COLLABORATING WITH REENGINEERING CONSULTANTS - MAINTAINING RESOURCES FOR THE FUTURE

The negotiations of a pharmacy department with a consulting firm hired to help cut the institution's staff are described. In July 1994 Duke University Medical Center announced its intention to reduce the number of full-time equivalents (FTEs) from 6500 to 5000 and hired a consult ing firm. The pharmacy department was scheduled to be studied for 16 w eeks. The entire pharmacy staff was educated about the initiative and about what management expected of the staff during the process. Each a ssistant director of pharmacy was asked to lead the ''operations impro vement process,'' as the re-engineering plan was called, in his or her area of responsibility. The assistant directors were to describe key work activities and their time requirements and develop instruments fo r measuring work activities. Data were collected on supplemental resou rce requirements for paid time off and educational and meeting time. R esource requirements for clinical pharmacy specialists and other selec ted staff members were determined separately. The data were collected for one fiscal month, and the assistant directors then began negotiati ng human-resource requirements with the consultants. The director fina lized the negotiations and presented the results to the hospital's lea ders and the consulting firm's executives. It was proposed to reduce t otal pharmacy FTEs by only 5%, and the department actually gained 1 ph armacist FTE. Far greater reductions were proposed for most other depa rtments (the entire medical center lost more than 800 FTEs). The pharm acy department at Duke dealt successfully with a re-engineering initia tive. Strategies that contributed to the success included teamwork, ac tive participation by the entire staff, empowering a core group to hel p lead in the process, and substantiating the value of the pharmacy's services to the medical center and its patients.