PEOPLE MANAGEMENT AND

ORGANIZATION BEHAVIOR

PREPARED BY
Dr.Ola Gamal Khashaba
MD,CPHIMS,CPHQ,TQM
Consultant of Clinical Pathology
Cairo University Hospitals
AMERICAN BOARD OF HEALTHCARE QUALITY

drolakhashaba@yahoo.com
The Healthcare Quality Handbook: A Professional Resource and Study Guide by Janet A. Brown, RN, CPHQ, and The 2010 /2011 (25th
Annual) Edition

OBJECTIVES

By the end of this course participants should be able to:

• Learn basic organization behavior
• Learn how to deal with organization change
• Practice important communication skills
• Understand work teams and skills
• Study human resources management

Dr.Ola gamal
1 Khashaba,MD,CPHIMS,CPHQ,TQM
 TOPICS

By the end of this course participants should be able to

cover the following topics:
Part I ORGANIZATION BEHAVIOR
• Chapter 1: CONCEPT AND PRINCIPLES OF
ORGANIZATIONS
• Chapter 2: ORGANIZATIONAL CHANGE MANAGEMENT
(Chapter VI- 5 Janet)
• Chapter 3: EFFECTIVE COMMUNICATION IN HEALTH
ORGANIZATIONS Janet Chapter VI-7

TOPICS

By the end of this course participants should be able to

cover the following topics:
Part II WORK TEAMS
• Chapter 4 : Team Coordination (Janet Chapter VI-6)
• Chapter 5 : Team Skills
• Chapter 6 : Empowerment, decision making and
Problem solving chapter 4 Janet

Dr.Ola gamal
2 Khashaba,MD,CPHIMS,CPHQ,TQM
 TOPICS

By the end of this course participants should be able to

cover the following topics:
Part III: UNDERSTANDING PEOPLE:
• Chapter 7: Why people behave as they do ?
• Chapter 8: Motivation
• Chapter 9: Power and influence
• Chapter 10: Leadership and management

TOPICS
By the end of this course participants should be able to
cover the following topics:
Part IV: MANAGING HUMAN RESOURCES Janet Chapter 9
• Chapter 11: Employee recruitment and selection
Chapter VI-9
• Chapter 12: Staff QM/PI orientation, Training, and
education. Chapter VI-10
• Chapter 13 : Staff Performance Appraisal Chapter VI-11
Janet
• Chapter 14: Case Study Presentations

Dr.Ola gamal
3 Khashaba,MD,CPHIMS,CPHQ,TQM
 PEOPLE MANAGEMENT AND
ORGANIZATION BEHAVIOR
PART I ORGANIZATION BEHAVIOR

Chapter 1- CONCEPT AND PRINCIPLES

OF ORGANIZATIONS

*
The Healthcare Quality Handbook: A Professional Resource and Study Guide by Janet A. Brown,
RN, CPHQ, and The 2010 /2011 (25th Annual) Edition

TOPICS

By the end of this chapter , participants will be able to:

• Define organization & Organization Behavior
• Identify organization principles
• Develop vision and mission , goals and
objectives
• Understand the organization structure
• Develop organization chart
• Understand the organization design

Dr.Ola gamal
4 Khashaba,MD,CPHIMS,CPHQ,TQM
 The Concept of organization
• When people come together to combine their
talents and efforts, they form organizations.
• Organizations are practices, procedures and
relationships entered into to coordinate
human talents and efforts toward common
goals.

Organization: Working Definition

• An organization is a deliberate
arrangement or framework of every group
working together to accomplish a specific
purpose. It refers to the complete body, with
all correlated functions, and also refers to
the coordination of all these functions as
they cooperate for the common purpose.

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Dr.Ola gamal
5 Khashaba,MD,CPHIMS,CPHQ,TQM
 FORMAL
ORGANIZATION
Structure
Hierarchy
division of labor
Environmental Rules,procedures Environmental
resources Business processes outputs
Process
Rights/obligations
Privileges/responsibilities
Values
Norms
People
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The Healthcare Organization

Purpose of healthcare organization:

• To plan, coordinate, monitor, and regulate
the delivery of healthcare services.

Dr.Ola gamal
6 Khashaba,MD,CPHIMS,CPHQ,TQM
 What is Organizational
Behavior?

• Organizational Behavior is the study of

human behavior in the workplace, the
interaction between people and the
organization with the intent to understand
and predict human behavior.

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• Common Characteristics of Organizations:

• Have a distinct purpose (goal)
• Composed of people
• Have a deliberate structure

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Dr.Ola gamal
7 Khashaba,MD,CPHIMS,CPHQ,TQM
 Purposes for Organizing
• Dividing work into specific jobs.
• Assigning tasks and responsibilities.
• Coordinating tasks.
• Clustering jobs into units.
• Establishing relationships.
• Establishing lines of authority.
• Allocating resources.

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Outcome of Organizing

• Organizing helps to reach effectiveness and

efficiency.
• Effectiveness: is the degree of achieving the
pre-determined objectives.
• Efficiency: is the best utilization of the
available resources.

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8 Khashaba,MD,CPHIMS,CPHQ,TQM
 The System Approach in
Organizations
• A system can be defined as a set of parts
coordinated to accomplish a set of objectives.
• The system approach in organizations considers the
interrelation of three main elements
• Inputs
• Processes
• Outputs

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The System Approach of Organizations

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9 Khashaba,MD,CPHIMS,CPHQ,TQM
 “System” & Deming
• A network of interdependent components
that work together to try to accomplish an
aim.

Key Organizational Components

1- Quality management “QM”.
2- Utilization Management “UM”.
3- Risk management “RM”.
4- Infection control “IC”.
5-Case management / discharge planning.
6- Practitioner credentialing, privileging, and
competency appraisal.
7- Continuing medical and clinical education.

Dr.Ola gamal
10 Khashaba,MD,CPHIMS,CPHQ,TQM
 Organizational Principles
• Each organization should have:
• Clear mission, vision, goals and objectives
• Organizational structure and design

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VISION
• A vision is a statement of where the
organization is headed.
• Describes what the organization hopes to be
in the future
• Spells out the highest ideas and wishes
• Idealistic aspirations
• “If you can dream it , you can make it
happen”

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Dr.Ola gamal
11 Khashaba,MD,CPHIMS,CPHQ,TQM
 MISSION
• A mission is a statement of why an
organization exists.
• The mission is a statement of purpose (why
are we here?)
• What are the main services?
• Who is our customer?
• How do we offer this service?
• Mission is flexible, dynamic, and capable of
responding to services as they occur.

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Goal

• The ultimate desired state towards which

objectives and resources are directed
• The goal is broad, long range, has no timing
• The goal is related to the organization
mission and vision

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Dr.Ola gamal
12 Khashaba,MD,CPHIMS,CPHQ,TQM
 Objectives

• Should be SMART
• Specific
• Measurable
• Appropriate / relevant
• Realistic / attainable
• Time-bound

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Organizational Structure and

Design
I. Organizational Structure
• It involves six key elements:
1. Work specialization
2. Departmentalization
3. Chain of command
4. Span of control
5. Centralization and decentralization
6. Formalization

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Dr.Ola gamal
13 Khashaba,MD,CPHIMS,CPHQ,TQM
 I. Organizational Structure
1. Work Specialization

• The degree to which tasks in the organization

are divided into separate jobs with each step
completed by a different person.
• The Job Characteristics Model (JCM)
• Identifies how jobs can be designed to help
people feel that they are doing meaningful and
valuable work
• The Job Characteristics Model necessitates
identification of job description, and job
design.

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I. Organizational Structure
2. Departmentalization

• Departmentalization is the organizational

element that specifies how employees and
their activities are grouped together.
Departmentalization is illustrated by the
organization charts.
• It is a fundamental strategy for coordinating
organizational activities because it
influences organizational behavior .
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Dr.Ola gamal
14 Khashaba,MD,CPHIMS,CPHQ,TQM
 29

Types of departmentalization include:

1. Functional Structure
• Grouping jobs by functions performed

Hospital General
Manager

HR Manager Outpatient Clinic Nursing Manager

Manager

What are the Advantages?

What are the Disadvantages?

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Dr.Ola gamal
15 Khashaba,MD,CPHIMS,CPHQ,TQM
 1. Functional Structure
• Advantages
• Efficiencies from putting together similar
specialties and people with common skills,
knowledge, and orientations
• Coordination within functional area
• In-depth specialization
• Disadvantages
• Poor communication across functional areas
• Limited view of organizational goals
• Focus on departmental versus organizational
issues
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2. Geographic Structure
• Grouping jobs on the basis of territory or
geography

Undersecretary for Curative Health

Services

CUH Manager CUH Manager CUH Manager CUH Manager

Governorate 1 Governorate 2 Governorate 3 Governorate 4

What are the Advantages?

What are the Disadvantages?
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Dr.Ola gamal
16 Khashaba,MD,CPHIMS,CPHQ,TQM
 2. Geographic Structure
• Advantages
• More effective and efficient handling of
specific regional issues that arise
• Serve needs of unique geographic markets
better
• Adaptable to local needs
• Disadvantages
• Duplication of functions
• Can feel isolated from other organizational

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3. Product/ Service Structure

• Grouping jobs by product line
MOHP

Preventive and Endemic Curative Health Care Population and FP Projects and Technical Other sectors…….
Dis. Sector Sector Sector Support

Dep. of Curative
Medical Services

Department of Endemic Department of Dentistry

Diseases

Department of Department of
Environment Pharmacy

What are the Advantages?

What are the Disadvantages?

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Dr.Ola gamal
17 Khashaba,MD,CPHIMS,CPHQ,TQM
 3. Product/ Service Structure
• Advantages:
• Allows specialization in particular products
and services
• Managers can become experts in their
industry/ service
• Closer to customers
• Disadvantages:
• Duplication of functions
• Limited view of organizational goals

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4. Process Structure
• Grouping jobs on the basis of product or
customer flow

Clinical Laboratory Manager

Reception Sampling Clinical Units Revision of Resuluts Revision of Resuluts

What are the Advantages?

What are the Disadvantages?

36

Dr.Ola gamal
18 Khashaba,MD,CPHIMS,CPHQ,TQM
 4. Process Structure

• Advantages
• More efficient flow of work activities

• Disadvantages
• Can only be used with certain types of
products/ services

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5. Customer Structure
• Grouping jobs by type of customer and
needs
Deputy Manager for Public Relations

Contracting Director Reception Director Sales Director

What are the Advantages?

What are the Disadvantages?

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Dr.Ola gamal
19 Khashaba,MD,CPHIMS,CPHQ,TQM
 5. Customer Structure
• Advantages
• 1.Customers’ needs and problems can be
met by specialists

• Disadvantages
• 1.Duplication of functions
• 2.Limited view of organizational goals

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I. Organizational Structure
3. Chain of Command
Authority
• The rights inherent in a managerial position to
tell people what to do and to expect them to
do it.
Responsibility
• The obligation or expectation to perform.
Unity of Command
• The concept that a person should have one
boss and should report only to that person.

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Dr.Ola gamal
20 Khashaba,MD,CPHIMS,CPHQ,TQM
 I. Organizational Structure
4. Span of Control
• Span of control is the number of employees
who can be effectively and efficiently
supervised by a manager.
• Width of span could be increased in the
following conditions:
• High skills and abilities of the manager
• Skillful and cooperative employees
• Similarity of tasks
• Standardization of tasks
• Simple, non complicated tasks
• Physical proximity of subordinates
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I. Organizational Structure
5. Centralization and Decentralization

Centralization
• The degree to which decision-making is
concentrated at a single point in the
organizations.
• Organizations in which top managers make
all the decisions and lower-level employees
simply carry out those orders.
What are the Advantages?
What are the Disadvantages?

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Dr.Ola gamal
21 Khashaba,MD,CPHIMS,CPHQ,TQM
 I. Organizational Structure
5. Centralization and Decentralization
Centralization
• Advantages:
• Uniformity of standards
• Use of talented manager
• Uniformity of decisions
• Disadvantages:
• Great demand on few managers
• Top managers may not have a broad view
• Authority and power to few people
• Decrease sense of participation
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What are the Factors Encouraging Centralization?

• Environment is stable.
• Lower-level managers are not as capable or
experienced at making decisions as upper-level
managers.
• Lower-level managers do not want to have a say in
decisions.
• Decisions are significant.
• Organization is facing a crisis or the risk of company
failure.
• Organization is large.

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Dr.Ola gamal
22 Khashaba,MD,CPHIMS,CPHQ,TQM
 Decentralization
• Organizations in which decision-
making is pushed down to the
managers who are closest to the
action.

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Decentralization

• Advantages:
• Decreased total responsibility
• Encourage involvement of all personnel
• Shortens lines of communications
• Brings decisions closer to those affected
• Disperses authority among many people
• Disadvantages:
• Lack of uniformity of standards
• Decisions might be taken by incapable managers
• Co-ordination problems
• Inter-unit competition
• Requires training
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Dr.Ola gamal
23 Khashaba,MD,CPHIMS,CPHQ,TQM
 What are the Factors Encouraging
Decentralization?
• Environment is complex, uncertain.
• Lower-level managers are capable and
experienced at making decisions.
• Lower-level managers want a voice in
decisions.
• Decisions are relatively minor.
• Corporate culture is open to allowing
managers to have a say in what happens.
• Company is geographically dispersed.

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I. Organizational Structure
6. Formalization
• The degree to which jobs within the
organization are standardized and the extent
to which employee behavior is guided by
rules and procedures.

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Dr.Ola gamal
24 Khashaba,MD,CPHIMS,CPHQ,TQM
 II. Organizational Design
• Refers to the process of coordinating the structural elements of organizations
in the most appropriate manner.

• According to classical organizational theory, effective

organizations have a formal hierarchy, a clear set of rules,
specialization of labor, highly routine tasks, and a highly
impersonal working environment.

• According to neoclassical organizational theory, effective

organizations are designed with flat hierarchical structures and
a high degree of decentralization.
• According to the contingency approach, the best design for an
organization depends on the nature of the environment in which
the organization is operating

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Types of Organizational Design

• According to their design, organizations
could be classified into mechanistic and
organic types.
Mechanistic Organizations characterized by:
• High specialization
• Rigid departmentalization
• Clear chain of command
• Narrow spans of control
• Centralization
• High formalization

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Dr.Ola gamal
25 Khashaba,MD,CPHIMS,CPHQ,TQM
 Types of Organizational Design
Organic Organizations characterized by:
• Cross-functional teams
• Cross-hierarchical teams
• Free flow of information
• Wide spans of control
• Decentralization
• Low formalization

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II. Organizational Design

• Refers to the process of coordinating the structural elements of organizations in
the most appropriate manner.

• According to classical organizational theory , effective

organizations have a …………………,
• …………………., a clear set of
• ……………………….of labor, highly
• ………………., and a highly impersonal
• ……………………………...

• According to neoclassical organizational theory, effective

organizations are designed with
• ……………………….. hierarchical
• ………………………….structures and a high degree of
• ………………………………….
• According to the contingency approach, the best design for an
organization depends on the nature of the ……………………..
• ………………………n which the organization is operating
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Dr.Ola gamal
26 Khashaba,MD,CPHIMS,CPHQ,TQM
 Factors Affecting Organizational
Design
1.Overall strategy of the organization
• Organizational structure follows strategy e.g.
• Innovation:
• Pursuing competitive advantage through meaningful and unique
innovations favors …………………………..
• ……………………..
• Cost minimization:
• Focusing on tightly controlling costs requires a
……………………….
• ………………………for the organization.
• Imitation:
• Minimizing risks and maximizing profitability by copying market
leaders requires ………………………..
• …………………………… elements in the organization’s structure.

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Factors Affecting Organizational Design

2.Size and structure of the organization
• As an organization grows larger, its structure tends to change from
…………to……………..
• ……………………. with increased
………………………..,………………………..,………………………..,……………………….
.
• ………………………………………………………………………………………...
3.Technology use by the organization
• Firms adapt their structure to the technology they use. Non-routine technology is
more suitable for ………………………..
• ………………………., while routine technology suits ………………………...
• mechanistic organizations more.
4.Degree of environmental uncertainty
• ……………………….. tend to be most effective in stable and simple environments.
• ………………………………………………..
• The flexibility of ………………………. is better suited for dynamic and complex
environments.
• ………………………………………………………..

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Dr.Ola gamal
27 Khashaba,MD,CPHIMS,CPHQ,TQM
 Contemporary (modern)
Organizational Designs

• Team structures: the entire organization is made up

of work groups or self-managed teams of empowered
employees.
• Matrix structures: specialists for different functional
departments are assigned to work on
projects/departments led by other managers. Matrix
participants have two managers .
• Project structures: employees work continuously on
projects; moving on to another project as each
project is completed.

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Matrix Organization

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Dr.Ola gamal
28 Khashaba,MD,CPHIMS,CPHQ,TQM
 Advantages of Matrix Organization
• Can achieve simultaneous objectives
• Managers focus on two organizational dimensions,
resulting in more specific job skills
Disadvantages of Matrix Organization
• Complex, leading to difficulties in implementation
• Behavioral difficulties from “two bosses”
• Time-consuming from a planning/coordination
perspective

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Boundary-less Organization

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Dr.Ola gamal
29 Khashaba,MD,CPHIMS,CPHQ,TQM
 Thank You
59

Dr.Ola gamal
30 Khashaba,MD,CPHIMS,CPHQ,TQM