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Figure 2-1 describes one way in which Fayol's management functions can be adapted to describe what managers do in today's world. There are three dimensions of management: (1) activities that managers perform, (2) resources that managers need, and (3) levels at which managers make decisions. Every action taken by a manager involves at least one aspect of each of the three dimensions.
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Management Activities
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Fayol's five management functions have been adapted to describe four activities that all managers perform. While managers who hold administrative positions in their organizations may have formal ways of performing these activities (and are evaluated on their ability to get them done), all managers (which means all of us!) perform each of these activities every day, whether we are thinking of them or not.
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The first of these four activities is planning. Planning is predetermining a course of action based on one's goals and objectives. Managers must consider many factors when planning, including their internal and external environments. The chief pharmacist at a community pharmacy or the director of a hospital pharmacy will develop plans to predetermine which drug products she wishes to carry or what professional services she might offer. Some pharmacists will even go so far as to develop formal strategic and business plans for their pharmacies (see Chapters 4, 5, 25, and 26). On the other hand, planning can also be very informal. Anyone who goes to work or school in the morning develops a plan for how he will get there (i.e., What time do I need to arrive? What form of transportation should I take? What route should I follow?).
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The next management activity is organizing. Organizing is the arrangement and relationship of activities and resources necessary for the effective accomplishment of a goal or objective. Once a pharmacist has decided which drug products or services she should offer, she needs to ask herself what resources she needs to provide them, how she will go about obtaining these resources, and then determine when she will need to obtain them. Once the person going to work or school has a plan, he needs to think about what else he may need to do to accomplish his goal (e.g., check the weather and traffic reports, get gas in his car, drop his kids off with a child care provider, etc.).
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The next step is the leading or directing step. This step combines Fayol's command and coordinate steps to provide a better description of what managers actually do in today's world. Leading or directing involves bringing about purposeful action toward some desired outcome. It can take the form of actually doing something yourself (the person going to work or school just needs to get up and go) or working with others to lead them to where you want your organization to be. A pharmacist eventually may offer the goods and services described in her plans, but almost certainly will need to work with a number of other people within her organization to accomplish this task. In the scenario, Krista Connelly, in her role as president of her ASP chapter, is responsible for seeing that the chapter's committees work effectively to accomplish their objectives. Working with others often requires leadership skills, which will be discussed in Chapter 16.
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The fourth step is the control or evaluation step. Control or evaluation involves reviewing the progress that has been made toward the objectives that were set out in the plan. This step involves not only determining what actually happened but also why it happened. Performing quality-control checks to help ensure that patients are receiving the desired medication in the appropriate manner is a very important function of a pharmacy practice. Pharmacists also can ask themselves if the goods and services they offered met their goals. These goals can be from the perspective of their patients (e.g., Did the goods and services result in high-quality patient care or improved clinical outcomes?), as well as from other perspectives (e.g., Did the service improve the pharmacist's job satisfaction? Did it improve the profitability of the pharmacy or organization?). The person going to work or school not only should ask himself if he arrived on time, but also should know why he did or did not (e.g., the traffic accident on the expressway, hitting the snooze button that third time before getting up, etc.). Chapters 8, 9, and 29 review methods that pharmacists use to evaluate the outcomes of their services, ensure the quality of their operations, and reduce the occurrence of medication errors.
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Management activities should be performed in order, starting with the planning step. They are also meant to be cyclic, meaning that what a manager learns in the control and evaluation step should be incorporated back into the planning step the next time she needs to accomplish that objective (Fig. 2-2). For example, if a pharmacy student receives a score on an examination that did not meet his goal, he should use what he learned in the evaluation step (e.g., what questions he got wrong, time spent studying, etc.) to help him plan for the next examination.
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Resources that Are Managed
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Regardless of their level or position within an organization, managers must use resources to achieve their goals and objectives. Keep in mind that resources are scarce, meaning that they are not available in unlimited supply. Both organizations and individuals must use resources efficiently to achieve their goals and objectives.
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The first resource that many managers think of is money. Customers generally provide money to pharmacies and pharmacists in exchange for goods and services. Employers generally pay their employees money in exchange for the services they provide to the organization. Managing money is important to any organization or individual, and several chapters of this book are dedicated to explaining how pharmacies and pharmacists manage money and use economic information to make decisions (see Chapters 17, 18, 19, and 20). Money in and of itself can be an important yardstick for measuring the success of an organization or an individual. However, most managers value money for its ability to allow them to obtain additional resources that are necessary to achieve other goals and objectives.
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Another resource that is very important to managers is people. In pharmacy practice, there is very little that any one person can accomplish on his or her own, regardless of the practice setting. Pharmacists must work with other employees in their pharmacies, other health care professionals, and especially the patients and customers they serve. Given the importance of this topic, an entire section of this book (Chapters 11, 12, 13, 14, and 15) is dedicated to the management of people.
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How many times have you heard someone say, “I'd have got that done if I'd have had more time”? Of all the resources managers have at their disposal, time can be the most limiting. After all, there are only 24 hours in a day! Time management is essential for today's busy pharmacist, as well as for most other people. In the scenario, Krista Connelly is a great example of a pharmacy student who could benefit from time and stress management. Chapter 10 is dedicated to time management, stress management, and organizational skills that can help you to get the most out of this precious resource.
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When many people think of pharmacy, they still think of a pharmacist standing behind a counter compounding drug products and dispensing prescriptions. While pharmacy practice continues to evolve from a product to a patient orientation, managing material resources is still an important function in any pharmacy. Community pharmacies filled 3.6 billion prescriptions in 2009, an increase of over 30 percent over the past decade (NACDS, 2010). The costs of these drug products, as well as the costs of the equipment and supplies necessary to dispense them safely and efficiently to patients, continues to rise in all practice settings. Just as people need to assess their needs and supplies of material goods (e.g., food, clothing, household supplies, etc.) before going on a shopping trip, pharmacies need to make the same assessments before purchasing drug products, equipment, and supplies. Chapters 6, 23, and 24 are all designed to help readers learn more about managing material resources.
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While the eighteenth and nineteenth centuries were known as the time of the industrial revolution, the twenty-first century certainly will be known as the information age. The advent of the computer and the Internet in the late twentieth century has resulted in an explosion of information that is literally at most people's fingertips. This already has had a tremendous impact on pharmacy practice, providing pharmacists with information about drugs and patients that they did not have only a few years ago. While it is not certain what implications this will have for pharmacy practice in the future, it is certain that information management is becoming an important job for pharmacists. Chapter 7 provides an overview of technologies that pharmacists use to manage information, as well as insights into what role information management may have in the future of pharmacy practice.
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When managers perform management activities, they can do so at a number of levels within an organization, and with a variety of different purposes in mind. While some people think of management activities occurring only in corporations and other complex organizations, management activities take place in all types of organizations, involving all levels of interactions among their members.
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There is not a person reading this book who has not performed self-management activities. Just the fact that you are a pharmacy student or pharmacist attests to the fact that you have performed a number of activities on your own just to get to this point. Self-management is the most frequently occurring level of management, if for no other reason than that practically every decision we make every day (both professional and personal) requires self-management. For example, pharmacists must prioritize and manage their time efficiently so that they can accomplish the wide variety of tasks, from ensuring that every prescription is dispensed accurately to making sure that they have time to counsel their patients.
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Next to self-management, the most frequent level on which managers find themselves performing is the interpersonal level. Interpersonal management occurs between the manager and one other person. In a pharmacy, this might involve a pharmacist counseling a patient about a medication or training a technician on how to submit a claim for a medication therapy management service with a third-party payer. Our personal lives are full of interpersonal relationships, including those with our parents, siblings, spouse, children, friends, and significant others.
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The level of management that occurs the least often is organizational management. This involves actions that affect groups of people. We frequently think of this occurring at work, especially when a pharmacist needs to develop a policy or make a decision that may affect many people at the pharmacy. High-level administrators in large organizations (e.g., pharmacy chains, hospitals, etc.) often make decisions that affect everyone within the organization. Keep in mind that people who hold administrative positions are not the only ones who perform organizational management. Anyone who has ever had to make an “executive decision” among a group of classmates who are studying for an examination or deciding where to go for lunch can relate to the kinds of organizational-level decisions that business leaders make every day.