MANAGEMENT AND ORGANIZATIONAL DESIGN STRATEGIC MANAGEMENT IN HEALTHCARE 11 February 2008

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

EFFICIENT VS EFFECTIVE EFFICIENT - DOING THINGS RIGHT EFFECTIVE - DOING THE RIGHT THINGS

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

KISS PRINCIPAL KEEP IT SIMPLE STUPID FIGURE 1.7 ON PAGE 25

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

JOBS OF A BUREAUCRAT COVER YOUR ASS CHECK YOUR STATUS

FAYOL’S PRINCIPALS 14 PRINCIPALS OF MANAGEMENT –page 114 GOOD BASIC CONCEPTS

CLASSIC CONCEPTS OF ORGANIZATION DESIGN DIVISION OF WORK AUTHORITY AND RESPONSIBILITY DEPARTMENTATION SPAN OF CONTROL COORDINATION

DIVISION OF WORK

ROLE OF THE INDIVIDUAL BALANCE OF GENERALIZATION AND SPECIALIZATION PEOPLE ARE NOT COMMODITIES

EFFICIENCY EVERYTHING TAKES TIME LOOK AT YOUR LAZIEST EMPLOYEE

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 AND RESPONSIBILITY

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

DEPARTMENTALIZATION

PURPOSE OF DEPARTMENTS DIVIDE WORK INTO MANAGEABLE UNITS COORDINATE WORK AMONG UNITS

BASIS OF DIVISION KNOWLEDGE & SKILLS PROCESSES OR FUNCTIONS TIME OR PLACE OUTPUTS CLIENTS

SPAN OF CONTROL

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

POWER LEGITIMATE AUTHORITY REWARD COERCIVE EXPERT REFERENT/CHARISMATIC

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

REWARD/PUNISHMENT PRAISE SELECTIVELY DISCIPLINE COLLECTIVELY

COORDINATION

STRUCTURAL ORGANIZATIONAL STRUCTURE SUPERVISION STANDARDIZATION

LESS FORMAL Customs, Informal Groups Feedback and Adjustment Committees, Planning Program Development

MANAGEMENT STYLES CLASSIC VS CONTEMPORARY HEIRARCHICAL VS COOPERATIVE LINEAR VS MULTITASKING FORMAL VS INFORMAL MALE VS FEMALE