Management of Health Information

Functions and Applications 2nd Edition

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Chapter 9

The Process of Organizing Health Information Services

Learning Objectives
After completing this chapter, the learner should be able to:
1. Define the management function of organizing.
2. Describe the three main parts of the basic model for organizational structure.
3. Give the advantages and disadvantages of dividing labor into discrete parts.
4. Demonstrate ways that rules and policies are used in creating a formalized organizational
structure.
5. Contrast managerial power with managerial authority.
6. Identify differences between line and staff relationships.
7. List reasons why the span of control varies from one manager to another.
8. Give the four departmentalized organizational structures and an example of each for health
care facilities.
9. Explain the advantages of using a contingency management approach in organizing.

Key Terms
Authority
Bylaws
Centralization of authority
Conceptual skills
Cultural competence
Delegation
Departmentalization
Division of labor
Formalization
Interpersonal skills
Mentoring
Power
Servant leadership model
Span of control
Span of management
Specialization of labor
Staff authority
Technical skills
Unity of command
Values statement

Lecture Notes
I. Introduction
II. Organizing defined
A. Differentiation
 B. Degree of regulations
C. Concentration of authority
D. Managerial power and authority
1. Coercive power
2. Reward power
3. Legitimate power
4. Expert power
5. Referent power
E. Resources
F. Unity of Command
G. Span of control
III. Organizational structure
A. Work team structures
1. Self-directed teams
2. Shared leadership teams
3. Temporary work teams
B. Informal organizational structure
1. Organizational culture
2. Cultural competence
3. Bylaws
IV. Role of contingency approaches in organizing
A. Servant leadership
B. Leadership grid
C. Management skills
1. Technical
2. Interpersonal
3. Conceptual
D. Delegation
E. Mentoring

Teaching Strategies
Share examples of the different types of power discussed in the chapter and how each may be
effective.

Answers to Critical Thinking Exercises

1. Describe the organizing function and give several reasons for organizing.
Organizing is the management function that determines what tasks are to be done, who shall
do them, the reporting structure, and at what level decisions will be made.

2. Relate how a manager integrates the planning process into the organizing function.
Some organizations have redesigned their structure and are now following the trend toward
process or customer departmentalization. This trend is likely to increase as needs of the
customers continue to be emphasized as the strategic planning process envisions goals and
objectives.
3. How is power and authority given to an HIM department manager?
Authority refers to the rights inherent in a managerial position to give orders and expect
them to be obeyed. Power refers to the capacity to influence the decision-making process.

4. Describe several aspects of an informal organization that differ from those of a formal
organization.
Informal organizational factors include:
1. Small groups: Small groups come into being to satisfy individual needs that cannot be
fully met by the formal organizational structure.
2. Leaders: Members choose leaders they perceive as important for satisfying their needs.
3. Informal groups: Informal groups are inevitable within HIM departments.
4. Positive aspects: Informal groups can complement the formal organizations and provide
stability to work teams.
5. Negative aspects: Role conflicts can occur when goals of the groups are not compatible
with the goals and objectives of the formal organization.

5. What is the organizing phrase used to describe the structure when the coding specialists are
organized into a team that works independently, making most of the decisions regarding
coding activities?
Self-directed team

6. Which of the four departmentalizations would be used to best advantage in an HIM

department? Defend your answer.
Answers will vary based on opinion.

Answers to Application of Theory Exercises

1. Identify at least two individuals you have encountered or observed as a leader. Compare the
traits you noticed about each person. Did the individual have formal or personal leadership
power? What leadership models did each seem to follow and what activities or behaviors
reflected their leadership styles?
Examples will vary based on experiences.

2. Give examples of the five types of power you have seen while interacting with employees in
a health care setting.
Examples will vary based on experiences. The five types of power are recognized as:
coercive, reward, legitimate, expert, and referent.

3. Show how automating several record tasks can lead to a change in the span of control for the
managers.
Answers will be individualized.

Suggested Responses to Case Study

You are a coding supervisor for large physician group practice. The lead physician in the group
insists that you instruct your coding staff members to code all office visits across the board as the
highest level code so that they get higher reimbursement. You inform the physician that coding
must be based on documentation, but the physician responds, “all of the physicians in this
practice perform high-level office visits, but they just do not have time to document everything.”
Following this conversation with the physician, the practice manager calls you in to reinforce the
message with an implied message that your job security may depend on cooperation with the
physician’s directions. The practice manager also reminds you that you should never question
anything that the physicians tell you to do since they are the ones providing your paycheck.
Outline your options in this situation and discuss the one you would choose, providing rationale
for your decision.

Options may include (but are not limited to):

1. Following the instructions of the lead physician
2. Refusing to comply with the instructions
3. Resigning
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