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AAPHP Preventive Services Toolkit

AAPHP Preventive Services Toolkit. Power Structure Analysis -- how to get the bureaucracy and legislature to do what you want them to do. Power. Power, in an organizational setting, is the ability to get other people to do what you want them to do. Definition of PSA.

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AAPHP Preventive Services Toolkit

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  1. AAPHPPreventive Services Toolkit Power Structure Analysis -- how to get the bureaucracy and legislature to do what you want them to do AAPHP PSTK PSA

  2. Power • Power, in an organizational setting, is the ability to get other people to do what you want them to do AAPHP PSTK PSA

  3. Definition of PSA • Power Structure Analysis (PSA) is a rapid and user-friendly protocol for stakeholder analysis designed to • Develop advocacy strategy • Determine feasibility of adoption of proposals • Identify stakeholder-related leverage and barriers AAPHP PSTK PSA

  4. PSA Rapid and User Friendly • Initial 1-2 hour meeting • Half-dozen phone calls • Follow-up ½ to 1 hour meeting AAPHP PSTK PSA

  5. PSA - Teaching Objectives • Describe concepts and tools of Power Structure Analysis (PSA) • Address mindset-related barriers to preventive services • Conduct a Power Structure Analysis AAPHP PSTK PSA

  6. PSA: Concepts and Tools • Stakeholder • Mindsets • Character types • Self deception • Games • Government, American style • Sunburst diagram • Myths and Magic of PSA AAPHP PSTK PSA

  7. Stakeholder • -- any person or interest group that cares enough about an issue or proposal to either support or oppose it • -- any person or group with an interest in the success of the enterprise AAPHP PSTK PSA

  8. Mindsets • Personal • Technical • Administrative • Policy/Political • Personal idiosyncrasy • Organizational Culture • Universal • Idiosyncratic • (Graham Allison: Essence of Decision) AAPHP PSTK PSA

  9. The Hierarchy of Mindsets • Personal Idiosyncrasy /organizational cultural • Policy/Political • Administrative • Technical AAPHP PSTK PSA

  10. ”Out of the Box” • “Out of the box” thinking is often recommended • What is the “box”? AAPHP PSTK PSA

  11. Character Types • Zealot • Advocate • Statesman • Conserver AAPHP PSTK PSA

  12. Games • Dysfunctional patterns of behavior • Self Deception • Usually sincere • Rarely ill intentioned • Games almost always damage the efficiency, economy and/or mission of the agency AAPHP PSTK PSA

  13. Games People Play–Technical • Low priority activities • Academic habits • “Productivity” AAPHP PSTK PSA

  14. Games People Play –Administrative • Doing what looks good on paper • Any excuse to cut (or pad) the budget • Obsession with rules and paperwork • Reorganization AAPHP PSTK PSA

  15. Games People Play –Policy/Political • Glib assertions easier than hard facts • Simple myths easier than complex reality • Public servant (or staff) portrayed as lazy or undedicated • Health Care Delivery Games • Skimming • Dumping • Inappropriate Utilization AAPHP PSTK PSA

  16. Games People Play –Personal/Organizational Culture • “Going with the flow” “getting along” • Reluctance to suggest promising new ideas • Silence in the face of incompetent or inappropriate behavior AAPHP PSTK PSA

  17. Government, American Style • Federal -- $$$$$$$$$$ • State – legal authority • Local – the problem • Federalism – how levels of government relate to each other • “layer cake” • “marble cake” AAPHP PSTK PSA

  18. Sunburst Diagram Domains: Personal Professional Culture Administrative Policy/Political AAPHP PSTK PSA

  19. Personal Domain Personal Values Family Character Type AAPHP PSTK PSA

  20. Professional Culture(Technical)Domain Professional Goals Colleagues Peers AAPHP PSTK PSA

  21. Administrative Domain Regulation and Accreditation Budget and Personnel Subordinates Boss Standard Operating Procedures AAPHP PSTK PSA

  22. Policy/Political Domain Clients/Patients Authorizationand Funding Community Image Interest Groups Legal/ Liability/ Tort AAPHP PSTK PSA

  23. Leverage The ultimate goal of the PSA exercise is leverage. This is the identification of an advocacy strategy by which one can use the perspective of one or more of the major stakeholders to influence others on your behalf. -- getting someone in another domain so excited about your proposal that they will advocate for it on your behalf AAPHP PSTK PSA

  24. Examples of Leverage • Tobacco Control Legislation • Getting hotel owners to advocate because of reductions to their cleaning costs and property damage • Getting restaurant owners to advocate to avoid installing costly air handling systems • Health club services and nutrition counseling • Getting marketing to advocate to help attract low-risk enrollees AAPHP PSTK PSA

  25. Group Exercise • -- conduct one or more brief PSAs on situations proposed by participants AAPHP PSTK PSA

  26. Stepwise PSA Process • Define your proposal • PSA initial meeting • Stakeholder research • PSA second meeting • Determine feasibility • Identify opportunities for leverage and synergism • Determine needs for additional stakeholder research • Develop advocacy strategy AAPHP PSTK PSA

  27. The Magic of PSA • New Ideas and program options • Leverage • Health outcomes not otherwise achievable • Prevent you from being “blindsided” • Political support for yet other initiatives AAPHP PSTK PSA

  28. True or False? • There are two sides to every issue • There’s not enough money • Dollars are our most important resource • What is good for me or for my agency is good for the community AAPHP PSTK PSA

  29. Q and A AAPHP PSTK PSA

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