Organizational Structure

What is Horizontal Hierarchy (bottom-up)?

Flat/bottom-up organizations attempt to engage ALL employees

What are benefits with horizontal hierarchy?

• Encourage intrapreneurship in an org

• promote/recognize innovation at all employee levels

• Create better engagement/satisfaction among employees

• allows employees to:

  • Be creative, feel comfortable asking questions about tasks, promote efficiencies they develop, can lead to inconsistencies between sites

What is the Vertical Hierarchy/top-down?

systemize employee activity more substantially

What are the goals in Vertical Hierarchy?

Focus on consistency of completing tasks

• Training employees on what is expected

• May not always provide needed background to understand why

What are the benefits with Vertical Hierarchy?

Understand expectations, limits the questioning of “why” things are done a certain way, eliminates the likelihood of inconsistencies between sites

What is Organizational Culture?

Shared beliefs shared held by members of the organization that guide interpretation and action by defining appropriate behavior for various situations

• influenced by reason for existence, organizational ethics

What are the 3 types of organizational culture?

1. Constructive culture

2. Passive-defensive culture

3. Aggressive-defensive culture

What is constructive culture?

members are encouraged to interact with people and approach tasks in ways that help them meet their higher-order satisfaction needs

What is Passive-defensive culture?

members believe they must interact with people in ways that will not threaten their own security

What is Aggressive-defensive culture?

members are expected to approach tasks in forceful ways to protect their status and security

What can a positive culture help develop?

retain quality employees, attract quality new talent, enhance efficiency, encourage teamwork and open communication

What can a negative culture lead to?

toxic environment with employee turnover, discourages employees from exploring innovation, discourages teamwork and leads to focus on independent work, employees become defensive and try to avoid blame

In the Inpatient health-system pharmacy, the general inpatient pharmacy org structure has typically been developed at….

individual sites (hospitals)

What does the Inpatient health-system pharmacy typically involve?

• director of pharmacy (overall pharmacy management position)

• Director of clinical pharmacy (manages clinical pharmacists/programs)

• Manager of inpatient pharmacy (manages central pharmacy activities)

What is the fundamental function of a hospital pharmacy?

Procurement, distribution and control of all pharmaceuticals used within the facility

What is the workflow related to the distribution process in a hospital pharmacy?

• Multiple individuals, dispersed throughout the facility, impacts most

  aspects of inpatient care

• Management of inpatient pharmacy services has significant impact on

  the overall facility

What is the organization culture at large chain community pharmacies?

Focus is on implementing systematic approaches to operating pharmacies

What do large chains mainly have in their organizational culture?

Corporate headquarters who oversee: regional directors/managers; local managers who oversee staff, techs, local pharmacy services and workflow

What is the organization culture at small chain/independent community pharmacies?

• Focus is on local store/pharmacy operations

• Typically offers much more flexibility

• Requires more engagement by PIC in overall mngmt (sets local culture, less corporate support)

What is the organization culture at outpatient health-system pharmacies?

• operate similar to traditional community pharmacies

• focused on outpatient dispensing

• management strategies target safe, effective, accurate rx dispensing

What do most outpatient health-system management structure involve?

local pharmacist manager, organizational pharmacy director, all fit under the umbrella of overall health-system administration

What is the impact of corporation size on organizational management that is larger?

the larger the corporation → the larger the number of decision makers →

• greater impact of each organizational decision, increased difficulty to ensure consistency between sites, increase oversight from corporate decision makers

What is the impact of corporation size on organizational management that is a single store/small corporation?

increased freedom to employees, often embrace employee driven innovation

In the pharmacy work environment, what can impact the day to day operations?

what the pharmacy’s organizational structure and practice setting

How can an optimal pharmacy design and layout options can be developed?

perform a workflow analysis

What is workflow analysis?

Defined as a systematic process by which tasks being performed in a particular work environment are broken down into individual steps and evaluate for variables such as accuracy, safety, efficiency, customer/patient satisfaction

How are tasks treated in a workflow analysis?

• all essential tasks are identified

• order in how the tasks/steps of process will be performed, along w/ environment in which steps will be conducted, are described and designed

What is a psychosocial environemnt?

relationships, employee attitudes, individual autonomy, organizational culture

What is a physical environment?

workspace, temp, airflow, safety, security

What is an important trait of the environment that should be considered in workflow design?

adaptability of environment

• organic workflows allow for modification based on needs

• mechanistic workflows are more rigid