MMHA 6000 Week 4 Managerial Roles Analysis Example

Twenty-Two Hours of Disturbances and Forty Minutes of Improvement: Mintzberg's Ten Roles Applied to One Composite Week of a Director of Ambulatory Operations

Student Name

Walden University

MMHA 6000: Foundations of Healthcare Administration

Instructor Name

Month Day, Year

Twenty-Two Hours of Disturbances and Forty Minutes of Improvement: Mintzberg's Ten Roles Applied to One Composite Week of a Director of Ambulatory Operations

Mintzberg's Framework

Mintzberg (1973) spent one week observing each of five chief executives at work and found little of the orderly planning that management textbooks described. Their work was brief, varied and constantly interrupted, most of it conducted by talking rather than reading or writing, and much of it in reaction to whatever arrived. He grouped what managers do into ten roles in three families. The interpersonal family includes figurehead, leader and liaison; the informational family includes monitor, disseminator and spokesperson; the decisional family includes entrepreneur, disturbance handler, resource allocator and negotiator. Mintzberg treated the roles as an integrated whole, so a manager who neglects one weakens the others. This paper applies the framework to a composite week for the director of ambulatory operations at Calder Ridge Medical Group, the invented eight-clinic group used throughout this course.

A Composite Week

The director oversees clinic managers at eight sites and reports to the vice president of ambulatory services. The log below summarizes the activities of one composite week, combined from typical demands of the role, with time spent and the role each activity represents.

Table 1

Activity Log for One Composite Week, With Role Assignments

Times are rounded and the activities are composite; the log stands in for a week's calendar and notes.

Each assignment follows Mintzberg's definitions. The walkout, the phone outage and the staffing gaps are disturbance handling because they are pressures the director did not choose and could not ignore. Meetings with the health department, radiology and the medical director are liaison work, maintaining relationships outside the director's own chain of command. The lease is negotiation; the overtime approvals are resource allocation; the chamber lunch is the spokesperson role. Only the same-day access plan was entrepreneurial, in that it was an attempt to start change rather than respond to it.

The Pattern

Table 2

Hours by Role for the Composite Week

The total, about 33 logged hours, excludes travel between clinics and routine email.

Disturbance handling consumed about two-thirds of the logged week, and the entrepreneur role got about forty minutes. Liaison came second, which fits a role that depends on departments the director does not control. Health care organizations make liaison work especially heavy, because clinicians, managers and trustees operate as distinct worlds that have to be connected rather than commanded (Glouberman & Mintzberg, 2001). The monitor role, reading data about the clinics, took half an hour, which means the director learned about problems mostly when they arrived as disturbances rather than from the reports that might have predicted them.

The largest single block, four hours on Wednesday's phone outage, shows how disturbance handling spreads. The outage itself belonged to information technology and the vendor. The director stayed involved because clinic managers had no authority to divert calls to another site or to approve the cost of a temporary line, so every decision came back to the director. Many of the week's other disturbances followed the same pattern: problems that clinic managers could see first but could not settle alone.

What the Imbalance Means

The imbalance matters because the roles that were squeezed are the ones that improve the organization. Mintzberg (2009) observed that managers often favor the immediate and concrete over the general, because current problems demand attention while improvement can always wait another week. At Calder Ridge, the cost is visible: the same-day access plan has been sketched three times in two months and never finished, while patients wait an average of 19 days for a new primary care appointment. The monitor role suffers too. A director who reads the access report for thirty minutes a week cannot spot patterns, such as staffing gaps recurring at the same clinic each Monday, that could turn repeated disturbances into a single fix.

One Structural Change

The proposed change is to route first-level disturbances to clinic managers through a rotating on-call manager. Each week, one of the eight clinic managers would take calls about staffing gaps, equipment problems and escalated complaints from all sites, with authority to move staff between clinics and approve same-day overtime up to a set limit. The director would be called only for problems above that limit or involving clinicians. A starting limit of $1,500 in same-day overtime or temporary staffing per incident would have covered every disturbance in the composite week except the phone outage, which needed vendor authority.

If the on-call manager absorbed half of the director's disturbance hours, the director would gain about eleven hours a week. The plan commits four of them to a protected block for the same-day access project and two to reviewing access and staffing data. The change has a cost: clinic managers would lose about one week in eight to cross-site coverage, and some problems would be handled less consistently than when one person decided them all. A monthly review of on-call decisions would let the director catch inconsistencies without taking the calls back.

References

Glouberman, S., & Mintzberg, H. (2001). Managing the care of health and the cure of disease, Part I: Differentiation. Health Care Management Review, 26(1), 56-69. https://doi.org/10.1097/00004010-200101000-00006

Mintzberg, H. (1973). The nature of managerial work. Harper & Row.

Mintzberg, H. (2009). Managing. Berrett-Koehler.