macro perspective of ot

8/4/2019 Macro Perspective of OT

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Key Dimensions of Key Dimensions of Health Services OrganizationsHealth Services Organizations DifferentiationDifferentiationIntegrationIntegration

CentralizationCentralizationChangeChangeInnovationInnovation



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Health Services OrganizationsHealth Services Organizationsas Systemsas Systems

Closed SystemClosed System – Maximize internal efficiency, predictability, andMaximize internal efficiency, predictability, and

orderorder

Open SystemOpen System – Openness, adaptability, and innovationOpenness, adaptability, and innovation



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ProductionProduction – Products or services at center of Products or services at center of

organizational activitiesorganizational activities

Boundary SpanningBoundary Spanning – Interface between organization and externalInterface between organization and external

environmentenvironment



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MaintenanceMaintenance – Physical and human infrastructurePhysical and human infrastructure

Adaptation Adaptation – Innovation as tool for changeInnovation as tool for change



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ManagementManagement – Organizes, directs, and overseesOrganizes, directs, and oversees

GovernanceGovernance – Provides strategic direction and imposesProvides strategic direction and imposesaccountabilityaccountability



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Areas of Managerial Activity Areas of Managerial Activity

Organization Theory–Macro ApproachOrganization Theory–Macro Approach – Organization as social systemOrganization as social system – Organizational designOrganizational design – Interorganizational relationshipsInterorganizational relationships – Change and innovationChange and innovation – Performance and strategyPerformance and strategy



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Areas of Managerial Activity Areas of Managerial Activity

Organizational Behavior–Micro ApproachOrganizational Behavior–Micro Approach – Examines individuals within organizationsExamines individuals within organizations – MotivationMotivation – LeadershipLeadership – Conflict managementConflict management



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Ecology of Ecology of Health Services OrganizationsHealth Services Organizations

Are Health Services Organizations Unique? Are Health Services Organizations Unique? – Professionalized providersProfessionalized providers – Lack of managerial control over groupLack of managerial control over group

generating work and expendituresgenerating work and expenditures – Dual lines of authorityDual lines of authority



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Are Health Services Organizations Unique? Are Health Services Organizations Unique? – Work must be precise and errorlessWork must be precise and errorless – Services are interdependent and requireServices are interdependent and require

coordinationcoordination – Require extreme degree of specializationRequire extreme degree of specialization



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Are Health Services Organizations Unique? Are Health Services Organizations Unique? – Defining and measuring output are difficultDefining and measuring output are difficult – Work is variable and complexWork is variable and complex – Work is usually nondeferrableWork is usually nondeferrable – Work is often performed under emergencyWork is often performed under emergency

conditionsconditions



The External Control of The External Control of

OrganizationsOrganizations



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The External Control of OrganizationsThe External Control of Organizations

BackgroundBackground – To understand the behavior of an organizationTo understand the behavior of an organization

you must understand the context of thatyou must understand the context of thatbehavior – the ecology of the organizationbehavior – the ecology of the organization



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Relevant features of an organization’sRelevant features of an organization’senvironmentenvironment – Labor force, suppliers, customers & clientsLabor force, suppliers, customers & clients

– CompetitorsCompetitors – Other organizationsOther organizations – Professional associations or bodiesProfessional associations or bodies – GovernmentGovernment – Communities in which the org operatesCommunities in which the org operates – Existing stock of knowledge and tech resourcesExisting stock of knowledge and tech resources – The broader social and cultural environmentThe broader social and cultural environment



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Open systems theoriesOpen systems theories – All theories point to some or all environmental All theories point to some or all environmental

features as importantfeatures as important

Resource dependency theoryResource dependency theory

Institutional theoryInstitutional theory

Organizational ecologyOrganizational ecology



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Resource Dependency TheoryResource Dependency Theory – focuses on the consequences of power differencesfocuses on the consequences of power differences

between organizationsbetween organizations

Institutional TheoryInstitutional Theory – examines the impact of the environment onexamines the impact of the environment on

organizations from a natural or social systemsorganizations from a natural or social systemsperspectiveperspective

Organizational TheoryOrganizational Theory – a macro perspective that uses sophisticateda macro perspective that uses sophisticated

mathematical models to study the growth patterns of mathematical models to study the growth patterns of populations of organizationspopulations of organizations



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Resource Dependency TheoryResource Dependency Theory – The key to organizational survival is the ability toThe key to organizational survival is the ability to

acquire and maintain resourcesacquire and maintain resources

No organization is completely self-contained,No organization is completely self-contained,they depend on other organizations and arethey depend on other organizations and arelinked by:linked by: – FederationsFederations – Associations Associations – Customer-supplier relationshipsCustomer-supplier relationships – Competitive relationshipsCompetitive relationships – Social-legalSocial-legal



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Resource Dependency Theory con’tResource Dependency Theory con’t All organizations must adhere to this All organizations must adhere to this –

Public organizationsPublic organizations

– Private organizationsPrivate organizations – Small organizationsSmall organizations – Large organizationsLarge organizations – Bureaucratic organizationsBureaucratic organizations – Organic organizationsOrganic organizations



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Resource Dependency Theory in actionResource Dependency Theory in action – Convents and abbeysConvents and abbeys

Designed to be virtually self-sufficientDesigned to be virtually self-sufficientNeeds kept at a minimumNeeds kept at a minimumFoods grown withinFoods grown withinClothing made by abbey’s laborClothing made by abbey’s labor

Usually single genderUsually single genderRecruited new membersRecruited new members – PrisonsPrisons



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Resource Dependency TheoryResource Dependency TheoryHow do we determine dependence?How do we determine dependence? –

The importance of the resourceThe importance of the resource

– The extent to which the interest group hasThe extent to which the interest group hasdiscretion over use and allocation of thediscretion over use and allocation of theresourceresource

– Alternative resources Alternative resources



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Resource Dependency Theory con’tResource Dependency Theory con’tResource exchangeResource exchange – Magnitude of the exchangeMagnitude of the exchange

An organization that creates only one An organization that creates only oneproduct or services is more dependentproduct or services is more dependenton its customers than an organizationon its customers than an organizationthat has a variety of outs that are beingthat has a variety of outs that are beingdisposed of in a variety of markets.disposed of in a variety of markets.Similarly, organizations which requireSimilarly, organizations which requireone primary input for their operationsone primary input for their operationswill be more dependent on the sourceswill be more dependent on the sourcesof supply for that input than organizationsof supply for that input than organizationsthat use multiple inputs, each in relativelythat use multiple inputs, each in relativelysmall proportion.small proportion.



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Resource Dependency TheoryResource Dependency TheoryMore on Resource ExchangeMore on Resource Exchange –

Criticality of the resourceCriticality of the resource

Criticality measures the ability of the organization toCriticality measures the ability of the organization tocontinue functioning in the absence of the resourcecontinue functioning in the absence of the resourceor in the absence of the market for outputor in the absence of the market for output

– Problematic conditions of resources comeProblematic conditions of resources comefrom the environment.from the environment.



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Organizational vulnerability derives fromOrganizational vulnerability derives fromthe possibility of an environment’s changingthe possibility of an environment’s changingso that the resource is no longer assuredso that the resource is no longer assuredDiscretion over resource allocation and useDiscretion over resource allocation and use – Basis for control over a possessionBasis for control over a possession

KnowledgeKnowledge

Ownership or ownership rightOwnership or ownership right Access AccessRegulationRegulation



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Basis for control over a possessionBasis for control over a possession – KnowledgeKnowledge

DoctorsDoctorsLawyersLawyersEngineersEngineers

– Ownership or ownership rightOwnership or ownership rightIndirect discretion which depends upon a social-political conceptionIndirect discretion which depends upon a social-political conceptionand on enforceable social consensusand on enforceable social consensus

– Access Access Any process that affects the allocation of a resource provides some Any process that affects the allocation of a resource provides somedegree of control over itdegree of control over it

– Executive secretaryExecutive secretary – RegulationRegulation

The ability to make to make regulations and rules can determine theThe ability to make to make regulations and rules can determine thevery existence and concentration of powervery existence and concentration of power



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DependenceDependence – A resource that is not important to an A resource that is not important to an

organization cannot create a situation of organization cannot create a situation of dependencedependence

When there are many sources of supply or potentialWhen there are many sources of supply or potentialcustomers, the power of any single one iscustomers, the power of any single one iscorrespondingly reducedcorrespondingly reduced



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macro perspective of ot

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