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How to Recognize the Most Effective Managers

Ever wonder what makes the difference between a truly effective manager, one you can honestly describe as a real leader, and "just another boss?" Watch a few first-line managers and middle managers in action for a while, critically evaluating their behavior and trying to remain sensitive to those of their actions to which people are primarily responsive. Look for those managers who seem to be followed not because staff are ordered, forced, or coerced to do so but because staff are simply willing to follow them.

 

At all but an organization's highest levels, managers, regardless of title, are workers as well as managers. The head nurse must at times function as a nurse, the laboratory manager will at times perform tests or interpret test results, the housekeeping supervisor will attend to any number of cleaning tasks personally, the chief diagnostic imaging technologist will perform procedures in addition to overseeing the work of others, and so on. Most of those who supervise the work of others must, either regularly or on occasion, themselves perform "technical tasks," that is, some of the nonmanagerial work of the department.

 

There is an age-old argument that occasionally surfaces in discussions about managing. This argument consists of the debate about whether it is necessary to know how to do the work one supervises or simply necessary to know how to manage. We can avoid this argument once and for all by agreeing that, in the vast majority of situations, it is necessary for the manager to function as both a worker and a manager.

 

The manager's fundamental responsibility is to ensure that the work of the department or work is accomplished. This responsibility is fulfilled in 2 ways, by personally doing some of the work and guiding others in doing some of the work. This latter activity essentially embodies the simplest but most all-encompassing definition of management-"getting things done through people." It is how these 2 areas of activity are addressed at any given time that determines whether the supervisor is a true leader or only another giver of orders.

 

The giver of orders relies primarily on telling others what to do. After all, is that not what the employees are there for-to do what the manger tells them to do? When a task arises, the giver of orders might readily delegate to staff, especially if the task is one the manager does not enjoy doing and would only as soon avoid. As quickly as the work comes in, the giver of orders hands it out to employees and remains occupied with tasks of personal preference, usually those activities seen as the province of "management." Generally, the giver of orders remains "facing upward" in the organization, toward his or her superior and visible to the higher management.

 

The effective manager, the true leader, knows how to delegate well but is not so quick to burden staff with mundane or unpleasant tasks. The effective leader will find a way to dispense with the mundane or unpleasant alone or, when necessary, will know how to spread around such tasks so that everyone, the manager included, shares the load.

 

At all but the highest organizational levels, the manager wears the hat of the worker, as well as the hat of the manager. In effect, the giver of orders denies his or her legitimate role as one of the workers and identifies largely with "management," functioning as a worker only when forced to do so by circumstances (and usually resentfully). The effective manager, however, knows that he or she is also one of the workers and behaves accordingly.

 

To understand why some managers are highly effective within their work groups and why some are not, consider who you would be more likely to follow willingly: the giver of orders who points to a task and says, "Go do it," or the leader who points out a task and says, "Let's go do it" and works side-by-side with you. In the last analysis, the effective manager is one who honestly believes that the manager exists primarily to facilitate the employees' accomplishment of their work as efficiently and effectively as possible.

 

This issue of The Health Care Manager (Issue 35:4, October-December 2016) includes the following articles for the reader's consideration:

 

* "The Experience of Patients Engaged in Co-designing Care Processes" addresses the experiences of patients involved in co-designing care under a unique program undertaken at an academic health sciences center. Being listened to and informed gave patients an opportunity to better understand patient needs and the complexity of care in the unit and in the organization.

 

* "A Qualitative Study of the Change-of-Shift Report at the Patients' Bedside" examines concerns about patient bedside change-of-shift reporting at a community hospital in northern Indiana, addressing the research question: "What are acute care nurses' perceptions of the change-of-shift report at the patients' bedside?".

 

* "Using Organizational Development for Electronic Medical Record Transformation" addresses the change process involved in responding to mandates requiring the transition from paper medical records to the use of electronic medical records.

 

* "Consumer Health Informatics: Promoting Patient Self-Care Management of Illnesses and Health" reports on a study undertaken to examine the present status of consumer health informatics, including the consideration of the need for tailored health communications and capacity building with chronic patients.

 

* "The Association Between Residential Care Facility Manager's Educational Attainment and the Presence of Structural and Service Innovations" reports on a project organized to examine the association between the administrator's educational attainment and innovation in residential care facilities, hypothesizing that administrator academic education and certification or licensure would be positively associated with facility innovation.

 

* The Case in Health Care Management: "But She's Really Sick" asks the reader to consider the situation faced by a manager who has 2 chronically absent employees, one of whom is known to be genuinely ill and one who seems to be abusing the system.

 

* "A Trend Analysis of Succession Planning in Health Care as Perceived by Chief Executive Officers in US Hospitals" reports on a study undertaken for the purpose of analyzing the perceptions of chief executive officers in US hospitals regarding leadership development and succession planning and subsequently comparing the results of the study with identical surveys from previous years.

 

* "Demand for Dental Services in Iran, Shiraz" reports on a cross-sectional and descriptive-analytic study designed to estimate the demand for the use of dental services by Shirazi inhabitants in Iran from June to October 2013, with the results suggesting means for improving access to and use of such services by people in need.

 

* "Oral Health Behaviors and Perceptions Among College Students" reports on a study with the purpose to determine the current oral care behaviors and perceptions of students at a midwestern college, using the oral health-related quality of life model as the theoretical framework to guide the study.

 

* "Are ICD Codes in Electronic Health Records Useful in Identifying Obesity as a Risk Factor When Evaluating Surgical Outcomes?" presents research that addresses an important methodological issue of patient safety and obesity for the purposes of examining clinical and administrative data for the reliability of using ICD diagnosis codes alone to identify obesity as a comorbidity and risk factor in care and management.

 

* "Improving Primary Care Retention in Medically Underserved Areas: What's a Clinic to Do?": The National Health Service Corps (NHSC) has attempted to increase the number of primary care providers in underserved communities through scholarships and through individuals in loan repayment programs (LRPs). This study assessed NHSC LRP propensity to work in underserved communities and asked NHSC LRPs about preferences for particular retention strategies and which strategies were used by their clinical sites.