management principles

Employee Development:
ch 11 (pg 364)
• an essential management responsibility: to shape and enhance employee behavior.
• advances in technology require continuous training.
• an important aspect of continuous quality improvement.
• part of organization’s policy of internal promotion process.
• required as part of licensure and accreditation
• sometimes included as a labor contract stipulation
• part of continuity of operations and succession
• important aspect in promoting employee satisfaction.
General Orientation:
ch 11 (pg 365)
• Brief history of the organization and its mission
• Identification of departments and services
• Employee policies including:
– drug, alcohol, and substance abuse consideration
– sexual harassment
– nondiscrimination issues
– conflict of interest prohibitions and gifts
– dress codes
• More employee policies:
– computer security and passwords
– privacy and confidentiality of all aspects of patient care.
– security, fire and safety, and disaster plans
– infection control
Departmental Orientation:
ch 11 (pg 366)
• Department mission and goals
• Organization chart of department
• Department policies and procedures
• Productivity and quality improvement monitors
Standards of Conduct and Behavior:
ch 11 (pg 366-369)
• Conflict of interest
• Use of organizational assets and information
• Referral practices
• Employee privacy
• Patient confidentiality
• Employee relationships
Email and the Internet:
ch 11 (pg 373-375)
• policy statement: for business use only
• reminder: no expectation of privacy
• clear statement of examples of prohibited use
• issues stemming from use of social networks in the workplace
Identification of Training Needs:
ch 11 (pg 375-376)
• Comparison of job requirements with current or new employee skill set
• Analysis of performance ratings
• Analysis of personnel records (e.g. lateness;
absenteeism; safety)
• Analysis of short and long term plans
• Analysis of current trends, laws, and standards
‘Just in Time’ Training
ch 11 (pg 376)
• Used in situations where worker is pulled from
regular duty
• To assist with an immediate, urgent need
• Examples: disaster situations; weather-related
• Intensive, highly specific steps to follow
Components of Training Objectives:
ch 11 (pg 379)
• Statement of main focus
• Level of mastery or acceptable performance
• Any conditions associated with the work tasks
• A time frame or performance standard for each
stage of the training program
Training Methods and Techniques:
ch 11 (pg 382)
• job rotation
• formal lecture presentation
• seminars and conferences
• role playing
• committee assignments
• case studies
• mentoring and peer pals (pg 386-387)
Evaluation of Outcomes:
ch 11 (pg 384-385)
• direct before-and-after comparison
• fact tests
• performance tests, based on the usual work content.
• evaluation in stages: practice activity; real work activity with continuous supervision; real work activity with decreasing supervision.
Resources for Training
ch 11 (pg 385-386)
• professional association materials
• distance learning
• shared learning activities among departments
ch 12 (pg 394-395)
• The ability to obtain compliance by means of coercion.
• The ability to have one’s own will carried out despite resistance.
• Force; naked strength.
• Does not seek consensus or agreement.
ch 12 (pg 395)
• Similar to power: seeks compliance
• Differs from power: does not use force
• Voluntary acceptance and compliance
• Seeks consensus and agreement
• Relies on persuasion
Formal Authority:
ch 12 (pg 395)
• Legitimate power
• The right to issue orders and to direct action
• The right to employ resources, make commitments, exercise control
Sources of Power, Influence, and Authority
ch 12 (pg 397)
• Acceptance or Consent
• Patterns of Formal Organization
• Cultural Expectations
• Technical Competence and Expertise
• Characteristics of Authority Holders
Related Terms:
ch 12 (397-398)
• Consent
• Zone of indifference
• Zone of acceptance
• The psychological contract
Professional Practitioner-Manager’s Authority:
ch 12 (pg 403)
• Hired for professional training and specialized
• Placed into a position having formal authority
• Enhanced by personality traits: manager as leader
• Enhanced by participative style, leading to wide zone of acceptance.
Use of Authority Restricted By:
ch 12 (pg 404)
• Organizational Position
• Legal and Contractual Mandates: Authority is limited by federal, state, municipal laws & regulations relating to safety, work hours, licensure, & scope of practice; by internal corporate charter and bylaws; by union contract.
• Social Limitations: social codes, values include implicit & explicit limits on the behavior of individual to act in a manner consistent. these are major factors in shaping the zone of acceptance & general cultural deference of individuals who are members of organization.
• Physical Limits
• Technological Constraints
• Economic Constraints
• Zone of Acceptance/Zone of Indifference: both authority and power have their limits, in the net cost of using either needs to calculate.
Importance of Delegation
ch 12 (pg 405)
• The manager cannot do everything!
• Delegating leads to increased zone of acceptance and cooperation.
• Workers who are in contact with clients can take effective action without delay.
• Manager is free to attend to other management
Do’s and Don’ts of Delegation
ch 12 (405-406)
• Know when to delegate, e.g. routine tasks.
• Know when NOT to delegate, e.g. hiring and firing, etc.
• Avoid countermanding supervisors.
• Set up a balanced system of availability and support.
Supporting the Unit Supervisor
ch 12 (406-407)
• Formal, periodic meetings focusing on work flow
• Formal meetings focusing on supervisory skills
• Mentoring and career path development
• Informal daily interaction as needed
• Combination of formal and informal interaction (“The Huddle”)
Aspects of Leadership
• The ability to get things done through people
• The ability to organize tasks and make things happen
• The ability to make the critical decisions
• The ability to achieve objectives by coordinating, motivating, and directing the work group
Functions of a Leader
ch 12 (409-410)
• Take calculated risks
• Be the catalytic agent for change
• Represent the group
• Absorb the group’s frustration and hostility
• Embody the values of the organization
Leadership Styles
ch 12 (411-413)
•AUTOCRATIC: also known as authoritarian leadership, is a leadership style characterized by individual control over all decisions and little input from group members.
•BUREAUCRATIC: is leadership based upon fixed official duties under a hierarchy of authority, applying a system of rules for management & decision making.
•PARTICIPATIVE: Style of leadership in which the leader involves subordinates in goal setting, problem solving, team building etc., but retains the final decision making authority.
•LAISSEZ-FAIRE: A non-authoritarian leadership style. Laissez faire leaders try to give the least possible guidance to subordinates, and try to achieve control through less obvious means. They believe that people excel when they are left alone to respond to their responsibilities and obligations in their own ways.
• PATERNALISTIC:A type of fatherly managerial style typically employed by dominant males where their organizational power is used to control and protect subordinate staff that are expected to be loyal and obedient. A manager with a paternalistic leadership style might be appropriate for a business with a more formal and hierarchical structure where creative thinking is not required of staff.
Influences on Leadership Style
ch 12 (pg 415)
• Work Assignment
• Employee’s Personality and Ability
• Employee’s Attitude toward Manager
• Manager’s Personality and Ability
Disciplinary Action
ch (pg 417)
Progressive Discipline Process:
ch 12 (pg 419-427)
1. General Counseling:Counseling sessions are used to bring a problem to the attention of the employee before it becomes so serious that it has to become part of a written warning and placed in the employee’s file.The purpose of this discussion is to alleviate any misunderstandings and clarify the direction for necessary and successful correction. Most “discipline” problems are solved at this stage.
2. Oral Warning (and record): the first stage of disciplinary measures, where an employee is told by the supervisor or manager that their work is unsatisfactory and must be improved
3. Written Warning:he immediate supervisor and a division manager or director will meet with the employee to review any additional incidents or information about the performance, conduct or attendance issues as well as any prior relevant corrective action plans. Management will outline the consequences for the employee of his or her continued failure to meet performance or conduct expectations.
4. Suspension/Layoff as necessary: When immediate action is necessary to ensure the safety of the employee or others, the immediate supervisor may suspend the employee pending the results of an investigation. Pay may be restored to the employee if an investigation of the incident or infraction absolves the employee.
5. Termination: Only after you’ve completed all these steps should you go ahead with firing your employee. You’ll do so knowing you gave him or her every opportunity to succeed. If you’ve documented your entire progressive discipline process, courts will know that, too.
Authentic Personal Leadership
ch 12 (pg 428)
• “Why should anyone be led by you?”
• Value-added characteristics
– engaged, conscious living
– gracious interpersonal relationships
– embodiment of values
“Personnel” Equals People
ch 13 ( pg 435)
• PERSONNEL – a more depersonalized term
• HUMAN RESOURCES – the preferred term; emphasis on people
A Vital Staff Function : HR or personnel
ch 13 (pg 436-427)
• Offers a variety of support services including:
– the personnel policy manual
– one-on-one guidance
• Engages in acquiring,maintaining,retaining
employees so that the objectives of the organization may be fulfilled.
A Service of Increasing Value
ch 13 (pg 437)
• Increase in employee-related tasks (e.g. wage and hour compliance)
• Proliferation of laws pertaining to employment
• The effects of flattening and subsequent elimination of layers of managers.
Primary Functions of Human Resources: task of HR.
ch 13 (pg 442-443)
• Employment: Recruitment
• Compensation (Wage and Salary Administration)
• Benefits Administration
• Employee Relations
Additional Functions: subdivision of HR
ch 13 (pg 443-444)
• Labor Relations
• Employee Health
• Training
• Payroll
• Security and parking
• Safety
• Child Care
Rounding Out Your Knowledge
ch 13 (pg 444-445)
• Know the functions of the human resources
• Attach a person’s name to each function.
• Make a working list of management activities
that lead you to interact with HR, e.g. search
for qualified employees; benefits questions; job descriptions; policy interpretations; disciplinary actions
A Universal Approach
ch 13 (pg 445-446)
• Make certain the function is part of HR
• Refine your question or need
• If answer not readily available, ask when one
will be supplied
• Negotiate agreeable deadlines
• Follow-up politely if deadline passes
Some Specific Action Steps
ch 13 (pg 447-448)
• Find new employee sources
• Bring job descriptions up to date
• Review disciplinary processes before implementation
• Provide performance appraisal processes
• Assist in developing training programs
Further Uses of HR as a Resource
ch 13 (pg 449-450)
• Examining staff turnover patterns
• Planning for future potential staffing needs
• Examining staff pay rates via salary surveys
• Providing a sounding board, a “safe harbor”
• Providing confidential guidance in difficult
• Recognizing individual employees, and groups
of employees
Well-Considered Feedback
ch 13 (pg 450)
• Line managers assist HR by providing:
– reactions and comments on personnel policies
– employee perceptions of pay and benefits
– comments on services, positive as well as
– employee feedback on benefits
– suggested changes in recruiting or retention
Human Resources Should Be: (ch 13)
• Protective of employees
• Concerned for the rights of employees (micro)
• Equally concerned for the organization as a whole (macro)
• Aware of the necessity for proper documentation of procedural steps
• Protective of the organization against legal risks.
Laws and Regulations Effecting
Employment: ch 13 (pg 453-457)
• National Labor Relations Act: labor relations
• Fair Labor Standards Act: wages & hours
• Equal Pay Act:1963 section fair labor standards act
• Civil Rights Act: 1964, Amended by equal employment & opportunity act of 1972.
• Americans with Disabilities Act: 1990
• Family and Medical Leave Act: FMLA 1993
• EEOC regulations re: Sexual Harassment: civil right act 1964
A Potentially Violent Person May
be One Who: ch 13 (457-458)
• is experiencing family problems
• has problems relating to the abuse of alcohol or drugs
• has a history of violence
• is a known aggressive personality
• is experiencing certain mental conditions (e.g. depression)
• possesses a poor self-image or low self-esteem
Some Steps to Prevent Violence:
ch 13 (pg 459)
• Treat everyone with respect and consideration.
• Keep all potential weapons stored beyond the
reach of patients and visitors.
• Take all threats seriously and report them
• Know your security procedures, alarms, and
warning codes.
Definitions of Communication:
• The exchange of ideas, thoughts, or emotions between or among two or more people.
• The transfer of meaning and the development of mutual understanding.
A Complex Process: (Ch 14 pg 466-447)
• Requires skill on both individual and group level.
• Requires awareness of increasing complexity as the number of people involved is increased.
• Requires conscious effort to make communication effective.
A Manager’s Day-to-Day Communications Include:
(Ch 14; pg 468)
• Receiving orders, instructions, and direction from above.
• Delivering orders, instructions, and direction to employees.
• Coaching, counseling, and disciplining employees.
• Interviewing and selecting candidates for employment.
• relating to managers and employees of other departments.
• Relating to patients, visitors, clients, customers, etc.
• Responding to questions and requests.
Face-to-Face Communication (Ch 14 pg 468)
Involved parties hear the words, perceive vocal tones, and can observe facial expressions and body language, and have the opportunity for immediate feedback and response.
Communication Via Telephone
(Ch 14 pg 469)
Involved parties hear the words and can perceive vocal tones, and have the opportunity for immediate feedback and response.
However, parties lack exposure to facial expressions and body language.
Communication Via Voice-mail
(Ch 14 pg 469)
Facilitates speed of initial transmission and conveys information without having to connect directly. Recipient can hear the words and perceive vocal tones, but facial expressions and body language are missing. Timing of feedback entirely dependent on the recipient.
Communication Via Letters and Memos
(Ch 14 pg 469-470)
Only the words are available to convey meaning. Feedback and response are generally the slowest of all means. Highly dependent on accuracy in choice of words and phrases. Provides a written record.
Communication Via Email:
(Ch 14 pg 470)
Only the words are available to convey the meaning. Feedback and response can range from immediate to never. Most highly
dependent on accuracy in choice of words and phrases. Can provides a written record if desired.
* In Selecting Communication Mode Consider:
• time available: how soon is resolution needed
• importance of the issue
• the complexity of the issue
• the sensitivity of the issue
• the need for negotiation or problem-solving
• the need for documentation (a paper trail)
In Verbal (Oral) Communication:
(Ch 14 pg 471)
• CONSCIOUS content: VERBAL: speeches, greetings. NON VERBAL: wave hello, nod head to affirm interest.
• UNCONSCIOUS content: VERBAL: slip of tongue, mistake in verbalizing. NON VERBAL: Cross legs away from speaker, smirk while hearing suggestion.
Communication Distance: (Ch 14 pg 472)
* Intimate distance 1 to 18 inches
* Personal distance 1.5 inches to 4 feet
* Social distance 4 to 12 feet
* Public distance 12 to 15 feet and beyond
Personal Tools to Foster Communication
(Ch 14 pg 474-475)
Communication Barriers
(Ch 14 pg 475)
• Facial expressions and body language
• Verbalization that interrupt the flow
• External distractions: noise; motion; confusion
The Staff Meeting (Ch 14 pg 447-478)
• Regular; planned; frequent
• Start and stop on time
• Limited in length
• Participative leadership style
• Decisions committed to writing
The General Meeting
(Ch 14 pg 478-479)
• Specially scheduled
• Infrequent
• Specific goal, e.g. information sharing; problem solving
• Participants selected on basis on potential contribution
• Advance notice to allow for preparation time
• Written follow-up
Email Considerations
(Ch 12 480-481)
• Avoid misuse
• Do not send unimportant or personal information
• Eliminate “junk” e-mails
• Try to deal with the message once and only once
• Avoid accumulating e-mails so messages are not overlooked or lost
• Use a clear, understandable subject line
• Write, edit, rewrite
• Remember: e-mail is not private
Memos and Letters
(Ch 14 482-483)
• Remember: this is a one-way communication
• Focus on clarity in expression
• Write for a specific audience
• Avoid unneeded words
• Use simple, direct language
• Say it and stop
• Edit and rewrite
Human Barriers to Communication
(Ch 14 pg 494-495)
• LANGUAGE: use of jargon, technical terms,slang
• UNCONSCIOUS MOTIVES: thought shaped by emotion
• PSYCHOLOGICAL FACTORS: past experiences and ideas shape individual or group perceptions
• CULTURAL CLASHES: differences in age, socioeconomic status, region of birth, and education level
• ORGANIZATION SIZE: creates layers which in turn create distortion
• LOGISTICAL FACTORS: lack of time, space, privacy
• OVER-STIMULATION: members bombarded with so many events that they become unable to process any more Information
• ORGANIZATIONAL STRUCTURE: Communication channels too formally delineated
• PHASE IN LIFE CYCLE: communication taxed at various developmental stages; need adaptation of structure for each phase
Signs of Managerial Discomfort
( Ch 15 pg 501-502)
• Budgeting: viewed as a chore.
• Performance appraisal: a dreaded function
• Employee problems: tendency to shy away from these
• Identification with the work group: polarizing attitude of “them” vs. “us”
• Disciplinary issues: dreaded, often minimized or avoided
• Personnel policies: remains unfamiliar with these; refers all to Human Resources
• Work priorities: inability to plan with priorities in mind
• Delegation failure: unable to utilize employees to their fullest
The Management Generalist
( Ch 15 pg 503)
• A legitimate role in itself
• Advanced education and training in management
• In health care organizations: frequently combined with health care specialization
A Constant Balancing Act
( Ch 15 pg 504)
• Maintain a balance between specialist and generalist
• Avoid the attitude: once a specialist, always a specialist
• Foster a liking for management role
• Stay current in both the technical/specialist field and the management field
Ego Barriers to Effectiveness
( Ch 15 pg 505)
• Maintaining an inflated view of the importance of one’s profession relative to others
• Devaluing the management profession
• Failing to recognize management as a specialty in its own right
• Failure to attend to the “big picture”: the organization as a whole
Overview: The Professional Managing the Professional
(CH 15 pg 507-508)
• The professional as a scarce resource
• Some special management problems
• Credibility of the professional’s superior
The Professional as Scarce Resource
(Ch 15 )
• The reality of periodic shortage of certain health care specialists
• Necessity of shifting focus: from recruitment to retention
• Attention to: better pay scales; more generous benefits; more attractive schedules; additional compensation for less popular assignments; a more clearly defined role; a stronger voice in matters of patient care
Some Special Management Problems
(Ch 15 pg 508-509 )
• Following are a number of characteristics and circumstances that create problems in managing professionals:
– Specialist is well educated within a specific discipline
– Individual accustomed to a high degree of autonomy
– Person may be licensed and credentialed to function with autonomy
– May assume a mandate to get things done and report later, if at all
– Possesses mobility: many can choose to move freely among
departments or organizations.
• Following are some more characteristics and circumstances that create problems in managing professionals:
– As a solitary operator, specialist constantly exercises individual
discretion and judgment
– Usually shows a high degree of self-confidence and independence of thought and action
– Is a self-starter; needs minimal supervision or direction
– Sometimes is tension between the lone operator and the team
– Sometimes is tension between the necessary autonomy and
hierarchical authority
Credibility of the Professional’s Superior
(Ch 15 pg 511-512)
• Specific tension when manager is from a different profession
• The ego barriers surface
• The question of manager’s competence to deal with a specialist’s area
• Again, the need for the health care specialist to accept management as a legitimate profession in its own right
Leadership Style
(Ch 15 pg 512-515)
• Given the autonomous nature of the health care specialists work:
-Use the participate/consultative style
-Remain aware of underlying motivation: McGregor’s Theory Y
Communication and the Language of the Professional
(CH 15 pg 519-521)
• Professional often speaks “inside language”: the jargon, the technical terms of a specialty
• “Inside language” an inevitable outcome of the growth of a specialty
• Tendency to use such language when communicating with others within the specialty
• Must be attentive to the need to shift to more general language when communicating with others; must avoid excluding others by using the “inside language”

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