Principles of Healthcare Management

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Principles of Healthcare Management Dr Yodi Mahendradhata,MSc,PhD Center for Health Service Management, FM GMU

65,000 people converge daily 2,500 doctors -> 9,000 examinations/consultations daily

4,600 procedures/diagnostic tests daily 1,300 inpatients daily

Mayo clinic attracted many patients 1924 1983 2007 Patient registration 60,063 276,800 520,000 Surgeries 23,628 30,800 76,300 Hospital beds 1,507 1,848 2,400

Mayo Clinic attracted many health workers 1983 2007 Physicians and scientists 889 2,706 Administrative and allied health staff 5,350 35,971 Residents, fellows, students 1,504 3,229 Total 7,743 41,906

Mayo Clinic s financial performance is strong 1983 2007 Total revenue (US$) 411,600,000 7,322,400,000 Total expenses (US$) Excess of revenue over expenses (US$) 353,100,000 6,699,600,000 58,500,000 622,800,000

The place to go if you re really sick The supreme court of medical opinion

One of the most influential and valuable service brand in the world A medical Mecca

A symbol of what is best in American medicine I am a better doctor

The best interest of patients is the only interest to be considered Dr William J Mayo, 1910

It has become necessary to develop medicine as a cooperative science Dr William J Mayo, 1910

Session structure Principles of General Management Principles of Healthcare Management

Part I Principles of General Management

Too many books, too little time* 700.000 600.000 500.000 400.000 300.000 200.000 100.000 0 General Management Medicine Health care management *Source: Amazon.com (2011)

Management? Getting work done through people American Management Association Getting the right things done Peter Drucker

Management school of thoughts Scientific management Behavioral Social Systems management Contingency management Decisional management Quantitative measurement Management process

Management process Planning Organizing What needs to be done, when and how Who does what, under what conditions Actuating How employee are led, motivated Controlling How the plan is being followed up

Management competencies* Informational Actional Interpersonal Personal *Mintzberg (2011)

Species of organization... Entrepreneurial Machine Political Missionary Project Professional

Management as a practice? Art Craft Science

Part 2 Principles of Healthcare Management

Management Medicine Position not profession Profession not position Apply science, but not a science by itself Science Effectiveness = art + craft + science Effectiveness = science + craft + art

Healthcare management is unique Customers are sick Customers live in service sites A need service Inherently personal Customized Risk of harm

Healthcare management framework (Shortell & Kaluzny 1997) Environment E n v I r o n m e n t Health System Organizations Group / Department Individual Environment E n v I r o n m e n t

Challenges faced by healthcare organization managers (Shortell & Kaluzny 1997) Personnel Technical perfomance Changing environment Survival & growth

Changing environment Technological and social change Environmental complexity and uncertainty Competitive forces Multiple performance demands

Survival and growth challenges Long-run survival Long-run performance and growth

Technical performance challenges Productivity Efficiency Quality Consumer satisfaction

Personnel challenges Commitment Turnover Apathy Conflict among professions

From organization challenges to management competencies Challenges Competencies Environment How to renew the organization Survival and growth How to chart the future Technical performance How to operate the technical system Personnel How to motivate and lead people and groups

How to renew the organization? Organization design Managing strategic alliance Organizational innovation and change Organizational performance

How to chart the future? Strategy making Creating and managing the future

How to best operate the technical system? Managing groups and teams Work design Coordination and communication Powers and politics

How to lead effectively? Motivating people Leadership Conflict management and negotiation

Effective participation in 21st century life and work will require basic managerial literacy Joan Magretta