5. Organization
5
๏ Rational combination of the activities of
a number of people
๏ for the achievement of a common
purpose or goal,
๏ by division of labour and function and
๏ through a hierarchy of authority and
responsibility
6. Organizing
6
Process of
๏ grouping the necessary responsibilities
and activities into workable units,
๏ determining the lines of authority and
communication, and
๏ developing patterns of coordination
7. Structure and role
7
๏ Organization structure is to help in creating
an environment for human performance
๏ Structure must define the tasks to be done
๏ Roles must also be designed in the light of
abilities and motivation of the people
available
8. Role for people
8
๏ What people do has a definite purpose or
objective
๏ They know how their job objective fits into
group effort
๏ They have necessary authority, tools and
information to accomplish the task
๏ It is better to fit the personnel to a sound
structure rather than to sacrifice sound
structure to individual whims of personality
9. Staffing
9
๏ Involves filling, and keeping filled, the
position in the organization structure
๏ By - identifying work-force requirements,
Inventorying the people available
๏ Recruiting, selecting, placing
๏ Promoting, appraising, planning the
careers of, compensating, and training to
accomplish their task effectively and
efficiently
10. Leading
10
๏ Influencing of people so that they will
contribute to organization and group goals
๏ Has to do predominantly with the
interpersonal aspect of managing
๏ People tend to follow those who offer a
means of satisfying their own needs,
wishes, and desires
๏ Involves motivation, leadership styles and
communication
11. Controlling
11
๏ Measuring and correcting of activities of
subordinates to ensure that events
conform to plans
๏ It measures performance against goals
and plans, shows where negative
deviations exist, and, by putting in
motion action to correct deviations,
helps ensure accomplishment of plans
12. Authority relationships
12
1. Super ordination / subordination
2. Authority and responsibility
3. Scalar principle
4. Functional authority
5. Splintered authority
6. Line and staff authority
7. Span of management
13. 1. Super-ordination / Sub-ordination
13
๏ Hospital / healthcare organization is
expected to perform efficiently at all
times
๏ Distinct status differences among
organizational members
๏ Its performance through directive, quasi-
authoritarian controls
๏ Relies upon formal policies, rules and
regulations for controlling work
relationships of its members
14. 2. Authority and responsibility
14
๏ Authority must be equal to responsibility
๏ Absoluteness of responsibility โ manager
delegate authority but the ultimate
responsibility is retained by the manager
๏ decentralization of authority depends on
the mgt. philosophy of governing board,
size of the health care organization
15. Authority and power
15
๏ Power, a much broder concept than
authority,
๏ is the ability of individuals or groups to
introduce or influence the beliefs or actions
of other persons or groups
๏ Authority in organization is the right in a
position (and, through it, the right of the
person occupying the position) to exercise
discretion in making decisions affecting
others
17. 3. Scalar principle
17
๏ Individual workers are placed in a
specific authority relationship to a
superior, whose authority can be traced
from the next level of authority, up to top
level of hierarchy
๏ Chain of command- shows who reports
to who, who has authority over others
19. 4. Functional authority
19
๏ Functional status is the position held by
an individual by virtue of the kind of work
he or she performs
๏ e.g. Physicians exercise substantial
influence throughout the hospital
20. 5. Splintered authority
20
๏ There are limits on each managers
authority and greater need for
coordination at various level of
organization
21. 6. Line and staff authority
21
๏ Line refers to those positions and elements
of the organization which have
responsibility and authority and are
accountable for accomplishment of primary
objectives
e.g. direct chain of command
๏ Staff elements are those which have
advisory or service function to the line
manager in the attainment of primary
objectives
e.g. personnel or finance
22. 7. The span of management
22
๏ Number of individuals whose activities can be
coordinated and controlled effectively by one
manager
๏ Depends on :
1. nature and flow of work
2. Training and motivation of workers
3. Organizational stability
4. Dispersal of work units
5. Managerial effectiveness
6. Availability of staff specialists
23. Delegation
23
๏ How much freedom, scope and power is
entrusted to subordinates to act on behalf
of manager, utilizing the resources of the
organization and for achieving desired
result
๏ Most serious symptom of poor organization
is unclear authority delegation
24. Principles of delegation
24
1. Delegation according to ability
2. Absoluteness of responsibility
3. Parity of authority and responsibility โ
delegated authority should be
commensurate with results expected
4. Definition of results expected
5. Unity of command โ delegatee should be
responsible to one boss
6. Authority levels โ decisions within the
authority competence of an individual
should be made
25. Steps in delegation
25
1. Selecting and assigning the task
2. Selecting the appropriate subordinate
3. Instructing the subordinates
4. Maintaining feedback and control
26. Tenets of delegation
26
1. A manager cannot delegate authority
which he does not have
2. Cannot delegate all his authorities
3. Delegate only operational authority not
authority to make policy and technical
authority
4. Delegation of authority is not absolute or
permanent โ always be recalled by the
delegator
27. What should never be
delegated
27
1. The power to discipline
2. Responsibility for maintaining morale
3. Overall control
4. Crisis situation calling for urgent
solution
5. Technical task or matter
6. Custodianship of trust and confidence
29. Management barriers
29
1. Unwillingness to give subordinate a
chance (Manager feels he can do the
job better, faster)
2. Unwillingness to let subordinates make
decision
3. Fear of subordinates making mistakes
4. Unwillingness to trust subordinates
5. Unwillingness to let go power
30. Management barriers
30
6. Disinclination to develop subordinates
7. Fear of taking risks
8. Uncertainty over tasks
9. Failure to establish effective control
10.Lack of organizational skill โ confusion
about authority and responsibility
31. Subordinate barriers
31
1. Lack of aptitude for work
2. Feeling of insecurity, lack of self-
respect
3. Fear of failure, of making mistakes
4. Lack of initiative
5. Lack of experience
6. Avoidance of responsibility
32. Multiple pyramid of hospital
organization
32
๏ Governing board โ ultimate authority
๏ CEO (administrator)
๏ Charged with the responsibility for
effectively managing the admin.
components of institution
๏Delegates authority to each dept. head
in admin. component
๏ Chief of Med. service
33. Difficulties in absence of single line of
authority
33
๏ Coordination difficult
๏ apportionment of authority, responsibility and
accountability is unclear
๏ difficulties in communication
๏ Dominations:
๏ Trustee domination
๏ Medical domination
๏ Administrator domination
๏ Multiple domination
34. Committee as part of organization
34
๏ A group entrusted with dealing with a
specific problem
๏ for group decision making
๏ formal (finance or development
committee) or informal
๏ Line or staff
35. Why committees become
necessary
35
1. Group deliberation and judgment
2. Representation of varied interests
3. Coordination of department policies
and plans
4. Sharing information
5. Consolidation of splintered authority
6. Avoidance of action
36. Drawbacks of committees
36
1. High cost in time and money
2. Compromise and watering-down of
decisions
3. Indecision
4. Forcing the decisions
37. Committees are success when:
37
๏ Formally organized
๏ Have assigned specific jobs to do
๏ Have a leader acceptable to all
members
๏ Keep written records of their
deliberations
๏ Know that recommendations are
accepted
38. Effective committee management
Checklist
38
๏ Purpose and scope
๏ need
๏ size
๏ How often to meet
๏ Committee members
๏ Subject matter
๏ Committee chairman
๏ Minutes and conclusion
39. Organizational chart
39
๏ Line or scalar chart, showing each layer
of organization in sequence
๏ Line relationship
๏ Staff position ----------
๏ Master chart and supplementary chart
40. Organizational chart
40
๏ Three types : Skeleton, personal and
functional
๏ Skeleton: Merely present the major units of
the organization
๏ Personal : show in addition, the major
positions and often the names of those
persons occupying them
๏ Functional : Not only depict the major units
but also describe briefly the functions,
purposes, duties, and activities of each
41. Advantages
41
๏ It depicts major lines of decision-making and
authority - can review it to determine any
inconsistencies and complexities
๏ Orient employees as to where they fit into the
organization, where each job fits in relation to
other jobs in the department
๏ Tool for managerial audit: span of control,
crossed lines of authority
๏ Conveys information about the chain of
command, supervisory relationship, channels of
communication, and line of decision making
42. Limitations
42
๏ Important lines of informal communication
and significant informal relationships
cannot be shown
๏ become obsolete easily if not periodically
update on occurrence of change
43. Matrix organization
43
๏ The existence of both hierarchical
(vertical) coordination through
department and formal chain of
command, and simultaneously lateral
horizontal coordination across
departments
๏ e.g. cardiac emergency team
44. Types of organization
44
๏ Two types of organization: formal &
informal
๏ Formal organization: Intentional structure
of roles in a formally organized enterprise
๏ If organized well - individual performance
contribute most effectively to
organizational goals
46. Informal organization
46
๏ A network of personal and social
relations not established or required by
formal organization but arising
spontaneously as people associate with
one another
๏ Relationship not appearing on an
organization chart
48. Span of control
48
๏ The number of persons a manager can
supervise effectively
๏ Organization level Vs. span of control
๏ 4-8 subordinate at upper level of
organization
๏ 8-12 at lower level (up to 20)
๏ Depends on nature of work and
environment
50. Organization with narrow spans
50
Advantages
๏ Close supervision
๏ Close control
๏ Fast
communication
bet. subordinates
and superiors
Disadvantages
๏ Superiors tend to get
too involved in
subordinates work
๏ Many levels of mgt.
๏ High cost due to many
levels
๏ Excessive distance
bet. lowest and top
level
52. Organization with wide spans
52
Advantages
๏ Supervisors are
forced to delegate
๏ Clear policies
must be made
๏ Subordinate must
be carefully
selected
Disadvantages
๏ Tendency to
overloaded
supervisors to become
decision bottlenecks
๏ Danger of supervisors
loss of control
๏ Requires exceptional
quality of managers
53. Organizational behavior
53
๏ A field of study that investigates the impact
that individuals, groups and structure have
on behavior within organization, for the
purpose of applying such knowledge
towards improving an organizationโs
effectiveness
54. Dependent Variables of OB
Model
54
1. Productivity
2. Absenteeism
3. Turnover
4. Job Satisfaction
55. Independent Variables
55
๏ Individual level variables
๏ Biographical character (age, sex, marital
status), personality, value and attitude, ability
๏ Group level variables
๏ Group structure, gp. Decision making,
communication, other groups and inter-gp
relationship (conflict, power and politic)
๏ Organization system variables
๏ Human resource policies, cultural system,
organization structure
56. Realities of hospital organization
56
๏ There are a number of important people who
consider themselves as heads
๏ Absence of single line of authority and with two
chains of command
๏ High interdependence
๏ Timing of the movement of patients through the
system is largely controlled by chance or by a set
of un-coordinated, individual decisions
๏ Individual goals of staff coincide more with
hospital goals
57. Realities of hospital organization
57
๏ Complex work of health care has a high risk
of serious or deadly error, which necessitates
highly reliable systems of practice at all
organization level
๏ Complex technical and medical systems
demand sophisticated technical expertise,
which require educated, efficient, and well co-
ordinated workforce
๏ Authoritative and permissive, highly
formalised yet loose-knit
