Anda di halaman 1dari 13

Fundamentals of Management in Health

Edmunda Bunoan-Rillon, GN, BSN, MHA, CGSC

INTRODUCTION
Up to this time, there seem to be a bit of confusion in the understanding of the terms, administration, and management. To some, administration deals with just the implementation of policies and the formulation of guidelines. Management on the other hand deals with the formulation of said policies as well as its implementation. Others look at administration as the function of people at the top level of organi ation while management is the function of people at the middle level of the hierarch!. "dding further to the confusion, the term leadership is meant to be the breathing of life in the organi ation b! inspiring the emplo!ees or staff. #owever, a more critical anal!sis of the terms reveals reveal that both administration and management have the same functions in an organi ation with no differentiation. $oth re%uire leadership as a necessar! ingredient in the common goal of directing an organi ation towards the achievement of its goals and objectives. "s far as we are concerned, managers, e&ecutives, administrators, supervisors, all perform management.

OBJECTIVES
After finishing this chapter, you should e a le to! 1) clarify the meaning of management in the health field; 2) explain the management processes and functions; 3) discuss Fayols principles of management; 4) compare and contrast the roles, functions and competencies of managers at the organizational hierarchy; and
'(

analyze how the arious management schools of thoughts affect todays organizations!

!" M#N#$EMENT DEFINED Its Natu%e and &u%'ose There are man! wa!s of defining management depending on the criteria used in looking at it. Management could be a '%o(ess, an a%t and a s(ien(e, a (lass of 'eo'le, or a %esou%(e )*eve! and *oomba+ ,-./(. 0t creates and controls change, and it is a universal activit!. 0t is a '%o(ess" "s a process, it is the series of s!stematic, se%uential or overlapping steps in designing and maintaining an environment, in which individuals working together in the group,group efficientl! accomplishes selected aims.
1/

2imultaneousl!, it involves the judicious use of resources, motivation of people, provision of leadership planning, and controlling an organi ation towards achievement of goals. The resources referred to are the human resources ) "#$man(, materials, mone! )funds( and methods. )%hese are commonly &nown as the 4 "s in management (. "s a process, it has three )3( important features+ dimension of time thus it is d!namic4 integrates efforts of a group4 and re%uires skill for conflict resolution.

%his 'asic definition can 'e expanded to mean( ,. Managers carr! out the managerial functions of planning, organi ing, staffing, leading, and controlling. 1. Management applies to an! kind of organi ation. 3. 0t applies to managers at all levels of the organi ation. /. The aim of all managers is to create a surplus. '. Managing is concerned with productivit!, which implies effectiveness and efficienc!. "ll s!stems re%uire management for effective and efficient performance. 0t is a '%ofession. 2kills in designing, instituting and controlling the process of management can be taught and learned thus management evolved as a profession. Universities toda! now offer degrees in management and some programs like health administration re%uire management courses. 0ts formal stud! includes discussions of the theories and practice of management. 0t is an a%t. Management can also be viewed as an art of getting things done through people. Management problems could also be solved thru individual st!les based on creativit!, judgment, intuition, and e&perience rather than the s!stematic methods of science. " good manager is one who can arrange person to task, person to person, getting things done at the right time and place and proper timing of decisions. 0t is a s(ien(e. " substantial portion of management can be accomplished thru the scientific method+ empirical measurement of data, causal links among phenomena, logical organi ational structure, and conclusions that can be validated e&perimentall!, etc. 0t is interdisciplinar!, drawing its strengths from the various disciplines as the focus of management is both ph!sical and human. 0t is a %esou%(e. Management is in itself a resource, together with capital, materials, and labor. The knowledge and practice of good management is in itself a wise investment in an organi ation. Upon it depends the success or failure of an enterprise. 0t is an elite or (lass of 'eo'le. 0n this sense, management is that group within an organi ation that has the legal authorit! to direct and control the organi ation. )" THE $O#*S OF OR$#NI+#TIONS #ND M#N#$ERS
1'

0t is often said that the aim of business managers is simpl! to make profit. $ut profit is reall! a measure of surplus. 5or man! firms, an important goal is the long6term increase in common stocks. 0n all kinds of organi ations, business or non6business, the logical and publicl! desirable aim is to create surplus. 0n health service organi ations, the goal is to provide affordable, appropriate and high %ualit! service in a manner that favorable health6related outcomes are achieved. 0t is not enough that health service is provided but that kind of service should be of high %ualit!, . 0t is affordable, appropriate, accessible )reaching out to more people(, effective, efficient, and customer satisf!ing for both the customers and , the health providers included. 7ualit! service is the e%uivalent of that surplus in production in the business sector that redounds to profit. Thus managers in an! kind of organi ation must establish an environment in which people can accomplish group goals with the least amount of time, mone!, materials, and personnel dissatisfaction or to accomplish as much as possible with available resources. ," FUNCTIONS OF M#N#$EMENT The real father of modern operational management theor! is #enri 5a!ol. 0n ,-,8, he wrote that the functions of a manager are to plan, organi e, command, coordinate, and control )in 5rench, pre oir, organise, commander, coordoner, et controler(. These functions are often modified, however the original list of 5a!ol remains as the basic outline for management functions. 2ome authors want to be more detailed, while others combine the functions in one entit!. Thus, the functions of management could be presented in an! of the following+ 9lanning 0mplementing :valuation 9lanning Organi ing "ctuating :valuating &IE 9lanning Organi ing 2taffing ;irecting <oordination =eporting $udgeting :valuation 9lanning Management

&OSDCORBE

&O#E

9lanning Organi ing Managing "ppraisal and control

&M

&OM#

9lanning Organi ing *eading <ontrolling :valuating

&O*CE

18

&lanning is the formulation of the steps to be taken b! an agenc! at some future time. 0t involves an anal!sis of both the internal and e&ternal conditions of the agenc! before coming out with the set of objectives the organi ation would like to achieve. 9lanning also includes the formulation of strategies and the other re%uirements needed in the accomplishment of goals thus a budget is also accomplished. O%gani-ing is concerned with the division of labor and corresponding assignment of duties and the establishment of lines of authorit! and of communication. "ctivities are anal! ed and the appropriate groupings of said activities are determined. =esponsibilit! for each group of activit! and corresponding authorit! is then assigned. =elationships of the different activit! groups are then identified and line of communications are established. Di%e(ting. This function initiates and maintains actions towards the objectives of the organi ation. :ffective directing re%uires delegation, communication, training and motivation. 5or better acceptance, the term has been changed to leading not directing. *eading is influencing people so that the! will contribute to group goals. Coo%dinating. <losel! related with the directing process is the orchestration of all the activities into the whole scheme of operation. <oordination begins b! seeing to it that all parts of the organi ation are bound together b! common goals and objectives. >hen the organi ation is alread! in operation, coordination is done through conferences, reports and supervision. Monito%ing and Cont%ol. Monitoring means keeping tract of the work being done and seeing to it that it is done in accordance with the %ualit! and other specifications set in the plan. The latter refers to controlling. 0t is greatl! dependent on the feedback mechanism thru an established information s!stem. " plan of work with the appropriate indicators indicating progress in time is a useful tool in monitoring. <ontrol activities relate to measurement of achievement. Means of control are budget for e&pense inspection records, and record of labor hours cost. E.aluating. This function is a s!stematic wa! of learning from e&perience and using the lessons learned to improve current and future activities. 0ts basic concern is to improve health programs and structures in the deliver! of health.
/.

$ENER#* &RINCI&*ES OF M#N#$EMENT /Fa0ol1s &%in(i'le2

9rinciples of management are fundamental truths e&plaining relationship between two or more sets of variables. The! are descriptive or predictive but not prescriptive. 5a!ol listed ,/ principles, which are usable regardless of changing and special conditions. ,( "rinciple of unity of command ? :mplo!ees should receive orders from one superior onl!. The more often the individual reports to a single superior, the more likel! that the individual will feel sense of lo!alt! and obligation and the less likel! that there will be confusion about instruction. This principle helps establish well defined, channels of authorit!.

1@

1( #i$ision of %or& ? This is the speciali ation that economists consider necessar! for efficienc! in the use of labor e.g., the assembl! line. 0n dividing the work though, the e&ception principle is considered. "ll possible work and decisions should be divided among subordinates leaving onl! the e&ceptional work and decisions to be handled b! the supervisor. 3( Authority and responsi ility ? 5a!ol finds the two related with responsibilit! arising from authorit!. "uthorit! is derived from position, and personal factors like intelligence, e&perience, moral factors, past service, etc. /( #iscipline ? 0t is the respect for agreements, which are directed at achieving obedience, application, energ!, and the outward marks of respect. 5a!ol sa!s that discipline re%uires good supervisors at all levels. '( 'nity of #irection ? This principle sa!s that each group of activities with the same objectives must have one head and one plan. 8( Su ordination of indi$idual to general interest ? >hen the two are different, management must reconcile them. @( RemunerationRenumeration ? 9a! and methods of pa!ment should be fair and afford the ma&imum satisfaction to emplo!ees and emplo!er. .( Centrali(ation ? 5a!ol refers to the e&tent to which authorit! is concentrated or dispersed. -( Scalar Chain ? There is a chain of superiors from the highest to the lowest. 0t should not be needlessl! broken but can be circuited if to follow it scrupulousl! would be detrimental. ,A( )rder ? 5a!ol follows the simple adage a place for ever!thing )ever!one(, and ever!thing )ever!one( in its )his( place. ,,( E*uity ? *o!alt! and devotion should be elicited from personnel b! a combination of kindness and justice on the part of managers. ,1( Sta ility of +enure ? 5a!ol finds unnecessar! turnovers to be both the cause and effect of management. ,3( ,nitiati$e ? 0t is the thinking out and e&ecution of a plan. 5a!ol e&horts managers to sacrifice vanit! to allow subordinates e&ercise it. ,/( Esprit Espirit de Corps ? 0n union there is strength. 0t is also an e&tension of the principles of unit! of command and emphasi ing teamwork and communication.

1.

3" M#N#$ERI#*

FUNCTIONS

#T

DIFFERENT

OR$#NI+#TION#*

*EVE*S There are various managerial levels in an organi ation. "t an! level of hierarch! in the organi ation, someone is given responsibilit! for the work at that level. #e is also given authorit! to accomplish the given responsibilit!. The fi%st line management or sometimes called,called o'e%ational management deals directl! with unit functions. The people in charge at this level are sometimes called unit head, supervisor or foreman. <oncern of management at this level are technical leadership to workers in the unit, thus manager has to be technicall! competent+ guidance, training, %ualit! control, and communication between rank and file and middle and top management. Middle management is between the first line management and top management. Management at this level interprets policies, strategies and broad directives. Much of the time of middle managers is spent on communicating between the first and top levels of management. To' *e.el Management is responsible for charting the direction of the agenc! and in formulating approaches to be adopted. "ll managers at the different organi ational levels carr! out the managerial functions as previousl! discussed. #owever, time spent for each function ma! var!. Top6level managers spend more time on planning and organi ing than do lower6level managers. *eading, takes a great deal of time at the operational level although in modern corporations of toda!, it has been found that leadership functions at top level management has greatl! increased. Time and scope spent on controlling does not var! much among managers at various levels. 5igure 3., illustrates the point.

E V A L U A T I N G

R G A N I Z I N

L E A D I N G

O N T R O L L I N G

Top Middle

L A N N I N G

Operational

-igure ./0/ Managerial -unctions of the )rgani(ational Hierarchy


1-

4" M#N#$ERI#* S5I**S

<orollar! to the different functions manager has to do, he has to have the necessar! skills to do so. =obert Bat + ),-@/( identified three kinds of management skills, and >eihrich and Boont + ),--3( added one more on the abilit! to solve problems. These are+ ,. +echnical s&ills. This refers to knowledge proficienc! in activities involving methods, processes, and procedures. Thus mechanics work with tools and their supervisors should know how to teach them use such tools. 1. Human s&ills. 0t is the abilit! to work with people4 its cooperative effortCteamwork4 itDs the creation of an environment in which people feel secure and wanted. 3. Conceptual s&ills. This is the abilit! to see the big picture, to recogni e significant elements in a situation, and to understand the relationships among elements. /. #esign s&ills. 0t is the abilit! to solve problems in a wa! that will benefit the enterprise. Managers must not onl! be able to see the problem but must also be able to design a workable realistic solution. "gain, the re%uirement of these skills var! at the various levels of management. "s shown in 5igure 3.1, technical skills are greatest at the operational level. #uman skills re%uirement is the same throughout4 and conceptual and designs skills are especiall! ver! critical and valuable at the top. T
CON

Top

E C H

S K I L L S

HU MA N

S K I L L S

CEP TUA L

DES S I K L L S GN I

Middle

N I C A

Operational

-igure ./1/ Managerial S&ills

3A

6" M#N#$ERI#* RO*ES Mint berg ),-@'( sa!s that the functions of management do not shed sufficient light on the actual activities of managers. 0nstead he offers ,A basic roles of managers that highlight actual management work which can be subsumed under 3 basic categori ation. These are+ Inte%'e%sonal Roles The figurehead role The leader role The liaison role Info%mation Roles The monitor role The dissemination role The spokesman role De(isional Roles The entrepreneur role The disturbance handler role =esource allocator 9erformance of ceremonial duties ;irect involvement to approve decisions and choose a management team ;ealing with outside people =eceipt and sending of information for control purposes 2haring of information 2peaks for his department 0nvolvement with constant addition or deletion of projects. ;evelops and promotes new projects and insures viabilit!. "ttention to problems arising out of strikes, bankruptcies, and interference ;etermines how much of the units total financial, personnel, suppl! and e%uipment resources will be allocated to the departments and when will these be available. =anges from negotiation of an argument to negotiation of a labor contract

The negotiator role

7" SCHOO*S OF M#N#$EMENT THOU$HTS 0t is well to note that points of view differ among the schools of thoughts because of the demands of the time when these thoughts came into prominence. Eou ma! select one or mi& them together to match with the needs of time in order to create !our own management st!le. These management theories can be classified under five major headings+ ,( 1( 3( /( '( 2cientific management "dministrative management #uman relations $ehavioral science Management science

3,

7"!"

S(ientifi( Management

The thrust of this movement was to achieve speciali ation in terms of work, the worker, and management. 0t believes that all tasks can and should be anal! ed b! the methods of scientific e&perimentation+ observation, data collection, h!pothesis formulation, testing, and implementation. The works of F%ed%i(8 Ta0lo% who is known as the founder of management science together with his associates, center on wa!s to increase the efficienc! or productivit! of workers in the ,.-ADs. The famous #awthorne studies of the >estern :lectric <ompan! revealed that the human factors like workersD attitudes and the effects of informal groups were an important influence on worker output. Ta!lor conducted time stud! e&periments and developed the concept of functional organi ation4 F%an8 $il9%eth is remembered for his time motion studies4 and Hen%0 $antt is known for his control charts and task and bonus s!stem. 7")" #dminist%ati.e Management

The administrative school concentrated on the %uestions of departmentali ation, coordination, and organi ation. "ssociated mostl! with the name of Hen%0 Fa0ol, this school of thought differed mainl! from the scientific management school in two ke! areas+ its premises were derived mainl! from common sense and e&perience rather than from e&perimentation and attention was refocused from specific situation toward a set of operating principles ? thus two sets of operating principles were advanced+ unit! of command and the scalar chain. 7"," S(hool of Human Relations

The human relations school represents the first large scale attempt to anal! e the relationship between human factors and productivit!. Ma%0 &a%8e% Follet recogni ed that individual and group motivating factors affect productivit! apart from those satisf!ing onl! ph!sical needs. Elton Ma0o also conducted e&perimental studies in the relationship of social factors to productivit! again at the #awthorne >orks of >estern :lectric in <hicago in ,-1/ to ,-31. These studies investigated the attitudes and reactions of workers toward var!ing ph!sical conditions such as changes in dail! working hours, shorter work weeks, different rest periods and so on. 0t was found out that ph!sical factors are not the sole determinants of productivit! and that interactions among workers had great impact to work. Ma!o observed that an organi ation is a social s!stem with informal groups and cli%ues. #e concluded that in addition to meeting the economic goals of an organi ation, management must also satisf! the social and ps!chological needs of the workers.

31

7":"

Beha.io%al S(ien(e

Theorists like #%g0%is and *i8e%t spurred managers to pa! serious attention to issues on motivation, leadership and productivit! in organi ations. 7"3" Management S(ien(e This school is also known as operations research and s!stems anal!sis. 9rincipal contributors were Chu%(hman, Russel #(hoff, Dant-ig and Bellman. 0t is both a bod! of knowledge and an approach to anal! e and solve management problems. 0t consists of various theories, methods, models and specific tools and techni%ues like linear programming, markov chains, simulation models, information models, program evaluation and review techni%ues, critical path, sensitivit! anal!sis, and cost effectiveness models. 7"4" Contem'o%a%0 Management Theo%ies 2/3/0/ Management By ) 4ecti$es 5MB)6 0n ,-'/, &ete% D%u(8e% observed the overemphasis to profit b! organi ations. To counter this perceived managerial preoccupation, he proposed the need for multiple objectives which could organi e and e&plain the whole range of business phenomena. #e believed that if objectives are carefull! formulated and pursued, other concerns will also fall into place. 2/3/1/ Moti$ational +heories Motivational researchers had concentrated on identif!ing the factors that stimulate satisfaction and productivit! and eliminating those that inhibit them. To the motivational theorists, the most effective manager is the one who creates an environment in which people are motivated, and therefore, highl! productive. Maslo;Ds #ierarch! of Feeds e&plain people behavior ? that man is driven first b! his ph!siologic needs, then his safet! and securit! needs, before he satisfies his self6actuali ation needs. These needs are sometimes loosel! termed int%insi( fa(to%s as the! originate from within. The work of Maslow can now be seen in organi ational developments as parental leaves, child care centers, fle&ible working hours. These innovations were designed to meet the needs of workers so that workers can concentrate on his work in the organi ation. 2/3/./ +heories 7 and 8 5McGregor6 M($%ego% ),-8A( in his book, The #uman 2ide of :nterprise, compared two sets of beliefs about human nature. Theor! G proposes that man is la !,
33

unmotivated, irresponsible, not too intelligent, and prefers to be directed rather than acting independentl!. $ased in this view, managers must direct and control people in order to insure that the work is done properl!. ;etailed rules and regulations need to be developed and strictl! enforced. Motivation is supplied b! a s!stem of rewards and punishment. 0n Theor! E, the behaviors in Theor! G are not inherent in human nature. 9assivit!, avoidance of responsibilit! are signs of poor leadership and indicate that peopleDs need for belonging, recognition, and self6actuali ation have not been met. Theor! E proposes that work itself can be motivating so that people can become interested in their work and will support organi ational goals. The! can be trusted and will do without constant supervision. Under the right conditions, the ordinar! person can be imaginative, creative, and productive. Major function of management therefore is to attend to such conditions. 2/3/9/ Hygienic -actors He%-9e%g ),-'-( enlarged on the theor! E approach. #e divided the needs that affect oneDs motivation to work+ those that affect dissatisfaction are called h!gienic factors and those that affect satisfaction )motivation factors(. The specific factors under each could be seen in Table 3., below. +a le ./0/ Her( erg:s Hygienic;Moti$ational -actors H0gieni( Fa(to%s "de%uate salar! "ppropriate supervision Hood interpersonal relations 2afe and tolerable working conditions Moti.ation Fa(to%s 2atisf!ing meaningful work Opportunities for advancement and achievement "ppropriate responsibilit! "de%uate recognition

The function of management then is to insure that both sets of needs are met, directl! or indirectl! b! providing opportunities in a conducive work environment. 2/3/</ +heory = 5)uchi6 0n ,-.,, Ou(hi e&panded and enlarged Theor! E with his Theor! I. Theor! I is humanistic and focuses on developing better wa!s of motivating people. 0mportant elements are collective decision making, long term emplo!ment, slower but more predictable promotions, indirect supervision and a holistic concern for emplo!ees, Ouchi basicall! used the seven basic criteria of McBinse! 2even 2 framework for management anal!sis which are as follows+

3/

,. 2uperordinate goals which criticall! bind binds together ever!thing in an organi ation. 1. 2trateg! 3. 2tructure /. 2!stems %he first four are called the )hard *!+ '. 2taff6concern for the right people 8. 2kills6developing and training people @. 2t!le6manner of handling peers, subordinates and superiors %he last three are called the )soft *!+ 7"4"4" Situational Theo%ies The motivational theories considered the emplo!ees as co6actors in management. $arel! is the environment given consideration. This lead to more theories called situational theories. The <ontingenc! approach of 5iedler is one and it states that there is no single approach that provides an ade%uate umbrella for the various management problems. 5actors like the nature of the task to be done, the power of the leader, and the favorableness of the situation affect management. SUMM#R< Management is the process of designing and maintaining an environment for the purpose of efficientl! accomplishing goals and objectives. Managers carr! out the functions of planning, organi ing, leading, controlling and evaluating. 0t is an activit! carried out at all levels of the organi ation. There is a commonalit! of skills re%uired to manage, however the depth of these re%uired skills var! with the level of organi ation. The goal of all managers is to create a surplus and to be productive. 9roductivit! is to achieve a favorable output6input ratio within a specific period of time, %ualit! considered. Management as a practice is an art4 organi ed knowledge on management is a science. "n organi ation operates in an open s!stem receiving inputs from the environment. The transformation processes of these inputs to outputs in terms of goods and services are is done b! management. The transformation processes consist of the so called managerial functions. The performance of said functions is guided b! certain concepts, principles, and technics developed b! the various management schools of thoughts.
Learning Activities/Exercises

3'

REFERENCES ,. #enr! >eihrich, #arold Boont . Management # $lo9al &e%s'e(ti.e. ,Ath edition, McHraw6#ill 0nternational :dition, ,--3. 1. =obert Bat . S8ills of an Effe(ti.e #dminist%ato% . #arvard $usiness =eview, Januar!65ebruar!, ,--'. 3. 9eter 5. ;rucker. Tas8s= Res'onsi9ilities= &%a(ti(es Management. $utler and Tanner *td. 5rome and *ondon, ,--,. /. ;ee "nn Hillies. Nu%sing Management # S0stems #''%oa(h . 1nd edition. >.$. 2aunders <o. ,-.-. '. *eve! and *oomba. #ealth <are "dministration a Managerial 9erspective, 1 nd ed. J.$. *ippincott <o. 9hila. ,-./.

38

Anda mungkin juga menyukai