Health Organizations SECOND EDITION Theory, Behavior, and Development James A Johnson, PhD, MPA, MSc Professor, School of Health Sciences Central Michigan University and Visiting Professor, St George’s University Grenada, West Indies Caren C Rossow, DHA, MSA, RN, FACHE Assistant Professor, College of Health Sciences Indiana University 9781284109825_FMxx_Print.indd 28/07/17 3:47 PM World Headquarters Jones & Bartlett Learning Wall Street Burlington, MA 01803 978-443-5000 info@jblearning.com www.jblearning.com Jones & Bartlett Learning books and products are available through most bookstores and online booksellers To contact Jones & Bartlett Learning directly, call 800-832-0034, fax 978-443-8000, or visit our website, www.jblearning.com Substantial discounts on bulk quantities of Jones & Bartlett Learning publications are available to corporations, professional associations, and other qualified organizations For details and specific discount information, contact the special sales department at Jones & Bartlett Learning via the above contact information or send an email to specialsales@jblearning.com Copyright © 2019 by Jones & Bartlett Learning, LLC, an Ascend Learning Company All rights reserved No part of the material protected by this copyright may be reproduced or utilized in any form, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission from the copyright owner The content, statements, views, and opinions herein are the sole expression of the respective authors and not that of Jones & Bartlett Learning, LLC Reference herein to any specific commercial product, process, or service by trade name, trademark, manufacturer, or otherwise does not constitute or imply its endorsement or recommendation by Jones & Bartlett Learning, LLC and such reference shall not be used for advertising or product endorsement purposes All trademarks displayed are the trademarks of the parties noted herein Health Organizations: Theory, Behavior, and Development, Second Edition is an independent publication and has not been authorized, sponsored, or otherwise approved by the owners of the trademarks or service marks referenced in this product There may be images in this book that feature models; these models not necessarily endorse, represent, or participate in the activities represented in the images Any screenshots in this product are for educational and instructive purposes only Any individuals and scenarios featured in the case studies throughout this product may be real or fictitious, but are used for instructional purposes only Production Credits VP, Executive Publisher: David D Cella Publisher: Michael Brown Associate Editor: Danielle Bessette Production Assistant: Brooke Haley Senior Marketing Manager: Sophie Fleck Teague Manufacturing and Inventory Control Supervisor: Amy Bacus Composition: codeMantra U.S LLC Project Management: codeMantra U.S LLC Cover Design: Kristin E Parker Rights & Media Specialist: Merideth Tumasz Media Development Editor: Shannon Sheehan Cover Image: © Magnilion/Shutterstock Printing and Binding: Edwards Brothers Malloy Cover Printing: Edwards Brothers Malloy Library of Congress Cataloging-in-Publication Data Names: Johnson, James A., 1954- editor | Rossow, Caren C., editor Title: Health organizations : theory, behavior, and development / edited by James A Johnson, Ph.D., M.P.A., M.Sc., Caren C Rossow, DHA, MSA, RN, FACHE Description: Second edition | Burlington, Massachusetts : Jones & Bartlett Learning, [2018] | Includes bibliographical references and index Identifiers: LCCN 2017019273 | ISBN 9781284109825 (pbk : casebound) Subjects: LCSH: Health services administration | Organizational behavior | Organizational sociology Classification: LCC RA971 H398 2018 | DDC 362.1068 dc23 LC record available at https://lccn.loc.gov/2017019273 6048 Printed in the United States of America 21 20 19 18 17 10 9781284109825_FMxx_Print.indd 28/07/17 3:47 PM DEDICATION To James Allen Johnson IV, Joseph Mark Johnson, and Arianna Elizabeth Johnson JAJ To Emily Jillian Carr and Addison Olivia Carr CCR IN MEMORIAM To those who have passed since the first edition: M Nicholas Coppola (chapter author) Reuben R McDaniel (chapter author) and Elizabeth R Johnson (daughter and artist) 9781284109825_FMxx_Print.indd 28/07/17 3:47 PM Brief Contents PART PART Organization Theory and Foundations Chapter Introduction to the Study of Health Organizations Chapter Anatomy and Physiology of Organization Theory Chapter Classical Theories of Organization 23 Chapter Modern Theories of Organization 35 Chapter Complexity and Postmodern Theories of Organization 47 Chapter Organizational Leadership Theory 59 Organization Behavior and Dynamics 83 Chapter Human Behavior and Motivation in Health Organizations 85 Chapter Group Dynamics and Teams in Health Organizations 99 Chapter Power and Politics in Health Organizations 113 Chapter 10 Conflict Theory and Interpersonal Dynamics in Health Organizations 122 Chapter 11 Models of Leadership Strategy and Influence for Health Organizations 133 Chapter 12 Decision Making, Analytics, and Communication in Health Organizations 155 iv 9781284109825_FMxx_Print.indd 28/07/17 3:47 PM Brief Contents PART v Chapter 13 Pathology and Dysfunction in Health Organizations 175 Chapter 14 Diversity and Organizational Culture in Health Organizations 185 Organization Development and Change 207 Chapter 15 Ethics and Values in Health Organizations 209 Chapter 16 Physician and Clinician Leadership in Health Organizations 221 Chapter 17 Governance and Board Development in Health Organizations 232 Chapter 18 Organizational Change and Sustainability in Health Organizations 251 Chapter 19 Organization Development and Crisis Management in Health Organizations 268 Index 275 9781284109825_FMxx_Print.indd 28/07/17 3:47 PM Contents Acknowledgments x Administrative Behavior 32 Foreword xi Conclusion 33 Preface xii Contributors and Collaborators xiv About the Authors xv Chapter 4 Modern Theories of Organization 35 Introduction 36 General Systems Theory 36 PART 1 Organization Theory and Foundations Contingency Theory 37 Transaction Cost Economics 38 Resource Dependence Theory 40 Institutional Theory 41 Chapter 1 Introduction to the Study of Health Organizations Population Ecology 43 Studying Organizations Chapter 5 Complexity and Postmodern Theories of Organization 47 Beyond The Classroom Chapter 2 Anatomy and Physiology of Organization Theory Introduction 10 What Is Theory? 10 Anatomy of Theory 13 Physiology of Theory 16 Conclusion 44 Introduction 48 Systems Approach in Health 48 Complexity Theory in Health Organizations 50 Emerging Perspectives .50 Complex Adaptive Systems 52 Conclusion 21 Managing Health Organizations as Complex Adaptive Systems 54 Learning Activities 21 Conclusion 57 Chapter 3 Classical Theories of Organization 23 Chapter 6 Organizational Leadership Theory 59 Introduction 24 Introduction 60 Scientific Management 24 Defining Leadership 60 Administrative Principles 26 A Chronological Review of Leadership Theory 61 Bureaucratic Principles 28 Leadership Phase Evolution 63 Human Relations 30 Conclusion 73 vi 9781284109825_FMxx_Print.indd 28/07/17 3:47 PM Contents PART 2 Organization Behavior and Dynamics vii Interpersonal Relationships 128 83 Conclusion 131 Chapter 7 Human Behavior and Motivation in Health Organizations 85 Chapter 11 Models of Leadership Strategy and Influence for Health Organizations 133 Introduction 86 Theories of Motivation 86 Motivation in the Work Environment 90 Changes in Motivation 95 Motivation and Learning 95 Conclusion 97 Chapter 8 Group Dynamics and Teams in Health Organizations 99 Introduction 100 Groups and Teams 100 Group Formation 100 Groups and Teams in Health Organizations 101 Roles, Diversity, and Trust 104 Group Processes 105 Performance and Group Effectiveness 106 Group Phenomena 110 Conclusion 110 Chapter 9 Power and Politics in Health Organizations 113 Introduction 114 Sources of Power 114 Politics in Health Organizations 117 Conclusion 120 Introduction 134 Strategic Prescription One: The Dynamic Culture Leadership Model 134 Strategic Prescription Two: The Omnibus Leadership Model 140 Tactical Prescription: The Inter-Professional Team Model: PAARP 144 Conclusion 152 Chapter 12 Decision Making, Analytics, and Communication in Health Organizations 155 Introduction 156 Decision Making 156 Reality-Based Models: Garbage Can Model Overview 158 Tools of Decision Making 161 Communication 163 Conclusion 172 Chapter 13 Pathology and Dysfunction in Health Organizations 175 Introduction 176 Health Organization Groups and Professions 176 Complexity and Work Intensity 177 Ambiguous and Conflicting Cultures 178 Organizational Decline 179 Chapter 10 Conflict Theory and Interpersonal Dynamics in Health Organizations 122 Management and Organizational Dysfunction 179 Introduction 123 Treatment and Prognosis 182 Theories of Conflict 123 Conclusion 183 Organizational Well-Being 181 Sources of Conflict 124 9781284109825_FMxx_Print.indd 28/07/17 3:47 PM viii Contents Chapter 14 Diversity and Organizational Culture in Health Organizations 185 Introduction 186 The Business Case for Diversity 187 The True Meaning of Diversity and Inclusion 191 The Impact of Prejudice 192 Diversity Management 193 Managing Diversity, Inclusion, and Health Equity in the LGBT Community 194 Disability and the Workplace 195 Aging in the Workplace 198 Diversity and Inclusion Impact on Care Delivery 198 Components of an Effective Diversity Program 200 Diversity in Healthcare Leadership: Two Major Studies 201 Conclusion 203 Ethics-Focused Culture 219 Conclusion 219 Chapter 16 Physician and Clinician Leadership in Health Organizations 221 Introduction—The Case for Leadership 222 Separation of Power 223 The 1990s—Integration Begins 224 Physician Values and Accountabilities 224 Effective Physician Leadership 225 Physician Leadership—Early Pitfalls 226 Cultivating Leadership Skills 226 From Clinician to Leader—Essential Changes in Mindset 227 Leadership Training Programs 227 Nursing Leadership 227 Interdisciplinary Education and Practice 228 The Future: Physician and Clinician Leaders 229 PART 3 Organization Development and Change 207 Chapter 15 Ethics and Values in Health Organizations 209 Introduction 210 Ethics 210 Ethical Theories 210 Ethical Principles 212 Organizational Ethics 213 Conclusion 229 Chapter 17 Governance and Board Development in Health Organizations 232 Introduction 233 Board Organization 233 Board Officers 233 Board Committees 234 Board Meeting Format 235 Institutional Ethics Committee 213 The Relationship Between Senior Management and the Board 237 Decision-Making Tools 213 Fiduciary Duties 237 Code of Ethics 215 Financial Oversight 239 Ethical Leadership 215 Operating Oversight 239 Culture 216 Strategic Oversight 239 Factors That Influence Culture 216 Cultural Change 218 Oversight of Patient Care and Resource Utilization 241 The Purpose of Health Organizations 218 Changing Board Models 243 Cultural Levels 219 9781284109825_FMxx_Print.indd 28/07/17 3:47 PM Contents Effective Governance: Cultures and Activities 244 Board Assessment 244 Board Member Education 246 Board Development 247 Current Issues and Controversies 248 Conclusion 249 Chapter 18 Organizational Change and Sustainability in Health Organizations 251 ix Chapter 19 Organization Development and Crisis Management in Health Organizations 268 Introduction 269 Development Practice and Philosophy 269 Development in a Changing World 269 Conclusion 272 Index 275 Introduction 252 Organizational Development: Framework for Change 253 Creating the Capacity to Change 257 Conclusion 264 9781284109825_FMxx_Print.indd 28/07/17 3:47 PM 278 Index contingency leadership, 66–68, 76t contingency theory, 37–38, 66–68 institutional theory vs., 42 SARFIT model, 38 contingent reward, 71 continuous measures, 14 continuous quality improvement (CQI), 258 controlling communication, 165 controlling, for confounders See confounders Convention on the Rights of Persons with Disabilities (CRPD), 196 conversational style, cultural differences in, 165 cooperative relationships, 31 cooperativeness, 125 coordinated management of meaning (CCM), 149 coordination, 108 of work, 27 coordinators, disaster, 272 Coppola, N., 10, 141 cost See also transaction cost economics (TCE) of care, 108 reduction goals, 168 Council on Education for Public Health (CEPH), counter-insurgency (political game), 118 coupling in organizations, 159 craftsman, 71–72 creative actions, 56–57 creative thinking, 197 creativity, 102 creep, theoretical, 140 criteria for selection and dismissal, 139 critical success factors (CSFs), 264, 270, 271 coordination with other organization, 271 for crisis management and response, 271b economic constraints, 271 in health systems, 49t mitigation of confusion, fear and panic, 272 for organizational and systems sustainability, 265t response capacity, 272 time management, 272 9781284109825_IDXx_Print.indd 278 training and coordination, 271–272 criticism See feedback cross-function team, 101 Crossing the Quality Chasm: A New Health System for the 21st Century, and Systems Thinking for Health Systems Strengthening (report), 49 CS (complexity science) See complexity of a system cultural competence, 130, 187, 201 communication, 164–166 defined, 199 to minimize care disparities, 198 cultural construct, 141–142 cultural disparities, 245 cultural diversity, 191 cultural factors See also organizational culture ambiguous and conflicting cultures, 178–179 groups and teams See group dynamics leadership and, 60 motivation and, 96 cultural patterns, domain of CCM, 149 culture, 90 change in, 218 defined, 130, 138 embedding/reinforcing mechanisms of, 138–139 ethics focused, 219 factors that influence, 216–218 levels of, 219 purpose health organizations, 218–219 curiosity, 102 as basic desire, 91t cybernetic (thermostat) systems, 37 cynicism, 178 D Daft, R.L division of organization subgroups, 218 Daniel, M., 222 Data Warehouse system, 168 de Vries, Kets, 179 debate, Deci’s theory of motivation, 88–89 decision making, 155–173 methods for, 156–157, 161–162 normative decision theory of leadership, 70 optimization of, 160–161 postmodern complex adaptive systems, 54–55 power from, 116, 117t reality-based models garbage can model, 158–161 rituals of, 159 theory of hierarchical goals, 33 tools, 161–162, 213–215 willful choice models, 156–157 deficiencies, in services, 197 dehumanization of workplace, 26, 30 demographics of healthcare workforce, 270 Denhardt, J., 92, 123 Denhardt, R., 92, 123 deontological/duty based ethics, 211–212 Department of Labor, US, 197 departmentalization of work units, 28 dependence on history, 51 dependence on others See independence, as basic desire dependency of resources See resource dependence theory depressive organizations, 179 descriptive ethics, 210 descriptive language, 165 design of facilities, 139 design of organizational structure, 139 design of systems and procedures, 139 desires list of (Reiss), 91t reward power, 115, 117t developmental change, 254, 264 Dewey, John, Diagnosing and Changing Organizational Culture (book), 259 dichotomous (binary) measures, 14, 16 didactic classroom learning, dilemma resolution See problem solving directive behavior, 69 directive leadership, 68 27/07/17 1:08 PM Index directness, 124 directors, boards of See governing boards disability, and workplace, 195–197 disaster coordinators training, 272 four phases of, 270, 271f preparedness and crisis management, 271 discipline, 102 disclosure, 129 discrimination, 189 disparities, 203 in healthcare organizations, 199–201, 200f dissatisfaction See satisfaction diverse leadership, 199, 203 diversity agents in complex adaptive systems, 53b aging in workplace, 198 business case for, 187–190 role of governance, 188–190 components of effective program, 200–201 Building the Business Case— Healthcare Diversity Leadership (survey report), 202–203 Diversity & Disparities: a Benchmark Study of U.S Hospitals, 202 cultural, 96 definitions, 188, 191 disability and workplace, 195–197 gender, 96 in healthcare leadership, 201–203 impact of prejudice, 192 impact on care delivery, 198–201 management of experiential, 193–194 gender, 193 generational, 193 in LGBTQ community, 194–195 of organization, drive away from, 43 and organizational culture in health organizations, 185–203 and performance, 194 programs, 186, 200–201 in teams and groups, 104–105 9781284109825_IDXx_Print.indd 279 true meaning of inclusion and, 191 in workforce, 270 Diversity & Disparities: a Benchmark Study of U.S Hospitals, 202, 245–246 diversity not valued, in team, 108 Diversity Wheel, 190, 190f, 191 division of work See administrative principles Donabedian, A., 142 Donaldson, L., 38 See also SARFIT (structural adaptation to regain fit) model dramatic organizations, 179 Drenkard, K., 228 drivers style, of leadership, 73 Drucker, Peter, 252 duties of care, obedience, and loyalty, 237 dyadic relation, 69 Dynamic Culture Leadership (DCL) model, 134–140, 135f, 136f explanation of leadership– management continuum, 136t explanation of science–art continuum, 137t dynamic structure, 51–52 dysfunction, in health organizations, 175–184 dysfunctional responses, 226 E eating, as basic desire, 91t economic gain, of health care organization, 218 economic stability, 200 Edmondson, Amy, 102–104 education, 200 effectiveness, group burnout and understaffing, 178 leadership and See also leadership contingency theory, 66–68 egoism, 212, 228 See also self-esteem Egypt, Electronic Health Records (EHRs), 168, 170, 172, 222 embedding mechanisms, 138–139, 151 emergence, 53b 279 emotions See also nonverbal communication transformational leadership, 70–71 trust, teams and groups, 105 See also conflicts empire-building (political game), 119 empiricism, 13 employee orientated leadership, 65 entrepreneurial organizations, 138 environmental changes, impact of, 241 environmental construct, 142 environmental impact on organization, 264 See also modern theories, of organization adaptation to environment, 44 co-evolution of complex adaptive systems, 53b interdependence with resources, 40–41 environmental responsibility, 270 episodes, domain of CCM, 149 Equal Employment Opportunity Commission (EEOC), 189 equality in language, 165 equilibrium, impossibility of, 52 equity, 71 equity theory, 92, 93 ERG theory, 88, 88f error avoidance, 110 Erwin, C., 108 espoused values, of organization, 219 esteem needs, 87 ethical behavior, 215 ethical conflict, anticipating, 214 ethical principles, 214 and organizational values, 214 ethical questions, for clarification, 214 ethical theories, 214 ethics, 149 defined, 210 of management See value systems ethics and values, in health organizations, 209–219 code of ethics, 215 decision making tools, 213–215 ethics defined, 210 27/07/17 1:08 PM 280 Index focused culture, 219 institutional ethics committee (IEC), 213 leadership, 215 organizational ethics, 213 principles, 212 theories, 210–212 ethnicity See cultural factors Eudaimonia concept, 210 evaluation, evaluative language, 165 exception, management by, 71 executive committee, governing board, 234, 237 executive function, 28 exhaustion, 178 existence, need for, 88 expectancy theory, 68, 88, 94 House’s path-goal model, 68 expected results, achieving, 56–57 See also stakeholders, in health organization expense-per-episode metric, 168 experiential diversity, 193–194 experiential learning, experimentation, 56 expert power, 115, 117t, 119 expertise, 252 political game, 119 exploitation of power, 52 External Control of Organizations: A Resource Dependence Perspective, The (book), 40 external environmental changes, impact of, 241 external laws, 216 extrinsic motivation, 87, 89 cultural factors, 96 organismic integration theory (OIT), 89–90 in work environment, 92 F face/construct validity, 20 faith-based theories, 211 falsification, 18 family, as basic desire, 91t Fayol, Henri, 27 See also administrative principles fear and panic, mitigation of, 272 feedback See also communication 9781284109825_IDXx_Print.indd 280 garbage can decision-making model, 159 in goal setting, 147 reward and coercive power, 115, 117t female, in healthcare organization, 193 fiduciary duties of governing boards, 237–239 Fiedler, F.E., 66–68 Fifth Discipline, The (book), 261 film and video assignments, filtering of group communications, 104 financial oversight, by governing boards, 234, 239 financial ratios, 168 financial viability, 264, 270 Fink, L.D taxonomy of significant learning, 5–6 flight, decisions by, 160 focal person, in teams, 104, 105 focus groups, 262 focusing, 264 force field analysis model, 254 forecasting, strategies based on, 55–56 formal statements, 139 formation of groups and teams, 100–101 forming, in group formation, 100, 148 Fottler, M.D., 101 foundation boards, 235 foundational knowledge, frameworks systems, 36–37 Franklin, Benjamin, 218 freedom See independence, as basic desire Freeman, J., 44 frequency of communication, 129 frequency of transactions, 39 Fried, B.J., 101 Friesen, M., 139, 264 funding, inadequate, 197 G Galbraith, J., 38 games, political, 118–120 gamesman, 72 garbage can model, 158–161 gender diversity, 96, 193, 245–246 expression/identity, 195 General and Industrial Management (book), 27 general systems theory, 36–37 Generation X, 193 generational diversity, 193 genetic-societal systems, 37 Gentile, M insights/tools to encounter unethical behavior, 215–216 Geronimo (leader), 60 Getting to Yes: Negotiating Agreement Without Giving In (book), 126 Ghoshal, S., 40 Gilbreth, L., 25–26 “global village,” 270 global warming, 261 globalization, 270 goal setting, 93 conflict See conflicts five principles of, 147 motivation and, 94 pursuing self-serving interests, 157 teams and groups, 101 governance governance, 249 nominating committee, 234 role of, 188–190 governing boards administrator roles, 238t assessment, 244–246 bylaws, 233–234, 237 CEO and, 234, 237, 246, 248 changing models, 243 clinical representation, 246 committees, 234–235 charitable giving committee and foundation board, 235 executive committee, 234 finance committee, 234 governance/nominating committee, 234 quality committee, 234–235 strategic planning committee, 235 development, 247–248 education for members, 246–247 effective governance by, 244 failure in governing, 246 27/07/17 1:08 PM Index gender representation, 246 in health organizations, 232–249 independence, 248 meeting format, 235 member composition, 245 paid vs unpaid, 248–249 performance self-assessments, 245 relationship with medical staff, 242 roles and responsibilities, 233–234, 245, 247 fiduciary, 237–239 financial oversight, 234, 239 operating oversight, 239 patient care and resource utilization oversight, 241–243 strategic oversight, 239–241 senior management and, 237, 240–241, 241–243 separation of board chairperson and CEO, 248 structure, 233–235, 247 Graber, David, 181 Graen, G.B., 69 Grashow, Alexander, 72 great groups, 147 “great man” theories, 61, 74t Great Wall of China, Greece, “green hospitals,” 270 Greenleaf ’s servant-leader, 71 gross profit margin, 169 group decision-making in leadership, 69 phenomenon, 110 polarization, 110 group dynamics See also individual motivation; relationships ambiguous and conflicting cultures, 178–179 See also conflicts defining groups and teams, 100 formation of groups, 100–101 group phenomenon, 110 group processes group cohesion, 106 role conflict, 105–106 socialization, 105 groups and teams in health organizations high-performing work teams, 102 9781284109825_IDXx_Print.indd 281 teaming, 102–104 types of healthcare teams, 101–102 typology of healthcare teams, 101 in-groups and out-groups, 69 interpersonal relationships, 32 leadership theories See leadership performance and group effectiveness, 106–110 common barriers and negative outcomes of, 108–110 states knowledge about, 106–108 team training, evaluation and research, 108 power and politics See power relationships See interpersonal relationships roles, diversity, and trust, 104–105 socialization, role conflict and group cohesion, 104–106 and teams in health organizations, 99–111 group level of organizations, 101 grouping work based on process See administrative principles groupthink, 110 growth, need for, 88 guardians style, of leadership, 73 Gulick, L., 27–28 H Hackman, M.Z., 71 Hammurabi code, in Babylonian cities, Handbook of Health Administration and Policy, 10, 263 Hannan, M.T., 44 Hannibal, Hawthorne studies, 30–31 See also human relations health defined, 181 financing/information factor, 49t managing equity in LGBTQ community, 194–195 Health Analytics Adoption, 4Ps of, 167f patients, 170 populations, 170–171 281 processes, 171–172 profitability, 168–170 health information technology (HIT), 171–172 Health Organizations (book), 178 health organizations, 200 ambiguous and conflicting cultures, 178–179 building blocks, 265t complexity and work intensity, 177–178 conflict theory and interpersonal dynamics in, 122–131 controlling costs and quality of, 218 critical success factors, 49t decision making, analytics and communication in, 155–173 diversity and organizational culture in, 185–203 diversity initiatives in, 187–189 ethics and values in, 209–219 forces that influence culture, 216–218, 217f governance and board development, 232–249 groups and professions, 176–177 human behavior and motivation in, 85–97 influence and responsibility of, 180 management and organizational dysfunction, 179–181 model of forces and factors that influence culture of, 217f models of leadership strategy and influence for, 133–153 organization development and crisis management in, 268–273 organizational change and sustainability in, 251–266 organizational decline, 179 organizational well-being, 181–182 pathology and dysfunction in, 175–184 personality and social types in, 180 physician/clinician leadership in, 221–229 politics in, 113–121 elements of playing politics, 118 27/07/17 1:08 PM 282 Index Mintzberg’s political games, 118–120, 120f preparedness plan for, 273b sources of power in, 117t individual based, 115–116 resources, 116 structural based, 116 stakeholders in, 257, 258 sustainability in, 266b ten core knowledge areas for managing, 7b treatment and prognosis, 182–183 health professionals, sources of power for, 117t Health Resources and Service Administration (HRSA), 186 health workforce factor, 49t healthcare quality, 242–243 Healthy People 2020, 199 Heifetz, Ronald, 72 Hersey-Blanchard’s situational leadership theory, 69–70 Hersey, P., 69 Herzberg’s theory of motivation, 87–88 hierarchical goals, theory of, 33 hierarchy of needs (Maslow), 86–87, 86f, 95 hierarchy of systems, 37, 39 “high-high” leaders, 66 high-performing work teams characteristics of, 103t personnel values of, 102 “high quality” concept, 135 high-status context, 166 higher-level thinking, 4–6 Higher Order principles, 141 Higher Powers, 141 history dependence, 51 Hitler, Adolf, 141 Hofstede’s individualistic vs collectivistic assumptions, 165 homogeneity, in organizations, 43 honesty, 102, 129 honor, as basic desire, 91t Hospital Trustee Professionalism Program, 188 Hospital Value-Based Purchasing (HVBP), 222 hospitals as community assets, 240 governance, and operational structures, 242f 9781284109825_IDXx_Print.indd 282 House’s path-goal theory (1971), 68, 76t human behavior, and motivation in health organizations, 85–97 human dimension, human diversity, 191 human relations, 24, 30–32 See also relationships theory, 30 human systems, 37 humility, 102 hygiene factors (Herzberg’s theory), 87–88 hypothesis, 17–18, 18f I idealism, as basic desire, 91t identity, group, 106 ignorance See uncertainty imperfect decision making, 160–161 importance of decisions, determining, 161 improvisation, 56, 271 in-group of subordinates, 69 in-house training, 182 inadequate funding/resources, 197 inclusion, 129, 187 and diversity impact on care delivery, 198–201 managing, in LGBTQ community, 194–195 true meaning of diversity and, 191 indebtedness, 71 independence, as basic desire, 91t individual-based power, 115–116 individual behavior See behavior, individual individual cultural construct, 141–142 individual decision-making in leadership, 69 individual leaders, 135 individual level of organizations, 101 individual motivation See also group dynamics burnout and understaffing, 178 House’s path-goal model, 68 in leadership See leadership individual preference, 159 individualism in language, 165 individualized consideration, 71 individuals, conflict between See conflicts Industrial Revolution, ineffectiveness, feeling of, 178 inertia, structural, 44 inevitability of change, 52, 269 influence See power information determining, 245 limits, 50–51 making decisions with, 32 sensemaking, 54–55 uncertainty reduction and absorption, 54 power, 116, 117t processing, 38 richness, 164 Information Silo, 168 infrequent communication, in team, 108 ingroup bias, 110 initiating structure, 64, 65, 65t Inpatient Prospective Payment System (IPPS), 222 inspirational motivation, 71 institution, defined, 42 institutional theory, 41–43 institutionalizing change, 263 instrumentality, 68, 88 insurgency (political game), 118 intangibles, 259–260, 260f integrated theoretical model, 141 integration, integrative learning, 7–8 integrators style, of leadership, 73 intellectual stimulation, 71 intensity of work, 177–178 intentional decisions See willful choice models for decision making inter-professional care delivery teams, 101 inter-professional collaborative practice domains, 150f inter-professional communication, 150 inter-professional team model (PAARP), 134, 144–152, 146f, 152f assemble and charter, 148 clinical inter-professional skills, 149–151 perform, 151–152 27/07/17 1:08 PM Index responsibilities of leadership when forming group, 146–148 interaction, political See politics, in health organizations interconnections, in complex adaptive systems, 53b interdependence, of resources and environment, 40–41 interdisciplinary education, 229 intergenerational demographics, 270 internalization hierarchy, 39 International Classification of Functioning, Disability and Health (ICF), 196 interpersonal dynamics, in health organizations, 122–131 interpersonal relationships, 32, 128 See also relationships factors to strengthen, 129–130 leadership and management roles, 130–131 interpersonal skills, 213 interrole conflict, 106 intersender conflict, 106 interviewing, healthcare executives, intrarole conflict, 105 intrasender conflict, 105 intrinsic motivation, 87, 89 elements of, 92, 93f intrinsic needs and motivation cultural factors, 96 in work environment, 92 Introduction to Public Health Management, Organizations, and Policy (book), 181 intuitional ethics committees (IEC), 212, 213 isomorphism, 43 J Jago, A normative decision theory, 68, 77t job overload, 178 job satisfaction, 94–95 Johnson, C.E., 71 Johnson, J., 3, 48, 139, 181, 247, 264 key concepts for effective teams, 101 on systems thinking, 50 9781284109825_IDXx_Print.indd 283 Johnson, S.M., 73 jungle fighter, 72 justice, 212 K Kaiser Foundation Health Plan, 224 Kant, Immanuel, 211 Katz’s skills theory of leadership, 66, 75t King Nebuchadnezzar, knowing, 55 See also learning desire for (curiosity), 91t information power, 116 knowability limits, 50–51 making decisions with, 32 sensemaking, 54–55 uncertainty reduction and absorption, 54 knowledge, teamwork-related, 100 Kotter, John, 261 Kouzes and Posner’s leadership framework, 79t Krathwohl, D.R., L Landry, A., 108 language, 218 Lawrence, P.R., 37–38 See also contingency theory leader-member relations, 67 exchange theory (LMX), 69 leadership adaptive leadership theory, 72–73 army leadership model, 80t assessment tools, 182 behavior phase, 63–64 for change and development, 259 change in, 258–259 characteristics of, 135 charismatic leadership model, 78t competency based leadership, 70, 78t contingency phase, 66–68, 76t defining, 60–61 developing skills, 226 dysfunction and pathology, 176 and governance factor, 49t “great man” theories, 61, 74t 283 healthy lessons for, 183t Katz’s skills theory of, 66, 75t Kouzes and Posner’s leadership framework, 79t leader-member exchange (LMX) theory, 69 and management roles, 130–131 managerial and strategic leadership model, 79t managerial grid, 66, 75t McGregor theory of, 62–63, 74t models/theories See leadership models modern trait phase, 62 normative decision theory, 68–69, 77t Ohio State leadership studies, 74t consideration, 64–65 initiating structure, 65t organizational theory, 59–80 path-goal theory, 68–70, 76t personality and organization theory, 75t and pitfalls, effective physician, 225–226 power and politics See power process, 139 psychoanalytic model of leadership, 71–72, 75t responsible for cultural competence, 194 results-based leadership, 80t situational leadership theory, 69–70 style, 67, 73, 151, 257f team assessment, 136, 137f tests and measures, 144–145t theories of, 61–73 contingency and situational theories, 66–68 great man and trait theories, 61 traditional tools for measuring, 143–144 training programs, 227 trait theory, 61–62, 74t transformational, 70–71, 78t University of Michigan Studies, 65–66, 75t vertical dyad linkage (VDL), 69, 77t Warren’s ministry L-model, 79t leadership models, 74–80t Dynamic Culture Leadership (DCL), 134–140 27/07/17 1:08 PM 284 Index and health organization influences, 133–153 inter-professional team model (PAARP) assemble/charter, 148 clinical inter-professional skills, 149–151 perform, 151–152 responsibilities of leadership when forming group, 146–148 Omnibus Leadership Model (OLM) constructs of, 140–141 environment construct, 142 higher order construct, 141 individual culture construct, 141–142 model, 142–143 traditional tools for measuring leadership, 143–144 Leading Change: Why Transformation Efforts Fail (article), 261 learning, 55 See also competence and competency development; knowing employee involvement and motivation, 96 sensemaking, 54–55 uncertainty reduction and absorption, 54 “learning how to learn,” learning organizations, 260 learning–based organization culture, 218 least preferred co-worker (LPC), 66, 67 legal authority, 29–30 legitimate authority political games and, 118–120 types of, 29–30 legitimate power, 115, 117t political games and, 118–120 Leiter, M.P., 178 Lemieux-Charles, L typology of healthcare teams, 101 length of stay, 108 lesbian, gay, bisexual, transgender, and queer (LGBTQ) community, 195 managing diversity, inclusion and health equity in, 194 Level leaders, by Collins, 182 9781284109825_IDXx_Print.indd 284 levels of learning, 4–5 The Leverage Network Inc (TLN), 188 Lewin, Kurt, 254 LGBTQ (lesbian, gay, bisexual, transgender, and queer community), 194–195 life scripts, domain of CCM, 149 life stages of organizations See population ecology limited information (knowability), 50–51 making decisions with, 32 sensemaking, 54–55 uncertainty reduction and absorption, 54 line vs staff (political game), 119 Linsky, Marty, 72 listening, 166–167 LMX (leader-member exchange) theory, 69 Locke, Edwin, 150 long term risks, 216 loose coupling in organizations, 159 lording (political game), 119 Lorsch, J.W., 37–38 See also contingency theory low-status context, 166 lower level learning, loyalty, 71 duty of, 237 honor, as basic desire, 91t LPC (least preferred co-worker), 66, 67 Lunenburg, F.C., 88 M Maccoby, Michael, psychoanalytic model of leadership, 71–72, 75t Makary, M., 222 “make it safe,” in teaming, 103 malevolence, 143t management behavior during conflicts, 126, 127b Yukl taxonomy of, 128 competences, differentiating leadership and, 226 by exception, 71 governing boards and senior, 234–235, 237, 241–243 in postmodernist complex adaptive systems, 54–57 teams for, 101 managerial and strategic leadership model, 79t managerial conflict, 124 managerial grid, 66, 75t managers, comparison of physicians and, 223t Managing Human Behavior in Public and Nonprofit Organizations (book), 123 March, J.G., 24, 26, 32 See also administrative behavior marketplace, 203 Maslach, C., 178 Maslow’s theory of motivation, 86–87, 86f, 95 Masterson, J.T individualistic vs collectivistic assumptions from, 165t mastery, 93 maturity, of subordinates, 69 Mayo, Elton, 31 McClelland, D.C acquired needs model of motivation, 90f application of conceptual model, 19f McDaniel, Ruben, on complexity theory, 50 McGregor’s leadership theories, 62–63, 74t meaning through communication, 163, 262 measurement tools, for leadership, 143–144, 144–145t measures, 14 baseline, 18 code sheets, 15 operationalizing, 14–15 quality of care, 242 mechanical approach to organizations, 24 mechanization, of people, 26 media richness theory (MRT), 149, 164 medical affairs committee, hospital, 235, 242 medical errors, 222 medical staff bylaws, 242 medical technology factor, 49t 27/07/17 1:08 PM Index Medicare Access and CHIP Reauthorization Act (MACRA), 222 Medicare Severity-Diagnosis Related Group (MS-DRG), 222 Medicare/Medicaid program, 252 meeting agenda, governing boards, 235 member skills, and experience assessment, 245 mental models, 260 messages See communication metrics, 168 Meyer, J.W., 42 Michigan leadership studies, 65–66, 75t microaggressions, 192 middle management, as death zone of radical change, 262 Mill, John Stuart, 211 Millennials, 193, 246 Miller, D., 179 mimetic behavior, 43 minorities, 203 Minority Trustee Candidate Registry (AHA), 189 Mintzberg’s political games, 120f alliance-building, 118 budgeting, 119 counter-insurgency, 118 empire-building, 119 expertise, 119 insurgency, 118 line vs staff, 119 lording, 119 rival camps, 119 sponsorship, 118 strategic candidates, 119 whistle-blowing, 119 young turks, 119–120 misconception, 197 mission–based organization culture, 218 mission/vision statements, of organization, 219 mitigation of confusion, 272 to disaster, 271, 271f of fear and panic, 272 model building, 10 models, changing board, 243 modern theories, of organization, 35–45 contingency theory, 37–38 9781284109825_IDXx_Print.indd 285 general systems theory, 36–37 institutional theory, 41–43 population ecology, 43–44 postmodern complexity vs., 50 resource dependence theory, 40–41 transaction cost economics (TCE), 38–40 modern trait theory, 62 mono-chronic time (M-time), 130 cultures, 166 Mooney, J.D., 28 “moral person” aspect, 215 moral psychology, 210 moral reasoning, 213 morality, 212, 214 Moran, P., 40 Morgan, G., 26 Morrison, Ian, 270 mortality, 108 motivation, and human behavior, 85–97 basic needs theory, 90, 90f changes in, 95 cognitive evaluation theory, 89 cultural factors, 96 ERG theory, 88, 88f expectancy theory, 88 and learning, 95–97 cultural diversity and motivation, 96–97 employee involvement in, 96 impact of age and cultural factors on motivation, 96 organismic integration theory (OIT), 89–90 and regulation flowchart, 90f self-determination theory (SDT), 88 theories of, 86–90 Deci’s theory of motivation, 88–89 Herzberg’s theory, 87–88 Maslow’s theory, 86–87, 86f, 95 Reiss’s theory, 90 in work environment, 90–95 job satisfaction, 94–95 workplace theories, 91–94 Motivation of Work, The (book), 87 motivators (Herzberg’s theory), 87–88 Mouton’s managerial grid, 66 Muchinsky, Paul, 91 myths, rationalized, 42 285 N National Cancer Institute (NCI), 48 statement on systems thinking, 49b National Clinician Scholars Program, 229 natural biological selection See population ecology natural law, 210 “nature vs nurture” debate, 140 needs, 88 hierarchy of (Maslow), 86–87, 86f negative feedback, motivation and, 89, 96 negative hypothesis, 18 negotiation, process of, 126 neighborhood, 200 Nelson, W.A proposal for decision making and ethical reasoning, 214–215 neoclassical economic theory, 157 nervousness, conceptual model of, 16f neurotic organizations, 179–180 newbie status, in organization, 216 newness, as liability, 44 Nightingale, Florence, 180 nominating committee, governing board, 234 non-routine problem solving, 32 nonlinear interdependencies, 57 non–maleficence, 212 nonparticipating leaders, in team, 108 nonprofit organizations, 248–249 nonverbal communication, 130, 163 normative decision theory, 68–69, 77t normative element of institutions, 42 normative ethics, 210 normative isomorphism, 43 norming (in group formation), 101, 148 null hypothesis, 17 nurses, subculture of, 177 nursing leadership, 227–228 nursing workforce, 246 O obedience, duty of, 237 objective outcomes, 107, 107t occupancy rates, 170 27/07/17 1:08 PM 286 Index OD (organization development), and crisis management in health organizations, 268–273 officers, governing board, 233 Ohio State leadership studies, 74t consideration, 64–65, 65t OIT (organismic integration theory), 89–90 OLM See Omnibus Leadership Model Omnibus Leadership Model (OLM), 134, 143f, 143t constructs of, 140–141 environment construct, 142 higher order construct, 141 individual culture construct, 141–142 model, 142–143 open communication, 105 open-systems theories of organization, 36, 37, 44 operating oversight by governing boards, 239 operational model, 134 operational performance, 239 operational structures, hospital governance and, 242f operationalized age variable, 14t operationalizing measures, 14–15 See also measures; variables opportunistic behavior, 38–40 optimization of decision making, 160–161 optimized leadership, 135 orchestrated organizational decline, 179 order, as basic desire, 91t organismic integration theory (OIT), 89–90 organization citizenship behavior (OCB), 20 changing, 259–260 organization, desire for See order, as basic desire organization development (OD), 252, 253–257 ancient examples of, in changing world, 269–272 disaster preparedness and crisis management, 271 managing workforce complexity and globalization, 270 9781284109825_IDXx_Print.indd 286 sustainable organizations, 270 values renewal, 270 and crisis management in health organizations, 268–273 framework for change, 253–257 and change management, 253 change models, 254–257 defining change, 253–254 health care’s changing environment, 253 practice and philosophy, 269 Organization for Economic Cooperation Development (OECD), 222 organization politics, 114, 118–120 organization theories classical theories, 23–34 administrative behavior, 32–33 administrative principles, 26–28 bureaucratic principles, 28–30 human relations, 30–32 postmodern complexity vs., 47 scientific management, 24–26 classification of, 24 leadership, 59–80 chronological review of theory, 61–63 defining, 60–61 phase, 63–73 modern theories, 35–45 contingency theory, 37–38, 42 general systems theory, 36–37 institutional theory, 41–43 population ecology, 43–44 postmodern complexity vs., 50 resource dependence theory, 40–41 transaction cost economics (TCE), 38–40 organization-wide respect, 201 organizational analysis, organizational behavior See power organizational change failure rates of planned, 259 framework for change, 253–257 organizational development, 253–257 and sustainability in health organizations, 251–266 organizational conflict See conflicts organizational coupling, 159 organizational culture, 216 See also cultural factors ambiguity and conflict, 178–179 See also conflicts groups and teams See group dynamics management and dysfunction of, 179–181 organizational decline, 179 pathology and dysfunction in, 175–184 physicians as subculture, 176–177 treatment and prognosis, 182–183 twelve forces influencing, 216–218 well-being, 181–182 organizational dysfunction, and management, 179–181 organizational effectiveness, 203 organizational ethics, 210, 213 organizational hierarchical roles, 226 organizational improvisation, 271 organizational mission, 216 organizational performance See performance, group organizational preparedness, 271 organizational structure, 216 organizational sustainability, 263–264 organizational theories, 9–21 organizational values, 270 Orlikoff, J., 248 out-group of subordinates, 69 out-of-the box thinking, 197 oversight, decisions by, 160 Oxford Handbook of Organizational Well-Being, 181 P Pablo, A.L., 159 paranoid organizations, 179 partial competence in leadership, 176 participation in decision making, 158 participative leadership, 68, 69 Pascal Metrics, 222 passive management, by exception, 71 path-goal leadership theory, 68, 76t, 141 pathology, in health organizations, 175–184 27/07/17 1:08 PM Index patient care quality, 241–243 patient-centered communication, 194 Patient Rights and Organizational Ethics, 213 patients, 170 satisfaction surveys, 170 pay-for-performance (P4P), 225 people -oriented physicians, 178 two dichotomous assumptions about, 62–63 perceived behavioral control, 147 performance assessment, 245 effective team, 101 of individual tasks See scientific management monitoring by governing boards, 239 phase of PAARP, 151–152 performance, group See also teams burnout and understaffing, 178 group phenomenon and, 110 leadership and See also leadership contingency theory, 66–68 managerial grid, 66 Ohio State leadership studies, 64–65 situational theory, 69–70 performing (in group formation), 101, 148 Perrow, C., 24, 26, 39–40 personal beliefs, 92 personal health, 218 personal mastery, 260 personal satisfaction job satisfaction, 94–95 motivation and See individual motivation within teams and groups, 106 personality, 138 and organization theory, 75t perspectives, integration of multiple, 56 Pfeffer, J., 40–41 See also resource dependence theory physical activity, as basic desire, 91t physical work setting, 217 physicians/clinicians case for leadership, 222 comparison of managers and, 223t effective leadership and pitfalls, 225–226 9781284109825_IDXx_Print.indd 287 future leaders, 229 integration beginning from 1990, 224 interdisciplinary education and practice, 228–229 interpersonal leadership behaviors, 227 to leader, from, 227 leadership in health organizations, 221–229 leadership training programs, 227 nursing leadership, 227–228 separation of power, 223–224 as stakeholders, 176–177 values and accountabilities, 224–225 physiological needs, 87, 90 physiology, of theory hypothesis, 17–18, 18f propositions, 16–17, 17f research questions, 18–19 theoretical application, 19–20 Pillars of Institutions, 42 Pink, Daniel H., 92 pioneers style, of leadership, 73 planning, importance of, 55–56, 272, 273b plant systems, 37 Plato, 10, 210 playing politics, elements of, 118 PM (postmodernism) See postmodernism and complexity science polarization, group, 110 policies, 93 politics, in health organizations power and, 113–121 poly-chronic time (P-time), 130 cultures, 166 poor decision making, in team, 108 population ecology, 43–44 population health management (PHM), 170–171 populations, 170–171 “POSDCORB” acronym, 28 position power, 67 positive feedback, motivation and, 89, 96 positive hypothesis, 17 postmodernism and complexity science, 47–57 complex adaptive systems characteristics of, 52–54, 53b 287 managing healthcare organizations as, 54–57 similarities of, 50–52 potential, creating and releasing, 56–57 Powell, J self-disclosure levels, 129, 129b power, 52, 113–121 as basic desire, 91t cultural differences in, 166 of leadership position, 66 need for, 90 organizational politics, 114, 118–120 and politics in health organizations, 113–121 sources of, 114–117, 117f, 117t individual based, 115–116 structural based, 116 Practice of Adaptive Leadership, The (book), 72 pragmatics, 151 pre-planning, 157 prejudice, impact of, 192 preparedness to disaster, 271, 271f organizational, 271 plan for health systems, 273b prestige See status, as basic desire Principle of Double Effect, 211 problem orientation (communication), 165 problem solving, conflict management style, 126b getting to yes and ultimate agreement, 126, 127b in postmodernist complex adaptive systems, 55 routine vs non-routine, 32 processes, 171–172 improvement team, 102 skills, 213 production orientated leadership, 65 productivity, 30 motivation and See individual motivation satisfaction and, 94 professional advocacy hypothesis, 187 professional development See competence and competency development professional life, recognition of, 216 professional organizations, 20 27/07/17 1:08 PM 288 Index proficiencies See competence and competency development profitability, 168–170, 169 project team, 101–102 propositions, 16–17, 17f provisionalism, in language, 165 psychoanalytic model of leadership, 71–72, 75t psychological needs, 90 Psychological Review (Journal), 86 Psychology Applied to Work, 91 Psychology of Self-Determination, The, 88 public accountability and reporting, 243 Public Company Accounting Reform and Investor Protection Act See SarbanesOxley Act (SOX) public health, 218 punishment See feedback purpose, 93 in groups See roles, in teams and groups Q qualitative methods for making decisions, 156, 162 quality of care, 242 committee, governing board, 234–235, 242 of communication, 163 as construct, 13 of decisions, 69 improvement, 101, 242–243, 264 quantitative methods for making decisions, 156, 161–162 quantum leadership, 73 questions See research questions Quinn, Robert, 259 R race See cultural factors racial discrimination, 189 racial diversity, 194 rational (legal) authority, 29 rational decision making, 69, 156 9781284109825_IDXx_Print.indd 288 rationale challenging, 216 expose faulty either/or thinking, 216 rationalized myths, 42 Rawls, John, 211 reflective equilibrium, 213–214, 214f reaction to crisis, 138 readiness, 69–70 readmissions, of patients, 170 reality, 157 reality-based models garbage can model, 158–161 reasonable accommodation, 196 reasoning ability, 228 “recognize the background,” 214 recognizing style, of leadership, 226 recovery from disaster, 271, 271f recruitment, and retention, 201 reducing uncertainty, 54 referent power, 115–116, 117t reframing, in teaming, 103 regulation of motivation, 95 regulative element of institutions, 42 reinforcement theory, 92, 94 reinforcing mechanisms, 138–139 Reiss’s theory of motivation, 90 relatedness, need for, 88, 90 relational behavior, 69 relationships See also human relations cooperative and interpersonal, 31–32 domain of CCM, 149 factors to strengthen, 129–130 importance of, 51 in-groups and out-groups, 69 interconnections in complex adaptive systems, 53b leader-member relations, 69 exchange theory (LMX), 69 motivation and relatedness, 89 power and politics See power for resource control, 41 social contact, as basic desire, 91t between variables, testing See hypothesis releasing potential, 56–57 representation, 187 res ipsa loquitur (thing speaks for itself), 142 research questions, 18–19 “resistance to change,” 252 resolution, decisions by, 160 resolving conflict See conflicts resolving dilemmas See problem solving resource availability resource power, 116, 117t for willful decision making, 157 resource dependence theory, 40–41 institutional theory vs., 42 resources, 142 inadequate, 197 utilization, 243 respect, 71 desire for acceptance, 91t in teams and groups, 105 response capacity, 272 determining options for, 214 to disaster, 271, 271f recommending, 214 responsibility, risky shift, 110 results-based leadership, 80t revenge, desire for, 91t revenue cycle management, in healthcare organizations, 169–170 rewards, 115, 117t expectancy theory, 94 House’s path-goal model, 68 and punishment, 216 “the right to bear arms” propositional statement, 17, 17f risky shift, 110 rituals, 217 of decision making, 159 rival camps (political game), 119 Roadmap for Hospitals (document), 194 Robert, Kelly, 151 Robert Wood Johnson University Hospital, 193 role modeling, 139 roles receiver/sender, 104 and responsibilities, 150 in teams and groups, 104 cohesion and, 106 conflicts among, 105–106 leaders See leadership relationships See interpersonal relationships Roman Empire, romance, as basic desire, 91t 27/07/17 1:08 PM Index Rothwell, William, 255 change process model, 256f routine problem solving, 32 Ruderman, Jay, 197 “rule of thumb” standards, 25, 26 S sadism, 143t safety needs, 87 Salancik, G., 40–41 See also resource dependence theory Samaritanism, 218 Samuel, Yitzhak, 179 Santa Fe Institute, 50 Sarbanes-Oxley Act (SOX), 240 SARFIT (structural adaptation to regain fit) model, 38 satisfaction job, 94–95 leadership and See leadership motivation and See individual motivation within teams and groups, 106 saving, as basic desire, 91t Schein, E.H., 138–139 schizoid organizations, 180 science, leadership as, 61 scientific management, 24–26 as physiological organization theory, 26 Taylor principles of, 25 Scott, W.R., 26 rational models to natural models, 36 Three Pillars of Institutions, 42 SDT (self-determination theory), 88, 95 self-actualization needs, 87, 95 self-confidence See competence and competency development; confidence self-containment, 28 self-determination theory (SDT), 88, 95 self-directed team, 102 self-disclosure, 129 Powell’s levels of, 129b self-esteem, 87, 95 self-organization of complex adaptive systems, 53b self-reflection, 192 9781284109825_IDXx_Print.indd 289 self-regulation of motivation, 95 self-reliance See independence, as basic desire self-serving goals, 157 self-understanding, 71 Senge, Peter, 261 senior management and governing boards, 237, 241–243 sensemaking in postmodern complex adaptive systems, 54–55 sensitivity, 105 servant leadership, 182 characteristics of, 72b principles of, 71 service delivery factor, 49t service patterns hypothesis, 186 service population, reflection of, 201 shared tacit assumptions, 219 shared vision, 226, 260 “sheep” people, 151 Shiver, J., 100 Shortell, S., 252, 259 significant learning, taxonomy of, 5–6 similarity, of groups/teams, 106 Simon, H., 24, 26, 32 See also administrative behavior theory of hierarchical goals, 33 sincerity, 129 Sitkin, S.B., 159 situational favorableness, 67 situational leadership theory (SLT), 69 situational updates, 124 situational variables, 68 six-step model, of decision making, 157 size, of groups/teams, 106 skills development See competence and competency development teamwork-related, 100 theory of leadership, 66 SLT (situational leadership theory), 69 small group discussions, SMART mnemonic, 147 Smith, B.E., 193 social contact, as basic desire, 91t social control of work, 31 social determinants of health (SDOH), 199, 200f social exchange theory, 123–124 social facilitation, 110 289 social justice See idealism, as basic desire social loafing, 110 social needs, 87 social responsibility, 258, 264, 270 See also value systems ambiguous and conflicting cultures, 178–179 social status, as basic desire, 91t social systems, 37 socialization, 105 societal values, 270 Society for Human Resource Management, 191 sociopathy, 180 SOX (Sarbanes-Oxley Act), 240 specialization, in administrative principles approach, 27 specificity of assets, 39 speech, domain of CCM, 149 sponsorship (political game), 119 spontaneity in language, 165 sports physical activity, as basic desire, 91t stability, of groups/teams, 106 stakeholders, in health organization, 257, 258 ambiguous and conflicting cultures, 178–179 limited authority over, 176 teams and groups, 104 theory, 212 standardized decisions, 161 standards of care, obedience, and loyalty, 237 star followers, 151 status as basic desire, 91t cultural differences in, 166 stereotypes, 192 stewardship, 71 stockpiling resources, 41 Stogdill, R.M Ohio State leadership studies, 64–65, 74t successful leader traits and skills, 62, 63t Stoll, C.G., 30 stories and legends, 139, 218 storming (in group formation), 100, 148 strategic candidates (political game), 119 27/07/17 1:08 PM 290 Index strategic oversight, by governing boards, 235, 239–241 strategic planning, governing boards and, 235, 239–241 strategic vision, 226 strategy language, 165 stress tranquility, as basic desire, 91t Structural Adaptation to Regain Fit model See SARFIT model structural-based power, 116 structural inertia, 44 structure as dynamic, 51–52 studying organizations competency development, 6–7 experiential learning, higher-level thinking, 4–6 integrative learning, 7–8 style of leadership, 67, 73 subcultures, in health organizations, 176–177 subjective norms, 147 subjective outcomes, 107, 107t subordinate characteristics, 68 Success Paradigm, The (book), 139, 264 Sullivan, Roland, 255 change process model, 256f Sun Tzu, 182 superiority in language, 165 support, to groups/teams, 106 supportive behavior, 69 supportive leadership, 68 guidelines for, 131, 131b surveys, 262 sustainability, 210 critical success factors (CSFs) for organizational and systems, 265t in health systems, 266b organizational, 263–264 and organizational change in health organizations, 251–266 sustainable organizations, 270 symbolic rituals of decision making, 159 symbols, 217 Syndemics Prevention Network, 48 synthesis, system complexity, 36, 47–57, 177–178 population ecology and, 44 postmodern complex adaptive systems 9781284109825_IDXx_Print.indd 290 characteristics of, 52–54, 53b managing healthcare organizations as, 54–57 systems defined, 36 diversity, 191 theory, 123 thinking, 48, 260–261 statement of National Cancer Institute (NCI), 49b typology of Boulding, 36–37 T Takahashi, N., 159 tangibles, 259–260, 260f task characteristics, 68 task complexity, in goal setting, 147 task division and coordination See administrative principles task force team, 102 task performance See scientific management task structure, 67 tautology, 13 tax-supported government programs, 218 Taylor, Frederick W., 24, 32 See also scientific management Taylor, Robert, 226 Taylorism, 25 TCE See transaction cost economics team effectiveness common barriers and negative outcomes, 108–110 common outcome measures, 107t states knowledge about, 106–108 team training, evaluation and research, 108 Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) program, 108, 109f teams, 101–102 See also group dynamics defining, 100 diversity and trust, 104–105 formation of, 100–101 and group dynamics in health organizations, 99–111 group phenomenon, 110 in healthcare, 101–104 learning, 260 managerial grid, 66 performance and effectiveness, group phenomenon, 110 roles in teams and groups, 104 cohesion and, 106 conflicts among, 105–106 leaders See leadership relationships See interpersonal relationships socialization, role conflict and group cohesion, 104–106 technology listening and, 166–167 oriented physicians, 178 temporal orientation, 130 terrorism, 271 testing relationships between variables See hypothesis theoretical creep, 140 theories anatomy of, 13–16 application of, 19–20 defined, 10–13 falsification of, 18 physiology of, 16–20 scope of, 10 theories, specific basic needs theory, 90 cognitive evaluation theory, 89 ERG theory, 88, 88f expectancy theory, 88 of leadership, 59–80 behavior theories, 63–73 chronological review of theory, 61–63 contingency and situational theories, 66–70 defining, 60–61 great man and trait theories, 61–62 phases of, 63–73 of motivation, 86–90 Deci’s theory, 88–89 Herzberg’s theory, 87–88 Maslow’s theory, 86–87, 86f, 95 Reiss’s theory, 90 organismic integration theory (OIT), 89–90 of organization (classical), 23–34 administrative behavior, 32–33 27/07/17 1:08 PM Index administrative principles, 26–28 bureaucratic principles, 28–30 human relations, 30–32 postmodern complexity vs., 47 scientific management, 24–26 of organization (modern), 35–45 contingency theory, 37–38, 41 general systems theory, 36–37 institutional theory, 41–43 population ecology, 43–44 postmodern complexity vs., 50 resource dependence theory, 40–41 transaction cost economics (TCE), 38–40 of organization (postmodern) See postmodernism and complexity science SARFIT model, 38 self-determination theory (SDT), 88 “theory building” methodology, 143–144 Theory of Human Motivation, A (article), 86 theory of planned behavior (TPB), 147, 147f “theory testing” methodology, 144 thermostat (cybernetic) systems, 37 Thomas, R Roosevelt, 191 Three Pillars of Institutions, 42 360-degree self-assessment, 134 tight coupling in organizations, 159 time -sensitive communication, 124 decision-making and, 69 in different cultures, 166 management, 272 “time is endless” propositional statement, 16, 17f Total Performance Score (TPS), 222 total quality management (TQM), 253, 258 Toward a Theory of Task Motivation and Incentives (book), 150 traditional authority, 29 traditionalists, 193 training See also competence and competency development; learning and education, 216–217 trait theory, 61–62, 74t tranquility, as basic desire, 91t 9781284109825_IDXx_Print.indd 291 transaction cost economics (TCE), 38–40 transactional leadership, 70 transcendental leadership, 37, 73 transformational change, 254, 259, 263 transformational leadership, 70–71 transhuman (AI) leadership, 73 transient teams, 101 transitional change, 254, 264 transparency, 124 triangulation methods, for making decisions, 156, 162 triple bottom line method, 264, 264f, 270 Trochim, W.M., 50 trust, 71, 129 See also conflicts in healthcare hypothesis, 187 teams and groups, 105 trustees, 233 See also governing boards Two-Factor Theory, 87–88 U uncertainty communication and, 164 in decision making, 158 mimetic behavior and, 43 reduction and absorption of, 54 uncontrollable organizational decline, 179 underrepresented minority (URM), 186 undiscovered organizational decline, 179 unethical behavior, in workplace, 215 unexpected events, responding to, 56 uninsured adults, 222 United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD), 196 United States (US) Department of Labor, 197 and workforce diversity, 186–190 unity of command principle, 27 University of Michigan studies (1950), 65–66, 75t unpredictable changes, 253 291 Unterberg, Mark, 180 urgency, 228 Urwick, L., 27–28 utilitarianism, 211 V valence, 68, 88 value systems, 149, 270 See also organizational culture ambiguous and conflicting cultures, 178–179 subcultures in healthcare organizations, 176–177 in transactional leadership, 70 variables, 13–14 confounders, 12, 16 contextual factors See contextual factors contingency See contingency theory operationalized descriptions of See measures testable relationship between See hypothesis VDL (vertical dyad linkage), 69, 77t vengeance, as basic desire, 91t veracity, 124, 129 vertical dyad linkage (VDL), 69, 77t Virgin Mary, as religious artifacts, 219 virtual teams, 102 virtue ethics, 210 vision, 226, 264 voluntary charity, 218 von Bertalanffy, Ludwig, 36 See also general systems theory Vroom, V.P., 88 expectancy motivation theory, 68 normative decision theory, 68, 77t vulnerability, 105 W Warren’s ministry L-model, 79t Weber, Max See bureaucratic principles whistle-blowing (political game), 119 whitewater changes, 253, 257, 258, 264 27/07/17 1:08 PM 292 Index willful choice models for decision making, 156–157 criticism of, 157 Williamson, O.E., 38–39 See also transaction cost economics (TCE) Witt/Kieffer healthcare, 202 Wolf, Martin, 88 Woods Johnson Foundation and Pew Charitable Trust, 259 Word Health Organization (WHO), 264 words, 93 cliques, 31 work environment, motivation in, 90–95 See also individual motivation Deci’s theory, 88–89 9781284109825_IDXx_Print.indd 292 Herzberg’s theory, 87 job satisfaction, 94–95 Maslow’s theory, 87 workplace theories, 91–94 work intensity, 177–178 worker-supervisor relationship, 252 workforce diversity, 186–190, 191 managing complexity and globalization, 270 training, 271–272 utilization, 201 work–life balance, 201 workplace aging in, 198 conflict, 123 disability and, 195–197 theories, 91–94 World Health Organization (WHO), 196, 249 about systems thinking, 49 World Report on Disability, 196 recommendations, 197 Y “yes-people,” 151 Yetton, P.W normative decision theory, 68, 77t young turks (political game), 119–120 Yukl, G., 68 taxonomy of managerial behaviors, 128, 131b 27/07/17 1:08 PM .. .Health Organizations SECOND EDITION Theory, Behavior, and Development James A Johnson, PhD, MPA, MSc Professor, School of Health Sciences Central Michigan University... to the first and second editions of this book, along with the many students who have used the text and provided valuable feedback and input leading to improvements in the second edition Lastly,... theorists, and health professionals who continue the advancement of our understanding of organizations in healthcare, public health, and the myriad related entities involved in health improvement