A Health Service Managers Organizational Theory - Term Paper Example

 Public Health: A Health Service Manager’s Organizational Theory, Personal Ideology, and Dilemma In Decision-Making Word Count: 2,500 I. Introduction Health services managers like this author are under an incredible amount of stress to provide excellent quality care for their clients. Typically, the job consists of having superior project management skills and an ability to delegate. According to recent research on the subject of organizational theory, it is projected that, “Well-conducted qualitative organizational analyses using a broadly symbolic interpretive perspective were pioneered in health care organizations by the Chicago School…The quantitative analysis of health care organization remains a strong tradition, especially in the USA…” (Dopson, et. al., 2006, pp. 16). Organizational theory in decision-making is especially helpful for this particular author, due to the relative ease with which one can navigate a particular theory. In this case, the chosen theory to be incorporated into a health services setting as a manager is postmodernism. The ideal personal ideology to have in this business, in the view of this author, is optimism. An optimistic outlook can have positive effects on everyone who surrounds the busy and harried health services manager. It is with this can-do attitude that most closely resembles the power of positive thinking. It is a most useful ideology to have in the face of difficulties as a health services manager. How one approaches a dilemma as a health services manager is a monumental task. For this particular dilemma, a situation will be analyzed in which a patient’s family is debating whether to take the patient off of life support. The role of the health services manager can be integral in a key decision such as this. Thus, the three elements that will be discussed here in the act of decision-making are: the organizational theory of postmodernism; the personal ideology of optimism; and how to approach a dilemma. II. Organizational Theory in Decision-Making Postmodernism is the organizational theory that is used for this particular author as a health services manager. According to Gergen (1992), “Postmodernism states there is no objective truth. The function of theories is not derived from their truth value but their pragmatic implications. The primary ingredient of theory is not its years of supporting data but its intelligibility.” Gergen (1992) says that the function of theories are not truth but functionality. One might then naturally ask, “How one would teach postmodern organization theory…and expect it to be useful? A manager operating under such assumptions of reality could never act” (Boje et al., 1996, pp. 255). However, this is not true. Postmodernist theory assumes many possibilities, and what is perceived in reality may have various meanings. Therefore, it is of extreme importance that the postmodernist, in his or her decision-making, has various options. According to Gergen (1992), postmodernism is critical of one's own suppositions. This, according to Martin (1990) is called deconstruction—a technique to show multiple ways a situation can be interpreted. The importance of deconstruction is that it exemplifies maximum optimization theory—a theory in calculus whereby all the available possibilities at hand are taken into account. This can help immensely in decision-making, because unless a health services manager avails himself or herself of all the available possibilities that could be the outcome of the situation, it might be very difficult to make a critically informed decision. Notwithstanding, it is of premier importance that the health services manager use deconstruction as a tool to aid in discerning whether or not to make certain decisions. For example, the postmodernist health services manager is much more likely to weigh all available options before making a decision. Not only this, but having a postmodernist attitude with regard to reflective thinking, the astute health services manager, like this author, realizes that answers are not always facile to comprehend, nor is reaching conclusions. Additionally, the possibility that there are multiple outcomes to a decision increases the chance that the more open-minded postmodernist health services manager will have a better outcome, seeing as how he or she weighs the potential solutions and available resources. Postmodernist organizational theory is crucial to the outlook of the intelligent health services manager, because postmodernist theory informs the way in which a health services manager approaches project management. One key to having good project management as a health services manager is to focus on the task at hand, and then be able to follow through after having weighed all the possibilities of the problem at hand and potential solutions. An excellent health services manager must have the foresight to be able to predict and prevent major catastrophes, having plans in place that are not myopic but rather are inclusive of all the different spheres of the health services spectrum. This includes having contingency plans in place in case of emergency, being able to identify protocol in place for emergencies, having developed protocol if there is none for emergencies, and delegating tasks amongst the health services environment. Whether the organization is large or small, it is the health services manager’s job to ensure that no one is left grasping for straws in an industry where conscious effort must be made in order to ensure that doctors, patients, and administration moves in a continuous and effortless flow. The qualified health services manager always makes sure that everyone knows what his or her role is within the organization, because a health services manager worth his or her salt knows that—having taken all factors into account—there is a best practices solution to every problem. Critically speaking, “…postmodern organization theory…[is]…in a search [of]…the existence of the paradox, the non-obvious or the counter-intuitive” (Hancock et. al., 2001, pp. 75). Postmodern organization theory, as a health services manager, can be very useful; and, in terms of the latter statement, sometimes good judgment indeed leads to unusual, subtle, or even unorthodox conclusions. For example, if one is making decisions and one realizes that there is a conflict of interests, it is possible in postmodernist organizational theory to satisfy both sides of the conflict by coming to a mutually agreeable solution. Postmodernist thinkers will try to include all sides of a conflict and try to integrate possible modes of resolution so that everyone involved in a situation is happy with the outcome. In fact, postmodernist thought deems it appreciable that subtle context clues are sometimes answers in themselves. It does not seem complicated, but in reality, some of the answers that are most apparently correct can often be those that are hidden or not instantaneously obvious solutions. This requires a depth of thought that the health services manager must work within, at a depth scarcely imaginable. However, working at that level of depth, the health services manager who is astute may come up some very interesting conclusions indeed. Oftentimes, in health care dilemmas, what is needed is insight. This can be sorely lacking in the health care industry, where only the physical, the scientific, and the empirical realms are deemed as having any socially redeeming value. However, the postmodernist health care services manager realizes that those elements are not the only ones that are useful or worthy of critical evaluation. In his or her expert estimation, the adequately-prepared health services manager who uses postmodernist organizational theory is basically concerned with being open-minded to as many solutions as possible in order to successfully manage any crises that may develop over time. III. Personal Ideology in Decision-Making One’s personal ideology as a health services manager is critical in shaping the perspective, or lens, which with one views the world. Just as postmodernist organizational theory affects how one makes decisions, so too does the health care service manager’s personal ideology or outlook on life. It is the opinion of this author that it is most effective to maintain a personal ideology of optimism in this role. In a capacity as health services manager, being optimistic serves several purposes. Being optimistic is critical when one is decision-making, because this affects several areas. One’s attitude affects the way one treats others, the way others treat oneself, and the way everyone relates to one another. Having an optimistic attitude certain ensures, at least in some regard, that at least one positive outcome is this: that oneself will remain positive. Even if the world is crashing down around the health services manager, the psychological defense that everything will turn out for the best is certainly an anchor of strength for any health services manager who strives to make quality care a reality for all of his or her underlings. To that end, it is with great care that the health services manager realizes that his or her actions, thoughts, and words reflect a certain attitude which is reflected in the lives of the people surrounding him or her. In that sense, it is altogether entirely important that a health services manager be cautious in regard with what he or she says to someone, does to someone, and how he or she reacts in certain situations. There are many wonderful reasons to remain optimistic. First of all, it ensures the inevitability that at least people who are going through a dilemma are being treated with respect. This means that the health services manager who has the outlook that the situation will evolve with the best possible outcome has a higher chance of actually having a positive outcome. Since positivity breeds positivity, it is of premier significance that the astute health services manager remain optimistic in all circumstances, even if the outcome of having made a particular decision looks like it may be negative. This is mainly so that, psychologically, the health services manager maintains a sense of stasis within one’s sphere of operation. Operating out of a state of panic will not help the health services manager to assist anyone. Rather, one of the positive aspects of remaining optimistic is that one is usually calm, cool, and collected, and is able to make decisions from a place or mindset of being at complete and utter peace. Meanwhile, it is the organization’s job underneath the health services manager to maintain balance by following all of the directives of the health services manager. Of course, in order for this to happen, it is cogent that all parties involved maintain lives that are themselves balanced and functional. Otherwise, no one in the organization (the health services manager included) will be in any position to help anyone, much less the patients requiring care that are part of that organizational structure. Thus, for these reasons, having a positive outlook on life can help aid the health services manager in decision-making in an enormous capacity. IV. Dilemma in Decision-Making One dilemma a health services manager may face at some point is that a family may require a team meeting—of both management and staff—deciding what to do if one of the family members is on life support and there is the decision on the table to take the person off life support. In this case, multiple views should take precedence. There is what the facts of the case are, what the doctors say, and what the family thinks. All of these factors are relevant to what the decision should be in a case such as this. The facts of the case may very well influence a health services manager in the direction of deciding how to influence the family in making a decision. For example, whether the person on life support is young or old, has any underlying medical conditions, the status of their vital signs, indications that the situation is improving or not, and what the person’s role in the family is are all valid factors in helping a family ask management to make a decision to withdraw life support or not. What doctors say to management is also crucial. Does the patient have brain waves? Is the person in a coma, whether incidental or intentionally induced to relieve pressure on the brain? Is there a chance at this person ever having a normal life? Would the person have to remain on ventilation for life? Would the person need a feeding tube or a gastrointestinal tube (G-tube), and if so how long would that person be dependent on these tubes as ways of getting nutritional supplements? But perhaps the most crucial question that will be asked of the doctor is, if this person will ever have the chance at having a normal life. In the case that the answer is no, it is most likely that management will confront the family with the option (either through giving a doctor the directive or telling the family directly) that life support be turned off. This is a dilemma that raises considerable ethical questions. How can a person who is breathing normally (or with the help of a ventilator) simply not be allowed nutrition or air based on the fact that they are basically non-responsive? What if the person is in a coma now but could ultimately one day show some sign of improvement? All of these factors must be taken into consideration when management, especially a health services manager, directs staff to approach a family about the possibility of such a horrific decision. Finally, what has the most weight perhaps is what the family thinks, after everything has been taken into consideration. Even the most liberal-thinking postmodernist health services manager must ultimately look at the facts realistically—after having weighed options many times—and, at some point ask the family to make a very tough choice. In the end, the health services manager may have a positive and sunny outlook on life, but such a worldview cannot account for the fact that, sometimes situations do not always have ideal solutions—and even may have solutions that are very difficult for everyone to deal with (staff, management, the patient, and the family included). Whatever decision is made, the important factor to keep under consideration is that the health services manager has summoned all of his or her substantive powers in order to make an informed and wise decision in the way to approach a dilemma such as this. It is with that knowledge that the intelligent health services manager approaches each new day and each new situation. V. Conclusion Decision-making can be an arduous process for a health services manager. Indeed, in a world where there are no easy solutions or quick fixes, it is of premier importance that the cautious and industrious health services manager have a healthy outlook on many fronts. In the first place, speaking from a certain perspective, a postmodern organizational theory is an invaluable tool for the health services manager, who may be called upon to weigh the relative relevancy and potency of various decisions that may affect the outcome of a problem or dilemma. Additionally, optimism is the personal ideology that characterizes the best health services managers. In the midst difficult dilemmas such as the aforementioned case study, these two ideologies can have impacts that are far-reaching and helpful. Organizational theory, personal ideology, and the ability to solve dilemmas are necessary and useful elements of the health services manager’s personal toolbox. REFERENCES Boje, D., Gephart, R.P., & Thatchenkery, T.J. (1996). Postermodern management and organization theory. USA: Sage Publications, Inc. Dopson, S., & Fitzgerald, L. (2006). Knowledge to action?: evidence-based health care in context. USA: Oxford University Press. Gergen, K. J. (1992). “Organizational theory in the post-modern era.” Rethinking organizations: new directions in organization theory and analysis. USA: Sage Publications, Inc. Hancock, P., & Tyler, M. (2001). Postmodernism and organization: a critical introduction. USA: Sage Publications, Inc. Martin, J. (1990). Deconstructing organizational behavior taboos: the supressions of gender conflict in organizations. Organization Science, 1: 339-359. Read More