Title: Organization of health services
1 Organization of health services
2- The term organization refer to " any collection
of persons, materials, procedures, ideas or facts
so managed ordered that in each case the
combination of parts makes a meaningful whole
that at achieving organization objectives.
3- In other words the process of organization
implies the arrangement of human nonhuman
resources in an orderly fashion to make a
meaningful whole that accomplishes organizational
objectives.
4Acquisition of human non human resources
- After deciding on the major operating units
departments the required resources must be
acquired fitted in the right place. On
appointment every employee must be informed of
what is expected of him (his/ her responsibility)
what is within his / her power (his/ her
authorities). This is usually found in the "job
description".
5Organizational charts
- formal relationship between people in various
position in the organization. - They shown who supervises whom how various
jobs departments are linked together to make
achieve coordinated system. - Main channels of communication (downward, upward
, horizontal, and diagonal)
6- Downward flow of authority (orders commands)
from superior to subordinate to chain of
command. - Upward flow of communication (accountability)
from subordinates to superior. - Horizontal flow of communication between
employees of the same level. - Diagonal communication flow between employees of
different level have different functions (e.g.
between nursing station and pharmacy )
7- In a chart solid lines denotes lines of
command (line of authority) whereas dotted lines
denotes counseling or advisory line.
8Types of charts
- Skeleton charts these present only the main
units or departments of the organization
9- Personal charts these show the major positions
or titles and may be the names of persons
occupying them. It is simply a diagram of the
formal authority structure. It shows by job title
, who reports to whom, and who has authority over
whom, but does not show the extent of that
authority or the duties each person in the
organization is expected to perform, except in so
far as duties are implied by job titles.
10- organizational manuals including job description
are prepared in relation to charts. Rarely we
have a functional chart.
11- Functional chart include a brief description of
the functions, purposes, duties and activities of
each person, but these are rarely done since they
are usually replaced by manuals including (job
description and job specification)
12Advantages of organizational charts
- 1. The executive managers to think more
specifically about the actual relationship
between workers. - 2. It give a quick visual illustrations of the
structural design communications in the
organization. - 3. they can be useful tool to familiarizes
outside about the organization as well as to
train orient new employees since they show
lines of authority, channels of communication.
13Disadvantages of organization charts
- 1. Must be updated continuously.
- 2. not practical with executives whom like
- freely changes jobs relations of employees.
- 3. Preparation circulation may be expensive in
a large organization. - 4. May produce hard feelings for those low in
the hierarchy. - 5. Difficult to describe all relationships of
the entire organization on the chart.
14Formal VS informal organizations
- The formal organization is planned prescribed
structure that displays the formal organizations
pattern of authority and responsibility
relationships.
15- The informal organization is unplanned
interactions - between members which actually not depicted on
any organizational chart. These relationships
and interactions which occur spontaneously
between members of the organization.
16- The basis of the interaction between these
informal groups or subsystems may be social,
technical, or power ties, may be, the informal
organization affects to a great extent the
achievement of the organizational goals.
17Positive aspects of informal organizations
- Complement the formal organization.
- Provides necessary social values and stability to
workgroup. - Simplifies the manager job.
- Provide an additional channel of communication
(grape vane).
18Negative aspects of informal organization
- 1. Dissimilar objectives.
- 2. role conflict.
19 Principles of classical Organization chart
- Departmentalization It is the major operating
division into which the work may be divided.
Departmentalization is the process of grouping
activities into units for Purposes of
administration.
20The grouping process follows certain patterns
- It can be grouping by services in which case
activities directly associated With services are
grouped together - Grouping can be by location e.g. inpatient
outpatient department, or by geographic area,
which occurs when activities are widely
dispersed. This has the benefit of meeting local
needs.
21- Grouping by clients. This resorted to assure
attention to certain groups of People like
mothers and children. Etc. - Grouping can also be by time e.g. morning,
afternoon night shifts.
22111- Specialization Division of labor
- The work necessary to accomplish goals
objectives is then divided into Specialized tasks
assigned to specific individuals. Dividing work
into Specialized tasks is advantageous because
each individual has limitations because a
greater uniformity skill in performance can be
obtained through Specialization of work.
23- Theoretically therefore, division of labor
increases the efficiency of individual group
performance. However one potential disadvantage
of extreme specialization in work is its bad
effect on job example of a worker in an
automobile factory who spends 8 hours day
performing one tiny repetitive task as inserting
a special nail in a Special place clarifies how
extreme specialization may have bad effects on
the psychology of workers.
24- Another disadvantage is the tendency of employees
within a given specialty to view their special
task as more important than the overall
organizational objectives. Therefore with
specialization there are the problems of
integrating coordinating the Specialized units
or departments to attain overall - objectives.
25- 1V- Coordination
- Coordination means assembling
synchronizing work efforts so that they function
harmoniously to attain organizational objectives.
In a health organization one finds many people,
supplies, equipments, forces, services. etc
fitted together to form department, sections,
hospitals, health centers..etc.
26In the coordination process many factors are
involved
-
- Parts and features that need to be arranged or
- operated together i.e. human and
non-human - resources (what is to be coordinated?).
- 2. Means by which by these parts are together
like - laws, Skills, norms, committees etc (how to
coordinate) - 3. Environment in which the parts to be
coordinated and means to hold them are existing
e.g. time place, - distance of physical facilities..et.
(Where when - to coordinate?).
27- V- Equal Authority , Responsibility, and
Accountability - Authority is the official power to act . It
vested on the organizational head giving him the
right to command and the subordinates the duty to
obey. - Responsibility refers to duty or an assignment.
- Accountability refers to the extent to which a
sub ordinate may be held by this superior to be
directly responsible for results good or bad.
28- VI- Centrality Centrality indicates the location
of a position in an organization where frequent
communication occurs.
291V- Centralization and Decentralization
- Refers to the level at which most or the
operating decisions will be made. The greater the
number of decisions made lower down the
management Hierarchy the greater the degree of
decentralization. Generally speaking, it is
advisable that decisions concerning day- today
matters should be Pushed down the organization
structure and not be handled by top management.
30Advantages of decentralization
- 1- Quick action regarding specific problems.
- 2- Facilitates adaptation of decisions
according to - local needs.
- 3-Relieves top management from involvement in
- routine decisions thus saving time and
energy. - 4-Increases flexibility of action as junior
staff are - allowed to make Prompt decisions without
having - to wait for approval from to management.
-
31- 5- Is effective in developing the junior staff to
hold top management Positions. - 6- Decentralization of management decisions may
be used to improve morale of lower level
employees.
32Advantages of Centralization.
- 1- Uniformity of policy and action.
- 2- Enables maximum use of the skills and
- knowledge of centralized Staff.
- 3-Fosters better control of the organizations
- activities.
- 4-Enables the use of not highly skilled
subordinates since every little detail is set by
the top management.
33- Note The operational question faced by to
management in deciding What amount of
centralization decentralization is desirable? - Can only be answered by saying that
- it depends on the individual
- Situation.
34- A concept which has come to be considered as an
integral part of the Centralization and
decentralization issue is delegation of
authority. - The more delegation of authority the greater the
decentralization.
35- V- Unity of Command
- The classical principle of command suggested
that each individual in the Organization should
be directly responsible to, and receive orders
from, Only ONE supervisor and through this
ultimately answerable to the head Of the
organization.
36- This prevents reception of conflicting orders
from more than one superior which may lead to
deleterious effects. No man can serve two masters
. At the same time, subordinates may be able - to play one superiors against another
thereby escape responsibility.
37Management by exception
- The manager need only be called upon to handle
the exceptions to the patterned decisions (i.e.
the exceptions to the routine decisions), he has
previously made in setting up the policies, rules
and Procedures. This way the manager becomes
involved only with the exceptional, non- routine
decisions, which usually pertain to more Serious
situations whereas the subordinate handles the
day to day decisions.
38- Criticism of classical theory
- The motivational assumptions are incomplete and
in accurate. - Intra-organizational conflict (competition) is
generally ignored. - Little attention is given to the role of
cognition in task identification and decision. - The phenomenon of program elaboration receives
little emphasis.
39Modern organizational structure
- Project organization As a structural means for
focusing a large amount of talent and resources
for a given period on a specific project or task.
The project " team of various specialists is put
together under direction of the project manager.
Here there is emphasis on direct horizontal
relations among specialist. Communication rarely
goes up. It offer greater flexibility and
response to innovative ideas.
40- Matrix organization when project organization is
superimposed on a functional, hierarchical
organization the result is matrix one. At this
point it is enough to say that matrix
organization incorporates some of the best
aspects of project organization and functional
organization.