2016 KMPK Sesi 9 LT DH Menjalankan Sistem Teknis Shortell

Shortell and Kaluzny
PROGRAM PASCA SARJANA IKM-FK UGM

LEARNING OBJECTIVES
Memahami organisasi pelayanan
kesehatan sebagai suatu sistem dan para
manajer di dalamnya
Memahami aspek manusia dalam
melakukan perencanaan,
pengorganisasian, pelaksanaan dan
pengendalian upaya kesehatan;
Memahami berbagai isu dalam
pelaksanaan program.
Memahami kebutuhan strategis agar
lembaga pelayanan dapat hidup dan
berkembang.

Organisasi dan Manajer
-Teori Organisasi dan Manajemen Pelayanan Kesehatan (Bab 1)
-

Memotivasi
dan Memimpin
Orang serta
Kelompok

Peran Manajer (bab 2)

Menjalank
an Sistem
Teknis

Memenuhi
Kebutuhan dan
Nilai-nilai Individu

Menentukan
Kelompok Kerja dan
Desain yang Tepat

-Memotivasi

Orang Lain
(Bab 3)
Memberi Arah

-Kelompok dan
tim dalam
organisasi
Pelayanan
Kesehatan (Bab
6)
-Desain Kerja (Bab 7)
Menetapkan
Mekasnisme
Komunikasi dan
Koordinasi

-Kepemimpin
an: Sebuah
kerangka
kerja bagi

pemikiran
dan tindakan
Mendorong
Kerjasama
-Manajemen
Konflik dan
Negoisasi

-Koordinasi dan
Komunikasi
(Bab 8)
Menggunakan

Memperbaru
i Organisasi

Menentukan Desain
Organisasi yang Tepat
-Desain organisasi
(bab 10)

Mendapatkan Sumber
Daya dan Mengelola
Lingkungan
-Mengelola Aliansi
Strategis (Bab 11)
Mengelola Perubahan
dan Inovasi
-Inovasi,
Perubahan dan
Pembelajaran
organisasi (Bab
12)
Mencapai Sasaran
-Kinerja
organisasi:
Pengelolaan demi
Efisiensi dan

Merencanaka
n Masa

Depan
Mengelola secara
Strategis
-Penyusunan
Strategi
dalam
Organisasi
Perawatan
Kesehatan
(Bab 14)
Mengantisipasi
Masa Depan
-Menciptaka
n dan
Mengelola
Masa Depan
(Bab 15)

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Organisasi dan Manajer
-Teori Organisasi dan Manajemen Pelayanan Kesehatan (Bab 1)
-

Memotivasi
dan Memimpin
Orang serta
Kelompok

Peran Manajer (bab 2)

Menjalank
an Sistem
Teknis

Memenuhi
Kebutuhan dan
Nilai-nilai Individu

Menentukan
Kelompok Kerja dan
Desain yang Tepat

-Memotivasi
Orang Lain
(Bab 3)
Memberi Arah

-Kelompok dan
tim dalam
organisasi
Pelayanan
Kesehatan (Bab
6)
-Desain Kerja (Bab 7)

Menetapkan
Mekasnisme
Komunikasi dan
Koordinasi

-Kepemimpin
an: Sebuah
kerangka
kerja bagi
pemikiran
dan tindakan
Mendorong
Kerjasama
-Manajemen
Konflik dan
Negoisasi

-Koordinasi dan
Komunikasi
(Bab 8)

Menggunakan

Memperbaru
i Organisasi

Menentukan Desain
Organisasi yang Tepat
-Desain organisasi
(bab 10)
Mendapatkan Sumber
Daya dan Mengelola
Lingkungan
-Mengelola Aliansi
Strategis (Bab 11)
Mengelola Perubahan
dan Inovasi
-Inovasi,
Perubahan dan
Pembelajaran
organisasi (Bab

12)
Mencapai Sasaran
-Kinerja
organisasi:
Pengelolaan demi
Efisiensi dan

Merencanaka
n Masa
Depan
Mengelola secara
Strategis
-Penyusunan
Strategi
dalam
Organisasi
Perawatan
Kesehatan
(Bab 14)
Mengantisipasi
Masa Depan
-Menciptaka
n dan
Mengelola
Masa Depan
(Bab 15)

Managing Groups and
Teams

Learning Objectives 6
 Describe the importance and types of groups and

teams in health services organizations.
 Distinguish between different approaches to

assesing work group performance
 Analyze the effect of a work group’s structure on

group performance.
 Explain the relationship between work group

norms and group productivity.
 Identify the key roles assumed by individuals in

work groups.
 Describe key aspects of group process including

communications structures, decision making, and
stages of group development.
 Define major causes and consequences of

intergroup conflict and identify alternative
strategies for managing conflict.

Types of groups and teams
in organizations
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Reference Groups
Friendship Groups
Interest Groups
Work Groups
Management teams
Temporary Groups or task forces
Intermittent Groups
Standing Committees

A Model of Work group
Performance
Group Characteristics:
•Group composition and size
•Group norms
•Role relationships
•Group role clarity
•Group cohesiveness
•Status differences

Group
Process :
•Leadership
•Communicatio
n
•Decision
Making
•Stages of
group
development

Effectiveness :
•Performance
or Productivity
•Member satisfaction

Intergroup Conflict :
•Interdependence among groups.
•Group role and task ambiguity.
•Intergroup differences in work orientation.
•Intergroup goal incompatibility.

Discussion Question 6
 Direktur yang baru-baru ini bekerja, diserahkan tugas

untuk memimpin rapat mingguan team manajemen. Team
manajemen ini membutuhkan beberapa dokter, perawat,
asisten dokter, dan petugas sosial. Apa kebijakan yang
akan anda berikan pada direktur RS untuk membantu
meningkatkan kerja team?


Sebuah kelompok interorganisasional telah dibentuk untuk
mengidentifikasi kendala-kendala dalam memberikan pelayanan
kesehatan. Bagaimanakah anda mengelola organisasi dalam
lingkup divisi dan global terjaga dengan manajemen yang baik.

 Dalam keadaan apa saja uncohesive group lebih produktif

daripada cohesive groups? Strategi apa yang harus dibuat
oleh pemimpin untuk membuat Cohesive group lebih
produktif?
 Strategi apa yang digunakan pemimpin group untuk

meningkatkan komitmen dari anggota group?
Bagaimanakah pemimpin group dapat memantau apakah
anak buahnya telah memiliki komitmen atau tidak?

Work Design

Learning Objectives 7
 Identify the range of approaches to work design,

including the psychological and task inventory
approaches.
 Understand the relationship between work design

and individuals motivation and productivity.
 Discuss the differences between work and

working.
 Identify components of work, their characteristics

and their performance requirement.
 Analyze the interconnectedness of components of

work among individuals and among work groups.
 Understand how to approach the design of

individual jobs and work units.

Approaches to job
design
 Task Inventory approaches.
 Psychological approaches

Analysis of Work
 Work,
is objective and impersonal, it is energy directed
at organizational goals, identifiable separately
from the person who does it.

 Working
it is a workers affective response to work. Is an
individual personal and subjective reaction.

Types of Work
 Direct work
effort that directly contributes to the
accomplishment of an organization’ s
goals

 Management Work
Providing the resources and and context
within which direct work can be perform.
 Support Work
Does not directly result in achievement of an
organizational goal, but it needed for effective
accomplishment of other job

Key points in Designing
Works
To evaluate works and working run
properly, we need a more detailed
analysis, which is :
 Determining components of work
 interconnectedness of work

Designing individual job
 It is important to match people and

their needs to jobs and their inherent
work requirements.
 People evaluate courses of action for

the purpose of choosing among them

Coordinating interconnected
work within organizational
 Interconnected elements of work are best placed within
units
an individual job.
 In this section, focus on how to achieve coordination.
 Van de Ven et al. Found variations in patterns of

coordination among unit facing different level of task
uncertainty.
 Charns et al extended the findings, Mintzberg suggest

that work groups use a combination of six approaches
to coordination and that the use of these approaches is
related to the effectiveness of patient care.


The Six approaches fall into two categories: programming
methods and feedback methods.

Discussion Questions 7
 Under what conditions does a job with a high motivating
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potential lead to high job holder motivation?
What are the potential pitfallsin job redesign ?
Give examples of highly motivated people who do not
contribute greatly to organizational productivity?
What is the relationship among individual motivation and
satisfaction and an organization’s ability to coordinate
work?
Give examples of situations in which dependable role
performance is required in a job but effort above minimum
level is not. What happens when individuals in such jobs
innovate? Give examples of jobs requiring cooperative
behavior. What happens when people in such jobs are
willing to give only dependable role performance?

Coordination
and
Communication

Learning Objectives
 Differentiate between pooled, sequential, and reciprocal
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interdependence.
Differentiate between intraorganizational coordination
and interorganizational coordination.
Discuss a variety of coordination mechanisms used in
intraorganizational settings.
Consider the aplication of the intraorganizational
coordinating mechanisms to a given situation using the
contigency approach.
Discuss the three major types of transactions used in
interorganizational coordination.
Discuss the management of interorganizational linkages.
Describe the elements of effective communications
Discuss the technical mechanism of communication.
Discuss the barriers to communication
Describe the flow of intraorganizational communication.
Describe the flow of interorganizational communication
Discuss the special case of communication between units
of a system.

Interdependence

 Pooled interdependence
 Sequential interdependence
 Reciprocal interdependence

Skills needed by
Managers
n&
o
i
t
ina
d
on
i
r
t
o
a
o
C
unic
m
Com

Within the Hospital

Managers
Coo
r
Com dinatio
m un
n
icat &
ion

With Other Organizations

Coordination
As a means of effectively linking together the various
part of an organization or of linking together
organizations and dealing with interdependence.

Intraorganizational
Coordination
Interorganizational

Intraorganizational
Coordination
Since the activities of health professionals are seen as
being complex, uncertain, and of great social importance,
three distinctive structural arrangements has evolved to
support the autonomy of these professions.

 Autonomous arrangement, present when an organization

delegates to a professional group goal setting,
implementation, and evaluation of performance and the
administration manages the support staff.
 Heteronomous arrangement, Professionals are

subordinated to the administrative structure with specific
responsibilities delegated to various professional groups.
 Conjoint arrangement, Professionals and administration

are equal in power.

Intraorganizational Mechanisms
of Coordination
 Hierarchical coordination, The various activities

are linked by placing them under a central
authority.
 Administrative system, emphasizing formal
procedures, provides a second mechanism for
coordinating activities.
 Voluntary Action, inw hich individuals or group
see a need for coordination, develop a method,
and implement it.

Mintzberg’s Five
Coordinating Mechanism
M Manager

M Manager

Analyst A
Analyst A
O
O
Mutual Adjusment

O

Direct Supervision

M
A

Standardization
Worker Skills

O

Outputs

O

O

Interorganizational
Coordination
Typology :
 Market Transactions, Involve the focal

organization and other organizations entering
into relationships in order to obtain operational
resources or product markets.
 Voluntary interorganizational relationship

transactions, Distinguished by the voluntary dimension
of the transactions.
 Involuntary Interorganizational Transactions, lead to

unique ways of managing interdependence.

Managing Interorganizational
linkages
It is important for a manager
to use a contigency approach
when establishing and
maintaining relationships with
interdependent organizations

Communication
 Provides information people need to make

decisions.
 Communications from the Managers perspective,
has:

Intraorganizational Communication , depends on
formal establishment of channels and networks
within the organizations.
Interorganizational Dimensions, occurs between
organizations or between organizations and
constituencies outside them.

Elements of Effective
Communication
Reinforcement

Desire to
Communicate

Effective
Communication:

•Being Understood
•Making meaning, not agreemen

Understanding How
others Learn

•Perceive and Process information
•Analytic vs Intuitive
•Abstract vs Concrete,etc

Purpose
Content

Information Cues
Eliciting Cues
Decision Cues
Importance
Complexity
Ascribed

Sender
Credibility Achieved
Time Frame Long vs Short

Barriers to
Communication
Environmental Barriers
Personal Barriers

Flows of intraorganizational
Communications
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Downward Flow
Upward Flow
Horizontal and Diagonal Flows
Communication Networks
Communication networks
Chain Networks
Y Pattern
Wheel Pattern
Circle Pattern
All-Channels Network

Upward
Downward
Communication
Communication
•Problems & Exceptions
•Implementation of goals,
•Suggestions for improvement
Strategies, Objectives
•Performance reports
•Job Instructions and rationale
•Grievances and disputes •Procedures and practices
•Financial and Accounting •Performance feedback
•Indoctrination
information

Influence

Interpret

Communication Flows in Health
care Organizations

COORDINATE
HORIZONTAL AND DIAGONAL COMMUNICATION
•Intradepartmental problem solving
•Interdepartmental coordination
•Staff advice to the departments

Discussion Questions
 Diskusikan perbedaan koordinasi intra dan inter

organisasional. Apa sajakah cara-cara yang dapat
digunakan oleh manajer untuk mencapai koorinasi tipe
tertentu?
 Jelaskan model komunikasi dan gambarkan model

komunikasinya!
 Anda baru saja diangkat menjadi manajer sebuah

proyek bersama antara RS tempat anda bekerja dengan
beberapa staff medis untuk mengoperasikan fasilitas
bedah. Program yang anda pentingkan adalah untuk
menjalin kerjasama yang efektif dengan RS. Buatlah
rencana proyek ini berdasarkan materi pada bab ini!
 Bayangkan Organisasi pelayanan kesehatan anda

menerima sebuah pemberitaan yang buruk.
Bagaimanakah organisasi anda akan bereaksi?

Power And Politics in
Health Services
Organizations

Learning Objectives 9
 Distinguish between rational and political models of

organization of their appropriateness to health
services organizations.
 Know the practical, managerial implications of the

effective use of power in health services organizations.
 Identify the conditions that promote the use of power,

politics, and informal Influences in health services
organizations.
 Understand the range of political strategies and tactics

employed by members of health services
organizations
 Understand the sources of power in health services

organizations.
 Know the key approaches for consolidating and

developing power by managers, physicians, and other
groups in health services organizations.

Power, Influences and
Politics, definitions
 Power, has been a notoriously elusive term to
define and identify within organizations.
 Influence, indicate actions that, either directly or
indirectly, cause a change in the behavior or
attitudes of another individual or group.
 Politics, domain activity in which participants
attempt to influences organizational decisions
and activities in ways that are not sanctioned by
either the formal authority system of the
organization, its accepted ideology, or certified
expertise.

Rational vs political
perspectives on management
Organizational management is influenced by two
models :
Rational models imply that the managers are orchestrating
the activities of a team whose members all subscribe to a
common set of goals and objectives.
Political Perspectives acknowledge the existence of power and
influence other than that vested in formal authority system or
professional expertise.

Sources of power
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

Access to resources
Access to information
Formal Authority
Skill in dealing with
uncertainty

Mintzbergs Political
Games
 Games to resist authority
 Games to counter the resistance to

authority.
 Games to build power bases.
 Games to defeat rivals
 Games to Effect Organizational
change

Power Strategies and
Tactics
The use of power is to implement
decisions.
 Power is most effectively used when it
is employed unobtrusively as possible.
 Effective attempts to influence is in an
aura of legitimacy and rational purpose.
 Coalition Building

Power, Politics, and
Organizational Performance
 In an organizations, the use of power

is to maintain the importance of a
decision has been made.
 Such Strategies for reducing the
level of influence are available for
manager who simply do not feel
comfortable for using power.