MANAGEMENT AND ORGANIZATIONAL DESIGN

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MANAGEMENT AND ORGANIZATIONAL DESIGN

• STRATEGIC MANAGEMENT IN HEALTHCARE
• 11 February 2008

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WHAT IS HEALTH ?

• A STATE OF COMPLETE PHYSICAL, MENTAL AND SOCIAL
  WELL-BEING, NOT MERELY THE ABSENCE OF DISEASE -
  WORLD HEALTH ORGANIZATION

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WHAT IS HEALTHCARE ?

• HEALTH CARE IS THE TOTAL SOCIETAL EFFORT,
  UNDERTAKEN IN THE PRIVATE AND PUBLIC SECTORS,
  FOCUSED ON PERSUING HEALTH
• MAY ACT ON INDIVIDUALS OR THE ENVIRONMENT
• EXPANDED GREATLY OVER THE LAST 40 YEARS

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PUBLIC HEALTH VS PERSONAL HEALTH

• PUBLIC HEALTH - TO IMPROVE THE HEALTH OF A
  POPULATION
• PERSONAL HEALTH - TO IMPROVE THE HEALTH OF THE
  INDIVIDUAL

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PREVENTION

• PRIMARY - PREVENTION OF DISEASE
• SECONDARY - PREVENTION OF CONSEQUENCES OF DISEASE
• TERTIARY - PREVENTION OF DEATH OR DISABILITY

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EFFICIENT VS EFFECTIVE

• EFFICIENT - DOING THINGS RIGHT
• EFFECTIVE - DOING THE RIGHT THINGS

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MANAGEMENT

• IT IS A PROCESS
• WORKS TOWARD OBJECTIVES
• USES RESOURCES
• OCCURS IN A FORMAL ORGANIZATIONAL SETTING

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MANAGEMENT FUNCTIONS

• DECISION MAKING
• PLANNING - DECIDING IN ADVANCE
• DIRECTING - INITIATING WORK
• CONTROLLING - REGULATING ACTIVITIES
• ORGANIZING - INTENTIONAL PATTERNS
• STAFFING

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KISS PRINCIPAL

• KEEP IT SIMPLE STUPID
• FIGURE 1.7 ON PAGE 25

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HEALTH CARE ORGANIZATIONS

• CONSTANT TENSION BETWEEN MANAGERS AND
  PROFESSIONAL OR TECHNICAL STAFF
• MANAGERS JOB SHOULD BE TO SUPPORT PATIENT CARE

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SYSTEMS FAILURES

• MOST PROBLEMS ARE SYSTEMS PROBLEMS
• MOST PROBLEMS ARE BLAMED ON PEOPLE
• CHANGE THE SYSTEM NOT THE PEOPLE

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WEBERS BUREAUCRACY

• CLEAR DIVISION OF LABOR
• POSITIONS ARE ARRANGED IN A HEIRARCHY - CHAIN OF
  COMMAND
• FORMAL RULES AND REGULATIONS GUIDE EMPLOYEES
• IMPERSONAL RELATIONSHIPS
• EMPLOYMENT BASED ON TECHNICAL COMPETENCE

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JOBS OF A BUREAUCRAT

• COVER YOUR ASS
• CHECK YOUR STATUS

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FAYOLS PRINCIPALS

• 14 PRINCIPALS OF MANAGEMENT
• page 114
• GOOD BASIC CONCEPTS

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CLASSIC CONCEPTS OF ORGANIZATION DESIGN

• DIVISION OF WORK
• AUTHORITY AND RESPONSIBILITY
• DEPARTMENTATION
• SPAN OF CONTROL
• COORDINATION

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DIVISION OF WORK
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ROLE OF THE INDIVIDUAL

• BALANCE OF GENERALIZATION AND SPECIALIZATION
• PEOPLE ARE NOT COMMODITIES

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EFFICIENCY

• EVERYTHING TAKES TIME
• LOOK AT YOUR LAZIEST EMPLOYEE

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GENERALIZATION

• EVERYONE DOES EVERYTHING
• WORK IS INTERESTING VARIED
• PRIDE AND ACCOUNTABILITY
• THE ORGANIZATION IS FLEXIBLE
• JACK OF ALL TRADES, MASTER OF NONE

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SPECIALIZATION

• EVERYONE DOES ONE TASK
• HENRY FORDS ASSEMBLY LINE
• TENDS TO BE BORING
• LITTLE INDIVIDUAL RESPONSIBILITY
• INFLEXIBLE - SLOW TO RESPOND
• REQUIRES MORE MANAGEMENT

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AUTHORITY AND RESPONSIBILITY
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AUTHORITY

• POWER DERIVED FROM ONES POSITION
• LINE AUTHORITY - CHAIN OF COMMAND
• STAFF AUTHORITY - ADVISORY

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RESPONSIBILITY

• OBLIGATIONS DERIVED FROM ONES POSITION
• TO PERFORM FUNCTIONS
• TO ACHIEVE OBJECTIVES
• THESE TWO OBLIGATIONS MAY CONFLICT

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DEPARTMENTALIZATION
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PURPOSE OF DEPARTMENTS

• DIVIDE WORK INTO MANAGEABLE UNITS
• COORDINATE WORK AMONG UNITS

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BASIS OF DIVISION

• KNOWLEDGE SKILLS
• PROCESSES OR FUNCTIONS
• TIME OR PLACE
• OUTPUTS
• CLIENTS

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SPAN OF CONTROL
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CONTROL

• FLAT VS TALL
• EXECUTIVE VS OPERATIVE
• HOW MANY ARE SUPERVISED
• HOW TIGHT IS THE CONTROL

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POWER

• LEGITIMATE AUTHORITY
• REWARD
• COERCIVE
• EXPERT
• REFERENT/CHARISMATIC

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LEADERSHIP

• BE WILLING TO DO ANYTHING YOU ASK OF YOUR PEOPLE,
  EVEN IF YOU ARE NOT ABLE TO DO EVERYTHING.

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REWARD/PUNISHMENT

• PRAISE SELECTIVELY
• DISCIPLINE COLLECTIVELY

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COORDINATION
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STRUCTURAL

• ORGANIZATIONAL STRUCTURE
• SUPERVISION
• STANDARDIZATION

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LESS FORMAL

• Customs, Informal Groups
• Feedback and Adjustment
• Committees, Planning
• Program Development

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MANAGEMENT STYLES

• CLASSIC VS CONTEMPORARY
• HEIRARCHICAL VS COOPERATIVE
• LINEAR VS MULTITASKING
• FORMAL VS INFORMAL
• MALE VS FEMALE