BARRIERS TO IMPLEMENTATION OF PERFORMANCE-BASED MANAGEMENT PRACTICES IN PHARMACIES IN A DEVELOPING COUNTRY

BARRIERS TO IMPLEMENTATION OF PERFORMANCE-BASED MANAGEMENT PRACTICES IN PHARMACIES IN A DEVELOPING COUNTRY

Sandeep Maharaj ¹, Sureshwar Pandey ¹, Farana Mohammed ¹, Saeeda Ali ¹, Amelia Niamath ¹, Chandika Persad ¹, Brent Roopchandsingh ¹, Fazal Ali ³, Isaac Dialsingh ², Robin Antoine ² and Ashok Sahai ²

School of Pharmacy, Faculty of Medical Sciences ¹, Department of Mathematics and Statistics ², The University of the West Indies, St Augustine Campus, Trinidad and Tobago

University of Trinidad and Tobago ³, O’Meara Campus, Arima, Trinidad and Tobago

ABSTRACTThe objective of this study was to conduct a survey and determine the barriers to implement performance-based management in pharmacies in Trinidad. PBM is defined as “a systematic approach to performance improvement through an on-going process of establishing strategic performance objectives, measuring performance, collecting, analyzing, reviewing, and reporting performance data, and using that data to drive performance improvement”(Performance Management Handbook). A questionnaire was conducted, with respect to the presence or absence of barriers to implementation of performance-based management at pharmacies along the East-West corridor of Trinidad. A twenty-two (22) question survey was administered to sixteen (16) pharmacies to be assessed. This region was chosen because of its close proximity and convenience. Fourteen (14) of the twenty-two (22) questions were based on a Likert-type scale, so that respondents were able to specify their level of agreement or disagreement of applicability on a symmetric “strongly agree - strongly disagree” scale for a series of statements based on the barriers of PBM implementation. Pharmacies were selected in a non-randomized manner. The SPSS statistical computer software was used to estimate a model that would best describe the barriers to the implementation of PBM in pharmacies of Trinidad. While Performance Based Management (PBM) is implemented in various pharmacies throughout Trinidad, it is usually found in those of larger companies with more staff employed and also with the infrastructure and funding available to support this type of management. Since most pharmacies operate with smaller staff, most aspects of PBM are not practised but this does not mean that the management are unaware of PBM. Some pharmacists and pharmacy owners have expressed intentions of employing PBM in the future and do follow some of its practices such as employee documentation and giving performance feedback. However with the many barriers to PBM existing, this type of management may seem too cumbersome for most businesses to implement fully. Although, PBM may not be fully implemented in pharmacies, (especially smaller businesses) if most pharmacy owners do not adapt to changes in the business settings they may not reap the full benefits that come with performance management

Performance-Management & Developing Country

INTRODUCTION: Performance based management (PBM) initiatives within the public service of Trinidad and Tobago have been in existence since the early 1960s. All high-performance organizations, whether public or private, are, and should be, interested in developing and deploying effective performance based measurements and PBM systems, since it is only through such systems that they can remain high-performance organizations. Performance management goes by many names, is defined in a variety of ways, and includes an array of concepts.

Within the past decade, PBM has attracted much research interest from both the academic and business communities.  In this respect, PBM is defined as “a systematic approach to performance improvement through an ongoing process of establishing strategic performance objectives; measuring performance; collecting, analyzing, reviewing, and reporting performance data; and using that data to drive performance improvement” (Performance Management Handbook). Although this may not be the ultimate definition, it is one that works best within the scope and concept of this study.

Basically, PBM follows the “plan-do-check-act” (Continuous Improvement) cycle developed by Walter Shewhart of Bell Labs in the 1930s. In the performance-based management cycle shown in Figure 1, the first step is to define the organization’s mission and to establish its strategic performance objectives (also known as the strategic planning phase). The next step is to establish performance measures based on and linked to the outcomes of the strategic planning phase.

Following that, the next steps are to do the work, collect performance data (measurements) and to analyze, review, and report that data. The last step is for management to use the reported data to drive performance improvement, i.e., make changes and corrections and/or “fine tune” organizational operations. Once the necessary changes, corrections and fine tuning have been determined, the cycle starts over again. (Note that accountability for performance is established at all steps in the framework.)

FIGURE 1: PERFORMANCE BASED MANAGEMENT CYCLE ¹

The effectiveness of the process is defined as the achievement of financial as well as non-financial targets, the development of skills and competencies, and the improvement of customer care and process quality.

Besides the latter, there are numerous benefits that PBM can offer a business. Some of these are as follows:

1. It provides a structured approach to focusing on strategic performance objectives
2. It provides a mechanism for accurately reporting performance to upper management and stakeholders
3. It brings all “interested” parties into the planning and evaluation of performance.
4. It provides a mechanism for linking performance and budget expenditures
5. It represents a “fair way” of doing business
6. It provides an excellent framework for accountability
7. It shares responsibility for performance improvement
8. Targeted Staff Development
9. Encouragement to staff
10. Reward staff for a job well done
11. Underperformers identified and eliminated
12.  Allows for employee growth

Despite these benefits, the fact remains that effective performance management systems are difficult to design and a number of various barriers have hindered businesses from successfully implementing performance based management. The implementation of an integrated performance management system (that is, integrating organization structure, human resources and technology towards superior public sector performance) is now at the forefront of the public service transformation agenda, as developed country status by year 2020 is the guiding vision and mandate of the Government of Trinidad and Tobago. Although Trinidad and Tobago’s public sector has not yet established a fully integrated performance management system, the Government recognizes the importance of such a system as a means of achieving the country’s vision and is moving assiduously towar