MANAGEMENT AND ORGANIZATIONAL DESIGN STRATEGIC MANAGEMENT IN HEALTHCARE 11 February 2008
Dec 30, 2015
WHAT IS HEALTH ?
• A STATE OF COMPLETE PHYSICAL, MENTAL AND SOCIAL WELL-BEING, NOT MERELY THE ABSENCE OF DISEASE - WORLD HEALTH ORGANIZATION
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
PUBLIC HEALTH VS PERSONAL HEALTH
• PUBLIC HEALTH - TO IMPROVE THE HEALTH OF A POPULATION
• PERSONAL HEALTH - TO IMPROVE THE HEALTH OF THE INDIVIDUAL
PREVENTION
• PRIMARY - PREVENTION OF DISEASE
• SECONDARY - PREVENTION OF CONSEQUENCES OF DISEASE
• TERTIARY - PREVENTION OF DEATH OR DISABILITY
MANAGEMENT
• IT IS A PROCESS
• WORKS TOWARD OBJECTIVES
• USES RESOURCES
• OCCURS IN A FORMAL ORGANIZATIONAL SETTING
MANAGEMENT FUNCTIONS
• DECISION MAKING– PLANNING - DECIDING IN ADVANCE– DIRECTING - INITIATING WORK– CONTROLLING - REGULATING
ACTIVITIES– ORGANIZING - INTENTIONAL PATTERNS– STAFFING
HEALTH CARE ORGANIZATIONS
• CONSTANT TENSION BETWEEN MANAGERS AND PROFESSIONAL OR TECHNICAL STAFF
• MANAGER’S JOB SHOULD BE TO SUPPORT PATIENT CARE
SYSTEMS FAILURES
• MOST PROBLEMS ARE SYSTEMS PROBLEMS
• MOST PROBLEMS ARE BLAMED ON PEOPLE
• CHANGE THE SYSTEM NOT THE PEOPLE
WEBER’S 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
CLASSIC CONCEPTS OF ORGANIZATION DESIGN
• DIVISION OF WORK
• AUTHORITY AND RESPONSIBILITY
• DEPARTMENTATION
• SPAN OF CONTROL
• COORDINATION
GENERALIZATION
• EVERYONE DOES EVERYTHING
• WORK IS INTERESTING & VARIED
• PRIDE AND ACCOUNTABILITY
• THE ORGANIZATION IS FLEXIBLE
• JACK OF ALL TRADES, MASTER OF NONE
SPECIALIZATION
• EVERYONE DOES ONE TASK
• HENRY FORD’S ASSEMBLY LINE
• TENDS TO BE BORING
• LITTLE INDIVIDUAL RESPONSIBILITY
• INFLEXIBLE - SLOW TO RESPOND
• REQUIRES MORE MANAGEMENT
AUTHORITY
• POWER DERIVED FROM ONE’S POSITION
• LINE AUTHORITY - CHAIN OF COMMAND
• STAFF AUTHORITY - ADVISORY
RESPONSIBILITY
• OBLIGATIONS DERIVED FROM ONE’S POSITION
• TO PERFORM FUNCTIONS• TO ACHIEVE OBJECTIVES
• THESE TWO OBLIGATIONS MAY CONFLICT
CONTROL
• FLAT VS TALL
• EXECUTIVE VS OPERATIVE
• HOW MANY ARE SUPERVISED
• HOW TIGHT IS THE CONTROL
LEADERSHIP
• BE WILLING TO DO ANYTHING YOU ASK OF YOUR PEOPLE, EVEN IF YOU ARE NOT ABLE TO DO EVERYTHING.
LESS FORMAL
Customs, Informal Groups
Feedback and Adjustment
Committees, Planning
Program Development