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Org Theory > Midterm > Flashcards

Midterm Flashcards

1
Q

3 party system of health care

A

Employers, payers (insurers), providers (clinicians and HCOs)

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2
Q

driving forces of health care system

A

3 party system, accreditation, basic issues

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3
Q

accreditation

A

joint commission and NCQA

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4
Q

Joint Commission

A

accredits HCOs (hospitals, nursing homes, inpatient facilities) (Medicare part A)

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5
Q

National Committee on Quality Assurance (NCQA)

A

accredits the insurance plans offered by third party payers (insurance companies)

Accredited employer offered plans

Employers pay NCQA to make sure insurance plans are good

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6
Q

basic issues in health care system

A
  1. quality/patient safety
  2. Cost
  3. Access —> getting into the system
  4. Service —> once in the system, how are you treated
  5. Physician and staff satisfaction
  6. Employee satisfaction
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7
Q

the role of management/that managers play

A 
Planning
Organizing
Staffing
Leading (Most important)
Decision-making
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8
Q

inputs/resources (6 inputs that managers manage)

A 
people/staff
Patients
Money
materials/equipment
Time
Information
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9
Q

outputs/goals (6 outputs that managers are held accountable for)

A 
quality/patient safety
profit/cost savings
Access (Getting into the system)
Patient satisfaction (How you are treated once you’re in the system)
Physician satisfaction
Staff satisfaction
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10
Q

management skills

A

technical, human, conceptual

As you move up in management ranks, you trade off between technical skills and conceptual

  • Top-tier management (senior level) more conceptual than technical
  • First line (entry level) more technical than conceptual

Doesn’t matter where you’re at, human skills are always vital (at the same level of importance)
-communication and team building

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11
Q

why health care organizations are different

A

social contract

Three missions of academic health centers (patient care, teaching, research)

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12
Q

3 advocates on behalf of society when social contract is broken

A

Government, press, legal system

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13
Q

triple aim

A

improve population health
improve experience of care
reduce per capita costs

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14
Q

health care transformation

A

emphasizing wellness over treating illness
“Not a human repair shop”
Cura personalis

Ex.
Acute, inpatient care —> continuum of care
Treating illness —> maintaining wellness
Individual patient —> population

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15
Q

Bureaucratic Theory

A

Arranging everything into a hierarchy; chest of drawers
Ex. very separated and defined hospital wings

Pro: everyone knows who they work for; ensures accountability

Con: creates silos/a fragmented system

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16
Q

Scientific Management

A

Programming each step of the way; defining how things should be done each step

Methodology to measure efficiency in the system

Time and motion studies
Ex. how long does it take to discharge patients? Let’s improve that!

Problems

  • Doesn’t take other areas into account (optimizing one part of a system can lead to delays in another part)
  • Doesn’t think about the person; only deals with efficiency

Ex. lean six sigma

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17
Q

Human Relations School

A

Participatory decision making and employee empowerment can lead to increased productivity

People will only help what they help build
-Somewhat of a placebo effect

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18
Q

Institutional Theory

A

Organizations must conform to external norms, rules, and requirements to receive legitimacy and support
-Joint commission and NCQA

build organizations upon standards which come from government agencies ; mandatory committees and functions)

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19
Q

leading

A

The process of influencing the activities of an individual or group toward a goal in a given situation

Leading and management are different
-Leadership is one of the roles of a manager; execution of the leadership role is the way managers accomplish goals

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20
Q

trait theory

A

Traits —> effectiveness or success

Initial theory was that there are 6 key traits that leaders need to be successful
-now it is understood that these 6 characteristics are necessary, but not sufficient to be an effective leader

6 characteristics are:
Intelligence
Articulateness
Confidence
Initiative
Persistence
Sociability
21
Q

behavioral perspective

A

Traits —> attitudes & behaviors —> effectiveness or success

Need both the 6 traits and good attitudes and behaviors to be a successful leader

2 most important behaviors are

  • Building structure (production orientation)
  • Maintaining relationships (ex. Employee orientation and team building)

having orientations in both getting the work done (production) and towards people (employee)

22
Q

Contingency Perspective

A

Traits —> attitudes & behaviors —> situation —> effectiveness or success

Where we are today

Path model goal

Critical variables (situational): leader, follower, work environment

23
Q

Situational Leadership Approaches

A

S1: Directing, if the employee is new
-High directive, low support

S2: coaching, employee here for ~1 month
-High directive, high support

S3: supporting, employee been with you for few months
-Low directive, high supportive

S4: Delegating, motivated worker who knows his or her job
-Low directive, low support

As the employee progresses, allowing for empowerment through moving up the situational styles
-If employee is capable and motivated (willing and able metaphor)

24
Q

manager vs clinician persepctives

A

Clinicians looking at short term, managers thinking strategically long term

Clinicians work collegial, Managers work hierarchical

25
Q

goals vs objectives

A

Goals are broad and aspirational
-Future thinking/longer thinking

Objectives are specific and must be achieved in order to accomplish the goal

26
Q

Objectives need to be SMART

A 
Specific
Measurable
Achievable
Realistic
Time bound (when objective is expected to be completed)
27
Q

8 step problem solving methodology for managers

A
  1. Define the problem
    - Most important
  2. Set the overall objective
  3. Conduct a root-cause analysis (ask “why” 5x)
  4. Generate alternative strategies (brainstorming)
    - Any idea that could possible address the problem
  5. Perform a comparative analysis
    - Narrow the brainstorm
  6. Select intervention and explain decision
  7. Develop an implementation plan & implement
  8. Develop an evaluation plan & evaluate
28
Q

Comparative Analysis Criteria:

A

Managers evaluate options (narrowing options down)

Step 5 on of problem solving

5 criteria for narrowing down

  1. Effective in solving the problem
  2. Cost effectiveness
  3. Consistent with strategic plan
  4. Timely
  5. Politically feasible
29
Q

implementation/work plan

A

Step 7 on of problem solving

Once solution is found, move to Implementation/Work Plan

3 things:

  • What: actions/tasks to be done
  • Who: who is responsible
  • When: timeliness
  • If appropriate can ask how much: resources involved

-Responsibility matrix:
Assign action steps to leaders and identify team members; put definitive start and end dates

30
Q

motivation

A

“A state of feeling or thinking in which one is energized or aroused to perform a task or engage in a particular behavior”

A primary task of management is to motivate people to perform at high levels toward meeting organizational objectives

Highly motivated staff = competitive advantage

31
Q

3 content theories

A

Maslow’s hierarchy of needs (self actualization is the highest level; level of competence where you feel good)

ERG Theory - modification from Maslow: combining categories
Existence, relatedness, growth

Motivator-Hygiene (Hertzberg) condensed further to Hygiene and Motivators

Hygiene factors are necessary but not sufficient
-Job security, salary, working conditions

What motivates are the three motivational factors

  • Advancement
  • Growth
  • Achievement
32
Q

equity theory

A

A process model (the how)

Comparing your input to someone else
-If they leave 20 min early, i want to leave 20 min early

33
Q

Reinforcement Theory

A

Antecedent/Stimulus -> behavior/response -> consequence

Antecedents occur before behavior (policies, verbal guidelines, goals etc.)

  • What stimulates the behavior
  • If there are no expectations —> bad behavior
  • If there are expectations —> good behavior

Consequence is determined by the behavior (reward or punishment)

34
Q

Goal Setting (the antecedent) must meet these criteria

A 
Specific
Challenging
Achievable
Known
Accepted
-“Will that work for you”
feedback/follow up
35
Q

motivation approaches

A

Empowerment: giving employee a goal and they figure out how to do it (not free reign; no compromising on the goal) (giving them opportunity to problem solve)

Behavior Modification: need to be very specific with a goal in mind, constant measurement and feedback to modify behavior (measurement and feedback)

Gain Sharing: whole team benefits (P4P for a whole group) ; not one individual reaping the gains of meeting objectives because working together to achieve higher (group performance)

Pay for performance: individual performance

Quality circles/total quality management (TQM)
Empower group to have good quality

Job redesign

36
Q

job redesign

A

Redesigning job to meet motivational needs of the individual

Autonomy
-People as a whole

Meaning

  1. Task identity (whole task)
  2. Skill variety
  3. Task significance (making an impact

Feedback

Emphasis on 1. Task Identify (whole task: the more you can create a job where your involved in the whole task, the more reward)

dentists doing siloed jobs story

37
Q

team

A

Collection of individuals who:

  1. Are interdependent (need the other person/people) in their tasks,
  2. Share responsibility for outcomes,
  3. See themselves and are seen as a social entity, and
  4. Manage relationships across organizational boundaries
38
Q

types of groups

A

Informal groups: not formed by the organization but by natural social networks

Formal groups

  • Work teams
  • Parallel teams**: committees that focus on long term issues
  • Project teams: team for a short term project
  • Management teams
39
Q

team characteristics

A
  • *Psychological safety
  • the freedom to speak up
  • *Team cohesiveness
  • The degree to which a team is committed to each other a to a task
Team composition (skills & diversity)
-Right skill mix and diversity and thought

Size and social loafing

  • The larger the group, the more likely someone doesn’t do their job/does the bare minimum
  • Ideally 5-7 people

Status differences

40
Q

Environmental Context

A

Intergroup relations & conflict

  • Strategies to resolve conflict
    1. intergroup team building
    2. Superordinate goal
    3. Interface management
    4. Self-contained teams

*Organizational structure
4 things that are really important in a firm’s culture
-Management modeling & reinforcement of training
-Management support: time, training, $, team rewards
-Captains (Who do people back up to)
-Implementation plan, change management

External environment
-Social capital

41
Q

Three General Approaches to leadership with difficult personalities

A
  1. Set ground rules prior to the meeting and enforce them
  2. Round Robin
  3. Take a break
42
Q

Communication networks & interaction patterns

A

Communication structure

  1. Centralized
  2. Decentralized

Team members have communications roles that they play

  • Boundary spanning activities (go beyond the team)
  • Ambassador is the spokesperson with the hierarchy (vertical)
  • Task-coordinator is a lateral coordinator with other teams
  • Scout goes beyond the organization to get external information (innovators scouting new ideas)
43
Q

Decision making— Groupthink symptoms: Lack of Critical Evaluation

A

Coming to decisions too quickly

Know people are in group think when they have these symptoms

  • Pressure to conform
  • Illusion of unanimity (silence is not unanimous)
44
Q

team learning

A

An interaction process of reflection and action (contemplation in action) through which team may discover and correct problems in their work process
-Ex. learning from customer feedback

to learn as a team you must have psychological safety

45
Q

Four criteria if you want to know if a team is effective or not

A

Performance, particularly productivity
Member satisfaction
Quality of work
Capacity for sustainability, particularly continued cooperation

46
Q

Stages of group development

A

Every team goes through 4 natural stages in the long term, and 5 if short term (adjourning)

  1. Forming
  2. Storming
  3. Norming
  4. Performing
  5. Adjourning
47
Q

forming phase

A

step 1 of group development (team charter)

  • Key action is establishing a clear direction/goal after getting to know each other
  • Being acquainted with each other and with team purpose
  • Establishing trust and familiarity
48
Q

storming phase

A

step 2 of group development (responsibility matrix)

Dealing with tensions and conflict

  • Group members attempt to influence the development of group norms, roles, and procedures
  • Stage has a high potential for conflict and group think
  • Coalitions or cliques may form

*Key action is determination of roles & of a way forwards

49
Q

norming phase

A

step 3 of group development (ground rules)

Key action is the setting of group rules that all agree to

  • Building cohesiveness and alignment
  • Agreement emerges on rules and procedures for decision making and expectations of members
  • Getting to know one another and holding the group together may become more important to some than successfully working on group tasks

Org Theory (2 decks)

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