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org theory exam 2 > exam 2 > Flashcards

exam 2 Flashcards

1
Q

organizational design

A

The arrangement of authority, responsibility, and flow of information within an organization, resulting in an organizational structure

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2
Q

relation to management activities

A
  1. Statement of mission
  2. Strategy development
  3. organization design
  4. Information needs
  5. Rewards
  6. Performance evaluation
  7. Feedback loop (change)

form (3) follows function (mission and strategy)

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3
Q

twin structural issues

A

differentiation and integration

Because we have so much differentiation (medical specialties) in the org, we need to integrate

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4
Q

continuum of structures

A

functional

direct contact

integrators and liaisons
-long-term point of contacts for each department to communicate across departments

task forces

  • limimited in time and focused
  • often interdepartmental

committees

  • the “parallel organizatin”
  • continue overtime and interepartmental

teams

programs/service line

  • Centers of excellence
  • Mini org within org for high volume and complex specialties
  • So large and so complex, you may have a specific program
  • Cancer and heart care
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5
Q

programming approaches to coordination of work

A

Standardization of work processes (Clinical pathways) (sometimes protocols): standardized way of going about your work

  • Benefits of standardization
  • Often protocols (same thing)
  • Pathway from admissions to discharge

Standardization of skills

Standardization of outcomes

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6
Q

feedback approaches to coordination of work

A

Supervision: exchange of information in hierarchical relationships

Mutual adjustment: not in hierarchical relationships; one-on-one relationships that occur to get jobs done; informal interactions between MDs and RNsd

Group coordination: more formal and typical done in morning rounds
-Get the whole team across disciplines together

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7
Q

responsbility matrix

A

fixes accountability

Assign task and responsibilities to primary owner, supper, coordination, decision

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8
Q

communication

A

the creation of exchange of understanding between sender(s) and receiver(s)

Repeat back in your own words so you understand what i meant

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9
Q

channels of communication

A

Face-toface

  • need to be face-to-face to solve a problem
  • If not possible, can do virtual

Virtual

Correspondence

Phone

E-mail

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10
Q

defensive communication to open communication

A

defensive communication is a barrier to open communication

Evaluating ——> descriptive

Controlling ——> supporting

Making statements ——> asking questions

Acting parent-child ——> acting adult-adult

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11
Q

how do we communication

A

Non-verbal 55% (why in-person is best)

Tone of voice 38%

Verbally 7%

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12
Q

communicating with stakeholders

A

stakeholder mapping
-Map out people with stake (interest in org) in org to determine stakeholders and then find out 4 things from them

Stakeholder analysis

  • Needs
  • Expectations
  • Challenges
  • recommendations
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13
Q

tools for managing organizational communication

A

Interviews

Nominal group technique; silent brainstorm then group together

Focus groups

  • Limited to 5-7 people; focus on a specific issue
  • Surveys or questionnaires will show up as a problem so you run a focus group to drill down on that problem

Questionnaires
-Less effective; bad response rate

Delphi techniques

  • Delphi technique used to reach out to people who cannot be there
  • Do this if you have geographically dispersed people
  • Survey, synthesize, send back out (see what others are saying and piggy back on those ideas), survey back again
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14
Q

key communication hints

A 
Eye contact
Voice, non-verbal
Consistency of message
Paraphrasing
Watch filters and barriers
Simple and focused
Enough time
Right channel
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15
Q

power

A

ability/potential to exert actions that either directly or indirectly cause a change in the behavior and/or attitudes of another individual or group

Often characterized by coercion

You have the ability but not the influence to take action

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16
Q

influence

A

actions, either directly or indirectly, cause a change on the behavior and/or attitudes of another individual or group

Influence is power turned into action

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17
Q

politics

A

ongoing process of managing influence, characterized by its hidden nature

This is a process whereby participants attempt to influence organizational decisions and activities in ways that are not sanctioned by the organization

18
Q

power abuse

A

use of power in ways that are not acceptable, often involves self-interest and not the organizations best interest

Often inflicts negative outcomes on workers, customers and other stakeholders

19
Q

sources of power

A

Structural
-hierarchical (you have power because you are the boss)

Structurally derived (ex. Support services)
-We have the power because we have the important services that you need

Cultural (ex. informal/peer leaders)

Knowledge-based
-someone with the knowledge to lead a project; specialties in medicine

Network centrality
-Being close to power

20
Q

preventing abuse of power

A

Transparency

Board and advisory boards
-important to make sure things are done correctly

External auditors
-Check the books

Code of ethics
-guidelines for how we behave in an organization

Appraisal systems

Personal integrity in hiring

21
Q

Conflict can be good but it can be detrimental if there’s too much and you don’t manage it well

A

Why we need conflict

  • Can stimulate productivity and creativity
  • Can unearth differences
  • Serves as an antidote to groupthink

Why we don’t need conflict

  • High levels can be detrimental and destructive
  • Diverts attention away from mission
  • Increases stress
  • Reduced well-being
  • Loss of trusting, supportive relationships
22
Q

3 types of conflict

A 
Task conflict (what to do)
-Disagreement about the actual job/task
Administrative conflict (how to do it)
-Disagreement on how task is to be done
Relationship conflict (ways to work together)
-Interpersonal conflict
23
Q

conflict management; each have tradeoffs for self/others

A

Pressing: assertive and uncooperative (win/lose)
-Times to do this such as urgency and patient safety

avoiding: unassertive and uncooperative (lose/lose)
- Need time to cool off or you don’t have enough info to resolve the conflict

Collaborating: assertive and cooperative (win/win)
-Trying to meet the needs of 2 people

Accommodating: unassertive and cooperative (lose/win)
-Needs of other more important than own

Compromising: no winners or losers
-Resolve by splitting the difference

24
Q

learning

A

Involves the acquisition of knowledge and skills through study, instruction, or experience. We take action, we gather info about the effects of our actions and then we revise our understanding of our world and ourselves. It is a balanced feedback loop

Gain skills, apply them, learn from that application, adjust as necessary

Experience is the best way to learn

importance of non-stop learning

25
Q

types of organizational learning

A

Adaptive (single loop) : patient shows up late, you work them in

  • Whack a mole
  • Adapt to circumstances then move on

Generative (double loop): what caused that patient to be late or what caused us to be behind schedule

  • Looking at underlying root causes
  • Fixes system
26
Q

disciplines of the learning organization

A

System thinking: how 1 thing affects another

Personal mastery

Mental models: challenge your own assumptions of people, things

Shared vision

Team learning

27
Q

5 building blocks of learning organizations

A
  1. Systematic problem solving
  2. Learning from own experience and past history
  3. Learning from the experiences and practices of others
  4. Transferring knowledge quickly and efficiently throughout the organization
  5. Experimenting with new approaches (innovation)
28
Q

the innovative process (5th step of learning organizations

A

Genesis (generate ideas and narrow down)

  • Generation, exploration of multiple ideas (brainstorming)
  • Convergence of ideas (pros/cons)
  • Trigger for concentrated effort
  • Vague goals, optimistic projections
  1. Development (develop a few ideas)
    - Multiple paths/approaches
    - adaptation/change based on experience/testing
    - evolving/changed goals
    - Sponsor involvement/influence on change
  2. Termination (decide which one to adopt)
    - Final adaptation.change to local or unique situation
    - Implementation or termination
    - Lessons learned
29
Q

characteristics of complex systems

A

Interconnected (change in one area affects another area)

Non-linear (small changes can produce big effects)

Dynamic (constant change, prior conditions influence current events)

30
Q

lewin’s change model

A

Unfreezing —> moving —> refreezing

31
Q

managing change

A
  1. Establishing urgency (unfreezing)
  2. Creating a guiding coalition (unfreezing)
  3. Developing a vision (unfreezing)
  4. Communicating the change vision (moving)
  5. Empowering broad-based action (moving)
  6. Creating short-term wins (moving)
  7. Consolidating gains (refreezing)
  8. Anchoring new approaches into the culture (refreezing)
32
Q

productivity

A

rate of outputs to inputs

Ex. number of admissions to ER nurses

33
Q

efficency

A

cost per unit of output

Ex. average labor costs per admissions

34
Q

effectiveness

A

degree to which goals and objectives are met

Ex. reduction in mortality or infections

35
Q

quality improvement

A

organized approach to planning and implementing continuous improvement in performance

36
Q

3 categories of quality measures

A

Structural: based on organizational features or participant characteristics (ex. % of doctors board certified)

Process: activities in carrying out work (ex. Number of patients seen, number of nurses trained)
-If you need a knee replacement, you might pick a doctor who does a lot of knee replacement every year (that doesn’t necessarily mean they’re good at it, but they have done a lot so maybe you want them more)

Outcome: evidence of degree that ultimate objective is met (ex. Health status)

  • Effectiveness
  • Hard to measure so structure and process often used as surrogate
37
Q

QI approaches

A

Clinical practice guidelines: recommendations for treatment for specific clinical conditions based on a synthesis of the evidence in literature
-Specify protocol; outline what needs to get done based on best practices

Crew resource management training: a technique from aviation industry to address errors from communication and decision making in teams
-Simulate stressful situations and give feedback

Benchmarking: process of comparing (and then enhancing) an organization’s performance to those of “best practices”

  1. Know your operation; assess strengths and weaknesses
  2. Know the industry leaders and competitors
  3. Incorporate the best
  4. Gain superiority

Lean: an improvement approach that focuses on improving efficiency and eliminating waste (excess inventory, duplicate steps, etc)
-eliminating waste (make things more efficient)

Six sigma: a data-drive methodology for eliminating defects in any process by applying a consistent framework of DMAIC (define, measure, analyze, improve, control) to minimize variation, improve processes, and enhance quality
-eliminate problems in the system (ex. Infection rates)

Total quality management: a participative, systematic approach to planning and implementing QI

38
Q

models of organization

A

traditional
-top –> bottom (think triangle) is leadership, management, labor (workforce)

total quality organization: servant leadership
-top –> bottom (think upsidedown triangle) is customers, labor (workforce), management, leadership

39
Q

common QI approaches

A

patient/customer focus

Employee involvement

Teamwork, QI teams

measurement/tracking

process/systems improvement

Use of problem solving tools

Management action/leadership

Improvement though

  1. Eliminating defects
  2. Meeting customer needs and preferences

Proactive risk assessment

High standards

Use of IT

40
Q

improving quality of care

A
  1. Develop a participative, team-oriented organizational culture that encourages input from professionals and other workers from all levels of the organization
  2. Establish high standards and expectations
  3. Develop information systems that provide relevant, timely, and accurate data for purposes of taking corrective action and reaching ever-higher standards
    - Use statistical thinking and tools to identify desired performance levels, measure current performance, interpret it, and take action when necessary
  4. Look for opportunities to improve quality by detecting and preventing potential problems in the process
  5. Design work to reduce complexity and increase standardization
  6. Develop reward systems that reinforce participation and high performance
  7. Recruit the best available talent
41
Q

Improving productivity and efficiency of care

A
  1. Develop accurate, timely, and useful management information systems
  2. Concentrate productivity improvement program in large departments where payoff will result
  3. Consider streamlining and consolidating departments and functions
  4. Develop scheduling systems consistent with professional values
    - Focus on areas where quality can be maintained or even enhanced through better scheduling of staff and support resources
  5. Cross train staff to gain greater flexibility
  6. Develop productivity based incentives based on work activities under the control of organizational members
  7. Set high standards by establishing “best practices” in one’s own organization as well as using comparison from competitors and industry leaders
  8. Involve organizational members, particularly professions, in the development, implementation

org theory exam 2 (1 decks)

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