to earns Management Concepts RHONDA BITTNER, B.A., R-T.(R), MAOM Management concepts ¢ through time, Health care ‘eading this article, readers should be able to: Discuss traditional management strategies and their relevancy to modern management techniques managers can learn nes Explain common manageria roles and behaviors as they relat to the management proces. concepts by evaluating clas Wi List and describe modern-day management concepts sical management strategies, dentify the characteristics of effective teams and team members. «as well as modern-day strate |W Desribe competitive advantage and the importance of internal resourres whe gis. Focusing on quality gris diffeent quality measures and their prrpose improvement and team build ing can help managers align the goals oftheir departments ith the goats of w organi calth care is the amber 1 delivery systems and is defined by quality zation, consequently improv: business industry in the standards in a consumer-driven market Jing paaien care United States today. At Many original management theories have approximately $1.4 trillion | influenced today’s concepts. By comparing, This article is a Divected dollars, health care expen: traditional management styles of the 1920s Reading. ditures account for more than 15% of the _ | with today’s approaches, radiologic tech- {gross national produt.! In 2003, an esti- nologists can discover theories that can be mated 543 million ¢ applied to their workplaces, procedures were performed with an esti mated cost of $100 billion, Traditional (Classical) Management Radiology managers and technologists Traditional management was deve must be adaptable to change to impl oped during the Industrial Revolution tment nev quality shaves that meet breeause large businesses needed profes | regulatory Suct ofstateand gorernmcne, | atonal mamagers, Management conecpts | entities and onganizaional demands. For | traditionally were built around 1 of 3 these reasons and more, itis essential hat | structures: the rules of bureaucracy radiology managers and technologists Which included rules and procedures, understand business and management hierarchy and a clear division of labor: sc | Conceprs that are identifiable in the busi- | entific theories, which involved| machine | hess of health care. The following discus. | worker relationships; and administration |. sion proves technologists with a clearer | which incided the flow of information understanding of how they are vital par. | within an organization | ticipants in a growing industry Weber considered the rules of bureau | | cracy the most logical structure for lrge | History of Management organizations because bureaucracies | Management concepts were born in the | are based on 3 key attributes.' Rational |. industrial era and have cominued to evoke | authority includes the law, procedres trongh toxlay’s technological age. This and rales that organizations must follows | grenthrequiesiapiadangencsavice |. Posisenalauliorly recogninen wee Hiperi RADIOLOGIC TECHNOLOGY November/December 2006, Vol. 78/No, 2 131or vs subordinate relationship, and charismatic authority focuses on the personal quialities of an individual. Weber noted that efficiency stemmed from clearly defined! and specialized functions, le form, written rules and procedures, technically trained bureaucrats, technical expertise, competency-based pro: al authority, hierarchical ‘motion and clearly defined career paths." The scientific concept focuses on machine-worker relationships to improve the efficiency of produc tion, thereby increasing productivity.” By creating jobs thy focused on economizing time, human energy nd other resources, job design could concentrate ‘on employees’ tasks and specific procedures that employees performed,” Although Taylor proposed methods designed to increase productivity, Frank and Lillian Gilbreth’s time and motion studies furthered the design of work methods so that managers could streamline organization processes by dividing a job imo different components, Gantt added dimension to scientific management with the development of the Gantt Chart, a tool used for scheduling overlapping tasks. Gantt also developed pay incentives for good work, in contrast to penalties for poor work, and recog nized that strong leadership and management skills led to effective dustrial organizations. The third structure, administrative management | emphasized the manager and the functions of man agement, This structure was championed by Fayol and Follet’s theories. For example, Fayol identified 5 fine tions of management: planning, organizing, command ing, coordinating and controlling.” He also defined 4 key principles of man: geri concepts, however, were based on the idea that the universal goal ofan organization is to achieve an inte gration of multiple individual efforts into a synergetic whole, Follet’s theories also inchided the universal principle, which isa circular or reciprocal response such as feedback and Law of Situation, which does not emphasize one “best way" to do anything, but instead emphasizes adaptabil ity to the situation." ment. Follet’s mat sway communications, and the Human Relations Focus Classical mana ings, particularly in the area of human relations. The Hawthorne Studies began to shift focus away from clas- sical management strategy to a style that acknowledged the importance of human relations. Specifically, these studlies identified a bias that occurs when people know they are being studied, Known as the Hawthorne Effect was not without shorteont 132 Nawember/December 2006, Vol 7 these studies demonstrated that working conditions hhad no cause-and-effect relationship with productiv- ity and that worker attitude was important.’ The study concluded afier 21 000 employee interviews, found that ‘employees’ complaints were symptomatic of an underly= ing problem on the job, at home or in the person's past.’ Barnard’s Acceptance Theory of Authority! also delved into the human relations aspect of manage- ‘ment. His theory suggested that managers only have as much authority as employees allow them to have, This indicates that authority flows downward, requires accep tance by the subordinate and requires the following con: di ns to be meu Employees must understand what the manager ‘wants them to do, Employees must be able to comply with the directive Employees must think the directive is aligned with Employees must think the directive is not contrary tw their personal goals." sanizational directives nard also developed the id of strategie pinning as the executive's foundation for establishing and main- taining an effective communications system, hiring and retaining effective personnel and motivating employees.’ The b ress beyond the behavioral approach, whieh often did not inc fh that empha sized motivation and leadership techniques. These early behavioral theories were simplistic; they focused on the idea that when managers make employees happy, they create hardler-working employees, man relations school of thought began to prog- case productivity, to an appro Contemporary behavioral science is more complex because it acknowledges the causes and consequences of human behavior, Maslow,” for example, described how the fulfillment of specific human needs is a motivating factor and is requited for human growth, The design of Maslow’s Hierarchy of Needs is based! on a pyramid, with some needs placed higher up in the pyramid than oth: ers. The basic concept of this pyramid is that the higher all the needs in the pyramid only come into focus one lower needs are satisfied, MeGregor defined opinions of managerial thinking as being either pessimistic (Theory X) or optimistic (Theory Y).’ Theory X assumes that people do not like work and ty to avoid it, thus managers have to control and coerce employees. Theory Yassumes that people do not naturally dislike work andl itis natural part of their lives; hus, people are internally motivated to reach work objectives. The evolution of human relation management theo: ries also included the understanding that a No, 2 RADIOLOGIC TECHNOLOGYney were largely untapped by x meaningful work, want to be creativity and compet ‘employers ~ employees wa productive and also want to contribute to the decision- making and leadership functions of their organizations, Integrating Management Theories The systems theory characterizes an or multiple units that operate as | system, based on interde pendencies and interrelationships. Organizations have inputs and outputs, interact with theit environment as they provide goods and services, and experience reacti in the form of feedback.’ For example, finance, human npt to accom resources and radiology departments alla plish an organizational goal by working toward synergy: which is the that the combined effect is greater than the sum oftheir individual efforts. This organizational goal could 1 accomplished by a single system, In other words, the com bined and coordinated actions of the parts achieve more than all che patts working independently, teraction of 2 oF more agents or forces so Contingency In the mid 1960s, the continger approach of management emerged. Emphasizing the con- +, or situational nection between organizational policies or procedures, «l the characteristics of the situation, the contingency sre of the onganiza- ‘events, The eontingeney the strnc approach suggests Butin tion 10 various possible or chan approach questions universal management practices.’ The ‘contingency viewpoint advocates the use or combinatio of other viewpoints with a focus on circumstances, Contemporary Management Contemporary management theories focus on quality a ‘of goods and services. Today’s the ties also focus on the organization's agility in respond- ing 1o rapid changes. Senge popularized the concept that dynamics of change occur throuigh employee empowerment and are reinforced by an organization committed to learning, The Harvard Business Review identified Senge’s “The Fifth Discipline” as one of the ragement hooks of the past 7 ‘most important Senge described learning « tions where people conti where new and coh to create the results they truly desire, tured, whi expansive patterns of thinking are m lective aspiration is set free, and where people are con- tinually learning to see the whole together.” Senge also said that learning organizations distinguish themselves, from traditional organizations by mastering 5 converg: RADIOLOGIC TECHNOLOGY Nowember/December 2006, Vo, ing disciplines: systems thinking, personal mastery, men: tal models (ie, deeply ingrained assumptions and gener alizations), building shared visions and team learning" Are learning organizations applicable to health ¢ Mayo Clinic leaders seem to think so, According to an artile written by Cortese andl Smolai, the problem with the U.S. health care system is that “it riad of professionals and organizations currently an [who] provide health care, but no vision has ever articulated for the disparate parts to function to and learn from each other” Managing in Health Care The health care industry faces challenges far greater than those that confront most other industries. In health care, technology and regulations often require teristic is reflective of a radical change; this cha complex, competitive and rapidly-changing environ: ment. Managers also must balance quality-oFife issues with profits’; therefore, today’s health care managers must develop critical-thinking skills and business sense beyond their own organization. The Healtheare Le: ness knowledge and skills as the ability to apply business, Jership Alliance identifies busi- principles to the health care environment. This model can help health care organizations transition from a reactionary organization to one that is proactive.” Like most businesses today, senior leaders establish a purpose and goals, or vision and mission, as to where they want to be in the future and how they expect to get there Both vision and mission statements are important because they serve to unite, guide, energize and mot: vate employves. More specifically, the vision st siding philosophy that reflects the of decisions, policies and actions, The mission statement is 1 clear, engaging tanget to help the organization move forware? Vision is based on fundamental motivating principles, values and tenets associated with life, It ends, ‘Cin contrast to the mission, which is elear toh engaging and often exciting, Importantly, both vision and mission identify and influence ways of formulating com- petitive strategies. Competitive advantage is an individual organization's capability to successfully compete based on the unique: ress of its internal resources. Internal resources are clas- sified into physical, human and organizational capital categories.” To establish competitive advantage, onga- nizations must integrate the performance of tasks and activities. This advantage can only be achieved if the ‘valuable, rare, costly to imi: 133