Management of Health Care Organizations
Management of Health Care Organizations: Assignment Week 2
Critical Reflection Paper: Chapters 4, 5 & 6.
Objective: To critically reflect your understanding of the readings and your ability to apply them to your Health care Setting.
ASSIGNMENT GUIDELINES (10%):
Students will critically evaluate the readings from Chapter 4, 5, and 6 in your textbook. This assignment is planned to help you review, appraisal, and apply the readings to your Health Care organization managing for Marketing and performance as well as become Prepared for emergencies and Structuring for Improvement of the Healthcare Organization.
You need to read the article (in the additional weekly reading resources localize in the Syllabus and also in the Lectures link) assigned for week 2 and develop a 2 page paper reflecting your understanding and capability to apply the readings to your Health Care organization managing. Each paper must be typewritten with 12-point font and double-spaced with standard margins. Follow APA format when referring to the selected articles and include a reference page.
EACH PAPER SHOULD INCLUDE THE FOLLOWING:
1. Introduction (25%) Provide a brief synopsis of the meaning (not a description) of each Chapter and articles you read, in your own words.
2. Your Critique (50%)
What is your reply to the content of the articles and the chapters?
What did you learn about Marketing Tools and techniques? How you can apply them to improve your Health Care Setting?
What did you acquire about get ready for an Emergency? How you can report an emergency using The National Incident Management System?
Did these Chapter and articles change your judgements and Opinions about Structural Contingency Theory? If so, how? If not, what remained the same?
3. Conclusion (15%)
Briefly summarize your thoughts & conclusion to your critique of the articles and Chapter you read. How did these articles and Chapters influence your opinions about Marketing Health and getting ready and prepared for Emergencies?
Evaluation will be based on how clearly you respond to the above, in particular:
a) The clarity with which you critique the articles;
b) The depth, scope, and organization of your paper; and,
c) Your conclusions, including a description of the impact of these articles and Chapters on any Health Care Setting Organization and planning.
ASSIGNMENT DUE DATE:
The assignment is to be electronically posted no later than noon on Saturday, January 18, 2020.
health care organization management
Chapter 4: Marketing
Health
Objectives
• Be familiar with traditional concepts of
marketing
• Understand frames and branding
• Know about marketing challenges and
opportunities that impact organizations that
provide health care services and public health
agencies
• Be able to integrate social media Web sites
into organizational marketing programs
Outline
•
Traditional Marketing Concepts
• Marketing Tools and Techniques
• Challenges and Opportunities
•
Marketing Principles
•
Social Media
• Systems Thinking
Traditional Marketing Concepts
• Marketing – An organized effort to plan, price,
promote, and distribute products and services
designed to satisfy the needs and desires of
consumers
• Marketing Strategy – A plan which addresses
the question of how to communicate and
promote an organization’s services within its
environment
Traditional Marketing Concepts
• Successful marketing efforts always remain
focused on consumers with the goal of
promoting products and services
– Potential Market
– Community Health Assessment
– Product mix
– Product line
Traditional Marketing Concepts
• The use of a community health assessment
will help a public health organization define
its potential market and ultimately
determine its product mix and the product
lines (which should reflect the 10 essential
services of public health identified by the
Centers of Disease Control and Prevention)
Linking Consumers with Services
• Marketing Channels (or delivery systems) are
used to deliver products or services to
consumers who want or need them.
Example: Print ads, internet, and television
• Promotional Campaigns inform, persuade, or
influence consumer decisions concerning
products or services
Promotional Campaign
4 Steps:
1) Get the consumer’s attention
2) Engage interest
3) Convince potential consumers that they
want or need the product or services being
promoted
4) Allow for the acquisition of a product or
service
Marketing Techniques
• Understand the resources, techniques
and tools for effective marketing
Framing
Branding
Framing
• Framing – A method for packaging and
positioning an issue in order to convey a
particular meaning (equivalent to a political or
journalistic ‘spin’)
– Framing leverages personal beliefs and
principles
– Framing can be used to assign
responsibility, credit, or blame
Branding
• Branding – Is a trade name or other symbol
given to a product or service which tend to be
visual reminders associated with that product
or service
Example: American Red Cross logo
– Branding can be strengthened when
programs and services are consistently of
high quality and excellent customer service
Marketing Challenges
• Limited resources (funding)
• Delayed benefits of community
health programs
• Consumers may not want or have
access to health services
• Competition has intensified for health
services providers
• Public scrutiny has increased
Marketing Principles
• Principle #1 – Needs and wants of the target
audience must be defined
– Could utilize community health assessment
• Principle #2 – Goals and objectives for the
marketing campaign are established
– Goals are broad and general, while
Objectives are specific and measurable
Marketing Principles
• Principle #3 – Develop programs that address
objectives
– Must be sensitive to cultural practices and
preferences
• Principle #4 – New promotions are tested
– Test marketing is performed on a small
sample population to identify need to
revisions or termination
Marketing Principles
• Principle #5 – Full-scale or widespread
promotion begins
– Promotions are rolled out to the entire
intended audience
• Principle #6 – Continual monitoring and
periodic evaluation of messages
– Data is collected and used to measure
progress towards objectives
Marketing Principles
• Principle #7 – Make decisions about the
future of the marketing program
– Based on the extent to which the marketing
campaign achieved its objectives and goals
the program undergoes either:
Extension
Termination (retirement)
Health Care Marketing
Opportunities
• Health care providers face competition
• Professional canons of behavior usually
limit individual health care professionals
to providing information to consumers
Public Health Marketing
Opportunities
• Public health has few competitors. This
lessens background noise that can obscure
positive marketing messages that are
intended to inform individuals about ways to
improve their health
• Not locked into a single type or form of
message
• The challenge for public health managers is to
increase the demand for programs and
services
Social Media
• Internet websites that allow for virtual yet
real-time multi-directional interaction with
various community members
• Sites were developed to provide channel of
communication for social interaction
• Examples:
– Facebook
– YouTube
Social Media Demographics
• Users of social media sites are more likely to…
1) be young (less than 25 years old)
2) be female
3) earn less than $30,000 per year
4) not have graduated from high school
5) live in urban areas
Social Media Policy
• Health organizations that plan to utilize social
media sites to promote or advertise their
services and programs should make sure to
account for the following items in their social
media policy:
– Who will coordinate the program?
– What web sites will be included?
– Who will monitor the site?
– Who will respond to postings?
Social Media Policy (continued)
– The creation of a statement of purpose,
goals, and objectives
– Language guidelines (for those who post
and respond)
– Acknowledgements of resources needed
to maintain social media site for effective
and timely interactions
Systems Thinking
• Applying ‘systems thinking’ to marketing
programs is accomplished by logically
integrating the marketing program’s
components with each other
– Reduces time needed to troubleshoot and
difficulty of troubleshooting
– Reduces time needed to frame or reframe
an issue
– Enforced through the use of branding
Chapter 5: Preparing for
Emergencies
Chapter Objectives
• Appreciate the importance of planning for
emergencies.
• Be familiar with the elements and use of the
National Response Framework and the
National Incident Management System.
• Appreciate the necessity for maintaining
communication channels during an
emergency.
Chapter Objectives
• Understand the importance of educating
members of the general public regarding
emergencies.
• Know the impact of emergencies on mental
health.
• Appreciate the importance of volunteers.
• Understand the importance of after-action
reports and other post-event activities.
Outline
•
Preparedness Planning
• The National Response Framework
• The National Incident Management System
• Using the National Incident Management
System
• Communications
•
Involvement of Hospitals
• Population Education
Outline
• Mental Health
•
Shelters
• Volunteers
•
Surveillance
•
Post-Event Activities
• After-Action Reports
• Documentation
Preparedness Planning
• Health practitioners are vital components of
the large system of emergency response.
• Responses to natural or human-made
disasters must be made in a timely manner.
• Responders must be trained in advance.
• Health practitioners can ensure preparedness
by applying the principles of assessment,
policy development, and assurance.
Components of Preparedness
• Identify essential stakeholders
– Include firefighters, police, hospitals, volunteer
agencies, health directors, and many others
– Trust, open channels of communication, and a
common plan must be built
Components of Preparedness
• Identify available resources and
establish formal agreements for their
use in an emergency
• Train staff using information and
exercises to prepare them for
response
National Response Framework
(NRF)
• The NRF specifies best practices and responsible
authorities for incidents ranging from local weather
emergencies to large-scale terrorist attacks
• Five key principles underlie the nation’s response to
emergencies:
– Engaged partnership
– Tiered response
– Scalable, flexible, and adaptable operational capabilities
– Unity of effort through unified command
– Readiness to act
The National Incident Managing
System (NIMS)
• Formal structure for coordinating and
controlling resources and activities during
emergencies
• Based on the Incident Command Structure
• Led by an Incident Manager/Commander, in
charge of operations, logistics, planning, and
finance sections.
• Uses common terminology and standard
operating procedures
Roles in NIMS
• Incident Manager/Commander: coordinates the
overall response
• Operations Section Leader: assumes direct
control of all actions focused on resolving an
emergency situation
• Logistics Section Leader: ensures that resources,
supplies, and personnel are available for
operations
• Planning Section Leader: develops guidelines to
be implemented by operations
• Finance Section Leader: establishes financial
guidelines and allocates funds
Using the NIMS
• Activated in an emergency
• Three primary goals:
1. Save and preserve life
2. Stabilize the environment
3. Protect property
• Action must be aligned with existing
emergency preparations and follow standard
operating procedures
• Decision making is a critically important skill
for incident commanders and section chiefs
Communications
• Critical in an emergency
• Multiple channels must be maintained
throughout a response
• Emergencies that disrupt infrastructure also
disrupt conventional communication techniques
such as telephones, fax, and e-mail
• Backups include: amateur radio, battery power,
and runners
• Preparing different modes of communication
before an emergency will improve response
capabilities
Involvement of Hospitals
• Integral components of the public health
system during emergencies
• Hospital capacity and occupancy data
influences evacuation, containment,
quarantine, treatment, and other decisions
• All emergency planning should include
hospitals and other care providing institutions
• An early warning system should be developed
that uses the information obtained from
hospitals and other sources
Population Education
• An integral component of any preparedness
planning
• Before an emergency occurs, messages must be
developed and transmitted to educate the
population
• A variety of methods, approaches, and
information are needed for different
communities, population subgroups, and types of
emergencies
• Delivery channels for a response should be
established and regularly reviewed
Mental Health
• Stress and problems related to mental health
are present in all emergencies
• Mental health is important for both
responders and members of the public during
and after a crisis
• Mental health professionals must be involved
in the planning and response. They should
continually adjust their methods and
messages as an emergency evolves or
continues
Shelters
• Providing shelter for affected people is a need
in most emergencies
• Shelters provide temporary housing, food,
water, clothing, sanitary services, and may
dispense antibiotics or immunizations or
providing clinical care
• Personnel, resources, and coordination are
essential
• Alternative strategy: “sheltering in place”
(bringing resources to people who stay put in
their homes)
Volunteers
• Trained volunteers can provide the additional
help when professionals are unavailable or
limited
• Must be identified, organized, trained,
credentialed, engaged, and evaluated before
an event
• The role of volunteers should be recognized
during and after a response
Surveillance
• An important component of the warning
system for a natural disaster or terrorist attack
• Vulnerable populations and potential targets
should be identified and followed
• Systems should be tested and evaluated prior
to an emergency
• Provides essential data regarding the size and
scope of the event during and after the
response
Types of Surveillance
• Syndromic Data Collection
– Uses specific codes for different symptoms related
to the nature of an emergency
– Approach currently used by hospitals,
laboratories, responders, and other organizations
• Sentinel Site Surveillance
– Routine data are automatically compared using
pre-established thresholds for diseases or
conditions of interest
– When the thresholds are exceeded, situation is
investigated
Post-Event Activities
• Concluding is almost as important as undertaking
a disaster response
• Planning should include objective criteria for the
decision to demobilize
• Demobilization: formal conclusion of a response,
but recovery operations may continue long after
• All activities should be reviewed and evaluated
• Documentation should be collected, reviewed,
and filed
After-Action Reports
• Standardized forms or formats that contain a
debriefing, an analysis, and a critique of the
plan for the response
• Essential component of all emergency
responses
• Enable organizations to identify and improve
their deficiencies
Documentation
• Gathering data, records, and assessments
concerning an incident is important and
should be ongoing
• If not done during the incident, should be
addressed as soon as possible after
• Essential from a legal perspective (can
influence future rights to compensation for
workers, volunteers, and members of the
public harmed in or by the crisis)
Chapter 6: Structuring for
Improvement
Objectives
• Understand the need to differentiate work roles
and tasks and different ways to achieve this goal.
• Appreciate the need to integrate work roles and
tasks.
• Be familiar with structural contingency theory.
• Be able to discuss different types of structures
(simple, machine bureaucracy, professional
bureaucracy, organic, and mechanistic).
• Understand structuring options that promote
organizational improvement.
Outline
• Dimensions of Organizational Structure
• Balancing Differentiation and Integration
•
Structural Contingency Theory
•
Types of Structures
• Structuring for Improvement and Value
Dimensions of Organizational
Structure
• Two dimensions of structure:
– Differentiation: the degree to which tasks and
workers are separated into different subunits.
– Integration: the degree to which seamless
coordination is achieved among subunits of a
system.
• Managers balance the need to split activities into
separate components and put them back in the
form of an integrated product.
Value of Differentiation
• Differentiation allows organizations to benefit from
specialization.
– This occurs when workers develop extensive
knowledge and experience around one particular
task or activity.
• Organizations make long-term decisions about
differentiation that are reflected in job descriptions
and the groupings of tasks and workers on an
organization chart.
– These decisions form the skeleton of an
organization or unit.
Ways to Differentiate
• Employees are typically assigned to units based
on the skill or knowledge that they bring to the
work setting.
• Example: If a clinic adds staff to handle
scheduling, billing, or custodial, the level of
differentiation increases.
• In a highly differentiated group or unit, workers’
tasks are specialized. One may clean rooms while
another stocks supplies. One may greet and
prepare customers for various services.
Who Must Worry About Integration?
• Units that are highly differentiated need to pay
attention to integration so all parts work toward a
joint goal.
• In small organizations that use routine and stable
technology, integration may not be a big issue.
• Example: the delivery of clinic services in a
community health setting calls for integrating the
activities of multiple clinical and clerical staff.
Ways to Integrate
• Aggregate all workers producing a particular
product, program, or service.
– Health care delivery facilities are often structured
around service lines such as Oncology.
– Product grouping satisfies a need to integrate
departments around a single product or service.
• Divisional groupings based on client categories
or geographic area.
– Helps organizations be more responsive to
particular groups of consumers.
Balance Differentiation and Integration
• Managers balance differentiation with
integration when structuring organizations.
• Structuring tools include
– Hierarchy
– Standardization and
Formalization
–
Centralization
– Coordinating mechanisms
Defining Hierarchy
• Hierarchy, or formal authority, divides
responsibility (differentiate) and integrates work
by holding employees accountable to higher
authorities.
• Hierarchy is illustrated by vertical relationships in
an organizational chart.
• Employees on lower levels are accountable to
managers on higher levels.
• Everyone knows who their manager is, and
everyone has one and only one supervisor.
Flat Versus Tall Hierarchies
• Flat: Few levels
– Allow for quick movement of information
and approval.
• Tall: Many levels
– Information transfer is slower and formal
approval requires more time.
Span of Control and Matrix Structure
• Span of control: The number of workers reporting to a
single manager.
– In a flat hierarchy, managers have larger spans of control.
– Tall hierarchies usually have smaller spans of control.
• Matrix structure: Employees report to two or more
supervisors.
– For example, workers may report to a departmental
supervisor as well as a supervisor of a service line.
– Matrix structures are flexible. However, employee
evaluations often create conflict. Which supervisor
completes the evaluation?
Standardization
• Standardization: degree of uniformity in
inputs, work processes, and outputs.
• Examples:
– Inputs: All workers receive the same training.
– Processes: Standardized by guidelines, rules, and
policies.
– Outputs: Dimensions of the output are specified
and defined.
Formalization
• Formalization: degree to which organizational
policies and norms are codified.
• Formalized units have many documented
procedures and policies.
• Documentation and record-keeping are
among the important responsibilities of
management.
Centralization
• Centralization: degree to which decisions and
information flow are controlled by a single
individual or unit.
• Organizations integrate procedures by
centralizing decision-making activities and
information flow.
• Decisions of a strategic nature are often
centralized at the top of the hierarchy of an
organization.
Liaisons, Committees, and Task Forces
• Coordinate activities through committees or
task forces.
• Cross-functional committees are a common
way to exchange information involving
different departments or functional areas.
• Units of organizations may appoint liaison
personnel to relate to other interdependent
groups or departments.
Structural Contingency Theory
• Structural Contingency Theory: The art and
science of structuring by making decisions about
structure within larger contexts.
• Context includes these six variables:
– Strategy
– Culture
– Technology
– Size
– Life Cycle
– Environment
Six Variables of
Structural Contingency Theory
• Strategy: Structure should match the unit’s strategy.
• Culture: Structure should match the underlying norms
and values.
• Technology: Type of technology is a determinant of
structure.
• Size: Larger size typically results in the need for greater
formalization and integration.
• Life Cycle: As organizations mature, they tend to
become increasingly inflexible.
• Environment: Environment is uncertain, defined as the
complexity and dynamism of its elements.
Types of Structures
• Structuring decisions tend to cluster because
dimensions of structure are interdependent.
• A few key concepts that usefully characterize
types of organizational structures have
emerged:
–
Simple Structures
– Bureaucracies: Machine and Professional
– Virtual, Network, and Self-organized Structures
– Mechanistic vs. Organic Structures
Simple Structures
• Simple structures: Have few levels of hierarchy
(flat), wide spans of control, and low levels of
differentiation and formalization.
• Usually has one person in charge.
• Issues of integration are relatively simple to
resolve.
• Decisions are made quickly.
• A small proportion of public health employees
work in organizations that have simple structures.
Bureaucracies
• Characterized by clear and stable differentiation,
steep hierarchies, centralized control, extensive
rules, and standardized procedures governing
performance.
• Consistency, equity, and uniformity encompass
bureaucracies
• Criticisms include being slow in responding to need
for change, tend to be rigid, self-perpetuating, and
insulated from external pressures.
• Further, bureaucracies can be alienating to workers,
customers, and clients, particularly those who are
atypical.
Machine Bureaucracies
• Machine: High degree of centralization and
extensive reliance on formal channels for
communication.
– The name reflects the fact that decisions tend to
be made by senior managers and mechanically
implemented by workers at lower levels.
Professional Bureaucracies
• Professional: Highly decentralized and
presence of a high proportion of professional
workers means that centralized control is
ineffective.
– To have influence, managers must become
facilitators, coordinators, and supporters rather
than directors of professionals.
Virtual, Network, and
Self-organized Structures
• Virtual teams, units, and organizations link
together their parts through distance
communication, typically using the Internet.
• Networks typically have few or no levels of
hierarchy and are often linked for specific
purposes and time periods.
• Self-organized teams are given an assignment,
often with a deadline, resources with which to
operate, and the autonomy to chart their path to
complete the assignment.
Mechanistic vs. Organic Structures
• Mechanistic structures exhibit low differentiation,
centralized decision-making, and high
standardization and formalization.
– This assures efficiency and consistency in
production.
• Organic structures exhibit high differentiation,
decentralized decision-making, and low
standardization and formalization.
– Integration occurs through the use of mutual
adjustment rather than centralization.
Structuring for
Improvement and Value
• Structuring decisions are highly leveraged
because their impacts are widespread and
long-lasting.
• Suggestions include:
– Encourage mutual adjustment
– Experiment with client-centered structures
– Push for more organic structures
– Use informal hierarchies and social networks
Encourage Mutual Adjustment
• Mutual adjustment achieves coordination
through continuous feedback among units.
• Each unit adjusts its activities based on
information about the activities of other units.
• Units can share information about their
activities, and understand the challenges of
others.
• Transparency and sharing are important.
• Mutual trust is critical.
Experiment with
Client-centered Structures
• Design structures on the basis of programs,
services, or product lines rather than on
professional specialty or traditional
departments.
• Involve consumers in the strategic planning
and oversight of the organization.
Push for More Organic Structures
• Theorists have argued that organic and self-
organizing structures are more appropriate for
dynamic and uncertain environments.
• Some structure is valuable even in
entrepreneurial start-up companies.
• Mature organizations may benefit from
introducing more organic structures and
experimenting with self-organization.
Use Informal Hierarchies
and Social Networks
• A formal hierarchy of authority is often not
followed, particularly if it is steep and slow to
respond.
• Employees know how to work around formal
structures to get things done.
• When formal hierarchies interfere with service
quality and delivering value to consumers, the
use of informal hierarchies and social
networks should be encouraged.