1. McConnell, Charles R.

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The CEO of a healthcare facility that employed ~700 people scheduled a regular weekly meeting with his 7 direct reporting managers. These managers were expected to reserve the hours from 10:00 am to noon each Wednesday for this meeting, and they were further expected to have specific agenda items ready for discussion.


The manager who mandates a meeting of direct reporting employees effectively controls that scheduled amount of time of those subordinates. The subordinate managers can understandably be expected to schedule their day around the weekly meeting. Apparently not especially mindful of the value of his subordinates' time, this particular CEO approached his own staff meeting as follows:


* As frequently as 50% of the time, he cancelled the meeting. However, notice of cancellation rarely occurred earlier than 15 minutes before meeting time and often failed to occur until the participants were already assembled.


* On days when the meeting convened, the CEO was usually 5-15 minutes late in arriving. Most of his tardinesses were for reasons well within his ability to control.


* On arriving, the CEO would often remember a call he "just had to make" and would do so while the 7 managers sat and waited. The CEO also frequently took incoming calls during the meeting, again forcing the 7 managers to wait.


* It usually required the CEO 2-5 minutes to find his agenda among the materials he carried, and at least once of every 3 or 4 meetings, he had to call his secretary to bring his agenda and notes to the conference room.


* In what was supposed to be an "around-the-table" presentation of items, the CEO always placed himself first. Given his habit of allowing himself frequent rambling digressions, he usually used as much as three-quarters of the meeting time on his own agenda items. The 7 managers were invariably forced to compress their reports and skip some agenda items altogether.


* Up to 20% of the time the CEO cut the meeting short to rush off to something else. On occasions when this occurred, his agenda items were the only items that made it onto the table.


* Overall, the CEO's behavior reduced a 2-hour meeting of 8 reasonably well-paid individuals-himself and 7 other managers-to an average actual meeting time of barely three-quarters of an hour and much of that of questionable effectiveness.



In Up the Organization (Alfred A. Knopf, Inc., 1970), Robert Townsend included a brief quiz titled "Rate Your Boss as a Leader." In one point, he suggests that a tough, effective leader "Won't let top management or important outsiders waste his time or his people's time. Is more jealous of his people's time than he is of his own."


Beware the manager whose behavior suggests the belief that the subordinates' time is the manager's to waste. The CEO of the foregoing example undoubtedly believed himself to be a tough, fast-moving, effective manager, when in the eyes of the subordinate managers he was a self-centered and disorganized individual who wasted the time of those around him and thus reduced everyone's effectiveness. In making it possible for the employees to do their jobs as they should, the truly effective leader must be the servant of the employees, not their master.


It pays to always remember that regardless of organizational level, one of the manager's primary responsibilities is to facilitate the subordinates' work performance and to make it possible for the people who do the work to do so as efficiently and effectively as possible.


This issue of The Health Care Manager offers the following articles for consideration:


"Caring: Utilizing Watson's Theory to Transcend Culture" speaks to the increasing necessity for caregivers to respond to increasing diversity with competency and theory-based practice strategies and emphasizes the lessons to be learned from a specific model of transcultural nursing.


"The Hospital Manager and Game Theory: Chess Master, Poker Player, or Cooperative Game Player?" illustrates how principles of game theory successfully translate to the hospital environment and suggests how knowledge of game theory can enhance the healthcare manager's enjoyment of the job.


"Union Certification Elections in Nursing Care Facilities" reports on a study of a number of union representation elections held in long-term care facilities and discusses the implications of union win rates for union organizers and facility administrators.


"The Economic Impact of Several Hospitals on Their Community" reports on a study undertaken to quantify the value that several hospitals in a hospital system have on their community, assessing hospitals as employers, providers of healthcare services, and contributors to the quality of life in their region.


The Case in Health Care Management, "Discharge for Cause," asks the reader to render a decision that either supports or recommends overturning the discharge of a relatively long-term employee under what might be considered questionable circumstances.


"Addressing the Phenomenon of Disruptive Physician Behavior" reviews the potential negative consequences of disruptive physician behavior and offers some suggestions for responding to such behavior.


"Responding to Threats of Workplace Violence: The Effects of Culture and Moral Panic" discusses the collision of a cultural context that encourages macho posturing and moral panic related to highly publicized instances of violence in workplaces, suggesting the need for healthcare organizations to be prepared to react appropriately when threats of violence arise.


"The Causes and Consequences of Conflict and Violence in Nursing Homes: Working Towards a Collaborative Work Culture" addresses the special dynamics that accelerates dysfunctional conflict in nursing homes and offers strategies, tactics, and other recommendations to help leaders build more collaborative work cultures.


"Accepting Leadership Responsibility: Preparing Yourself to Lead Honestly, Humanely, and Effectively" suggests that much modern organizational leadership is clearly self-serving and that fulfillment of a leader's essential leadership responsibilities requires the adoption of a serving attitude and the ability to subordinate personal needs to the needs of the organizations and its clients and employees.


Charles R. McConnell