Matrix Management in Hospitals.docx
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Matrix Management in Hospitals.docx
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MatrixManagementinHospitals
MatrixManagementinHospitals:
TestingTheoriesofMatrixStructureandDevelopment
Astudyof315hospitalswithmatrixmanagementprogramswasusedtotestseveralhypothesesconcerningmatrixmanagementadvancedbyearliertheorists.Thestudyverifiesthatmatrixmanagementinvolvesseveraldistinctiveelementsthatcanbescaledtoformincreasinglycomplextypesoflateralcoordinativedevices.Thescalabilityoftheseelementsisevidentonlycross-sectionally.Theresultsshowthatmatrixcomplexityisnotanoutcomeofprogramage,nordoesmatrixcomplexityatthetimeofimplementationappeartoinfluenceprogramsurvival.Matrixcomplexity,finally,isnotdeterminedbytheorganization'staskdiversityanduncertainty.Theresultssuggestseveralmodificationsinprevailingtheoriesofmatrixorganization.(*)
INTRODUCTIONOrganizationtheoryandresearchhavenotempiricallyaddressedthetopicofmatrixmanagementadequately.Whilemuchhasbeenwrittenaboutmatrixmanagementsinceitsimplementationintheaerospaceindustryduringthelate1950sandearly1960s,includingseveralbooks(Galbraith,1973,1977;DavisandLawrence,1977;Knight,1977),mostofithasbeencasestudies,descriptivearticles,andchaptersonorganizationdesign.Giventhecase-orientedandnormativelybasedapproaches,littleefforthasbeendevotedtoidentifyingandmeasuringthecharacteristicsofmatrixstructure.Themajorityofauthors(e.g.,Galbraith,1972;Kolodny,1979)hasviewedmatrixmanagementasthefinalstepintheutilizationoflateralcoordinativemechanisms,rangingfromliaisonrolesandtaskforcestothepurematrix.Thisseriesofcoordinativemechanismsisbelievedtorepresentvariousstagesinanhistoricalprogressionfromoneorganizationalformtoanother.Researchhasbeenplagued,however,byalackofdataandtheinherentdifficultiesofstudyingaseriesoflateralcoordinativemechanisms.Thediversityinthetypesofcoordinativemechanismsandthepossibilitythattheyevolveintohigherforms(ordevolveintolowerones)requirethatempiricalstudiesbebothcomparative(i.e.,withadequatesamplingofeachtypeofmechanism)andlongitudinal(i.e.,usingpanelortime-seriesdata).Theonepreviousempiricalstudyoflateralcoordinativemechanismsiscomparativebutnothistorical(LawrenceandLorsch,1967).Thispaperaddressesthetheoreticaldeficienciesintheliteraturebyidentifyingtheelementsofmatrixmanagementanddevelopinghypothesesabouttheirinterrelationshipsanddeterminants,basedonearlierworkbyLawrenceandLorsch(1967)andGalbraith(1971,1972,1977).Theseelementsandhypothesesarethenevaluatedempiricallyinastudyofunitmanagementinhospitals.Unitmanagementisamatrixprogramthatexhibitspatternedstructuralvariation,muchlikeaseriesofcoordinativemechanisms.Thepaperalsoanalyzesthedevelopmentofmatrixprogramsandtheimpactofmatrixcomplexityonprogramsurvival.Thefindingsconfirmorinvalidatemanyofthelong-heldassumptionsaboutmatrixmanagementandsuggestsomerefinementsincurrenttheoriesofmatrixorganizationdesign.
THEORY
MatrixManagementStructureandDevelopment
Matrixmanagementistypicallyviewedastheendpointinasequenceoflateralcoordinativearrangements.FollowingLawrenceandLorsch(1967),Galbraith(1972:
65)proposedaGuttman-typescaleofcoordinativedevices("cross-functionalforms")inwhichthematrixorganizationevolvesfromandbuildscumulativelyonseveralearlierarrangements.Thisscaleencompassesliaisonroles,taskforces,teams,integrators,integratingdepartments,andfinally,thepurematrixorganization.Galbraithusedthefunction-by-projectformtoillustratethematrixorganization:
functional(vertical)departmentscrosscutbyproject(horizontal)managers.Heneverthelessmadeitclearthatthematrixisnotlimitedtothesebasesoftheauthoritystructure(1971:
29).Rather,amatrixorganizationcanencompassanycombinationoforganizingprinciples,suchasfunction,product,andgeographicarea(DavisandLawrence,1977:
71).Galbraith'sseriesofcoordinativemechanismsincreasestheorganization'scapacitytohandleuncertaintasksandtheirhighinformation-processingdemands.Themoreelaboratemechanismsareappropriateforhigherlevelsoftaskdiversityanduncertainty(LawrenceandLorsch,1967;Galbraith,1972;Kimberly,Leatt,andShortell,1983).Inordertobeeffective,organizationsmustdevelopaninformation-processingcapacitythatmatchestheinformation-processingrequirementsofitstasks,whichareafunctionoftaskdiversity,i.e.,"thenumberofelementsrelevantfordecision-making"(Galbraith,1972):
departments,specialties,productlines,andtaskuncertainty(e.g.,uncertaintyregardingresourcesneededortimeinvolved).Thesequentialcharacterofthesecoordinativemechanismssuggeststhatmatrixcomplexityisassociatedwithmatrixage.Researchersalsosuggestthatmatrixprogramsthatdevelopincrementallythroughthesestagesenjoygreatersurvivalprospectsthanfullyimplementedmatrixprograms.Finally,researchersconjecturethatmatrixmanagementisatransitionalstructure,notapermanentone(Galbraith,1971:
37;Kolodny,1979:
544).Notonlyisthereevolutionfromlesscomplextomorecomplexlateralarrangements,butthematrixmayalsoevolveintooneofthemorepredominantformsofdepartmentalization(e.g.,product-linemanagement).
DefinitionofMatrixManagementandOrganization
Matrixmanagementencompassestheentireseriesofeffortstolayoneormorenewformsofdepartmentalizationontopofanexistingform(e.g.,todevelopafunction-by-projectgrid).Thishierarchicaloverlayisadefiningcharacteristicofmatrixprograms.Asthenewformofdepartmentalizationgrowsmoreelaborate(e.g.,projectteamsproliferateandbecomeadministeredbyprojectmanagersanddepartments),thegridgrowsmoredense,andthestructureapproachesamatrixorganization.Thedegreetowhichthenewandexistingformsofdepartmentalizationbecomeblendedandbalancedisvariable.Idefinematrixorganizationastheparticularstructuralarrangementinwhichthetwoformsoperatewithbalancedpriorityandauthorityonarelativelypermanentbasis.Thepurematrixincludesabalanceofpowerandjointdecisionmakingbetweenfunctionaldepartmentheadsandprojectmanagers(e.g.,collaborationonbudgets),dualinformationandreportingsystems,anddualauthorityrelations(e.g.,two-bossmanagers)(Galbraith,1971:
36).
ElementsofMatrixManagement
Matrixprogramsvaryintermsofthestructuralandadministrativeelementsthatbuildupononeanothertoformmoredensegrids.Onecanidentifyatleastsixelements,usingGalbraith's(1971)exampleofa"functionbyproject"matrix:
(1)Structuraldifferentiation:
Thenewhierarchicaloverlaymaybedifferentiatedfromtheexistingstructurebyestablishing(a)adirectorofprojectmanagementand(b)adepartmentofprojectmanagement;
(2)Dualauthority:
Matrixprogramsmaydevelopdualauthorityrelationshipsinwhichlower-levelmanagersfromtheoriginalhierarchy("sharedsubordinates"or"two-bossmanagers")aresupervisedbyofficialsfrombothhierarchies("matrixbosses").
Suchrelationshipsaredesignedtoincreasetheinfluenceandpowerofthenewhierarchytocoordinateactivitiesacrosstheoldhierarchy;(3)Decision-makinginfluence:
Managersinthenewhierarchymayberesponsibleforadministration,budgeting,andpolicy-makingactivitiesinadditiontocoordinatinglocal-levelpersonnel.Suchinfluenceisrequiredtomaintainthequalityoflocaldecisions(Galbraith,1972);(4)Dual-supportsystems:
Thenewhierarchymaydevelopitsownsetofadministrativesupportsystems:
strategicplanning,budgeting,informationprocessing,employeeappraisal,andcareerladders(DavisandLawrence,1977;Kolodny,1979);(5)Internaldiffusion:
Asmatrixprogramsdevelop,theymayencompassmoreoftheorganization'sactivity(e.g.,agreaternumberofpersonnel,departments,productlines,orgeographicalareas);and(6)Temporaldurationandcoverage:
Asmatrixprogramsdevelop,theymayalsobecomepermanentratherthantemporary,coveranyorallworkshifts,andcoverweekendaswellasweekdayhours.Interrelationshipsamongelements.Thesixelementsarevariablebutareexpectedtoco-varyinsystematicways.Researchonorganizationalstructureandgrowth(Hall,Haas,andJohnson,1967;BlauandSchoenherr,1971;DewarandHage,1978;DaftandBradshaw,1980)suggeststhatsmallmatrixprogramsshouldbeassociatedwithlowerlevelsofcomplexity,formalization,decentralization,andsupportstaffandlargematrixprogramswithhigherlevels.Forexample,amatrixistypicallyinitiatedonatrialbasiswithonlyafewprojectmanagers.Duetotheirsmallnumber,thesemanagersreporttotheheadofafunctionaldepartmentratherthantoaseparateprojectdepartmentwithitsowndirectorandsupportsystems.Projectmanagersoccupyliaison-coordinativerolesonly,withlittleresponsibilityfordecisionmaking,littleauthorityoverfunctionalpersonnel,andlittlecoverageofactivitiesacrossfunctionaldepartments.Overtime,matrixprogramsgrowinsizetoencompassmoreprojectmanagers,organizationaldepartments,andpersonnel.Theprobationarystatusoftheprojectmanagerbecomespermanent.Themanageriscededmoredecision-makingresponsibilityandauthorityoverothers.Thepermanenceandincreasedstatureoftheprogramisreflectedinaformalprojectdepartment,withitsowndirectorandsupportsystems.Thedimensionsofmatrixstructurearethusexpectedtobepositivelyintercorrelated.Theseelementsarealsoexpectedtobehierarchicallyordered.Galbraithhypothesiz
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