Principles of Healthcare Management
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1 Principles of Healthcare Management Yodi Mahendradhata Center for Health Policy & Management, FM GMU
2 Excellent healthcare organization? 1. Name an excellent healthcare organization 2. Describe the characteristics of excellence 3. How do they achieve excellence?
3 Excellence in healthcare organization* Patient care is safe, effective, patient-centred, timely, efficient and equitable The community s health and healthcare needs are met Caregivers and other associates are attracted and they are given support to do their best Expenditures are controlled so that the total cost is within the community s economic reach *White & Griffith (2010)
4 Excellent healthcare organizations are well-managed organizations
5 What do we mean by management?
6
7 Management? Getting work done through people American Management Association Getting the right things done Peter Drucker
8 Management school of thoughts Scientific management Behavioral Social Systems management Contingency management Decisional management Quantitative measurement Management process
9 Management process Planning Organizing What needs to be done, when and how Who does what, under what conditions Actuating How employee are led, motivated Controlling How the plan is being followed up
10 Leadership roles (Shortell & Kaluzny 2000) Innovator Broker Producer Director Coordinator Monitor Facilitator Mentor
11 Different types of organizations?
12 Key organization metaphors
13 Organization frames and management challenges (Bolman & Deal 2008) Frames Machine Family Jungle Temple Challenges Align structure to task, technology, environment Align organizational and human needs Develop agenda and power base Create faith, beauty and meaning
14 Management competencies?
15 Management competencies* Informational Actional Interpersonal Personal *Mintzberg (2011)
16 How unique is healthcare management?
17 Healthcare management is unique Customers are sick Customers live in service sites A need service Inherently personal Customized Risk of harm
18 Components of healthcare organizations* Caregiving teams Clinical support teams Operational support teams Strategic support teams *White & Griffith (2010)
19 Caregiving teams* Caregiving teams Clinical support teams Primary care Secondary care Tertiary care Operational support teams Strategic support teams *White & Griffith (2010)
20 Clinical support teams* Caregiving teams Clinical support teams Clinical laboratory Pharmacy Imaging Social service Operational support teams Strategic support teams *White & Griffith (2010)
21 Operational support teams* Caregiving teams Clinical support teams Operational support teams Personnel Information Facilities Accounting Supply management Strategic support teams *White & Griffith (2010)
22 Strategic support teams* Caregiving teams Clinical support teams Operational support teams Governance Strategic positioning Finance Stakeholder relation Internal consulting Marketing Strategic support teams *White & Griffith (2010)
23 Health professionals are managed and/or managing (Shortell & Kaluzny 2000) Environment E n v I r o n m e n t Health System Organizations Group / Department Individual Environment E n v I r o n m e n t
24 Most doctors lead and manage all the time. Doctors may not recognize they re doing this, but from day one in their careers, when they re working as a clinician as part of a team, they will be dealing with leadership and management issues. Lee, 2013
25 Whatever their role, doctors must do the following* Engage with colleagues to maintain and improve the safety and quality of patient care. Contribute to discussions and decisions about improving the quality of services and outcomes. Raise and act on concerns about patient safety. Demonstrate effective team working and leadership. Promote a working environment free from unfair discrimination, bullying and harassment, bearing in mind that colleagues and patients come from diverse backgrounds. Contribute to teaching and training doctors and other healthcare professionals, including by acting as a positive role model. Use resources efficiently for the benefit of patients and the public *General Medical Council, 2013
26 Management Medicine Position not profession Profession not position Apply science, but not a science by itself Science Effectiveness = art + craft + science Effectiveness = science + craft + art Ref: Mintzberg (2011)
27 What challenges do healthcare managers face?
28 Personnel challenges Commitment Turnover Apathy Conflict among professions
29 Technical performance challenges Productivity Efficiency Quality Consumer satisfaction
30 Changing environment Technological and social change Environmental complexity and uncertainty Competitive forces Multiple performance demands
31 Survival and growth challenges Long-run survival Long-run performance and growth
32 Challenges faced by healthcare organization managers (Shortell & Kaluzny 2000) Personnel Technical perfomance Changing environment Survival & growth
33 What competencies must healthcare managers posses?
34 How to lead effectively? Motivating people Leadership Conflict management and negotiation
35 How to best operate the technical system? Managing groups and teams Work design Coordination and communication Powers and politics
36 How to renew the organization Organization design Managing strategic alliance Organization innovation and change Organizational performance
37 How to chart the future Strategy making Creating and managing the future
38 From organization challenges to management competencies (Shortell & Kaluzny 2000) Challenges Competencies Environment How to renew the organization Survival and growth How to chart the future Technical performance How to operate the technical system Personnel How to motivate and lead people and groups
39
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