FACHE Board of Governors Exam
Study Group
Management Module
Speaker:
James B. Burke, FACHE
Chief Operating Officer
Hahnemann University Hospital
Agenda
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Objective, Purpose and End state
Overview and Management Module Structure
Study material on Management Module
Review sample questions
Additional references
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Tonight’s Study Group
• Objective
– The FACHE study group will use their knowledge and
experience to thoroughly study the Management
Module of the BOG Exam
• Purpose
– To achieve a level of comprehension valuable to both
our exam prep and our professional development
• End state
– Study group members will be able to pass questions
from the Management Module
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Overview
Management
This area covers general management
principles, planning, organizing, directing, and
controlling in addressing overall organizational
objectives.
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Management Module Structure
Management Knowledge (30 of 200 Questions)
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Knowledge of:
– Implementation planning (e.g., operational plan, management plan)
– Contingency planning (e.g., emergency preparedness and response)
– Organizational systems theory and structuring (e.g., span of control, chain of command,
interrelationships of organizational units)
– Management functions (e.g., planning, organizing, directing, controlling)
– Leadership theory and situational applications
– Team-building techniques
– Mediation, negotiation and dispute resolving techniques
– Potential impacts and consequences of decision making in situations both internal and
external
– How an organization’s culture impacts its effectiveness
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Ability to:
– Analyze and evaluate information to support a decision or recommendation
– Distinguish relevant from irrelevant information
– Integrate information from various sources to make decisions or recommendations
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Mgt Functions & Decision Making
• Five Management Functions
– Planning
– Organizing
– Controlling
– Directing
– Staffing
• Must juggle all functions
• Decision making binds together and enables these
functions
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Decision Making
• Decision making is subset of problem solving
• Problem Solving Framework
– Problem analysis
– Course of action development
– Decision making
– Evaluation of results using explicit + measurable
criteria
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Skills, Roles and Competencies
of Leaders and Managers
• Managers
– Caretaking, status quo / transactional?
• Leaders
– Visionary, dynamic / transformational?
Senior Leaders / Managers must be able to
operate in both roles
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Skills by level
• Conceptual Skills
• Interpersonal Skills
• Technical Skills
– Senior Managers heavily use conceptual skills
– Middle and entry level managers evenly mix all
three skills
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Roles
• Interpersonal Roles
– Figurehead
– Influencer
• Informational Roles
– Monitor
– Spokesperson
• Decisional Roles
– Entrepreneur
– Negotiator
Successful leaders / managers integrate all these roles smoothly
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Competencies
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Conceptual
Technical
Managerial
Clinical
Interpersonal
Collaborative
Political
Commercial
Governance
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Sources of Power
• Leaders are able to influence behavior
through authority or power
• Sources of power:
– Legitimate / formal
– Reward
– Coercive
– Expert
– Referent
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Using Power
• Most leaders have blended sources of power
• Risks and benefits of using types of power
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Leader Traits
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Assertive
Cooperative
Decisive
Dependable
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Leader Skills
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Intelligence
Conceptually skilled
Creative
Persuasive
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Leader Styles
• Likert’s continuum of leadership effectiveness
– Autocratic
– Benevolent
– Consultative
– Participative / democratic
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Situational / Contingency Theory
• Leader changes behavior according to
situation
– More sophisticated, flexible and effective
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Designing Formal Organizations
• Planning drives organizing, which in turn drives design of
organizations
• Senior Managers / Boards focus on:
– Authority and Responsibility
– Department structure
– Coordination of relationships
• Managers focus on:
– Individuals, workgroups and workgroups clusters
– Span of control
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Organizational Design
Health System
HS Org
Cluster
(Clinical Staff)
HS Org
Cluster
Cluster
Cluster
Workgroup
(Dept / teams)
Workgroup
Workgroup
Workgroup
Workgroup
Workgroup
Workgroup
Workgroup
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Informal Organization
• Reflects wishes and preferences or workers
• Characterized by “dynamic behavior and
activity patterns” (!!)
• Informal and Formal Organization structures
combine to form the reality of the actual
organization
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Strategic and Operational Planning
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Strategic and Operational Planning
• Strategic Planning / Management
– Long term goals and direction
• Strategic Issues Management (SIM)
– Systematic process that proactively influences the
external environment vs. reacting to events
– (Google search / Amazon)
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Strategic and Operational Planning
• Operational Planning
– Direction and activities of individual units and
departments
– Operational plan must be coordinated with, and is
subordinate to, the Strategic Plan
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Planning Characteristics
Type Of
Planning
Scope
Time Frame
Owners
Approach
Strategic
Broad
• Strategies
• Mission
• Objectives
• General Policy
Long Range
Senior
Managers
•Developmental
• Incremental
• Proactive
• Reactive
Operational
• Dept
objectives
• Programs
• Policies
Short Term
Middle
Managers
•Developmental
• Incremental
• Proactive
• Reactive
Narrow
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Contingency Planning
• External Disaster Planning
– Mass Casualty
• Internal Disaster Planning
– Earthquake
– Hurricane
– Staff food poisoning
– Utility cut
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Managers as Negotiators
• Win-Win (Cooperative)
• Win-Lose (Competitive)
• Informal
– Handshake / memo
• Formal
– Contracts
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Conflict in Negotiations
• Resource allocation
– Money, goods, services
• Psychological Dynamics – more difficult
– Ego
– Fairness
– Appearances
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Resolving Disputes
• Legal…last resort; Negotiate first!
• Alternative Dispute Resolution (ADR)
– Used for decades for commercial disputes
– Private, inexpensive, efficient
• ADR Includes:
– Binding and Non-Binding Arbitration
– Mediation, mini trials, fact finding
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ADR
• Application of ADR techniques
– Mediation good when ongoing relationship is
desired
– Binding arbitration required to resolve disputes
involving malpractice
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Management Study Guidelines
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Understand the management functions and their link to decision making.
Know various management skills, roles, styles and contingency (situational)
leadership theories.
Comprehend the concepts of designing and redesigning formal organizations.
Differentiate the formal and informal organization and how each can aid in
achieving objectives.
Distinguish strategic and operational planning and know their elements and
processes.
Understand contingency planning and its application in health services
organizations.
Know the uses of negotiation and how managers use their skills as negotiators.
Understand alternative dispute resolution and the roles of mediation and
arbitration
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Sample Questions
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Sample questions
http://www.ache.org/mbership/credentialing/E
XAM/govselftest.cfm
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References
Management and Business
• Haimann's Healthcare Management, Eighth Edition, by Rose T. Dunn, FACHE
• Healthcare Strategic Planning, Second Edition, by Alan M. Zuckerman, FACHE,
FAAHC
• Health Services Management: Readings and Commentary, Eighth Edition, by
Anthony R. Kovner, Ph.D., and Duncan Neuhauser, Ph.D.
• The Leader's Change Handbook, by Jay A. Conger, Gretchen M. Spreitzer, and
Edward E. Lawler III (This book contains chapters covering several knowledge
areas.)
• Leadership for the Future: Core Competencies in Healthcare, by Austin Ross,
LFACHE; Frederic J. Wenzel; and Joseph W. Mitlyng
• Managing Health Services Organizations and Systems, by Beaufort B. Longest, Jr.;
Jonathon S. Rakich; and Kurt J. Darr, J.D., Sc.D., FACHE
• Mastering the Negotiation Process: A Practical Guide for the Healthcare Executive,
by Christopher L. Laubach
• The Well-Managed Healthcare Organization, Sixth Edition, by John R. Griffith,
FACHE, and Kenneth R. White, Ph.D., FACHE
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References
All Modules:
• http://www.ache.org/mbership/credentialing/EXAM/booklist.cfm
Exam Prep three-book Study Set:
• The Financial Management of Hospitals and Healthcare
Organizations, Fourth Edition, by Michael Nowicki, EdD, FACHE,
FHFMA
• The Well-Managed Healthcare Organization, Sixth Edition, by John
R. Griffith, FACHE and Kenneth R. White, PhD, FACHE
• Human Resources in Healthcare: Managing for Success, Third
Edition, by Bruce J. Fried, PhD and Myron D. Fottler, PhD
• http://www.ache.org/pubs/redesign/productcatalog.cfm?pc=WW
W1-2115S
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