The Reality of Management

Overview

• Outline of the Current Structure in the Health Services

• The Management of the System• The Personal Experience• The Elements of the System that require

Management• Moving into Management

Outline of Current Structure of the System

• The Health Boards– The Acute Services– The Community Services

• The Voluntary Agencies– The Acute Services– The Community Services

Outline of the Current Structure in the Health Services II

• Patients• The Medical Profession• The Nursing Profession• Other Health Professions• Other Healthcare Employees

The Management of the System I

• The Department of Health and Children– The Minister– The Department Officials

• The Health Boards– The Board– The Chief Executive– Programme Managers– General Managers

The Management of the System II

• The Voluntary Sector– The Chief Executive– Divisional Managers / Management Teams

• The Voluntary/Volunteer Sector– Full Time Administrators– Voluntary Staff

Clinical Services Division I

• Diagnostic Services– Radiology

• General• CT• MRI• Ultrasound• Nuclear Medicine• Interventional• Neurovascular

• Diagnostic Services– Pathology

• Chemical Pathology• Histopathology inc..

Cytology • Microbiology• Haematology• Blood Transfusion• Histocompatibility &

Immunogenetics• Toxicology

Clinical Services Division II

• Diagnostic Services (contd.)– Cardiology

• Echocardiography• Interventional• ECG

– Audiology– Pulmonary Function– Neurophysiology

• Other Clinical Services– Pharmacy– Poisons Information

Unit– Clinical Psychology

Clinical Services Division III

• Therapeutic Services– Physiotherapy– Occ. Therapy– Medical Social Work– Dietetics & Nutrition– Speech & Language

Therapy

• Therapeutic Services (contd..)– Orthopody– Chiropody– Clinical Photography

The Personal Experience

• The Expectations• The Ambitions• The Goals• The Change• The Turmoil• The Challenge

The Expectation

Stages in Change

• Immobilisation• Denial of Change• Incompetence• Acceptance of Reality• Testing• Search for Meaning• Integration

The Experience

The Reality

‘Administration’ or ‘Management’

• ‘Administrator’ or ‘Manager’

• ‘Professionals’ or ‘Non-professionals’

• ‘Carers’ or ‘Bureaucrats’

• ‘Real’ workers or ‘Interferers’

The ‘CRUDE OIL’ Analogy

• Lubricating Oil • Petrol• Kerosene • Liquid Paraffin • Petroleum Jelly • Paraffin Wax • Bitumen

Hitting the High Spots

The Elements of the System that Require Management

• The Financial Function• The Personnel Function• The Purchasing Function• Patient Service Function• The Planning Function

The Fundamental Principle of Enlightened Management

• “If you want one year of prosperity,• Grow Grain• If you want ten years of prosperity,• Grow Trees• If you want one hundred years of prosperity• Grow People”

• Chinese Proverb

What Matters Most ?

• The Priorities for any Manager– People– People– People

• If you can’t manage people • you can’t manage effectively

Management: The Key Challenges

• Managing Expectations – One of the most difficult of Management

Functions• Managing Personalities

– Get to know your own first• Managing Politics

– Departmental– Professional

Things We All Need

• Support - both personal and informational– e.g. Coaching and Mentoring

• Patience - the System Moves Slowly• Guidance - Managers do not know as much

as you do about your job and ……...The obverse is also usually

true !

Changes

• Funding• Organisation• Structures• Services• Technology

Major Recent & Forthcoming Changes

• A Management Development Strategy for the Health and Personal Social Services in Ireland– The Office for Health Management– Competency Based Recruitment Systems

• The role of the C & AG• Accountability Legislation• Freedom of Information Act

A Model of Management Development (Baker & Dixon)

Organisational Development Management Development Personal Development

Competencies and Skills Required

Performance Appraisal Self Assessment and Personal Development Needs

Development Centres

Training and Development Programmes

Organisational Database on Management Personal DevelopmentDevelopment Plan Development Plan

PlacementJob RotationSecondmentMentoring

Career Counselling

Succession Planning Career Planning

Monitoring and Evaluation

The Learning Organisation

• The Requirements– Shared Vision– Systems Thinking– Mental Models– Team Learning– Personal Mastery

Moving IN

• Learn about yourself– Your Behavior / Drivers - BP PM TH HU BS– Your Preferences - Myers-Briggs– Your ‘Learning Style’ - Honey & Mumford

• Only then can you understand others• Personal Development Plan - with Mentor• Team Building - Belbin

Moving OUT

• Healthcare Professionals have more common features than differences

• Professional Identity• Inter-Professional Rivalry and Threats• A Sense of Service• The Issue of Recognition• Get out of the lab and meet your colleagues

Moving ON

• Turn a ‘Demand-led Mentality’ (weak) into a ‘Supply-led Mentality’ (strong) via Service Plans for your Services

• Look at Developments as ‘Opportunities’ not ‘Threats’ (NPT)

• Be proactive with respect to changes which are far-sighted

• Consider Diversification

Future Changes ?

• Change is scientific,• Progress is ethical;• Change is indubitable,• Whereas progress is a

matter of controversy G.B.Shaw 1950

•The Zebra Long Wing Butterfly Heliconius charitonia: Metamorphosis

Vision

• Work With the System not Against it• Use your positive reputation to good effect• Dialogue rather then Debate• Explore ‘other’s views• Give yourself a clap on the back for the

excellence of your contributions