Unit 4.Organization Theory and Health service management.pptx

Management Theories and health service management

1. UNIT 4. Organization Theories and Health service management NDATUMUREMYI JAPHET BLS,MPH(Epidemiology and Disease control)

2. Introduction Organization Theory is the study of how organizations function, are structured, and behave. It examines the relationships among people, resources, and processes within organizations to achieve their goals efficiently. It provides a framework for understanding the complexities of organizational dynamics and offers insights into improving management practices.

3. Historical Context The field of Organization Theory has evolved over time, influenced by changes in societal needs, industrial practices, and management philosophies. Three Major Eras: Classical Era (1900–1930s): Focused on efficiency, hierarchy, and formal structure. Human Relations Era (1930s–1950s): Emphasized the human aspect of organizations. Modern and Postmodern Era (1950s–present): Integrated systems thinking, adaptability, and culture.

4. Classical era of organizational theory As the first step towards a systematic study of organizations, the Classical Organizational Theory is very important. It primarily deals with the anatomy of formal organizations and also views one as a machine and the employees as parts of the machine . Therefore, in order to increase the efficiency of the organization, each employee working in it must become efficient.

5. 6 Pillars of Classical Organizational Theory Division of Labor : Work is divided to achieve specialization and improve individual performance. Departmentalization: Group activities and jobs into departments to minimize costs and ensure administrative control. Coordination : Maintain harmony among functions to ensure unified action and organized group effort. Scalar and Functional Processes : Establish a clear chain of authority (scalar chain) for delegation, communication, and decision-making. Structure: Create a logical arrangement of organizational functions to effectively achieve objectives. Span of Control :Define the number of subordinates a manager can efficiently supervise.

6. Criticism to classical theory Too Rigid – It sees organizations as machines, which makes it inflexible and ignores the fact that people and situations change . Ignores Human Side – It treats workers like machine parts, focusing only on efficiency and structure, but not on motivation, teamwork, or emotions . Closed System – It assumes organizations do not interact with their environment, which is unrealistic because businesses are always affected by society, economy, and technology Oversimplified – It makes things look easier than they really are, without considering the complexity of real organizations . In short t he Classical Theory is criticized for being too mechanical, ignoring human needs, and failing to adapt to changing environments.

7. Human Relations Theory The Human Relations Theory emphasizes the importance of human behavior, social relations, and employee well-being in the workplace . It emerged as a response to the limitations of Classical Theory, which focused heavily on structure and efficiency but overlooked human factors. The Human Relations Theory of Management, established by Elton Mayo in the 1920s This theory emphasizes the significance of individual job satisfaction and how it leads to increased motivation and productivity.

8. Elements of human relation theory Focus on People : Prioritizes individuals over machines, emphasizing human behavior and motivations. Social Context : Recognizes the workplace as a social system where interactions shape behavior and productivity. Influence of Human Relations : Highlights the role of job satisfaction, belonging, and inclusion in motivating employees. Group Dynamics : Emphasizes how work group norms and relationships influence individual behavior and attitudes. Job-Related Symbols of Power : Acknowledges that symbols of power maintain social structures and influence behavior. Individualized Approach : Encourages managers to address unique employee needs, avoiding a one-size-fits-all approach. Employee Participation : Promotes motivation and openness to change by involving employees in decision-making and goal-setting

9. Criticisms of Human Relations Theory Overemphasis on Informal Relationships : Focuses too much on group dynamics, neglecting formal structures and rules needed in large organizations. Ignoring Power Dynamics : Overlooks workplace power imbalances, which can create inequality and exclusivity. Limited Focus on Performance : Prioritizes motivation and satisfaction but gives insufficient attention to performance and outcomes. Ignoring Employee Heterogeneity : Assumes employees have similar needs, ignoring individual differences. Limited Applicability : More suitable for smaller or less complex organizations, but less effective in large, complex settings.

10. Modern and Postmodern theory Modern Organization Theory focuses on rationality, structure, and efficiency within organizations, viewing them as systems governed by clear rules, hierarchies, and processes. It prioritizes stability, predictability, and goal achievement through scientific methods and measurable outcomes, drawing from classical theories like bureaucracy (Max Weber) and scientific management (Taylorism). Key elements include hierarchy, formal structures, objectivity in decision-making, and optimization of productivity. However, it faces criticism for overlooking human behavior, informal relationships, and being too rigid to adapt to change.

11. Modern and Postmodern theory In contrast, Postmodern Organization Theory challenges these assumptions, emphasizing flexibility, decentralization, collaboration, and subjectivity. It rejects rigid hierarchies and standardized processes, promoting adaptability, diversity, and multiple perspectives on reality. Postmodern theory values innovation, creativity, and experimentation, while acknowledging the subjective nature of work and organizational structures. However, it can suffer from a lack of structure and clarity, potentially leading to inconsistency and inefficiency, especially in large organizations

12. Comparison of modern and postmodern theory

13. Organizational Behaviour issues in Health organizations Organizational behavior study broadly explores the behavior and influence of individuals, groups, and structures in an organization and their impact on the function and effectiveness of that organization. Organizational behavior issues in health organizations can significantly impact the quality of care, employee satisfaction, and overall organizational efficiency

14. Common organizational behaviour issues in Health organizations Communication Breakdown Poor communication between medical staff, administration, and patients can lead to misunderstandings, mistakes, and delays in treatment. Effective communication is crucial in healthcare settings for patient safety and team collaboration. Leadership and Management The leadership style in health organizations often affects employee morale and performance. Autocratic or ineffective leadership can result in low job satisfaction, burnout, and high turnover rates, especially among healthcare professionals like nurses and doctors. Employee Burnout Healthcare professionals are often overworked, leading to burnout, fatigue, and a decline in performance. Long hours, emotional strain, and the stress of dealing with patient outcomes can create a high-stress environment.

15. Common organizational behaviour issues in Health organizations Workplace Culture : A negative or toxic organizational culture can hinder collaboration, trust, and overall job satisfaction. This may lead to high employee turnover, lack of engagement, and an unwillingness to share knowledge and best practices. Conflict Resolution Conflicts between staff members or between healthcare professionals and patients can disrupt the smooth functioning of an organization . Addressing conflicts effectively is crucial to maintaining a productive and harmonious work environment. Change Management Healthcare organizations are often subject to regulatory changes, new technologies, and evolving treatment protocols . Resistance to change among employees can impede progress and reduce the organization's ability to adapt to new challenges.

16. Common organizational behaviour issues in Health organizations Team Dynamics Healthcare relies heavily on interdisciplinary teams, and poor team dynamics can affect the delivery of care. Issues such as role confusion, lack of trust, and ineffective collaboration can lead to fragmented care. Diversity and Inclusion . Health organizations must manage a diverse workforce. Challenges may include addressing disparities in care, ensuring culturally competent services, and promoting inclusive practices that respect diversity among staff and patients Ethical Dilemmas Health organizations often face ethical challenges, such as balancing patient autonomy with medical expertise, managing scarce resources, and addressing end-of-life care decisions. How an organization addresses these issues can impact both patient trust and staff morale.

17. Motivating People in Health care Organizations Motivating people in healthcare organizations is critical for enhancing employee performance, improving patient outcomes, and ensuring a positive work environment . Motivated healthcare professionals are more likely to deliver high-quality care, exhibit strong teamwork, and remain engaged and committed to their roles. However, healthcare settings come with unique challenges that influence motivation, including high stress, emotional burnout, and complex organizational structures. To effectively motivate individuals in healthcare, it’s important to consider both intrinsic and extrinsic factors, as well as the diverse needs of employees in different roles

18. Intrinsic Motivation: Fostering a Sense of Purpose Healthcare workers often have a strong intrinsic motivation due to the nature of their work—helping others. However, healthcare organizations can further enhance intrinsic motivation by: Promoting meaningful work, recognition, and autonomy are key strategies for motivating healthcare employees. Connecting daily tasks to broader goals , like improving patient care and saving lives, enhances employees' sense of purpose. Regular recognition of their contributions—beyond financial rewards—boosts morale and helps reduce burnout, especially in high-stress environments. Allowing healthcare workers autonomy and involving them in decision-making processes fosters a sense of ownership, increasing job satisfaction and motivation. These strategies collectively enhance engagement and performance in healthcare organizations.

19. Extrinsic Motivation: Rewards and Incentives While intrinsic motivation is key, healthcare organizations can also employ extrinsic motivators to drive performance: Competitive Compensation and Benefits : Offering fair and competitive salaries, along with benefits such as health insurance, paid time off, and retirement plans, is important for attracting and retaining healthcare talent . Ensuring that employees feel their compensation reflects the demands and responsibilities of their roles is vital. Bonuses and Performance-Based Incentives Offering financial incentives, such as bonuses or profit-sharing for achieving specific targets (e.g., quality metrics, patient satisfaction scores), can motivate healthcare professionals to perform at their best. Recognizing employees’ efforts and accomplishments with tangible rewards can reinforce positive behaviors .

20. Extrinsic Motivation: Rewards and Incentives Professional Development and Career Growth Encouraging continuous learning and providing opportunities for professional development, such as training, certifications, or leadership programs, can increase job satisfaction. Health organizations that invest in their employees' growth show a commitment to their careers, fostering a sense of loyalty.

21. Leadership Styles and Their Impact on Motivation Effective leadership is crucial for motivating healthcare staff and fostering a positive work culture. Transformational leaders inspire and engage employees by communicating a clear vision and setting meaningful goals, encouraging excellence. Supportive leaders provide emotional support, listen to staff concerns, and address burnout, creating a valued and caring environment. Servant leaders focus on their team members' needs, promoting collaboration, empathy, and shared responsibility, which motivates staff to perform at their best. These leadership approaches enhance morale, job satisfaction, and performance in healthcare organizations.

22. Teamwork and Collaboration Effective teamwork is essential in healthcare for improving patient care and fostering a positive workplace culture. Encouraging collaboration through open communication and knowledge sharing promotes a sense of community and shared responsibility. Clear roles and responsibilities help prevent confusion and burnout, motivating employees by clarifying their contributions. Additionally, addressing conflicts promptly and fairly, along with providing conflict resolution training, ensures challenges are handled constructively, maintaining team motivation and cohesion.

23. Addressing Work-Life Balance A healthy work-life balance is crucial for maintaining motivation in healthcare professionals, who often work long, irregular hours under high pressure. Addressing this balance can help prevent burnout and foster a motivated workforce Offering flexible scheduling, such as part-time options or shift-swapping, helps healthcare workers balance personal and professional lives, reducing stress and improving job satisfaction. Providing mental health support, including counseling and stress management resources, is essential for preventing burnout and maintaining a healthy workforce. Encouraging regular breaks allows employees to recharge, boosting energy, focus, and motivation, ultimately improving their performance in patient care.

24. Creating a Positive Work Environment A positive organizational culture and work environment are fundamental to employee motivation. Healthcare organizations can foster a supportive atmosphere by: Promoting Inclusivity and Diversity : Encouraging an inclusive culture where all employees, regardless of background or role, feel valued and respected can significantly improve motivation. Celebrating diversity fosters a sense of belonging and boosts morale. Celebrating Successes Regularly celebrating both small and large achievements within the organization, whether through team awards, shout-outs, or public recognition, helps to maintain high morale and motivation levels. Providing Safe Work Environments Ensuring that healthcare workers have a safe physical and emotional environment is crucial for motivation. A safe, supportive environment helps employees focus on their tasks without distractions or unnecessary stress.

25. Managing teams and Groups in Healthcare Organizations A team is a small number of consistent people committed to a relevant shared purpose, with common performance goals, complementary and overlapping skills, and a common approach to their work. Team members hold themselves mutually accountable for the team results or outcome The health team is a group of people who have common goal/objectives, determined by the community health needs, to the achievements of which each member of the team contributes, in accordance with his/her competence and skills and in accordance with the functions of others.

26. Integrated Health Care Team /IHCT/ It integrates a group of individuals with diverse training and backgrounds who work together as an identified unit or system Team members consistently collaborate to health and health related problems of their clients that are too complex to be solved by one discipline or many disciplines in sequence In order to provide care as efficiently as possible, an IHCT creates formal and informal structures that encourage collaborative problem solving

27. Integrated Health Care Team /IHCT/ Team members determine the team’s mission and common goals; work interdependently to define and manage health problems; and learn to accept and capitalize on disciplinary differences, differential power, and overlapping roles To accomplish these, they share leadership that is appropriate to the presenting problem and promote the use of differences for confrontation and collaboration. They also use differences of opinion and problems to evaluate the team’s work and its development.

28. Integrated Health Care Team /IHCT/ Health workers trained to follow the principles in team work are more responsive to the needs of the community they serve. The services they provide are more cost effective and are more satisfied in their career paths and their profession.

29. Similarities and Differences of a Team and a Group The terms team and group are not exactly the same A group is a collection of two or more individuals interacting and interdependent, which has come to achieve a particular objective. It is characterized by frequent communication among members over time and a size small enough to permit each member to communicate with all other members on a face to face basis as a result each group member influences and is influenced by others. Basically a group is a collection of individuals who come together for a joint effort but whose outcome relies primarily on individual contribution of its members

30. Similarities and Differences of a Team and a Group Characteristics Group Team Accountability Members may not be accountable to the action of the group. They are only accountable for individual effort of action. Members share a common goal and purpose, therefore, each team member is mutually accountable for the team’s outcome. Areas of responsibility Focus on individual roles, tasks and responsibility, even though group may cooperate Individuals cooperate, communicate and share responsibility among each other. Approach to work They communicate the assessment and tasks are distributed to individuals. Individualized approach to work. They discuss as a team and determine goals. They jointly develop action plan. They have common approach to work. Level of authority The leader is more responsible and authorized than the members. The leader is equally responsible and authorized like any member of the team.

31. Characteristics of Health Teams Effective functioning health teams share similar characteristics with other teams and the following eight basic characteristics are identified 1. A clear, elevating goal . All members of the team should be able to visualize the results of gaining the goal. 2 . The team should be driven by the results of their efforts . 3. Competent members ; the team should be made up of people who can perform the roles in which they are functioning. 4. Unified commitment ; all members of the team agree on the goal and feel a strong , urgent, and personal commitment to reach the goal. 5 . A collaborative climate ; To create a good relation and working environment, members of a team need to maintain honesty, openness, consistency, competence and respect.

32. Characteristics of Health Teams 6.Standards of Excellence: involve standards from many different sources. 7 . External Support and Recognition : A team functions much better when it is recognized for its accomplishments by the greater organization or by the society. It is important to have ways to provide this recognition. 8 . Principled Leadership : The right person in a leadership role can add tremendous value to any collective effort. Leaders are responsible for sustaining the vision of the team. They empower the members of the team to enhance their creative and functioning abilities.

33. Advantages of Team Work Improves performance outcomes : Synergistic teamwork enhances contributions and achieves better results by leveraging collective efforts and shared ideas. Increases employee responsibility : Transferring real responsibility and authority to teams fosters a sense of ownership and accountability among team members. Empowers teams : Teams gain increased accountability, responsibility, and authority, enabling autonomous functioning and decision-making. Frees managers for strategic tasks : Delegating operational responsibilities to teams allows managers to focus on coaching, mentoring, teaching, and long-term planning . Creates higher employee satisfaction: When teams have real responsibility and authority, the decisions they make are theirs. The feelings of increased ownership and control within their work life lead to higher levels of employee satisfaction.

34. Team Approach Team approach is defined as the way that management attempts to bring about balance among the different people concerned. Well developed and efficient teams are those that can quickly evaluate a complex situation and decide how to state the problem, so the members of the team can use their skills to focus on an integrated approach.

35. Team Approach The success of team’s work depends to a great extent on how well its members work together and with the people they serve . Good management can help a team to work together harmoniously and efficiently through: Setting and sharing objectives Encouraging good personal relations Distributing tasks Coordinating the activities of the team Applying sound organizational principles

36. Healthcare organization

37. Classification of healthcare organizations Classification of healthcare organizations can base on Type of services delivered Number of beds Ownership etc

38. Classification of healthcare organizations Based on the type of service delivered a healthcare organization cab classified as General hospital Specialized Hospital Based on number of bed a hospital can be Small hospital (less than 100 beds) Medium hospital(100-500beds) Large hospital (>500 beds) Based on ownership a hospital is classified as Government Private Teaching Charity

39. Organizational pattern of the hospital Organization: A formal system of interaction and coordination that links the tasks of individuals and groups to help achieve organizational goals. Purpose of organization pattern Channel information to managers Distribution of Authority Interrelationship among different units

40. Unique Features of Hospitals and Health Care Organizations

41. Structural components of organizations

42. Pyramid of healthcare organization in Rwanda