Experimento

The year 2008 was important in that a major transformation in the role of KPIs took place

on how KPIs could affect everyone in the organisation were diffused through a series of

workshops, monthly staff assemblies, internal publications and departmental meetings.

The significance of KPIs lies in that they are not only a form of quantitative measurement

of individual and organisational performance, but are also important for their discourse

that encourages thinking and doings aimed at improving understandings of key issues

within an organisation that can support the achievement of its goal.

The implementation of KPIs at the end of the concession period helped the organisation

to promote the idea of KPIs to members. The threat of non-renewal of the concession

encouraged members to concentrate their efforts on enhancing the organisation’s

performance, in particular in improving the speed of delivery of pharmaceutical items to

the hospital and clinics. One member of the warehouse staff, responsible for the transport

section in the branch located on the east coast of the country, argued:

“We have to ensure that our products are delivered to the hospital on time, else this could be the reason for not getting the renewal!”

With almost 90% of its revenue derived from concession business, it made sense that

everyone in the organisation demonstrated to the government their seriousness in

fulfilling their accountability under the concession contract. The most important impact

of implementing KPIs was their role in changing the practical understandings of the

concession practices. Instead of relying on the guidelines specified in the concession

contract, the organisation introduced its own set of KPIs to measure the performance of

its services which were more reflective of its capabilities. For example, the organisation

working days, while delivery to hospitals in other parts of the country was in seven

working days. To avoid the tendency of achieving the delivery target at the expense of

the quality of the services, the achievement of the delivery target was matched against the

number of complaints received. These efforts proved to be fruitful in preparing the

organisation for more stringent requirements in the second term of the concession

contract.

The same member of warehouse staff from the transport section added that he kept a

personal diary to record the tasks that he completed every day (usually he recorded the

delivery order number that was assigned to him). This, he argued, would be the evidence

to show to his superior in case he did not satisfy the performance evaluation of his

superior. He said:

“[…] the bosses always say that you have to show initiative in order to get incentive. I choose to keep personal diary because it can be verifiable.”

For its part, the government has urged its agency to play a greater role in monitoring the

GRCs. For that reason, increased involvement was noted towards the end of concession.

The government not only started to call for frequent face-to- face meeting, but also its

officials visited the suppliers under the adoption scheme and requested the organisation to

provide reasons for the backorder, urging it to solve the problem and asking for more

reports on stockholding levels in the organisation’s warehouse. For example, in 2008, the

government requested for the first time to be involved in the selection of the supplier

interviewed, would allow them to gain better understanding of the supply side practice of

the concession business. The organisation welcomed this effort as it showed the

government’s concern over the performance of the suppliers; furthermore, the

organisational members argued that it was, to a certain extent, part of the government’s

responsibility, since it appointed the suppliers.

The collaboration between the government and the organisation was strengthened by such

activities as the joint audit to the suppliers’ manufacturing facilities. Through these

activities, the government and the organisation managed to share part of the

accountability to the public in terms of the compliance of the vendor’s manufacturing

facilities to the GMP.

A senior government official described the changes in the government practices in

monitoring the organisation:

“In actual thing, we do get involve in choosing the suppliers to supply the products under APPL items, but previously we do not really get involve in monitoring the relationship between MNPharma and the suppliers, we did not. Now we get involve in choosing the suppliers and at the same time we get involve in monitoring the supply chain things and our concern are that we cannot accept anymore, MNPharma says oh, the supplier has got problem, they cannot supply these things, you know, so we want to know why and we want to know how they are going to overcome this. Before this, when MNPharma has a problem, they will call, please help us to settle, no more. Now we want to know why and how you are going to settle it.”

Senior Government Officer 2

On the part of the organisation, more frequent meetings with the government were

conducted to urge them to speed up the approval process to buy from alternative suppliers

informally visited the government officers to discuss paperwork and suggestions to

improve the delivery to the hospital, and especially to deal with the problem of backorder

that was beyond the control of the organisation.

The role of liaison officer was expanded to include the provision of relevant reporting to

the government, especially in terms of providing information about the supplies of

products to the hospitals and clinics. By the end of the study, the management of the

organisation was in the process of creating a separate liaison unit specifically to deal with

the Ministry of Health.

The dialogue session became a very important platform that allowed face-to-face

discussion between the organisation, the hospitals, clinics and the monitoring agencies.

Although it had been in existence for some time, towards the end of the concession it had

become a platform for the organisation to justify its relevance and importance in fulfilling

public accountability. The dialogue session offered the opportunity for both parties to

discuss problems and negotiate solutions: the effort of the organisation to compile the

problems from the hospitals, to present the status of these problems and to propose

solutions were argued by many of the government officials as being useful in improving

communication and coordination between the hospitals, organisations and the monitoring

agencies. One of the agenda items in the dialogue session included the presentations of

The face-to-face meetings and dialogue sessions, and the work of liaison officer all

reflected efforts made to humanise the conditions of the concession contract. They also

represented strategising activities that aimed at the achievement of the broad objectives of

the organisation. The role of liaison officer, for instance, was not only intended to speed

up the information flow between the organisation and the government, but, importantly,

she was responsible for capturing information that would help the organisation to

interpret what is not explicitly stated in the concession contract. Interestingly, the role of

liaison officer was one of the strategising activities to assist the organisation in obtaining

first-hand information on other government healthcare projects that was not included in

the scope4of the concession agreement. The effort of the organisational members to visit

the government officers informally to discuss the problem of backorder was reflective of

the concern over bottom line as backorder represented the reduction in the organisational

revenues when the organisation would not be able to sell the products to the hospitals and

clinics. This attempt was also in line with the organisation’s public accountability in

ensuring sufficient stocks of the pharmaceutical products in the government hospitals and

clinics. The general understandings established by the concession contract, together with

the understandings shaped by KPIs, infused strategic actions that were enacted through

socialising accountability.

As a result of a series of negotiations between the government and the organisation, both

parties agreed that the main issue to be addressed from the first concession was to change

4 _{Concession agreement gives the organisation the right to supply 571 pharmaceutical items to the}

government hospitals and clinics. This constitutes about 50% (by SKUs) of the overall consumption of the government hospitals and clinics.

the delivery period from sixty days to seven days with a penalty of a certain percentage in

the case of late delivery. Furthermore, for each pharmaceutical item, there were at least

two approved suppliers to reduce the problem of dependency on one supplier, as

encountered in the first concession period; there would also be a clause that required the

organisation to undertake product sampling at least once in every six months to reduce

the problem of unsatisfactory quality.

When questioned about the large discrepancy between the old delivery terms and the

proposed change in the new contract, Senior Manager Logistic 2 comments:

“It is good because that will make us more competitive. That means we ourselves also have to reengineer our processes and find improvement.”

The Senior Government Officer 2 also views the new terms as promising:

“But whatever it is, because MNPharma, the concessionaire, they have the logistic, they are developing the IT facilities to facilitate in term of procurements, providing us the information on the inventory, and also their efforts to improve the delivery systems […..] [t]here is no problem of accepting them, is just that we want to make sure that both parties, the government and the concessionaire, they gain, both of them win.”

The two above comments reveal the perception of both parties on the concession

contract, implying that both parties acknowledged the weaknesses on their part in the first

concession contract. For the organisation, the new terms of the contract were a challenge

to fine tune their activities to improve their performance. To a certain extent the new

terms also signified the government’s attempt to regain some of the control that had

interpretation by its parties: they drew on the concession contracts as a source of general

understandings and intentions of the concession practices. Intentions, or aims, of the

practice are also associated with affectivities (Schatzki, 2002), thus the strategising

activities are a reflection of practitioners’ choice of the most intelligible action based on

their understandings of the practice. As the case noted, the lack of understandings of what

was expected from the concession business, together with the ambiguity of the conditions

of the contract, encouraged the organisational members to acquire more knowledge and

understandings through informal interactions, frequent meetings and the expanding role

of the liaison officer. Such socialising effects improved learning and introduced changes

into the organisational and governmental practices towards the end of the concession. The

practitioners on both sides were considering new terms and conditions in the new

concession agreement. It can therefore be observed that the interplay between

hierarchical and socialising forms of accountability occurred through strategising.

The present study also suggests that the interplay between hierarchical and socialising

accountability contributes to the temporal symmetry of power between the organisation

and the government. Through concession agreement the power rests substantially with

the government. However, this was only partially exercised as a result of the ambiguity of

some parts of the concession contract, such as no provision for a penalty in the case of

late delivery. To remedy this, the government turned to socialising accountability to

expand their control on the concession practices. For example, they collaborated with the

organisation in a joint audit with the vendor’s factory, and took part in the committee for

by the ambiguity of the contract to gain some power to shape the concession practices.

For instance, the pressure it exercised on the government to speed up the approval

process for procuring backorder items from alternative suppliers was suggestive of

temporal symmetry of power between the parties. Furthermore, the exercise of

organisational power in this sense challenged the condition of the contract requiring the

organisation to maintain sufficient stocks for public consumption. Some conditions of the

concession agreement also directly contributed to the temporal symmetry of power

between the government and the organisation. For example, the condition that required

the organisation to set up the IT system in the hospital proved to be a source of power to

the organisation. As Senior Manager 1 in the logistic division comments:

“If the government wants to seek from others [to give the concession to other company], they can do but the new company has to spend about USD60 million on infrastructures, we have it paid off within the last 15 years. We have the advantage in term of cost, experiencewise, we supply to remote locations whatever, Zuellig and Diethlem [two Multinational players in pharmaceutical industry in the country] never do such work.”

The fifteen years’ experience in dealing with the distribution of pharmaceutical items to

the government hospitals and clinics throughout the country not only assisted the

organisation in building a trusting relationship between its own members and the

personnel in hospitals and clinics, but, importantly, it became the source of

competitiveness with other pharmaceutical players in the domestic market.

The organisation’s investment in the IT system was acknowledged by the majority of the

“You see the problem at our side is very poor monitoring system, in fact there is no system at all, when MNPharma supplied the computer system [ the organisation set up the computerised procurement system for the government], that feature to catch the late delivery is not inside, is not in their interest to put that feature inside the system.”

Senior Government Officer 4

The present study is suggestive of the coexistence of the hierarchical and socialising

accountabilities within an organisation and the dynamic relationship between the two.

This interplay between the two forms occurs through strategising and, as the following

section will illustrate, it assists the organisation in managing dual accountability. The

next section will discuss the organisational practices in managing dual accountability,

illustrating how KPIs as general and practical understandings were embedded in the

strategic actions of the organisational members.

In document Sistema de exigencias socio psicológicas para facilitar el rendimiento de los grupos creativos (página 42-49)