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The Plight of Pharmacists at Tertiary Hospital Essay


Introduction

The performance of employees in an organization is influenced by the work atmosphere and organizational culture that values the input of the individuals in the workplace. According to Bowen and Ostroff (2004), the expectation of many employees is to have a good work environment. For instance, a safe, healthy and friendly environment aids in bringing the best out of the employees, and it is a core element of job satisfaction.

The friendly environment can be achieved by the organization’s human resource manager’s putting in place an HR policy that balances all the processes of the organization. For example, a clear framework for managing disputes, development of public relations, and effective communication. The factors are crucial in the creation of efficient work teams which enhance the performance of an organization.

In the case of the pharmacists at a tertiary hospital in the Gulf Region, there are challenges that affect the execution of their mandates as desired. For example, communication dilemmas, disputes, incentives and organizational culture challenges are the major impediment to the performance of the pharmacy. The following paper applies congruence model, an organizational-wide level model to determine how the fit or lack of it between the elements affect the organization with the key focus on pharmacy practice and management.

Overview of the challenges in the Pharmacy

An organization cannot achieve a motivated team without good human resource management practices that motivate the employees in order to promote the work satisfaction. A critical analysis of the work dynamics of pharmacists at the tertiary hospital in the Gulf Region shows that there are challenges in the work processes. This is due to many issues that the pharmacists face ranging from leadership, employee relationships, communication, use of technology and compensation.

Ideal work environment plays a critical role in ensuring optimal performance of the employees. The work environment in the organization is not conducive. There is no good fit between the pharmacy department and other departments and as a result, cases of drug shortages are reported. Even though the pharmacists blame it on technology failure in which sometimes they have to bypass the barcodes, it is clear that there is no good leadership to coordinate the departments in order to ensure that IT systems are working as required. This signifies the lack of effective communication which affects the general performance of the organization. It lowers the motivation of the pharmacists to deal with unsatisfied patients.

Also, there are challenges of workload especially during the peak hours where many customers have to wait for long to be served. The other problem relates to the cooperation between employees. Therefore, there is the need to look for means to address the challenges that pharmacists face in their line of duty. The shortfalls can be related to inadequacies in factors such as supervision strategy, work load, job security, and staff cooperation.

The employees are not motivated due to disparities in the financial compensation system. For example, there is favor of expatriates over the locals. The disproportional payment negatively affects the motivation of the pharmacists. Also, there are indifferences in the staff/manager relationship which affects the general work processes. These factors lead to a riffle effect and hence the lack of cohesive work teams which increases instances of mistakes and employees ignoring each other.

This is the case of with Pharmacist A, who is less motivated due to lack of training. The manager has also not guaranteed a proper climate in which pharmacist A can train so that they perform duties and tasks. Non-cooperative employees during training sessions, as well as laziness during training, have affected the ability of pharmacist M to achieve full potential.

Based on the above dynamics that negatively influence the performance of employees, managers should ensure that work environments focus on the development of relationships so that employees achieve their full potential. In the third case, there are challenges of communication dilemma in which there is no clear channel of communication. There are conflicts in orders given to the pharmacists by different leaders, and hence, it becomes very difficult to determine what to implement and what to ignore. Secondly, there is no formal training process for new employees; the organization has left employees to self-learning process.

Thus, it is evident that functions of the organizations are disjointed which creates a platform for many disputes. This scenario relates to findings by Bhattacharya and Wright (2005) who pointed out that lack of congruence in the workplace demeans the performance of employees and hence affecting the competitive advantage of an organization. In the case of the hospital, with the current incongruence, it cannot achieve its mandate of providing optimal care to the community.

Thus, there is the need for proper set up of organizational structures that will enhance leadership that unifies the operations of the hospital. This can be achieved by invoking better HRM processes. It is worth noting that lack of proper organization leads to serious problems in relation to the management of daily activities. Hence, the need for proper processes that ensure fit in the organizational processes in terms of coordination between the pharmacists, organizational culture, leadership, and a good work relationship. This will ensure that personal needs such as work-life balance, remuneration, and personal satisfaction are achieved. On the other hand, motivated employees will improve the performance of the organization.

Congruence Model

Different factors affect the performance of an organization. The performance of an organization can be enhanced by understanding the drivers or the causes of performance and how they relate. Based on the analysis of the factors that influence the hospital, there is a depiction of some issues that derail optimal performance of pharmacists. In order to put in place measures to address the current challenges, application of Congruence Model can be used to examine the key elements affecting the operation of the hospital and how they can be applied to create fit in the organization.

The congruence model was developed by Michael Tushman and David Nadler. The Congruence Model is a management tool that is used to analyze issues affecting an organization in relation to team organization and measures that can be applied to fix the challenges. Congruence is a measure of the extent in which pairs of components fit together. Nadler et al. (n.d.) stated, “Other things being equal, the greater the total degree of congruence or fit between the various components, the more effective will be the organization” (p. 43).

In this perspective effectiveness relates to the degree to which the outputs of groups, individuals, and level of the organization are comparable to the expected outputs. The model is based on tenets of organizational performance, and it incorporates key elements of people, structure, culture and tasks (Nadler, Tushman & Hatvany, n.d.). According to Nadler et al. (n.d.), high congruence among the elements is a predictor of better performance.

On the other hand, the lack of congruence lowers the motivation of employees and hence reduces output. For instance, an organization with competent employees, but that lacks organizational culture results in the lack of fit which affects the overall work environment. Thus, the competence of the employees cannot be manifested in the organization.

Application of the Model

With the age of technology, many organizations have employed the use of technology by automation of their operations. However, the lack of good relationships within an organization the achievement of the results required. A case example relates to the automation of systems in the tertiary hospital, but still there are shortages in the stores, and the movement of inventory is not clearly monitored due to possible lack of coordination between departments. Thus, the congruence model provides a better way of organizing the various elements that are key to organizational performance in order to promote the performance of the organization.

Task (work) is one of the four components the Congruence Model. The first step towards congruence in an organization is to understand the core activities of the organization. The main consideration of the components is to examine the crucial tasks that are carried out within the organization. This is mainly based on how work is done and how it is processed. Therefore, the HRM should examine the knowledge required to carry out the work, the intrinsic rewards that may be provided in order to complete the work, the approach needed to ensure efficiency to carry out the work. Task is also related to the interdependencies between the people executing the work.

Concerning the tertiary hospital, the processing and execution of the pharmacy processes are faced by challenges of poor coordination. For instance, there are challenges with the application of technology in dispensing the drugs. In addition, there is no coordination between employees which negatively the work output. In general, there is no fit in the work processes, and hence, the accuracy and efficiency of the hospital are affected.

The second component of the model is the people. This component deals with the identification the type of individuals who are involved in performing the organizational tasks. In the process of the identification, there is the need to consider the preferences of the people, their expectations, and the perception they hold about their duties. Demographic factors also come to play such as ethnicity and gender.

The preferences entail the peoples’ requirements in terms of compensation, career progression, and commitment to the organization. The factors are critical in influencing the relationship between the employees and their ability to work towards attaining the organization’s goals. This is a critical factor in the pharmacy; most of the incongruence seems to happen due the management and leadership of the organization failing to put in place strategies to address the needs of the pharmacists.

For example, there are concerns that the compensation in the organization is disproportional. Besides, some employees go out of their way to put extra effort in their duties, but they are not rewarded. It is the expectation of many employees that compensation should take into consideration the personal work output. However, this is not the case at the tertiary hospital.

The various cases presented by the employees shows that the HRM leadership is disconnected with the expectations of the employees and hence the low motivation. According to Malik, Danish and Munir (2012), leadership consists of strategies that motivate, inspire, and encourage individuals with the aim of spurring growth and development in an organization. Motivation helps the followers to make priorities by concentrating on the goals of the organization rather than their personal goals. This is paramount in the organizational development. A key element of motivation is a reward in the form of salaries that correspond to the performance of the employees. Therefore, to ensure fit, there should be a leadership style that fosters all direction communication such as transformational leadership style.

Organizational structure is the third component which entails the examination of the formal structure of the organization, the systems, and processes that aid in the performance of the organization. The component focuses on the design of the organization, the standardizations, how the work is quantified and the subsequent rewards, and the rigidity of the lines of the management process. In the tertiary hospital, there are no systems that measure the performance of the employees hence no reward system based on performance. Also, the pharmacy lacks a clear organizational structure, which leads to the communication dilemma as there is no formal structure on how instructions are passed to the pharmacists.

Finally, the fourth component is the informal organizations which include the arrangements within an entity which are usually implicit but contribute to the overall organizational behavior. The factors can enhance or derail the performance of the organizations. A great deal of the informal organization depends on the attitudes, motivation, and beliefs. Leadership style plays a critical role in the informal organization. Concerning, the hospital, there is the lack of clear work culture which is depicted by the lack of teamwork spirit. The pharmacists do not responsibility within their department as collective requirement; instead, they blame each for mistakes that happen. For example, mistakes made by the untrained pharmacist make the colleagues ignore and blame her.

From the four elements of the congruence model, it can be pointed out that performance of the pharmacy department is not efficient as expected. This is due to incongruence that characterizes the operations. The implications of the analysis are that there s the need to reorganize the hospital’s processes in order to achieve a fit that will restore the pharmacy to improved performance. Figure 1 is a sample of the organization of the four critical elements required to achieve the performance of an organization.

The Congruence Model

Process of Achieving Congruence

The congruence between the HR practice and the strategy of the firm has been emphasized as a key factor in the strategic human resource management. Wei (2006) noted that it entails bringing together the function of human resource to the strategy of the organization. Furthermore, many studies have been conducted to find out the relationship between the human resource strategic management, and the performance of the organizations. The key finding has been that there is the need for a fit in the overall organizational performance in order to achieve the desired performance. Fit refers to the planned pattern of human resource deployment and activities that enhance a good work environment in order to achieve the organizational goals.

Fit can either be vertical or horizontal. The vertical fit entails congruence among the HRM practices while the vertical fit aids the alignment of human resource practices within the organization in order to ensure better management of the firm. This may include proper communication systems. Thus, for an organization to ensure increased performance, there is the need to achieve the both the horizontal and vertical fit.

The determinants of horizontal fit include the HR organizational policy, investment and key processes of the human resources management and the options of the HR practices. These factors result in congruence of the HR practices. For example, in the tertiary hospital, vertical fit relates to the policy of the organization in relation to the employment, training and compensation of the employees.

In the case for the pharmacists, the HRM lacks a good policy on the training of the employees and hence the incongruence in relation to the relations among the pharmacists and hence the mistakes in the drug prescriptions and monitoring of inventory. Similarly, the compensation of the employees differs depending on the affiliation or nationality instead of performance based remuneration. Therefore, there is no good balance of the processes. Wei (2006) observed that if some functions are treated as less important than others, there is the likelihood of HRM inclining to the functions perceived as ‘great’ and hence with time, divisions in the management occurs which leads to neglecting the perceived lesser functions.

For example, a policy that does not place attention to practices such as training and compensation and emphasizes only on employees’ ability to meet targets, leads to poor congruence. The case has been experienced in the hospital, for example, it seems training of new employees has been relegated to the category of the less essential functions. The result has been compromised drug prescription.

To achieve the horizontal fit, there is the need to ensure balance by incorporating a policy that emphasizes the importance of all HR practices. In such case, new recruits in the hospital should be given training priority. In addition, compensation should be streamlined to ensure that there are no disparities, and individual performances are recognized and appreciated. The policy should also result in a recruitment policy that ensures that there are enough pharmacists to serve the customers.

On the other hand, vertical fit is usually impacted by the organizational values and cultures. According to Cable and Edwards (2004), determinants of vertical fit influence how quick a strategy can be executed in an organization. The values and cultures of an organization are influenced by the leadership and management of the organization. For example, in the pharmacy, there is no clear culture and values of the organization. As a result, the communication processes in the organization lead to dilemma as the pharmacists do not know the orders to follow.

In addition, there is a problem of performance culture in which the pharmacist blames the technological failure to the inability to have all drugs stocked in the stores. The disconnect affects the overall performance of the organization and patients are disappointed in the final states of treatments by pharmacy department.

The proposition to achieve the vertical congruence in terms of leadership, performance culture and overall organizational values, is that there should be a work design that is compatible with the overall work environment and the adjustment of the practice in order to ensure that there is a strategic change. The strategic change will make sure that pharmacists work in a manner that will promote patient-centered care. It is worth noting that pharmacy plays an integral role in the overall process of health care provision.

A failure in the department implies that the main goals of the hospital are not realized. Overall, for congruence to be realized in the hospital, the four elements have to fit together, i.e. the culture, structure, people, and tasks. Nadler et al. (n.d.) pointed out that when there is unison to support and promote improved performance, it leads to an organization-wide system that can realize its core mandates by functioning effectively. However, when the unison lacks, there is increased friction in the organization, which limits the ability of the organization to perform optimally.

Conclusion

The performance of any organization is affected by how different factors interact to create a good work environment. In the case of the pharmacists in the tertiary hospital in the Gulf Region, it is evident that the various elements of the organization are not in congruence. This has been the main cause of the inefficiencies and ineffectiveness. Thus, there is the need to realign the processes of the organization to achieve a fit in the operations.

The changes should be aimed at creating synergies in the four elements in order to attain a cohesive workforce that will transform the functions at the pharmacy departments. It is worth noting that it is the task of the human resource managers to initiate leadership that will lead to the transformation towards achieving the required balance. The primary role of any management team is to ensure that organizations function efficiently. One fundamental process of achieving performance is by making sure that there is congruence in the organizations. This is crucial for health institutions that have to provide patient-centered care.

References

Bhattacharya, M., & Wright, P.M. (2005). Managing human assets in an uncertain world: applying real options theory to HRM. International Journal of Human Resource Management, 16(6), 929-948.

Bowen, D.E., & Ostroff, C. (2004). Understanding HRM-firm performance linkages: The role of the ‘strength’ of the HRM system. Academy of Management Review, 29(2), 203-221.

Cable, D. M., & Edwards, J. R. (2004). Complementary and supplementary fit: a theoretical and empirical integration. Journal of Applied Psychology, 89(5), 822- 824.

Malik, M., Danish, R., & Munir, Y. (2012). The role of transformational leadership and leaders’ emotional quotient in organizational learning. World Applied Science Journal, 16(6), 814-818.

Nadler, D. A., Tushman, M. L., & Hatvany, N. G. (n.d.). Managing organizations. Boston: Little, Brown and Company.

Wei, L. (2006). Strategic Human Resource Management: Determinants of Fit. Research and Practice in Human Resource Management, 14(2), 49-60.

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IvyPanda. 2020. "The Plight of Pharmacists at Tertiary Hospital." October 1, 2020. https://ivypanda.com/essays/the-plight-of-pharmacists-at-tertiary-hospital/.

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