Managerial approach

The Managerial Role

Copyright © 2006 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 2

Purpose and Overview

• Purpose– To understand roles of the health care

manager• Executive leadership• Organizational management• Strategic management • Business enterprises • Clinical and business service components



• Overview– Behavioral Perspective

– The Practice of Management: Integrating Organizational Process Management and Leadership Roles and Skills



• Overview– Strategic Perspective of Health Care

Management

– Health Care’s Distinctive Context and Executive Leadership Requirements



• Overview– Crossing the Quality Chasm: Distinctive

Challenges

– Developing a Standardized Knowledge Base for Professional Leadership and Health Care Managers


Behavioral Perspective of the Managerial Role

• Integrated and applied activity within a dynamic and evolving system


Mintzberg’s Managerial Roles

• Interpersonal – Figurehead– Leader– Liaison



• Informational Roles– Monitor– Disseminator– Spokesperson



• Decisional Roles– Entrepreneur– Disturbance Handler– Resource Allocator– Negotiator


Mintzberg’s Model of Management

• Person

• Frame of job

• Agenda of work


Behavioral Perspective of Managerial Styles

• Managerial Roles – Conceptual– Administrative– Interpersonal – Action



• How Managers Perform Roles– Linking– Conceiving– Leading



• Managerial Approaches to Action– Deductive – Inductive



• Management Mind-Sets – Reflective– Analytic– Worldly– Collaborative– Action


Integrating Management and Leadership Skills

• Systemic Organization Structure– Mission– Strategies, goals, and accountabilities – Production function – Strategic affiliations– Organizational culture



• Direction-Setting Processes– Learning about the organization– Framing an agenda– Aligning individuals– Framing, testing, and revising initiatives



• Negotiating and Selling Processes– Framing issues – Soliciting help and presenting proposals– Building and maintaining contacts and

communication – Building and managing coalitions



• Monitoring and Controlling Processes– Ensuring organizational operation as planned– Detect unexpected shocks and disturbances– Initiation of corrective action– Restoration of organizational equilibrium



• Work Processes– Customers– Transformations– Supply-chain systems serving customers

requiring alignment to achieve mutual support



• Work Processes– Quality control– Cost containment– Reduce cycle times



• Work Processes– Enhance operating performance– Decrease fragmentation – Improve cross-functional integration



• Organizational & Behavioral Processes– Decision making – Communication – Organizational learning



• Organizational & Change Processes– Creation– Growth – Transformation – Decline



• Organizational Management Work– Coping with complexity: good management

helps to ensure organization’s survival



• Executive Leader Roles– “Organizational system manager-in chief”’ – “Boundary spanner-in chief” – “Resource developer/investor-in chief” – “Transformation manager-in chief”


Strategic Perspective of Health Care Management Role

• Defines strategic goals for organization’s survival and growth

• Apply strategic management concepts



• Organizational Transformation– Strategic planning to manage evolution of

organization over time– Apply continuous judgment in ongoing

operations



• Strategic Transformation– Identify opportunities to develop new

competencies– Allow organization to create and experiment– Maintain sustainable competitive advantage



• Strategic Execution– Select and execute appropriate strategies to

achieve goals


Health Care’s Distinctive Context and Executive Leadership Requirements


Health Care’s Distinctive Context and Executive Leadership Requirements• Managing Clinical and Technology-Based

Production Systems– Core “production work” to provide safe,

effective, efficient clinical services


Health Care’s Distinctive Context and Executive Leadership Requirements• Managing Organizational Complexity

– Complex and strongly resource-dependent organizations

– Monitor and evaluate safety, effectiveness, and efficiency

– Intervene to improve services and ensure accountability


Health Care’s Distinctive Context and Executive Leadership Requirements• Providing Value-Oriented Leadership

– Health delivery organizations – Executive leadership


Challenges Facing Health Service Managers

• Institute of Medicine’s (IOM) Report: To Err is Human: Building a Safer Health System– 44,000–98,000 annual deaths from

preventable medical errors– Ranked as nation’s eighth-leading cause of

death



• IOM Recommendations – Design safe systems of care– Provide leadership– Respect human limits in process design



• IOM Recommendations – Promote team functioning– Anticipate the unexpected– Create a learning environment



• IOM Design Principles– Standardize and simplify equipment, supplies,

and processes– Establish team training programs– Implement non-punitive systems for reporting

and analyzing errors



• IOM Report: Crossing the Quality Chasm: A New Health System for the 21st Century

• Health care services should be safe, effective, patient-centered, timely, efficient, and equitable



• IOM Report: Crossing the Quality Chasm

• Six challenges:1) Redesign care processes

2) Use information technologies

3) Manage clinical knowledge and skills



• IOM Report: Crossing the Quality Chasm

• Six challenges:4) Develop effective teams

5) Coordinate care

6) Incorporate performance and outcome measurements throughout operations


Developing Standardized Knowledge for Leadership

• Adaptation and transformation require development of leadership competencies



• Skill Sets Managers Need to Succeed– Technical – Human relations– Team management – Facilitating and managing groups– Conceptual



• Chief Executive Officer Must – Effectively balance conflict– Effectively strategize– Adapt to change



• Competencies for Leadership Transformation– Achievement Orientation– Analytical Thinking– Community Orientation– Information Seeking



• Competencies for Leadership Transformation– Innovative Thinking– Strategic Orientation– Financial Skills



• Execution– Accountability – Change Leadership– Collaboration– Impact and Influence– Initiative– Organizational Awareness



• Execution– Performance Measurement– Information Technology Management– Communication– Process Management and Organizational

Design– Project Management



• People– Interpersonal Understanding– Professionalism– Relationship Building– Self-Confidence



• People– Self Development– Talent Development– Team Leadership– Human Resources Management



• Competency Development – Career-long action-based reflective activity– Gained through a life-long process of

experience-based reflection and growth



• Five Mind-Sets1) Reflective

2) Worldly

3) Analytical

4) Collaborative

5) Action

Managerial approach

Business

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