Hospital Pharmacy Management


The three basic elements of delegation (responsibility, authority and accountability) are discussed with regard to effective management.
Major guidelines for effective delegation are noted including
(1) Securing a mutual commitment to responsibilities involved
(2) Establishing goals and checkpoints;
(3) Giving appropriate authority to the delegate; and
(4) Avoiding by-passing the delegate.

Key words: Administration; Pharmacy, institution, hospital

Delegation is one of those management techniques that receive consistent lip service but somewhat less than consistent application. As with most techniques of management, delegation, to be effective, must be carefully, constantly and thoughtfully applied. Frequently, managers limit their potential and attempt to perform to many functions themselves. The "I'd rather do it myself" syndrome is more pronounced in the new manager. This individual explains that by the time he shows or tells someone else how o does a job, he could have more easily done it himself. This explanation (or excuse) may very well be true for the first time, but if the task is properly delegated the manager's intimate involvement ends.

Basic Elements of Delegation

There are three basic elements of delegation: responsibility authority and accountability. Two of these elements (responsibility and authority) are inseparably related. A surefire method of doing a poor job of delegation is not to delegate the appropriate authority to discharge the responsibilities of the task. Responsibility is a key element of delegation but it is not delegated at all. The fact that the pharmacy director has delegated the task of narcotics control to a subordinate does not diminish the responsibility of that director for narcotics control.
The acceptance of responsibility on the part of the delegate must be a clearly defined and understood part of the delegation process. Clear acceptance of responsibility is necessary for employee development and organizational growth. The well-motivated employee actively seeks new responsibilities and opportunities that go along with those responsibilities. It is vital in this element of delegation to carefully define the responsibilities involved, their importance, and their relationship to other jobs. A good understanding of the scope of responsibly can forestall problems at a later date.

Responsibility

Acceptance of responsibility by professionals (e.g. pharmacists) is a slightly different problem than with nonprofessionals. Responsibility for one's own actions and the actions of supportive nonprofessionals is part of the basic definition and orientation of the pharmacist. The problem of the hospital pharmacy administrator is to allow the pharmacist to recognize and accept the administrative responsibilities necessary to accomplish departmental and institutional objectives.

Authority

The second element of delegation is authority, and this is the factor that is in fact delegated. Management literature has stressed over the past several years the necessity for delegation of appropriate authority. "Never give responsibility without the authority necessary to discharge the responsibility," has been the theme of the advice in relation to the delegation process. This fact, even though well known by now, needs to be expanded in a couple of facets. One consideration with the delegation of authority is that only "token" authority fails to provide the called and growth potential that the developing individual needs. Robert Townsend in Up the Organization talks about authority delegation:

Many give lip service, but few delegate authorities in important matters. And that means all they delegate is dog work. A real leader does as much dog-work for his people as he can: He can do it, or see a way to so it without it, or see a way to do without it, ten times as fast. And he delegates as many important matters as he can because that creates a climate in which people grow.

Delegation is an important means toward the attainment of the goals of an organization. This is rue if for no other reason than to assure that decisions are made as low as possible in the organization. Decisions made at the lowest level will then usually be made by the people most competent to make them. Townsend again points out:" The charge of the Light Brigade was order by and officer who wasn't there looking at the territory."
In delegation of authority, the right to retract that authority resides with the delegator. But thus right must be very carefully and judiciously used. In fact, retraction of delegated authority is essentially an terminal act. The delegator and the delegate are both hard pressed to return to the original relationship after to return to the original relationship after delegated authority is removed. A dangerous procedure, similar to retraction, is short-circuiting and bypassing a delegate. The supervisor who is constantly (or even occasionally) giving directions and orders to people who work under a subordinate is courting disasters
By-passing a subordinate supervisor has a universally bad effect on everybody concerned and solves very little. If a delegate is not discharging his delegated authority, if a delegate is not discharging his delegated authority, the remedy lies with that individual, not around that individual.

Accountability

After delegation of authority and acceptance of responsibility, the third element of delegation comes in focus. This element is accountability and the control process. Mention of these terms sometimes conjures up the wrong kinds of images. Control should not mean that a supervisor is exercising power over other people but rather is using this process as a tool to ensure that delegated authority and accepted responsibility are being applied toward the organization's programs and objectives.
There are a number of ways in which controls may be exercised in order to ensure successful task completion. Budgeting is a control process and when properly used can be an effective control mechanism. Delegation of authority to commit and use resources can be most often measured as a function of budget variance.
Another control mechanism is to establish specific, short-term goals. When such goals are mutually established and agreed upon, both the manager and the delegate should be able to progress toward the achievement of those goals.
Depending upon the needs of the individuals and the complexity of the situation, varying numbers of checkpoints may be established to ensure continuing accountability.
Exercise of control is most often a delicate balance between how must is enough and how much is too much. The best use of control is to emphasize the positive kinds of control (i.e. goal setting) and to use only when absolutely necessary the negative kinds (i.e. disciplinary measures).

Conclusion
A compilation of some major guidelines to effective delegation is tabulated below:

1. Discuss frankly and completely the responsibilities involved
2. Secure a mutual commitment to these responsibilities
3. Be certain that appropriate authority is in the hands of the delegate
4. Prior to and during a process insist upon adherence to agreed goals and checkpoints
5. Don't be short-circuit or by-pass the delegate/
6. Delegate important as well as routine projects and tasks
7. Ones done, don't meddle in the process
8. Delegate both the interesting and the mundane