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The
major determinant of quality management is consumer satisfaction,
and this requires a close working relationship between operations,
marketing and human resources.
A
few definitions.
Operations
management is the management of activities relating to the
creation of services, through transforming inputs into outputs.
In service businesses, the three key areas comprising operations
are productivity management, capacity management and quality management.
Productivity focuses on the relationship between the input
of resources and the output in services. Improvements in productivity
require an increase in the ratio of outputs to inputs.
Capacity involves the rate of output that can be achieved
from a process, and plays a mediating role in influencing productivity
results and quality results.
Quality management involves designing, measuring and improving
the quality of services so that consumer expectations are met
or exceeded.
Now
I think it is fairly obvious that operations management in pharmacy
has declined in recent years.
One only has to listen to the complaints about excessive dispensing
volumes and declining retail sales, coupled with a lack of skilled
pharmacists, to realise that all is not well.
Pharmacy operations management should seek to have a balanced
internal system, with a clear understanding of what has to be
traded off in each segment of management to achieve that balance.
An operations manager should be able to create and deliver a specified
service package to consumers, while consistently meeting a high
standard of quality and productivity.
Profits
can no longer be simply measured by an increase in sales volume
(e.g. prescription numbers, which in isolation have always been
seen as a measure of pharmacy profitability), but by productivity
increases (which in turn are measured by capacity and quality).
The problem with traditional pharmacy productivity measures is
that they have focused on outputs, rather than outcomes.
Service productivity measures need to emphasise effectiveness
rather than efficiency, and must focus on quality.
Consumer satisfaction rather than units processed (output).
Now
the interesting fact is that by improving quality, management
is enabled to increase productivity.
This results in lower costs, a better competitive position and
happier people within the pharmacy environment.
Importantly, a gain in productivity is also a gain in capacity,
particularly in production line processes such as dispensing.
Individual best efforts are not sufficient to drive the quality
process.
It requires a good look at the direction a pharmacy practice must
take.
Best efforts only result in the equivalent of a random walk without
any guidance.
Quality is only achieved by an improvement in the entire process,
and for this you must take a systems approach.
The
base of competition is changing, and astute managers are looking
at their service delivery from the consumer's perspective.
Competitiveness in terms of cost and quality is now just simply
assumed by consumers.
However pharmacy competitors are able to "move the goalposts"
almost at will, and pharmacy is still trying to catch up in this
battle.
This is not being competitive.
Time is now emerging as a vital competitive dimension (and this
does not mean the five minute "fast dispensing service").
What it does mean is that the primary goal of productivity improvement
is to reduce overheads and one way to achieve this is to "squeeze
out" wasted time in all service processes, so that the total
result is an overall consumer benefit.
The uptake of new Information Technology systems is one way of
achieving a "squeeze out".
Each
party must see value in every transaction for an exchange to take
place between a buyer and a seller.
The total benefits must exceed the total costs.
Both parties must perceive that they are deriving a continuing
value from that relationship for a long-term relationship to be
created and to be able to survive.
Consumers have real expectations and make satisfaction judgements
after "consuming" a service, but the evaluation process
typically places more importance on "how" the process
of delivery was achieved, as distinct from "what" (outcome)
was delivered.
Combined, these two dimensions create the "image" of
the service provider.
Be aware that "image" has a stricter connotation if
you become involved in e-commerce.
In that arena, the consumer assumes new powers, and woe betide
any pharmacist who does not perform to these new standards, which
are definitely tied to performance as well as price.
Consistently
delivering satisfactory outcomes for consumers, that are cost
effective for a pharmacy practice, is a major challenge.
If you just aim to satisfy a consumer, then there is still the
potential for them to be lured to other competitors.
The aim must be to delight customers (the "Ahhh" factor).
See earlier article
on the ahhh factor and expedionary marketing at at this link
The
translation for highly satisfied consumers is a higher sales volume,
more productive assets and a higher return on investment.
Some
basic rules for service management:
*
If you cannot define something, you cannot measure it.
* What you can't measure, you cannot manage.
* Without a clear understanding of the phenomena you are investigating,
measurement is not possible.
Managers
who can identify with one or more of the above rules, are simply
unable to position their practice in a marketing environment and
are further unable to deliver their services to the complete satisfaction
of their consumers.
It is impossible to know if goals are being achieved.
Traditionally, consumer research has been applied to map consumer
needs.
The service provider determines which services to offer, based
on the outcomes of these research projects.
Astute organisations will produce their their own individual research
in addition, to determine whether consumers are satisfied with
what is being delivered.
This enables a self evaluation to occur, with subsequent beneficial
change being the end result.
It also represents a "time squeezing" process, because
it reduces the time needed to invoke an action to prevent a market
share loss.
It is a quality improvement process.
Quality
must be designed into services from the outset.
Developing quality specifications for a service involves an assumption
that the attributes of a service, tangible and intangible, are
directly measurable.
Establishing quality standards is a necessity and must enable
an audit to occur, preferably on a generic and broad scale.
It should be based on the dimensions that consumers use to judge
a pharmacy's service.
These dimensions have been identified as the appearance of physical
facilities, equipment and personnel; communication materials;
reliability - the ability to perform the promised service dependably
and accurately; responsiveness and the willigness to help consumers
and provide prompt service; assurance- the knowledge and courtesy
of employees and their ability to convey trust and confidence;
and empathy- the provision of caring through individualised attention
to consumers.
The
failure of a pharmacy service can result from one or more, of
four potential shortfalls:
*
Not knowing what consumers expect.
* Specifying quality service standards that do not match consumer
expectations.
* A service performance that does not match specifications.
* Not living up to levels of service performance promoted through
pharmacy marketing communications.
How
do you measure up?
One
final word.
The
process of delivering quality services should be totally in the
control of management.
The measurement of the effectiveness should also be under the
control of management, but this may need an impartial third party
to be involved in the measurement.
It must always be a "bottoms up" process, not a "top
down".
In other words, if you are not the final arbiter of your own practice,
you have lost control.
Whose standards of quality measurement are you working under?
Most
of my articles build one on the other. For
a complete list, visit this link.
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A
Happy Christmas and a Quality New Year to all i2P Readers
From
Peter Sayers
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