Introduction to Health Management and Economic

Basic Concepts and Principles Bassam Abu Hamad September 2011

Rules of the game

           Mutual respect Punctuality by all Time commitment No mobile calls One person speaks at a time Respect of others opinions No bilateral talks No smoking in the class Respect of deadlines Every body is VIP Every idea is appreciated even the crazy ones

Management

PH needs

Why Study Management?

 Universality of Management

 Management is needed in all types and sizes of organizations at all organizational levels in all work areas  Management functions must be performed in all organizations; consequently, have vested interest in improving management
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UNIVERSAL NEED FOR MANAGEMENT

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Why Study Management? (cont.)

 The Reality of Work  Most people have some managerial responsibilities  Most people work for a manager

Challenges of Being a Manager -being a manager is hard work -- must deal with a variety of personalities -- must motivate workers in the face of uncertainty
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What Is Management?
Management

 the process of coordinating work activities so that they are completed efficiently and effectively with and through other people elements of definition  Process - represents ongoing functions or primary activities engaged in by managers  Coordinating - distinguishes a managerial position from a non-managerial one. It helps nonto avoid conflict and duplication. 1-8

Elements of definition  Efficiency - getting the most output from the least amount of inputs  doing things right  concerned with means  Effectiveness - completing activities so that organizational goals are attained  doing the right things  concerned with ends Prentice Hall, 2002 1-9

Management is an integral part of human experience. Management influences and is influenced by social, political, cultural, economical, technological and environmental dimensions (Mullins, 1996).

Efficiency and Effectiveness in Management

Efficiency (Means) Effectiveness (Ends) Goal Attainment
Low Waste High Attainment

Resource Usage

Management Strives For: Low resource waste (high efficiency) High goal attainment (high effectiveness)
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Management is getting things done by people. Done properly, within the available time and resources (Aspinwall, 1998). The principle underlying management definitions is the commitment to achievement.

Who Are Managers?

Manager

 Someone who works with and through other people by coordinating their work activities in order to accomplish organizational goals  Changing nature of organizations and work has blurred the clear lines of distinction between managers and nonnon-managerial employees
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Managerial Titles
 First-line managers - manage the work of nonFirstnonmanagerial individuals who are directly involved with the production or creation of the organizations products  Middle managers - all managers between the firstfirst-line level and the top level of the organization manage the first-line managers first Top managers - responsible for making organizationorganization-wide decisions and establishing the plans and goals that affect the entire organization

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Top-level management Look to the organization as a whole Coordinate internal and external influences Make major decisions Determining philosophy Setting policy Creating goals and priorities Performs leadership roles Less involved in daily management operations Example PHC Director, Director of nursing, Director of pharmacy.

Middle level managers Involved in some long term planning Act as a channel between lower and top level managers Setting objectives Coordinates lower level activities Involved in establishing policies Coordinate and link groups Monitor and manage the performance of subunits Implementing changes or strategies generated by top level. Example Supervisors, Head of Districts, Unit Managers

irst level managers Concerned with specific units work flow Deal with immediate problems Daily operations Meeting personal needs of staff Working closely with patients Influence providers satisfaction and performance Supervise performance of non managerial employees Direct responsible for producing the service Examples Primary care doctors and nurses, team leaders, case managers, and in-charge doctors and nurses.

Organizational Levels

Top Managers Middle Managers First-line Managers Non-managerial Employees

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There seems to be no obvious pattern for leaders success; they are           Right brained, left brained Tall and short Fat and thin Articulate and inarticulate Assertive and retiring Brave and cowards Dressed for success and dressed for failure Participative and autocratic There were more variations than themes Even their managerial styles were restlessly different

Management Functions and Processes

 Henri Fayol, a French industrialist from the early part of the 1900s, proposed that managers perform five management functions: POCCC (plan, organize, command, coordinate, control).

What Do Managers Do?

 Management Functions and Process  most useful conceptualization of the managers job  Planning - defining goals, establishing strategies for achieving those goals, and developing plans to integrate and coordinate activities  Organizing - determining what tasks are to be done, who is to do them, how the tasks are to be grouped, who reports to whom, and where decisions are made  Leading - directing and motivating all involved parties and dealing with employee behavior issues  Controlling - monitoring activities to ensure that they are going as planned Prentice Hall, 2002 1-21

 Management Functions and Process (cont.)

 Management process  set of ongoing decisions and work activities in which managers engage as they plan, organize, lead, and control  managerial activities are usually done in a continuous manner

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Management Roles
 specific categories of managerial behavior  Interpersonal - involve people and duties that are ceremonial and symbolic in nature  Informational - receiving, collecting, and disseminating information  Decisional - revolve around making choices  emphasis that managers give to the various roles seems to change with their organizational level
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Roles attached to management

Interpersonal Informational Decisional

Figurehead Leader Liaison

Monitor Disseminator Spokesman

Entrepreneur Disturbance handler Resource allocator

Scapegoat

Negotiator

Management Use of Time

Management Skills  Technical - knowledge of and proficiency in a certain specialized field  Human - ability to work well with other people both individually and in a group  Conceptual - ability to think and to conceptualize about abstract and complex situations  see the organization as a whole  understand the relationships among subunits  visualize how the organization fits into its broader environment Prentice Hall, 2002 1-26

SKILLS NEEDED AT DIFFERENT MANAGEMENT LEVELS

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What we look for in managers?

Technical skills Human skills Conceptual skills Motivation to manage

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Managing Systems  System - a set of interrelated and interdependent parts arranged in a manner that produces a unified whole  provides a more general and broader picture of what managers do than the other perspectives provide  Closed system - not influenced by and do not interact with their environment  Open system - dramatically interact with their environment  organizations - take in inputs from their environments  transform or process inputs into outputs  outputs are distributed into the environment
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The Organization As An Open System

Environment System Inputs
Materials Human resources Capital Technology Information

Transformation
Employees work activities Management activities Technology and operations methods

Outputs
Products and services Results Information Mortality and morbidity

Feedback

Environment
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 Managing Systems

 managers must  coordinate various work activities  ensure that interdependent parts work together  recognize and understand the impact of various external factors  decisions and actions taken in one organizational area will affect other areas and vice versa Prentice Hall, 2002 1-31

Mintzberg has identified eight managerial job types that managers fall into Contact man is characterized by liaison and figurehead roles. Political manager is characterized by spokesman and negotiator roles. Entrepreneur looking for opportunities to initiate or implement change and mainly characterized by entrepreneur and negotiator. Insider mainly concerned with the smooth running of the organization mainly characterized by resource allocator and leader

Real time manager main role is disturbance handler usually found in dynamic, competitive or high-pressure environment. Team manager more concerned with the internal of the organization and performs leader, monitor and spokesman roles. Expert manager is described as having the key roles of monitor and spokesman. New manager performs roles of liaison and monitor.

What Is An Organization?
Organization, a deliberate arrangement of people to accomplish some specific purpose  elements of definition 1. each organization has a distinct purpose 2. each organization is composed of people 3. all organizations develop some deliberate structure  todays organizations have adopted 1. flexible work arrangements 2. open communications Prentice Hall, 2002 1-34 3. greater responsiveness to changes 

 Organizations are systems of interdependent human beings  Organizations are group of two or more working together to achieve certain goals  Organizations are systems of behavior designed to enable humans and machines to achieve goals

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Our people are greatest asset You do not get a first class response from people who are treated as a second class citizens. They do not belong to you. (Peter Wickens, 1997) 1997)

organizations are driven by human capital and it is crucial to have a scientific look at this factor of services/production

Sources of Power and leadership influence Reward power Coercive power Legitimate power Referent power Expert power Personal power (charismatic and feminist)

Mistakes managers usually make

Insensitive to others Cold and arrogant Betrayal of trust Overly ambitious Performance problem Over-managing Unable to staff effectively Unable to think strategically Unable to adapt to different styles Over dependent on advocate Failure to build a team and delegate to it.

Influencing people to act

Leadership primary tasks

Set direction, mission, vision, goals, Build commitment, motivation, spirit, teamwork Confront challenges, innovation, change, turbulence

Leadership primary tasks

Set direction, mission, vision, goals, Build commitment, motivation, spirit, teamwork Confront challenges, innovation, change, turbulence

Leadership qualities

Integrity Courage Initiative Energy Optimism Perseverance Balance Ability to handle stress Self-awareness

What should you know when you think of yourself as a leader? To go first, to show the way, e.g. Columbus. To be the best, the wisest, the fastest, the strongest, and the most valuable to humanity, Dr Sabin, Dr Salk and Khuch. To solve important problems, develop methods Mr.Ford and Iben Batuota. Take charge, inspire, lead into action, e.g. Mohammed (PBUH). Fight for what is right and good (Lincolin, Ghandi, Buddha, Abu Thear. Dare to challenge for change e.g. Einstein.

Management style (which suits you more??)

Autocratic Consultative Supportive Achievement oriented style Participative

Management style (which suits you more??)

Democratic Consensus Delegation Laissez-Faire Transformational Situational

cont.
 Managing in Different and Changing Situations

 require managers to use different approaches and techniques  Contingency perspective - different ways of managing are required in different organizations and different circumstances
 The contingency perspective, sometimes called the perspective, situational approach, is a view that the organization recognizes and responds to situational variables as they arise.

 stresses that there are no simplistic or universal rules  contingency variable

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Management Theories

In understanding behavior and managing people at work, it is worth remembering the bag of gold syndrome. However, hard you try or whatever you do, there are some people who you just cannot please: they will always find something to moan about. Give them a bag of gold and they will complain that the bag is the wrong color.

Theories of management- Classical Emphasis on purpose Formal structure Hierarchy of management Technical requirement And common principles of organizations

Theories of management- Human relations Attention to social factors at work Groups Leadership Informal organizations Peoples behaviors

Theories of management- Systems Integration of the classical and human relations approaches Socio-technical mix system The organization within its external environment

Theories of management- contingency No one best design of organization A Range of situational variables

Theories of management Principles of scientific management (Taylorism) the development of science for each persons work the scientific selection, training, and development of workers cooperation with workers to ensure work is carried out in the prescribed way the division of work and responsibility between management and the workers

Disadvantages Uncontrolled authority Neglected personal factors Human rights violation Idealistic Rational Work is boring and requires little skills

Applications Job description Training Performance related pay Protocols

Bureaucracy The four main feature of bureaucracy are Specialization Hierarchy of authority Systems of written rules Impersonality

Criticisms Means become an end. Officials dependence upon bureaucratic status, symbols, and rules. Lack of initiative Development of officious bureaucratic behaviors Stereotyped behavior and lack of responsiveness to individuals problems

Applications Job specification Organization structure Formal aspects of the organization Protocols

Theory X and theory Y

X Work is something to be avoided People want to do as little as possible Use control Supervision Punishment

Y
Work is motivating People want to do their jobs well Use guidance Development Reward

Studies Hawthorne Elton Mayo Maslow Alderfer Hertzberg Vroom Expectancy Theory

Thank you