Organisations and management

Question 1

benefits of targets

Answer 1

need to be SMART
can measure progress - accountability, audits
can align personal objectives with targets
benchmarking
attach to financial incentives schemes
identify outliers
share best practice
drives efficiency and quality
focus the system on common goals
inform service improvements and resource allocation

Question 2

disadvantages of targets

Answer 2

risk other areas being deprioritised
masks complexity
can mask clinical priorities - e.g. prioritising patients based on wait time not need
perverse incentives - gaming/cherry picking
under or overtreatment
compromise quality of care
demoralising if not met
need buy in from staff
some aspects of care are hard to measure
reporting requirements

Question 3

example of a target

Answer 3

elective care: 2% of patients waiting for planned treatment should be seen within 18 weeks of being referred from GP services to hospital treatment by 2029.

Question 4

Motivation theories

Answer 4

Herzberg hygiene-motivation theory
Maslow’s hierarchy of needs
McGregor’s x and y theory

Question 5

Maslow’s hierarchy of needs

Answer 5

Maslow’s theory states that our actions are motivated by certain physiological and psychological needs that progress from basic to complex. People are motivated to fulfil basic needs before advancing to the next level.
Biological & physical needs
Safety needs
Belongingness and love needs
Esteem needs
Self-actualisation

Question 6

strategy vs policy

Answer 6

strategy = a high level plan designed to achieve a goal
policy = a set of measures or principles which seek to achieve a goal - fixed rules which guide decision making

Question 7

nuffield ladder (8)

Answer 7

eliminate choice
restrict choice
guide choice through disincentives
guide choice through incentives
change the default
enable choice
provide information
do nothing

Question 8

Authority

Answer 8

is legitimized power – a voluntary submission to authority (Weber)
o conceptualized by Weber in the 1940s
o tradition
o rational-legal authority (position power)
o charisma (personal power)
o pure rational authority (expertness)

Question 9

Power

Answer 9

• a much broader concept than authority
• is possession of controlling influence or ability to make things happen
• may refer to non-legitimized authority
• is the capacity to overcome resistance
• may be subtle or overt within a group or organisation
• French and Raven in 1986 also identified (in addition to the above) different power
  types:
  o Resource or reward power, e.g. granting or withholding high grades by professors
  o Coercive power, the power to punish, e.g. firing a staff
  o Negative power, capacity to stop things happening
  position power
  personal power
  specialist power

Question 10

health care funding models and considerations

Answer 10

beveridge (taxation)
social insurance/bismarck
private insurance
mixed
OOPP

considerations:
- incentives to control spending
- justice/equity
- admin and costs of running
- data
- choice
- access
- information asymmetry
-quality, responsiveness and efficiency
- input of government - political influence

Question 11

General taxation example

Answer 11

UK
taxes raised from whole population to pay
seeks to pool risk
public providers - minimal private
UHC
providers funded by public system via ICBs

Question 12

Private insurance model

Answer 12

US
focus on individualism rather than collective
indivudals (or their employers on their behalf) take out private insurance
some publicly funded insurance schemes e.g. for the unemployed and elderly
Private providers - reimbursed by insurance companies
some co-payments for patients
not UHC
regressive model

Question 13

Bismarck model

Answer 13

France
employees and employers pay contributions to a fund to cover a defined package of services
government provides schemes for uninsured
some copayments
gov can raise additional funds e.g. through polluter pays policies
unlike private insurance model - the contribution is not related to the individual’s risk

Question 14

motivation theories

Answer 14

Maslow’s hierarchy of needs
self actualisation
self esteem
love and relationships
safety
physical

Question 15

How teams are formed and what makes and effective team

Answer 15

Tuckmans stages - forming, storming, norming, performing, adjourning
Belbin’s roles - SIC CTR PMS
lencioni five dysfunctions of a team:
focus on results, hold each other accountable, commitment, resolve conflict (avoid group think), build trust

Question 16

Goleman’s 6 leadership styles

Answer 16

commanding (do what I say)
visionary (come with me)
pacesetting (do as I do, now)
coaching (try this)
democratic (how should we do this)
Affiliative (people come first)

CVPCDA

Question 17

three rules of delegation

Answer 17

manager and employee must be confident that
employee understands that task
employee has the skills needed
the manager will provide feedback

Question 18

outcomes of negotiation matrix

Answer 18

degree of assertiveness vs degree of cooperation
win lose
win win
lose lose
lose win
compromising

Question 19

what are the three components of an organisation

Answer 19

structure
people working together
common goals

Question 20

frameworks for where are we now?

Answer 20

SWOT / PESTLE
McKinsey 7s
5 whys/root cause
stakeholder analysis
formula for change - D * V * F > R

Question 21

McKinsey 7 S

Answer 21

shared values
systems
structure
strategy
staff
style
skills

Question 22

where do we want to go frameworks

Answer 22

vision review
SMART targets

Question 23

how do we get there frameworks

Answer 23

Motivation of employees - Maslow’s needs
diffusion of innovation
ADKAR
Lewin - unfreeze, change, re-freeze
PDSA for smaller processes
stakeholder management

Question 24

how will we know when we’ve got there frameworks

Answer 24

REAIM (for policy)
Maxwell’s EEE AAA
Logic model
KPIs

Question 25

Policy formation frameworks

Answer 25

Lewes and Simmnet 5 approaches (medical, behavioural, educational, empowerment, societal) Nuffield ladder

Question 26

Policy triangle - for policy development

Answer 26

policy context policy content process actors

Question 27

Policy streams - for policy development

Answer 27

problem stream solutions stream politics stream all three need to align for change to happen

Question 28

Framework for persuasive comms

Answer 28

monroe's motivated sequence: grab attention establish the need satisfy the need visulise the future take actions

Question 29

Belbins roles

Answer 29

Shaper Implementer Completer finisher Coordinator Teamworker Resource investigator Plant/problem solver Monitor-evaluator Specialist

Question 30

symptoms of groupthink

Answer 30

illusions of unanimity, unquestioned beliefs, rationalization, stereotyping, "mindguards," illusions of invulnerability, and direct pressure on opposing views.

Question 31

Handy’s ideal traits of a team (MOLT)

Answer 31

organisation (clear purpose and objectives), members (specific expertise, know their roles), teamwork (mutual support), leadership (coordinates and takes responsibility)

Question 32

performance management cycle

Answer 32

planning, monitoring, reviewing, rewarding

Question 33

7 pillars of clinical governance

Answer 33

Clinical effectiveness Risk management Audit Patient centered and safety Information management Education and training Staff

Question 34

clinical audit stages

Answer 34

identify the topic / re-audit identify the relevant standards collect the data anlayse the data make recommendations implement the change e.g. HIV late diagnosis audit

Question 35

adair action centred leadership model

Answer 35

three overlapping areas of leadership responsibility: 1. Task– Achieving the goal and getting the job done. 2. Team – Building and maintaining team cohesion. 3. Individual – Supporting and developing each team member. A good leader balances all three areas to ensure effectiveness. simple and practical Flexible – Works across different industries and team structures. Team-oriented – Encourages collaboration and individual growth. Cons: Lacks depth on emotional intelligence – Doesn't fully address personal leadership traits. Situational factors not emphasized – Doesn't adapt as explicitly to different environments. Assumes equal weight on all three areas

Question 36

Policy cycle

Answer 36

A PIE Agenda setting - whats the problem Policy formation - options, stakeholders, evidence implementation - interpretation, organisation, application evaluation

Question 37

types of change

Answer 37

magnitude (incremental or transformational) and origin (spontaneous, emergent, deliberate)

Question 38

Programme budgeting

Answer 38

Programme budgeting considers how a budget is or should be spent across programmes and takes into account the objectives/goals and outcomes achieved. It gives details of all the activities that take place within a given budget

Question 39

innovation - what is it, process, ways to encourage

Answer 39

ability to generate and execute creative ideas - viable solutions input (ideas) -> process -> output (innovation) requires: motivation, expertise, flexible thinking ways to encourage: brainstorming, culture, team away days, funds and schemes to support scaling up (NHS accelerated access collaborative), management by objectives, reduce group think and fear of change ways to increase spread of an idea: advantageous, interoperable, simple, can be trialed, visibly more effective

Question 40

personal management skills

Answer 40

time management (prioritisation matrix of importance and urgency), self awareness (myers briggs, reflection), stress management, difficult people,