HIM001/APT1: IMPROVE
PROCESSES IN A HEALTH
SERVICE DELIVERY
ORGANIZATION
All tasks/learning team meetings & lectures
,Learning team meeting 1
APT1: Improve processes in a health service delivery organization,
10-09-2024
Resources:
- Mintzberg, H. (2023). Our world of organizations (Chapter 1). In: Understanding
organizations...finally!: structuring in sevens (1st edition). Berret-Koeler Publishers, Inc.
Oakland, CA. Pages 1–8
- Mintzberg, H. (2023). The Players and the Parts (Chapter 2). In: Understanding
organizations...finally!: structuring in sevens (1st edition). Berret-Koeler Publishers, Inc.
Oakland, CA. Pages 9–23
- Mintzberg, H. (2023). Part II The Building Blocks of Organization Design (Chapters 4, 5, 6)
In: Understanding organizations...finally!: structuring in sevens (1st edition). Berret-
Koeler Publishers, Inc. Oakland, CA. Pages 37-64
- Mintzberg, H. (2023). The Professional Assembly (Chapter 9). In: Understanding
organizations...finally!: structuring in sevens (1st edition). Berret-Koeler Publishers, Inc.
Oakland, CA. Pages 86-96
Learning goals:
1. What an organization is and which basic players and parts it has.
2. The basic principles within organizations such as division of labour, coordination
mechanisms, structure, and (de)centralization.
3. The basic structure, conditions, and pro’s/cons of a professional assembly.
1. What is an organization and which basic players and parts has it?
Organization = collective action structured for the pursuit of a common mission. Several people
work in some formalized arrangement to accomplish something.
Structure of an organization = the pattern of relationships designed to enable its people to take
that action together. Bunch of people with a collective goal
Principal players in an organization:
- Operators: producing the products, rendering the customer services, and whatever
supports these directly.
, o Servers in restaurants, purchasing agents in manufacturing companies, nurses
in hospital
- Support staff: support the operations indirectly
o Develop the information systems, provide the legal
services, welcome visitors at the reception
- Analysts: use analysis to control and adapt the activities in
one way or another: they plan them, schedule them, measure
them, budget them, and sometimes train the people who do
them – they just don’t do themselves.
o Technostructure
- Managers: oversee all this, having formal responsibility for a
unit in the organization, or the whole of it.
o A unit is some part of the organization designated in
its formal structure.
o Line managers à strategic apex: bottom-top
managers
- Culture: the system of beliefs that permeates the organization, providing a common
frame for all the players, ideally to breathe some life into the skeleton of the structure
o The way of doing these
- External influencers: seek to shape the behaviour of the organization from the outside.
o Special interest groups that lobby, now referred to ask stakeholders.
§ Stakeholders are the owners of the stock
Many of the influencers of businesses are now referred as stakeholders, in contrast to the
owners of the stock, who are called shareholders. Together, all these influencers form an
external coalition that may be passive, actively dominated by one group, or divided among
several.
Example hospital: overall goal to cure patients.
- Operators: nurses, doctors, people
- Support staff: quite broad, human resources, recruitment, secretary, legal services
- Analysts: people who are involved in Quality of Care (researchers/data analysts)
- Managers: different kinds of managers, executive board, cardiology supervisor (chief
doctor)
- Culture: old hierarchy
- External influencers: stakeholders e.g. investors, politics, health insurance, different
hospitals have influence on each other, government
o Stakeholder = influencer
Old version: 6 basic parts of the organization:
- Operating core: the people who perform the basic work of producing the products and
rendering the services
- Strategic apex: full time manager who oversees the whole
system
- Middle line: a hierarchy of authority between operating
core and the strategic apex
- Techno structure: analysts from this outside the
hierarchy of line authority, look at how the company can
be more efficient
- Support staff: units who provide various internal services
à HR, finance, IT
, - Ideology = culture: traditions and beliefs of an organization that distinguish it from other
organizations
2. The basic principles within organizations such as division of labour, coordination
mechanisms, structure, and (de)centralization.
Division of labour = principal involves breaking tasks down within the organization and
responsibilities are assigned to different roles of the group à aim: make organization more
efficient.
- The mission of the organization and the technology it uses
An organization is the product of organizing dealing with two opposing structural
requirements.
- Every organized human activity gives rise to two fundamental and opposing
requirements:
o The division of labor into various tasks to be performed.
o The coordination of those tasks to accomplish the activity.
- The structure of an organization can be defined as the total of the ways in which its
labour is dived into distinct tasks and then its coordination achieved among those tasks.
- Organizing (= creating parts and connections) à managing (= coordinating of what is
organized)
Coordination mechanisms: different ways to see the organization
- Chain
o Work is seen to flow in a linear sequence
o Manager is on top of the horizontal chain
§ Fabric of water bottles
- Hub
o Coordination center, a focal point of activity
§ Airport
o Manager is in the center
- Web(/network)
o Webs or networks are open-ended movement of people,
information, and/or materials, with no fixed sequence or center
o Manager is everywhere, along every line and at all the nodes,
can be everywhere and everyone
§ One single research department
- Set
o The parts are “loosely coupled”, barely connecting with each
other
o Manager may do better by staying out of it
§ Maastricht University (FHML, SBE, FASOS, LAW)
Coordination = people doing different things have to work together.
Six coordination mechanisms:
1. Mutual adjustment: communicating directly; achieves
coordination of work by the simple process of information
communication
- Coordination without control, while the other four coordinating mechanisms are
different forms of control
- Flexible
PROCESSES IN A HEALTH
SERVICE DELIVERY
ORGANIZATION
All tasks/learning team meetings & lectures
,Learning team meeting 1
APT1: Improve processes in a health service delivery organization,
10-09-2024
Resources:
- Mintzberg, H. (2023). Our world of organizations (Chapter 1). In: Understanding
organizations...finally!: structuring in sevens (1st edition). Berret-Koeler Publishers, Inc.
Oakland, CA. Pages 1–8
- Mintzberg, H. (2023). The Players and the Parts (Chapter 2). In: Understanding
organizations...finally!: structuring in sevens (1st edition). Berret-Koeler Publishers, Inc.
Oakland, CA. Pages 9–23
- Mintzberg, H. (2023). Part II The Building Blocks of Organization Design (Chapters 4, 5, 6)
In: Understanding organizations...finally!: structuring in sevens (1st edition). Berret-
Koeler Publishers, Inc. Oakland, CA. Pages 37-64
- Mintzberg, H. (2023). The Professional Assembly (Chapter 9). In: Understanding
organizations...finally!: structuring in sevens (1st edition). Berret-Koeler Publishers, Inc.
Oakland, CA. Pages 86-96
Learning goals:
1. What an organization is and which basic players and parts it has.
2. The basic principles within organizations such as division of labour, coordination
mechanisms, structure, and (de)centralization.
3. The basic structure, conditions, and pro’s/cons of a professional assembly.
1. What is an organization and which basic players and parts has it?
Organization = collective action structured for the pursuit of a common mission. Several people
work in some formalized arrangement to accomplish something.
Structure of an organization = the pattern of relationships designed to enable its people to take
that action together. Bunch of people with a collective goal
Principal players in an organization:
- Operators: producing the products, rendering the customer services, and whatever
supports these directly.
, o Servers in restaurants, purchasing agents in manufacturing companies, nurses
in hospital
- Support staff: support the operations indirectly
o Develop the information systems, provide the legal
services, welcome visitors at the reception
- Analysts: use analysis to control and adapt the activities in
one way or another: they plan them, schedule them, measure
them, budget them, and sometimes train the people who do
them – they just don’t do themselves.
o Technostructure
- Managers: oversee all this, having formal responsibility for a
unit in the organization, or the whole of it.
o A unit is some part of the organization designated in
its formal structure.
o Line managers à strategic apex: bottom-top
managers
- Culture: the system of beliefs that permeates the organization, providing a common
frame for all the players, ideally to breathe some life into the skeleton of the structure
o The way of doing these
- External influencers: seek to shape the behaviour of the organization from the outside.
o Special interest groups that lobby, now referred to ask stakeholders.
§ Stakeholders are the owners of the stock
Many of the influencers of businesses are now referred as stakeholders, in contrast to the
owners of the stock, who are called shareholders. Together, all these influencers form an
external coalition that may be passive, actively dominated by one group, or divided among
several.
Example hospital: overall goal to cure patients.
- Operators: nurses, doctors, people
- Support staff: quite broad, human resources, recruitment, secretary, legal services
- Analysts: people who are involved in Quality of Care (researchers/data analysts)
- Managers: different kinds of managers, executive board, cardiology supervisor (chief
doctor)
- Culture: old hierarchy
- External influencers: stakeholders e.g. investors, politics, health insurance, different
hospitals have influence on each other, government
o Stakeholder = influencer
Old version: 6 basic parts of the organization:
- Operating core: the people who perform the basic work of producing the products and
rendering the services
- Strategic apex: full time manager who oversees the whole
system
- Middle line: a hierarchy of authority between operating
core and the strategic apex
- Techno structure: analysts from this outside the
hierarchy of line authority, look at how the company can
be more efficient
- Support staff: units who provide various internal services
à HR, finance, IT
, - Ideology = culture: traditions and beliefs of an organization that distinguish it from other
organizations
2. The basic principles within organizations such as division of labour, coordination
mechanisms, structure, and (de)centralization.
Division of labour = principal involves breaking tasks down within the organization and
responsibilities are assigned to different roles of the group à aim: make organization more
efficient.
- The mission of the organization and the technology it uses
An organization is the product of organizing dealing with two opposing structural
requirements.
- Every organized human activity gives rise to two fundamental and opposing
requirements:
o The division of labor into various tasks to be performed.
o The coordination of those tasks to accomplish the activity.
- The structure of an organization can be defined as the total of the ways in which its
labour is dived into distinct tasks and then its coordination achieved among those tasks.
- Organizing (= creating parts and connections) à managing (= coordinating of what is
organized)
Coordination mechanisms: different ways to see the organization
- Chain
o Work is seen to flow in a linear sequence
o Manager is on top of the horizontal chain
§ Fabric of water bottles
- Hub
o Coordination center, a focal point of activity
§ Airport
o Manager is in the center
- Web(/network)
o Webs or networks are open-ended movement of people,
information, and/or materials, with no fixed sequence or center
o Manager is everywhere, along every line and at all the nodes,
can be everywhere and everyone
§ One single research department
- Set
o The parts are “loosely coupled”, barely connecting with each
other
o Manager may do better by staying out of it
§ Maastricht University (FHML, SBE, FASOS, LAW)
Coordination = people doing different things have to work together.
Six coordination mechanisms:
1. Mutual adjustment: communicating directly; achieves
coordination of work by the simple process of information
communication
- Coordination without control, while the other four coordinating mechanisms are
different forms of control
- Flexible
