CPOM Module 6, Section 2: Role Descriptions, Competency Matrices, and Staffing Models
MODULE 6: WORKFORCE PLANNING & RECRUITMENT EXCELLENCE

Section 2: Role Descriptions, Competency Matrices, and Staffing Models

A practical guide to crafting best-in-class job descriptions that attract top talent. We will explore how to build detailed competency matrices for every role and analyze various staffing models (centralized, decentralized, hybrid) to determine the best fit for your hospital.

SECTION 6.2

Role Descriptions, Competency Matrices, and Staffing Models

Creating the Detailed Blueprints for a High-Functioning Pharmacy Team.

6.2.1 The “Why”: From Vague Postings to Strategic Blueprints

In the previous section, we were the high-level architects, creating the site plan for our department. We used forecasting to determine the overall size and scale of our workforce—the total number of FTEs required to meet the hospital’s needs. Now, we must transition from architect to structural engineer and interior designer. We move from the macro to the micro, from asking “how many?” to defining “who does what, to what standard, and where?”

This section is dedicated to creating the detailed blueprints for every single role within your team. A vague, poorly constructed job description is like a blurry floor plan; it leads to confusion, attracts the wrong applicants, sets unclear expectations, and makes effective performance management nearly impossible. Conversely, a strategic and meticulously crafted set of role definitions, competency models, and a well-chosen staffing structure provides the clarity and foundation upon which all other talent management activities are built. It is the essential scaffolding for excellence.

A role description is not an administrative task to be delegated and forgotten; it is a strategic communication tool. It is your primary instrument for attracting A-players, defining success, and aligning individual responsibilities with departmental goals. A competency matrix then adds another layer of detail, defining not just what an employee must do, but how they must do it and what excellence looks like in practice. Finally, your staffing model defines the operational philosophy of your department—the physical and logistical structure that dictates how these well-defined roles will interact to deliver patient care. Mastering these three interconnected elements is the key to transforming a group of employees into a cohesive, high-performance team.

Analogy: Designing a Michelin-Star Kitchen

Think of yourself as the executive chef designing a brand-new, world-class restaurant. Your success depends not just on your recipes, but on the meticulous design of your kitchen and your team.

First, you choose your Staffing Model—the fundamental layout and philosophy of your kitchen. Will it be a traditional Brigade de Cuisine (a highly centralized model), where a long line of specialized chefs each performs a single, repetitive task with extreme efficiency? Or will it be a modern Station Model (a decentralized model), where a small, cross-functional team of chefs (the “fish station,” the “meat station”) works together to create an entire plate from start to finish?

Once you’ve chosen the model, you create the Role Description for each position. It’s not enough to hire a “cook.” You need a Saucier, a Pâtissier, a Garde Manger. Each role description is a precise blueprint: it defines their exact responsibilities (the Saucier is responsible for all stocks and sauces), the tools they must master (rondeau pans, tamis), and who they report to.

Finally, you create the Competency Matrix for each role—this is your “skills and standards” manual. For the Saucier, the matrix would detail the required technical competencies: “Mastery of the five French mother sauces,” “Ability to properly mount a sauce with butter.” It would also include behavioral competencies: “Ability to communicate clearly and calmly during high-pressure dinner service,” “Maintains a clean and organized station at all times.”

Without these three elements—a well-defined operational model, precise role descriptions, and rigorous competency standards—you would have chaos. With them, you have the structure required for culinary excellence. The same principles apply directly to managing a high-performance pharmacy department.

6.2.2 Masterclass: Crafting High-Impact Role Descriptions

A role description (or job description) serves three primary functions: it is a recruitment tool to attract talent, a management tool to define expectations, and a legal document to define the essential functions of a job. Most organizations do a poor job of all three, using generic, outdated templates filled with corporate jargon. Your goal is to create a document that is clear, compelling, and compliant.

A best-in-class role description is a marketing document. It should excite the right candidate about the opportunity and politely dissuade the wrong one. It communicates your department’s standards, culture, and priorities before an applicant even clicks “apply.”

The Anatomy of a World-Class Role Description

Every role description you write should be structured with the following key components. Let’s break down each one with examples of “weak” versus “strong” execution.

Component Purpose & Importance Weak Example Strong Example
Job Title Creates the first impression and determines who finds your posting. It should be specific, professional, and use industry-standard language. “Pharmacy Technician” “Pharmacy Technician Specialist, Sterile Compounding (IV Room)” or “Pharmacy Technician II, Medication Reconciliation”
Position Summary The 2-4 sentence “elevator pitch.” It should concisely explain the purpose of the role and its contribution to the department’s mission. It should be engaging and inspiring. “This position is responsible for performing technical duties under the supervision of a pharmacist.” “As the Clinical Pharmacy Specialist for Critical Care, you will serve as the medication expert for our 24-bed ICU. You will be a fully integrated member of the multidisciplinary team, rounding daily to optimize complex pharmacotherapy, prevent adverse drug events, and ensure our most critically ill patients receive the safest and most effective care possible.”
Essential Duties & Responsibilities The core of the document. This section details the primary tasks and responsibilities. Use action verbs and quantify where possible. Group similar tasks together.
  • Fills medications
  • Enters orders
  • Answers phones
  • Other duties as assigned
 Medication Distribution & Safety (70%)
  • Verifies approximately 200-250 new CPOE medication orders per shift for accuracy and clinical appropriateness…
  • Supervises and validates the work of up to 4 pharmacy technicians…
  • Provides timely and evidence-based drug information to physicians and nurses…
Clinical Initiatives & Quality Improvement (30%)
  • Actively participates in the hospital’s Antimicrobial Stewardship Program…
  • Conducts monthly nursing unit inspections…
Qualifications The minimum requirements to be considered for the job. This section must be carefully crafted to be non-discriminatory and legally defensible. Split into “Minimum” and “Preferred.” “Must have a PharmD and be a good communicator.” Minimum Qualifications:
  • Doctor of Pharmacy (PharmD) from an ACPE-accredited school.
  • Current, unrestricted Pharmacist license in this state…
Preferred Qualifications:
  • Completion of a PGY-1 Pharmacy Residency.
  • Board Certification (e.g., BCPS).
  • Two (2) or more years of experience in an acute care hospital setting.
Knowledge, Skills, & Abilities (KSAs) This describes the underlying competencies needed to perform the duties. It’s less about credentials and more about demonstrable skills. “Must be detailed-oriented.”
  • Knowledge: Deep understanding of hospital pharmacy operations, sterile compounding standards (USP <797>), and medication safety principles.
  • Skills: Proficiency with EMR systems (Epic preferred), automated dispensing cabinets (Pyxis), and IV workflow software.
  • Abilities: Ability to manage multiple competing priorities in a fast-paced environment. Ability to communicate complex clinical information clearly and concisely.
Physical Demands & Work Environment Essential for ADA compliance. This section clearly states the physical requirements of the job (e.g., standing, lifting) and the nature of the work environment (e.g., exposure to hazardous drugs). (Often omitted) “Must be able to stand and walk for up to 8 hours per shift. Must be able to lift up to 25 pounds. This position involves potential exposure to hazardous materials, including chemotherapy, and requires the use of personal protective equipment.”
Legal Gotchas: How a Poorly Written Role Description Creates Risk

Your role descriptions will be scrutinized during any legal challenge related to hiring, promotion, termination, or disability accommodation. Work closely with your Human Resources department to avoid these common pitfalls.

  • Discriminatory Language: Avoid any language that could be perceived as biased based on age (“young and energetic”), gender, or other protected classes. Focus exclusively on bona fide occupational qualifications.
  • Unrealistic “Minimum” Qualifications: If you list a PGY-2 residency as a “minimum qualification” but then hire someone without one, you have undermined the validity of your own document and could be open to a discrimination claim from a qualified candidate you rejected. Be realistic about what is truly required versus what is preferred.
  • Vague “Essential Functions”: The Americans with Disabilities Act (ADA) requires employers to provide reasonable accommodations for employees to perform the “essential functions” of their job. If your role description is vague, it becomes very difficult to define what is essential, weakening your position in any accommodation dispute.
  • The “Other Duties as Assigned” Trap: While common, this phrase should not be used as a catch-all to assign major responsibilities not listed in the description. The core duties should represent at least 80-90% of the job.

6.2.3 Masterclass: Building and Using Competency Matrices

A role description tells an employee what to do. A competency matrix tells them how to do it well. A competency is an observable and measurable cluster of knowledge, skills, abilities, and behaviors (KSAs) that are critical to successful job performance. A competency matrix is a tool that defines these critical competencies for each role and describes what successful performance looks like at various levels of proficiency.

This is the key to moving beyond subjective performance reviews (“I feel like Jane is doing a good job”) to objective, behavior-based evaluations (“Jane consistently demonstrates the ‘Problem Solving’ competency at an ‘Exceeds Expectations’ level, as evidenced by her proactive identification of a flaw in the ADC workflow and her development of a solution that reduced stockouts by 15%.”). This framework is the foundation of fair and effective talent management.

The Three Building Blocks of a Competency Model

A comprehensive competency model is built from three distinct types of competencies. Every role in your department will be a unique blend of all three.

1. Core Competencies

These are the foundational values and behaviors expected of every single employee in the department, from the director to the newest technician. They define your culture. Examples: Patient Safety Focus, Teamwork & Collaboration, Communication, Professionalism & Accountability.

2. Functional Competencies

Also known as technical competencies, these are the specific knowledge and skills required to perform a particular job. They are role-dependent. A technician’s functional competencies (e.g., Aseptic Technique) are different from a clinical pharmacist’s (e.g., Pharmacokinetic Dosing).

3. Leadership Competencies

These are required for anyone in a formal or informal leadership role. They focus on skills related to managing people, processes, and strategy. Examples: Talent Development, Financial Acumen, Strategic Thinking, Change Management.

Deep Dive: Building a Competency Matrix for a Clinical Pharmacist

Let’s construct a sample matrix for a Clinical Pharmacist role. The key is to define the competency and then provide concrete behavioral anchors for what different levels of performance look like. This removes ambiguity from performance reviews.

Competency Type Competency Name Behavioral Anchors / Performance Levels
Core Patient Safety Focus
  • Needs Improvement: Occasionally overlooks potential errors; requires prompting from others to identify safety risks.
  • Meets Expectations: Consistently verifies orders accurately; uses standard safety checks; reports errors through appropriate channels.
  • Exceeds Expectations: Proactively identifies system-level safety risks; suggests process improvements to prevent future errors; mentors others on safety best practices.
Teamwork & Collaboration
  • Needs Improvement: Works in isolation; is reluctant to help colleagues; communicates in a way that creates friction.
  • Meets Expectations: Willingly assists colleagues when asked; maintains positive and professional relationships; shares information freely.
  • Exceeds Expectations: Proactively offers assistance to others; actively seeks out opportunities to collaborate with nursing and medical staff; is sought out by others for their collaborative spirit.
Functional Clinical Problem Solving
  • Needs Improvement: Identifies only obvious drug therapy problems; struggles to synthesize multiple pieces of patient data.
  • Meets Expectations: Routinely identifies and resolves common drug therapy problems (e.g., renal dose adjustments, drug interactions).
  • Exceeds Expectations: Solves complex and unusual drug therapy problems; anticipates potential problems before they occur; effectively manages patient care in the absence of clear evidence or guidelines.
Antimicrobial Stewardship
  • Needs Improvement: Verifies broad-spectrum antibiotic orders without question; rarely suggests de-escalation.
  • Meets Expectations: Follows hospital antibiotic protocols; recommends appropriate empiric therapy based on guidelines; ensures appropriate bug-drug matches.
  • Exceeds Expectations: Proactively recommends IV-to-PO conversions and de-escalation of therapy; educates providers on optimal antibiotic use; identifies trends in resistance patterns.
Leadership (for a Senior Clinical Pharmacist) Mentoring & Teaching
  • Needs Improvement: Is reluctant to take on students or train new staff; feedback is often unclear or unhelpful.
  • Meets Expectations: Serves as a preceptor for students and residents when assigned; provides constructive feedback to new employees.
  • Exceeds Expectations: Actively seeks out teaching opportunities; is recognized as a go-to mentor for junior staff; develops new training materials and educational programs for the department.
Using the Matrix to Drive Performance

This detailed matrix is not just an evaluation tool; it is a roadmap for development.

  • Hiring: You can now design behavior-based interview questions directly from the matrix. Instead of “Do you have teamwork skills?”, you ask, “Tell me about a time you had to collaborate with a difficult colleague to solve a patient care problem.” This forces the candidate to provide concrete evidence of the competency.
  • Performance Reviews: The conversation becomes specific and objective. “Let’s talk about the ‘Clinical Problem Solving’ competency. I rated you as ‘Meets Expectations.’ You do an excellent job with day-to-day issues. To get to ‘Exceeds Expectations’ next year, I’d like to see you take the lead on managing the pharmacotherapy for one of our complex transplant patients.”
  • Promotions & Career Pathing: The matrix makes the requirements for advancement crystal clear. To move from a Clinical Pharmacist I to a Clinical Pharmacist II, an employee must demonstrate consistent “Exceeds Expectations” performance in 3 out of 4 Functional Competencies.

6.2.4 Masterclass: Analyzing and Choosing Pharmacy Practice Models

The pharmacy practice model is the overarching operational and clinical philosophy that dictates how and where your staff delivers services. It is the “kitchen layout” from our analogy. Choosing the right model—or, more commonly, the right blend of models—is a critical strategic decision that impacts efficiency, clinical outcomes, staff satisfaction, and how the pharmacy department is perceived by the rest of the hospital. There are three primary models, each with distinct advantages and disadvantages.

A. The Centralized Model: The Engine of Efficiency

In a purely centralized model, the vast majority of pharmacy personnel and operations are located in one physical space—the central pharmacy. Pharmacists verify orders remotely from this location, and medications are sent to the floors via pneumatic tube systems or courier services. Communication with nurses and physicians is primarily electronic or by phone.

Workflow of a Centralized Model

CPOE Order Placed by Provider → Order Enters Pharmacist Verification Queue → Pharmacist in Central Pharmacy Verifies Order Electronically → Medication Prepared in Central Pharmacy (e.g., IV compounded, first dose pulled) → Medication Delivered to Floor via Tube/Courier → Nurse Administers Medication

Deep Dive: Pros and Cons of a Centralized Model
Advantages (Pros) Disadvantages (Cons)
  • Operational Efficiency: Allows for economies of scale. Centralizing staff and inventory streamlines workflows, reduces redundancy, and maximizes the use of automation (e.g., carousels, robots).
  • Easier Supervision & Standardization: With staff in one location, direct supervision, training, and ensuring standardized processes are much simpler for managers.
  • Optimized Inventory Control: Managing a single, centralized inventory reduces overall drug spend, minimizes expired waste, and simplifies purchasing.
  • Cost-Effective: Generally requires fewer total FTEs than other models to manage the same volume of orders, making it the most cost-effective from a pure labor perspective.
  • Lack of Clinical Visibility: Pharmacists are physically and professionally disconnected from the patient care units. This can lead to missed opportunities for clinical intervention and a perception of pharmacy as just a “dispensary.”
  • Communication Barriers: Relying on phone and electronic messaging can be inefficient and lead to delays in resolving clinical issues. It’s harder to build strong collaborative relationships with nurses and physicians.
  • Slower Turnaround for STAT/First Doses: The time required for delivery from a central location can be a major source of nursing dissatisfaction and can delay patient care.
  • Reduced Professional Satisfaction: Pharmacists may feel like they are on an “assembly line,” leading to lower engagement and higher burnout for clinically-oriented staff.

B. The Decentralized Model: The Engine of Clinical Integration

In a decentralized model, pharmacists (and sometimes technicians) are physically based on the patient care units. They work from satellite pharmacies or dedicated medication rooms, rounding with the medical teams, and providing real-time consultation to nurses and physicians. The central pharmacy still exists but is primarily focused on sterile compounding and bulk distribution.

Workflow of a Decentralized Model

CPOE Order Placed by Provider → Order Routes to Unit-Based Pharmacist → Pharmacist Verifies Order on the Unit (often after real-time discussion with provider) → Medication Prepared on the Unit (from satellite stock/ADC) or Requested from Central → Nurse Administers Medication

Deep Dive: Pros and Cons of a Decentralized Model
Advantages (Pros) Disadvantages (Cons)
  • High Clinical Impact: Pharmacist integration into the care team leads to more frequent and higher-quality clinical interventions. They can prevent errors before they happen.
  • Improved Communication & Collaboration: Face-to-face interaction builds trust and rapport with nurses and physicians, making pharmacy a valued clinical partner.
  • Faster Problem Resolution: Clinical issues are resolved instantly at the point of care, rather than through a series of phone calls.
  • Enhanced Professional Satisfaction: Allows pharmacists to practice at the top of their license, leading to higher job satisfaction and better retention of clinical talent.
  • Higher Labor Costs: This model is significantly more expensive as it requires a higher pharmacist-to-patient ratio to provide coverage on the units.
  • Inventory Control Challenges: Maintaining multiple satellite inventories increases drug spend, the risk of expired medications, and the complexity of inventory management.
  • Potential for Practice Variation: Without strong central oversight, practice can become inconsistent between different units, leading to quality and safety risks.
  • Difficult Supervision: Managing and supervising staff who are spread throughout the hospital is a significant challenge.

C. The Hybrid Model: The Engine of Balanced Value

The hybrid model, as its name suggests, attempts to capture the best of both worlds. It maintains a robust, efficient central pharmacy for the majority of operational tasks (e.g., cart fills, batch compounding, non-STAT order verification) while strategically deploying decentralized clinical pharmacists to the highest-acuity, highest-impact areas where their expertise provides the greatest ROI.

Workflow of a Hybrid Model

The workflow is dynamic. An order for a routine medication on a med-surg unit might follow the centralized path. An order for a complex vasopressor titration in the ICU would route directly to the decentralized ICU pharmacist for immediate verification and management.

Deep Dive: Pros and Cons of a Hybrid Model
Advantages (Pros) Disadvantages (Cons)
  • Optimized Resource Allocation: It allows you to focus your most expensive resource (clinical pharmacist time) on the patients who will benefit the most (e.g., ICU, ED, Oncology, Transplant).
  • Balances Cost and Quality: It maintains the operational efficiencies of a centralized core while providing the high-touch clinical value of a decentralized model in key areas.
  • Flexibility and Scalability: The model can be easily adapted. As the hospital opens a new service line, you can add a decentralized pharmacist to support it without redesigning your entire operation.
  • Creates Career Paths: It naturally creates a tiered structure where pharmacists can advance from central operational roles to decentralized clinical specialist roles.
  • Coordination Complexity: Requires excellent communication and handoffs between the central and decentralized teams to ensure seamless patient care.
  • Potential for Cultural Divide: Can inadvertently create a “two-tier” system where decentralized “clinical” pharmacists are perceived as having a higher status than central “operational” pharmacists, leading to resentment.
  • Requires Sophisticated Technology: To be effective, it relies on smart order routing rules within the EMR to get the right order to the right pharmacist at the right time.
  • Difficult to Staff Off-Shifts: It can be challenging to provide 24/7 decentralized coverage, often meaning nights and weekends revert to a fully centralized model, which can cause workflow inconsistencies.

6.2.5 Conclusion: Integrating Blueprints, Competencies, and Models

The work described in this section—crafting role descriptions, building competency matrices, and selecting a practice model—is the foundational strategic work of a pharmacy leader. These elements are not independent; they are a deeply interconnected system. Your practice model dictates the types of roles you need. Your role descriptions define the responsibilities of those roles. And your competency matrices define the standard of excellence for performing those responsibilities.

By moving away from reactive hiring and embracing your role as a proactive talent architect, you build a department with unparalleled clarity. Every team member understands their purpose, how their work contributes to the larger mission, and what success looks like. This clarity is the ultimate antidote to ambiguity and low morale. It is the blueprint that enables you to build a team that is not just staffed, but is truly designed for excellence.