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Samenvatting stof + lecture aantekeningen BMZ2025

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Samenvatting van de stof van het blok BMZ2025, inclusief lecture notes (niet losse lecture notes)

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  • 15 mei 2023
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  • 2022/2023
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florienwittenhorst
BMZ2025: ENTREPRENEURIAL MANAGEMENT IN HEALTH CARE
INTRODUCTION TO THE COURSE

Entrepreneurship refers to the process of creating, developing, and managing a new business venture to achieve a profit of
fulfill a specific need in the market.

Characteristics: innovation, pro-activity, creativity, resilience, risk-taking

Entrepreneur in an existing organization  intrapreneur

Intrapreneurship (in healthcare) refers to the act of creating new products, services, or processes within an established
organization, with the goal of driving innovation and growth.

Aims of intrapreneurship: improve patient outcomes, increase efficiency, improve processes, and reduce costs.

Intrapreneurs: nurses, physicians and other care staff, administrators, policy officers.

BARRIERS

- Complex organizational structures
- Risk aversion and resistance to change
- Limited resources
- Lacking innovation readiness

LECTURE 1: ORGANIZATION AND MANAGEMENT

What is an organization? “Collective action structured for the pursuit of a common mission”

Structure  the pattern of relationships designed to enable its people to take that action together.

SIX BASIC PARTS OF THE ORGANIZATION

 Operating core: operators, those people who perform the basic work of producing the
products and rendering the services
 Strategic apex: one full-time manager, who oversees the whole systems (as the
company grows  more managers of operators, but also managers of managers)
 Middle line: hierarchy of authority between the operating core and the strategic apex
 Techno-structure: more complex organization  group of people, analysts, who
perform administrative duties – plan and control the work of others – often labelled
“staff”
 Support staff: add staff units to provide various internal services, like
cafeteria/mailroom/legal counsel/etc.
 Ideology: strong culture, traditions and beliefs of an organization (entire system)

KEY PLAYERS:

Operators: deliver the services or produce the products

Support staff: provide indirect services to support operations (cafeteria staff, secretaries, counselors, HR, payroll

Analysts: work to control and adapt organizational activities via planning, scheduling, measuring, etc.

Managers: middle, lower level and high (C-suite) management

,Culture: provides a common frame or reference for all players, belief system

Influencers: external stakeholders who attempt to influence organization

SIX BASIC COORDINATING MECHANISMS

Coordination can be achieved via

 Mutual adjustment: achieves coordination of work by the simple process of information communication (informal)
 Direct supervision: one person coordinates by giving orders to others, oversees and is responsible for work for others
 Standardization
o Work processes: specification – programming of the content of the work directly, the procedures to be
followed. So specifying process and rules
o Outputs: not what is to be done, but of its results. So performance, rather than process
o Skills: as well as knowledge, where the worker is rather specialized than the work or the outputs. So training
specification
o Norms: workers share a common set of beliefs and can achieve coordination based on it. So embedding shared
beliefs to support functioning

THE ESSENCE OF ORGANIZING

To make a movie together, or score a goal, people doing different things have to work together. This is called coordination, and
it is the essence of organizing, following the division of labor.

- Dictated by the mission of the organization (in a restaurant we need a cook, waitresses, bartenders, etc.)
- More division of labor  more specialization (and more complexity)

Vertical differentiation = hierarchy

Horizontal differentiation = functionalism

The essence of organizational design is the manipulation of a series of parameters that determine the DoL and the achievement
of coordination:

 Job specialization: number of tasks in a given job and the worker’s control over these tasks
 Behavior formalization: standardization of work processes by the imposition of operation instructions, job descriptions,
rules, regulations.
o Rely on any form of standardization of coordination  bureaucratic (mechanist organization: rigid and tightly
controlled)
o Not  organic: highly adaptive and flexible
 Training: the use of formal instructional programmes to establish and standardize in people the requisite skills and
knowledge to do particular jobs in organizations
 Indoctrination: programmes and techniques by which the norms of the members of an organization are standardized 
become responsive to its ideological needs  make decisions and take actions
 Unit grouping: the choice of the bases by which positions are grouped together into units (usually shown on the
organization chart)
 Unit size: the number of positions contained in a single unit
o The equivalent “span of control” is not used here, because sometimes units are kept small despite an absence
of close supervisory control
 Planning and control systems: used to standardize outputs
o Action planning systems
o Performance control systems
 Liaison devices: devices to encourage mutual adjustment (hoe managers ervoor kunnen zorgen dat binnen het bedrijf
beter gecommuniceerd wordt, door welke structuur van de organisatie, zoals integrating managers)
 Decentralization: diffusion of decision-making power. When all the power is in one place it is centralized. So either
vertically or horizontally extent the power of decision-making to more individuals

, THE SITUATIONAL FACTORS

Age and size:

Older  more formalized behavior
Larger  more formalized behavior, more elaborate structure, the larger the size of its average unit
Structure reflects the age of the industry form its founding

Technical system: instruments used in the operating core to produce the outputs

Environment: various characteristics of the organization’s outside context, related to markets, political climate, economic
conditions, and so on.

Power: per example the greater the external control of an organization, the more centralized and formalized its structure

COORDINATION

Putting parts and players together to produce a seamless experience for the customer requires coordination.

Organizing = creating parts and connections

Managing = coordinating what has been organized (parts, players, etc.)

Managerial functions: planning, organizing, directing, controlling, and managing

A manager: ‘Someone who coordinates and oversees the work of other people so organizational goals can be accomplished
(Robbins & Coulter)

Management/managing: ‘the process of assembling and using sets of resources in a goal-directed manner to accomplish tasks in
an organizational setting’. (Hitt. et al 2013) It is a process that involves a series of activities and operations, such as planning,
deciding, and evaluating.

The act of coordinating what has been organized (parts, players, etc.).

 Note: coordination may be seen as the output of managerial functions




HEALTH CARE AS A PROFESSIONAL BUREAUCRACY

- Reliance on professional expertise and skills
- Highly specialized
- Typically organized in functional units
- Clear hierarchy but decentralized power (to professionals)
- Rigid

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