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LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 Topic 1  Sell a product for more th...

LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 Topic 1  Sell a product for more than the cost of ORGANIZATION making it; or  A collection of people working together to  Nonprofit organization can add wealth to achieve a common purpose. society  A unique phenomenon that enables its  Provide a public service that is worth members to perform tasks far beyond the more than its cost reach of individual accomplishment. PRODUCTIVITY  Share a broad purpose providing goods or  A common way to describe how well an services of value to customers and clients. organization is performing overall.  It measures the quantity and the quality of CHARACTERISTICS OF AN ORGANIZATION work outcomes relative to the cost or resources used.  Can be measured at the individual and group and organizational levels. Distinct Deliberate Purpose Structure Effec ve but not Effec ve and efficient High efficient Goals achieve Goals achieve No wasted resources Resources wasted High productivity Goal People attainment Neither effec ve nor Effec ve but not Low efficient efficient Goals not achieve Goals not achieve Resources wasted No wasted resources ORGANIZATIONS AS SYSTEM  All organizations are complex systems whose Poor Good many interrelated parts should function together so that a common purpose is achieved. ORGANIZATIONAL THEORY  Open system interacts with their environments  A set of generalization and concepts and in the continual process of obtaining resource approaches to the study of organization. inputs and transforming them into product  It serves two purposes: outputs in the form of finished goods and/or  Improvement of the understanding of services. how agencies function and relate to other levels and segments of the ORGANIZATIONS AS OPEN SYSTEMS society.  Provision of knowledge and insight for The The The designing and administering environment organization environment organizations in ways adjudged as supplies creates consumes good and effective. Resource Product inputs: outputs: Three Major Theories People Finished  The differences are based on the fact that at Money Work activities goods and/or the start of their evolution, the students of the Materials turn resources services organization were focusing their attention on Technology into outputs Transformation the aspects of organization which they felt very Information Process important at the time:  Classical or Traditional Model Consumer Feedback  Neoclassical Theory or Behavioral ORGANIZATIONAL PERFORMANCE Model  For an organization to perform well, its  Systems Theory resources must well be utilized and its customers must be well served -> value creation  Business organization can earn a profit. LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 4. Full-time paid officials: only or major CLASSICAL THEORIES OF ORGANIZATION employment; paid on the basis of position.  Earliest theory mainly concerned with the 5. Career officials: promotion based on formal structure of the institution. seniority and merit; designated by Ex. Church, military (chain of command) supervisors  Has 3 schools of thought: 6. Private/Public split: separates business  Bureaucratic Model and private life  Scientific Management  The finances and interests of the two  And Principles of Administration should be kept firmly apart: the school resources of the organization are quite  Emphasized rationality, predictability, distinct from those of the members as impersonality, technical competence and private individuals. formal division of labor.  There is “one best way” to organize.  There are “universal” principles of SCIENTIFIC MANAGEMENT management.  Frederick Taylor (1856 – 1915)  Organizations are “mechanical” and “closed-  Father of Scientific Management systems”.  Published: Principles of Scien fic Management  Organizations exists for “production related”  Demonstrated that individual tasks could be goals, thus the emphasis is on “internal scientifically analyzed efficiency”.  Time and motion study, fatigue study, skills  Structure of “formal organizations” are study defined. KEY POINTS OF SCIENTIFIC MANAGEMENT BUREAUCRATIC MODEL  Scien fic Job Analysis – observation, data  Max Weber - Father of Modern Sociology gathering, and careful measurement  Analyzed bureaucracy as the most logical and determine “the one best way” to perform each rational structure for large organizations. job  Positional authority of a superior over a  Selec on of Personnel – scientifically subordinate stem from legal authority. select and then train, teach, and  Charismatic authority stems from the personal develop workers qualities of an individual.  Management Coopera on –  Weber outlined his ideal bureaucracy as managers should cooperate with defined by the following parameters: workers to ensure that all work is done A continuous system of authorized in accordance with the principles of jobs maintained by regulations. the science that developed the plan 1. Specialization: encompasses a defined  Func onal Supervising – managers “sphere of competence,” based on its assume planning, organizing, and divisions of labor decision-making activities, and  A stated chain of command of offices: workers perform jobs a consistent organization of supervision based on distinctive levels of authority ADMINISTRATIVE MANAGEMENT 2. Rules: an all-encompassing system of  Henri Fayol - Father of Modern Management directives which govern behavior:  Emphasizes the manager and the functions of  Rules may require training to management. comprehend and manage.  Organizational structure coordinated by 3. Impersonality: no partiality, either for or management: against, clients, workers, or administrators.  key to a rational and efficient  Free selection of appointed officials: administration equal opportunity based on education  Organizations should be structured based on 4 and professional qualification criteria: LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024  purpose they serve  process they use SYSTEMS THEORY  persons and things dealt with and  place and condi ons where they  Organizations as sets of variables that are func on interrelated in such a way that changes in one  Unity of command direction is essential variable affects other variables  Authority and responsibility should be delegated down the hierarchy to their local CONTINGENCY THEORY levels  Narrow span of control is desirable  There is no one way of managing that will apply  Systematic planning best to all situations  Human psychological variables should be taken  Managers must study very well the situation, in to account and based on his diagnosis, he can then  5 functions of managers: determine which of the three models or 1. Plan 4. Coordinate combination he will follow. 2. Organize 5. Control 3. Command Summary:  14 Principles of Management  Classical theories 1. Division of work  Importance of well-structured 2. Authority and responsibility organization with appropriate division 3. Discipline of labor with its resulting specialization 4. Unity of command and the need for written rules to 5. Unity in direction coordinate and direct the organization 6. Subordination of individual interests  Neo-classical or Behavioral theories to general interests  Social and human factors are more 7. Remuneration of personnel important determinants of workers’ 8. Centralization behavior than the physical work 9. Scalar chain environment and material incentives, 10. Order and yet importance of monetary 11. Equity returns/incentives cannot be denied 12. Stability of tenure of personnel  Systems theory 13. Initiative  Holistic understanding of the situation 14. Esprit de corps with thorough analysis of the input- throughput-output process and the NEO-CLASSICAL THEORY use of quantitative methods  Elton Mayo - school of human relations  Con ngency theory  Organization should be seen as a social  Catch-all approach structure, an intricate web of human rela ons together by a system of sen ments The Changing Environment  Chester Bernard - cooperation system  Social and psychological incentives are primary, economic is secondary  4 basic standards or orders 1. Order must be understandable by those who are supposed to receive them 2. Order must be consistent with the goals and purpose of the organization as they are understood by its members 3. Order must be compatible with the personal interest of those affected 4. Order must be feasible LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 Topic 2 TYPES OF ORGANIZATIONAL STRUCTURES Formal:  Delineated by an organizational chart and job descriptions.  Official reporting relationships are known to every manager. Informal:  A set of evolving relationships and patterns of STAFF/FUNCTIONAL AUTHORITY ORGANIZATIONAL human interaction STRUCTURE  Not officially prescribed. JOB/POSITION CATEGORIES: Basis of Informal Formal Group 1. Line Position Comparison Group  In the direct chain of command  Responsible for the achievement of General Feature Unofficial Official the goals.  Direct authority or line authority Major Concepts Power and Authority and  Line officers/managers politics responsibility 2. Staff Position  Intended to provide expertise, advice, Primary Focus Person Position and support for the line positions.  i.e., authority to advise the line Source of leader Given by Delegated by  Staff officers or managers power group management  Staff authority or functional authority o Staff departments have Guidelines of norms Rules and Policies authority over line personnel behavior in narrow areas of specialization. Rewards and Sources of control sanctions penalties TYPES OF SPECIALIZED STAFF 1. Advisory FORMAL ORGANIZATIONAL STRUCTURE CATEGORIES  Management Information System, LINE ORGANIZATIONAL STRUCTURE  Operation Research and Quantitative Techniques,  Only direct, vertical relationships between  Industrial Engineering, different levels in the firm.  Planning  Authority follows the chain of command. 2. Service  Maintenance, ADVANTAGES DISADVANTAGES  Purchase, Tends to simplify and clarify Neglects specialists in  Stores, authority, responsibility, and planning  Finance, accountability relationships  Marketing Promotes fast decision- Overloads key persons 3. Control making  Quality control, Simple to understand As the firm grows larger, line  Cost control, organization becomes more  Auditing ineffective  Staff can perform 1-3 functions. LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 DISADVANTAGES: DIVISIONAL ORGANIZATIONAL STRUCTURE 1. May create conflict between line and staff personnel. Have a different basis on formed departments.  e.g. Staff officers may resent their lack 1. Function of authority 2. Product 2. Line managers may dislike staff personnel 3. Geographic territory teaching them even though they recognize the 4. Project specialists’ knowledge and expertise. 5. Combination approach 3. Some staff have difficulty adjusting to the role, especially when line managers are reluctant to accept advice. 4. Coordination between line and staff may become difficult. ADVANTAGES: 1. Line and staff have a direct vertical relationship between different levels. 2. Staff specialists advise and assist line managers/officers in specialized areas. 3. Use of expertise of staff specialists. 4. The span of control can be increased 5. Relieves line authorities of routine and PROJECT ORGANIZATIONAL STRUCTURE specialized decisions. 6. No need for all-round executives.  A temporary organization designed to achieve specific results by using teams of specialists from different functional areas.  Focuses all its energies, resources, and results on the assigned project.  When the project is complete, the team members o May go back to their previous positions or o May be assigned to a new project.  Project examples: COMMITTEE ORGANIZATIONAL STRUCTURE o Research and development projects, o Product development,  Formed for managing certain o Construction of a new plant, housing problems/situations complex, shopping complex, bridge  Temporary decisions. ADVANTAGES DISADVANTAGES Committee decisions are Committees may delay better than individual decisions, consume more decisions time, and hence more expensive. Better interaction between Group action may lead to committee members leads to compromise and indecision. better coordination of activities Committee members can be ‘Buck passing’ may result. motivated to participate in Most valuable when work is: group decision-making. Group discussion may lead to  Defined by a specific goal and target date for creative thinking. completion.  Unique and unfamiliar to the organization. LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024  Complex having independent activities and ADVANTAGES DISADVANTAGES needing specialized skills Decentralized decision- High administration cost. making.  Critical for possible gains or losses. Strong product/project Potential confusion over  Not repetitive coordination. authority and responsibility. Improved environmental High prospects of conflict monitoring. CHARACTERISTICS Fast response to change. Overemphasis on group decision-making 1. Personnel are assigned to a project from the Flexible use of resources Excessive focus on internal existing permanent organization and are under relations. the direction and control of the project Efficient use of support systems. manager. 2. The project manager specifies what effort is needed and when work will be performed whereas the concerned department manager executes the work using his resources. 3. The project manager gets support from production, quality control, engineering, etc. 4. The project manager and the respective functional managers have the authority over the project team members. MATRIX ORGANIZATIONAL STRUCTURE HYBRID ORGANIZATIONAL STRUCTURE A permanent organization designed to achieve specific results by using teams of specialists from different USES: functional areas in the organization.  Organizations that face considerable Feature: environmental uncertainty that can be met through a divisional structure and that also  Superimposes a horizontal set of divisions and require functional expertise or efficiency reporting relationships onto a hierarchical  Used by multinational companies, e.g., functional structure. International Business Machines USA.  Often used when the firm has to be highly  Multinational corporations may have their responsive to a rapidly changing external corporate offices in the country of origin and environment. their international divisions established in various countries reporting to the CEO or Product/Business Group president at the headquarters. Functional Managers Managers  Depends on factors such as degree of  In charge of specialized  In charge of one or resources more products international orientation and commitment.  e.g. production, quality  Authorized to prepare  The international divisions or foreign control, inventories, product or business subsidiaries may be grouped into regions scheduling, and group strategies  Each region may be subdivided into countries marketing.  Call on the various within each region. functional managers for the necessary resources. BOTH  Have somewhat equal power.  Possible for conflict and frustration.  The opportunity for prompt and efficient accomplishment is quite high.  Negative effects of dual authority  Functional managers may lose some authority because product managers are given the budgets to purchase internal resources LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 Topic 3 Topic 4 THE DIFFERENCE BETWEEN ADMINISTRATION & HOSPITAL AS AN ORGANIZATION MANAGEMENT  The hospital is an organizational system  System – As a whole it is composed of several Features Administration Management parts which are inter related and inter- 1 Nature Determinate or Executive of dependent to promote a common goal Thinking Function Doing Function  How does it relate to hospital? 2 Type of work Decision on Implementation o It is related to organization and objectives and of policies management policies 3 Levels of Top Level Middle and Lower o Emphasis is on interaction of authority Level individuals, group, organization and 4 Influence Public opinion Objectives and their environment and outside policies of o Structuring and integrating activities sources concern that is people working or coordinating 5 Designation Administrator, Manager, Officer in charge Supervisor together 6 Main Functions Planning and Directing and control organizing Primary Objectives of a Hospital 7 Skills required Conceptual and Technical and  To provide adequate personalized care and human skills human skills 8 Usage Used in govt and Business treatment public sector organization  Its principal product is medical and surgical service  Management runs the healthcare organization Secondary Objectives of a Hospital  Administration handles the staffing  Maintenance and survival  Healthcare management  Organizational stability and growth  concerned with disciplines such as policy,  Financial solvency accounting and facilities management  Medical, paramedical education and research  The healthcare manager is concerned with  Various employees related activities the overall operation of the facility or network  Healthcare Administrator HOSPITAL ORGANIZATION  The day-to-day management of staff  Gives the framework of hospital operation  Guided by hospital mission/vision and core values  Functional table of organization  Leader to run the organization Model Organizational Structure General Functions: a. Medical Service - shall be responsible for providing quality inpatient and outpatient care and high standards of clinical training for medical and allied medical personnel provision of ancillary and allied health services to patients’ promotion of research activities implementation of clinical resource management system and advising and assisting the chief of hospital in the formulation and implementation of policies, plans and programs of the hospital  LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 b. Nursing Service - shall be responsible for implementing nursing Nursing Service programs for total quality health care; providing nursing care to medical cases; and Office of the Medical Center Chief developing coordinating and implementing relevant training programs for nursing personnel. NURSING SERVICE c. Hospital Operations and Patient Support Service Critical Nursing Unit Special Care Areas - shall be responsible for the provision of Operating Room administrative services relating to personnel Central Supply management, administrative records Obstetric Complex management, property and supply management, general services, engineering and security. Health Operations and Patient Support System Office of the Medical d. Finance Center Chief - shall be responsible for the provision of financial services relating to budgeting, accounting, cash operations, billing and claims. Hospital Operation and Patient Support System Basic Organizational Structure Procurement Human Resource Management Office of the Medical Center Chief Finance Service Integrated Hospital Professional Education Office of the Medical Operations and and Training Center Chief Management Program Finance Service Medical Nursing Non- Medical Budget Accounting Medical Nursing Hospital Finance Organizational Configuration Service l Service Operation Service and Patient  Organizational Structure and Staffing pattern Support shall take into consideration the following Service factors: a. Minimum DOH Licensing Requirements Medical Service and Philhealth Accreditation Requirements b. Hospital Licensing Category (Level 1, 2 and Office of the Medical Center Chief 3 hospitals) based on DOH c. Special Society Training Accreditation Medical Service Requirements (particularly for Medical Staff) OPD d. Distribution of Medical Staff to cover the Department of Pharmacy OPD, ER and inpatient hospital areas ER Department Pathology e. Health Human Resource Master Plan Clinical Department Nutrition and Department of Dietetics Special Care Areas Radiology LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 Level 1 DOH Requirement Level 2 DOH Requirement  LICENSING REQUIREMENTS FOR LEVEL 1  LICENSING REQUIREMENTS FOR LEVEL 2 HOSPITAL SERVICE CAPABILITY HOSPITAL SERVICE CAPABILITY ___ 1. Administrative Service ___ 1. Administrative Service ___ 1.1. General Administrative Service ___ 1.1. Personnel ___ 1.1.1. Records ___ 1.2. Accounting ___ 1.1.2. Bookkeeping ___ 1.3. Medical Records ___ 1.1.3. Clerical Work ___ 1.4. Supply ___ 1.1.4. Maintenance ___ 1.2. Patient Transport Service ___ 1.5. Housekeeping ___ 2. Clinical Service ___ 1.6. Laundry and Linen ___ 2.1. General Medicine ___ 1.7. Maintenance ___ 2.2. General Pediatrics ___ 1.8. Patient Transport Service Security ___ 2.3. General Obstetrics and Non-Surgical ___ 1.9. Dietary Gynecology ___ 1.10. Social Service ___ 2.4. Minor Surgery ___ 2. Clinical Service ___ 2.5. Emergency and Outpatient Service ___ 2.1. General Clinic Care ___ 3. Nursing Service ___ 2.1.1. Medicine ___ 3.1. Minimal Care and Management ___ 2.1.2. Pediatrics ___ 3.2. Health Education and Counseling ___ 2.1.3. Obstetrics and Gynecology ___ 4. Ancillary Service ___ 2.1.4. Surgery and Anesthesia ___ 4.1. Primary Clinical Laboratory ___ 2.2. Emergency Service ___ 4.2. Radiology - 1st Level ___ 4.3. Pharmacy ___ 2.3. Outpatient Service The service may be contracted out but available for 24 ___ 3. Nursing Service hours 7 days a week. A contract of service or ___ 3.1. Intermediate Care and Management memorandum of agreement with a service provider ___ 3.2. Health Education and Counseling should be secured as a prerequisite for license to ___ 4. Ancillary Service operate. ___4.1. Secondary Clinical Laboratory A certificate of affiliation with a licensed facility within ___4.2. Radiology - 1st Level the locality should be secured as a prerequisite for ___4.3. Pharmacy license to operate The service is optional.  LICENSING REQUIREMENTS FOR LEVEL 2 HOSPITAL PERSONNEL ___ 1. Administrative Service  LICENSING REQUIREMENTS FOR LEVEL 1 HOSPITAL PERSONNEL ___ 1.1. Chief of Hospital / Administrative ___ 1. Administrative Service Officer Clerk (pool) ___ 1.1. Administrator ___ 1.2. Clerk (accounting) ___ 1.2. Clerk ___ 1.3. Medical Records Clerk ___ 1.3. Utility Worker ___ 1.4. Storekeeper / Linen Custodian Utility ___ 1.4. Driver Worker 1 at any time plus 1 reliever ___ 1.5. Driver 1:12 beds at any time 1:24 beds at any time ___ 1.6. Nutritionist / Dietitian ___ 2. Clinical Service ___ 1.7. Cook / Food Service Worker ___ 2.1. Physician ___ 1.8. Medical Social Worker ___ 3. Nursing Service ___ 2. Clinical Service ___ 3.1. Nurse ___ 2.1. Physician ___ 3.2. Nursing Attendant / Midwife ___ 2.2. Physician (On Call) ___ 3. Nursing Service ___ 3.1. Chief Nurse / Supervising Nurse ___ 3.2. Staff Nurse LEADERSHIP & MANAGEMENT Week 4: Medical Staff Organization Prepared by: AMANA, ANG and ARAH Lecturer: Dr. Maryam Lizbeth R. Lee-Sahijuan Date: Aug. 27, 2024 ___ 3.3. Nursing Attendant / Midwife ___ 1.7. Medical Records Officer ___ 1.8. Medical Records Clerk Level 3 DOH Requirement ___ 1.9. Supply Officer  LICENSING REQUIREMENTS FOR LEVEL 3 ___ 1.10. Storekeeper HOSPITAL SERVICE CAPABILITY ___ 1.11. Laundry Worker ___ 1. Administrative Service ___ 1.12. Utility Worker ___ 1.1. Personnel ___ 1.13. Security Guard ___ 1.2. Accounting ___ 1.14. Maintenance Personnel ___ 1.3. Budget and Finance ___ 1.15. Driver ___ 1.4. Medical Records ___ 1.16. Nutritionist / Dietitian ___ 1.5. Property and Supply ___ 1.17. Cook ___ 1.6. Housekeeping ___ 1.18. Food Service Supervisor ___ 1.7. Laundry and Linen ___ 1.19. Food Service Worker ___ 1.8. Maintenance ___ 1.20. Medical Social Worker ___ 1.9. Ambulance Service ___ 2. Clinical Service ___ 1.10. Security ___ 2.1. Chief of Clinics ___ 1.11. Dietary ___ 2.2. Department Head ___ 1.12. Social Service ___ 2.3. Physician ___ 2. Clinical Service ___ 2.4. Dentist ___ 2.1. Specialty Clinical Care ___ 2.5. Dental Aide ___ 2.1.1. Department of Medicine ___ 3. Nursing Service ___ 2.1.2. Department of Pediatrics ___ 3.1. Chief Nurse ___ 2.1.3. Department of Obstetrics and ___ 3.2. Supervising Nurse Gynecology ___ 3.2. Head Nurse ___ 2.1.4. Department of Surgery and ___ 3.3. Staff Nurse Anesthesia ___ 2.2. Critical Care ___ 2.2.1. Intensive Care ___ 2.2.2. Post Anesthesia Care ___ 2.2.3. Pathologic Premature Nursery ___ 2.3. Emergency Service ___ 2.4. Outpatient Service ___ 2.5. General Dentistry ___ 3. Nursing Service ___ 3.1. Intensive Care and Management ___ 3.2. Health Education and Counseling ___ 4. Ancillary Service ___ 4.1. Tertiary Clinical Laboratory ___ 4.2. Radiology 2nd Level ___ 4.3. Pharmacy  LICENSING REQUIREMENTS FOR LEVEL 3 HOSPITAL PERSONNEL ___ 1. Administrative Service ___ 1.1. Chief of Hospital ___ 1.2. Administrative Officer ___ 1.3. Clerk (pool) ___ 1.4. Bookkeeper ___ 1.5. Billing Officer ___ 1.6. Cashier