11. #2 Complicated Systems
Pix Source: www.edrawsoft.com/example-service-workflow.php
• An example of complicated “engineering” model:
12. #3 Complex Systems
Source: www.nature.com/nrclinonc/journal/v11/n3/fig_tab/nrclinonc.2014.6_F1.html
• A complex interactions between molecular networks within cells:
13. 3 Types of Systems
Source: Adapted from Glouberman and Zimmerman (2002)
16. Characteristics of Complex Systems
Source: Adapted from Glouberman and Zimmerman (2002)
• องค์ประกอบภายในระบบ “เชื่อมโยงกันอย่างใกล้ชิด” (tightly linked)
• “คุณสมบัติผุดบังเกิด” หรือ“คุณสมบัติอุบัติใหม่” (emerging property)
ที่เกิดขึ้นใหม่จากปฏิสัมพันธ์ระหว่างองค์ประกอบย่อยภายในระบบ
(“The whole is not equal to the sum of its parts.”)
• “การตอบสนองย้อนกลับ” (governance by feedback)
• “การจัดการตัวเอง” (self-organizing)
• “การเปลี่ยนแปลงอย่างต่อเนื่อง” (constantly changing)
21. • เรากำลังเดินทางไปที่ใดและเมื่อไหร่?
(“Where” are we going to, and when?)
Vision/
Mission
• เราจะเดินทางไปสู่จุดหมายได้อย่างไร?
(“How” are we going there?) Strategy
• เราต้องทำอะไรบ้างที่จะไปถึงจุดหมาย?
(“What” do we need to do to be there?) Action
30. • Five Steps in the Strategic Management Process:
① การวิเคราะห์สถานการณ์/สภาพแวดล้อม (Situation analysis)
② การจัดวางทิศทางขององค์กร (Setting organizational direction)
③ การกำหนดกลยุทธ์ (Strategic formulation)
④ การปฎิบัติตามกลยุทธ์ (Strategic implementation)
⑤ การควบคุมเชิงกลยุทธ์ (Strategic control)
กระบวนการจัดการเชิงกลยุทธ์
Source: Adapted from: Wheelan and Hunger. (2006); วัฒนา วงศ์เกียรติรัตน์ และคณะ (2537)
31. ตัวอย่าง: CNMI’s Strategic Management
Adapted from: Wheelan and Hunger. (2006) Strategic Management and Business Policy.
To set a
shared vision
and mission
of the project:
“To build a
medical
institute that
is publicly
perceived as
the incubator
of change
towards a
better
societal
health"
To identify
specific
goals of the
new campus
from the
perspectives
of customer,
learning and
growth,
process,
and
resource
To decide
on how we
can achieve
such
specific
goals in
BE 2560
and beyond
To set a
broad
guideline
for team’s
decision-
making,
(esp.
when
conflicting
ideas
arise)
To launch
initiative or
activities in
each
division/
section/
department
To figure
out what
the whole
project
really costs
To determine
sequence of
steps needed
to do the jobs
To monitor
performance
of the
management
team and
take
corrective
actions if
needed
1
2
3
4
5
6
#1
#2
#3
#4
#5
43. Combined
Strategy
Customer Perspective
How can we develop our students
to be change agents in health systems?
Process
Perspec-ve
At what process do we need to excel
to fulfill our customer expectations?
Learning
&
Growth
Perspec-ve
How will we sustain
our organizational ability to improve?
Resource Perspective
How will we secure
our most important financial resources
and non-financial resources?
Figure
source:
Adapted
from
www.slidehunter.com
Balanced
Scorecard
(BSC)
44. Strengths
Advantages
Financial reserves, likely returns
Qualifications, certifications
Competitive advantages
Capabilities
Location and geography
Innovative aspects
Resources, Assets, People
Processes, systems, IT, communications
Culture, attitudes, behaviours
Management cover, succession
Experience, knowledge, data
Strong brand names
Marketing - reach, distribution, awareness
Unique selling points “USP”
Price, value, quality
Weaknesses
Lack of competitive strength
Gaps in capabilities
Disadvantages of proposition
Weak brand name
Financials
Cash flow, start-up cash-drain
High cost structure
Our vulnerabilities
Timescales, deadlines and pressures
Reliability of data, plan predictability
Continuity, supply chain robustness
Processes and systems, etc
Management cover, succession
Morale, commitment, leadership
Opportunities
Market developments
Competitors vulnerabilities
Niche target markets
New USP's
New markets, vertical, horizontal
Partnerships, agencies, distribution
Geographical, export, import
Unfulfilled customer need
New technologies
Loosening of regulations
Changing of International trade barriers
Business and product development
Seasonal influences
Technology development and innovation
Threats
Environmental effects
Seasonal, weather effects
Economy - home, abroad
Political effects
Legislative effects
Market demand
New technologies, services, ideas
IT developments
Shifts in consumer preferences
Obstacles
Sustainable financial backing
Insurmountable weaknesses
Competitor intentions
New policies or regulations
Emergence of substitute products
Posi-ve
Nega-ve
InternalExternal
SWOT
Analysis
Figure
source:
Adapted
from
conceptdraw.com
45. Sun Tzu’s the Art of War
Pix source: th.wikipedia.org/wiki/
"การชนะร้อยทั้งร้อยมิใช่วิธีการอันประเสริฐแท้
แต่ชนะโดยไม่ต้องรบเลย จึ่งถือว่าเป็นวิธีอันวิเศษยิ่ง”
หลักการสำคัญในตำราพิชัยสงครามของซุนวู: รู้เขารู้เรา รบร้อยครั้ง มิพ่าย
"หากรู้เขารู้เรา
แม้นรบกันตั้งร้อยครั้งก็ไม่มีอันตรายอันใด
ถ้าไม่รู้เขาแต่รู้เพียงตัวเรา
แพ้ชนะย่อมก้ำกึ่งอยู่
หากไม่รู้ในตัวเขาตัวเราเสียเลย
ก็ต้องปราชัยทุกครั้งที่มีการยุทธนั้นแล”
47. Pix source: Leerapan et al. (2014). Poster Presentation at 3rd Global Health Symposium, Cape Town, South Africa
“รู้เขา” Opportunity/Threat
Stakeholders in
Health System
of Thailand
50. “รู้เรา” Strength/Weakness
Pix source: WHO’s framework for action. (2007)
Your Organization/Program/Project is a little health system!
Ø วางแผนโดยพิจารณาความสัมพันธ์/ปฏิกิริยาในระบบ (interactions)
51.
Exploit
(Rapidly
pursue
opportuniRes)
Search
(Overcome
weaknesses
with
strengths
in
order
to
pursue
opportuniRes)
Confront
(Pursue
the
opportuniRes
once
the
gaps
are
bridged)
Avoid
(Create
a
defense)
Strategy
forma-on
Strength-‐Opportunity
Strength-‐Threat
Weakness-‐Opportunity
Weakness-‐Threat
SWOT/TOWS
Matrix
53. บทเรียนจากการบ้าน Workshop LDC5/1
• ตัวอย่าง: การควบคุมและดูแลโรคเรื้อน
– Where we are now? & Where we are heading?
• Data: Primarily based on “descriptive” stat/epi data; “trend”
• Informal analysis:
– To explain/link intervention-outcome
(e.g. early detection/diagnosis w/ P4P)
– To find “potential causes” of problems
(e.g. new cases in new population groups)
– To conduct limited literature review that might help finding
“root causes”
54. บทเรียนจากการบ้าน Workshop LDC5/1
• ตัวอย่าง: การควบคุมและดูแลโรคเรื้อน
– What’s next?
• To focus on migrants (ผู้ป่วยพม่า)
• To focus on high prevalence areas (สคร. 9 & 10)
Ø Primarily focus on “What, Where, Who”
Ø Could focus more on “Why”: Why the situation is the way it
is, and why it isn’t the way it isn’t?
Ø Need “How” to improve the current situations
55. บทเรียนจากการบ้าน Workshop LDC5/1
• ตัวอย่าง: การควบคุมและดูแลโรคเรื้อน
– Where we are now? & Where we are heading?
• WEAKNESS: New cases in migrants (ผู้ป่วยพม่า, สคร. 9 & 10),
Thai healthcare providers not familiar with leprosy
• THEAT: Old strategies succeeded in the past, but how to deal
with the nature of “becoming/being a rare disease”
• STRENGTH: What are important lessons learned from other
diseases with similar nature?
• OPPORTUNITY: AEC, expanded usage of IT, rapid growth of
providers in the private sector (dermatology/health screening)
56. บทเรียนจากการบ้าน Workshop LDC5/1
• ตัวอย่าง: การควบคุมและดูแลโรคเรื้อน
– What’s next, strategically? (Changing SWOT to “HOW”)
• Early detection of non-specific dermatological signs (light/dark
patches) with referral/consultation using IT
• Working overseas (e.g. as international aid programs/projects)
• Build a new network of providers outside MOPH
61. Adapted from: Wheelan and Hunger. (2006) Strategic Management and Business Policy.
To set a
shared vision
and mission
of the project:
“To build a
medical
institute that
is publicly
perceived as
the incubator
of change
towards a
better
societal
health"
To identify
specific
goals of the
new campus
from the
perspectives
of customer,
learning and
growth,
process,
and
resource
To decide
on how we
can achieve
such
specific
goals in
BE 2560
and beyond
To set a
broad
guideline
for team’s
decision-
making,
(esp.
when
conflicting
ideas
arise)
To launch
initiative or
activities in
each
division/
section/
department
To figure
out what
the whole
project
really costs
To determine
sequence of
steps needed
to do the jobs
To monitor
performance
of the
management
team and
take
corrective
actions if
needed
1
2
3
4
5
6
#1
#2
#3
#4
#5
Strategic Management Process
62. Project/Program Management Tools
Planning
Tracking
ReporRng
Managing
Risks
• Project charter
• Gantt chart
• Timeline chart
• Project status dashboard
• Program status dashboard
• Team to-do list
• Burndown chart
• Issues tracking
63. #1 Situation Analysis
-Analyze internal factors of organization
-Analyze external factors of organization
-Define strategic advantages & challenges
Tools
-Self-assessment
-Market Survey & Public hearing
-SWOT analysis
#2 Direction Setting
-Define organizational visions
-Define organizational missions
-Set organization level strategies
Tools
-Mandates from the government
-Consultations with internal and external
stakeholders
#3 Strategy Formation
-Define strategic objectives of business units
-Set business unit level strategies
-Set functional level strategies
-Define strategic objectives of functional units
Tools
-SWOT analysis & 7S analysis
(Business Units)
-SWOT analysis & 7S analysis
(HR, IT, LR, PR, Finance, etc.)
#4 Strategy Implementation
-Launch initiatives/projects/activities
-Change organizational structure and culture
Tools
-Performance agreement
-Project management
-Organizational change & development
#5 Strategy Control
-Monitor & Evaluate
Tools
-BSC/KPIs, Strategic Map, Gantt Chart
Review
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☐
☐
☐
Review
Review
Review
As of 2013-11-4
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Strategic Management: Project Methodology