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Collaborating with re-engineering consultants: maintaining resources for the future

J C McAllister1

  • 1Duke University Medical Center, Durham, NC 27710, USA.

American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists
|December 1, 1995
PubMed
Summary
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Pharmacy departments can successfully navigate institutional staff reductions. Effective teamwork and demonstrating service value helped Duke

Area of Science:

  • Healthcare Management
  • Pharmacy Administration
  • Organizational Change

Background:

  • Duke University Medical Center planned a significant staff reduction (1500 full-time equivalents).
  • A consulting firm was hired to assist with this institutional re-engineering initiative.
  • The pharmacy department was specifically targeted for a 16-week operational study.

Purpose of the Study:

  • To describe the negotiation process between a pharmacy department and a consulting firm during staff re-engineering.
  • To detail strategies employed by the pharmacy department to manage the reduction initiative.
  • To evaluate the success of the pharmacy department's response to proposed staff cuts.

Main Methods:

  • Pharmacy staff were educated on the re-engineering process and management expectations.

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  • Assistant directors led "operations improvement" in their areas, defining work activities and time requirements.
  • Data on supplemental resource needs (paid time off, education, meetings) were collected.
  • Resource requirements for clinical specialists and other staff were assessed separately.
  • Negotiations on human resource requirements were conducted between department leaders and consultants.

    • Main Results:

    • The pharmacy department proposed only a 5% reduction in full-time equivalents (FTEs).
    • The department ultimately gained one pharmacist FTE, contrasting with significant losses in other medical center departments.
    • Most other departments faced much larger FTE reductions (over 800 FTEs lost across the medical center).

    Conclusions:

    • The Duke pharmacy department successfully managed the re-engineering initiative.
    • Key success factors included teamwork, staff participation, empowered leadership, and demonstrating the pharmacy's value.
    • Proactive engagement and data-driven negotiation were crucial for preserving pharmacy staffing levels.