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COM > Lecture 1 Organizations in health care, structure and design trade-offs > Flashcards

Lecture 1 Organizations in health care, structure and design trade-offs Flashcards

1
Q

What is an organization

A
  • People working collectively for a common purpose
  • An organized group of people with a particular purpose
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2
Q

Mechanic organizational structure

A
  • Task-oriented
  • Efficient and productive
  • Formalized, central and complex
  • Stable and simple environment
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3
Q

Organic organizational structure

A
  • Task, authority & routines constantly redefined
  • ‘Flat’ organization
  • Informal, decentralized, simple
  • Complex & dynamic environment
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4
Q

Bureaucracy definition

A

Bureaucracy is an organizational structure characterized by regulatory procedures, division of responsibility, hierarchy, and impersonal relationships.

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5
Q

Operating principles of bureaucracy

A
  1. Rationalisation (rules/procedures)
  2. Formality
  3. Specialization
  4. Hierarchy (top-down)
  5. Universal access, but no individual control
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6
Q

Critiques bureaucracy

A
  • Dehumanizing effect
  • Little room for ‘human beings’
  • Inflexible/rigid
  • Inefficient and viscous
  • Differentiation & Disintegration
  • Limited rationality
  • Limited morality
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7
Q

Why is a hospital bureaucratic

A
  • Standardization of processess
  • Highly specialized
  • Hierarchy
  • Universal access, but no individual control
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8
Q

New Public Management

A

From supply-driven to demand-driven
- Strengthening position of healthcare consumers
- Achievements made ‘tangible’
- Accountability not solely horizontal anymore
- Improvement of performance
Creates a tension between the relation of professionalism and management

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9
Q

Professionalism

A

Protected professionals treat cases
- Skills
- Norms
- Expertise
- Service ethic
- Quality
- Humanity

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10
Q

Managerialism

A

Well-run organizations deliver products for customers
- Hierarchy
- Markets
- Results
- Accountability
- Efficiency
- Profitability

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11
Q

Dutch regulated market ‘competition’ by New Public Management

A
  • Regulated health care market
  • Transparency
  • Accountability
  • Demand & supply driven
  • Tension between management & professionalism
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12
Q

Market failure in health care

A
  • Health care is not a business
  • Insufficient ‘competition’ to offer high quality care at best price
  • No direct interaction between supply and demand, but mediated by third party
  • Increased accountability –> bureaucracy revisited
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13
Q

Formalization

A

The extent to which rules, procedures, and other guides to action are written and enforced

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14
Q

Centralization

A

The extent to which authority to make decisions is retained in top management

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15
Q

Complexity

A

The number of different jobs and/or units within an organization

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16
Q

Design key trade offs mechanic vs organic

A

centralization vs decentralization
control vs autonomy
differentiation vs integration
narrow span of control vs wide span of control
tall hierarchy vs flat hierarchy

17
Q

Centralization vs decentralization

A

Easier to implement vs more responsive to local circumstances
consistency with strategy vs opportunities for staff development
easier to achieve coordination and control vs sense of control good for staff motivation
‘faster’ decision-making vs -

18
Q

Control vs autonomy

A

Top down vs bottom up

19
Q

Differentiation vs integration

A

Differentiation:
- highly specialized vs collaboration
- patient has a disease vs holistic view of pt and care delivery
- health care silos

20
Q

Organization structure

A
  1. service/product line structure (integration, projectized)
  2. functional structure (differentiation, functional)
  3. matrix structure (balanced matrix)
21
Q

Functional structure

A
  • Organized based on the necessary functions of an organization, incl production, marketing, finance, accounting, human resource
  • Relatively small organizations with narrow range of products and services
22
Q

Advantages functional structure

A
  • Encourages specialization and efficiency
  • Importance of general manager
  • Standardisation = high efficiency
23
Q

Disadvantages functional structure

A
  • Inefficient use of managerial time
  • Can create tunnel vision: employees may only see their problems, and not from whole organization
  • Fragmentation of services for customers
24
Q

Service/product line structure

A
  • Products are preferred basis as a firm grows by increasing the numbers of products on the market
  • Concentrating authority, responsibility and accountability in specific departments
  • Product-based divisions are often freestanding departments
25
Q

Advantages service/product line structure

A
  • More autonomy can promote entrepreneurship
  • more integration
  • offer ‘unique’ product/service in market
26
Q

Disadvantages service/product line structure

A
  • Some duplication of activities unavoidable
  • Coordination across business units difficult. Internal rivalry for customers and resources
  • Less efficiency
27
Q

Matrix structure

A
  • Combines service/product and functional
  • in midst of a continuum
  • balanced compromise between 2
  • dual authority system: a functional and a product manager
  • in organizations that 1 require responses to rapid changes, 2 face uncertainties with high-information processing requirements and 3 have financial and human resources constraints
28
Q

Advantages matrix structure

A
  • flexibility in conditions and uncertainty
  • constant interaction, channeled both horizontal and vertical
  • efficient use of resources and skills
  • opportunities for personal development
  • more aware of total organization
  • improving motivation and commitment
  • cross-fertilization of ideas
29
Q

Disadvantages matrix structure

A
  • some duplication of activities unavoidable
  • coordination across business units difficult. internal rivalry for customers and resources
  • dual reporting relationships. workload not centrally known
30
Q

Boundaryless organizations

A

chains of commands are eliminated, spans of control are unlimited, and empowered teams

31
Q

virtual organizations

A
  • alliance of separate individuals or organizations, all with different competencies, working together to bring a project to market faster
  • often interorganizational networks with one parental organization
  • flexible and efficient

COM (13 decks)

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