1. Key Definitions HST 4770

2. Health Services Organizations Also known as HSOs Defined as entities that provide the organizational structure within which the delivery of health services is made directly to consumers, whether the purpose of the services is preventive, acute, chronic, restorative, or palliative.

3. HSOs - continued Historically, HSOs were predominantly independent, freestanding organizations. Beginning in the 1970’s and continuing through the 80’s and 90’s, many HSOs have joined together to form systems of organizations.

4. HSOs - continued Examples are adult ambulatory services, adult inpatient hospital services, stand- alone cancer units, ambulatory and in- patient rehabilitation services, skilled and intermediate nursing services, adult day services, respite services, family planning services, and ambulatory and in-patient psychiatric services.

5. Health Systems Also known as HSs Unified organizational arrangements or a system of organizations. (HSOs working together to provide a seamless continuum of care.) Defined as formally linked HSOs, possibly including financing arrangements, joined together to provide more coordinated and comprehensive health services.

6. Managers Defined as people who are formally appointed to positions of authority in organizations or systems who enable others to do their direct or support work effectively, who have responsibility for resource utilization, and who are accountable for work results.

7. Managers - continued The primary differences between levels of managers are the degree of authority and the scope of responsibility for each level. Senior-, middle-, and first-level managers are responsible for very different types of activities. All of these activities are important and no organization can be successful unless the management work at each level is done well and unless the work at each level is carefully integrated with that does at the other levels.

8. Management Defined as the process, composed of inter-related social and technical functions and activities, occurring in a formal organizational setting for the purpose of accomplishing predetermined objectives through the use of human and other resources.

9. Management – 4 Main Elements It is a process—a set of interactive and interrelated ongoing functions and activities. It involves accomplishing organizational objectives. It involves achieving these objectives through people and the use of other resources. It occurs in a formal, organizational setting.

10. Types of work performed by managers in organizations & systems: Direct Work Support Work Management Work

11. Direct Work Includes some combination of patient care, research, education, and the production of services.

12. Support Work Is a necessary and facilitative adjunct to direct work. Includes activities as fund-raising and development, provision of legal counsel, marketing, public relations, finance, or human resources.

13. Management Work Involves establishing organizational objectives and creating an organizational environment in which the direct work, aided by support work, can lead to the accomplishment of the objectives.

14. Health Defined as the maximization of the biological and clinical indicators of organ function and the maximization of physical, mental, and role functioning in everyday life. Health is strongly influenced by lifestyles and by heredity, as well as by the type, quality, and timing of health services that people receive.

15. Health Care Defined as the total societal effort, undertaken in the private and public sectors, focused on pursuing health.

16. Health Services Defined as specific activities undertaken to maintain or improve health or to prevent decrements of health. Preventive – blood pressure screening, mammography Acute – surgical procedures, antibiotics Chronic – control of diabetes or hypertension Restorative – physical rehabilitation Palliative – pain relief or comfort in terminal stages of disease

17. Management Functions Planning Organizing Staffing Directing (motivating, leading & communicating) Controlling Decision Making

18. Management Functions – cont. Managers perform the basic functions simultaneously. Decision Making is an integral part of each of the basic functions. All managers perform these functions to some degree regardless of their hierarchical level.

19. Planning Means deciding what to do—charting a course of action for the future. It establishes and devises the means to achieve organizational objectives. Planning is a necessary precursor to the other management functions. It sets the foundation for organizing and enhances efficiency and effectiveness.

20. Organizing Begins with the establishment of individual positions, then workgroups such as departments and units, then clustering workgroups into larger subdivisions of the organization, and then clustering them all into the entire organization. In some cases, the organizations themselves are then clustered into systems or networks.

21. Organizing - continued Successful designs depend on appropriate distributions of responsibility and authority as the organization is built. Authority is the power that is derived from a person’s position in the organization. Responsibility is the obligation to execute work, whether it is direct, support, or management work.

22. Organizing - continued All staff have responsibilities as a result of their organizational positions. The source of the responsibility is one’s superior in the organization. When responsibilities are delegated to staff, they also must be given the authority to make commitments, use resources, and take the action necessary to fulfill their responsibilities.

23. Staffing Involves acquiring, maintaining, and retaining human resources. Works very closely with the organizational function. Includes both technical and social skills.

24. Staffing - continued Technical aspects include human resources planning, job analysis, recruitment, testing, selection, performance evaluation, compensation and benefits administration, employee assistance, and safety and health. Social aspects include activities that influence the behavior and performance of organization members and include training and development, promotions, counseling, and discipline.

25. Directing Focuses on initiating action in the organization or system. Managers must be able to lead, motivate, and communicate with those they direct. Success is based on how well the managers can communicate with their staff. Leadership must be able to instill in its members a common vision and to direct compliance to that vision.

26. Directing - continued Inducing people to follow directions is caused behavior. Therefore, skill at motivating people is crucial to effective directing. Managers who effectively communicate their visions and preferences have an advantage in the ability of their staffs to follow through with those visions.

27. Controlling Involves gathering information and monitoring activities and performance, comparing actual results with expected results, and intervening when necessary to take corrective action. It is the regulation of activities and performance in the organization in accordance with the requirements of plans.

28. Controlling - continued It is a function of managers at all levels, and its basic purpose is to ensure that what is intended is what is done. Control involves four basic steps: establishing standards, measuring performance, comparing actual results with standards, and correcting deviations from standards.

29. Decision Making It is intertwined with each of the functions of management. All managers make decisions but their decisions vary in scope and nature, as well as techniques used. A senior manager will make policy decisions that affect entire organizations; middle- and first-level managers make decisions within their areas of authority and responsibilities.