MANAGEMENT AND ORGANIZATIONAL DESIGN

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MANAGEMENT AND ORGANIZATIONAL DESIGN

• STRATEGIC MANAGEMENT IN HEALTHCARE
• 10 February 2009

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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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MANAGEMENT COMPETENCIES

• SKILLS
• KNOWLEDGE
• ABILITY
• NATIONAL CENTER FOR HEALTHCARE LEADERSHIP page
  250

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MANAGEMENT MEASURES

• STRUCTURAL - NUMBER OF BEDS
• PROCESS PATIENT VISITS
• OUTCOME READMISSIONS

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MANAGEMENT STYLES

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

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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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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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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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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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COORDINATION
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STRUCTURAL

• ORGANIZATIONAL STRUCTURE
• SUPERVISION
• STANDARDIZATION

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LESS FORMAL

• ORGANIZATIONAL CULTURE -
• PATTERN OF SHARED BELIEFS
• INSTITUTIONAL MEMORY -
• LAST ONE STANDING