307 Notes

L1
Reasons for learning management
1. Inc. complexity of healthcare (rapid advancement technology, service, change,
human resource management) e.g. telehealth
2. Inc. demand on quality care and professional care (knowledge, patient
management)

Factors that affects decision making

Values, preference, life experience, gender, thinking styles

Management is a process of leading and directing.

-planning, organizing, staffing, directing, controlling, decision making
Manager
-assigned position within a formal organization
-legitimate source of power
-specific functions, duties and responsibilities
-formal responsibility and accountability for rationality and control
-control, decision making, decision analysis and results
-manipulate decision (people, environment, money and time)

Leadership is a process of influencing and motivating people to act towards achieving

a common goal.
Leader
-does not need to be people in traditional positions of authority
-obtain power through other means like influence, not delegated authority
-focus on group process, information gathering, feedback, empowering others
-direct willing followers

10 leadership flaws
1. A lack of energy and enthusiasm
2. Acceptance of their own mediocre performance
3. Lack of a clear vision and direction
4. Having poor judgment
5. Not collaborating
6. Not walking the talk
7. Resisting new ideas
8. Not learning from mistakes
9. A lack of interpersonal skills
10. Failing to develop others

6 traits of an integrated leader-manager

1. Visionary and futuristic, think longer term
2. Toward larger organization
3. Influence other beyond their own group
4. Visions, values and motivation
5. Politically astute, coping conflicts requirements and expectations
6. Change and renewal

Development of management theory

1. Scientific management (1900 – 1930)
2. Bureaucratic organizations (1922)
3. Management functions (1925)
4. Human relations management (1930 – 1970)

Scientific management (Frederick Taylor)

Four principles
1. Time, motion studies, expertise of experienced workers
=scientifically designed work with greatest efficiency of time and energy
2. Identify employee’s abilities and limitations
=best matched to the most appropriate job
3. Workers should be able to view how they fit with the organization and contribute
to overall productivity
4. Enhance cooperation and interdependence between managers and workers
Critiques: lacking humanism, dramatic increase in productivity and profits
Solutions: satisfy workers and managers with adequate financial rewards as a result of
increased productivity.

Bureaucratic organization (Max Weber)

1. Clear division of labor
2. System of rules covering the rights and duties of each position
3. System of regulations governing employment and promotion
= legalized, formal authority and consistent rules and regulations
= increase work efficiency
Critiques: oversimplified management and employee roles, ignore bilateral
relationships between employee and management, unnecessary delay
 Management functions
-Five functions of management (Henri Fayol)
Planning, organizing 人机物法, staffing, directing, controlling
-POSDCORB of Gulick
Planning, organization, staffing, directing, coordinating, reporting, budgeting

Human relations management

-participatory and humanistic management e.g. participative decision making
- management paid special attention to workers, hence increase productivity
(Hawthorne effect)
-theory X and Y (employee satisfaction = managerial attitudes, influenced by
managers’ assumptions about human nature)
-managerial domination = discouraged and passive workers, cannot fulfill self-esteem
and independence needs
Critiques: time consuming, unmet organizational goals, not everyone likes less
structured (sheep)

Historical development of leadership theory

1. Great Man Theory (some people are born to lead, some born to be led)
2. Trait Theory (some characteristics or personality traits are associated with
leadership) e.g. charisma, emotional balance, tact, ability
3. Behavioral Theories (STYLES OF LEADERSHIP)
-Authoritarian leaders
-strong control, motivated by force with commands, top down approach, I and
you
-Democratic leaders
-Less control, economic and ego, suggestions and guidance, we approach
-Laissez-faire leaders
-Little or no control, motivated support
4. Situational and contingency leadership theories (social system of contingencies)
(dominant style matches situation)
5. Interactional leadership theories (leadership based on organizational environment
and culture, interactive relationship)
-nature of the task according to the ability, experience and motivation
-theory z (human motivations and well-being)
-productivity and worker satisfaction
– Reactive leader (crisis driven, abusive to subordinates)
– Responsive leader (mold subordinates to work together as a team)
– Proactive leader (participative decision making, more future oriented, hold common
values)
– High-performance teams (Maximum productivity, attained worker satisfaction)
5. transactional and transformational leadership
Transactional leaders
-focus on goal, day to day operation
-set goals
-give directions
Transformational leader
-right thing for the right person
-charisma and enthusiasm for motivation
-uniqueness of their followers

New leadership and management strategies

1. Servant leadership (serve to employee to achieve collaboration and employee
loyalty) (open minded, ability to deal with ambiguity, paradoxes and complex
issues, clear on goals, sharing critical challenges, think before react, foresight and
intuition, relationships and connection, professional judgement and fair treatment,
collaboration)
2. Principle agent theory (informational advantages and own preferences (conflict of
interests) (solutions: appropriate incentives to act for the best interest)
3. Human and social capital theory (group’s collective knowledge, skills and
abilities) (organization invest in education and professional development)
4. Emotional intelligence (one’s ability to perceive, control, and evaluate emotions)
(rational thinking mind, emotional feeling mind) (self-awareness, self-regulation,
motivation, empathy, social skills)
5. Authentic leadership (congruence of activities, actions and deeds and leader’s
values, principles and beliefs)
(balanced processing, internalized moral perspective, rational transparency, self-
awareness) (purpose, values, heart, relationships, self-discipline)
6. Thought leadership (challenge the status quo and attract followers, problem
orientated, future orientated)
7. Quantum leadership (change is constant, flexible and mobile work environment)
8. Cultural bridging (ethnic diversity, generational diversity)
L2 ???
SWOT analysis
Basic steps in management
Types of budget
Goal (broad) VS Objective

L3
Concept of planned stage
Phases of change
Responsibilities of a change
Driving and restraining forces for change
Rational-empirical, Normative-reeductive, power-coercive strategies
Manage resistance to change

Concept of Planned Change

Effort + change agent= planned change

Well thought-out, deliberate effort

+
Change agent = person skilled in the theory and implementation of a planned change
=> deliberate application of knowledge and skills by a leader to bring about a change

Inside vs outside change agent

e.g timing affected by stress, balance between stability and change, motivation, extent
of the interest
Requirement
Mindset transformation, vision and expert planning skills, reassess goals proactively,
visionary in identifying where change is needed

Kurt Lewin developmental of change theory

Unfreezing=> movement=>refreezing
Unfreezing (recognize the need for change, understand concerns)
Movement- change (plan the change, implementation)
Refreezing (stabilizing the system change into status quo) (at least 3-6 months)
(measure impact of change)

Lewin’s Driving and Restraining Forces

Driving force (facilitators)
Increase driving force by,
-opportunity for advancement
-social gratification for status
-enhance self-esteem
-family supportive of efforts
Restraining force (barriers)
-conformity to norms
D.F>R.F= CHANGE

3 Classic change strategies

1. Rational-empirical strategies
(giving current evidence to support the change)
Assumption:
-restraining force due to lack of knowledge
-human are rational beings, will change if there’re factual information
2. Normative-reeducative strategies
(group norms and peer pressure to socialize people)
Change agent:
-Interpersonal relationship
3. Power-coercive strategies
(using authority inherent in an individual position to effect change)
(enactment of new laws, group power)
=change only when rewarded
= authority measures leading to resistance (restraining force)

Resistance
Change= alteration on balance => resistance and conflict
Level of resistance is affected by,
1. Type and level of change (individual are easier than groups, knowledge than
attitudes and beliefs)
2. Related to values, educational levels, cultural and social background and
experience with change
Natural and expected response to change
-provide change support and resources
-identify promoter or resistance

Planned change as a collaborative process

Change process involves dissatisfaction, gossips or rumors, negative views
=need of collaborative process
-engage and empower subordinates, good communication, repeat message

Leader-manager: the role model

Manager
Change=/= threat, but a challenge and opportunity as new and innovative
How to facilitate change?
-actively engaged, role model to staff
-assist followers in making the needed change requirement in their work
Organizational change: non-linear change theories
1. Complex adaptive system (CAS) theory (micro level)
2. Chaos theory (butterfly effect) (finding the underlying order in systems)

Leadership qualities
-embrace the environment
-set priority
-establish direction and be persistent
-stimulate creativity and innovation
-be a role model
-be sensitive to people
-maintain credibility and build trust
-be open and listen
-organization values and goals for ability to live, willingness to change
-personal integrity

L4
Role of leaders/ managers in shaping an organizational culture
Importance of developing well-structured committees in an organization
Elements that determine organizational effectiveness
Strategies to build a personal power base
Different types of patient care delivery systems

Management process
Planning >organizing >staffing >directing >controlling

Organizing
Relationships, Procedures, Equipment, Tasks
Organization
-authority and decision making

Formal organizational structure

-work division, departmentalization
-highly planned, visible, systemically arranged

Informal organizational structure

-social network of employee
-blurred or shifting lines of authority and accountability

Organizational Theory (Max Weber: bureaucracies)

-division of labor
-hierarchy of authority
-impersonal rules and impersonality
-system of procedures
-rules of rights and duties
-technical competence on selection for employment

Organizational structure
+Relationships and chain of command
+Span of control
+Managerial levels
+Centrality

Relationships and chain of command

Solid horizontal line: communication between people with similar spheres of
responsibility and power but different function
Solid vertical line: formal chain of command, status and power, inter-professional
approach (top: decision making authority)
❌command: conflicts, reduce productivity
Dotted line: staff positions, staff to provide information and assistance, limited
authority

Span of control
-number of people directly reporting to one manager
-↑span of control ↓level of hierarchy
-Wider/ narrower, more ppl/less ppl report to manager
Managerial levels
A) Top level managers
B) Middle-level managers (coordinate the efforts of lower levels of the hierarchy)
(bridge)
C) First-level managers (concerned with their specific unit’s work flow)

Centrality
-location of a position on an organization chart, determined by organizational distance

Types of organizational structure

-Line structures
-Ad hoc design
-Matrix structure
-Service line organization
-Flat designs
communication patterns, relationships, authority

Line structures
-Bureaucratic organizational designs
-Authority and responsibility
-Efficiency and simplicity
Cons: Monotony, alienate workers, restrict upward communication

Ad hoc design
-temporary basis to complete a project
-overcome the inflexibility of line structure
-handle increasing large amounts of available information
Cons: reduce strength in the formal chain of command, reduce employee’s loyalty

Matrix structure
-focus on product and function e.g. good patient outcome, staff education and
adequate staffing
Cons: slow decision making, dual authority: frustration and confusion

Service line organization

L4 + L5 ………