The use of managing up in an institution's time of financial crisis is described. The goals of crisis management include survival, maintaining quality and service, learning issues and impacts, supporting the team, and preparing for the aftermath as the crisis subsides. Survival calls for a commitment by leaders to remain focused, and to maintain and support the management team. Pharmacy directors must be able to adapt to chaos and to the limited information disseminated by senior leadership. Identifying the underlying cause of the crisis, which may not be directly related to the measures taken to resolve it, is also critical to survival. Among the keys to maintaining quality and service are keeping the staff focused on patient care and maintaining credibility by sharing all information that is available. Pharmacy directors need to maintain the confidence of their staff members and to encourage them to do the best they can with the resources available. Taking the initiative to acquire appropriate data, to translate that data into relevant information, and to seek benchmarks for comparison is also important. Once the crisis has passed, attention must be given to updating and maintaining databases, supporting the staff, and improving morale. Scenario planning can help identify measures that might be taken if another crisis should develop. Using principles of managing up can prepare pharmacy directors for optimal response to an institutional financial crisis.

 

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