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COM Summary MPA 2023
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Summary of the Communication, Organization and Management (COM) course lectures of the MPA master at the VU.
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COM SummaryHC1: Organizations in health care, structure and design trade-offs
Mechanistic model:
- Task oriented
- Effiency and productivity
- Formalized, centra land complex
- Stable/simple environment
Organic model:
- Tasks, authority and routines are constantly redefined
- ‘flat’ organisations
- Informal, decentralized, simple
- Complex en dynamic environment
Critiques on bureaucracy:
- Dehumanizing employees
- Inflexible
- Differentiation and disintegration
- Limited rationality and morality
Examples are belastingdienst, ups and a garage
Hospital is bureaucratic because:
- Standardization of processes
- Highly specialized
, - Hierarchy: slow, slow innovation
- Universal access, but no individual control, supply drives vs demand driven care
New Public Management (NPM):
- Strengthening position of healthcare consumers
- Achievements made ‘tangible’: in contrast to esoteric professional knowledge
- Accountability not solely horizontal anymore (role of insurers)
- Improvement of performance
In NPM there is a tension between professionalism and managerialism:
,Centralization vs decentralization:
Control vs autonomy:
Top-down management or bottom up management?
Differentiation vs integration:
, How are tasks divided and coordinated?
Differentiation = highly specialized, patent = disease, operating in healthcare silos, which affects
patients:
Integration = holistic view of patients and care delivery.
Functional structure:
Organized based on the necessary functions of an organisation, including production, marketing,
finance, accounting, HR.
Relative small organisations with narrow range of products and services
Service/product line structure
Products are preferred basis as a firm grows by increasing
the numbers of products on the market. Concentrating
authority, responsibility and accountability in specific
departments. Product-based divisions are often
freestanding departments.
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