Organisational behavior
Healthcare organizations under pressure
Week 1: professionalism
Healthcare organisations face
- Numerous challenges
- Numerous solutions -> effectiveness depends on whether professionals are willing to
change their behavior -> do they will be a team member in a multidisciplinary
network.
- Organizational behavior helps to navigate by understanding human behavior.
What is organizational behavior?
- Organizational behavior is the study of individuals and their behavior within the
context of the organization in a workplace setting. It is an interdisciplinary field that
includes sociology, psychology, and management.
- A field of study that investigates the impact that individuals, groups, and structure
have on behavior within organizations for the purpose of applying such knowledge
toward improving an organization’s effectiveness.
- Explain and predict human behavior by replacing intuitive explanations with
systematic study.
- Organization behavioral management tries not to stand on common sense -> but to
build an educated view on evidence studies -> to build an opinion about evidence-
based studies and not about common sense.
Hawthorne study
- Hawthorne effect
- Important obese studies
- Conducting of lighting on influence of productivity
- The presence of researcher and manager led to different results.
Different from HRM
- Human resource management; is it the same? No, it is related.
- The management of work and people towards desired ends -> to come to the final
product.
- HRM involves management decisions related to policies and practices that together
shape the employment and are aimed at achieving individual, organizational and
societal goals.
- Organizational behavior is all about the behavior of individuals.
Common sense or organizational behavior? Gezond verstand of OB?
- Hospitals should require parttime nurses to work one hour per week more to solve
the labor shortage (based on McKinsey study).
- HRM impacts hospital performance in a way that it can reduce patient mortality.
- Being a physician in 2023 requires taking on a role as medical leader.
, - Common sense= gezond verstand -> praktisch oordeel over alledaagse zaken, of een
fundamenteel vermogen om waar te nemen, begrijpen en oordelen op manier die
door alle mensen wordt gedeeld.
Professionals
Increasing pressures
- Social cultural pressures: meer diversiteit en culturen -> gezondheidszorg systemen
moeten zich aanpassen om zorg te bieden passend bij deze diversiteit. Ook
technologische vooruitgang. Veranderende sociale normen en waarden kunnen
verwachtingen met betrekking tot gezondheid en gezondheidszorg beïnvloeden, zoals
patiëntenrechten.
- Financial-economic pressures: stijgende kosten gezondheidszorg. Beperkte toegang
tot gezondheidszorg door financiële druk.
- Technological pressures: opkomst van technologie. Telemedicine: zorg op afstand,
meer uitdaging mbt regelgeving en privacy.
- Public- and political turmoil: onvrede over toegankelijkheid van zorg. Ook zorgen over
kwaliteit van zorg kunnen leiden tot onrust. Politieke besluitvorming mbt
hervormingen in regelgeving of introductie van nieuwe programma’s. Pandemieën,
zoals corona. Ook ethische kwesties kunnen politieke discussies opwekken.
- You need to respond to political discussions.
Trends in healthcare
- From mono to multidisciplinary practices: People have not only one task, but they
have multiple practices on multiple disciplinaries.
- From supply centered to client/patient centered: Changing the providing of care from
supply centered to the needs of patients.
- From intramural to extramural services: providing the care outside the hospital.
- From single organizations and practices to networks -> a lot of organizations together
Lot of coordinative work involved.
How to schedule things
Towards holistic and integrated service delivery (horizontal and vertical integration)
Has a major impact on professionals and organizations?
Comprehensive and coordinated approach to providing healthcare services.
Horizontal integration: collaboration and coordination of services across different
service providers or organizations at same level of care. The coordination and
collaboration among various departments within a hospital.
Vertical integration: coordination of healthcare services along the continuum of
care, from primary prevention to tertiary care. It involves linking services at
different levels of care provide a more continuous healthcare. Between primary
care providers, and hospitals to ensure a smooth transition of care for patients.
Holistic service delivery: addressing the overall well-being of an individual.
Integrated care: seamless coordination of different healthcare services to provide
a unified and patient-centered experience.
, To enhance the quality of care, improve patient outcomes, and increase overall
efficiency by breaking down silos between different components of healthcare
system.
Who are professionals?
- Physician
- Nurses
- What is a professional?
Dimensions of professionalism
- Expertise; knowledgeable about stuff -> highly educated
Unique expertise
Complex knowledge, scientific.
Functional knowledge, reflective skills -> able to use the ideas and theories. Also,
about reflexive skills; every client is different, what do the specific patient/client
needs and in what circumstances.
Beneficial for society; you are important for the society.
Professionalism is about applying general, scientific knowledge to specific cases.
Knowledge, you get due to testing.
Both tacit (stilzwijgend) and explicit knowledge (uitdrukkelijk)
- Authority
Legitimate power: professional has the legitimated reason to decide for you what
you need. They have proof that they know it. It is based on knowledge, and often
based on person being part of profession. They have legal standards -> helps
them to gain authority.
Based on knowledge
Based on legal, organizational, professional, personal status.
Unquestioned; authority is being unquestioned.
- Autonomy; professionalism as controlled content (autonomy)
It is about control.
Task; one single task.
Function: stable over time, consists of multiple tasks. Organization decides what
kind of tasks are included. In a particular organization, it depends per organization
what the function is.
Occupation (bezigheid): certain type of tasks, they are not only stable, but they
are also stable when you go from one organization to another organization. It is
the same within different organizations.
Profession: a profession has more say -> they also decide who are going to be in
this profession. What kind of criteria are used -> special status, is also officially
believed and framed in regulations.
Freidson: a profession is a special status in the division of labour that is supported
by an official and sometimes public belief that it is worthy of that status.
Professional autonomy
- It could refer to individual or group (professional group decides what is the content of
the training).
, - According to Beauchamp and Childress: virtually all theories of autonomy view two
conditions as essential for autonomy; liberty (independence from controlling
influences) and agency (capacity for intentional action). This means that individuals
have the ability to act with purpose and conscious deliberation. Intentional actions
are those that are performed with a specific goal or purpose in mind. An agency
means that individuals can act independently and make choices.
- It is about the privilege and ability of self-governance.
- The quality and state of being independent and self-directing, especially in decision
making, enabling professionals to exercise judgement as they see fit during the
performance of their job.
- Autonomy stands for liberty, thus the independence from controlling influences, and
agency; the capacity for intentional action.
- There are different types of autonomy:
Types of autonomy
- Political autonomy; mate waarin professional recht heeft om eigen politieke
beslissingen te nemen. Ontwikkelen en implementeren van gezondheidszorgbeleid op
hun specifieke behoeften. Autonomie van zorginstellingen -> beheer van financiën,
personeelsbeleid, beslissingen over organisatie van zorgdiensten.
- Economical autonomy: professional decides themselves what they earn -> the
income of doctors was really high-> now changed.
- Clinical autonomy
Medical professionals
Focused on the process, organizing the care.
Focused on the content; what is needed (professional discretion) -> freedom to
decide.
Different views on professionalism (classic view)
- How profession is viewed depends on your perspective
1. A list of traits and behaviors; observe -> what is this professionalism.
2. As a role played in society (functionalism).
3. As a social construction.
4. As means and effect of social control (critical studies).
1. Professionalism as a list of traits and behaviors
- Of the profession
Organized professional groups that
Defines standards of training
Criteria of competence
Quality criteria
A code of ethic
Has exclusive rights to perform certain tasks
- Of a professional
Specialized knowledge; professional has specialized knowledge
Altruistic; een handeling om iets bij te dragen zonder er zelf baat bij te hebben.
Reflexivity
