Principles of Health Management

ORGANIZING and ORGANIZATION

Organizing- Organizing is the second managerial

function. Having planned, the manager must now organize so that personnel can accomplish the plans with efficiency and effectiveness.

- Organizations are necessary because they facilitate a greater accomplishment of work than could be done by individual effort.

Contd.• Organization is a collection of people

working together under a division of labor and a hierarchy of authority to achieve a common goal.

• Organizing is to put a constant relationships between different jobs, that foster cooperation between individuals and groups inside the organization in order to achieve the common goals and objectives of the organization.

Contd.Organizing is a logical process that involves: 1- Defining the agency’s mission and objectives.2- Establishing policies and plans.3- Clarifying the activities necessary to meet the

objectives.4- Organizing the activities for best utilization of

available human and material resources.5- Delegating the responsibility and authority necessary

to do the activities to appropriate personnel.6- Grouping personnel vertically and horizontally

through information systems and authority relationships (Organization Structure).

Contd.

- Organization Structure constitute the formal framework in which the management process take place.

- The proper O.S. help in:1- providing effective work and Comm.

Systems.2- improving the abilities and developing the

skills of the workers.

Types of O.S.

There are two types of organization structures which are formal and informal, and both of them are found in almost all organizations.

1- Formal O.S.:-

It is defined by the executive decision issued from the concerned authority as a result of the planning process.

Formal O. S.• It is a diagram that show the relationships

among people and their positions through describing the positions, responsibilities, and relationships inside the organization.

• There are many subtypes of the formal organization structures that could be utilized in the health organizations (4 subtypes).

Contd.A- Line O.S. :-

- The oldest and the simplest one.

- It is a descending structure where those having the greatest decision making and authority are located at the top, and those with the least, at the bottom.

Contd.

• Advantages:-

1- simplicity and clarity of authority lines.

2- Unity of commands (one person/one boss).

3- quick decision making process.

• Disadvantages:-

1- Restricted upward communications

2- no specializations which burden the head manager.

Formal O.S.

B- Functional O.S. :-

- Employees are grouped in departments by task with each department reporting to its own manager.

- All pharmacy tasks are under pharmacy services, and the same is true for the other specialties.

Contd.

• Advantages of Functional O.S. :-

1- no task duplication

2- use resources efficiently

3- simplify training (common tasks are grouped)

• Disadvantages:-

1- poor coordination among functions

2- unclear lines of responsibilities (Slow response).

Contd.C- Dual Management:-• It Separates between technical and administrative

responsibilities.• It has one hierarchy in which technical

professionals make technical decisions and control the technical matters, and another hierarchy in which supervisory management makes decisions about issues such as personnel and budget.

• This dual hierarchy gives equal status to managers and technical professionals. It provides a broad range of cooperation and consultancy between both teams.

Contd.D- Matrix O. S. :-

- This structure has a formal vertical as well as horizontal chain of command.

- It is used in huge organizations and contain both a main staff as well as branch staffs.

- Advantages:

1- flexibility

2- cost containment.

Contd.

• Disadvantages of the Matrix Structure:

1- The dual authority which can be frustrating and confusing for the heads of the departments.

2- A matrix is a time-consuming structure because frequent meetings are required in order to resolve problems and conflicts.

Contd.2- Informal Organization Structure:-• The informal organization comprises personal and

social relationships that do not appear on the organizational chart (personal relationships).

• It helps members meet personal objectives and provides social satisfaction. People who have little formal status may gain recognition through the informal structure.

• Informal authority is not commanded through organizational structure but it comes from the follower’s natural respect for a colleague’s knowledge and abilities.

Contd.

• To avoid informal O. S., it is advised to:

- Sharing the different workers in the decision making process.

- Create the spirit of teamwork and cooperation between managers and their workers.

- To clearly follow Suitable person/suitable place concept.

Organizing-related Concepts

* CHARTS: An organizational chart is a drawing that shows how the parts of an organization are linked. It depicts the formal organization relationships, areas of responsibility, lines of authority, persons to whom one is accountable, and channels of communication.

Contd.

• Span of control (Span of supervision):-

It is the number of people that a manager can effectively and efficiently supervise in an organization.

- SOC can simply be determined by counting the number of subordinates.

- ↑ in SOC ……….. ↓ management levels.

Contd.

▪ The ideal SOC is ranging from 5-12 but it could be less or more depending on various factors such as:-

1- task complexity and nature of the work.

2- managers and employees skills & abilities.

3- geographic location & the comm. channels.

4- rate of change in the work environment.

Contd.• Centralization and Decentralization:

• In organization with centralized decision making, decisions are made by few manager at the top of the hierarchy.

• Decentralized decision making diffuses throughout the organization and it especially allow problems to be solved at the level at which they occur.

Contd.• Advantages of decentralization:

1- Decentralization promotes interpersonal relationships and ↑ flexibility.

2- Decentralization fosters democracy in management and brings decision making closer to action.

3- Decentralization develops managers by allowing them to manage.

4- freeing top managers for long run planning, goal planning and policy development, and so on.

Contd.• Disadvantages of decentralization:-

1- Divisions may become individualized and competitive to the extent that they sacrifices the overall objectives for short run profitability and work against the best interests of the organization.

2- Involves increased costs, It requires more manager and large staffs.

3- Division managers may not inform top management of their problems.

Contd.

• Authority:-

Is the official power to issue instructions and orders. It is given by the organization structure and the person position in order to direct the work of the organization, e.g. the manager may have the authority to hire, fire, or discipline others, and so on.

Contd.

- Authority delegation:-

Is the partial transference of the manager authority or power (mainly decision making) to his followers.

- Authority delegation doesn’t mean that the manager lose his responsibility over the delegated activities and he can withdraw it at any time.

Contd.• Delegation maximizes the utilization of the

talents of subordinates. Their involvement tends to increase their motivation and the commitment to accomplish the goals while freeing the manager to concentrates on the accomplishment of overall goals and objectives rather than the day-to-day details.

Contd.• Principles of authority delegation:

1- for the superior : to be sure that the subordinate is able to bear the delegated responsibilities, and also to monitor and follow up the work of the subordinate.

2- for the subordinate: to properly use the delegated authority and readiness to bear the responsibility without any fear or personal exploitation.

Contd.

• Committees:Is the formation of a group of people inside

the organization for a certain purpose.• Purpose for using committees:-1- solving problems and decision making.2- provide some needed recommendations

about certain issues.3- creating new ideas and alternatives and

providing them for the top managers.

Contd.

- Committees may be permanent or temporary, and their decisions are either recommendations or firmly taken.

• Critique of committees:

1- committee opinions are mostly for consultancy, not firmly applied.

2- time-consuming discussions & controversies.

3- to avoid contradictions, compromise solutions are usually adopted.

Contd.• ( The best committee is a committee of

one)

Factors that help in committees success:1- define the comm. Task accurately.2- define the committee time framework.3- qualified head & members of the comm.4- follow up of the committee work by the top

management.

Contd.• Characteristics of effective organization:-1- Unity of the goal and integration of the roles by

all functions for this purpose.2- Unity of leadership and commands to avoid

vagueness and interruption among workers.3- Proper span of control that is based on the factors

that affect it.4- balance between authority and responsibility

(proportional relationship).

Contd.

5- Delegation of authority for qualified persons on the hierarchy.

6- flexibility of the organization that make it parallel with the surrounding changes that may require what is called “ Re-organizing”.

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