INTRODUCTION TO

HEALTH SERVICES MANAGEMENT-

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 Learning objectives
At the end of this unit, students will be able to:

• Describe the nature of management,

• define management and managers, characterize their importance to organizations.
• Identify and briefly explain four/five basic management functions in organizations.
• Describe the kinds of managers found at different levels and in different areas of the
organization.
• Identify the basic managerial roles that managers may play and the skills they need to
be successful.
• Discuss the science and art of management and describe how people become
managers.
• Justify the importance of history and theory to management, explain the historical
context of management, and discuss precursors to modern management theory.
• Summarize the scope of management in organizations.

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 Rationale for the course
• Health professionals often find themselves in a
managerial position
• Health services in sense of equity need good
management
• Resources are scarce, need proper management
for optimal utilization
• Difficult to target all health problems at a time,
hence need good management skills in
prioritizing health problems for intervention
 Key Definitions
• Health:-
 is the maximization of the biological & clinical indicators of
organ function,
 Maximization of physical, mental, & role functioning in every
day life.

• Health care:-
 Total societal effort, undertaken in the private & public sectors,
focused on pursuing health.

• Health services:-
 are specific activities within the larger domain of health care
undertaken to maintain or improve health or to prevent
decrements of health.
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 Key Definitions…
• Health service organizations:- are entities
that provide the organizational structure
within which the delivery of health services is
made directly to consumers.
• purpose of the services is :
preventive,
Curative,treatment
acute , chronic, restorative or palliative

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• ORGANIZATIONS AND NEED FOR MANAGEMENT

 Objectives:
Define relationships between management
and organization
Identify and discuss the management process
Discuss on the :
• Managerial roles,
• Types of managers and
• Skills required
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 Definitions and concepts
• Organization
– Two or more people who work together in a
structured way to achieve a specific goal or set of
goals.
– formal and informal
– In both people are kept together
believing there is a benefit working together to
achieve a common goal
What does goal mean ?

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 Definitions and concepts…
• Goal : The purpose that organization
strives to achieve.

• GOALS are the fundamental elements of an

organization. Why?

• Goal is the reason to exist and an organization can

not exist without a goal
• An organization can have more than one goal

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What do all organizations need to achieve goals?
To achieve goals all organizations should:

Have a method,
Resource,
Allocate resources

Thus the need for management.

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 What is management?

• Has several meanings.

• Depending on context and purpose
• No universally accepted standard definition
of management
• Concerned with human begins whose
behavior is highly unpredictable.
• Is a young, developing discipline whose
concept are continually changing.
 What is management?...

• The process of planning, organizing, staffing,

leading, and controlling the work of organization
members and of using all available organizational
resources to reach stated organizational goals.

• It is a process of reaching (predetermined)

organizational goals by working with and
through people and other organizational
resources (finance, equipment and
information).
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 What is management?...

– It is a process of utilizing efficiently the available resource to

achieve organizational goals.
– It is the practice of consciously and continually shaping
organizations.
• Planning:-managers think through their goals and actions in
advance.
• Organizing:-managers coordinate the human and material
resource of the organization.
• Staffing:-
• Leading:- how managers direct and influence subordinates,
getting others to perform essential tasks.
• Controlling:-managers attempt to assure that the
organization is moving toward its goals.
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 What is management?...

• Formal or informal organizations managers are BASIC.

• Management process occurs in a formal organizational setting.
• Who are the managers?

Why are they basic?

• In all organizations managers are essential. Because managers
are:
People responsible for directing the effort’s aimed at helping
organizations achieve their goals
People responsible for helping organization members set and
reach goals.

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 What is management?...
• Definition: HSO/HS managers are :
1.people formally appointed to positions of
authority in organizations or systems
2.who enable others to do their direct or support
work effectively,
3.who have responsibility for resource utilization,
4.who are accountable for work results.

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 Exercise

• What are the reasons for the existence of the

organization?

• Why do we study organizations and management?

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Reasons For Studying Organization & Management

1. Living in the Present :

 Organizations have role on the standard of living
 We rely on organizations daily for food, clothing,
medical care, etc.

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 2. Building the Future:
Organizations work or move to the desirable
future;
new treatment for diseases, new practices,
new products, new management, etc.
Positive/Negative impact

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 Reasons For Studying Organization & Management…

3. Remembering the Past :

 Connections to the past history.
 Patterns of human relationship
 People define themselves in terms of the
organization they have been a part of.
 Keeping record and value own history and keeping
traditions alive.
 How would history be important? Give some
examples of organizations and their history.

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 Management

 Management deals with time

Time Management is to create a desirable future.
Management is either practiced or is a reflection of a
particular historical era.
Management produces effects that emerge over time.
Organizations, managers and other individuals deals with
time

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 Management deals with human relationships
Managers act in relationships : two-way streets.
 Influence on both sides
Managers act in relationships that have spillover
effects for other people. Better or worse
Managers juggle(Manage) multiple simultaneous
relationships.
Organizations, managers and other individuals think
about future human relationships.
About new relationship and modify existing ones.

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 The early Management pioneer
• The History of development of management is
essentially the History of mankind.
• Management is as old as civilization.
• The Egyptian pyramids
• The Axum oblique
• The Great Wall of China is current evidence, where these
projects of tremendous scope, employing tens of thousands
of people, were under taken well before modern times.
• Without proper planning, organizing and
controlling such projects would have been not
completed satisfactory.
 The early Management Pioneers…

• A round 1750, the period of industrial

revolution,
• was the essence of the substitution of machine
power for human power.
• Continuous innovation in the filed of science
and technology led to the emergence of
factories and factories led to the need for
management and organization
 Development of management

• Formal management study (like it exist today )

is a product of 20th century as separate and
distinct subject.
• It is the work of Fredrick Winslow Taylor
(during the scientific management movement
(1900).
• However, it is as old as civilization
 Managing and managers

Managers and organizational

performance

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 Managing and managers

 Managers and organizational performance:

• Management is a major and PRINCIPAL activity that is

responsible to make a difference how the organization

is doing,
affecting and
affected by people

Thus there is a need for measuring Managers and

organizational performance.

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 Cont…
 Managerial performance measures
 How efficient and effective a manager is.
 How well a manager determines and achieves
organizational objectives.

 Organizational performance: measures

How efficient & effective an organization is.
How well it achieves it’s objectives.

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 Managing and managers……..

• Which one is the best for managers / organizations,

efficiency or effectiveness?
– Effective management is the main resource of developed
countries
– Effective management is the most needed resource of
developing countries
– Efficiency: the ability to minimize the use of resources in
achieving organizational objectives. “Doing things right.”
– Effectiveness: the ability to determine appropriate objective.
“Doing the right thing.”

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 The Management process
 Management: different definitions but common
elements:
 Process: a systematic method of handling activities.
 Involves achieving goals through people and utilization
of other resources
 Management is a process: a set of interrelated and
interactive on-going activities and functions.

What does this definition imply ?

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 Functions : Management functions
 describes how managers do what they do.
 Basic management functions or activities that make up the
management process are:

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 i) Planning
 It is the process of establishing goals,
 a suitable course of action to achieve the goals,
 Helps to deal with the present and anticipate the future.
 Think through their goals and actions in advance.
 It involves what to do, how to do and when to do
 Is a primary management function. Why?

• Through planning managers clearly put and outline

exactly what organizations must do to be successful.

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 The Management functions ………….
ii) Organizing
 Coordinate the human and material resource of the
organization.
 Mechanism to put plans into action. How?
 Arranging and allocating work, authority and
resources among organization members to achieve
goals.
 Establishing authority & responsibility relationships;
division of work, job design, coordination,
information and feedback systems in the
organization.

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 The Management functions ………….
• Do we need different structures for different goals?
• Do we need different structures depending on the
available resources?

Organizational design:
 The process of matching an organizational structure
to goals and resources.
How do you address relationships and time in this
process?

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 The Management functions …
iii) Leading (directing, motivating, and
communicating)
• Primarily concerned with people in the organization.
 Process of directing and influencing task-related
activities of group members or an entire organization.
 Process of guiding the activities of organization
members in appropriate direction.
• Influencing ,directing , actuate (activate ,motivate)
• Time and relationships.

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 The Management functions …

iv) Controlling
• The process of ensuring/ conforming the actual
activities in relation to planned activities.
• A function for which managers:
– Establish standards of performance
– Gather information and Measure current performance
– Compare performance with standard
– Taking corrective action
– Rewarding

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 The Management functions …

v) Decision Making
• Choosing between or among alternatives.
• A function made at all levels from planning up to
controlling.
– Senior managers make policy decisions and resource
allocation decisions that affect the entire and various parts of
the organizations.
– Middle- and first-level managers make decisions about
allocating and utilizing resources provided by senior
management within their areas of authority and responsibility.

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 The Management functions …
• . PLANNING ORGANIZING (developing
(deciding in international patterns of
advance what is to relationships among people and
be done) other resources)

DECISION
CONTROLIN MAKING
G (Choosing STAFFING
(Regulating between or
(Acquiring,
activities in among
maintaining,
accordance alternatives)
and retaining
with plans)
human
DIRECTING resources)
(Initiating work
in the
organization)
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 Types of managers and managerial roles

A. Classification by management level

 Traditional by level in the hierarchy

First-line (or first/ low level) ,Supervisory mangers:
Middle managers: Middle level
Top/ senior managers : high level
 Other classification
Policy level
Administrative or coordinating level
Operations level
1. First-line ( first/ low level) ,Supervisory
mangers:
– Responsible for the work of operating,
– do not supervise other managers
– Direct non management employees,
– have authority and responsibility for overseeing a
specific type of work and a particular group of workers.
– First or lowest level of managers in the organizational
hierarchy.

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 2. Middle level managers
• Managers in the midrange of the organizational
hierarchy
• Responsible for other managers and sometimes
for some operating employees
• Report to more senior managers

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 3.Top level managers / senior
• Responsible for the overall management of the
organization.
• Establish operating policies.
• Guide the organization’s interaction with its
environment.
• Small in number

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• List types of managers for the three levels by
choosing one organization.
1. First-line mangers:
Course team Supervisors, Coaches, Technical supervisor
2.Middle level managers:
Department heads, Heads of services
3. Top level managers:
Executive officer, president, vice president

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• Are there different names for a manager?
Different names of manager include
executive administrator, leader, boss, principal, chief,
supervisor, senior manager, superintendent,
commissioner, overseer, officer, Coach ,President,
Executive, Prime minister etc.
Attributes common to all regardless of title or level
• formally appointed to positions of authority by the
organization
• Directing work efforts of others subordinates and non
subordinates
• Responsible for utilization of organizational resources
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accountable to superiors for work results 42
B.Functional and general manager
Classification based on scope of activities
 Functions: Refers to a group of similar activities in an
organization, such as marketing, production, finance.
 Functional Manager: Responsible for one
organizational functional area/activity e.g. finance,
human resource management
 General Manager: Responsible for all functional
activities e.g. a company’s functional activities such as
production, sales, marketing, and finance.

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• Is it possible to have more than one general manager
in an organization?
• Do both functional and general managers perform the
four management functions?
• Yes, the difference is in the scope of activities they
oversee.

• The primary differentiation between levels of

managers is the degree of authority and scope
of responsibility in organizational activity.
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 C) Management skills
• major resource
 primary determinant for a manager to be effective and
efficient
 performance and personality traits
• Three basic types of skills are needed for successful
management
1. Technical skill:
 the ability to use procedures, techniques and knowledge
of a specialized field
– using specialized knowledge and expertise in executing work
related techniques and procedures.
– Related to things :process or physical objects
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2.Human (interpersonal) skill :

the ability to :
work /get along with,
understand,
motivate, and lead other people as individuals.
builds cooperation among the team.
Working with people : Attitude, communication.

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 3. Conceptual skill:
 Ability to see the organization as a whole
 Mental abilities of managers to visualize the complex
relationships in a workplace-among people, among
departments, among various organizations….
 A manager with this skill has the ability or better
understand how various functions of the organization
complement one another
 The relationship of the organization to its environment
 How changes in one part of the organization affect the
rest of the organization

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 Management skills……

• All managers use all these three types of skills in

performing management work but in different mix
(degree).
 The senior manager is vitally concerned with how the service
in general fits into the organization.
 In contrast the low level manager, whose primary function is to
troubleshoot an entire operating staff, may be constantly
required to make decisions on the basis of technical
knowledge of procedures while rarely having time to think
about the relationship of the specific service to other
departments of the organization.

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Which skill is needed by all managers?
• Because the common denominator are people at all levels, an
inability to work with people, not a lack of technical skills, is
the main reason some managers fail to reach their full
potential.
• A manager with Human skill
 Knows weaknesses and strengths,
 Knows how feelings hurt others.
Choose
 Either people have to be controlled Vs self discipline
 Do not make wrong judgments about people without
studying contents of information.

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 Managerial Roles
In addition to engaging in the function of management
managers also perform other activities associated with
certain management positions.
Two ways to answer the question, "What do managers
do?" are
 the functional approach (traditional) and
 the role approach ( depicted by Henry
Mintzberg)
 Managerial functions relate to the desired outcomes of
managerial action,
 Managerial roles categorize managers' actual behavior.

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 The Managerial Roles…
Henry Mintzberg
 concluded from his observation of managers
that management is best explained in terms of
roles.
 criticized the functional approach:
 for making management appear to be simple, more
orderly /Methodical /neat than it really is.
Managers practically adopt certain patterns of
behavior (roles) when feeling managerial positions.

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 The ten facts of managerial life, derived from
direct observation, characterize managers as
hard-working and busy people who engage in
many and varied, primarily oral, interactions
with others.
 Three managerial role categories (of a formal
authority and status), according to Mintzberg,
are interpersonal, informational, and
decisional.

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1)Interpersonal Roles-
• The three interpersonal roles managers play are
as:-
a) figurehead - they engage in activities that are
ceremonial and symbolic in nature; as a symbol of
legal authority, attending ceremonies, signing
documents, etc.
b) liaison - role involves formal and informal contacts
beyond the vertical chain of command (both inside
and with external stakeholders), to establish
relationships that will help them achieve
organizational objectives. i.e. links in horizontal as well
as vertical chain of communications
c) leadership- role includes motivating & leadership
when they seek to inspire, and set examples through
their own behavior. i.e. managers are accountable,
responsible, & motivator.

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2) Informational Roles –
The three informational roles are:
a) Monitor - filter, evaluate and choose to act or react to
that information.
b) Disseminator - role involves choosing to disseminate
the information.
communicating selected information to subordinates
c) Spokesperson - represent and speak on behalf of
the organization.
communicating selected information to outsiders

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3)Decision-Maker Roles-

 The authority granted by their organization &

supported by their interpersonal & informational roles;
permits managers to play decisional roles.

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There are four decision maker roles:
a)Entrepreneur /Change agent: designing and
initiating changes within the organization .organizations are
internally dynamic and continuously affected by the
environment.
Unless managers act ?
b)Disturbance Handler-They handle both internal and
external disturbances and take corrective action.
They anticipate disturbances and resolve conflicts.
c) Resource allocator - managers decide who gets what
based on priority setting.
d)Negotiator - managers choose how to interact with their
superiors, peers, and subordinates. i.e. Negotiating with
other parties representing organizational interests.

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Roles are interrelated: Liaison ,information, decision
making…
 A key message on role of managers is they have to be
very versatile when it comes to dealing with human
relationship.
 When the interconnected roles are each played well, the
result is synergistic.
 Being a good negotiator makes a manager a better disturbance
handler.
 Playing the information roles effectively improves performance
in the decisional roles because managers have information
with which to make decisions.

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 The Managerial Roles: Roles are interrelated ……
 Different levels of these roles is used at different levels of managers
& by different individuals.
 Senior managers engage in :
1. figure head,
2. entrepreneur and
3. spokesperson roles more frequently than do other
managers.
 Middle level managers often are heavily involved in
1. disturbance handler and
2. resource allocator roles, and
3. many of them rely on their abilities to successfully play their
informational roles as a key ingredient in their work.
 First level managers may
1. play leader ,
2. disturbance handler, and
3. negotiator roles extensively in their daily work. 58
Exercise
• Provide prominent examples of interpersonal
roles that you had as a manager or have
observed from a manager.
• Provide prominent examples of informational
roles that you had as a manager or have
observed from a manager.
• Provide prominent examples of decision-
making roles that you had as a manager or
have observed from a manager.

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 Summary
Explain the importance of
organizations and management
• Organizations have profound effects on our
lives, our standard of living, and our futures.
Because organizations endure in time, they
help us connect our pasts, presents, and
futures.
• Organizations, both formal and informal,
have plans and goals.
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 Summary
• How well organizations achieve their goals
depends on managerial performance- the
manager’s effectiveness and efficiency.

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 Summary
Define the four principal activities of the
management functions

• The management functions include the

interrelated activities of planning,
organizing, leading, and controlling.
• All of these activities involve human
relationships and time.

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 Summary
Describe different categories of managers
• Managing is living in the middle of the relationships
that make up and sustain an organization.
• Managers can be classified by level- First-line, middle
and top.
• They can also be classified by organizational activity_
functional managers, are only responsible for only
one activity, and general managers are responsible
for all the functions in an organizational unit.

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 Summary
Discuss different skills that managers must have and
the roles they play.
• In moving organizations toward their goals,
managers adopt a wide range of interpersonal,
informational and decision- making roles.
• Time and human relationships are crucial parts of
these roles.
• Managers at different levels need different types of
skills.

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 References
 Stoner J.A.F, Freeman R.E., Gilbert Jr. D.R.
Management. 6th edition, 1996.

 Beaufort.B, Longest,Jr, Jonathon S. Rakich, Kurt

Darr,J.D. Managing Health service organization
and systems 4th edition 2003,Hamilton printing
company, Rensseleaer, New York.
 Rao V.S.P and Narayana P.S. Principles and
Practices of management, 1st edition (1987),
Konark Publishers.
 Hersey P., Blanchard K.H. and Johnson D.E.
Management of organizational behavior:
Utilizing human resources, 7th edition (1996),
Prentice Hall.
 Kreitner R. Management. 7th edition (1998),
Arizona State University, Houghton Mifflin
Company, New York.
 Shortell S. M. and Kaluzny A.D. (1997).
Essentials of Health Care Management, Delmar
Publishers
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 References
• Griffin, R.W. (2006). Management. (original
edition). Delfli. AITBS

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