Matrix management in hospital pharmacy departments.

The results of a nationwide survey to determine the managerial structures of selected hospital departments are reported. A questionnaire was mailed in August 1990 to a random sample of 1792 hospital pharmacy directors. The survey included questions on hospital bed capacity and ownership and on the managerial structures used for several departments and services, including pharmacy, satellite pharmacy, home health care, and hospice care. Recipients were asked to indicate a centralized management structure if decisions were made by a single individual; decentralized if the responsibility was distributed down the hierarchy; functional if departments were grouped according to specialties, skills, and knowledge; and matrix if the vertical hierarchy was overlaid by lateral mechanisms of authority. A total of 567 usable responses were received, for a response rate of 31.6%. Across departments, the most frequently reported type of management was centralized. Functional systems and systems that included a combination of features were cited least often. Of the pharmacy departments, 24.5% had decentralized management. Matrix management was used for 11.8%, 9.7%, 7.0%, and 4.7% of the pharmacy, home health-care, hospice-care, and satellite pharmacy departments, respectively, and was used more often in large hospitals than small hospitals. Pharmacy departments in nonprofit hospitals tended to use decentralized management more often than those in for-profit institutions. Centralized management was used most frequently by pharmacy departments, followed by decentralized and matrix management structures. Few pharmacy directors reported plans to implement matrix management.