Dasar Pemahaman & Teori Organisasi AYUN SRIATMI
Dra. Ayun Sriatmi, M.Kes
ORGANISASI ( PROFIT & NON PROFIT )
PENCAPAIAN TUJUAN
TUJUAN KEMASYARAKATAN
KEMASYARAKATAN
PENCAPAIAN
SISTEM
SISTEM &
& FORMASI
FORMASI SOSIAL
SOSIAL
NEGARA //
NEGARA
STATE
STATE
Nirlaba ))
(( Nirlaba
PASAR //
PASAR
MARKET
MARKET
Laba ))
(( Laba
MASY. SIPIL
SIPIL //
MASY.
SOCIETY
SOCIETY
Nirlaba ))
(( Nirlaba
ORGANISASI
PRINSIP FUNGSI : MEMBERI PELAYANAN PADA MASYARAKAT
ORGANISASI SWASTA
SWASTA YANG
YANG MENCARI
MENCARI UNTUNG
UNTUNG
ORGANISASI
PRIVATE FOR
FOR PROFIT
PROFIT ))
(( PRIVATE
ORGANISASI SWASTA
SWASTA SETENGAH
SETENGAH PEMERINTAH
PEMERINTAH
ORGANISASI
PRIVATE QUASI
QUASI PUBLIC
PUBLIC ))
(( PRIVATE
ORGANISASI SWASTA
SWASTA NON
NON PROFIT
PROFIT
ORGANISASI
PRIVATE NON
NON PROFIT
PROFIT ))
(( PRIVATE
ORGANISASI PUBLIK
PUBLIK // BADAN
BADAN PEMERINTAHAN
PEMERINTAHAN
ORGANISASI
PUBLIC ORGANIZATION
ORGANIZATION ))
(( PUBLIC
1. SISTEM TERTUTUP ( CLOSE – SYSTEM APPROACH )
Didasarkan pada asumsi bahwa gambaran terpenting organisasi
adalah pada aktivitasnya dengan struktur internal dan proses
yang terisolisasi / tertutup secara relatif dengan lingkungan
eksternalnya.
2. SISTEM TERBUKA ( OPEN – SYSTEM APPROACH )
Perilaku organisasi sangat dipengaruhi oleh kondisi
lingkungannya.
Struktur organisasi, proses dan performance / kinerjanya sangat
dipengaruhi oleh kondisi input dari lingkungannya dan output
yang dihasilkan ( outcome ).
CLOSED SYSTEM APPROACH
OPEN SYSTEM APPROACH
1. Rational Approach
1. Rational Approach
a. Contingency Theory
b. Decision Theory Aproach
2. Natural System Approach
2. Natural Approach
a. Resources Dependences /
Political Negotiation /
Strategic Contingencies
b. Population Ecology
I.
CLOSED SYSTEM APPROACH
1. Rational Approach
- By Taylor, Gullick & Urwick, Mooney ( Principles of Management )
- Fokus pada :
• span of control
•
•
•
•
unity of command
appropriate delegation of authority
departemenisasi
metode kerja
- Taylor ( Scientific Management ) menyarankan :
•
•
•
•
Programming the job
Choosing the right person to match the job
Training the person to do the job
Job design, etc
Max Weber ( Theory of Bureaucracy ) konsisten dengan
model tertutup diatas, dengan memberikan 5 kriteria
ideal birokrasi ( ideal type of bureaucracy) :
1.Kejelasan organisasi secara eksplisit,
prosedur kerja spesifik untuk aktivitas
pemerintahan.
2.Distribusi / pembagian kerja / aktivitas
tertentu diantara office holder.
3.Struktur hierarki kewenangan yang
digambarkan jelas.
4.Seleksi berdasarkan kemampuan dari
kompetensi teknis yang dimiliki
5.Fungsi-fungsi official yang lebih bersifat
hubungan impersonal
2. Natural Approaches
• Dikembangkan sebagai reaksi atas pendekatan
rasional.
• Menekankan pada “ human relation “ individual
(perilaku individu dalam organisasi)
• Keberhasilan organisasi ditentukan oleh keberhasilan
individu dalam pencapaian tujuan ( satisfaction of
individual )
• Tokohnya antara lain : Chester I Barnard,
Douglas Mc Gregor, Chris Argyris, Rensis Likert, dll.
ORGANISASI
PRINSIP FUNGSI : MEMBERI PELAYANAN PADA MASYARAKAT
PERSAMAAN :
1.
MELAYANI LINGKUNGAN
2.
MENGHADAPI TANTANGAN DARI LINGKUNGAN, antara lain :
a. Birokrasi
b. Internal dan Eksternal Organisasi yang tolak PERUBAHAN
c. Tekanan – tekanan dari Interest Group
d. Kesulitan untuk membagi “ ADIL “ ( keadilan ) karena
sifatnya yang
cenderung relatif.
3.
PERTANGGUNGJAWABAN ( ACCOUNTABILITY SYSTEM )
4.
KARAKTERISTIK ORGANISASI ( menyangkut prinsip2
organisasi ) :
Struktur Organisasi
Departemenisasi
Pembagian Kerja
Hierarki Wewenang & Kontrol
SDM, capai
dll
( untuk
prinsip : TO GET THE JOB DONE
)
KLASIFIKASI
KLASIFIKASI ORGANISASI
ORGANISASI NON
NON PROFIT
PROFIT
PUBLIC––CONSUMPTION
CONSUMPTIONGOODS
GOODS
PUBLIC
VS
PRIVATE––CONSUMPTION
CONSUMPTIONGOODS
GOODS
PRIVATE
By : KOTTEN
1. Badan Pemerintah yang dibentuk dengan UU & diberi wewenang
untuk memberi pelayanan & pungut pajak.
2. Organisasi Non Profit Swasta / Sektor Independen yang diorganisir
diluar kewenangan Pem & UU.
3. Organisasi Swasta Quasi Pemerintah, dibentuk berdasar
wewenang legislatif.
By : OLECK ( ditinjau dari sudut mencari untung )
1. PUBLIC BENEFIT
2. MUTUAL BENEFIT
3. PRIVATE BENEFIT
ORGANIZATIONSAND
ANDM
M
ANAGERS
ORGANIZATIONS
ANAGERS
•Org
anizationTheory
Theoryand
andHealth
HealthCare
CareM
M
anag
ement
•Org
anization
anag
ement
M
anag
erialRole
Role
**M
anag
erial
Need to …
M
OTIVATEAND
ANDLEAD
LEAD
M
OTIVATE
PEOPLEAND
ANDGROUPS
GROUPS
PEOPLE
OPERATETHE
THE
OPERATE
TECHNICALSYS
SYS
TEM
TECHNICAL
TEM
•S
atisfyngindividual
individual
•S
atisfyng
needsand
andvalues
values
needs
Perception,M
M
otivati
((Perception,
otivati
vation,Neg
Neg
otiation))
vation,
otiation
•Determiningthe
the
•Determining
appropratework
work
approprate
desig
desig
nn
•Providingdirection
direction
•Providing
Leadershipand
and
((Leadership
M
anag
ership))
M
anag
ership
•Recog
nizingthe
the
•Recog
nizing
natureof
ofgg
roups
nature
roups
(S
ocialSS
tructureof
of
(S
ocial
tructure
W
orkGroups
Groups))
W
ork
By
In response to problems of
personnil ( Commitment,
Absenteeism, Turnover,
Apathy & Conflict among
Professionals )
•Establishingcommu
commu
•Establishing
nication&&coordina
coordina
nication
tionmechanism
mechanism
tion
•Controlling
•Controlling
Performance
Performance
Authority,Power
Power&&
((Authority,
Influence))
Influence
By
In response to problems of
technical performance
( Productivity, Efficiency ,
Quality & Consumer
Satisfaction )
RENEW
RENEW
THEORGANIZATION
ORGANIZATION
THE
CHART
CHART
THEFUTURE
FUTURE
THE
•Determiningappropri
appropri
•Determining
ateorg
org
anization
ate
anization
desig
desig
nn
•Acquiringresources
resources
•Acquiring
manag
ingthe
the
&&manag
ing
Environment
Environm
ent
•M
anag
ingchang
chang
•M
anag
ing
ee&&
Innovation
Innovation
M
anag
ing
••M
anag
ing
trateg
ically
SS
trateg
ically
Anticipatingthe
the
••Anticipating
Future
Future
•Attaininggg
oals
•Attaining
oals
Effective&&Efficien
Efficien))
((Effective
By
In response to problems of
the environment
( Complexity & uncertainty,
Technological & Social change,
Competitive force, Multiple
performance demands )
By
In response to problems of
survival and growth
( long-run survival, long-run
performance and growth )
TEORI
TEORI ORGANISASI
ORGANISASI &
&
MANAJEMEN
MANAJEMEN PELAYANAN
PELAYANAN KESEHATAN
KESEHATAN
1. Sistem & Komposisi ?
2. Jenis & Karakteristik Organisasi Yankes ?
3. Persamaan & Perbedaan Organisasi Yankes dengan
Organisasi Lain ?
4. Dukungan Teori Organisasi dalam Kerangka Manajemen &
Organisasi Yankes ?
5. Issue – Issue Penting ttg Organisasi dan Manajemen
Yankes ?
* Efisiensi dan Efektivitas
* Konflik dan Perubahan
* Kelangsungan Hidup dan Pertumbuhan
ISTEM
TEMYANKES
YANKES
SSIS
ORGANIS
AS
ORGANIS
AS
II
PENDUKUNG
PENDUKUNG
PEM
BIAYAAN
PEM
BIAYAAN
PEM
ERINTAH
PEM
ERINTAH
KETENAGAAN
KETENAGAAN
PROVIDER
PROVIDER
DIVERSITY OF PROVIDERS
COMPLEXITY OF CARE
•VARIANS PROFESSIONAL
•VARIANS KUALIFIKASI
•TERORGANISIR & AKTIVITAS dlm
BERBAGAI BENTUK & J ENIS
•BERSIFAT INDIVIDUAL s/d
ORGANISASIONAL
P
R
O
F
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ORGANISASI PENDUKUNG / PENYOKONG
SISTEM PELAYANAN KESEHATAN
1. Regulatory and Quasi Regulatory
( Planning Services )
2. Third Party Financing Organizations
3. Professional Association
4. Pharmaceutical & Medical Equipment Supply
Corporation
5. Educational and Training Facilities
ORGANISASI PELAYANAN
PELAYANAN
ORGANISASI
KESEHATAN
KESEHATAN
1. Sulit mendefinisikan & mengukur output
2. Variabel yang mempengaruhi kinerja sangat banyak &
kompleks
3. Pekerjaan cenderung bersifat kegawatdaruratan / emergency
dan dalam suasana yang serba tidak terduga.
4. Aktivitas pekerjaan dengan tingkat ketergantungan yang tinggi
diantara variasi kelompok profesional.
5. Ijin toleransi yang sangat kecil untuk kesalahan – kesalahan.
6. Pekerjaan / aktivitas dipengaruhi tingkatan spesialisasi yang
tinggi ( spesialistik )
7. Mengutamakan profesionalitas & loyalitas terhadap profesi
8. Eksistensi organisasi & manajemen yang lebih efektif dalam
mengontrol semua kelompok dalam pertanggungjawaban &
pembiayaan
9. Eksistensi pada 2 sisi kewenangan :
a. Dalam “ create “ masalah – masalah koordinasi.
b. Dalam akuntabilitas & “ confusion “ peranan masingmasing.
Pelayanan Kesehatan
VALUES // NILAI
NILAI
VALUES
A Typology of Four Health Care Organizations
ATTRIBUTES
In-Patients
Services
Ambulatory
Services
Community Based
Services
Nursing Homes
ENVIRONMENT
( COMPLEX & DINAMIC )
Highly complex & dinamic,
large number of external
regulation & high degree
of competition
Somewhat less complex
env, but competitive &
regulatory factors
increasing
Complexity limited
primarily to wide variety
of federal & state funded
programs
Fairly complex
environment due to
state regulations and
third party financing
MISSION & GOALS
Primarily treatment
oriented
Primarily individual
diagnosis, treatment &
prev oriented
Community-wide
prevention, diagnosis &
treatment oriented
Maintenance and social
supported oriented
GOAL CONGCRUENCE
Goals not particularly well
integrated or congcruence
Relatively high degree
of goal congcruence
Somewhat lower degree
of goal congcruence &
integration due to wide
range of services typically
offered
High degree of goal
congcruence centered
around maintenance
and social support
TIME ORIENTATION
TOWARD PATIENTS
On Average,
Six days
Minutes
Hours
Months / Years
DEGREE OF
SPECIALIZATION
Highly specialized
Dependent on the
number of different
specilaities in the
practice
Highly specialized
depending on range of
programs & services
offered
Least highly specialized
DEGREE OF TASK
INTERDEPENDENCE
High degree of task
interdependence
Relatively low
interdependence
As a function of number
of programs & services
that must be coordinated
Moderate
interdependence
CONCENTRATION OF
DECISION MAKING
Low level of
concentration, decision
making diffused
Most highly
concentrated in the
patient’s physician
Low level of
concentration, decision
making diffused among
the various programs
Decision making
moderately
concentrated
MANAGER – PHYSICIANS
RELATIONSHIP
Impersonal, Structured
Personal, Unstructured
Peer to peer
Distant, transistory
WA RNING … !!!!
1. ADANYA
ADANYA PERBEDAAN
PERBEDAAN VARIASI
VARIASI
1.
SUBSTANSIAL (( ukuran,
ukuran,kepemilikan
kepemilikan,,
SUBSTANSIAL
lokasi &
&hubungan
hubungan faktor-faktor
faktor-faktor lainnya
lainnya ))
lokasi
2.PERBANDINGAN
PERBANDI NGANYG
YGDILAKUKAN
DILAKUKAN
2.
HANYABERSIFAT
BERSIFAT RELATIF
RELATIF
HANYA
( Summary of Mechanistic & Organic Design Characteristic )
ENVIRONMENT
Complex &
unstable
TASK TECHNOLOGY
PEOPLE
DESIGN
Higher efficiency
& effectiveness
Variable
High percentage * Low specification of rules
of professional
and procedures
* Decentralized participative
decision making
ORGANIC CHARACTERISTIC
* Differentiated reward system
* Nonprogrammed coordination
and control
Simple & stable
Routine
Low percentage
of professional
MECHANISTIC CHARACTERISTIC
* High specification of rules and
procedures
* Centralized nonparticipative
decision making
* Simple, undifferentiated reward
system
* Programmed coordination
and control
Higher efficiency
& effectiveness
ORGANISASI ( PROFIT & NON PROFIT )
PENCAPAIAN TUJUAN
TUJUAN KEMASYARAKATAN
KEMASYARAKATAN
PENCAPAIAN
SISTEM
SISTEM &
& FORMASI
FORMASI SOSIAL
SOSIAL
NEGARA //
NEGARA
STATE
STATE
Nirlaba ))
(( Nirlaba
PASAR //
PASAR
MARKET
MARKET
Laba ))
(( Laba
MASY. SIPIL
SIPIL //
MASY.
SOCIETY
SOCIETY
Nirlaba ))
(( Nirlaba
ORGANISASI
PRINSIP FUNGSI : MEMBERI PELAYANAN PADA MASYARAKAT
ORGANISASI SWASTA
SWASTA YANG
YANG MENCARI
MENCARI UNTUNG
UNTUNG
ORGANISASI
PRIVATE FOR
FOR PROFIT
PROFIT ))
(( PRIVATE
ORGANISASI SWASTA
SWASTA SETENGAH
SETENGAH PEMERINTAH
PEMERINTAH
ORGANISASI
PRIVATE QUASI
QUASI PUBLIC
PUBLIC ))
(( PRIVATE
ORGANISASI SWASTA
SWASTA NON
NON PROFIT
PROFIT
ORGANISASI
PRIVATE NON
NON PROFIT
PROFIT ))
(( PRIVATE
ORGANISASI PUBLIK
PUBLIK // BADAN
BADAN PEMERINTAHAN
PEMERINTAHAN
ORGANISASI
PUBLIC ORGANIZATION
ORGANIZATION ))
(( PUBLIC
1. SISTEM TERTUTUP ( CLOSE – SYSTEM APPROACH )
Didasarkan pada asumsi bahwa gambaran terpenting organisasi
adalah pada aktivitasnya dengan struktur internal dan proses
yang terisolisasi / tertutup secara relatif dengan lingkungan
eksternalnya.
2. SISTEM TERBUKA ( OPEN – SYSTEM APPROACH )
Perilaku organisasi sangat dipengaruhi oleh kondisi
lingkungannya.
Struktur organisasi, proses dan performance / kinerjanya sangat
dipengaruhi oleh kondisi input dari lingkungannya dan output
yang dihasilkan ( outcome ).
CLOSED SYSTEM APPROACH
OPEN SYSTEM APPROACH
1. Rational Approach
1. Rational Approach
a. Contingency Theory
b. Decision Theory Aproach
2. Natural System Approach
2. Natural Approach
a. Resources Dependences /
Political Negotiation /
Strategic Contingencies
b. Population Ecology
I.
CLOSED SYSTEM APPROACH
1. Rational Approach
- By Taylor, Gullick & Urwick, Mooney ( Principles of Management )
- Fokus pada :
• span of control
•
•
•
•
unity of command
appropriate delegation of authority
departemenisasi
metode kerja
- Taylor ( Scientific Management ) menyarankan :
•
•
•
•
Programming the job
Choosing the right person to match the job
Training the person to do the job
Job design, etc
Max Weber ( Theory of Bureaucracy ) konsisten dengan
model tertutup diatas, dengan memberikan 5 kriteria
ideal birokrasi ( ideal type of bureaucracy) :
1.Kejelasan organisasi secara eksplisit,
prosedur kerja spesifik untuk aktivitas
pemerintahan.
2.Distribusi / pembagian kerja / aktivitas
tertentu diantara office holder.
3.Struktur hierarki kewenangan yang
digambarkan jelas.
4.Seleksi berdasarkan kemampuan dari
kompetensi teknis yang dimiliki
5.Fungsi-fungsi official yang lebih bersifat
hubungan impersonal
2. Natural Approaches
• Dikembangkan sebagai reaksi atas pendekatan
rasional.
• Menekankan pada “ human relation “ individual
(perilaku individu dalam organisasi)
• Keberhasilan organisasi ditentukan oleh keberhasilan
individu dalam pencapaian tujuan ( satisfaction of
individual )
• Tokohnya antara lain : Chester I Barnard,
Douglas Mc Gregor, Chris Argyris, Rensis Likert, dll.
ORGANISASI
PRINSIP FUNGSI : MEMBERI PELAYANAN PADA MASYARAKAT
PERSAMAAN :
1.
MELAYANI LINGKUNGAN
2.
MENGHADAPI TANTANGAN DARI LINGKUNGAN, antara lain :
a. Birokrasi
b. Internal dan Eksternal Organisasi yang tolak PERUBAHAN
c. Tekanan – tekanan dari Interest Group
d. Kesulitan untuk membagi “ ADIL “ ( keadilan ) karena
sifatnya yang
cenderung relatif.
3.
PERTANGGUNGJAWABAN ( ACCOUNTABILITY SYSTEM )
4.
KARAKTERISTIK ORGANISASI ( menyangkut prinsip2
organisasi ) :
Struktur Organisasi
Departemenisasi
Pembagian Kerja
Hierarki Wewenang & Kontrol
SDM, capai
dll
( untuk
prinsip : TO GET THE JOB DONE
)
KLASIFIKASI
KLASIFIKASI ORGANISASI
ORGANISASI NON
NON PROFIT
PROFIT
PUBLIC––CONSUMPTION
CONSUMPTIONGOODS
GOODS
PUBLIC
VS
PRIVATE––CONSUMPTION
CONSUMPTIONGOODS
GOODS
PRIVATE
By : KOTTEN
1. Badan Pemerintah yang dibentuk dengan UU & diberi wewenang
untuk memberi pelayanan & pungut pajak.
2. Organisasi Non Profit Swasta / Sektor Independen yang diorganisir
diluar kewenangan Pem & UU.
3. Organisasi Swasta Quasi Pemerintah, dibentuk berdasar
wewenang legislatif.
By : OLECK ( ditinjau dari sudut mencari untung )
1. PUBLIC BENEFIT
2. MUTUAL BENEFIT
3. PRIVATE BENEFIT
ORGANIZATIONSAND
ANDM
M
ANAGERS
ORGANIZATIONS
ANAGERS
•Org
anizationTheory
Theoryand
andHealth
HealthCare
CareM
M
anag
ement
•Org
anization
anag
ement
M
anag
erialRole
Role
**M
anag
erial
Need to …
M
OTIVATEAND
ANDLEAD
LEAD
M
OTIVATE
PEOPLEAND
ANDGROUPS
GROUPS
PEOPLE
OPERATETHE
THE
OPERATE
TECHNICALSYS
SYS
TEM
TECHNICAL
TEM
•S
atisfyngindividual
individual
•S
atisfyng
needsand
andvalues
values
needs
Perception,M
M
otivati
((Perception,
otivati
vation,Neg
Neg
otiation))
vation,
otiation
•Determiningthe
the
•Determining
appropratework
work
approprate
desig
desig
nn
•Providingdirection
direction
•Providing
Leadershipand
and
((Leadership
M
anag
ership))
M
anag
ership
•Recog
nizingthe
the
•Recog
nizing
natureof
ofgg
roups
nature
roups
(S
ocialSS
tructureof
of
(S
ocial
tructure
W
orkGroups
Groups))
W
ork
By
In response to problems of
personnil ( Commitment,
Absenteeism, Turnover,
Apathy & Conflict among
Professionals )
•Establishingcommu
commu
•Establishing
nication&&coordina
coordina
nication
tionmechanism
mechanism
tion
•Controlling
•Controlling
Performance
Performance
Authority,Power
Power&&
((Authority,
Influence))
Influence
By
In response to problems of
technical performance
( Productivity, Efficiency ,
Quality & Consumer
Satisfaction )
RENEW
RENEW
THEORGANIZATION
ORGANIZATION
THE
CHART
CHART
THEFUTURE
FUTURE
THE
•Determiningappropri
appropri
•Determining
ateorg
org
anization
ate
anization
desig
desig
nn
•Acquiringresources
resources
•Acquiring
manag
ingthe
the
&&manag
ing
Environment
Environm
ent
•M
anag
ingchang
chang
•M
anag
ing
ee&&
Innovation
Innovation
M
anag
ing
••M
anag
ing
trateg
ically
SS
trateg
ically
Anticipatingthe
the
••Anticipating
Future
Future
•Attaininggg
oals
•Attaining
oals
Effective&&Efficien
Efficien))
((Effective
By
In response to problems of
the environment
( Complexity & uncertainty,
Technological & Social change,
Competitive force, Multiple
performance demands )
By
In response to problems of
survival and growth
( long-run survival, long-run
performance and growth )
TEORI
TEORI ORGANISASI
ORGANISASI &
&
MANAJEMEN
MANAJEMEN PELAYANAN
PELAYANAN KESEHATAN
KESEHATAN
1. Sistem & Komposisi ?
2. Jenis & Karakteristik Organisasi Yankes ?
3. Persamaan & Perbedaan Organisasi Yankes dengan
Organisasi Lain ?
4. Dukungan Teori Organisasi dalam Kerangka Manajemen &
Organisasi Yankes ?
5. Issue – Issue Penting ttg Organisasi dan Manajemen
Yankes ?
* Efisiensi dan Efektivitas
* Konflik dan Perubahan
* Kelangsungan Hidup dan Pertumbuhan
ISTEM
TEMYANKES
YANKES
SSIS
ORGANIS
AS
ORGANIS
AS
II
PENDUKUNG
PENDUKUNG
PEM
BIAYAAN
PEM
BIAYAAN
PEM
ERINTAH
PEM
ERINTAH
KETENAGAAN
KETENAGAAN
PROVIDER
PROVIDER
DIVERSITY OF PROVIDERS
COMPLEXITY OF CARE
•VARIANS PROFESSIONAL
•VARIANS KUALIFIKASI
•TERORGANISIR & AKTIVITAS dlm
BERBAGAI BENTUK & J ENIS
•BERSIFAT INDIVIDUAL s/d
ORGANISASIONAL
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ORGANISASI PENDUKUNG / PENYOKONG
SISTEM PELAYANAN KESEHATAN
1. Regulatory and Quasi Regulatory
( Planning Services )
2. Third Party Financing Organizations
3. Professional Association
4. Pharmaceutical & Medical Equipment Supply
Corporation
5. Educational and Training Facilities
ORGANISASI PELAYANAN
PELAYANAN
ORGANISASI
KESEHATAN
KESEHATAN
1. Sulit mendefinisikan & mengukur output
2. Variabel yang mempengaruhi kinerja sangat banyak &
kompleks
3. Pekerjaan cenderung bersifat kegawatdaruratan / emergency
dan dalam suasana yang serba tidak terduga.
4. Aktivitas pekerjaan dengan tingkat ketergantungan yang tinggi
diantara variasi kelompok profesional.
5. Ijin toleransi yang sangat kecil untuk kesalahan – kesalahan.
6. Pekerjaan / aktivitas dipengaruhi tingkatan spesialisasi yang
tinggi ( spesialistik )
7. Mengutamakan profesionalitas & loyalitas terhadap profesi
8. Eksistensi organisasi & manajemen yang lebih efektif dalam
mengontrol semua kelompok dalam pertanggungjawaban &
pembiayaan
9. Eksistensi pada 2 sisi kewenangan :
a. Dalam “ create “ masalah – masalah koordinasi.
b. Dalam akuntabilitas & “ confusion “ peranan masingmasing.
Pelayanan Kesehatan
VALUES // NILAI
NILAI
VALUES
A Typology of Four Health Care Organizations
ATTRIBUTES
In-Patients
Services
Ambulatory
Services
Community Based
Services
Nursing Homes
ENVIRONMENT
( COMPLEX & DINAMIC )
Highly complex & dinamic,
large number of external
regulation & high degree
of competition
Somewhat less complex
env, but competitive &
regulatory factors
increasing
Complexity limited
primarily to wide variety
of federal & state funded
programs
Fairly complex
environment due to
state regulations and
third party financing
MISSION & GOALS
Primarily treatment
oriented
Primarily individual
diagnosis, treatment &
prev oriented
Community-wide
prevention, diagnosis &
treatment oriented
Maintenance and social
supported oriented
GOAL CONGCRUENCE
Goals not particularly well
integrated or congcruence
Relatively high degree
of goal congcruence
Somewhat lower degree
of goal congcruence &
integration due to wide
range of services typically
offered
High degree of goal
congcruence centered
around maintenance
and social support
TIME ORIENTATION
TOWARD PATIENTS
On Average,
Six days
Minutes
Hours
Months / Years
DEGREE OF
SPECIALIZATION
Highly specialized
Dependent on the
number of different
specilaities in the
practice
Highly specialized
depending on range of
programs & services
offered
Least highly specialized
DEGREE OF TASK
INTERDEPENDENCE
High degree of task
interdependence
Relatively low
interdependence
As a function of number
of programs & services
that must be coordinated
Moderate
interdependence
CONCENTRATION OF
DECISION MAKING
Low level of
concentration, decision
making diffused
Most highly
concentrated in the
patient’s physician
Low level of
concentration, decision
making diffused among
the various programs
Decision making
moderately
concentrated
MANAGER – PHYSICIANS
RELATIONSHIP
Impersonal, Structured
Personal, Unstructured
Peer to peer
Distant, transistory
WA RNING … !!!!
1. ADANYA
ADANYA PERBEDAAN
PERBEDAAN VARIASI
VARIASI
1.
SUBSTANSIAL (( ukuran,
ukuran,kepemilikan
kepemilikan,,
SUBSTANSIAL
lokasi &
&hubungan
hubungan faktor-faktor
faktor-faktor lainnya
lainnya ))
lokasi
2.PERBANDINGAN
PERBANDI NGANYG
YGDILAKUKAN
DILAKUKAN
2.
HANYABERSIFAT
BERSIFAT RELATIF
RELATIF
HANYA
( Summary of Mechanistic & Organic Design Characteristic )
ENVIRONMENT
Complex &
unstable
TASK TECHNOLOGY
PEOPLE
DESIGN
Higher efficiency
& effectiveness
Variable
High percentage * Low specification of rules
of professional
and procedures
* Decentralized participative
decision making
ORGANIC CHARACTERISTIC
* Differentiated reward system
* Nonprogrammed coordination
and control
Simple & stable
Routine
Low percentage
of professional
MECHANISTIC CHARACTERISTIC
* High specification of rules and
procedures
* Centralized nonparticipative
decision making
* Simple, undifferentiated reward
system
* Programmed coordination
and control
Higher efficiency
& effectiveness