Case Study on Health Care Institution

Public Administration: Case Study on Health Care Institution This work will examine public administration theories and concepts along with individuals that have contributed to the field of public administration while simultaneously reviewing the case study set out for examination in this work in writing. The case study relates a hospital matter in which the hospital has received $250,000 funding which is not earmarked resulting in several key administrative personnel in the hospital contemplating how they believe the funding should be utilized and each with their own personnel departmental agenda in mind.

Contemporary Public Administration Basu (2004) states that modern public administration "has usurped more and more functions within its scope.

Besides law and order, revenue collection and security functions, it operationalizes a vast array of public laws, provides public services like post and telegraphs and transport facilities in cities and towns, and is the main instrument of socioeconomic transformation in developing societies." (p.2) Basu notes that public administration in the socialist state "touches on all aspects of citizen's lives form education to recreation." (p.2) Moreover, "the scope and importance of public administration increases with increasing societal complexity, specialization and differentiation." (2004, p.2) Due to the emphasis on promoting efficiency, egalitarianism or rapid socioeconomic development the work and responsibilities vested in public administration has expanded and an overall decline in other social institutions included the "extended family, religion, etc.

In the present age which took care of the individual's material and spiritual needs earlier, has largely led to this over-dependence on the state." (Basu, 2004, p.2) II.

Critical Roles in Public Administration Basu notes that Gerald Caiden states the following critical roles that public administration in contemporary society has assumed: (1) Preservation of the polity; (2) Maintenance of stability and order; (3) institutionalization of socioeconomic change; (4) management of large-scale commercial services; (5) ensuring growth and economic development; (6) protection of the weaker sections of society; (7) formation of public opinion; and (8) influencing public policies and political trends. (Basu, 2004, p. 3) Marx writes that administration "is determined action taken in pursuit of a conscious purpose.

It is the systematic ordering of affairs and the calculated use of resources aimed at making those things happen which one wants to happen." (Basu, 2004, p. 2) Administration is stated in the work of J.M. Pfiffner to be "…the organization and direction of human and material resources to achieve desired ends. Therefore the two essentials of administration are: (1) cooperative effort; and (2) pursuit of common objectives." ( Basu, 2004, p.

3) The work of FA Nigro defines public administration as: (1) A cooperative group effort in a public setting; (2) Covering all three branches -- executive, legislative and judicial -- and their interrelationships; (3) has an important role in the formulation of public policy and is thus a part of the political process; (4) is more important than, and also differ3ent in significant wants from private administration; (5) (5) as a field of study and practice has been much influenced in recent years by the human relations approach; and (6) (6) is closely associated with numerous private groups and individuals in providing services to the community.

(Basu 2004, p. 3-4) III. The Case Study Examined The case study at focus in this brief study is one in which the Assistant Director of Biomedical Research, the Assistant Director of Teaching, the Associate Director of Patient Care and the Hospital Director and Chief Operating Officer (CEO) all express their own agenda of how the funding of $250,000 should be spent and naturally each individual visualizes the monies best spent in their own departments within the organization.

However, it is noted that there is a certain degree of rationality in the thoughts of each of these individuals concerning where the funding either would be or alternatively should be spent given the goals of the organization at issue in this case study.

Expressed by the thought processes of the individuals identified in this case study is a great deal of diversity in thought and at the same time these individuals seem to be bound by some overarching principle in common even with the diversity of views that are held in regards to what should be done with the funding. Johan P.

Olsen (2007) writes in the work entitled "Organization Theory, Public Administration, Democratic Governance" that an observation has historically been made and noted is a great amount of diversity "in human motivation and logics of action. Actions have been seen as drive by habit, emotion, coercion, formal-legal rules, and calculated expected utility." (Weber, 1978 cited in Olsen, 2007, p. 11) The ideas of "bounded rationality" or the assumption that individuals are acting upon simple models of the world have over time influenced much of organizational research including economics and various social sciences.

Bounded reality is "within an individualistic perspective & #8230;treated as another set of constraints upon the calculation of expected utility and a 'logic of consequentiality'." (Olsen, 2007, p. 11) The change occurring from the communal perspective is one that is fundamental in nature and specifically a 'logic of appropriateness' has added to and even replaced a logic of consequentiality.

Political organizations, systems of governance and institutions are witnessed as making provision of a context in which the majority of the time behavior is "rule-driven, that is governed by routinized, experience-0based standard operating procedures defining what is normal, acceptable, reasonable and appropriate. Olsen states that the concepts of "communicative rationality and deliberation have served to remind students of formal organizations that there is more that comprises human intelligence that "good means-end understanding." (Olsen, 2007, p. 10-11) IV.

Rationality Rationality, in the individual process of utility calculation has been by reason challenged upon the bases of social processes, defining and interpreting what is reasonable ends and means both within the culture and community Stated as an implication of the real acknowledgement of the diversity that exists in the logics of action of human beings is that theories relating to formal organization, public administration and democratic governance are more likely to be helpful if they take into account a repertoire of possible logics of action than if they a priori assume a single dominant behavioral logic." (Olsen, 2007, p.

11) Furthermore, theories are more assistive if the character of actors is viewed as being variable characterized by flexibility rather than being viewed as either universal or constant. Theories are also more assistive is the varying conceptual views of actors are acknowledged as being connected to differentiated conceptual view of structures of organization and institution.

(Olsen, 2007, paraphrased) Rationality is conceptually present in the case study at focus in this study as each administrative personnel represented in this case study acknowledges that there are other departments in need however, each returns in their thoughts to what they believe is the most important issue. It is clear that each of these administrators has their own constituents to whom they are answerable.

According to Olsen (2007) there is a tension between "hierarchical responsibility and accountability…[and]…responsiveness to customers, clients and participatory networks… in public administration." Normative democratic theory holds that actors should not hold responsibility for events that they have no control or exert no influence upon. Stated as an implication by Olsen is that the organizational setting: "…is characterized by complex interactions, interdependencies, ambiguous compromises, and chance elements (rather than clear and consistent goals, commands or rules), the more there will be multiple and fuzzy responsibility relations.

And the more difficult it is to disentangle the influence of a single actor or institution, the more likely that the concepts of responsibility and accountability will lose much of its traditional content. Democratic responsibility, responsiveness and accountability, therefore, are closely linked to the distribution of relevant resources and whether actors control resources that make it possible for them to act adequately on relevant preferences or rules of appropriate behavior." (Olsen, 2007, p. 12) V.

Resources Resources are stated to determine the "capacity for action and what different actors can accomplish" dependent on the organization and the various forms of distribution of resources by the organization. Olsen states that 'bureaucracy' and 'democracy' "imply norms for arranging authority, power and resources that enable and constrain different actors differently. Resources are stated to be the possession of individuals and social groups and to be embedded in common institutions as well.

The balance of public and private resources is stated by Olsen to be "a contested issue in normative democratic theory, with an individualistic perspective" that emphasizes the "primary of private resources and a communal perspective giving priority to resources embedded in common institution." (Olsen, 2007, p.12) The bureaucracy is stated to have its roots in Weber and is often described as the elected politician's servant however, many times the description of bureaucrats states they are the politician's master, "…the servants of a ruling class or some organized societal group, or the carriers of expertise or constitutional rules and principles." (Olsen, 2007, p.

13) It is a struggle for a democracy to attempt the balancing of a "…vigorous yet responsible and responsive public administration, and it has turned out to be important to have a profession or full-time administrative staff to protect one's interests and values." (Olsen, 2007, p.

13 ) The public program has as its bases the various assumptions about what citizens have the ability and the will to do and the assumption that citizens are "informed, resourceful and active" means the less likely that those with less in the way of resources will benefit to the extent that the groups that are more resourceful will benefit. (Jacobsen, 1964, 1965, paraphrased cited in Olsen, 2007, p.

14) Public programs are based upon different assumptions about what citizens are able and willing to do, and the more a program assumes informed, resourceful and active citizens, the less likely that individuals with few personal or group resources will benefit as much as more resourceful groups (Jacobsen 1964,1965 in: Olsen, 2007, p. 14).

It is therefore clear that the vision of the liberal-democratic legislature is that of the political authority centric power in that the authority of the legislature is derived from the people and that through the electoral institutions however, this does not relate the reality of the resources impact on decisions and neither does the various channels that exist between public authorizes and citizens come to light and individual resources are not evenly distributed and this impacts public policy matters that are formulated at least partially by the distribution of group and individual resources.

The challenge in this study is to maintain a balance among the three major objectives of the hospital, which are: (1) the provision of quality patient care; (2) the provision of quality education and training; and (3) biomedical research. The grant amount received in this scenario is the amount of $250,000.00.

There are competing interests where the funding allocation is concerned and specifically as follows: 1) The Assistant Director of Biomedical Research envisions the following allocation of funds: (a) A new research facility - $250,000.00; (b) Establishment of a $5,000 fund to reward an outstanding staff researcher; and (c) Attend national and international symposium and to host a symposium - $250,000.00.

2) The assistant director of teaching envisions the following allocation of funds: (a) More competitive salaries - $50,000.00; (b) Remodel and improve interns living facilities - $30,000.00; (c) Seminar rooms -- conversion of a wasted storeroom - $20,000.00; and (d) Visiting Professor Program - $10,000.00 to $25,000.00. 3) The Associate Director for Patient Care envisions the following funding: (a) Heating and air conditioning installation - $150,000.00; (b) (this includes improvements to the central system, storm windows, awnings, and electronic controls which equals cost savings through increased efficiency; and (c) Three machines to remove wax buildup $5,000.00 X 3 = $15,000.00.

The decision concerning allocation of the grant funding is upon the basis of the hospital's primary objectives. Because the following two funding sources precisely adhere to the objectives of the hospital they have been chosen for allocation of the grant funding: (1) Heating and air conditioning installation including improvements to central system, storm windows, awnings and electronic controls to be funded at $150,000.00; and (2) Biomedical Research $100,000.00.

It is certain that without proper heating and cooling that patients cannot receive the best possible care and in addition, the funding of the first stated receiver of funds will serve to increase efficiency and bring about cost savings to the organization. As biomedical research is, also one of the three primary hospital objectives the remainder of the funding for $100,000.00 after funding the heating and air installation and accompanying improvements will go to fund biomedical research at the hospital.

Summary and Conclusion This work has examined public administration theories and concepts and the work of individuals that have contributed to the field of public administration. This work has at the same time, reviewed the case study attached to this work in 'Appendix A' relating to a matter of funding resources in which several key administrative personnel are focused upon and which each individual clearly has their own research agenda self-assigned.

It does appear that these individuals are conformed to a great extent to the organizational fundamental processes in regards to funding resource allocation. Each has their own ideal budget for the monies while at the same time acknowledging that they did not expect to receive any funding whatsoever and that this most recently non-earmarked funding was a surprise. It is likely that these administrators will have to choose what they believe is of primary importance to each of these departments along with the various needs of each department.

As pointed out in the research in this study, the democratic process is one in which a cooperative effort occurs and in which there is equity assigned in the funding and allocation of organizational resources. Each of the administrators is clearly focused on their personal responsibility and those who are stakeholders which include the patients of each department represented as well as the organizational employees of each of these departments. References Basu, R. (2004) Public Administration: Concepts and Theories. Sterling Publishers Pvt. Ltd. 2004.

Retrieved from: http://books.google.com/books?id=yoQ45hn_dFsC&dq=public+administration:+theories+and+concepts&source=gbs_navlinks_s Olsen, J. (20007) Organization Theory, Public Administration, Democratic Governance. 1 Jan 2007. Retrieved from ARENA at: http://www.arena.uio.no/publications/working-papers2007/papers/wp07_01.pdf Behn, R.D. 2001, Rethinking Democratic Accountability. Washington DC: Brookings. Bleiklie, I. et al. (eds.) 1985, Politikkens forvaltning. Bergen: Universitetsforlaget. Blyth, M. 2006, Great punctuations: Prediction, randomness, and the evolution of comparative political science. American Political Science Review 100 (4): 493-498. Christensen, T. And P.

Laegreid 1998, Public administration in a democratic context -- a review of Norwegian research. In N. Brunsson and J.P. Olsen (eds.): Organizing Organizations: 147-170. Bergen: Fagbokforlaget. Christensen, T. And P. Laegreid (eds.) 2001, New Public Management -- the Transformation of Theory and Practice. Aldershot: Asgate. Christensen, T. And.