Chapter 1 Organization Theory and Health Services Management

Chapter 1

Organization Theory and Health Services

Management

3Copyright © 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 3

Purpose and Overview

• Purpose– To learn about the major influences affecting

health care organizations – Discussion of managerial perspectives– Discussion of managerial theories



• Overview– The Changing Health Care System– Ecology of Health Services Organizations – Key Dimensions of Health Services

Organizations – Health Services Organizations as Systems



• Overview– Areas of Managerial Activity – Major Perspectives on Health Services

Organizations – Metaphors of Health Services Organizations


The Changing Health Care System
















Ecology of Health Services Organizations



• Are Health Services Organizations Unique? – Defining and measuring output are difficult– Work is variable and complex– Work is usually nondeferrable – Work is often performed under emergency

conditions



• Are Health Services Organizations Unique? – Work must be precise and errorless– Services are interdependent and require

coordination– Require extreme degree of specialization



• Are Health Services Organizations Unique?– Professionalized providers– Lack of managerial control over group

generating work and expenditures– Dual lines of authority


Key Dimensions of Health Services Organizations

• External Environment

• Vision

• Mission

• Goals

• Strategies


Key Dimensions of Health Services Organizations

• Differentiation

• Integration

• Centralization

• Change

• Innovation


Health Services Organizations as Systems

• Closed System – Maximize internal efficiency, predictability,

and order

• Open System – Openness, adaptability, and innovation



• Production– Products or services at center of

organizational activities

• Boundary Spanning– Interface between organization and external

environment



• Maintenance– Physical and human infrastructure

• Adaptation– Innovation as tool for change



• Management– Organizes, directs, and oversees

• Governance– Provides strategic direction and imposes

accountability


Areas of Managerial Activity

• Organizational Behavior–Micro Approach– Examines individuals within organizations – Motivation– Leadership– Conflict management


Areas of Managerial Activity

• Organization Theory–Macro Approach– Organization as social system– Organizational design– Interorganizational relationships– Change and innovation– Performance and strategy


Major Perspectives on Health Services Organizations

• Bureaucratic Theory– Procedures for governing activities– Hierarchical structure– Lack of individual freedom– Rigid behavior



• Scientific Management School– Span of control– Unity of command– Appropriate delegation of authority– Departmentalization– Work rules and methods to improve efficiency



• Human Relations School– Individual, group dynamics, and relationships– Participatory decision making – Self-actualizing aspects of work



• Contingency Theory– Organization is situational– Continuum that moves toward organic from

bureaucratic structure



• Resource Dependence Theory– Obtaining resources from environment



• Strategic Management Perspective– Positions organization to environment and

competitors



• Population Ecology Theory– Environmental forces "select out" certain

organizations for survival– Minimizes role of managers



• Institutional Theory– Requires conformity to rules to receive

legitimacy and support



• Social Network Perspective– Behavior is social in nature – Successful organizations develop and use

social networks



• Complex Adaptive Systems– Interdependent, embedded, and

unpredictable– Experimentation– Application of simple rules– Co-evolution of organization and environment








Metaphors of Health Services Organizations

Documents

Chapter 1 Organization Theory and Health Services Management