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"That's detail work, and I'm not concerned," said the new manager as he dismissed an employee's question with an impatient wave of his hand. "Never bother me with details," he went on, "that's implementation-that's technician work."


Was there a touch of scorn in the way the manager said technician? Perhaps not everyone in the room caught it right away, but they could hardly miss it when the new manager added, "I'm not a technician or an implementer. I'm an idea person, and I let others worry about the details."


Most of the 18 people in the room, including 4 subordinate supervisors, had lived most of their working lives amid concern for details. So all of the employees heard the new manager express contempt for the way they spent much of their working time.


In declaring himself in this manner during his first few days on the job, this manager was perhaps helping to ensure that he would not be a long-term employee. One does not make a positive impression on employees by demeaning the work they perform. Over the long haul, staff and their attitudes toward the manager can have a great deal to do with whether the manager succeeds or fails. One can go so far as to say that staff's attitude toward the manager can eventually make or break the manager.


Frequently, however, it is from the glaringly incorrect or the outright failure that we are best able to learn about the management approaches that work and those techniques that do not work. Demonstrated contempt for details is a stepping stone toward failure as a manager.


Fewer words prove truer in organizational life than President Clinton's oft-quoted "The devil is in the details." The finest plan borne of the noblest intentions will fail if someone does not conscientiously attend to the details. Nearly everything done, every decision made, culminates in the details of implementation, and more often than not the majority of the difficulty experienced in implementing a plan of any complexity lies in identifying, aligning, and resolving the details. Whether one is concerned with the implementation of a staff reduction, the introduction of a new benefits package, the scheduling of job candidates for interview, or the simple introduction of a new procedure, it is the details that count. It is the details and how they are attended to that can spell success or failure for an undertaking.


A manager's contempt for the details will be perceived by the employees as contempt for them as well as for their work. We do not suggest, however, that the person at the top need always be conversant with all the details of every activity undertaken. It would be unrealistic to expect the manager to be able to do every job in the group as effectively as the people who do the work every day. Yet many managers, doubtless a majority, did large amounts of detail work as they became more responsible in an organization, and more than a few still readily accept a certain amount of detail work as part of their responsibility.


The manager quoted in the opening lines dramatically underscored his contempt for details-and detailers-by citing his supposed value as an "idea person." In the majority of disciplines found in work organizations, there are few "ideas" that have not already been explored in numerous ways. Therefore, if a self-proclaimed idea person can do no more than repackage the ideas of others, what is this manager's value to the organization and to the staff? Also, when it comes to having ideas that will improve the performance of the work, no people are better positioned than the ones who actually perform that work every day; they can see what the manager cannot see.


Better managers succeed by enabling their employees to get the work done in the most effective manner possible, by running interference for them, by clearing obstacles from their path, and by making sure they have the support needed to accomplish the work. This requires a respect for the details; not an intimate working familiarity with the details but rather honest recognition of their existence and importance.


Today's manager cannot-and need not-readily come up with truly original ideas that break new ground. Rather, the manager's value lies in doing what others have done before but improving upon it, doing it differently and more efficiently, and better overall. That, and paying attention to details.


This issue of The Health Care Manager (33:4, October-December 2014) offers the following articles for the reader's consideration.


* * "The Negative Impact of Organizational Cynicism on Physicians and Nurses" reports on a study investigating the effects of cynicism on organizational commitment, job satisfaction, and interest in leaving one's hospital employment for other employment for a sample of 205 physicians and 842 nurses.


* * "Implementation of Measures to Improve the Surgical Care Improvement Project Perioperative Prophylactic Antibiotic Compliance: Quality and Financial Implications" addresses the impact of proper perioperative prophylaxis on an estimated annual 1 million inpatient days and $1.6 billion in excess health care costs that are secondary to preventable surgical site infections, stressing the need to create low-cost, standardized processes on an institutional level to improve compliance with prophylactic antibiotic administration.


* * "Transforming the Image of Nursing: The Evidence for Assurance" suggests that a nurse's uniform influences perceptions about nursing practice and thus contributes significantly to the overall image of a nurse and describes the planning, evidence gathering and implementation of a major initiative to promote professional nursing practice.


* * "The Financial Impact of Hospitals on the Local Economy-2 New Factors" reports on a research effort that presents a descriptive analysis of the financial impact of several hospitals on their local economy, referring to 3 components of financial impact: the hospital system as a major health care provider, the hospital system as a large employer, and the hospital system as an entity whose employees contribute greatly to their local community.


* * "Determinants of Social Quality and their Regional Disparities: An Integrated Approach for Health Equity in South Korea" addresses the concept of social quality in describing how favorable are the socioenvironmental components that impact the individuals' lives, through study of a number of social quality indicators.


* * Case in Health Care Management: "No Better Than I Used to Be?" Asks the reader to consider how to address the problem presented by differences in performance evaluation scores by 2 different managers evaluating the same employee.


* * "Machiavellianism in Health Care Explored: Differences in Aspiring Managers and Patient Care Professionals" reports on a study conducted to determine the differences between aspiring health care managers and patient care professionals regarding Machiavellian tendencies, concluding that a significant mix of Machiavellian traits exist within both groups and that these need to be both cultivated and controlled.


* * "Development of Balanced Key Performance Indicators for Emergency Departments Strategic Dashboards Following Analytic Hierarchical Process" reports on a 2-phase study undertaken for the development of a balanced set of key performance indicators for using in emergency department strategic dashboards following an analytic hierarchical process, resulting in a methodology that can serve as a reference model for development of key performance indicators in various performance-related areas based on a consistent and fair approach.


* * "Learning Through 'Huddles' for Health care Leaders: Why Do Some Work Teams Learn as a Result of Huddles and Others Do Not?" addresses the question: Given that "shared knowledge is obtained through group-based learning," why are some teams learning and others are not? Based on the findings in the literature review on learning in groups, teams learn from huddles and others do not because of communication style and dialogue among group members, communication style and dialogue facilitated by the leader, team and member perceptions, and team membership.


* * "Comparison of Learning Organization Indicators in 2 Universities in Shiraz as Viewed by the Personnel" reports on a descriptive field study conducted on 499 university staff (208 from Shiraz University and 291 from Shiraz University of Medical Sciences) comparing 2 major institutions as learning organizations and addresses the need to take measures to promote learning organization indicators to an ideal level, thereby contributing to the country's success and advancement.


* * "An Updated Look at Document Security: From Initiation to Storage or Shredder" suggests that in these days of close attention to security of information handled electronically, there is often a tendency to overlook the security of hard-copy documents; therefore, guidelines are furnished for protecting employee privacy by separating retention practices for business information from personal information.