Health Policy And Management

Front 1

willingness - to-pay (WTP)

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methods for valuation of payments, principle in normative economics states that the value of something is simply measured by what people are willing to pay for it

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efficacy

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maximum possible benefit, often achieved with controlled trials

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effectiveness

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the actual decrease in disease achieved when the intervention is applied over a large, non homogeneous population

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resources

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things or services used to produce services and goods that can be used to satisfy wants

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human wants

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things, services, goods, and circumstances that people desire

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economic efficiency

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the relationship between inputs and cost

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cost-effectiveness analysis

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is for ranking preferred alternatives for achieving a single goal or specified basket of benefits

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Health economics

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addresses the choices a society and its individuals make about health care

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economics

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addresses the choices a society makes about how it uses its resources

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free rider

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If an individual doesn't receive a vaccination, but all the other group members are vaccinated, the individual is called this

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ethics

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can be defined as the study of standards of conduct and moral judgment

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voluntary

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consent must be given freely, without coercion or other interference with the decision

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competent

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consent can only be given by someone who is mentally capable of knowing the nature and consequences of the decision

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bureaucrat

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public employees at all levels, it includes persons who hold managerial or supervisory positions

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leadership

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a process through which an individual attempts to intentionally influence human systems in order to accomplish a goal

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9 opperational attritbutes of leadership

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1.) leadership is a process

2.) only idividuals lead not organizations

3.) focus of leadership is on individuals or groups

4.) leadership means influencing

5.) objective of leadership is goal accomplishment

6.) leadership is intentional rather than accidental

7.) leadership is not confined to the excutive suite

8.) leadership requires a significant degree of personal courage

9.) leadership is highly situational and is dependent on the leader, organization, and environment

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5 forms of power commonly used by leaders

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1.) legitamate: comes from one's postion in the organization

2.) reward: power results from the avility to reward certain behavior by pay, etc.

3.) coercive: leaders use their ability to punish followers for not doing what the leader wants

4.) expert: derived from knowledge required by the organization

5.) referent: a.k.a. charismatic power - individuals create admiration, loyalty, and the desire to copy the actions of the leader among followersa

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according to Kurt Lewin , 3 types of leadership styles

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1.) authoritative style

2.) participative style

3.) delegative style

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authoritative style leadership

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when leaders tell their employees what they want done and how they want it accomplished, without getting the advice of their followers

ex: use on new employee who is just learning the job

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"bossing people around" leadership

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abusive, unprofessional style

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participative style leadership

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involves the leader including one or more employees in the decision-making process (determining what to do and how to do it)

ex: use when team of workers know their job

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delegative style leadership

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allows employees to make decisions, however, the leader is still responsible for the decisions that are being made

ex: use this style when worker knows more than you about the job

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authoritarian style leadership,

participative style leadership,

delegative style leadership

use all 3 combined when:

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ex: telling your employees that a procedure is not working correctly and a new noe must be established (authoritarian); asking for their ideas and input on creating a new procedure (participative); assigning tasks in order to implement the new procedure (delegative)

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Kurt Lewin catorgorized leadership behavior into 3 categories

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1.) autocratic leaders

2.) democratic leaders

3.) laissez-faire leaders

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autocratic leaders

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made decisions without the input of the members of the group

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democratic leaders

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leaders sought to make decisions on the basis of the rule of the majority

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laissez-faire leaders

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provided neither direction to group members nor interation with the group, they just let things occur

Front 28

research on behavior of leaders in industrial and military employees from Ohio State University study shows 2 behaviors

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1.) consideration: a highly considerate leader who is sensitive to people's feelings and tries to make things pleasant for the followers

2.) initiating structure: a kind of leader who is concerned with spelling out the task requirement and clarifying other aspects of the work agenda

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Blake and Mouton Leadership Grid: 2 dimensions

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the grid is set up along two dimensions:

1.) production: focus, leader behaviors are directed on accomplishing assigned objectives and tasks

2.) people: the behavior of leader is centered on enhancing the quality of manager-follower and follower-follower interactions

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Blake and Mouton Leadership Grid, 5 leader types

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1.) produce or perish leader (high production, low people) - leaders are task oriented and are hard on their workers (autocratic)

2.) team leader (high production, high people) - leaders lead by example and eneavor to foster a team environment in which all team members can reach their highest potential

3.) country club leader (low production, high people) - leaders predominatly use reward power to maintain discipline and to encourage the team to accomplish its goals

4.) impoverished leader (low production, low people) - the leaders use a "delegate and disappear" management style

5.) middle-of-the-road leader (moderate production, moderate people) - leaders who use this style are able to balance goal and task accomplishment in addition to need fulfillment of followers

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contingency model

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a combination of both trait and behavior perspectives into combined approach for leadership

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contingency model developed by Tannenbaum and Schmidt (1973): Tannenbaum and Schmidt Leadership Continuum Model

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in this model leadership behavior is viewed as a continuum ranging from boss - (leader) centered to subordinate -centered

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contingency model developed by Fred Fiedler (1967): Leadership Match Model

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Managers are unable to change their leadership style to any appreciable degree. Leadership effectiveness is dependent on selecting a situation that is the best fit for a person's style.

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Path-goal Contingency Model of Leadership by Vroom (1964)

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Based on the expectancy theory of motivation. People are motivated to do things when they expect some sort of reward for their efforts, such as bonuses.

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Attribution Theory by Mitchell, Green, & Wood (1981)

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selection of leadership style by the manager is driven by the way follower behavior is perceived and interpreted

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4 contingency models

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1.) Tannenbaum and Schmidt Leadership Continuum Model

2.) Fred Fiedler Leadership Match Model

3.) Path-goal Contingency Model of Leadership by Vroom

4.) Attribution Theory by Mitchell, Green, & Wood

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4 alternative leadership perspectives

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1.) Evidence- based leadership

2.) Servant leadership

3.) Transformational leadership

4.) Emotional Intelligence and leadership

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evidence based leadership by Kouzes and Posner, 5 similar patterns of behavior in leaders

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1.) model the way

2.) inspire a shared vision

3.) challenge the process

4.) enable others to act

5.) encourage the heart

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servant leadership by Robert Greenleaf, 2 types

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1.) servant-leader: is servant first, the natural feeling that one wants to serve, to serve first

2.) leader first: the leader has the need to assuage an unusual power drive or to acquire material possessions

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transformational leadership by James McGregor Burns (1970), has 4 components

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1.) charisma or idealized influence

2.) inspirational motivation

3.) intellectional motivation

4.) individualized consideration

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charisma or idealized influence

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involves possessing a dynamic, energetic, and commanding presence

ex: Robert F. Kennedy

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inspirational motivation

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appeals to basic values with enthusiasm and an eloquent speaking style to offer a compelling vision

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intellectual stimulation

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means inspiring people to think differently or creatively by suggesting new ways of looking at things

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individual consideration

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means paying attention to people as individuals and helping them meet their needs

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transactional leadership

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is based on simle exchange or rewarding followers for a job well done, most leadership models are said to be transactional

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4 core competencies of emotional intelligence and leadership: 1995 Dabuek Goleman

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1.) self-awareness: the ability to read one's emotions and recognize their impact while using gut feelings to guide decisions

2.) self-management: involves controlling one's emotions and impulses and adapting to changing circumstances

3.) social awareness: the ability to sense, understand, and react to others' emotions while comprehending social networks

4.) relationship management: the ability to inspire, influence, and develop others while managing conflict

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10 important attributes of servant leaders

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1.) listening receptively

2.) acceptance of others and having empathy

3.) foresight and intuition

4.) awareness and perception

5.) powers of persuasion

6.) ability to conceptualize and to communicate

7.) ability to exert a healing influence upon individuals

8.) building community in workplace

9.) practice contemplation

10.) recognize servant leadership begins with desire to change oneself

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4 things effective leaders continually do well

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1.) provide attention through vision

2.) provide meaning through communication

3.) provide trust through positioning

4.) provide deployment of self through positive self-regard

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managers

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are persons who are formally appointed to positions of authority in organizations

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line managers

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manage people and things

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staff managers

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such as the human resources department and the fiscal office, support the work of line managers

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organizational philosophy

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the ethical context in which goods and services are rendered

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management or managing has four main elements

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1.) process comprised of interrelated social and technical functions and activities

2.) that accomplishes organizational objectives

3.) achieves these objectives through use of people and other resources

4.) does so in a formal organizational setting

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5 management functions

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1.) planning

2.) organizing

3.) controlling

4.) directing

5.) staffing

all of these are connected to decision making, which is a part of problem solving

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managing

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caretaking and maintaining status quo (transactional)

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leader

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is more visionary and dynamic (transformational)

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senior managers

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use more conceptional skills

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middle and entry level managers

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use an even mix of technical, conceptual, and interpersonal skills

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Henry Mintzberg found that managers have different roles, the general categories of which include: 3

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1.) interpersonal

2.) informational

3.) decisional

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managers' competencies (have at different levels in management):

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1.) conceptual

2.) technical managerial/clinical

3.) interpersonal/collaborative

4.) political

5.) commerical

6.) governance competencies

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managers' skills: 3

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1.) technical skills

2.) conceptual skills

3.) human/interpersonal skills

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technical skills

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are the abilities of managers to use the methods, processes, and techniques of managing (such as preparing a budget or a pro forma, planning a new process, or reorganizing a workshop), technical skills tend to decrease in importance as managers become more senior

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conceptual skills

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are the mental ability to see how various factors in a given situation fit together and interact, seeing second and third order consequences of decisions and nondecisions is especially important, the need to conceptualize skills increases significantly as managers become more senior

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human/interpersonal skills

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include cooperating with others, understanding them, and motivating and leading them in the workplace, human relations skills tend to become less important as managers become more senior

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roles managers engage in: 6

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1.) interpersonal

2.) informational

3.) decision making (entrepreneur, resource allocator, and negotiator)

4.) designer

5.) strategist

6.) leader role

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conceptual competence

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middle and entry level managers use competence to understand how their work fits into the larger organization, as well as interrelationships in their areas of responsibilities, senior managers use their ability to conceptualize to predict consequences of decisions and nondecisions

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technical managerial/clinical competency

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enable managers to perform the work of management, as well as understand and more effectively direct the work in the units for which they are responsible, managers without a clinical or technical background must make a determined and persistent effort to understand the basics of specialized activities in their areas of responsibility, as well as in the organization generally

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interpersonal/collaborative competency

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requires that managers have a good interpersonal and collaborative skills so as to effectively lead or direct others, these skills enable the manager to instill a common vision, stimulate a dtermination to pursue the vision, and meet the objectives that are part of the vision

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political competency

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means senior level managers must understand and be able to work with the political processes of local, state, and even federal government, effective application of this competency is key to meeting the health needs of the community, the position and technical knowledge held by senior managers enables them to influence the legislative and rule making (regulatory) processes

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commercial competency

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and economic success require that organizations create economic exchanges that offer value to those involved, managers must establish and maintain an environment that facilitates these economic exchanges, this necessitates these economic exchanges, this necessitates a businesslike orientation for basic operation, but with humanitarian and Samaritan overlay, many not-for-profit and government organizations fall prey to an overemphasis on doing good and neglect to manage in a business like fashion

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governance competence

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means working with the governing body to establish a vision, assemble resources, lead the organization, and ensure accountability to stakeholders, these efforts require that senior managers interact effectively with members of the governing body, the governing body determines the right thing (direction) for the organization, management determines the right way to achieve it, many chief excutive officers (CEOs) are voting members of their governing bodies or if not, they attend governing body meetings and sit on its committee, regardless, they interact with governing body members in various settings and in a variety of ways

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legitimate power

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formal

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leader traits: 4

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1.) assertive

2.) cooperative

3.) decisive

4.) dependable

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leader skills: 4

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1.) intelligent

2.) conceptually skilled

3.) creative

4.) persuasive

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Renis Likert - continuum of leadership effectiveness spans: 4

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1.) autocratic

2.) benevolent

3.) consultative

4.) participative/democratic

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situational or contingency theory

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an approach asserting traits, behaviors, and styles are inadequate to explain the success of leaders

hypothesis: certain actions or responses (behavior/styles) in some situations lead to success, while their use in other situations causes failures

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interrelationships of decision making and the five management functions

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1.) planning - the first step in managing, managers at all levels plan, planning establishes objectives, although the focus, context, and terms are different

2.) organizing - develops intentional patterns of relationships among staff and other resources in the health service organization (HSO) to achieve these objectives, departmentation results from organizational design

3.) staffing - managers may give little thought to human resources until there is a problem with staffing, which includes acquiring, maintaining, and retaining human capital in the organization, staffing is technical (planning, job analysis, performance evaluation, compensation, and benefits) and social (training, promotion, and counseling)

4.) directing - occurs when managers initiate action, effectively directing depends on being able to lead, motivate, and communicate with staff for whom one is accountable, ability to motivate is linked to having a shared vision

5.) controlling - at root managers control by comparing actual with desired output and making adjustments, controlling is directly linked to planning, controlling has four steps: setting standards, measuring performance, comparing actual with expected results, and acting to correct deviations

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middle and senior level managers spend most of their time

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problem solving

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problem solving includes 6 steps

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1.) problem identification

2.) making assumptions

3.) developing tentative alternative solutions

4.) selecting alternatives

5.) implementing solution

6.) evaluating results

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problem analysis: 2 steps

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1.) divided into problem recognition and definition

2.) developing a problem statement

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problem recognition and definition

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occurs when actual results are inconsistent with desired results

example of desired results:

1.) organizationwide objectives, such as quality service

2.) program objectives, such as increasing customer satisfaction

3.) improving the performance of an employee

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problem recognition occurs in 3 stages

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1.) gestational/latency - in which some cue or triggering event indicates a potential problem

2.) categorization -managers become aware that something is wrong, but cannot clearly describe it

3.) diagnosis - efforts to obtain the info that will provide greater certainty in problem definition

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problem statement

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puts what is learned during the definition stage into a brief description of the problem to be solved

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good problem statements have 4 parts

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1.) an invitational stem

2.) an ownership component

3.) an action component

4.) a goal component

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divergent

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means thinking in different directions or searching for a variety of answers to a question that may have many right answers

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amorphous

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lack specificity

ex: organizational malaise or morale problems are amorphous

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iterative problem solving is also known as

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heuristic problem solving

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facts and reasoning

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a fact can be defined as an actuality, certainity, reality, or truth

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inductive reasoning

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moves from the single event or fact to a conclusion or or a generalization based on that event or fact

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deductive reasoning

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uses the facts of related or similar events to reach a conclusion

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once facts have been identified, two other issues arise:

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1.) one is the weight to be given to them

2.) a second issue is that facts are subject to judgment and interpretation

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circumstantial evidence is based on

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inferences (deductions) that are drawn from facts

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hearsay

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refers to words attributed to a third party

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assertions

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may be based on fact, hearsay, or rumor, they may also be called judgments or conclusions

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developing assumptions

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the problem statement developed in the problem analysis (1) allows the next step, developing assumptions, (2) assumptions never supersede facts

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assumptions are of three types

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1.) structural

2.) personal

3.) problem centered

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structural assumptions

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relate to the context of the problem - they are boundary assumptions: the problem lies within (or outside) a manger's authority

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personal assumptions

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are conclusions and biases that decision makers bring to the problem, often they are based on experience

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anchoring

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occurs when the individual chooses a starting point (an anchor), perhaps from past data, and then adjusts from the anchor based on new info

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sunk-cost trap

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the tendency of decision makers to make decisions in a way that justifies past choices, meaning that old investments of time and resources cannot be recovered, but further committments are made because it is so difficult for managers to admit past mistakes

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problem-centered assumptions

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cover a wide range, including perceived relative importance of the problem, degree of risk posed by the problem, and how urgently a solution is needed, other problem-centered assumptions include economic and political costs and benefits, the degree to which subordinates or superiors will accept solutions, and the likelihood of success if a solution is implemented

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assumptions differ in at least two ways

Back 102

1.) qualitatively

2.) in the amount of control that decision makers have over them, ex: structural assumptions that no funds are available to solve a problem profoundly affects the solutions that can be considered

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identifying tentative alternative solutions

Back 103

once the manager has recognized, defined, and anaylzed the problem, established its cause and parameters, prepared a problem statement, (1) made assumptions, (2) tentative alternative solutions are developed, (3) collect data and evaluate merits of alternatives for an initial accept/reject decision

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creativity

Back 104

defined as imagination and ingenuity and should be distinguished from innovation

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innovation

Back 105

defined as changing or transforming

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ready made tactics

Back 106

assume that organizations have a store of fully developed solutions - a situation in which solutions wait for problems

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search tactics

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identify solutions from available ideas, proposals are elicited and compared to identify solutions that seem viable

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design tactics

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seeks a custom-made solution - an opportunity for creativity

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developing and applying decision criteria

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the alternatives that met the general criteria applied in the tentative alternative solution loops are now ready for formal assessment

decison criteria include those in the desired outcomes: individual and organizational work results, objectives, standards, and expectations

at least three other decision criteria are usually applied: effectiveness of the alternative in solving the problem, feasibility of implementation, and acceptability of the alternative based on objective and subjective analyses

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selecting, implementing, and evaluating the alternative solution

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a manager selects an alternative (makes a decision), this does not end the problem solving process, implementation and evaluation must be planned, the effects of the intervention change, that has been implemented must be evaluated to determine that they are consistent with desired results, the problem has been resolved

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integral

Back 111

built in

Front 112

Max Weber

Back 112

was first to develop a theory about bureaucracy, which in its pure form was said to be the ideal and most rational form of organizing

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Henri Fayol

Back 113

identified 14 principles that are essential to management, they are intuitive and rational, yet they are often violated

ex: division of work, authority, unity of command, scalar chain, and equity

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Niccolo Machiavelli

Back 114

he discussed the risks of being loved by subordinates, versus being feared by them, as well as the risks of being generous in payment gifts

Front 115

Division of Work by Adam Smith

Back 115

it suggests the importance of specializing as a means of making workers more proficient and efficient

Front 116

Authority and Responsiblity Relationships

Back 116

authority is the power derived from someone's position in an organization, and someone responsible for certain functions or certain results must have sufficient authority or power to achieve them

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departmentation

Back 117

results from the organizations need to specialize and the division of labor that specialization produces

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span of control

Back 118

there are inherent limits to the number of subordinates that can be effectively supervised, smaller (narrower) spans of control result in taller organizations, larger (longer) spans of control result in flatter organizations

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coordination by Chester Barnard

Back 119

quality of coordination is crucial factor in survival of organization

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contemporary theorist by Peter Drucker

Back 120

wrote about managers, management, and organizations, and conceptual framework for contemporary management theory, this theory says there may be charismatic leaders, but they are too few in number to make a difference, his views are on the traits of leaders and personalities

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contemporary theorist W. Edwards Deming

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philosophy is customer driven and has the goal of meeting and exceeding customer's preferences, his 14 points of management focus on how organizations achieve quality

Front 122

strategic planning

Back 122

addresses the longer term direction and goals selected by the organization through its governance and managemenet in order to accomplish its goals

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strategic issues management (SIM)

Back 123

is a systematic process that proactively seeks to influence the external environment to make it more favorable to the organization rather than reacting to events after they occur

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opperational planning

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focuses on the direction and activities of individual units and departments of the organization

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contingency planning

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seeks to predict the events that will affect the organizations ability to meet its mission, mitigates their potential negative implications, and if possible turns them into a public relations or political advantage

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managers as negotiators

Back 126

the art of negotiating or bargaining applies to all internal and external transactions in which the parties decide what they will give and what they want to get

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negotiation

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characterized as win-win (cooperative) in which both parties benefit or win-lose (competitive) if one party prevails at the expense of the other

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two sources of conflict in negotiation

Back 128

1.) how the resources will be divided - the money, goods, or services

2.) resolving the psychological dynamics and satisfying the personal motivations of the negotiators in the organizations involved

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nonjudicial means of resolving disputes

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the methods used to settle disputes other than by recourse to the legal system are known as alternative dispute resolution (ADR)

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mediators

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are neutrals who work with the parties to achieve a resolution of the dispute that is acceptable to them, they have no authority to impose a settlemement, but use various techniques and persuasion to move the parties to a point where the dispute can be settled

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arbitrators

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are neutrals who are appointed pursuant to a contract signed by the parties to a dispute, the contract states that the parties will abide by the decision of the arbitrator

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public health managers are expected to use

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politics and power to achieve organizational goals

Front 133

is a key to organziational success

Back 133

management style

Front 134

successful managers have a clearly identified

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personal ethic, which they are willing to share through word and deed

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timing - change without crises is a hallmark of

Back 135

good management, effective managers identify issues far enough in advance to avoid a crises

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staff is made up of

Back 136

clinical professionals, clerical staff, community volunteers, , and university interns

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informal groups

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are created to fill some sort of social or personal interest or need

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formal groups have the following characteristics:

Back 138

they have boundaries (generally written policies and procedures, rules, and regulations, or formal bylaws), they have distinct member roles, there are specific tasks that are performed and measured, and they operate within a specific organizational context

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leadership in teams

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is frequently seen as the ability to influence others toward the achievement of a particular goal or task

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model of team effectiveness consist of: 5 items

Back 140

1.) team characteristics - composition, size, status differences, pshychological safety, team norms, team cohesiveness

2.) nature of task - team goals, task interdependence

3.) environmental contest - intergroup relationships and conflict, organizational culture, external environment

All of the above items lead to:

4.) team processes - leadership; communication: networks, interaction patterns; decision-making, learning, stages of team: development

This leads to:

5.) team effectiveness - performance, member satisfaction, quality of work, capacity for sustainability

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communication networks and interaction patterns

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crucial elements of team processes, without workable communication structures, important info may be lost or inaccurately communicated

Front 142

redundant communication

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is critical to reducing misunderstanding and making sure everyoone is hearing the same thing

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maintenance behaviors in teams

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are activities in teams that enhance interpersonal relationships and lead to open communication, support for team members, and confilct reduction

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task behaviors in teams

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those activities that relate specifically to completing the task at hand

Front 145

decison making in teams is frequently a cause of significant

Back 145

intergroup conflict, particularly how decisions are being made

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paralysis by analysis

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the unwillingness/inability to make a decision because there is always more data that can be collected and additional analysis that can be performed

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free-rider effect

Back 147

this is the person who obtains the benefits of group membership but does not accept a proportional share of the costs of membership

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groupthink

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where a team prematurely moves to a poor decision, when the desire for harmony and consensus overrides the rational efforts of the members to think clearly about a situation

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group learning

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takes place when the collective skills, talents, and insights of the group come together in a way that allows the larger group to learn from its members and its environment in a way not available to individual members

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development process includes: 5 stages

Back 150

1.) forming - the stage where team members get to know one another and the purpose of the team

2.) storming - the stage where the team is frequently in conflict, as members try to influence norms, roles, and procedures

3.) norming - teams at this stage are growing in cohesiveness and purpose as agreement on roles, expectations, and decision making take place

4.) performing - the team is most productive at this stage, where they move forward toward the accomplishment of agreed upon goals and objectives

5.) adjourning - this is the stage at which temporary teams wrap up their work and disband

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status differences

Back 151

can have an important effect on team members and their interaction with one another

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psychological safety

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is a measure of the willingness of team members to take interpersonal risks and the beliefs they hold about the consequences of those risks, particularly when others disagree

Front 153

team norms

Back 153

are powerful influences on the behavior of individuals and groups

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team cohesiveness

Back 154

a function of the extent to which team members are committed to the task of the group

Front 155

Fried Model of team characteristics: 5

Back 155

1.) composition

2.) status differences

3.) psychological safety

4.) team norms

5.) team cohesiveness

Front 156

composition of teams: 4 items

Back 156

1.) adequate staff and diversity

2.) expertise required to perform well

3.) members too similar or too dissimilar

4.) has team worked together before

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team goals and accompanying tasks can be catorgized according to

Back 157

goal clarity, complexity, and diversity

Front 158

task interdependence

Back 158

a form of task diversity and speaks to the degree to which team members need to depend on one another in order to accomplish the task

Front 159

environmental context

Back 159

is mediated by intergroup relationships and conflict, organizational culture, and the external environment itself

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intergroup conflict

Back 160

the conflict that arises when different teams are at odds with one another as opposed to the conflict that exists between or among members of a single team

Front 161

Fried suggest strategies for teams to work effectively together: 4 items

Back 161

1.) intergroup training, team-building

2.) structure relationship between teams around mutually important goals

3.) examine how teams interact to determine sources of conflict

4.) reorganize teams into new groups that can work independently of one another

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organizational culture

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is one of the most frequently voiced complaints about why teams fail to work as needed

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external environment

Back 163

it can sometimes be more important than the internal environment, ex: funding to support the activities of the organization, the ability to create and sustain these relationships is important

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Principles of Organization Design: 4 items

Back 164

1.) organization is never static - it is always changing

2.) allow a particular organization design to be in place so that you can evaluate whether or not it is most appropriate

3.) change in leadership, shifting organizational goals, changes in financial condition might dictate a particular design

4.) the design process is a core part of management activities and must take into account authority, responsibility, accountability, and resources

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5 parts to an organization

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1.) strategic apex - senior leadership

2.) operating core - these are people who do the fundamental work of the organization

3.) middle-line - the people who connect the strategic apex with the operating core - department managers

4.) technostructure - the technical staff whose work is required but is not central to operations

5.) support staff - these people directly support the work of those in the operating core

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for Mintzberg, ideologies represent the collection of

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beliefs, culture, norms, and values that inform the work of everyone in the organization

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Mintzberg, ideologies can be arranged into 5 basic organizational forms

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1.) simple structure: this structure is a start up, entrepreneurial organizations - only strategic apex exists

2.) machine bureaucracy: organizational design in which standardization of work is absolutely required

3.) professional bureaucracy: this organization values standardization of work, but the focus is on the professional workers who occupy the operating core

4.) divisionalized form: this organizational arrangement takes multiple machine or professional bureaucracies and controls them under a single ownership structure

5.) adhocracy: these are temporary organizations that come together for a particular purpose and then dissolve

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factors influencing organizational form: 6

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1.) mission

2,) environment

3.) organization

4.) culture

5.) human resources

6.) politics

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mission

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statement of organization's purpose or reason for being

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environment

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one of the activities all smart and strategic organizations perform on a routine basis is an external environmental assessment, what is going on outside of the organization that affects its effectiveness, such as technology, legal and regulatory requirements, community demographics, worker supply and demand, competitors

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organization

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where the environmental assessment is external in nature, the organization assessment is more internally focused. ex: SWOT analysis: strengths, weaknesses, opportunities, and threats

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culture

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the system of shared norms, beliefs, and behaviors that govern the activities of the members of the group

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human resources

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people who will be asked to populate the organization

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politics

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formal structures, reporting relationships, and methods are distinct political realities that mediate organizational effectiveness

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forms of organization design

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core principles of design and redesign, ex: Charnes and Tewksbury say there are 5 organization designs of increasing level of integration by program: functional, divisional, matrix, parallel, and program

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functional

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clear linear hierarchy of departments and reporting relationships

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divisional

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in more complex organizations, it makes sense to group functions around divisions, each of which is responsible for its own administrative operations

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matrix

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an attempt to overcome the problems of functional and divisional designs, in this case functional and program or product line managers are jointly responsible for specific activities, one clear concern is that workers below the managerial level have two bosses instead of just one and is expensive in terms of personnel costs and multiple accountability systems

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parallel

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the ideal state is to allow person to better manage and respond to both internal and external environmental changes

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program

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sometimes called product/service line management - places a single person in charge of all aspects of a given product/service or group of products/services

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organizational design summary

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a dynamic process that depends on public health leaders who are willing to change the ways they have done things in the past, who are aware of strong and weak signals in their environments, and who have the vision to see the sort of design that is the best fit for the current and near term conditions of their organziation

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governance and management

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the legal authority for the organization resides with tghe governing board and not with your or your staff