IS THE WORK EVER "ALL CAUGHT UP?"
Some time ago, a tiny newspaper article (actually, a single-paragraph filler that provided few details and cited no sources) claimed that, on the average, the top managers of all kinds of work organizations put in nearly 60 hours on the job each week. This amounted to nearly 20 hours or more per week than the time spent on the job by the average nonmanagerial worker. Middle managers and first-line supervisors, the article said, averaged approximately 7 fewer hours per week than do top managers.
Probably, few working managers have not occasionally said something on the order of: "If I were not a manager, but just one of the crew like I used to be, I could leave at the end of a normal work day and forget about all this grief until next morning." Many who work the manager's 50-plus hours per week have frequent cause to reflect that even this amount of time on the job often seems inadequate in light of everything to be done. The manager's job, it seems, is never quite done.
Many nonmanagerial employees can legitimately say they are "all caught up" at the end of the workday. This may mean that the work that had to be done that day was done or at least that required output kept up with input and the overall task did not fall behind. But can a manager often say the same? Or should a manager ever be able to say "I'm all caught up?"
Truly, the manager's job is never done. People problems-problems with employees as well as with patients, clients, and the public-occur with unpredictable frequency. Problems with seekers of medical service and others from outside of the organization usually occur in the here and now; most of these situations must be dealt with as they arise. Likewise, many employee problems must be dealt with on the spot or at least must be addressed in the short run. Although the manager may have much to do on the problems-with-things side of the role-developing and refining work procedures, coordinating and allocating resources, writing reports, and responding to requests, for example-sometimes, the problems-with-people side of the role dominates to the exclusion of all else.
The manager's primary resource is time. The average manager is almost always under some degree of time pressure, and for the conscientious manager, much of this time pressure is self-imposed. As managers, we quickly learn that it is necessary to make the most of every minute and every hour, moving from task to task and problem to problem with a sense of priority. We also quickly learn that every minute of available time can be used to some constructive end, that even if all current work is under control and no personnel problems are at hand, any available time can be put to good use to ensure that things will run better in the future. We all have in mind projects that we would like to take care of "when a little time is available," "after the rush is over," or "during the calm between storms."
Managers have been told for years to concentrate on doing the right things, using intelligent planning, rather than simply doing things right. However, the experienced manager knows that doing the right things and always doing them the right way takes time-more time than would often seem to be available. Thus, all too often, we succumb to the natural pressure to take the quick way out, to render a snap decision or toss in a fast fix because the right way requires time we feel we do not have. We skip lightly over the planning phases of our work because of the nagging feeling that time spent planning is not productive because it does not yield immediate results.
When time is in limited supply, we tend to use more and more of it for doing and less for planning and learning. However, we discover again and again that time spent in conscientious planning-even if it is only 10 minutes used at the end of today to align tomorrow's priorities-pays for itself many times over in ensuring that we are indeed serving first things first.
As planning time should be a prime consideration of the manager, so too should time for learning and self-development receive a measure of priority treatment. A conscientious manager, although certainly not spending 50% of the available time reading the literature of the field, would make time for reading material of immediate and specific relevance to the job. One might not, for example, immediately read every article in the current issue of The Health Care Manager (although we would be more than pleased if you did just that). Rather, a reasonable expectation would be for one to read, within a reasonable time after receiving an issue, 2 or 3 articles that perhaps offer insight on a topic of active interest or concern.
Because the needs and interest of the health care manager are many and varied, so have we varied the topic offerings of The Health Care Manager in our effort to serve those needs.
This issue (25:4, October-December 2006) offers the following for reader consideration:
* "An Organizational Approach to Understanding Patient Safety and Medical Errors" suggests that minimal progress in matters of patient safety necessitates an organizational approach to patient safety, using new techniques, and offers suggestions for furthering research into matters of patient safety.
* "Employment-at-Will: Guidelines for Healthcare Manager" explains the doctrine of employment-at-will, demonstrates how this doctrine has been eroded over time by the passage of employment-related legislation, and describes several exceptions to the doctrine.
* "Project Planning for Health Care Software Implementations" addresses the need to spend sufficient time on appropriate project planning to ensure successful project outcomes, recognizing that more than three fourths of health care software project implementations fail to achieve their original objectives.
* "A Theoretical Model to Address Organizational Human Conflict and Disruptive Behavior in Healthcare Organizations" offers a model for leaders to apply in addressing human conflict and disruptive behavior, recognizing that a culture high in internal conflict will fall short of its full potential to deliver quality health care.
* "Improving Safety Management in Health Care Organizations" addresses means of reducing workplace accidents and resulting injuries through improved safety management and recommends the essential components of an effective accident program.
* The Case in Health Care Management, "Dealing With the Repeat Offender," asks the reader to consider how to address the difficulty presented by an employee who seems to exhibit a pattern of relatively serious errors at extended intervals.
* "Halfway There, Check to See If You Are? Six of 11 Health Insurance Portability and Accountability Act Rules Are Set" reviews the status of implementation of the 6 of the 11 component rules of the Health Insurance Portability and Accountability Act.
* "Electronic Health Record in the UK: Shedding Some Light From a Manager's Perspective" addresses, from the perspective of a health information professional from the United States, the status of the effort to introduce a true electronic health record into the National Health Service in the United Kingdom.
* "The Hidden Costs of Caring: What Managers Need to Know" addresses the causes and effects of vicarious trauma, compassion fatigue, and secondary traumatic stress on direct-care staff and examines the negative impact of these phenomena on organizational functioning.
* "Managing Overutilization, Quality of Care, and Sustainable Health Care Outcomes in Oman" looks at the challenges faced in managing escalating health care costs in Oman, focusing specifically on overutilization and its attendant problems.
* "The End-Stage Renal Disease Industry and Exit Strategies for Nephrologists" describes a window of opportunity for rapid consolidation and expansion for small and medium-sized chains of dialysis operations and provides a framework for sellers to prepare a dialysis business for divesture.
* "Effective Employee Counseling for the First-Line Health Care Manager" presents employee counseling as a necessary skill for the manager of people and suggests how this counseling skill can be acquired through practice and the conscientious application of some simple guidelines.