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AAPHP Preventive Services Toolkit. Power Structure Analysis -- how to get the bureaucracy and legislature to do what you want them to do. Power. Power, in an organizational setting, is the ability to get other people to do what you want them to do. Definition of PSA. - PowerPoint PPT Presentation
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10/10/06 AAPHP PSTK PSA Module 6, Slide 1
AAPHPPreventive Services Toolkit
Power Structure Analysis
-- how to get the bureaucracy and legislature to do what you want them to do
10/10/06 AAPHP PSTK PSA Module 6, Slide 2
Power
Power, in an organizational setting,
is the ability to get other
people to do what you want
them to do
10/10/06 AAPHP PSTK PSA Module 6, Slide 3
Definition of PSA
Power Structure Analysis (PSA) is a rapid and user-friendly protocol for stakeholder analysis designed to
Develop advocacy strategy Determine feasibility of adoption of proposals Identify stakeholder-related leverage and barriers
10/10/06 AAPHP PSTK PSA Module 6, Slide 4
PSA Rapid and User Friendly
Initial 1-2 hour meeting Half-dozen phone calls Follow-up ½ to 1 hour meeting
10/10/06 AAPHP PSTK PSA Module 6, Slide 5
PSA - Teaching Objectives
Describe concepts and tools of Power Structure Analysis (PSA)
Address mindset-related barriers to preventive services
Conduct a Power Structure Analysis
10/10/06 AAPHP PSTK PSA Module 6, Slide 6
PSA: Concepts and Tools
Stakeholder Mindsets Character types Self deception Games Government, American style Sunburst diagram Myths and Magic of PSA
10/10/06 AAPHP PSTK PSA Module 6, Slide 7
Stakeholder
-- any person or interest group that cares enough about an issue or proposal to either support or oppose it
-- any person or group with an interest in the success of the enterprise
10/10/06 AAPHP PSTK PSA Module 6, Slide 8
Mindsets
Personal Technical Administrative Policy/Political
Personal idiosyncrasy Organizational Culture
Universal Idiosyncratic
(Graham Allison: Essence of Decision)
10/10/06 AAPHP PSTK PSA Module 6, Slide 9
The Hierarchy of Mindsets
Personal Idiosyncrasy /organizational cultural
Policy/Political Administrative Technical
10/10/06 AAPHP PSTK PSA Module 6, Slide 10
”Out of the Box”
“Out of the box” thinking is often recommended
What is the “box”?
10/10/06 AAPHP PSTK PSA Module 6, Slide 11
Character Types
Zealot Advocate Statesman Conserver
10/10/06 AAPHP PSTK PSA Module 6, Slide 12
Games
Dysfunctional patterns of behavior Self Deception
Usually sincere Rarely ill intentioned
Games almost always damage the efficiency, economy and/or mission of the agency
10/10/06 AAPHP PSTK PSA Module 6, Slide 13
Games People Play–Technical
Low priority activities
Academic habits
“Productivity”
10/10/06 AAPHP PSTK PSA Module 6, Slide 14
Games People Play –Administrative
Doing what looks good on paper
Any excuse to cut (or pad) the budget
Obsession with rules and paperwork
Reorganization
10/10/06 AAPHP PSTK PSA Module 6, Slide 15
Games People Play –Policy/Political
Glib assertions easier than hard facts
Simple myths easier than complex reality
Public servant (or staff) portrayed as lazy or undedicated
Health Care Delivery Games Skimming Dumping Inappropriate Utilization
10/10/06 AAPHP PSTK PSA Module 6, Slide 16
Games People Play –Personal/Organizational Culture
“Going with the flow” “getting along”
Reluctance to suggest promising new ideas
Silence in the face of incompetent or inappropriate behavior
10/10/06 AAPHP PSTK PSA Module 6, Slide 17
Government, American Style
Federal -- $$$$$$$$$$ State – legal authority Local – the problem Federalism – how levels of
government relate to each other “layer cake” “marble cake”
10/10/06 AAPHP PSTK PSA Module 6, Slide 18
Sunburst Diagram
Domains:
Personal
Professional Culture
Administrative
Policy/Political
10/10/06 AAPHP PSTK PSA Module 6, Slide 19
Personal Domain
Personal Values
Character Type
Family
10/10/06 AAPHP PSTK PSA Module 6, Slide 20
Professional Culture (Technical) Domain
Professional Goals
ColleaguesPeers
10/10/06 AAPHP PSTK PSA Module 6, Slide 21
Administrative Domain
Boss
Budget and Personnel
Standard Operating
Procedures
Subordinates
Regulation and Accreditation
10/10/06 AAPHP PSTK PSA Module 6, Slide 22
Policy/Political Domain
Authorization and Funding
Interest Groups
Legal/ Liability/ Tort
Clients/Patients
Community Image
10/10/06 AAPHP PSTK PSA Module 6, Slide 23
Leverage
The ultimate goal of the PSA exercise is leverage. This is the identification of an advocacy strategy by which one can use the perspective of one or more of the major stakeholders to influence others on your behalf.
-- getting someone in another domain so excited about your proposal that they will advocate for it on your behalf
10/10/06 AAPHP PSTK PSA Module 6, Slide 24
Examples of Leverage
Tobacco Control Legislation Getting hotel owners to advocate because of
reductions to their cleaning costs and property damage
Getting restaurant owners to advocate to avoid installing costly air handling systems
Health club services and nutrition counseling Getting marketing to advocate to help
attract low-risk enrollees
10/10/06 AAPHP PSTK PSA Module 6, Slide 25
Group Exercise
-- conduct one or more brief PSAs on situations proposed by participants
10/10/06 AAPHP PSTK PSA Module 6, Slide 26
Stepwise PSA Process
1. Define your proposal2. PSA initial meeting3. Stakeholder research4. PSA second meeting
1. Determine feasibility2. Identify opportunities for leverage and synergism3. Determine needs for additional stakeholder research4. Develop advocacy strategy
10/10/06 AAPHP PSTK PSA Module 6, Slide 27
The Magic of PSA
New Ideas and program options Leverage Health outcomes not otherwise
achievable Prevent you from being “blindsided” Political support for yet other
initiatives
10/10/06 AAPHP PSTK PSA Module 6, Slide 28
True or False?
There are two sides to every issue There’s not enough money Dollars are our most important
resource What is good for me or for my
agency is good for the community
10/10/06 AAPHP PSTK PSA Module 6, Slide 29
Q and A