MANAGEMENT PRINCIPLES FOR HEALTH CARE SERVICESweb90.opencloud.dssdi.ugm.ac.id/wp-content/uploads/sites/644/2018/... · Merencanakan Masa Depan Memenuhi Kebutuhan dan Nilai-nilai Individu-Memotivasi

MANAGEMENT PRINCIPLES FOR HEALTH CARE SERVICES

Shortell and Kaluzny

PROGRAM PASCA SARJANA IKM-FK UGM

LEARNING OBJECTIVES

Memahami organisasi pelayanan kesehatan sebagai suatu sistem dan para manajer di dalamnya

Memahami aspek manusia dalam melakukan perencanaan, pengorganisasian, pelaksanaan dan pengendalian upaya kesehatan;

Memahami berbagai isu dalam pelaksanaan program.

Memahami kebutuhan strategis agar lembaga pelayanan dapat hidup dan berkembang.

Organisasi dan Manajer

-Teori Organisasi dan Manajemen Pelayanan Kesehatan (Bab 1)

-Peran Manajer (bab 2)

Memotivasi dan Memimpin Orang serta Kelompok

Menjalankan Sistem Teknis

Memperbarui Organisasi

Merencanakan Masa Depan

Memenuhi Kebutuhan dan Nilai-nilai Individu

-Memotivasi Orang Lain (Bab 3)

Memberi Arah

-Kepemimpinan: Sebuah kerangka kerja bagi pemikiran dan tindakan

Mendorong Kerjasama

-Manajemen Konflik dan Negoisasi (Bab 5)

Menentukan Kelompok Kerja dan Desain yang Tepat

-Kelompok dan tim dalam organisasi Pelayanan Kesehatan (Bab 6)

-Desain Kerja (Bab 7)Menetapkan Mekasnisme Komunikasi dan Koordinasi

-Koordinasi dan Komunikasi (Bab 8)

Menggunakan Pengaruh

-Kekuatan dan Politik dalam Organisasi Pelayanan Kesehatan (Bab 9)

Menentukan Desain Organisasi yang Tepat

-Desain organisasi (bab 10)

Mendapatkan Sumber Daya dan Mengelola Lingkungan

-Mengelola Aliansi Strategis (Bab 11)

Mengelola Perubahan dan Inovasi

-Inovasi, Perubahan dan Pembelajaran organisasi (Bab 12)

Mencapai Sasaran

-Kinerja organisasi: Pengelolaan demi Efisiensi dan Efektifitas (Bab 13)

Mengelola secara Strategis

-Penyusunan Strategi dalam Organisasi Perawatan Kesehatan (Bab 14)

Mengantisipasi Masa Depan

-Menciptakan dan Mengelola Masa Depan (Bab 15)










Memberi Arah


Mendorong Kerjasama














Mencapai Sasaran






Organization Theory and Health Services Management

Learning Objectives 1 : Identify the major forces affecting the delivery of health

services.

Understand how these major forces affect the role of the health service manager.

Identify some of the commonalities and differences among major types of health services organizations.

Identify and understand the basic processes that must be accomplished by any organization.

Identify and understand the different units of analysis associated with studying organizations.

Identify, understand, and apply the major perspectives on organizations to real problem facing health services organizations.

OVERVIEW

Keadaan Ekonomi, Politik, Sosial dunia yang selalu berubah membawa Continuos Paradigm Shift terhadap sektor pelayanan kesehatan.

Kompleksitas Pelayanan Kesehatan sendiri semakin menambah kebutuhan akan MANAJEMEN

Organisasi

Dibutuhkan untuk membuat proses pelayanan kesehatan bekerja secara efektif dan efisien dengan cara membawa greatest value.

Membawa kerangka berpikir baru dalam mensikapi perubahan dalam pelayanan kesehatan

Klasifikasi Organisasi Pelayanan Kesehatan

Health Maintenance Organizations

Home Health Care Agencies

Hospitals

Pharmaceutical Companies

Health Services Organizations as a systems

Based on Process :

Production

Boundary Spanning

Maintenance

Adaptation

Management

Governance

Units of Analysis

Individual

Group / Department

Organization

Inter organizational

Environment

EnvIronment

EnvIronment

Environment

Organizations Theory

Bureaucratic Theory

The Scientific Management School

Human Relations School

Contingency Theory

Resources Dependence Theory

Strategic Management Perspectives

Population Ecology Theory

Institutional Theory

Discussion Questions 1

Bila Anda memiliki wewenang didalam program peningkatan kualitas Kaiser Permanente’s, Pendekatan teori organisasi yang mana yang paling cocok untuk itu ?

Selama dekade terakhir ini, ada lebih dari 100 RS yang ditutup sementara beberapa ratus lainnya di reorganisasi. Cobalah diskusikan mengapa keadaan ini terjadi! (lihat debate time 1.1)

Dengan melihat pendapat bahwa organisasi kesehatan sebagian besar hampir identik dengan organisasi lain, setujukah anda, diskusikanlah !

THE MANAGERIAL ROLE

Learning Objectives 2

Understand historical perspectives on the managerial role and their underlying concepts.

Recognize the managerial challenges posed by changes in the external environment and within health care organizations.

Understand the changing roles of managers in providing vision and leadership, adapting the organization to its environment, and designing the organization to enact its mission and to achieve its objectives.

Recognize changing skiklls and knowledge required by managers in light of environmental and organizational dynemics

Conceptions of Managers

Traditional Conception

Political-Personal Conception

Organizational Conception

Traditional Conception

Functional model

Assumes that basic management function will be performed in any organizations, and they represent the key contribution of management.

Human Relations

Has its Central Theme the motivation of individuals to the achievement of organizational ends

Political-Personal Conception

Emphasizes the centrality of power and personal tactics in understanding the managerial role.

Organizational Conception

More Complex view, by taking into account factors both within the organization and its environment and considering their respective effects.

The New Managerial Challenges

Cost Efficiency

Quality Improvement

Greater Accountability in delivering services

Turbulence environment

Interorganizational Complexity

New Roles For Managers

Designer

Leader

Strategist


Cobalah deskripsikan apa yang dilakukan oleh manajer dalam organisasi pelayanan kesehatan, dari fungsi, tugas, sasaran, dan pengetahuan serta keahlian yang dibutuhkan!

Apakah hal-hal seperti mengadaptasikan lingkungan, menentukan visi, misi, merancang organisasi merupakan hal yang sama-sama perlu untuk dilakukan? Cobalah pikirkan kekuatan dan kelemahan anda!

Seberapa pentingkah menurut anda bahwa manajer harus cukup menguasai semua aspek manajemen? Bagaimana menurut anda manajer harus bersikap menghadapi persaingan dimana dalam bidang itu dia tidak memiliki kapabilitas yang cukup










Memberi Arah


Mendorong Kerjasama














Mencapai Sasaran






MOTIVATING PEOPLE


Define Motivation and distinguish it from other factors that influence individual’s performance.

Recognize popular but misleading myths about motivation

Understand that motivation depends heavily on the situations in which individuals work

Understand manager’s role in motivating people.

Identify key characteristics of the content of people’s work that motivates them.

Identify important processes involved in motivating people

Asses and deal with motivational problems.

Motivation and Management

A State of feeling in which one is energized or aroused to perform a task or engaged in a particular behavior

Myths about Motivation

Motivated workers are more productive

Some people are just motivated while others aren’tMotivation can be mass produced

Money makes the world go round

Manager’s Role

Assessing motivation to their employee, periodically

Framework of employee motivation

Need Deficiency

Search for ways to satisfy unmet needs

Choice of alternatives to satisfy unmet needs

Evaluation of need satisfaction afterImplementing alternatives

Determination of future needs and search or choice for satisfaction

Motivation Theories

Content PerspectivesTheory that focus on needs and need deficiencies

Process PerspectivesFocus based on Process involved in motivation

Content Perspectives

Maslow’s Need Hierarchy

ERG Theory

Two Factor Theory

Learned Need Theory

Comparison of need theories of motivation

Maslow ’S Model

Alderfer’sModel

Herzberg’sModel

McClelland’s Model

Self Actualization needs

Ego and self esteem needs

Social and belongingness needs

Safety and securityneeds

Physiological needs

Growth Needs

Relatedness Needs

Existence Needs

Mot

ivation

fact

ors

AchievementRecognitionAdvancementThe Work itselfPossibility for personal growthREsposibility

StatusCompany policy & administrationQuality of supervisionRelations with supervisorRelations with peersRelations with subordinateSalaryJob SecurityPersonal Life Working Cond

Achievement

Power

Affiliation

Process Perspectives

Equity Theory

Expectancy Theory

Reinforcement Theory

Goal Setting

Motivational Problems & Solutions

Inadequate performance definition

Impediments to employee performance

Inadequate performance-reward linkages

Problems

Solutions

Behavior ModificationPay For Performance

Enhanced AchievementWell Defined Performance Standard


Bagaimanakah Teori motivasi Content perspective dan process perspective dapat digabungkan didalam aplikasi organisasi?

Bagaimanakah cara mendiagnosa masalah-masalah motivasi dari faktor-faktor lain yang mempengaruhi kinerja individu?

Bagaimanakah teori motivasi dapat digunakan untuk memilih pemecahan terbaik dari kepentingan individu?

Leadership

Learning Objectives 4 Better appreciate why leadership skills are so important.

Understand what leadership is and what it is not.

Understand the distinction between management and leadership.

Understand the leadership role and how it is executed in health services organizations.

Understand the major leadership perspectives as well as some emerging theories and concepts.

Consider how different leadership perspectives can be combined into a more integrative framework.

Appreciate several distinctive challenges of leading in health services organizations.

Continue developing leadership knowledge and skills.

Overview

Leadership is one of the most highly valued management abilities

Leadership is the process through which an individual attempts to intentionally influence another individual or a group in order to accomplish a goal.

Leadership Core concepts

Is a Process, an action word, not a noun

Locus of leadership is in a person

Focus of leadership is other individuals and groups

Influence is leadership’s center of gravity

Key points of Leadership

Leadership is Multidirectional.

Although its multidirectional, Leadership focus on the downward.

The focus is generally other managers; Managers lead other managers.

Leadership depends on the power associated.

Leadership effectiveness and Success:What We knowPerspectives of Leadership :

The Trait perspective

The Behavioral perspective

The Contingency Perspective

The Trait perspective

The Nature Argument :

Traits Leadership Effectiveness & Success

The Nurture Argument

Traits Abilities andBehavior

Leadership effectiveness

& Success

The Situational Argument

Traits Abilities andBehavior

Leadership effectiveness

& Success

The Behavioral perspective

Low Initiating

Structure, High

consideration

Style

High InitiatingStructure, HighConsideration Style

Low InitiatingStructure, Lowconsideration Style

High InitiatingStructure, LowConsideration Style

Initiating Structure

The Contingency Perspective

Leadership Match Model

Path Goal Model

LEAD Model

Attribution Theory

Emerging Theories & Concepts

Transformational Leadership

Concerned with changes than exchanges. Seeking to

alter both the objective and nature of manager-follower interactions, lead by empowering.

Charismatic Leadership

Distinct social relationship between the leader and

follower, in which the leader presents the revolutionary idea & Follower accepts the idea not by rationally, but by

believes

High Performance leadership, Depends on :

Systems Thinking,Mastering a conceptual framework and associated set of analytical tools or technique which allow us to understand these

patterns and how they can be changed.

VisioningEffective managers lead by pulling, not pushing

Facilitating learningOrganizations and the environments in which they operate are not static. Changes tends to revolutionary than evolutionary

Distinctive aspect of leadership in health services organizations

Leading the Clinical Professionals

Leadership and Gender in Health Services Organizations


Bagaimanakah menurut anda kepemimpinan itu? Dan apa sajakah faktor-faktor yang berpengaruh dalam efektivitas kepemmpinan?

Ceritakanlah gaya kepemimpinan anda! Dan diskusikanlah itu dengan rekan-rekan anda.

Menurut anda apakah karakteristik dari organisasi kesehatan yang membutuhkan peran kepemimpinan dari manajer?

Setelah melihat data dari ACHE mengenai kaitan Gender dan kepemimpinan, bagaimana menurut pendapat anda? Bagaimana implikasi dari data ini ?

Conflict Management and Negotiation


Identify reasons that conflict is prevalent in health care organizations.

Understand several different types of conflict management technique, based on various concerns of the disputants.

Identify the basic concepts and dimensions of negotiation.

Appreciate the importance of planning for a negotiation and know the key issues to consider when preparing to negotiate.

Identify and understand special types of conflict management situations, such as multiparty negotiations and third-party intervention.

The Importance of Conflict Management The Marketplace is growing increasingly global

as firms face competition from foreign company.

The epidemic of corporate restructuring experienced during the past decade produced the framework for the development of todays organized delivery systems

Shift from manufacturing based to a service based

The Causes of Conflict

The role of resource scarcity

Beneficial vs. Detrimental effects of conflict

Jehn’s Typology of Conflict

Levels of Conflict

Individual Level

Group Level

Managing Conflict

The Dual Concern Model

Models as typology of conflict management, focusing on

four ways that people handle conflict:

Accomodation

Pressing

Avoidance

Negotiation

Dual Concern Model

Accomodation

Pressing

Avoiding

Negotiating

Collaborating

Compromising

Assertive

Concernfor Self

Unassertive

Uncooperative Concern for others Cooperative

Negotiation, the key points

Basic ConceptsA Negotiator never has to negotiate; there always alternatives to reaching an agreement through a negotiation.

The Distributive dimension of negotiation

1. Know your BATNA (Best Alternatives to a Negotiated

agreement)

2. Determine your bottom line or reservation price

3. Set a Goal of aspiration level that is significanly better than your bottom line and optimistically realistic.

4. Think of what objective Standards might be acceptable to the other party.

5. Plan your opening. An initial offer should not be to extreme, but it should prevent the other party from anchoring the negotiation.

6. Develop reciprocity. Avoid making unilateral concessions

Negotiation, the key points (Con’t) The integrative Dimension of Negotiation.

The assumption is that one party can gain without the other

party necessarily having to lose.

The Mixed motive nature of negotiation.

Simultaneously balance cooperative and competitive behavior

The Role of information sharingSymmetric Information

Multiparty Negotiations

Difference between two and multiparty negotiations

Two party negotiations is less complex than multi party negotiations

Fairness and Ethics in Negotiation

Fairness Norm :

Equality

Equity

Need

Managing conflict through third party intervention

There are several types of intervention strategies

Manager

as Inquisitor

as Arbitrator

as Mediator


Jenis keahlian apakah yang dibutuhkan manajer dalam mengelola konflik yang ada? Apakah anda memilikinya? Bagaimana meningkatkan kelemahan anda dalam mengelola konflik ini?

Setelah melihat debate time 5.1, apakah indikasi sebuah HSO memiliki konflik? Bagaimanakah sistem untuk memantau indikator itu.

Strategi pihak ketiga apakah yang akan dijalankan oleh manajer sebagai pihak ketiga?

Dalam menangani konflik antar-group, kelompok mana yang paling sering mengalami konflik?

Jika anda dalam posisi James Grover di Chiefland memorial hospital tindakan apa yang harus anda ambil untuk meredakan konflik antara hoffman and Young? Jelaskan langkah-langkah anda!










Memberi Arah


Mendorong Kerjasama














Mencapai Sasaran






Managing Groups and Teams


Describe the importance and types of groups and teams in health services organizations.

Distinguish between different approaches to assesing work group performance

Analyze the effect of a work group’s structure on group performance.

Explain the relationship between work group norms and group productivity.

Identify the key roles assumed by individuals in work groups.

Describe key aspects of group process including communications structures, decision making, and stages of group development.

Define major causes and consequences of intergroup conflict and identify alternative strategies for managing conflict.

Types of groups and teams in organizations

Reference Groups

Friendship Groups

Interest Groups

Work Groups

Management teams

Temporary Groups or task forces

Intermittent Groups

Standing Committees

A Model of Work group Performance

Group Characteristics:•Group composition and size•Group norms•Role relationships•Group role clarity•Group cohesiveness•Status differences

Group Process :•Leadership•Communication•Decision Making•Stages of group development

Effectiveness :•Performanceor Productivity

•Member satisfaction

Intergroup Conflict :•Interdependence among groups.•Group role and task ambiguity.•Intergroup differences in work orientation.•Intergroup goal incompatibility.

Discussion Question 6

Direktur yang baru-baru ini bekerja, diserahkan tugas untuk memimpin rapat mingguan team manajemen. Team manajemen ini membutuhkan beberapa dokter, perawat, asisten dokter, dan petugas sosial. Apa kebijakan yang akan anda berikan pada direktur

RS untuk membantu meningkatkan kerja team?

Sebuah kelompok interorganisasional telah dibentuk untuk mengidentifikasi kendala-kendala dalam memberikan pelayanan kesehatan. Bagaimanakah anda mengelola organisasi dalam lingkup divisi dan global terjaga dengan manajemen yang baik.

Dalam keadaan apa saja uncohesive group lebih produktif daripada cohesive groups? Strategi apa yang harus dibuat oleh pemimpin untuk membuat Cohesive group lebih produktif?

Strategi apa yang digunakan pemimpin group untuk meningkatkan komitmen dari anggota group? Bagaimanakah pemimpin group dapat memantau apakah anak buahnya telah memiliki komitmen atau tidak?

Work Design


Identify the range of approaches to work design, including the psychological and task inventory approaches.

Understand the relationship between work design and individuals motivation and productivity.

Discuss the differences between work and working.

Identify components of work, their characteristics and their performance requirement.

Analyze the interconnectedness of components of work among individuals and among work groups.

Understand how to approach the design of individual jobs and work units.

Approaches to job design Task Inventory approaches.

Psychological approaches

Analysis of Work

Work,is objective and impersonal, it is energy directed at organizational goals, identifiable separately from the person who does it.

Working

it is a workers affective response to work. Is an individual personal

and subjective reaction.

Types of Work

Direct work

effort that directly contributes to the accomplishment of an organization’s goals

Management Work

Providing the resources and and context within which direct work can be perform.

Support WorkDoes not directly result in achievement of an organizational goal, but it needed for effective accomplishment of other job

Key points in Designing Works

To evaluate works and working run properly,

we need a more detailed analysis, which is :

Determining components of work

interconnectedness of work

Designing individual job

It is important to match people and their needs to jobs and their inherent work requirements.

People evaluate courses of action for the purpose of choosing among them

Coordinating interconnected work within organizational units Interconnected elements of work are best placed within an

individual job.

In this section, focus on how to achieve coordination.

Van de Ven et al. Found variations in patterns of coordination among unit facing different level of task uncertainty.

Charns et al extended the findings, Mintzberg suggest that work groups use a combination of six approaches to coordination and that the use of these approaches is related to the effectiveness of patient care.

The Six approaches fall into two categories: programming methods and feedback methods.


Under what conditions does a job with a high motivating potential lead to high job holder motivation?

What are the potential pitfallsin job redesign ?

Give examples of highly motivated people who do not contribute greatly to organizational productivity?

What is the relationship among individual motivation and satisfaction and an organization’s ability to coordinate work?

Give examples of situations in which dependable role performance is required in a job but effort above minimum level is not. What happens when individuals in such jobs innovate? Give examples of jobs requiring cooperative behavior. What happens when people in such jobs are willing to give only dependable role performance?

Coordination and Communication

Learning Objectives Differentiate between pooled, sequential, and reciprocal

interdependence.

Differentiate between intraorganizational coordination and interorganizational coordination.

Discuss a variety of coordination mechanisms used in intraorganizational settings.

Consider the aplication of the intraorganizational coordinating mechanisms to a given situation using the contigency approach.

Discuss the three major types of transactions used in interorganizational coordination.

Discuss the management of interorganizational linkages.

Describe the elements of effective communications

Discuss the technical mechanism of communication.

Discuss the barriers to communication

Describe the flow of intraorganizational communication.

Describe the flow of interorganizational communication

Discuss the special case of communication between units of a system.

Interdependence

Pooled interdependence

Sequential interdependence

Reciprocal interdependence

Skills needed by Managers

Managers

Within the Hospital

With Other Organizations

Coordination

As a means of effectively linking together the various part of an organization or of linking together organizations and dealing with interdependence.

Coordination

Intraorganizational

Interorganizational

Intraorganizational Coordination

Since the activities of health professionals are seen as being complex, uncertain, and of great social importance, three distinctive structural arrangements has evolved to support the autonomy of these professions.

Autonomous arrangement, present when an organization delegates to a professional group goal setting, implementation, and evaluation of performance and the administration manages the support staff.

Heteronomous arrangement, Professionals are subordinated to the administrative structure with specific responsibilities delegated to various professional groups.

Conjoint arrangement, Professionals and administration are equal in power.

Intraorganizational Mechanisms of Coordination

Hierarchical coordination, The various activities are linked by placing them under a central authority.

Administrative system, emphasizing formal procedures, provides a second mechanism for coordinating activities.

Voluntary Action, inw hich individuals or group see a need for coordination, develop a method, and implement it.

Mintzberg’s Five Coordinating Mechanism

M Manager

Analyst A

O O

Mutual Adjusment

M Manager

Analyst A

O O

Direct SupervisionM

A

O OWorker SkillsOutputs

Standardization

Interorganizational Coordination

Typology : Market Transactions, Involve the focal organization and

other organizations entering into relationships in order to obtain operational resources or product markets.

Voluntary interorganizational relationship transactions, Distinguished by the voluntary dimension of the transactions.

Involuntary Interorganizational Transactions, lead to unique ways of managing interdependence.

Managing Interorganizational linkages

It is important for a manager to use a contigency approach when establishing and maintaining relationships with interdependent organizations

Communication

Provides information people need to make decisions.

Communications from the Managers perspective, has:

Intraorganizational Communication, depends on

formal establishment of channels and networks

within the organizations.

Interorganizational Dimensions, occurs between organizations or between organizations and constituencies outside them.

Elements of Effective Communication

Desire toCommunicate Effective

Communication:•Being Understood•Making meaning, not agreement

Understanding How others Learn•Perceive and Process information•Analytic vs Intuitive•Abstract vs Concrete,etc

Purpose Information Cues

Eliciting CuesDecision Cues

Content Importance

Complexity

Sender Ascribed

Credibility Achieved

Time Frame Long vs Short

Reinforcement

Barriers to Communication

Environmental Barriers

Personal Barriers

Flows of intraorganizational Communications

Downward Flow

Upward Flow

Horizontal and Diagonal Flows

Communication Networks

Communication networks

Chain Networks

Y Pattern

Wheel Pattern

Circle Pattern

All-Channels Network

Communication Flows in Health care Organizations

Upward Communication•Problems & Exceptions•Suggestions for improvement•Performance reports•Grievances and disputes•Financial and Accounting

information

Downward Communication•Implementation of goals,Strategies, Objectives•Job Instructions and rationale•Procedures and practices•Performance feedback•Indoctrination

COORDINATE

HORIZONTAL AND DIAGONAL COMMUNICATION•Intradepartmental problem solving•Interdepartmental coordination•Staff advice to the departments

Inte

rpre

t

Discussion Questions

Diskusikan perbedaan koordinasi intra dan inter organisasional. Apa sajakah cara-cara yang dapat digunakan oleh manajer untuk mencapai koorinasi tipe tertentu?

Jelaskan model komunikasi dan gambarkan model komunikasinya!

Anda baru saja diangkat menjadi manajer sebuah proyek bersama antara RS tempat anda bekerja dengan beberapa staff medis untuk mengoperasikan fasilitas bedah. Program yang anda pentingkan adalah untuk menjalin kerjasama yang efektif dengan RS. Buatlah rencana proyek ini berdasarkan materi pada bab ini!

Bayangkan Organisasi pelayanan kesehatan anda menerima sebuah pemberitaan yang buruk. Bagaimanakah organisasi anda akan bereaksi?

Power And Politics in Health Services Organizations


Distinguish between rational and political models of organization of their appropriateness to health services organizations.

Know the practical, managerial implications of the effective use of power in health services organizations.

Identify the conditions that promote the use of power, politics, and informal Influences in health services organizations.

Understand the range of political strategies and tactics employed by members of health services organizations

Understand the sources of power in health services organizations.

Know the key approaches for consolidating and developing power by managers, physicians, and other groups in health services organizations.

Power, Influences and Politics, definitions

Power, has been a notoriously elusive term to define

and identify within organizations.

Influence, indicate actions that, either directly or indirectly, cause a change in the behavior or attitudes of another individual or group.

Politics, domain activity in which participants attempt to influences organizational decisions and activities in ways that are not sanctioned by either the formal authority system of the organization, its accepted ideology, or certified expertise.

Rational vs political perspectives on managementOrganizational management is influenced by two models :

Rational models imply that the managers are orchestrating the activities of a team whose members all subscribe to a common set of goals and objectives.

Political Perspectives acknowledge the existence of power and influence other than that vested in formal authority system or professional expertise.

Sources of power

Access to resources

Access to information

Formal Authority

Skill in dealing with uncertainty

Mintzbergs Political Games

Games to resist authority

Games to counter the resistance to authority.

Games to build power bases.

Games to defeat rivals

Games to Effect Organizational change

Power Strategies and Tactics

The use of power is to implement decisions.

Power is most effectively used when it is employed unobtrusively as possible.

Effective attempts to influence is in an aura of legitimacy and rational purpose.

Coalition Building

Power, Politics, and Organizational Performance

In an organizations, the use of power is to maintain the importance of a decision has been made.

Such Strategies for reducing the level of influence are available for manager who simply do not feel comfortable for using power.










Memberi Arah


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Mencapai Sasaran






Organization Design

Learning Objectives

Understand the principles of organization design

Have an awareness of the evolution of organization design.

Use a framework for understanding organization design considerations.

Analyze common organization designs in terms of their applicability, Strengths, and limitations.

Consider guidelines for changing organization designs.

What is Organization Design

OD is the way of building blocks of

organization which, authority, responsibility, accountability, information and reward are

arranged or rearranged to improve effectiveness and adaptive capacity.

Management role in OD

Management primary task is to maintain and improve performance in the organization.

In designing OD managers should consider input from

employee. OD must be design bottom-up not Top down.

Organization design in relation to other management activities.

Statement Of Organizational Mission

Strategy Development& Implementation

OD

Information Needs

Rewards

Performance Evaluation

Feed Back

Levels of OD

Position

Work Group

Cluster of Work Group

Total Organization

Network

System

Things to consider before design

The Mission

Environmental Assessment

Organizational Assessment

Human Resources Assessment

Political Process Assessment

Variety Designs of HSO

Classic Design :

Functional Design

Divisional Design

Matrix Design

New Evolving Design :

Parallel Design

Product Line or Program Design

Influences on the future OD

The Mission

Future Environment

Organization

Human Resources

Political Process

Organizations in transition

MANAGING STRATEGIC ALLIANCES

Learning Objectives Understand why strategic alliances are increasing in use, particularly

among health care organizations.

Distinguish between different types or forms of strategic alliances, using number of dimensions.

Classify an alliance both in terms of what it looks like and what it is meant to do.

Understand how alliance motivation is often related to alliance structure and outcomes.

Identify whethet your motivations for a strategic alliance are compatible with those of your alliance partner.

Think about strategic alliances in terms of the likely stages of development that alliances often experience and the critical issues that you may face at each stage.

Distinguish between an alliance problem and an alliances symptom and recognize the different implications for managerial intervention.

Understand both the pros and cons of alliances.

Alliances in health care industries

Strategic alliances dalam organisasi selalu diibaratkan dengan orang yang sedang membina hubungan pacaran, dimana ada kemungkinan hubungan yang harmonis dengan kekuatan yang sinergis atau konflik yang menghancurkan.

Types and forms of alliances

Ownership and control

Number of members

Governance Structure

Mandated vs Voluntary Participation

What are Alliances meant to do

Pooling vs Trading Alliances

Cost reduction vs Revenue Enhancement

Quality, innovation, and learning

Power enhancement, uncertainty reduction, and risk sharing.

The Alliance Process : A Multistage Analysis

Emergence : Finding Partners

Transition

Maturity

Critical Crossroads

Frameworks for analyzing alliance problems

Locating the problem

Separating the root from the symptom.

Organizational Innovation and Change

Learning Objectives

Describe the change process that occurs within health services

organizations and identify factors which facilitate or inhibit that

process.

Identify and understand the types of changes associated with technical operations and the methods to manage such changes.

Identify and understand the types of changes and methods associated with identify \ing and introducing new services.

Describe the types of changes involving administrative, structural, or strategy mechanisms and the approaches that affect such change processes.

Describe human resource changes and identify methods for managing such changes.

The Change Process

Both changes and innovation involve a number of distinct stages :

Awareness

Identification

Implementation

Institutionalization

Types of Changes

Technical Changes

Product or service changes

Administrative, structural, or strategy changes.

Human resources changes.

Organizational Performance

Learning Objectives

Understand the importance of assesing organizational performance.

Define performance measures for organizations.

Understand the important issues in defining, measuring, and using performance measures.

Evaluate professional work.

Compare management models based on quality assurance and quality improvement.

Manage for quality improvement in health care.

Understand management roles to create high performance organizations.

Overview of performance

The terms widely used in assessing health service is

Efficacy, capability of a health service under ideal conditions and applied to the right problems.

Appropriateness, focuses on whether an efficacious treatment was apllied to the right patient at the right time.

Effectiveness involves ascertaining the quality in which a service is carried out.

Issues in assesing effectiveperformance

Fundamental perspectives about organizations.

Domain of activity

Different levels of analysis

Technical issues in assessment

Classes of measures

Structural measures

Process measures

Outcome measures

Factors associated with effective performance :

Quality of professional staff

High standart

experience with other cases

more professional staffs with high capability in managing conflict.

Participative organization cultures emphasizing team approaches.

Timely and accurate performance feedback.

Active management of environmantal forces.

Two models for changing performance

Quality Assurance

Quality Improvement

Cause and effect diagram for continous improvement

Environmental Characteristics

Unit CharacteristicsPatient Characteristics

InterorganizationalCharacteristics

OrganizationalCharacteristics

ProviderCharacteristics

Outcomes of care

Managers role in creating high performance Health care Organizations

Problem in measuring performance are a challenging factor in HCO.

The task of defining, measuring, and influencing performance is

so difficult that management can play a key role.

Managing Trade-offs

Need a paradigm shift from mechanical model to a new model of commitment, and a cycle of

continous improvement

Each department determines who are the customer and what are they really want.

Leadership strategies for high

performance HCO

Stretching

Maximizing learning

Take risks

Exhibit transformational leadership

incline toward action.

Create chemistry

Manage uncertainty

Remain loosely coordinated

Possess a strong culture

signify meaningful values










Memberi Arah


Mendorong Kerjasama














Mencapai Sasaran






Strategy making in HCO

Learning Objectives

Define the concepts of strategic management.

Undewrstand the major school of thought in strategic management and how the relevance of each might be dependent upon the degree of turbulence in the environment.

Understand the major sources of competitive advantage, some major examples, of these sources, and why they are important in the design of strategy.

Understand how multiorganizational structures can facilitate implementation of health care strategies.

Identify the major structural features of markets and be able to apply them in the analysis of health care strategies.

Identify the major force of threat in the porter framework and be able to use them in conducting strategic analyses.

Understand the relationship between strategy and market structure and be able to apply this understanding to the analysis of health care markets.

Strategic Management

Goal formulation

Environmental analysis

Strategy Formulation

Strategy Evaluation

Strategy implementation

Strategic control.

Schools of thought

School

Prescriptive SchoolDesignPlanningPositioningDescriptive ScholsEntrepreneurialCognitiveLearningPoliticalCulturalEnvironmentConfiguration

Strategy Formulation as

A Conceptual processA formal Processan analytical process

A Visionary ProcessA Mental ProcessAn Emergent Processa Power Processan ideological processa passive processan episodic process

Strategy

Positioning a business to maximize the value of the capabilities that distinguish it from its competitors

Strategy is an integrating set of ideas and concepts that guide an organization in its attempts to achieve competitive advantage over rivals.

Strategic comfort zones for shifting pace

Prospector Analyzer Defender

Reactor

Five forces Michael Porter

Potential Entrants

Buyers

Substitutes

Supplier Competitors

Creating and Managing the Future

Learning Objectives

Identify the major trends likely to affect the delivery of health care.

Understand the changing role of physicians, nurses, and other allied health care providers within health services.

Understand the changing role of management and the competencies required to function in the managerial role.

The organization and the environment

Changing social norms and expectations

Demographic composition and epidemiology

Technology Development

Organizational arrangements

Financing

Social experimentation

The Worlds is changing

Changing Role of Physician

Changing Role of Nurse

Expanding role of allied health professionals

Health Services Policy

Dalam menetapkan kebijakan sangat dipengaruhi oleh keadaan masa depan.

Untuk meramalkan masa depan perlu melakukan riset

Kadangkala Manajer tidak memiliki waktu dalam melakukan riset sehingga diperlukan kerjasama dengan para peneliti.

The Managerial Role

Role performance and emerging challenges

Preparing future managers

Tugas pak dwi

tugas sesi 9 pak dwi

tugas individu.

1. susun perbedan antara grup dan tim besertarujukannya, bukan persepsi.

2. susun perbedaan taks inventory approach danpsycology aproach

3. susun perbedaan job, task, work, dan assignment

deadline 11 oktober 2018

kirim ke [email protected]

Documents

MANAGEMENT PRINCIPLES FOR HEALTH CARE SERVICESweb90.opencloud.dssdi.ugm.ac.id/wp-content/uploads/sites/644/2018/... · Merencanakan Masa Depan Memenuhi Kebutuhan dan Nilai-nilai Individu-Memotivasi