

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THE CUSTOMER SERVICE The interaction between the service

organization/service provider, and the customer

Pharmacy is a service business

CHARACTERISTICS OF SERVICES:

“SELLING THE INVISIBLE”

The customer is a participant in the service process

Services are produced and consumed

simultaneously

Services are perishable

Service site location is dictated by the consumer

Economies of scale are difficult to achieve in

services

Standardization of services is difficult

Services are labor-intensive

Service output is difficult to measure33

STANDARDS FOR SERVICES

Reliability: the ability to perform the promised service dependably and accurately (most valued by customers)

Responsiveness: the willingness to help customers and provide prompt service

Assurance: the knowledge and courtesy of employees and their ability to convey trust and confidence

Empathy: the caring, individualized attention provided to customers

Tangibles: the appearance of physical facilities, equipment, personnel, and communication materials

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MANAGING A SUCCESSFUL SERVICE ENCOUNTER

EMPOWERED EMPLOYEES NEED:

Information about the organization’s performance

Rewards based on the organization’s performance

Knowledge that allows employees to understand and contribute to organizational performance

Power to make decisions that influence organizational direction and performance

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AN EMPOWERED EMPLOYEE WILL:

Respond more quickly to customer needs during the service encounter

Respond more quickly to dissatisfied consumers during service recovery

Feel better about their jobs and themselves

Interact with consumers with more warmth and enthusiasm

innovate and improve 37

MEASURING SERVICE QUALITY

Quality of Service = Expectations – Perceptions

Quality of the service is defined by the gap between the expectation for the service and the perception of how it was delivered.

Perception is everything

CUSTOMER EXPECTATIONS

Ideal = Desired

Adequate = Satisfaction

Zone of tolerance = any level of service in

the gap between ideal and adequate

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DESIGNING SERVICES

What is the product (service)?

―consumer benefit‖ -- tangible and intangible

How will this service be priced?

Financial return, market share, or meet the competition

How will the service be positioned, promoted, and branded?

On what basis can the market be segmented—demographic,

geographic, psychographic, etc.

How will the service be delivered?

Brick and mortar location and/or internet

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DESIGNING SERVICES

What will the facility look like? What will the employees look

like?

First impressions

What procedures/protocols will be put in place for the

delivery of the service?

Quality measures

Who will deliver the service? How will they be trained,

promoted, and motivated?

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