The bureaucracy I will discuss is the company for which I work. We are a large-scale pharmacy benefits manager. If you receive your medication through a home delivery program, there’s a good chance it’s through my employer.
The company is headquartered in St. Louis, Missouri and has sites all over the country. My employer employs people at entry-level positions up to formally-trained and experienced, degreed professionals.The dysfunction in this bureaucracy is lack of communication between units.
I am a patient care advocate, which is basically just a customer service representative. When everything goes as it should, I can provide one-call resolution. When things do not go as planned, I may have to communicate with a supervisor, pharmacist, pharmacist technician, or another patient care advocate. Most of the time, the trouble comes in due to a breakdown of communication.
This affects me because my stress level rises when I know that a situation is going to get escalated and there isn’t a thing that I can do to resolve the patient’s issue. More importantly, it affects the patient because these are medications that they depend on for life or for maintaining their quality of life. ?There are many examples of the communication breakdowns. A patient may call us back because we have left them a voice mail stating that they need to contact us about their medication.
Instead of the representative that left the message documenting the reason for leaving the message, in the call summary, she will put, “See order status for reason. ” When you look at the order status, it gives some general reason that doesn’t give you enough information to present and sound intelligible while doing so to the patient. Another example of this type of dysfunction is when I have to address a patient’s question about clinical information concerning their medication.Patient care advocates have been trained to transfer the patients to pharmacists so that they can assist with the clinical information, and if this isn’t done, advocates will receive demerits on their quality score.
Sometimes the pharmacist will make the advocate relay the information to the patient by refusing to take over the call or to be conferenced into the call. One would think that the pharmacists would get the same training that the advocates get when it relates to what is and isn’t considered clinical information, but somehow they often have different perspectives on the issue.I believe that a lack of communication to some degree is inevitable in a corporation due to the sheer number of employees. If an organization is not careful, employees will start to feel alienated.
When an employee does begin to feel alienated, his/her productivity will be affected as well as the company’s turn-over rate. One way that organizations can bridge communication gaps and avoid alienation is to solicit improvement advice from employees at all levels, and actually implement some of them.