Tip of the Week: Driving Productivity with Organizational Factors

There are things in the pharmacy manager’s control to which they should attend, and other things not in their direct control about which they should at least be cognizant rather than ignore.

Individual pharmacy personnel work in organizations that have much to say about how that work is conducted, what is prioritized, and thus the level of productivity of those employees, regardless of their capacity, and their effort.

A study published in the United Kingdom’s Health Services and Delivery Research journal described how service provision across community pharmacies vary by certain pharmacy organizational characteristics, such as ownership, staffing, and skill mix. Thus, the authors sought to explore variation in clinical productivity, such as levels of service delivery, and service quality in pharmacies, and to identify the organizational factors associated with this variation.

These investigators employed a mixed-methods approach: a community pharmacy survey, administrative data analysis, a patient survey, and stakeholder interviews. They selected 9 socioeconomically diverse geographical areas where pharmacies would participate. This involved 39 pharmacies from these regions, with patients that received prescriptions, and medicines use review (MUR) services. They examined patient satisfaction with information about medicines and medication adherence.

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The community pharmacy questionnaire included data such as ownership type, organizational culture, staffing and skill mix, working patterns, management structure, safety climate, and pharmacy—general practice integration. The research found that pharmacy clinical productivity varied across most of the organizational factors examined, as well as local area income, patient age and health needs, pharmacy location, public perceptions and expectations, supply chain problems, and levels of remuneration.

Pharmacy managers might increasingly be responsible for pharmacy outcomes in regard to potential revenues. The research highlighted here showed that a strong organizational culture that is supportive of its employees and ensures adequate staffing, in number and in quality, was highly indicative of clinical pharmacy performance. It also demonstrated the need for pharmacy managers to have adequate and tight control over supply chain issues to prevent shortages that exacerbate staff and patient stress.

Moreover, regulatory issues such as scope of practice and pharmacist-technician ratios, and the socioeconomic and health status of the patients served will impact their outcomes regardless of how effective the pharmacy is in providing services. This behooves pharmacy owners/managers to be knowledgeable of such factors when negotiating collaborative agreements, and contracts.

In other words, there are things in the pharmacy manager’s control to which they should attend, and other things not in their direct control about which they should at least be cognizant rather than ignore.


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Additional information about medication therapy management and management functions can be found in Pharmacy Management: Essentials for All Practice Settings, 5e. You or your institution can subscribe to AccessPharmacy to access the textbook.

Shane P. Desselle, RPh, PhD, FAPhA, is Professor of Social/Behavioral Pharmacy at Touro University California. He is author of Chapter 1: The “Management” in Medication Therapy Management and Management Functions in the textbook Pharmacy Management: Essentials for All Practice Settings, 5e.


Jacobs S, Bradley F, Elvey R, et al. Investigating the organizational factors associated with variation in clinical productivity in community pharmacies: a mixed-methods study. Health Services and Delivery Research. 2017. No.5.27. https://www.ncbi.nlm.nih.gov/books/NBK458849/.