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In order for integration between physician practices and hospitals to be successful, each will have to overcome cultural differences that have contributed to a sometimes adversarial relationship. Such differences can be attributed to opposing views related to focus, perspective, working environment, decision making, goals, working style, and management style.
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Is a sea change occurring in the organizational politics of health care institutions? How is information informally spread throughout the office? It used to be that gossip was the vehicle by which employees learned much about the organization's culture and news. But now, organizations are characterized by a growing faction of staff who are emotionally detached and have a "day-laborer" mentality. The grapevine is not as effective as it once was. Non-participation includes ignoring the grapevine both as listener and feeder. What implications does this have for your organization?
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In the new millennium, the delivery of medical care will be different from today. As we begin the next thousand years of the human journey, changes in the way medical care is provided will reflect broader changes in the social, economic and political fabric of society as a whole. There are three particularly important themes that will shape how we provide care in the future.
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Top-level managers know that conflict over issues is natural and even necessary. Management teams that challenge one another's thinking develop a more complete understanding of their choices, create a richer range of options, and make better decisions. But the challenge--familiar to anyone who has ever been part of a management team--is to keep constructive conflict over issues from degenerating into interpersonal conflict. From their research on the interplay of conflict, politics, and speed in the decision--making process of management teams, the authors have distilled a set of six tactics characteristic of high-performing teams: They work with more, rather than less, information. They develop multiple alternatives to enrich debate. The establish common goals. They make an effort to inject humor into the workplace. They maintain a balanced corporate power structure. They resolve issues without forcing a consensus. These tactics work because they keep conflict focused on issues; foster collaborative, rather than competitive, relations among team members; and create a sense of fairness in the decision-making process. Without conflict, groups lose their effectiveness. Managers often become withdrawn and only superficially harmonious. The alternative to conflict is not usually agreement but rather apathy and disengagement, which open the doors to a primary cause of major corporate debacles: groupthink.
Conflict in systems development is nothing new. It can vary in intensity, but there will always be two possible outcomes--one constructive and the other destructive. The common approach to conflict management is to draw the battle lines and apply brute force. However, there are other ways to deal with conflict that are more effective and more people oriented.
This article is one form of communication, but it is a one-way method. When we discuss communication problems, we usually refer to a breakdown in the process of sharing information with each other--two way communication. We ask questions such as, How do we establish communication? What do we need to do to maintain the process of communication? Why do the lines of communication break down? There are of course, many factors that either contribute to or block out communication. This article deals with one insidious factor that is absolutely necessary to establish and maintain communication and happens to also be one of the reasons for breakdowns in the process of communication. That factor is your own paradigm. In fact, your paradigm may be the number one problem that blocks communication.
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Explore the source record for details and available documents.
A central aspect of successfully redefining our approaches to service delivery is tapping the potential that exists within each member of an organization. How we relate within the organization and how we view the environment and markets in which our organization functions are critical issues.
To encourage innovation and improve departmental and organizational bottom lines, Winchester Hospital, Winchester, Massachusetts, developed and implemented a middle management and staff incentive compensation plan. Middle managers and staff who participate in projects that provide savings to the hospital are paid a share of the savings. The plan allows staff the option of designing "horizontal" projects, in which a project leader carries out a project individually or with peers, or "vertical" projects, in which a project leader directs a team of key individuals. Increasing numbers of vertical projects have been proposed since the plan's inception in 1994. In addition to increasing the hospital's operating income, the program provides cost-effective, variable compensation, which especially appeals to motivated, high-performing employees; motivates employees to overcome roadblocks; facilitates a team approach that bridges traditional departmental boundaries; and encourages a beneficial and collegial competitiveness among managers.
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The white paper proposals for partnerships in the NHS of the future are much less developed than those for performance. It is unclear whether collaborative activities are discretionary or mandatory. Effective inter-agency co-operation will require central government to give joint working a higher priority.