ABSTRACT
There is nothing more difficult to take in hand, more perilous to conduct or more uncertain in the success than to take the lead in the introduction of a new order of things.
—Niccolo Machievelli
The pharmacy manager, Dianne Watts, was away on long-term sick leave. In her absence, Maureen Wright assumed duties as pharmacy manager until Dianne’s return. Maureen, who is also a nonpharmacist, has been a relief manager for several years. Within a week of assuming duties, she announced several changes that she intended to make. Shelving of bags of dispensed medications was done by healthcare assistants as and when time permitted, leaving time for dispensers to do their work uninterrupted. Dispensers were made responsible for shelving. Maureen instructed the responsible pharmacist to perform six medicine use reviews (MURs) per week. Waiting time, she said, was too high and she wanted that reduced by
25%. She set an arbitrary target for signing up patients for the repeat dispensing service. There was no consultation on these matters with anybody in the pharmacy. Because there was no employee participation, the staff were extremely disappointed with the manner in which the changes were introduced. When the staff protested, her reply was: “Unless these changes are made, you’ll have to look elsewhere for jobs.”
