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Organization of health services

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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.

4
Acquisition 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".

5
Organizational 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.

8
Types 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)

12
Advantages 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.

13
Disadvantages 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.

14
Formal 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.

17
Positive 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).

18
Negative 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.

20
The 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.

22
111- 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.

26
In 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.

29
1V- 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.

30
Advantages 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.

32
Advantages 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.

37
Management 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.

39
Modern 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.
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