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42910 ch02 007 024 qxd 4 29 10 11 44 am page 7 jones bartlett learning llc not for sale or distribution chapter 2 introduction to management and leadership concepts ...

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                                                         © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION
                                                                                                                               CHAPTER 2
                                  Introduction to Management and
                                      Leadership Concepts,Principles,
                                                                                                              and Practices
                                                                                                                                                     Kurt Darr
                                                                                                 ity for work results.Line managers manage people and things;
                             INTRODUCTION
                             Everyone manages.We manage our finances,time,careers,and            staff managers, such as the human resources department and
                             relationships.We tend not to think of these activities as “man-     the fiscal office, support the work of line managers.
                             aging”or of ourselves as being “managers.”Nevertheless,they
                             are. These examples of managing or being managers are rela-          LEARNING OBJECTIVES
                             tively simple and straightforward, even though we may find              After reading the chapter, the reader will be able to:
                             many of them fraught with difficulty. It is when the concepts              1. Review the background on managing and management.
                             of managing or being a manager are applied to organizations                2. Discuss organizational culture, philosophy, and performance.
                             that complexity increases—almost always exponentially. At                  3. Describe the elements of management knowledge.
                             this point it becomes necessary to study and understand the                4. Describe the five functions of management and decision making.
                             theoretical bases of management.                                           5. Discuss the distinctions between managing and leading.
                                 The practice of management and the classical enuncia-                  6. Outline management skills, roles, and competencies.
                             tion of management principles can be traced to the 19th cen-               7. Review the steps in managerial problem solving.
                             tury. The development of management as an academic                         8. Discuss designing formal organizations.
                             discipline based on a body of knowledge that can be taught is              9. Describe the contributions of contemporary management
                             a recent development and is generally attributed to the work                 theorists.
                                                                                                       10. Discuss negotiating and alternative dispute resolution.
                             of Peter F. Drucker in the latter half of the 20th century. That
                             body of knowledge is taught in graduate schools of business         ORGANIZATIONAL CULTURE, PHILOSOPHY, 
                             and in programs that prepare managers of public health de-          AND PERFORMANCE
                             partments,programs,and health services organizations,such
                             as hospitals,clinics,and long-term care facilities.This chapter     Management, organization, culture, and organizational phi-
                             provides a basic introduction to management theory and prob-        losophy are inextricably linked; they are especially linked to
                             lem solving, and concludes with a brief discussion of negoti-       organizational effectiveness. Much has been written about an
                             ation and alternative dispute resolution.                           organization’s culture and the need for managers to not only
                                 Managersare persons who are formally appointed to po-           understand the values in that culture, but to move that cul-
                             sitions of authority in organizations.They enable others to do      ture in the direction of values that further the organization’s
                             their work and are accountable to a higher authority for work       mission and vision. The value system of an organization can
                             results. Primarily, the differences between levels of managers      also be called its organizational philosophy—the ethical context
                             are the degree of authority and the scope of their accountabil-     in which goods and services are rendered.Ethics audits are an
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                                                       © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION
                     8        Introduction to Management and Leadership Concepts, Principles, and Practices
                   important tool managers can use to “biopsy” the organiza-        ing.Little that managers at all levels in an organization do falls
                   tion’s value system. These audits are comprised of staff sur-    outside the purview of the five management functions.
                   veys; observations of staff/patient interaction; and reviews of  Management theorists and practitioners may chose one or two
                   staff recruitment, selection, and training. Audits provide an    of the five functions as most important, but this is not borne
                   understanding of the culture so that the culture’s values can be out normatively. When one considers the full range of what
                   moved in the desired direction.                                  managers do (or should do) as they perform their work,con-
                       Managers are judged by their organizations’performance.      centrating on a few to the exclusion or diminution of the oth-
                   The way managers set standards, coordinate and integrate         ers will invariably cause problems for the organization.
                   workgroups,make decisions,and design the organization af-             Decision making is an inherent activity of managers,and
                   fect performance.In addition,it is patently clear from research  they make decisions within and among the five management
                   and anecdotal evidence that high-performing organizations        functions. Decision making is part of the process of problem
                   have a values system that furthers the organization’s goals.     solving,which also includes problem analysis.Performance of
                   These values are expressed in explicit and implicit ways by      the management functions and the decision making of prob-
                   managers and are expected to be present in the work of all       lem solving should be evaluated using explicit and measurable
                   members of the staff. Managers must model appropriate be-        criteria.In addition to engaging in the five management func-
                   havior. It is logical to conclude that an organization in which  tions, managers must utilize specific skills, play various roles,
                   all staff understand the desired values and incorporate them     and evidence a number of competencies.
                   into their work lives will achieve its goals more effectively.   Managing and Leading
                   MANAGEMENT THEORY                                                Some theorists and academicians distinguish managers and lead-
                   Management or managing has four main elements.It is (1) a        ers, based on the view that managing is more caretaking and
                   process comprised of interrelated social and technical func-     maintaining status quo (transactional) whereas leading is more
                   tions and activities (2) that accomplishes organizational objec- visionary and dynamic (transformational).That distinction may
                   tives, (3) achieves these objectives through use of people and   be more important pedagogically than in practical application,
                   other resources,and (4) does so in a formal organizational set-  however, especially at the organization’s operating level. Senior
                   ting. In concert with managers at various levels, senior man-    managers must ensure effective current organizational activities
                   agement establishes organizational objectives, and all who       andthat an organization’s future is envisioned.Using this vision,
                   work in the organization strive to achieve them.Management’s     the organization can be transformed as needed.
                   work includes providing an organizational context in which            As they work to achieve organizational objectives, man-
                   direct and support work can be performed effectively, and        agers use technical,conceptual,and interpersonal skills.These
                   preparing an organization to deal with threats and opportuni-    skills are applied in various proportions, depending on the
                   ties in its external environment.                                manager’s task and level in the organizational hierarchy.
                       Managers at all levels shape organizational values and cul-  Usually,senior managers make greater use of conceptual skills,
                   ture by their decisions and through leading by example (mod-     whereas middle- and entry-level managers use a more even
                   eling), even though senior managers usually have the clearest    mix of the three.
                   and most direct effect.The organization’s overall performance         The research of Henry Mintzberg found that managers
                   is the best evidence of managers’efforts.Regardless of hierar-   have different roles, the general categories of which include
                   chical level, managers throughout an organization engage in      interpersonal,informational,and decisional.Each may be seg-
                   the same basic,generic functions,even though decisions made      mented. For example, the interpersonal role includes figure-
                   at senior levels have the most dramatic effect on the organiza-  head and influencer, informational includes monitor and
                   tion (Rakich, Longest, & Darr, 2000). Managers can be de-        spokesperson, and the decisional role includes entrepreneur
                   scribed by the functions they perform, the skills they use, the  and negotiator. Successful managers integrate these various
                   roles they play, and the competencies they must have to suc-     roles and are likely to engage in them without making a clear
                   ceed.This emphasizes the process of managing.                    distinction.
                   Management Functions and Decision Making                              Another way to understand managers’work is to identify
                                                                                    their competencies, some of which are found in the catego-
                   The five management functions of planning,organizing,con-        rizations discussed earlier. Conceptual, technical managerial/
                   trolling, directing, and staffing are brought to life and con-   clinical,interpersonal/collaborative,political,commercial,and
                   nected by decision making, which is itself a subset of the       governance competencies are used in different proportions by
                   essential process for managers that is known as problem solv-    managers at various levels of the organization.
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                                                       © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION
                                                                                                                             Management Theory        9
                                                                                             Roles Managers engage in a wide variety of roles as they do
                            Management Skills and Roles
                            Figure 2-1suggests the relationships of technical,conceptual,    their work.
                            and human relations skills and shows their typical weighting          •  The interpersonal roles of figurehead, leader, and liai-
                            at various levels. Specific situations require greater or lesser         son derive from the formal authority of the manager.
                            use of the skills at all levels of the organization.                  •  The informational roles include monitor, dissemina-
                                                                                                     tor, and spokesperson. The informational roles have
                            Skills                                                                   special significance in organizations in the health field,
                                •  Technical skills are the abilities of managers to use the         which are more complex and require effective com-
                                   methods,processes,and techniques of managing (such                munication. Access to information is a measure of
                                   as preparing a budget or a pro forma, planning a new              power.Less secure and capable managers tend to hoard
                                   process,or reorganizing a workgroup).Technical skills             information or provide it only reluctantly, thus rein-
                                   tend to decrease in importance as managers become                 forcing their importance.
                                   more senior.                                                   •  As noted, decision making is integral to the manage-
                                •  Conceptual skills are the mental ability to see how var-          ment functions. There are various types of decisional
                                   ious factors in a given situation fit together and inter-         roles, including entrepreneur, resource allocator, and
                                   act. Seeing second- and third-order consequences of               negotiator.In this group,negotiation may be the most
                                   decisions and nondecisions is especially important.               important and is an almost daily activity of managers.
                                   The need to use conceptual skills increases significantly      •Thedesignerrole is similar to that of the management
                                   as managers become more senior.                                   function of organizing.Managers at different levels will
                                •  Human/interpersonal skills include cooperating with               design various components of the organization.
                                   others,understanding them,and motivating and lead-             •Thestrategistroleis not unlike the manager’s planning
                                   ing them in the workplace.Human relations skills tend             function. It suggests a specific focus on how to adapt
                                   to become less important as managers become more                  their organizational domains to external challenges and
                                   senior.                                                           opportunities.
                                                FIGURE 2-1 Skills used by different types of public health managers
                                                             Level of position                            Degree of authority
                                                                 in the                                     and scope of 
                                                               organization                                responsibility and
                                                                hierarchy        TYPE OF MANAGER               activities
                                                                  HIGH            SENIOR MANAGER               LARGE
                                                                MIDDLE            MIDDLE MANAGER              MEDIUM
                                                                  LOW                FIRST-LEVEL               SMALL
                                                                                      MANAGER
                                                                          Technical   Conceptual Human Relations
                                                                            skills       skills        skills
                                                Source: Adapted from Rakich, Jonathon S., Beaufort B. Longest, Jr., and Kurt Darr. Managing Health Services
                                                Organizations and Systems,4th ed.(Baltimore: Health Professions Press: 2000).p.11.Used by permission.
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                      10       Introduction to Management and Leadership Concepts, Principles, and Practices
                        •  The leader role is affected by how well the roles of de-          •  Governancecompetencemeans working with the govern-
                                                                                                         1
                           signer and strategist are performed. The leader role is              ing body to establish a vision, assemble resources, lead
                           more difficult because of the dynamism of the health                 the organization,and ensure accountability to stakehold-
                           services field, the multiple constituencies of its organ-            ers.These efforts require that senior managers interact ef-
                           izations,and the potential need for extensive sharing of             fectively with members of the governing body. The
                           the leader role.                                                     governing body determines the right thing (direction)
                   Competencies In addition to the classical management func-                   for the organization; management determines the right
                   tions and managerial roles,managers must develop a number                    way to achieve it. Many chief executive officers (CEOs)
                   of competencies.                                                             are voting members of their governing bodies,or,if not,
                                                                                                they attend governing body meetings and sit on its com-
                        •  Conceptual competence is like that of the conceptual                 mittees. Regardless, they interact with governing body
                           role. Middle and entry-level managers use conceptual                 members in various settings and in a variety of ways.
                           competence to understand how their work fits into the
                           larger organization,as well as the interrelationships in     Leadership Behavior
                           their areas of responsibility. As suggested earlier, sen-    Managers as leaders influence followers to achieve objectives
                           ior managers use their ability to conceptualize to pre-      because they have authority or power.Various sources of power
                           dict consequences of decisions and nondecisions.             have been identified:legitimate (formal),reward,coercive,ex-
                        •  Technical managerial/clinical competencyenables man-         pert,and referent.These sources of power are more likely to be
                           agers to perform the work of management, as well as          complementary than mutually exclusive.Effective leaders un-
                           understand and more effectively direct the work in the       derstand the risks and benefits of using each type of power
                           unit(s) for which they are responsible.Managers with-        and try to use them appropriately. Some researchers have
                           out a clinical or technical background must make a de-       sought to explain leader success by identifying leader traits
                           termined and persistent effort to understand the basics      such as assertive, cooperative, decisive, and dependable, and
                           of specialized activities in their areas of responsibility,  leader skills such as intelligent, conceptually skilled, creative,
                           as well as in the organization generally.                    and persuasive.Other researchers focused on leader styles,such
                        •  Interpersonal/collaborative competency requires that         as Rensis Likert (1903–1981),whose continuum of leadership
                           managers have good interpersonal and collaborative           effectiveness spans autocratic, benevolent, consultative, and
                           skills so as to effectively lead or direct others. These     participative/democratic.
                           skills enable the manager to instill a common vision,             An approach asserting that traits,behaviors,and styles are
                           stimulate a determination to pursue the vision, and          inadequate to explain the success of leaders is called situational
                           meet the objectives that are part of the vision.             or contingency theory. Its hypothesis is that certain actions or
                        •  Political competency means senior-level managers must        responses (behavior/styles) in some situations lead to success,
                           understand and be able to work with the political            while their use in other situations causes failure.Incorporating
                           processes of local,state,and even federal government.        situational factors or contingencies into the analyses of leader
                           Effective application of this competency is key to meet-     styles made them more sophisticated and enhanced their us-
                           ing the health needs of the community. The position          ability. Many of the efforts to analyze leaders and the reasons
                           and technical knowledge held by senior managers en-          for their success overlap,but they all contribute to understand-
                           ables them to influence the legislative and rule-making      ing managers qua leaders (Rakich et al., 2000, ch 15).
                           (regulatory) processes.
                        •  Commercialcompetencyand economic success require             Management Functions
                           that organizations create economic exchanges that offer      Figure 2-2 shows the management functions and their inti-
                           value to those involved. Managers must establish and         mate connection with decision making. None is necessarily
                           maintain an environment that facilitates these eco-          more important than another. They are complementary and
                           nomic exchanges.This necessitates a businesslike ori-        tend to have a sequence of use and connection. The dynamic
                           entation for basic operation,but with a humanitarian
                           and Samaritan overlay. Many not-for-profit and gov-
                                                                                        1
                           ernment organizations fall prey to an overemphasis on         Governing body is a generic term used to describe the body to whom the
                           doing good and neglect the need to manage in a busi-         public health manager is accountable,whether it is a city council, county
                                                                                        council, commissioners elected by a special tax district, commissioners ap-
                           nesslike fashion.                                            pointed through an interstate compact,or the like.
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