PTPM-211-Online-Session-1-Topic-1-Organization-and-Organizational-Planning PDF

Arthur San Pedro Calces, PTRP 1 st Topic ORGANIZATION AND Organizational Planning At the end of the session a student will be able to : o Describe the different components of a structured organization o Compare the different levels of an organization o Analyze the congr...

Arthur San Pedro Calces, PTRP 1 st Topic ORGANIZATION AND Organizational Planning At the end of the session a student will be able to : o Describe the different components of a structured organization o Compare the different levels of an organization o Analyze the congruency of the fundamental documents and its implication on behavioral expectation  TOPIC OUTLINE o Introduction to Organization and Administration o Members of the Rehabilitation Team o Organizational Culture o Fundamental Documents o Basic Parts of an Organization o Operating Structure o Factors Affecting the Operating Structure o Organizational Structure o Changes in the Organizational Structure  INTRODUCTION Organization - person or group of people established to accomplish an overall goal / the action of organizing or planning something. Administration - principles, practices and techniques employed in achieving the objectives; Management Organization and Administration in Physical Therapy - direction and management of Rehabilitation / Physical Therapy Units (Hospitals, Community Centers, Schools for handicapped individuals and Public Health Agencies) ORGANIZATION Administration MEMBERS OF THE REHABILITATION TEAM Interdisciplinary Rehabilitation Team - consists of a number of disciplines and is dictated by the service needs of the patient. Nurses Advance Chaplains Practice Nurses Dieticians Patient Physiatrist and Family Social Therapists Workers Case Psychologists Managers Interdisciplinary Rehabilitation Team o Patient and Family o Nurses o Advance Practice Nurses o Physiatrists o Therapists o Psychologists o Case Managers o Social Workers o Dieticians o Chaplains The Role of Team Members Discipline Physiatrist Primary Role Responsible for Physical Medicine and Rehabilitation Management of patient’s care Collaboration Often leads the team with other Team Members Discipline Staff Nurse Primary Role Coordinates and provides day-to-day patient care; Educates patient / family regarding medical and health issues as well as skills needed to provide safe health care; Patient advocate Collaboration Supports and coaches patients to practice with other newly learned skills; Cues them as needed; Team Provides feedback to the Therapists regarding Members patient ability to follow through with skill and if there are cognitive, behavioral, or physical changes during the day that are impeding patient’s ability to consistently perform on unit. Discipline Physical Therapist Primary Role Maximizes patient function by working with patients to improve gross motor skills; Focuses on mobility, including ambulation, balance, wheelchair skills. Collaboration PTs and OTs work together to develop strength, with other balance and teaching skills needed for ADLs; Team Patient works on wheelchair transfers, whereas Members OT incorporates what PT has taught patient to practice toilet transfers, and instructs patient on clothing management, and personal hygiene Discipline Speech-Language Pathologist Primary Role Evaluates and treats cognition, communication, swallowing disorders and hearing deficits Collaboration Communicates with team regarding patient with other communication needs, how to cue patient when Team learning an activity, impact of cognitive deficits Members on ability to learn and retain information; Communicates with team regarding feeding and swallowing disorders and works with Physicians, Nurses and Dieticians about appropriate food and liquid consistencies, compensatory strategies to maintain safe swallow. Discipline Occupational Therapist Primary Role Assist patient gain maximal function in areas of ADL’s Collaboration OTs and PTs collaborate to assist patient to with other become functional with all components of skills Team / ADLs Members Discipline Therapeutic Recreation Primary Role Assists patients to re-enter their community and helps patients adapt so they can enjoy leisure activities Collaboration Incorporates what patient has learned from with other other disciplines to assist patient with Team community re-entry and leisure activities in Members preparation for patient discharge. Discipline Respiratory Therapist Primary Role Evaluates and treats a patient’s breathing, including assist of ventilation as needed. Collaboration Supports maintenance of respiratory status and with other prevention of complications related to Team inactivity; Works with PT to increase tolerance Members for increased mobility. Discipline Neuropsychologist Primary Role Evaluates cognitive and behavior status, assists in the adjustment to illness / disability; Provides support to patient and family as they come to grips with issues related to illness / disability. Collaboration Works with team regarding cognitive and with other behavioral needs of patients, developing Team appropriate plans of care related to cognitive Members and behavioral management. Discipline Case Manager Primary Role Coordinates implementation of treatment plan, communicates insurance benefit information to patient / families and the team; Advocates for services; Acts as liaison officer between patient, hospital, and payer; Provides update information to insurance companies; Coordinates optimal use of available benefits. Collaboration Coordinates team to look at patient days, status with other of insurance to assist in planning for discharge, Team and to keep members mindful of time allotted to Members accomplish goals. Discipline Social Worker / Discharge Planner Primary Role Focuses on psychosocial support; Prepares patients and families for discharge; Identifies supportive services, resources needed after discharge; Links patient / family to Community Physicians, Services, Home Health Care, Long-Term Care Facilities, and Medical Equipment Providers. Collaboration Communicates patient / family wishes regarding with other necessary services; Collaborates with team Team regarding patient’s needs; Communicates status of services obtained; Works with case management in Members coordinating all written information that will go home with patient; Provides necessary information about patient to community providers to ensure continuity of care. Discipline Dietician Primary Role Oversees patient’s nutritional status & works with Physician to provide necessary dietary requirements; Provides patient / family education on diets. Collaboration Collaborates with team to adapt diet according with other to patient’s needs; Works with patient / family to Team provide foods of preference with dietary Members restrictions; Communicates nutritional status to team. Discipline Advanced Practice Nurse Primary Role Conducts comprehensive assessment; Integrates education, research, and consultation into clinical practice. Collaboration Collaborates with Nursing peers, with other Interdisciplinary Team, including Physician, Team regarding evidenced-based practice; Integrates Members education, research and consultation into clinical practice. Discipline Chaplains Primary Role Supports patients in their spiritual / religious practices; Provides encouragement and support Collaboration Guides team to provide support while coping with other with illness / disability, consistent with patient’s Team faith / belief Members Discipline Vocational Services Primary Role Evaluates impact of illness / injury on vocation; Assists patients with adaptations to return to present vocation or retraining / education. Collaboration Communicates status of patient’s vocational with other needs; Works with Therapists to develop, adapt, Team or improve skills required for return to work or Members school. ORGANIZATIONAL CULTURE Organizational Culture - system of shared assumptions, values, and beliefs, which governs how people behave in organizations  FUNDAMENTAL DOCUMENTS Fundamental Documents - are expression of the fundamental guiding assumptions. Statements - formal guiding assumptions expressed in documents, to guide the organization’s members.  Fundamental Documents Philosophical Vision Mission Statement Statement Statement Value Statement Principles Philosophical Statement - expresses the organization’s philosophy – values and principles (Could be written in separate statement) Value Statement Principles Value Statement - supplies the why’s of the mission and offers support for the mission Principles - are overarching / principal guidelines for human conduct that are proven to have enduing permanent value. *** It defines what the organization BELIEVES in. Vision - future oriented, detailed description of outcomes o Ultimate goal statement. o The least tangible of an organization’s guiding documents o Dream the organization o Communicate the long-term plan o Inspirational Valley Physical Therapy Saco Bay Orthopaedic and Sports PT “Valley Physical Therapy “Saco Bay Orthopaedic and Sports will be recognized as a Physical Therapy will be a leader in leader in physical therapy the provision of autonomous physical practice in Santa Cruz therapy services. We will County, providing cutting demonstrate leadership and develop edge, state of the art, alliances within the Northern New evidence based physical England consumer and medical therapy.” ( 2007 ) communities through innovative practice, education and research, quality of care, professionalism, socio-economic adaptability and financial responsibility. These criteria will be pursued indefinitely by our dedicated staff.” ( 2007 ) Mission - explains why the organization exists; Organization’s purpose. o Clear statement of purpose and priorities o Reflects values or beliefs (culture) o Presents the unique attributes o Infers the roles of stakeholders o Generates commitment to and pride in the organization o Consistent with legal and corporate requirements (if applicable) Tagline - phrase to quickly translate the business’s positioning and brand identity. o Memorable o Short o Conveys brand’s point of difference o Brand’s market position and key benefits o Differentiates a business from all others o Reflects brand identity, character, promise and personality BASIC PARTS OF AN ORGANIZATION Strategic Apex Technostructure Middle Support Staff Line Operating Core o Operating Core - includes all those employees who themselves produce the basic products and services o Administrative Component (Management) Strategic Apex - top general managers and their personal staff. Middle Line - managers in a direct line of formal authority between the Strategic Apex and of the Operating Core. o Support Services Technostructure - consists of those analysts. Support Staff - includes those group that provide indirect support.  OPERATING STRUCTURE Operating Structure - the way an organization balances the division and coordination of work between employees.  Methods of Work Coordination (Mintzberg,1979) Direct Mutual Work Supervision Accommodation Standardization Direct Supervision - is the control and direction of the work of employees by another employee, typically a manager / supervisor. Supervisor o Direct knowledge of the work of a group of employees. Mutual Accommodation - the simplest method of work coordination; may also be the most effective method of work coordination for the most complex situations. Work Standardization - reduces the need for direct supervision (oversight) and mutual accommodation (voluntary working adjustments) because it reduces the variation in the performance of employees. Work Process and Task Standardization Approaches Skill Standardization (Mintzberg,1979) Output Standardization FACTORS INFLUENCING OPERATING STRUCTURE Internal External Ownership Industry needs Mission Performance Benchmarks Purpose Environmental Stability Values and Philosophy Environmental Complexity Production Technology Market Stability Strategic Direction Market Competition Competitive Strategies Environmental Predictability Age Legal Climate Size Legislative Climate History INTERNAL FACTORS INFLUENCING OPERATING STRUCTURE Ownership Production Major Internal Technology Factors Culture Size and Age Ownwership Three Types o Private Ownership - solely by an individual, a group of individuals, or another privately owned business o Public Ownership - a publicly traded owned by a group of diverse individuals who have elected to invest in the business through stock o Governmental Ownership - local, state, or federal government body and indirectly by the citizens Production Technology Production Technology - type of work and the technology Unit Production Production Technological Mass Production Systems (Woodward, 1965) Process Production Three Types of Production Technological Systems (Woodward, 1965) o Unit Production - customer’s special requirements (customer-specific product ) o Mass Production - large quantity / volume of a similar output / product. o Process Production - large quantities of liquids, gases or other continuous-flow products, such as electricity and intermittent production of chemicals. Culture - patterns of social interaction that define the norm within the organization (Goffee & Jones, 1996) Types of Human Relations o Sociability - true friendliness between employees o Solidarity - organization’s ability to pursue shared objectives quickly and effectively. Size and Age (Mintzberg, 1979) o As organization age, size also increases, more complex management structure, differentiation of organizational subunits, and a more dominant organizational culture.  EXTERNAL FACTORS INFLUENCING OPERATING STRUCTURE Customers Competitors External Factors Demographic Shifts Economic Climate Governmental Regulations Technological Innovation Stability (External Environment) - reflection of the rate and predictability of environmental change. Complexity - diverse and ever changing expectations of customers, products, regulations and competitors. Market Diversity - variety of customers, products, and services Hostile Environment - arise from significant and unpredictable demands from multiple sources (its labor force, the government, the community, or its competitors)  ORGANIZATIONAL STRUCTURE Organizational Structure - defines the relationships among and between the parts of the organization. Organizational Chart - graphic representation of structure. Solid Lines - represent direct reporting relationships. (indicate both accountability and responsibility) Dotted Lines - represent communications and/or indirect control. ORGANIZATIONAL DEVELOPMENT Stages of Organizational Development (Mintzberg, 1995) Craft Stage Entrepreneurial Stage Bureaucratic Stage Divisional Stage Adhocracy / Matrix Stage Craft Stage - most basic stage of organizational development o Small with little or no division of labor (at this stage) o All members are considered equally competent in providing services. o Often, if there is a division of supervision and labor, the supervisor will also be able to and have to be involved in performing all of the tasks performed by members of the operating core. Working Owner Employees Entrepreneurial Stage - the second stage of organizational development. Owner Contract Support Management Employees Bureaucratic Stage - happens when the entrepreneurial organization continues to grow and the demand for continued division.  Owner Support Vice President Director Director Manager Manager Manager Manager Supervisor Supervisor Supervisor Supervisor Staff Staff Staff Staff Staff Divisional Stage - movement towards a divisional structure Centralized - rests largely with management at the corporate / central office. Decentralized - functions are left to the divisions.  Chief Executive Executive Support Vice President Contracts Clinic A Clinic B OT PT Office Office Reception / Billing Manager Manager Site 1 Site 1 Supervisor Billing PT Site 2 Site 2 Records OT Clinical Staff Reception Speech Site 3 Site 3 Transport Psych Adhocracy / Matrix Stage - alternative to the traditional bureaucratic structure; Hybrid between the traditional bureaucratic and the product line structure..  Chief Executive Officer Chief Operations Officer Program Manager Program Manager Program Manager Department Manager Department Staff from All Staff from All Staff from All Manager Clinical & Clinical & Clinical & Support Support Support Department Departments Departments Departments Manager Serving Patients Serving Patients Serving Patients Department in the Product in the Product in the Product Manager Line Line Line Department Manager CHANGES IN THE ORGANIZATIONAL STRUCTURE Possible Reasons o Does not meet quality, productivity or financial goals. o Purpose and fundamental documents changes. o Popularity Assessment o Division of work o Employee relationship o Employee skill needs o Methods of work coordination o Number and type of people employed o Work group composition o Work process o Work standards (Policies, Procedures and Protocols) Steps in Reorganization Formalize All Changes Reorganize the Structure Identity Solutions Identify gaps between Organizational current performance Assessment and (Internal and External) performance expectation  REFERENCES o Medina, R. (2011). Human Behavior in Organization. Sampaloc, Manila. Rex Book Store, Inc. o Nosse, L & Friberg, D. (2010). Managerial & Supervisory Principles for Physical Therapists. Baltimore, MD, USA. Williams & Wilkins. 3rd Ed o Nosse, L & Friberg, D. (1992). Management Principles for Physical Therapists. Baltimore, MD, USA. Williams & Wilkins. 3rd Ed o Scott, R & Petrosino, C. (2010). Physical Therapy Management. Singapore, Elsevier Pte Ltd.