Ownership transformations – direction of anti-crisis changes in the organization of health care
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Z Lubuskiej WyŜszej Szkoły Zdrowia Publicznego w Zielonej Górze
Z Instytutu Medycyny Wsi im. W. Chodźki w Lublinie
Med Og. 2010;16(2):251-265
Changes are currently among the most important characteristics of the functioning of all open systems management, which are combined together: human, material and financial and information resources. The management of changes becomes, therefore, an opportunity and a necessity simultaneously for all who may have an influence on changes and plan to participate in their introduction. This is a process requiring special skills and comprehensive knowledge, and frequently experience, which would allow noticing well in advance the possibilities of the occurrence of interferences at the individual stages of the process. The management of changes may be compared to the skilled art of management in general, where the object subject, as well as the situation and mutual relationships create the conditions for success. The presented publication discusses the problem of management changes from the theoretical, methodological, empirical and prognostic aspects. The foundation on which the considerations are based are changes in the health care system, with particular attention paid to changes in hospitals, which is the subject of own studies. Health care is a specific area with respect to analysis performed from the perspective of the management of changes, for it is in constant movement. However, the above-mentioned specificity is not exclusively associated with this feature, but with abnormalities occurring in the process of changes. These abnormalities are sometimes so deep that it is difficult to avoid suspicion that in this area the management of changes, the course of the process understood according to the organized activity, remains unknown. Chaos definitely dominates, enhanced by the omnipresence of the ‘trial and error’ method, temporary solutions and insufficiently considered decisions. The analysis of changes is presented which took place in hospitals, as well as in the form of a description, and the results of studies concerning in what way the selected organizations managed the changes. The proposal of the direction of changes is also presented, at the bottom of which are primarily the results of the diagnosis made, and the principle of the efficiency of the process of changes in management. The cognitive advantage of the study may be referred to a wider cohort of organizations functioning in health care.
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