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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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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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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-
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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-
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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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