Chapter 2

The Managerial Role

 Purpose and Overview
• Purpose
– To understand roles of the health care
manager
• Executive leadership
• Organizational management
• Strategic management
• Business enterprises
• Clinical and business service components

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 Purpose and Overview
• Overview
– Behavioral Perspective
– The Practice of Management: Integrating
Organizational Process Management and
Leadership Roles and Skills

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 Purpose and Overview
• Overview
– Strategic Perspective of Health Care
Management
– Health Care’s Distinctive Context and Executive
Leadership Requirements

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 Purpose and Overview
• Overview
– Crossing the Quality Chasm: Distinctive
Challenges
– Developing a Standardized Knowledge Base for
Professional Leadership and Health Care
Managers

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 Behavioral Perspective of the
Managerial Role
• Integrated and applied activity within a
dynamic and evolving system

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 Mintzberg’s Managerial Roles
• Interpersonal
– Figurehead
– Leader
– Liaison

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 Mintzberg’s Managerial Roles
• Informational Roles
– Monitor
– Disseminator
– Spokesperson

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 Mintzberg’s Managerial Roles
• Decisional Roles
– Entrepreneur
– Disturbance Handler
– Resource Allocator
– Negotiator

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Mintzberg’s Model of Management
• Person
• Frame of job
• Agenda of work

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 Behavioral Perspective of
Managerial Styles
• Managerial Roles
– Conceptual
– Administrative
– Interpersonal
– Action

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 Behavioral Perspective of
Managerial Styles
• How Managers Perform Roles
– Linking
– Conceiving
– Leading

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 Behavioral Perspective of
Managerial Styles
• Managerial Approaches to Action
– Deductive
– Inductive

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 Behavioral Perspective of
Managerial Styles
• Management Mind-Sets
– Reflective
– Analytic
– Worldly
– Collaborative
– Action

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 Integrating Management and
Leadership Skills
• Systemic Organization Structure
– Mission
– Strategies, goals, and accountabilities
– Production function
– Strategic affiliations
– Organizational culture

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Integrating Management and
Leadership Skills

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 Integrating Management and
Leadership Skills
• Direction-Setting Processes
– Learning about the organization
– Framing an agenda
– Aligning individuals
– Framing, testing, and revising initiatives

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 Integrating Management and
Leadership Skills
• Negotiating and Selling Processes
– Framing issues
– Soliciting help and presenting proposals
– Building and maintaining contacts and
communication
– Building and managing coalitions

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 Integrating Management and
Leadership Skills
• Monitoring and Controlling Processes
– Ensuring organizational operation as planned
– Detect unexpected shocks and disturbances
– Initiation of corrective action
– Restoration of organizational equilibrium

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 Integrating Management and
Leadership Skills
• Work Processes
– Customers
– Transformations
– Supply-chain systems serving customers
requiring alignment to achieve mutual support

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 Integrating Management and
Leadership Skills
• Work Processes
– Quality control
– Cost containment
– Reduce cycle times

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 Integrating Management and
Leadership Skills
• Work Processes
– Enhance operating performance
– Decrease fragmentation
– Improve cross-functional integration

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 Integrating Management and
Leadership Skills
• Organizational & Behavioral Processes
– Decision making
– Communication
– Organizational learning

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 Integrating Management and
Leadership Skills
• Organizational & Change Processes
– Creation
– Growth
– Transformation
– Decline

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 Integrating Management and
Leadership Skills
• Organizational Management Work
– Coping with complexity: good management
helps to ensure organization’s survival

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 Integrating Management and
Leadership Skills
• Executive Leader Roles
– “Organizational system manager-in chief”’
– “Boundary spanner-in chief”
– “Resource developer/investor-in chief”
– “Transformation manager-in chief”

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Integrating Management and
Leadership Skills

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 Strategic Perspective of Health
Care Management Role
• Defines strategic goals for organization’s
survival and growth
• Apply strategic management concepts

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 Strategic Perspective of Health
Care Management Role
• Organizational Transformation
– Strategic planning to manage evolution of
organization over time
– Apply continuous judgment in ongoing
operations

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 Strategic Perspective of Health
Care Management Role
• Strategic Transformation
– Identify opportunities to develop new
competencies
– Allow organization to create and experiment
– Maintain sustainable competitive advantage

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 Strategic Perspective of Health
Care Management Role
• Strategic Execution
– Select and execute appropriate strategies to
achieve goals

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Strategic Perspective of Health
Care Management Role

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Health Care’s Distinctive Context and
Executive Leadership Requirements

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Health Care’s Distinctive Context and
Executive Leadership Requirements
• Managing Clinical and Technology-Based
Production Systems
– Core “production work” to provide safe,
effective, efficient clinical services

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Health Care’s Distinctive Context and
Executive Leadership Requirements
• Managing Organizational Complexity
– Complex and strongly resource-dependent
organizations
– Monitor and evaluate safety, effectiveness,
and efficiency
– Intervene to improve services and ensure
accountability

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Health Care’s Distinctive Context and
Executive Leadership Requirements
• Providing Value-Oriented Leadership
– Health delivery organizations
– Executive leadership

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 Challenges Facing Health
Service Managers
• Institute of Medicine’s (IOM) Report: To
Err is Human: Building a Safer Health
System
– 44,000–98,000 annual deaths from
preventable medical errors
– Ranked as nation’s eighth-leading cause of
death

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 Challenges Facing Health
Service Managers
• IOM Recommendations
– Design safe systems of care
– Provide leadership
– Respect human limits in process design

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 Challenges Facing Health
Service Managers
• IOM Recommendations
– Promote team functioning
– Anticipate the unexpected
– Create a learning environment

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 Challenges Facing Health
Service Managers
• IOM Design Principles
– Standardize and simplify equipment, supplies,
and processes
– Establish team training programs
– Implement non-punitive systems for reporting
and analyzing errors

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 Challenges Facing Health
Service Managers
• IOM Report: Crossing the Quality Chasm:
A New Health System for the 21st Century
• Health care services should be safe,
effective, patient-centered, timely, efficient,
and equitable

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 Challenges Facing Health
Service Managers
• IOM Report: Crossing the Quality Chasm
• Six challenges:
1) Redesign care processes
2) Use information technologies
3) Manage clinical knowledge and skills

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 Challenges Facing Health
Service Managers
• IOM Report: Crossing the Quality Chasm
• Six challenges:
4) Develop effective teams
5) Coordinate care
6) Incorporate performance and outcome
measurements throughout operations

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Challenges Facing Health
Service Managers

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 Developing Standardized
Knowledge for Leadership
• Adaptation and transformation require
development of leadership competencies

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 Developing Standardized
Knowledge for Leadership
• Skill Sets Managers Need to Succeed
– Technical
– Human relations
– Team management
– Facilitating and managing groups
– Conceptual

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 Developing Standardized
Knowledge for Leadership
• Chief Executive Officer Must
– Effectively balance conflict
– Effectively strategize
– Adapt to change

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 Developing Standardized
Knowledge for Leadership
• Competencies for Leadership Transformation
– Achievement Orientation
– Analytical Thinking
– Community Orientation
– Information Seeking

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 Developing Standardized
Knowledge for Leadership
• Competencies for Leadership Transformation
– Innovative Thinking
– Strategic Orientation
– Financial Skills

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 Developing Standardized
Knowledge for Leadership
• Execution
– Accountability
– Change Leadership
– Collaboration
– Impact and Influence
– Initiative
– Organizational Awareness

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 Developing Standardized
Knowledge for Leadership
• Execution
– Performance Measurement
– Information Technology Management
– Communication
– Process Management and Organizational
Design
– Project Management

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 Developing Standardized
Knowledge for Leadership
• People
– Interpersonal Understanding
– Professionalism
– Relationship Building
– Self-Confidence

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 Developing Standardized
Knowledge for Leadership
• People
– Self Development
– Talent Development
– Team Leadership
– Human Resources Management

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Developing Standardized
Knowledge for Leadership

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 Developing Standardized
Knowledge for Leadership
• Competency Development
– Career-long action-based reflective activity
– Gained through a life-long process of
experience-based reflection and growth

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 Developing Standardized
Knowledge for Leadership
• Five Mind-Sets
1) Reflective
2) Worldly
3) Analytical
4) Collaborative
5) Action

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