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A Színek Tükrében korhaz_2005_12.qxd 12/6/2005 12:22 PM Page 6 MENEDZSMENT HOGYAN DÖNTSÜNK STRATÉGIAI KÉRDÉSEKBEN? A színek tükrében cióra öt potenciális jelölt, Mark Skála meghatározása A mindennapi működés során alkalma- GREENE, Doug ROSS, Peter BENTON, Túlzottan ragaszkodunk a számokhoz. zott intuitív döntési technikák, bár több- John CARTER és Kerry WEAVER közül Felejtsük el őket! Kevés dolgot tudunk nyire hatásosak, mégis ritkán hatéko- kell választanunk. pontosan számszerűsíteni, illetve a nyak, illetve optimálisak stratégiai dön- számszerűsítés következtében az agyunk tési helyzetekben. Márpedig a kórház, a A szempontok tisztázása rögtön különböző jelentéstartalmakat is kórházi osztály jövője szempontjából ko- hozzárendel a számokhoz (például ösz- rántsem mellékes, hogy milyen technoló- A választáshoz elengedhetetlen a döntési szeadhatóság, abszolút nagyság…). giákat, eljárásokat alkalmaznak és fog- szempontok előzetes tisztázása. Egyrész- Használjunk színskálát. Érdemes egy nak alkalmazni a jövőben, milyen to- ről fontos a döntés során minél több szín árnyalatait használni (jelen esetben vábbképzéseken vesznek részt alkalma- szempontot figyelembe venni, másrész- a lila), például úgy, hogy a negatív dol- zottaik, kik is egyáltalán az alkalmazot- ről törekedni kell a fontos kritériumok gokhoz világosabb színeket, míg az egy- tak és kik vezetik őket. kiválasztására. re pozitívabbnak ítélt tényezőkhöz egyre A gyakorlatban 5-7 jól kiválasztott sötétebb árnyalatot rendelünk. A döntési Döntési szituáció szempont ideális helyzetet teremt; egy- szituációk többségében az 5-ös skála a szerre biztosított a döntés kellő megala- legjobb választás, de elképzelhető ettől A vezető életének része a felelősségteljes pozottsága és a döntési folyamat kezel- eltérő számú színárnyalatot (vagy színt) döntéshozás. Különösen hangsúlyos a fele- hetősége. A példánkban ilyen szempont- tartalmazó skála használata is. lősség a jövőt döntően befolyásoló kérdé- ok lehetnek a jelölt képzettsége, szakmai sekben (annak ellenére, hogy nem biztos, a gyakorlata és elismertsége, személyisége, Színezzünk! vezető megéli az adott pozícióban döntése kapcsolatai, fizetéssel szemben támasz- gyümölcsét). Mégis ritka az átgondolt, stra- tott igénye. Kész a mátrix, kész a skála, nincs más tégiai döntéseket segítő technikák alkal- dolgunk, mint kiszínezni a cellákat. Két mazása a hazai kórházak gyakorlatában, Mátrix kialakítása stratégia ajánlott; vagy haladjunk oszlo- miközben a legtöbb iparágban jelentős fej- ponként, vagy soronként. Figyelembe vé- lődésről számolhatunk be e tekintetben az A lehetőségek és a szempontok ismere- ve a kényelmi és időszempontokat, mi elmúlt dekádra visszatekintve. tében kialakítható egy 5x5-ös táblázat, szempontokként (soronként) haladva ja- melynek oszlopait a lehetőségek, míg vasoljuk az összevetést. A lehetőségek kiválasztása sorait a szempontok alkotják (vagy tet- A képzettség tekintetében Doug ROSS szés szerint fordítva). A kérdés már csak és Kerry WEAVER végzettsége kimagas- Gyakran az is gondot jelenthet, hogy mi- az, hogy mire használjuk a kialakított ló, Mark GREENE-é és a sebész Peter lyen lehetőségek jöhetnek számításba, cellákat. BENTON-é átlagon felüli, míg John amikor döntenünk kell. Az alternatív meg- Megjegyzendő, hogy a mátrix oszlo- CARTER lelkes újonc. Hasonló a helyzet oldások kiválasztása a döntéselőkészítés pai közé csak azok a lehetőségek kerül- a gyakorlat és az elismertség tekinteté- egy korábbi fázisát jelenti, a következők- nek be, amelyek kivitelezhetőségével ben is, azzal a megjegyzéssel, hogy BEN- ben részletesen bemutatott módszer célja szemben nincsenek elvi akadályok, TON és WEAVER elismertsége alacso- kifejezetten a lehetőségek közötti válasz- mint például a munkakör betöltéséhez nyabb szakmai végzettségüknél. A színe- tás megkönnyítése. minimálisan szükséges szakmai képesí- zést a többi szempont szerint is végre- A szemléltetés kedvéért tekintsük a tések hiánya vagy súlyos összeférhetet- hajtva elénk tárul a „színes jövő”. következő helyzetet: vezető orvosi pozí- lenség. Szép, szép, de melyiket válasszam? Az optimális megoldás a legsötétebb ki- egyensúlyozott lehetőség. Az első kritéri- um (legsötétebb) azt jelenti számunkra, hogy a legtöbb szempontból átlagon felüli választást jelent, míg a második kritérium (kiegyensúlyozott) arra vonatkozik, hogy a lehetőségnek minimális a buktatója. ROSS és WEAVER ugyan rendkívül te- hetséges orvosok, azonban mindkettejük esetében a kinevezés rejtett buktatót rejt A döntést segítő mátrix (fehér területek). ROSS esetében a mun- 6 Kórház 2005/12. korhaz_2005_12.qxd 12/6/2005 12:22 PM Page 7 MENEDZSMENT Kórházi menedzsment Dániában Évekkel ezelőtt szokásos volt, hogy a központi kórházmenedzsmentet egyetlen személyre bízzák, aki orvosi háttérrel rendelkezett. A mai KITEKINTŐ költségtudatos társadalomban azonban a kórházigazgatótól alapvetően megkövetelik, hogy üzemgazdasági, és ne orvosi végzettséggel rendelkezzen. Ennek megfelelően a nyolcvanas évek óta kísérletileg a legtöbb kórházban a kórházmenedzsmentet több személyre osztot- ták fel, akik pénzügyi és orvosi ismeretekkel rendelkeznek. Gyakori példa a hármas menedzsmentmodell, amely egy gazdasági, egy orvos- és egy ápolási igaz- gatót tartalmaz. Mivel a felelősségek nem teljesen elkülönítettek, ez a döntésben problémákhoz vezethet, és megegyezés híján csökken a menedzsment haté- konysága. Ezenkívül más menedzsmentmodelleket is kipróbálnak. Kisebb régiókban több kis kórház egy menedzsment alatt fuzionált, a nagyobb kórházakban pedig az ún. elnökségi modellel kísérleteznek. Eszerint a kórház felső menedzsmentje a főigazgató egyszemélyes felelőssége alatt áll, akit egy igazgatási gré- mium támogat, amely nemcsak egy orvost és egy ápolási vezetőt foglal magában, hanem pénzügyi kontrollert, személyzeti menedzsert, mérnök vezetőt, fej- lesztési vezetőt is. A jövőbeni kórházmenedzsment valószínűleg továbbra is sokrétű lesz, nem utolsó sorban a kórházak különböző mérete és feladatai miatt. A szervezetet azonban előreláthatólag az az általános kívánság fogja befolyásolni, hogy a költségvetési felelősséget lefelé decentralizálják. Az elv a követke- ző: a tényleges menedzsmentszintnek kell viselnie a felelősséget a tevékenységekért, és a decentralizálásnak fokoznia kell a dolgozók motivációját, emelnie a jó közérzetüket és a fokozott produktivitás lehetőségét. Hospital kahelyi partnerkapcsolatok (annak elle- Variációk mátrixot több „szakértővel”; akár ma- nére, hogy szakmai kapcsolatai erősek!) A módszer szofisztikálására több lehető- gukkal a jelöltekkel, akár más kollégák- és a túlzott fizetésigénye, míg WEAVER ség is nyitva áll. Például a módszer fino- kal is kitöltetjük, és a következtetéseket esetében az emberi-munkahelyi kapcso- mítása, ha azt is figyelembe vesszük, hogy összevetjük. latok rossz kezelése tartogat rejtett konf- az egyes szempontok nem egyformán sú- Zárásként nem is kívánhatunk mást, liktust. lyosak a döntésünkben. Ez vizuálisan úgy mint színes jövőt (nemcsak) a kórházba! BENTON és CARTER szerencsétlensé- oldható meg, ha az egyes szempontokhoz gére GREENE a páros összevetésekben tarozó soroknak eltérő a magasságuk, és HORTOVÁNYI LILLA ÉS SZABÓ ZSOLT ROLAND jobb náluk. Az ő oszlopa a legsötétebb és annyival magasabb az egyik sor a másik- egyben a legegységesebb. Tehát, mint az nál, amennyivel fontosabb az a szempont Budapesti Corvinus Egyetem, Vezetéstudományi Intézet, ábrából is szó szerint „látszik”, GREENE a döntésünk meghozatalában. Stratégiai és Nemzetközi az optimális jelölt a vezető orvosi beosz- Egy másik lehetőség a döntés megbíz- Menedzsment Kutatóközpont tásra a potenciális jelöltek közül. hatóságának javítására, ha a kialakított A minõségi digitális képalkotásért! Kellemes ünnepeket és még sikeresebb új évet kívánunk a magyar kórházaknak! REAFOTÓ KFT. 1106 Budapest, Gitár u. 34-36. Tel/fax: 1 261-9558, 1 260-6634 web: www.reafoto.hu e-mail: [email protected] A Magyar Kórházszövetség hivatalos lapja Kórház 2005/12. 7.
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