Chapter 1

Hospital Administration

Objectives: At the end of the topic, the student should be able to do the following:

1. Define hospital administration.

2. Describe the history of hospital administration.
3. Describe the role of healthcare professionals in the delivery of healthcare services.
4. Discuss how does the hospital industry differs from other industries.
5. Discuss the classification of hospitals according to objectives, ownership, and level
of care.
6. Enumerate the hospital services.

The very first requirement in a hospital is that it should do the sick no harm. –Florence
Nightingale

Patient care is the central purpose of any healthcare organization. Excellent care to
every patient is often stated as the hospital’s main objective. Hospitals provide care in a
variety of inpatient and outpatient settings using their strength to meet patient needs.
Many hospitals now expand their mission to “sustaining population health,” a substantially
broader mission seeking the World Health Organization’s (WHO) goal: “a state of
complete physical and social well-being and not merely the absence of disease or
infirmity.”

Population health includes:

1. Excellence in care to individual patients, including preventive care.
2. Fulfillment of needs that go beyond healthcare- the housing, food, and social support
that is essential to sustaining health and managing chronic disease.
3. Meeting the needs of people who are not patients helps them stay well and avoid
becoming patients.

Hospitals that utilize most of the health budget play a very important role in the
country’s health system. A hospital administrator must be well aware of the scientific
methods to run and evaluate the hospital functions and services objectively.
 The radiologic technologists should have a good understanding of hospital
organization and management for better care of their patients. Moreover, they should also
have enough knowledge for the management of human, material, and financial resources
in a cost-effective way with an optimum time approach. Hospitals are among the most
complex organizations in modern society. The modern hospital itself is a universe, with a
variety of objectives, and a scalar division of labor to achieve those objectives.

Definition of Hospital

The older concept of a hospital for the provision of curative care is not valid
anymore. A hospital’s role is not only in the provision of curative care, but an equally
important role is the promotion of preventive and promotion of healthcare.

A WHO expert committee on organization of healthcare defined hospitals as

follows:

“The hospital is an integral part of the social and medical organization, the function
of which is to provide for the population, complete health care, both curative and
preventive, and, whose outpatient services reach out to the family and its home
environment; the hospital is also center for the training of health workers and social
research”.

Preventive and promotion efforts should be so effective that, the people should
have optimum health with a minimum need for curative consultation, and even less for
the hospital admission. WHO, UNICEF, and NGOs worked together to change the role of
hospitals working in isolation, to involve primary healthcare. It started providing basic as
well as referral services. It integrated preventive and curative healthcare, through primary
health care centers.

History of Hospital Development

The word hospital is an Italian word derived from hospitality meaning to be a guest.
It is represented by staff and serpent. The staff represents patient while the serpent
represents caring off. Hospitals were not always taken in high esteem. The initial hospitals
were in almshouses in America, away from the city, and were used to keep the people
from infectious diseases.
 Generic insignia for a hospital.

The Hospital as Healthcare Institution

Some health issues require escalated medical treatment and individual

consideration, not available in the patient’s home or a medical clinic. This is conceivable
only in a hospital where an enormous number of medical experts apply their knowledge
and skills with cutting-edge facilities.

Below are several objectives of hospitals:

1. Provide optimum health services

2. Provide care, cure, and preventive service
3. Protect the human rights of clients
4. Provide training for professionals
5. Provide in-service and continuing education in all discipline
6. Participate and conduct research
 The basic function of a hospital is to provide treatment to the injured and sick without
having any social, economic, or racial discrimination. Photo by: Pixabay

The role of the hospital is not only in the provision of curative and preventive care,
but also to promote health care. One of the important roles of hospital administrators is
to occupy this role.

Hospital administration is the term used to denote the entire operation of the
hospital as a business. The administration is composed of medical and health service
managers. Administrations range in size, and the duties of the administrator vary with the
size and complexity of the hospital. The hospital administration incorporates services and
products dedicated to improving the health of individuals which includes health care
equipment, medical services, pharmaceuticals, biotechnology, and research.

High-performing healthcare systems are critical to addressing key health challenges

faced by hospital administrators. The delivery of modern healthcare depends on the
expanding group of competent professionals working as an interdisciplinary team.

Today, the hospital is the place for the diagnosis and treatment of human illnesses
and the restoration of health and well-being. The basic function of a hospital is to give
treatment to the injured and sick without having any social, financial, or racial
discrimination. Some other significant functions and services of modern hospitals are
preparing healthcare professionals, upholding clinical research, and helping all activities
provided by the government and other non-government organizations to prevent
diseases.
The Hospital as Distinct from Other Industries

Hospitals and other medical service associations are regularly depicted as unique,
or at least different from other types of organizations, like industrial organizations. These
distinctions are felt to be significant in the management of hospitals. Below are the
highlights of the hospital which makes it different from other industries.

 Defining and measuring output is difficult.

 The work involved is felt to be more highly variable and complex than in other
organizations.
 Much of the work is of an urgent and non-deferrable nature.
 The work permits little tolerance for ambiguity or error.
 Activities are highly interdependent, requiring a high degree of coordination among
diverse professional groups.
 The work involves an extremely high degree of specialization.
 Hospital personnel are highly professionalized and their primary loyalty belongs to the
profession rather than to the organization.
 There exists little effective organizational or managerial control over the group most
responsible for generating work and expenditures; physicians and surgeons.

The Hospital Industry

The hospital as a service industry is entitled to provide patients with quality

healthcare. Therefore, a hospital has the following characteristics:

1. Intangibility

Health services are highly intangible which implies they cannot be tested or examined
before consumption. The intangibility factor can be compensated by physical
evidence like the place, people, communication, and price that patients can see. A
hospital with clean and neat corridors, good customer service, advanced medical
equipment, and competent healthcare professionals play an important role in a
patient’s preference.

2. Variability

Health services are subject to a degree of variability. There are variations in services
performance offered by the provider’s employees depending on skills, customer
service, etc. as the service offered by the hospitals is highly judgmental and
 individualized. The variations in service also depend on the affordability of the patient
and the reputation of the hospital.

3. Quality of Healthcare Service

Verbal exchange is the best publicity and it assumes an important function in setting
the foundation of ascertaining service quality. Patients who are happy with a service
delivered by the hospital can bring several patients to that hospital than advertising.

Functions of Hospital

Personal health services are the services provided by hospitals, health centers,
and nursing homes, apart from privately practicing physicians.

The care provided has been traditionally classified into the:

1. promotion of health,
2. prevention of disease,
3. early diagnosis and treatments,
4. rehabilitation,
5. research, and
6. health education

Promotion of Health

Good well-being practices promote health through adequate nourishment,

exercise, rest, personal individual cleanliness, well-being screening, and education.
Healthcare professionals are concerned with the advancement of health. The healthcare
professionals and the patient work together to successfully advance health as well as
illness care.

Prevention of Disease

Primary prevention is an assistance to ensure against specific infections through

vaccination, use of specific supplements, and protection against work hazards and
accidents. All diagnostic and therapeutic activity has a preventive component in that it
seeks to prevent further deterioration of a patient’s health. Health screening, yearly
clinical assessments and monitoring of the patient with susceptibility to specific diseases
fall under secondary prevention. It is sensible to expect that by preventing infection to the
extent possible, the number of patients looking at clinical considerations can be
decreased and subsequently control overall health care costs.

Early Diagnosis and Treatment

The earlier a disease is diagnosed and treated, the better the prognosis. The
standard of early detection and treatment of cases in the general population is the premise
on which infection control is built. A good deal of early diagnosis now comes through
hospital-based screening and periodical clinical consultation among healthy people.
Diagnostic and treatment services can be made available through ambulatory outpatient
or inpatient hospital care. The idea of a place for clinical treatment consolidates health
centers, well-being support organizations, home care services, and hospitals.

Rehabilitation

WHO defines rehabilitation as ‘the combination and coordinated use of medical,

social, educational, and vocational measures for training or retraining the individual to the
highest possible level of functional ability. Apart from the restoration of functions,
rehabilitation medicine involves disciplines such as physical medicine, occupational
therapy, speech therapy, education, and vocational guidance. Rehabilitation, thus, must
start early in the process of medical treatment.

Research

Research is an integral part of hospital services. It is by

this means that most of the advances in the medical sciences have been achieved. Good
training regarding research principles followed by the application of the same in a real-life
situation helps in discoveries.

Health Education

Health education means providing information to people to change their behavior

in a positive direction. This is the most neglected service, though the most important one.
This is the most important way of preventing diseases and promoting health in the
community when a patient and his attendants seek care, they are very receptive to the
information about the problem. Useful information can be provided through a wellness
clinic, diabetes center, vaccination center, etc.

Classification of Hospital
Hospitals are classified according to:
1. Objectives
2. Ownership
3. Bed Capacity
4. Level of Care

According to Objectives

a. Teaching cum Research Hospital

These hospitals are teaching based and healthcare is their secondary objective.
College is attached for medical, nursing, or pharmacy education. They are engaged
in promoting research activities and training for medical students. Medical colleges
are attached to these hospitals.

b. General Hospital
The main objective of these hospitals is to provide medical care. General hospitals
are meant to provide a wide range of various types of healthcare, but with limited
capacity. They care for patients with various disease conditions for both sexes to all
ages, medical, surgical, pediatrics, obstetrics, eye, and ear, etc. They also offer
teaching and research facilities but these are secondary objectives.

c. Special Hospitals
These hospitals concentrate on a particular organ of the body or a particular disease.
They limit their service to a particular condition, orthopedics, maternity, pediatrics,
geriatrics, oncology, etc. The main objective is to provide specialized medical
services.

According to Bed Capacity

a. Small Hospital – up to 100 beds
b. Medium size Hospital- more than 100 to 300 beds
c. Large Hospital- more than 300 beds

According to Ownership

a. Government Hospital
 The government or public hospitals are owned, managed, controlled by the
government, and receive government funding. This type of hospital provides free
medical care and services to the community.

The Southern Philippines Medical Center (SPMC) is the largest government hospital in
the Philippines and a premier referral center for Southern Mindanao. It is located at J.P.
Laurel Ave., Davao City. Photo by: CNN Philippines

b. Semi-Government Hospital
The semi-government hospitals are autonomous bodies. These are usually
government-owned and at the same time controlled corporate hospitals.

c. Voluntary Agencies Hospitals

They are owned and managed by voluntary organizations.

d. Private Hospitals
These hospitals are owned and managed by private individuals.

According to the Level of Care

In the Philippines, hospitals fall under 3 different levels as set out by the Department
of Health (DOH) guidelines. These are:

a. Level I
Level I is the most basic. Hospitals under this bracket don’t require intensive care
units and cater to patients who need minor care and monitoring.
b. Level II
A Level II hospital contains all the elements of Level I. It has additional facilities like
an ICU for critically ill patients and specialist doctors for other medical services.

c. Level III
A level III hospital contains all the elements of Level II with the addition of specialty
interventions like physical rehabilitation or dialysis treatment. It also offers to teach
and/or training with an accredited residency training program for physicians like
pediatrics, surgery, gynecology, pediatrics, etc.

Hospital Services

The main product of the hospital is the medical services. Services may differ from
one hospital to another. The following are the services rendered by a typical hospital.

1. Emergency Services
This type of service needs attention on a priority basis. The emergency department
is specially meant for patients having a sickness of a grave, acute, or chronic nature
requiring immediate treatment. It also serves injured patients brought by accidents or
falls.

2. Out-Patient Services
It is also known as Out-Patient Department (OPD). OPD is a part of the hospital
with allotted physical facilities and medical and other staff, with regularly scheduled
hours to provide care for patients who are not registered as inpatients. These patients
receive treatment or diagnosis but do not stay overnight.

3. In-Patient Services
After the patient is examined in the OPD or ER, they have advised admission in
the in-patient ward for monitoring or treatment, if necessary. The patient is required to
decide on his admission. The charges are different for private and general wards.

4. Intensive Care Unit

The intensive care of a hospital is usually where patients that are critically ill are
admitted. This is also meant for patients who require special treatment. There are
 machines to monitor heart rate, blood pressure, ventilators to assist the patient in
breathing, and other life-saving purposes.

5. Operation Theatres
An operating theatre is a facility within a hospital where surgical operations are
carried out in an aseptic environment. One of the important facilities that every
operating theatre needs is integration with the blood bank.

Historically, the term "operating theatre" is referred to as

tiered theater or amphitheater in which students and other spectators could watch
surgeons perform surgery. Photo by iStock.

6. Supportive Services
Sterilization, supply, and maintenance of instruments, materials, and garments
are some of the supportive services that assist the hospital services. The nutrition
and dietetics department supplies healthy meals in the hospital. Pharmaceutical
services are also important and they influence the treatment program of hospitals.

The other supportive services are:

 Hospital medication
 Official laundry
 Laboratories
 Clinical pathology
 Blood bank
 Radiology department
  Nursing Services

7. Auxiliary Services
The auxiliary services consist of:
 Registration and indoor case records
 Stores management
 Medical record-keeping
 Mortuary arrangement
 Dietary services
 Housekeeping
 Engineering and maintenance ad
 Security

8. Ambulance Services
An effective ambulance service is a part and parcel of hospital services to deal
with emergency problems and hence the provision of timely care.

9. Social Media Services

This is a neglected service. An effective social media service will help in
preventing the disease, promoting health in the community, and thus preventing
the load on hospital services

Elements of Hospital Administration

Hospital administration is keeping the hospital running efficiently, leading the

healthcare professionals who work there and managing resources. It is essential to
understand the elements of the hospital for the success of the entire operation. The
elements of hospital administration are planning, organizing, staffing, directing,
coordinating, reporting, budgeting, and supervising.

1. Planning is decision-making for future events. The process of organization implies

the arrangement of human resources in an orderly fashion to accomplish
organizational objectives.

2. Organizing involves assigning tasks, grouping tasks into departments, delegating

authority, and allocating resources across the organization.
3. Staffing is the process of recruiting personnel in the organization, by hiring the right
type and an adequate number of employees to each unit for the time required.

4. Directing means giving instructions, guiding, counseling, motivating, and leading the
staff in an organization doing work to achieve organizational goals.

5. Coordination brings different elements of complex activity or organization into a

relationship that will ensure efficiency or harmony.

6. The reporting to management is a process of providing information to enable in

judging the effectiveness of their responsibility centers, for taking corrective measures,
and to facilitate future decision-making.

7. Budgeting is the process of forecasting the amount of money required to accomplish

a task and creating a plan to spend the money efficiently.

8. Supervision refers to the day-to-day relationship between the supervisor and his
immediate subordinates. Supervision should be a positive experience that enables the
supervisor and the subordinate to develop a common understanding of how they will
work together.

Coordinating Hospital Leadership

Whether publicly or privately funded, hospitals are businesses, and they need to
operate as such. Hospital managers and other leaders must communicate frequently with
doctors, staff, and patients. All hospital leaders and managers not only oversee
administrative staff and tasks but can also play a vital role in individual patient healthcare
plans. To be effective, they should maintain an open line of communication with those
around them and also facilitate information sharing between hospital departments and
with other institutions

Transmitting Patient Data

Patient records are shared via inter and intrahospital communications. Delays in
receiving records can cost the hospital each year from unnecessary expenses. Patient
data are used to create a thorough medical history and provide appropriate medical care.
When patient data are not shared between departments or other health care
organizations, there may be much a higher chance of practice errors and subsequent
increased costs.
Sharing Research Findings

The health care industry relies on research to create and improve tools and
procedures. However, some third party-researchers- such as those who work for private
companies or pharmaceutical laboratories are reluctant to share their findings with
providers because of competitive pressures in their industries. Lack of access to the latest
research can stall medical advancement, waste funding, and negatively impact health
outcomes. For healthcare techniques to evolve, providers must implement
communication systems that allow researchers to quickly and easily collaborate, both
within the same organization and across multiple organizations.

Telemedicine Advancements

Healthcare professionals are increasingly embracing telemedicine, which involves

using a variety of internet-connected technologies to serve patients remotely. Hospitals
and other healthcare organizations use internal online networks, or intranets, to create
more efficient communication processes.

This makes patient record sharing and cross-departmental communications much

easier. What once may have been communicated via printed files and memos can now
be shared electronically within the organization and sent to other organizations.

Telemedicine goes even further by allowing patients to receive medical care and advice
from the comfort of their homes. Photo by: Pixabay
 Using state-of-the-art communication tools, patients and healthcare providers can
discuss health concerns via video conferencing which eliminates the need for the patient
to visit the provider’s office. Not only does this cut down on cost for both the provider and
the patient, but it also creates a seamless communication experience for everyone
involved.

Chapter Summary

Hospitals play a big role in the promotion of health, prevention, and treatment of
diseases. These roles make the hospital industry unique from other industries, such as
business, education, etc. The hospital as a service industry is entitled to provide patients
with quality healthcare. Access to comprehensive quality health care services is important
for promoting and maintaining health, preventing and managing diseases, reducing
unnecessary disability, and premature death, and achieving health equity for the
community.

_____________________________________________________________

The New Medical Director

Phillip is the new medical director. Three years ago, he was just a newbie physician
and has worked up to the highest level of the organization. Since he is the newly
appointed medical director, he is in the process of building his reputation and making a
good impression on the board of trustees.

A patient was rushed to the hospital for immediate treatment. He learned that the
patient is a famous and influential person and his presence makes a good impact on the
hospital which may please the board and they should make sure that the patient recovers
in their hospital for good publicity. Phillip ordered the attending physicians to give the
patient the best quality care for the patient. However, the attending physicians informed
him that the hospital is not equipped with advanced facilities which will eventually
jeopardize the patient’s condition. Phillip’s thoughts of good impression and publicity
perished.

Case Questions
1. If you were the new medical director, what will you do?
2. In the light of the given case, which is most important?

Answer the following

1. Define hospital.

2. Discuss the history of the hospital's development.

3. Discuss how hospitals are distinct from other industries.

4. Explain the role of the hospital as a healthcare institution.

5. Define rehabilitation.

6. Discuss the characteristics of hospitals.

7. What are the different functions of the hospital industry? Explain.

8. Enumerate the classification of the hospital. Discuss each classification.

9. Discuss the different hospital services.

 Chapter 2

Management

Objectives: At the end of the topic, the student should be able to do the following:

1. Discuss the concept of management.

2. Describe how management has evolved as a field of knowledge, theory, and practice.
3. Distinguish administration, management, and leadership.
4. Discuss the theories of management.
5. Discuss the importance of management in healthcare.

The first rule of management is delegation. Don’t try and do everything yourself because
you can’t. –Anthea Turner

The practice of management can be traced to the 19 th century. Although attempts

to improve it are as old as civilization, the systematic study of management is only just
more than one hundred years old. The development of management as an academic
discipline based on a body of knowledge is generally attributed to the work of Peter
Drucker in the latter half of the 20th century. That body of knowledge is taught in business
schools and programs in healthcare organizations such as hospitals and clinics. This
chapter provides a basic introduction to management and its relevance to the healthcare
industry.
 Photo by: Pixabay
Concept of Management

The process of management is relevant to all people who seek to influence the
behavior of others. Many authors who discuss management and leadership believe that
understanding the process is necessary, even though they often differ semantically when
identifying the process components. Management is the coordination and administration
of tasks to achieve a goal. Below are some common definitions of management by
famous writers:

 According to Harold Koontz, management is the art of getting things done

through people in a formally organized group.

 According to Robert L. Trewelly and M. Gene Newport, management is

defined as a process of planning, organizing, and controlling an organization’s
operations to achieve coordination of the human and material resources which is
important in the attainment of objectives.

 Kreitner defined management as the process of working with and through

others to effectively achieve organizational objectives by efficiently using limited
resources in the changing environment.

 According to Frederick Taylor, management is the art of knowing what to

do, when to do it, and seeing that is done in the best and cheapest way.

Management is the art of creating an environment in which people can perform

and individuals can operate towards the attainment of group goals. It includes the
activities of setting the strategy of an organization and coordinating the efforts of its
employees to accomplish its objectives through the application of available resources
such as financial, natural, technological, and human resources.
 Managers are judged by their organization’s performance. The way managers set
standards, coordinate, and integrate workgroups, make decisions, and design the
organization which affects performance.

To be an effective manager, one must need to develop a set of skills, including

planning, communication, organization, and leadership. An effective manager must also
need extensive knowledge of the organization’s goals and vision and how to direct
employees, sales, and other operations to accomplish them.

Management vs. Administration and Leadership

This section discusses the distinction between management and administration,

and between management and leadership. They are often used interchangeably but they
are different in several ways. For a student in management, it is important to distinguish
these terms to avoid confusion in the future because these terms are oftentimes used
simultaneously. Therefore, it is important to understand their differences to isolate each
function more effectively.

Management vs. Administration

Management and administration have two distinct functions. As defined earlier,

management can be understood as the skill of getting the work done through others.
Management performs departmental planning, organizing, staffing, and controlling.

Meanwhile, the administration is mainly responsible for the following:

(1) Formation of policies, plans, and procedures.

(2) Setting up of vision, mission, goals, and objectives.
(3) Implementing rules and regulations, etc.

Management is concerned with the day-to-day operations of the organization while

the administration lays down the fundamental framework of the organization. Meanwhile,
the administration is only concerned with the formulation of the organization’s major goals
and objectives whereas management is the body that operates to achieve those goals
and objectives by following the policies and plans formulated by the administration.
 In other words, the administration is the body that makes the policies, while the
management is the body that implements the policies set by the administration.

Management vs. Leadership

The terms management and leadership are also mistakenly used interchangeably
but these two things are somewhat different. It is important to understand that leadership
is an essential part of effective management. Ideally, managers must be effective leaders.
Leadership is defined as the potential to influence and drive the group's efforts in
accomplishing a certain goal.

A manager must have the traits of a leader. Leaders motivate and develop their
employees. Organizations require effective leadership and management for efficient
operations.

Leadership differs from management in ways that:

1. While managers delegate authority and responsibility; leaders provide direction by

inspiring and motivating the employees to achieve a certain goal.
2. While management focuses on planning, organizing, staffing, directing, and
controlling; leadership focus on listening, teamwork, building relationships, inspiring,
and motivating the employees.
3. A manager gets his authority under his position in the organization; a leader gets his
authority from his followers.
4. While a manager follows the organization’s policies and procedures; a leader follows
his instinct.
5. Management is more of a science as the managers are exact, planned, and logical.
Meanwhile, leadership is the art of achieving progress through the involvement and
actions of others.

Levels of Management

All organizations from one-person businesses to giant corporations need

managers. Small businesses may be managed by one or just a few managers. Large and
medium-sized companies may have many levels of management.

Senior Management

The highest level is known as senior management. Senior management has

several important functions. First, it establishes the goals, or objectives, of the
organization. Second, it decides how to use the organization’s resources. This level of
management usually includes the chairperson of the company’s board of directors, the
chief executive officer (CEO), the chief operating officer (COO), the chief financial officer
(CFO), and the company’s vice presidents. Senior managers are not involved in the
company’s day-to-day problems. Instead, they concentrate on setting the direction the
company will follow.

Middle Management

Middle management is responsible for meeting the goals that senior management
sets. Middle managers can include department heads and district sales managers. This
level of management sets goals for specific areas of the organization and decides what
the employees in each area must do to meet those goals. For example, senior
management might set a goal of increasing company sales by 15% in the next year. To
meet that objective, middle management might develop a new advertising campaign for
one of the organization’s products or services.

Supervisory Management

The front-line level of management is supervisory management. Supervisory

managers make sure that the day-to-day operations of the organizations run smoothly.
They are in charge of the people who physically produce the organization’s goods or
provide its service. Forepersons, team leaders, crew leaders, and store managers are all
examples of supervisory managers.

Large companies usually have three kinds of managers. These managers are
responsible for making sure that the daily operations of the store run well. Middle
managers are responsible for making sure that all store managers are performing well.
The middle manager also may suggest ideas for increasing sales, improving service, or
reducing costs within their districts. On the other hand, senior managers make decisions
about the company’s policies, products, and organizational strategy. A decision to
increase salaries throughout the company would be made by senior management, for
example.

Theories of Management

Management theories are concepts surrounding recommended management

strategies, which may include tools such as frameworks and guidelines that can be
implemented in modern organizations. Generally, managers will not rely solely on one
management theory alone, but instead, introduce several concepts from different
management theories that best suit their workforce and company culture.

For a long time, theorists have been researching the most suitable forms of
management for different work settings. This is why management theories come into play.
Although some of these theories were developed centuries ago, they still provide a stable
framework for running businesses.

Frederick Taylor (1856-1915) and Scientific Management Theory

Management began to develop as a body of knowledge more than a century ago

with the scientific management work of Frederick W. Taylor. In his work, he claimed that
management is not only made up of theory, but it is a source of knowledge from the
applications within the factory and continuously evolved. To increase productivity, Taylor
introduced the collaboration between the manager and the workmen as an essential
principle in the implementation of Taylorism. If the collaboration between the manager
and personnel working the organization is not attained, other methods and techniques
are of little use.

In the scientific management approach, production processes are broken into

small units, and employee and material movements are studied to find the most efficient
way to perform each job. These subtasks are meant to make the process more organized
and efficient, with multiple employees working on one assignment. Although the scientific
method seems to adopt the increase in production, it endeavors to solve the problems
between the manager and the workmen.

Taylor’s ideas became known as Taylorism and scientific management. This

approach to management was further developed by Frank and Lillian Gilbreth (1917) and
Henry L. Grant (1919). Gilbreth’s work included studies of surgeons, which led to creating
the surgical nurse job to assist the surgeon and the use of a tray to hold instruments.
Followers of Taylorism later realized that the best way to perform a job depended on the
worker’s experience, the work situation, and other factors. The principles of scientific
management are still used today in many organizations including the healthcare industry.

Max Weber (1864-1920) and Bureaucratic Theory of Management

According to the bureaucratic theory of Max Weber, bureaucracy is the basis for
the systematic formation of any organization and is designed to ensure efficiency and
economic effectiveness. It is an ideal model for management and its administration to
bring an organization’s power structure into focus. With these observations, he lays down
the basic principles of bureaucracy and emphasizes the division of labor, hierarchy, rules,
and impersonal relationship. He suggested an ideal model for management as a
bureaucratic approach. Weber postulated that the ideal organization was a formalized,
somewhat rigid bureaucracy that had rules everyone in the company obeyed and in which
people were given positions based on competence; clear, formal hierarchies established
chains of command for decision-making, and division of labor was in place to allow
employees to align their skills with work needs.

Weber defined bureaucracy as an organizational structure that is characterized by

many rules, standardized processes, procedures, and requirements, several desks, the
meticulous division of labor and responsibility, clear hierarchies, and professional, almost
impersonal interactions between employees. His bureaucracy theory was widely
perceived as an improvement over the nepotism, irrational behaviors, and lack of
professionalism that existed in organizations during that time.

Henri Fayol (1841-1925) and Administrative Theory

Another early influential contributor to management theory, a contemporary of

Weber was Henri Fayol. Fayol was a pioneer in developing an administrative theory to
improve organizations rather than improve individual jobs as Taylor did. He developed a
general theory of business and is recognized as one of the founders of modern
management. Fayol is credited with identifying strategic planning and employee
recruitment and motivation as critical management functions. He was also one of the first
theorists to promote management as a separate discipline from psychology, sociology,
and other fields.

His ideas were top-down, for managers to apply to lower levels of the organization.
This theory attempts to find a rational way to design an organization as a whole. The
theory generally calls for a formalized administrative structure, a clear division of labor,
and delegation of power and authority to administrators relevant to their areas of
responsibilities. Fayol believed his principles were flexible and applicable to any kind of
organization. This principle has contributed much to the foundation of theory for
managing people that are still widely used today.

Fayol identified five key functional areas which include planning, organizing,
staffing, directing, and controlling. It is important to note that they are independent of each
other and are highly inseparable. This means that one function cannot be accomplished
without the other. For example, careful planning without organizing or directing cannot
expect to achieve a good result. Each function is a dedicated component in the field of
management, and an effective manager is competent in each of these areas.

Functions of Management

1. Planning is the function of management that involves setting objectives and

determining a course of action for achieving specific organizational objectives.
Planning requires that managers be aware of environmental conditions facing their
organization and forecast conditions which include budgeting to guide its future
activities. The documents developed may include strategic plans, operating plans, or
project plans.

Planning drives managers to ask the fundamental question “What do we want to

achieve?” and then leads them to create road maps to accomplish what is desired.
According to Henri Fayol, one of the earliest management theorists, planning is the
most difficult function that managers complete.

Planning greatly reduces the chances of being caught unprepared. This is the first
and the most important step of the management process.

2. Organizing is the part of the management process that involves bringing all of the
system's resources- people, capital, and equipment- into action toward goal
accomplishment.
 Organizing the resources required to complete the objectives identified in
the plan is the next managerial function. Organizing is the function of management
that involves developing an organizational structure and allocating resources to
ensure the accomplishment of objectives. The structure of the organization is the
framework within which effort is coordinated. The structure is usually represented
by an organizational chart that provides a graphic presentation of the chain of
command within an organization.

A leader desires to include all people and situational elements into the
system that will be carrying out a particular goal and to organize them so the group
is working together toward goal accomplishment.

3. While organizing includes allocating resources to tasks, staffing specifically

addresses the human resource component and the relationship to planned
objectives. Healthcare is a service industry and therefore careful considerations in
hiring competent personnel are required. Having the right people in the right place
at the right time is essential to meeting organizational objectives, and to guarantee
that the organization can function objectively.

4. Directing is a key managerial role with human resources from a motivational and
communication perspective. While organizing and staffing get the pieces in place,
directing is the process of inspiring employees to complete tasks for the
organization in such a way that the human resource is maximized. Leading
involves the social and informal sources of influence that one must use to inspire
actions taken by others. In a word, directing and leading require leadership. If
managers are effective leaders, their subordinates will be enthusiastic about
exerting effort to attain organizational objectives.

The elements of direction are the following:

a. Supervision- implies overseeing the work of subordinates by their superiors. It

is the act of observing and directing work and workers.

b. Motivation- is the process of inspiring, stimulating, or encouraging the

subordinates with zeal to work. Monetary and non-monetary incentives may
be used for this purpose.

c. Leadership- is the process by which managers guide and influence the work
of subordinates in the desired direction.
 d. Communication- is the process of passing information, experience, opinion,
etc. from one person to another.

5. Controlling is the last component in the management process which involves

setting up mechanisms for on-going evaluation. Controlling is a process where
feedback of results and periodically following up to compare results with plans. It
involves ensuring that performance does not deviate from standards.

Controlling is the feedback loop that managers use to ensure that

organizational objectives are being addressed and met as planned. Managers
need to examine the process that is being followed to complete the objectives,
surveying milestones along the way, and guarantee that appropriate steps are
being taken to move towards achieving the organization’s goals and objectives.

Elton Mayo (1880-1949) and Behavioral Theory of Management (Hawthorne Effect)

The behavioral management theory is often called the human relations movement
because it addresses the human dimension of work. Behavioral theorists believed that a
better understanding of human behavior at work, such as motivation, conflict,
expectations, group dynamics, and productivity is essential in every organization.

One of the early major advances in management is the study that resulted from
the research conducted by Elton Mayo and Fritz Roethlisberger in the 1920s on
organizational behavior, often referred to as the Hawthorne studies because they were
conducted on workers at the Hawthorne factory of the Western Electric Company in
Chicago. The Hawthorne findings were influential in refocusing management strategy
from scientific management to include the social and psychological aspects of human
behavior in organizations.

They hypothesized that worker productivity would improve if employees choose

their coworkers, worked as a group, were treated distinctively, and had sympathetic
supervisors. Following numerous experiments, they concluded that monetary incentives
and working conditions were generally less important to productivity than employees’
needs and desire to be a part of a group and their involvement in decision-making.
Employees were motivated by more than money, and productivity was affected by factors
other than just pay and optimizing workflow.

Douglas McGregor (1950s-1960s) and Theory X and Y

 Theory X and Theory Y are theories of human motivation and management. They
were created by Douglas McGregor while he was working at the MIT Sloan School of
Management. The two theories proposed by McGregor describe contrasting models of
workforce motivation applied by managers in human resource management,
organizational behavior, organizational communication, and organizational development.

Theory X (a person refusing to work) assumes that work is inherently distasteful to

workers and they will attempt to avoid work whenever possible. Moreover, it assumes
that workers are not ambitious, have a little desire for responsibility, and prefer to be
directed while Theory Y (a person cheering the opportunity to work) highlights the
motivating role of job satisfaction and encourages workers to approach tasks without
direct supervision. Under Theory Y assumptions, there is an opportunity to align personal
goals with organizational goals by using the employee’s own need for fulfillment as the
motivator.

Management use of Theory X and Theory Y can affect employee motivation and
productivity in different ways, and managers may choose to implement strategies from
both theories into their practices.

William Ouchi (1981) and Theory Z

Theory Z was invented by an American economist and management professional,

William Ouchi, following the X and Y theory by Douglas McGregor. Theory Z focused on
increasing employee loyalty to the company by providing a job for life with a strong focus
on the well-being of the employee, both on and off the job. According to Ouchi, Theory Z
management tends to promote stable employment, high productivity, and high employee
morale and satisfaction. Another assumption is that employees expect reciprocity and
support from their organization. Employees find work-life balance important and want to
maintain this environment.

Significance of Management in Healthcare

Healthcare is one of the fastest-growing industries and as the number of jobs in

the industry rise, so does the need for healthcare service managers. Healthcare service
managers are typically responsible for planning, coordinating, and directing the delivery
of quality service to patients in hospitals, clinics, and any other healthcare-related
organizations. These roles require a strong balance of healthcare knowledge and
business skills to keep facilities safe, efficient, and profitable.
 The healthcare service manager’s team consists of management personnel,
medical doctors, and allied healthcare professionals. Each profession has a role in
providing quality patient care. These professions use a unique blend of skills for working
with both internal teams and patients. They not only have to know how to communicate
with other healthcare professionals but also with patients and their families.

Chapter Summary

The intricacies in the healthcare industry highlighted the demands for

healthcare managers. Similar to other industries, the healthcare industry demands
competent manpower and effective management. Management and leadership are
different concepts when they are defined in terms of roles- administrators are making the
policies and managers are responsible for implementing the policies, whereas leaders
influence and drive the group efforts in accomplishing a certain goal.

Social Media and Productivity

St. Mary’s Hospital is losing productivity because of social media. According to

their monitoring, employees use Facebook, Instagram, and TikTok during working hours.
On average, employees spend an hour a day on social media sites. This reduces
productivity by 12.5%. Nearly half of the office and department employees accessed
Facebook during work time. Therefore, the hospital implemented that hospital employees
are not allowed to use their mobile phones while at work. CCTVs have been installed to
monitor the employee’s activities.
Case Questions:

1. What is meant by productivity?

2. Do you think that the rule implemented is appropriate?
3. If you were the manager, how will you deal with employees who are engaged in
their mobile phones during working hours?
4. How does productivity play the role in management?
5. What theory of management should be applied in this situation?

__________________________________________________________

Answer the following

1. Define the following:

1.1 Management

1.2 Administration

1.3 Leadership

2. How do administration and leadership differ from management?

3. Describe the levels of management.

4. Discuss the concepts of the following theories:

4.1 Scientific management

4.2 Bureaucratic Theory of Management

4.3 Administrative Theory

4.4 Behavioral Theory of Management

4.5 Theory X and Y

 4.6 Theory Z

5. Discuss the different functions of management.

6. What is the importance of management to healthcare?

 Chapter 4

Organizational Behavior

Objectives: At the end of the topic, the student should be able to do the following:

1. Define organizational behavior.

2. Explain the role of organizational behavior in management.

3. Discuss the levels of analyses in organizational behavior.
4. Discuss the role of organizational behavior in the healthcare industry.

5. Explain the value of the systematic study of organizational behavior.

6. Discuss the evolution of organizational behavior.

7. Discuss the importance of organizational behavior in the healthcare setting.

An organization, no matter how well designed, is only as good as the people who live and
work in it. - Dee Hock

Organizations are found in all walks of life. Government offices, banks, schools, colleges,
hospitals, factories, institutes, political parties, and so on. Organizing is a basic function of
management. It refers to the identification and grouping of activities to be performed, process
involving the defining, and establishing the authority-responsibility relationship. This enables
people to work most effectively together in achieving the organizational objectives.

In general, organizing consists of determining and arranging for men, materials, machines,
and money required noitong by an enterprise for the attainment of its goals. In its operation sense,
the term organizing means defining responsibilities of the employed people and how their
activities are to be related.

The final result of organizing is the creation of a structure of duties and responsibilities of
persons in organizational different positions, grouping them according to the similarity, behavior,
and interrelated nature of activities. In brief, the organizing process results in the outcome called
"organization", consisting of a group of people working together for the achievement of one or
more common objectives.

Organization

The organization is the form of every human association for the attainment of a common
purpose. It is a pattern of ways in which large numbers of people have intimate face-to face
contact with all others, are engaged in a variety of tasks; relate themselves to each other in
conscious, systematic establishment and accomplishment of mutually agreed purposes.
 The basic feature of any organization is the hierarchy of persons in it. It, therefore,
distinguishes among different persons and decides who will be superior and the subordinate. All
the organizations allow an unwritten rule that the subordinate cannot delay the orders of the
superiors.

The Need for Organization

The organization is needed to execute the management function. The study of organization
has to be made necessary for the following reasons:

a. It provides an ideal setting for the study of human behavior. The study of organization leads to
man's important discoveries that are vital for the continued well-being of the institutes particularly
and the society in general. IT

b. Knowledge of organization helps managers to effectively. know various things, such as how to
run the organization and protect the environment needs, how to motivate, how to manage
conflicts, and how to introduce behavioral changes, and so on.

c. Organizations pervade all the important phases of man's life. A man is born in organizations
(hospitals, clinics, etc.), is educated in organizations (schools, colleges, etc.), and works in an
organization (hospital, factories, businesses, etc.)

We have seen that the outcome of an organizing process is the "organization". Organizing is
the process by which managers bring order out of chaos and create proper conditions for effective
teamwork. diamant s

Organizational Behavior

Organizational behavior is an academic discipline that deals with the systematic study of
human behavior in an organizational environment. It is the study of factors that influence the
behavior of individuals and groups within the organization and the way they respond to a particular
situation.

Organizational behavior is concerned with group dynamics; how an individual performs in a

group; and how leadership affects organizational functions. The main function is to analyze how
employees behave and function in an organization. Generally, when employees are led
effectively. they are motivated to do their best.

Moreover, the study of organizational behavior provides concepts and principles to help
understand the dynamics of human behavior within the organization and provides tools for making
decisions to achieve organizational goals.
 Organizational behavior is an applied behavioral science that is built on contributions from
several other behavioral disciplines like psychology, sociology, social psychology. anthropology,
and political science. It applies the knowledge I gained about individuals, groups, and the effect
of structure on behavior towards the end of making organizations work more effectively. It is
concerned with the study of what people do in an organization and how that behavior affects the
performance of the organization. Organizational behavior includes the core topics of motivation,
leader behavior, and power, interpersonal communication, group structure and process, learning,
attitude development and perception, interpersonal change, and conflict.

Importance of Organizational Behavior

Organizational behavior is a study involving the impact of individuals, groups, and structure
or behavior within the organization. This study is useful for the effective working of an
organization. It is a study of what people do within an organization and how their behavior affects
the performance of an organization. Organizational behavior is concerned mainly with
employment-related matters such as job, work, leaves, turnover, productivity, human
performance, and management. Organizational behavior also includes the core topics like
motivation, leader behavior and power, interpersonal communication, group structure and
process, learning attitude, perception, conflicts, work design, and work stress.

Organizational behavior does offer challenges and opportunities for managers since it
focuses on ways and means to improve productivity, minimize absenteeism, increase employee
job satisfaction, etc. Organizational behavior can offer managers guidance in creating an ethical
work climate. This is because organizational behavior can improve the prediction of behavior.

Understanding organizational behavior is becoming very important for managers. Due to

global competition, it is becoming necessary for the employees to become more flexible and to
cope with rapid changes. It is becoming challenging for managers to use organizational behavior
concepts.

Historical Evolution of Organizational Behavior

By looking back at the history of organizational behavior, one can gain a great deal of insight
into how the field got to where it is today. Three individuals are important who promoted ideas
that had a major influence in shaping the direction and boundaries of Organizational behavior.
They are Adam Smith, Charles Babbage, and Robert Owen.

Adam Smith

In his discussion made in "The Wealth of Nations" in 1776, brilliantly argued on the economic
advantage that organizations and society would reap from the division of labor called work
application in industry. He illustrated it with the help of an application in the industry. He concluded
that division of labor raises productivity by increasing each worker's skill and dexterity by saving
time that is commonly lost in changing tasks and by encouraging the creation of labor-saving
inventions and machinery. The result of his theory was seen in the 20th century in the form of
extensive development of the assembly-line production process.

Charles Babbage

A British mathematics professor, in his book, "On the Economy of machinery and
manufacturer" published in 1832 added to Smith's list of the advantage that accrued from the
division of labor, the following:van h

a. It reduces the time needed for learning a job.

b. It reduces the waste of material during the learning stage.

c. It allows for the attainment of high skill levels.

Robert Owen

A Welsh entrepreneur was one of the first industrialists to recognize how the growing factory
system was workers. He argued that money spent on improving labor was one of the best
investments that business executives can make. He argued for regulating hours of work for all,
child labor too, public education, the company furnished meals at work, and business involvement
in community projects.

Classical Era

It covered the period from 1900 to 1930 approximately when the first general theory of
management began to evolve. The major contributors were Fredric Taylor, Henry Fayol, Max
Weber, Mary Parker Follett, and Chester Barnard.

Scientific Management

It was Fredric Taylor who noticed that employees use vastly different techniques to do the
same job which he improved. At his time, there were no clear responsibilities laid for workers and
management. The work done by workers was very slow. Workers' output never matched their
abilities and attitudes. No effective work standards existed. Taylor made a mental revolution
among both the workers and management by defining clear guidelines for improving production
efficiency. The four principles of management that he defined are as follows:

a. Develop a science for each element of an individual. b. Scientifically select, train, teach and
develop the worker.
c. Co-operate with the workers heartily to ensure that all work to be done is by the principles of
the science that has been developed.
d. Divide work and responsibility almost equally between management and workers.

Administrative Theory

The administrative theory describes efforts to define the universal functions that managers
perform and principles that constitute good management practices. The major contribution to this
theory was that of a French industrialist, Henry Fayol.

He proposed that all managers perform five management functions: planning, organizing,
staffing, directing, and controlling. In addition, he described the practice of management as
something distinct from accounting, finance, production, distribution, and so on.

Structural Theory

Simultaneously, the German sociologist Max Weber developed a theory of authority

structures and described the organizational activity as based on authority relation. He looked at
management and organizational behavior from a structural perspective. Weber described an ideal
type of organization that he called a bureaucracy.

The study of organizational behavior helps in studying:

a. Why do people behave in a particular way? b. Why one group is more effective than the other?

c. Why one person is more effective in one organization as compared to the other organizations?

Three Levels of Analysis in Organizational Behavior

Organizational behavior can be analyzed at different levels within the organization, and each
level has a unique set of roles, responsibilities, and goals.

Individual Level

It deals with the concepts at the individual level. Individuals differ in many aspects such
as personality, attitude, perception, learning, and motivation.

Group Level

A group is a collection of two or more individuals to achieve a common goal. Examples of

group-level concepts are team, conflict, leadership, power, and politics. The group-level may
include how groups are formed, how to make effective teams, how to individually and collectively
the group activities can be improved, how to motivate employees, and which type of would be
suitable for a particular assignment.
Organizational Level

Organizational level means the level of the company's instructional structure identified by the
administrator for purposes of measuring performance. An organization is a collection of people
who work together to achieve individual and organizational goals. It is a coordinated social unit
composed of two or more people that function on a relatively continuous basis to achieve a
common goal. This level deals with the concepts at the organizational level.

Examples of organizational-level concepts are change management and organizational culture.

Other concepts include the concept of an organization, different organization models, and
organizational change along with its impact and implementation.

Models of Organizational Behavior

Every organization develops a particular model in which the behavior of the people takes
place. This model is developed based on management's assumptions about people and the vision
of the management. Since these assumptions vary to a great extent, these result in the
development of different organizational behavior models. Davis has described four organizational
behavior models which are as follows:

1. Autocratic

2. Custodial

3. Supportive

4. Collegial

Autocratic Model

In the autocratic model, managerial orientation is towards power. Managers see authority
as the only means to get things done, and employees are expected to follow orders. The result is
high dependence on the managers. The model asserts that employees need to be instructed and
motivated to perform while managers do all the thinking. The model is largely based on Theory X
assumptions of McGregor where human beings are taken inherently distasteful to work and try to
avoid responsibility. Very strict and close supervision is required to obtain a desirable
performance from them. This model is quite useful to accomplish performance, particularly where
the employees can be motivated by physiological needs.

Custodial Model

In the custodial model, the managerial orientation is towards the use of money to pay for
employee benefits. A successful custodial approach depends on providing economic security,
which many companies are now offering as high pay scale, remunerations in the form of health
benefits, corporate cars, financial packaging, and many other forms of incentives. These
incentives increase the employee's satisfaction level and help them to achieve a competitive
advantage. To avoid layoffs, employers also try to retain employees, reduce overtime, freeze
hiring, encourage both job transfers and relocations, and provide early retirement incentives.

The custodial approach induces employees to show their dependency and loyalty towards
the company and not to the managers. The employees in this environment are more
psychologically contented and preoccupied with their rewards, but it is not necessary that they
would be strongly motivated to perform.

Supportive Model

The supportive model depends on managerial leadership rather than on the use of power
or money. Managers aim to support employees in their achievement of results. The focus is
primarily on the participation and involvement of employees in the managerial decision-making
process.

The supportive model is widely accepted chiefly in the developed nations where the needs
of the employees are different as it fulfills many of the employees' emerging needs. This approach
is less successful in developing nations where the social and economic need of the working class
is different. In short, in the supportive model, money is not what retains the satisfaction of the
employees, but it is a part of the organization's life that has been put to use and makes others
people wanted.

Collegial Model

The collegial model is an extension of the supportive model. The term collegial refers to a
body of people having a common purpose. The collegial model is based on the team concept in
which each employee develops a high degree of understanding towards others and shares
common goals. Employees need little direction and control from management. Control is basically
through self-discipline by the team members. The organizational climate is quite conducive to self
fulfillment and self-actualization. Collegial models tend to be more useful with unprogrammed
work requiring behavioral flexibility, an intellectual environment, and considerable job freedom.

The various models of Organizational behavior are based on the assumption of human
characteristics and how they can work best. Since situational variables are strong factors in
determining the organizational processes, managers cannot assume that a particular model is
best suitable for all purposes and all situations. Rather all the models will remain in practice and
that too with considerable success. This is why managers are taking several steps to humanize
their organizations, such as participation, morale building, and so on to make the organization
more effective.

Organizational Behavior in the Healthcare Industry

 Organizational behavior studies can help guide managers in the healthcare industry. It assists
health care managers to minimize negative effects (such as stress and conflict) and maximize
their ability to motivate staff and effectively lead their organization. Healthcare organizations
consist of complex, changing relationships, and reporting structures. They involve multiple
specialties with different professional cultures and a wide variety of services, making healthcare
one of the most challenging industries to manage.

According to Marcus (1995), healthcare work is accomplished via intricately structured an

set of relationships. Formal and informal rules determine who speaks to whom, who makes what
decisions, and who has what information. People are organized and decisions are aligned in a
cautiously defined order.

Service providers are highly professionalized, with their distinct ethics and culture.
Healthcare professionals are differentiated by their training, licensure, and skills. The implications
of this structure are heightened in acute care settings, where conflicts in priorities often arise
because healthcare professionals are trained differently.

The delivery of patient care and services today is not an individual effort but instead
involves cross-disciplinary teams that must coordinate their efforts and constantly adapt to rapid
knowledge and expansion. Also, the critical nature of healthcare requires that actions be precise
to ensure specific positive outcomes. Unlike manufacturing and many other industries, healthcare
has limited room for error in the provision of its services to patients. Many of these events are
caused by a failure to adequately communicate critical information and coordinate efforts.

Organizational behavior study is relevant to healthcare industry's rapid reorganization and

transformation. the Economic forces, government regulations, and employers are driving change
with governments and businesses across the globe altering their existing healthcare system to
improve quality patient care.

Chapter Summary

In today's work culture, it is important to understand the behavior of employees in the

organization knowing the complex nature of human behavior. The study of organizational
behavior can help guide managers in the healthcare industry. It gives insight into how employees
behave and perform in the workplace. It helps develop an understanding of the aspects that can
motivate employees, increase their performance, and help the organization establish a strong and
trusting relationship with its employees.

Organizational behavior study is relevant to the healthcare industry's rapid

reorganization and transformation. Organizational behavior is important to ensuring patient
safety, ethical behavior among healthcare professionals, patient-centered care, and effective
change in facilities which is bound to improve healthcare delivery and patients' satisfaction.
 CHAPTER 5
Human Resource Administration

Objectives: At the end of the topic, the student should be able to do the following:
1. Discuss the importance of healthcare professionals in the delivery of healthcare
services.
2. Define human resources administration
3. Discuss the functions of human resources.
4. Distinguish hospital management from hospital administration.
5. Discuss the role of human resources in healthcare.
6. Define organizational chart.
7. Discuss the advantages and limitations of an organizational chart.
To build a rewarding employee experience, you need to understand what matters most
to your people. - Julie Bevacqua
The healthcare industry is a general term standing for all services related to health care.
It refers to the treatment and management of illness, and the preservation of health
through services offered by the medical, dental, pharmaceutical clinical laboratory
sciences, nursing, and allied health professions. Medical care embraces all the services
designed to promote advanced well-being, including preventive, curative, od palliative
mediations to the individual or the community
Healthcare Professionals
Healthcare professionals are vital to the delivery of high-quality healthcare services.
Broad training, skills, and education are fundamental to addressing society's need for
protected and skillful medical services. The specialized methods and skills that
healthcare professionals obtain through methodical programs of study are the basis for
socialization into their profession.
The healthcare field is intensive and is distinguished from other service industries by the
number of licensed and registered personnel it employs and the variety of subdivisions
of the field. These healthcare subfields have emerged as a result of the specialization of
medicine, the development of public health, increased emphasis on health promotion
and prevention, and technological advances.
Hospital Management vs. Hospital Administration
The terms hospital management and hospital administration are often used
interchangeably. However, to provide a distinction, hospital management is in charge of
the entire healthcare organization while hospital administration takes care of the staff
and employees. The hospital administrator is responsible for hiring staff for a specific
department but it is the hospital management who determines if an applicant should be
hired as an employee. A hospital administrator determines the best ways to help
employees to be more efficient and understands the type of treatment and facilities to
provide to patients. Meanwhile, the hospital manager decides on the treatment, the
number of employees, and how each department should run.
Human Resource Administration
Human resources administration is the management of the overall employment
experience of people working in an organization. The purpose of human resources is to
sustain and increase the contribution of the associates to the healthcare organization's
mission by improving skills, effectiveness, engagement, and commitment. In fulfilling its
purpose, human resources maximize the productivity of an organization by optimizing
the effectiveness of its employees.
Human resource management is a continuous process to ensure the development of
employee competence, dynamism, motivation, and effectiveness in a systematic and
planned manner Rao, 1990). It deals with bringing about improvements in the physical
capacities, relationships, values, knowledge and skills of the employee required for
achieving the purposes of the organization (Balaji. 1990). If employees are effective
their contribution to the organization will be effective, consequently, the organization will
also be effective in accomplishing its goals
The functions of a human resource manager fall into three major areas: (l) recruitment
and selection of employees, (2) employee compensation and benefits, and (3) training
and development
Recruitment and Selection
Recruitment is the process of screening and selecting potential and qualified employees
based on objective criteria for a particular job. Recruitment and selection are important
in human resource management which is designed to maximize employee strengths to
meet the employer's strategic goals and objectives. It is the process of sourcing,
screening shortlisting, and selecting the right candidates required for vacant positions.
The goal of this process is to attract qualified applicants for a certain job. The
recruitment and selection process is essential to every organization because it reduces
the costs of mistakes such as engaging incompetent, unmotivated, and under-qualified
employees.
Training and Development
Training and development refer to educational activities within a company created to
enhance the knowledge and skills of employees while providing information and
instruction on how to better perform specific tasks. In training, the initiative is taken by
the management to meet the present need of the employees. Furthermore, in
development, the initiative is taken by the individual to meet the future need of the
employees.
Training and development are the indispensable functions of human resource
management. It is an attempt to improve the current or future performance of
employees by increasing the ability of an employee through educating and enhancing
one's competence in a particular profession.
Employee Compensation and Benefits
Compensation covers the employee's direct pay in the form of salary. Meanwhile,
benefits cover the employee's indirect pay, like health insurance, stock options,
retirement, and social benefits such as vacation leave or study leave. The
compensation, benefits, and reward schemes are not only important for retaining and
motivating employees but also attracting new people to the company. Salary and
incentive packages are one of the main reasons why people apply for specific jobs. This
function fulfilled by the human resource involves benchmarking, ensuring current
documentation, and strategizing compensation and benefits with performance.
Objectives of Human Resource Administration in Hospitals
The broad objective of human resource management is to contribute towards the
realization of the hospital's goal. The specific objectives are to:
• Achieve and maintain good human relations within the hospital.
• Enable each employee to make his maximum personal
contribution to the effective working of the hospital.
• Ensure respect and the well-being of the individual employee.
• Ensure the maximum development of the individual, and help him contribute his best
to the hospital. Ensure the satisfaction of the various needs of individuals to obtain their
maximum contribution to achieving the hospital's goals.
Human resources management is responsible for promoting the well-being of the
employees such as they create certain programs to boost employees' social, emotional,
and mental health. And whenever conflict arises among employees, it is the human
resources manager's job to settle their indifferences or conflicts. In other words, all the
concerns of the employees are the responsibilities of the human resource manager.
Role of Human Resource Administration in Healthcare
Human Resource Administration is vital in healthcare. Effective human resources
management plays a crucial role in the success of health care systems. Proper
management of human resources is essential in the recruitment and retention of clinical
and non-clinical staff maintaining staff morale, providing opportunities for professional
development, and in the ability of a healthcare organization to deliver quality healthcare
services and improve patient health outcomes. Healthcare organizations can gain a
competitive advantage by effectively managing their human resources. Achieving a
competitive advantage through human resources must be based on the unique
combination of an organization's human capital, strategy, and core responsibilities that
differ from one organization to another.
The future belongs to healthcare managers who can improve organization performance
while managing change through engaged and committed employees. A hospital is a
microcosmic community that operates like a small city, presenting the same issues with
a stronger dynamic due to the human interaction factor.
Organizational Chart
Into an organization, it is important to know the lines of authority to have a clear picture
of where to report and to find colleagues quickly and easily. Organizational charts or
hierarchy charts are a graphical representation of an organization's structure.
Organizational charts help employees identify all team leaders within their organization.
Providing this information to all employees minimizes the amount of time wasted
dictating who to pass on information to.
The purpose of the organizational chart is to illustrate the communication, reporting
relationship, and chains of command within the organization. A chain of command is an
official hierarchy of authority that dictates who is in charge of whom and of whom
permission must be asked. An example of a chain of command is when an employee
reports to a supervisor, who reports to a manager, who reports to the vice president,
who reports to the president.
The chart reflects the employees' names, job positions, and which department they
belong which links them to other employees and departments in the organization.
Through organizational charts, individuals gain a quick understanding of how the
organization is designed, the number of levels, and where each employee fits into the
organization.
The organizational chart is often maintained by the human resources and updates with
new hires and when employees change positions or leave the company.
Organizational charts are used to justify adding or reducing headcount and used to
determine where an employee might have an opportunity to shift job roles.
Importance of Organizational Charts
Organizational charts help to demonstrate clear reporting structures for all the
employees in the organization. It creates a roadmap for how the work is to be done and
the process required is to ensure the information is shared throughout the company.
And the way to ensure this takes place efficiently is to have one supervisor or manager
and a few employees directly reporting to one.
In a larger organization, employees need to know who is their reporting head so that
whenever there are issues or they require guidance about complex problems, their
superiors can provide help when needed. It is best to seek help at the earliest. A clearly
defined chain of communication helps efficiently spread the message and minimizes
losses in translation.
In this organizational chart, the following are the reporting relationships of employees:
1. The radiologic technologist staff (CT-scan, general x-ray,
ultrasound) report directly to each section head. The section heads (CT-scan, general x-
ray, ultrasound) report directly to the chief radiologic technologist.
2. The chief radiologic technologist reports directly to the chief radiologist.
3. The chief radiologist reports directly to the office of the medical director.
Limitations of Organizational Charts
Organizational charts offer various benefits such as reflecting the reporting relationships
and lines of authority, organizational charts also have several limitations, such as: 1. If
updated manually, organizational charts can be quickly
become out-of-date, especially in large organizations that changes their employees
regularly.
2. They only show 'formal relationships' and do not reflect the
pattern of social relationships which develop.
3. They provide little information about the managerial and leadership style adopted by
the organization.
Chapter Summary
Human resource practices are essential for arranging tasks, responsibilities, and
performance of employees. Without human resource management, organizations would
not be able to effectively recruit and retain employees, improve and enhance the
organization, and wouldn't be able to maintain a healthy, accepting workplace culture
and environment. Human resources management not only helps to keep employees
happy and well-trained, but it also ensures that the organization is working within the
guidelines of regulations and solves any liability issues that may arise.
The role of human resources managers in the healthcare industry is confined to
managing safety and legal issues, ensuring efficient performance, and developing
problem-solving and decision-making skills.
Proper management of human resources is important in the recruitment and retention of
clinical and non-clinical staff, maintaining staff morale, providing opportunities for
professional development, and in the ability of a health care organization to deliver
quality health care services and improve patient health outcomes.
Training Needs
Vaun is the X-ray section head in a radiology department. There are eight registered
radiologic technologists under him. Their formal education, responsibilities, and
experiences are very similar, providing for an extremely closeknit group that shares
responsibilities. One day, the chief radiologic technologist informed him that she would
provide funds for two of his radiologic technologists to attend the Annual Convention for
Radiographers for two days in a different City. The training budget is only good for two
radiologic technologists because of the considerable amount of expenses in
registration, fare, accommodation, and allowance.
It is Vaun's perception that all of his radiologic technologists would very much like to
attend, and from the standpoint of staffing, there is no particular reason why anyone
should attend over another
Case Questions:
1. If you were in the place of Vaun, how would you decide who will attend the annual
convention?
2. How does human resource management play in this situation?
Healthcare professionals are vital to the delivery of high-quality healthcare services.
Broad training, skills, and education are fundamental to addressing society's need for
protected and skillful medical services.
 The terms hospital management and hospital administration are often used
interchangeably. However, to provide a distinction, hospital management is in
charge of the entire healthcare organization while hospital administration takes
care of the staff and employees.
 The hospital administrator is responsible for hiring staff for a specific
department but it is the hospital management who determines if an applicant
should be hired as an employee.
 Human resources administration is the management of the overall
employment experience of people working in an organization
 The purpose of human resources is to sustain and increase the contribution of
the associates to the healthcare organization's mission by improving skills,
effectiveness, engagement, and commitment.
 The functions of a human resource manager fall into three major areas: (1)
recruitment and selection of employees, (2) employee compensation and
benefits, and (3) training and development.
 Recruitment is the process of screening and selecting potential and qualified
employees based on objective criteria for a particular job.
 Training and development are the indispensable functions of human resource
management. It is an attempt to improve the current or future performance of
employees by increasing the ability of an employee through educating and
enhancing one's competence in a particular profession.
 Compensation covers the employee's direct pay in the form of salary.
Meanwhile, benefits cover the employee's indirect pay, like health insurance,
stock options, retirement, and social benefits such as vacation leave or study
leave.
 The broad objective of human resource management is to contribute towards the
realization of the hospital's goal.
 Human resources management is responsible for promoting the well-being of
the employees such as they create certain programs to boost employees' social,
emotional, and mental health.
 Proper management of human resources is essential in the recruitment and
retention of clinical and non-clinical staff maintaining staff morale, providing
opportunities for professional development, and in the ability of a healthcare
organization to deliver quality healthcare services and improve patient health
outcomes.
 Organizational charts or hierarchy charts are a graphical representation of an
organization's structure. Its purpose is to illustrate the communication, reporting
relationship, and chains of command within the organization.
 A chain of command is an official hierarchy of authority that dictates who is in
charge of whom and of whom permission must be asked.
 Organizational charts offer various benefits such as reflecting the reporting
relationships and lines of authority but also have several limitations.
 Organizational charts help to demonstrate clear reporting structures for all the
employees in the organization and it creates a roadmap for how the work is to be
done and the process required is to ensure the information is shared throughout
the organization.
RT203 Chapter 6

Administration of the Radiological Facility

The primary role of diagnostic imaging services is to support and serve other departments in a hospital
or healthcare practice in providing diagnostic or treatment. The characteristics of a radiology
department are determined by the roles and functions of the hospital and the needs of the community
it serves. Although there is no typical or average radiology department, certain characteristics are
common to most departments. The organization of a radiology department affects its internal structure
and the disposition and management of personnel and fiscal resources. Management aims to arrange
employees into a working group according to their work functions. Administration directs the efforts
and skills of employees toward reaching departmental objectives cohesively and satisfyingly.

Specialized areas within a radiology department may include diagnostic radiology, nuclear medicine, and
sonography. In large departments, there may be sections devoted to radiation oncology, radiation
biology, and radiation physics.

This chapter is devoted almost exclusively to the diagnostic radiology department because it is the
largest and most often the first clinical affiliation for the student. Currently, sections in the radiology
departments devoted to diagnostic services only sometimes called imaging are departments,
departments of imaging, or diagnostic radiology departments.

Administration and Staff Responsibilities

The hospital administrator and medical staff are responsible for the operation of the hospital. The
administrator is responsible for planning, developing, and maintaining programs that implement the
policies and achieve the goals established by the governing body. This person organizes the
administrative functions of the hospital, delegates duties, establishes formal meetings with personnel,
and provides the hospital with administrative direction.

The radiology management staff has the following responsibilities:

1. Participation in medical staff activities as required.

2. Establishment of an effective working relationship with the medical staff, the administration, and
other departments and services.

3. Development and approval of all policies and procedures for the radiology department.
4. Verification of the qualities and capabilities of all radiology staff technical personnel.

5. Development of comprehensive safety rules in cooperation with the hospital safety committee.

6. Review and evaluation of the quality and appropriateness of radiology services

Radiology Staff Activities

The main objective of the diagnostic radiology department is to aid physicians in their efforts to
diagnose and treat diseases by providing them with timely and reliable information obtained from
radiographic examinations.

To ensure the reliability of this diagnostic information, careful attention must be given to the
performance of every examination, beginning when the examination is ordered and continuing until the
examination is ordered, and continuing until the examination results have been returned to the
requesting physician.

Diagnostic radiology services should be conveniently available to meet the needs of the patient and
should be directed by one or more qualified radiolohists and a sufficient number of qualified technical
personnel.

Staffing

Radiologic technologist managers' roles are complex and demanding. They are the most essential
positions to drive the success of an organization. Of the many responsibilities and challenges, the roles
entail, staffing remains one of the important to daily unit operations, to patient safety, to patient and
family satisfaction with care and services, to physician satisfaction, and employee satisfaction. Staffing
issues often cause radiologic technology managers great concern.

As mentioned in Chapter 2, staffing is a function of planning for hiring and deploying qualified human
resources to meet the needs of patients for care and services. Because the staffing process guides the
development of a unit's staffing plan for the year, it is typically conducted in conjunction with the
development of the personnel budget. Radiologic technologist managers must consider several variables
that affect both the staffing process and the personnel budget. There must be routine assessments
throughout the year to ensure acuity changes or service changes have not altered the required staffing.
Scheduling

Scheduling is a function of implementing the staffing plan by assigning unit personnel to work specific
hours and specific days of the week. This task is allotted through personnel budget, fair distribution, and
the creation of a master schedule for the unit that meets each employee's personal and professional
needs. Although completely satisfying each staff member is not always possible, a schedule can usually
be created that is both fair and balanced from the employee's perspective while still meeting the patient
care needs. Creating a flexible schedule with a variety of scheduling options that leads to work schedule
stability for each employee is one mechanism for retaining staff within the control of the radiologic
technology managers.

Furthermore, radiologic technology managers must consider many variables to create a fair and
balanced schedule. Below are examples of variables radiologic technology managers can anticipate and
must consider as they prepare the unit's schedule.

• Hours of operation

• Shift rotation

• Weekend rotation

• Approved benefits for the scheduled period (vacations, holidays, and such

• Approved leaves of absence Short term disability

• Approved seminar, orientation, or continuing education Scheduled meetings for the scheduled period

Other anticipated variables can complicate the best prepared schedule. When faced with call-ins for
illness, funeral leaves, or an emergency leave of absence, radiologic technologist managers must
attempt to fill a shift vacancy on short notice. Requesting staff to add hours over their planned
commitment, floating staff from another unit, or seeking overtime are examples of strategies that
radiologic technologist managers may be compelled to use to ensure safe staffing of their units.

Flowcharts and Organizational Charts

Organizational charts and department flowcharts establish clear lines of authority, responsibility, and
accountability to provide proper spans of control, create appropriate independence operations, And
define administrative record-keeping responsibilities.

Procedures Manual
Most radiology departments develop their radiology information manuals and make them available to
other departments, physicians, or associated institutions. These procedures manuals are generally
designed to meet joint accreditation standards, state standards, and hospital codes. Many radiology
departments find it helpful to include general instructions for patients; precautions to be observed in
the transport of the very confused, ill, medicated, or feeble patient; and, when indicated, patient
isolation procedures.

The manual usually includes samples of authorization forms for various radiographic studies. Because of
their potential hazards, many radiographic studies require the authorization or consent of the patient
before the study is performed.

The manual usually includes a section of instructions in the preparation for patient contrast studies. This
may include the sequencing of each radiographic examination that may be done on the same day. This
information is helpful to students or new personnel who are learning the policies and procedures
specific to their particular area. The description of each radiographic examination covered in the manual
includes the details of the procedure as well as the preparation for the study.

Safety

Safety in the health care environment for both the patient and the employee is very important.
Equipment safety has become a major concern in many institutions as a result of the proliferation of
medical equipment and the increase in the number and complexity of diagnostic tests requested by
physicians. Standards set for hospital accreditation require not only initial compliance but also, and
more importantly, a continuing program of testing and preventive maintenance.

Radiologic Compliance Evaluations

Compliance evaluations, which include the inspection and testing of x-ray units, should be performed at
the recommended intervals. These tests include table-top exposure rate measurements, half-value layer
determinations, scatter radiation surveys, and timer and collimator accuracy checks, among others. All
tests and inspections must be documented to satisfy the record-keeping requirements for accreditation.

Shielding Evaluation
Measurements of the adequacy of structural shielding as required by state regulations should be made
and documented. Electrical and mechanical safety inspections and tests for compliance with currently
accepted standards for medical equipment should also be documented.

Personnel Monitoring

Personnel monitoring is the measuring of the radiation exposure received by personnel in the
performance of their duties. Exposure reports on personnel should be reviewed monthly for high
exposures or exposures exceeding the maximum permissible dose. The radiation exposure reports
should be posted in a highly visible area.

Electrical Safety

Electrical safety is very important in the radiology department because of the high-voltage equipment
used. It is also a concern of the entire hospital; thus an electrical safety policy is a hospital-wide
program. An awareness of the use of electronic equipment in diagnostic and therapeutic patient support
is essential for all personnel. Written policies and procedures are usually available regarding electrical
safety.

Sanitation and Infection Control

Sanitation practices are of great concern to departments of radiology because so many patients are seen
in the department daily. Radiographers do not spend a great deal of time with each patient, but they see
a large number of patients each day. In practicing proper sanitation, rooms must be kept clean, and
orderly. Building and service equipment, such as air conditioning and ventilation systems, must be well
maintained. Attention must be given to storage areas, waste disposal, and laundry. Sanitation practices
must be given storage areas, waste disposal, and laundry. Sanitation practices and policies must also be
a hospital-wide concern.

Infection control affects the entire hospital as well as the radiology department. The accrediting body
for hospitals recommends a hospital wide infection control program. Some elements of the infection
control program are mechanisms for reporting and identifying infections, maintaining records of
infections among patients and personnel, and reviewing and evaluating aseptic isolation and sanitation
techniques. Written policies on patient isolation procedures and control procedures relating to the
hospital environment, which includes central service, housekeeping, laundry, engineering, food, waste
management, are developed for hospital-wide use.
Use of Teleradiology

W Diagnostic x-ray facilities utilizing the practice of teleradiology, the communication protocols, file
formats, and image data compression shall conform to Digital Imaging and Communication in Medicine
(DICOM). There shall be no reduction of clinically diagnostic image quality whenever the image is
compressed and transmitted for image interpretation. This means to ensure that the image is properly
identified and delivered on time to the patient shall be provided.

Lab Moreover, the integration of PACS in the departmental workflow should be provided. If PACS is
available, the use of an electronic source of identity, ordering and scheduling information, and the
integration of disparate sources information shall also be provided.

The official interpretation of clinical images, emergency examination in the on-call situation, and
additional opinions by external consultation shall be done by the radiologist.

Quality Management Systems in Radiology

A good quality management system is essential to a safe and efficiently run medical imaging
department, providing quality clinical images while maintaining patient and staff radiation doses as low
as reasonably achievable (ALARA). Quality management includes all aspects of medical imaging
techniques such as room and workflow design, equipment selection, equipment purchase, installation
oversight, acceptance testing, commissioning, quality control, ongoing equipment maintenance and
support, and disposal at the end of the equipment's useful life.

Quality management must also provide oversight of imaging informatics systems in the imaging
department as this has become an integral part of today's imaging department.

Quality Assurance

The radiology administrator and the radiology management staff must maintain quality assurance, the
monitoring, and testing of imaging equipment as well as the control of variables in the clinical setting, to
minimize unnecessary duplication of radiographic examinations and maximize the quality of diagnostic
information. They must also review and evaluate the quality and appropriateness of radiologic services.

License to Operate of Medical X-ray Facilities

A License to Operate or LTO is a license that must be secured to operate an establishment before
engaging in the manufacture, importation, exportation, sale, offer for sale, distribution, advertisement,
etc. In the case of the radiology department, a License to Operate must be secured first before
operation and this must be updated regularly to continue operation.

In the Philippines, the radiologic technology manager or the Radiation Protection/Safety Office has to
secure the License to Operate in the Bureau of Food and Drug Administration (FDA). No x-ray facility
shall be allowed to operate without a valid authorization issued by the FDA. The following are the
requirements for application:

1. Duly accomplished medical x-ray license application (2 copies).

2. License application fee (refer to the schedule of fees) 3. Photocopy of the Official Receipt of the
personal dose monitor (TLD or OSL) from the provider of personnel dose monitoring service.

4. Photocopy of valid Professional Regulation Commission (PRC) license of all the radiologic/x-ray
technologists.

5. Photocopy of the certificate of all the radiologist(s) for being a Fellow of the Philippine College of
Radiology (FPCR) or Diplomate of the Philippine Board of Radiology (DPBR).

6. Photocopy of the PRC board certificate of all radiologic/x-ray technologists.

7. Certificate of training of the radiologic/x-ray technologist in radiation protection if he/she acts as the
radiation protection officer.

8. Certificate of training of the head of the facility in radiology if he is not an FPCR/DPBR for government
facilities and in areas with no FPCR/DPBR within 45 km vicinity radius.

9. Photocopy of a valid notarized contract of employment of the entire radiologic/x-ray technologist.

The CDRRHR recommends that the contract be valid for at least one year.

10. Duly filled-out and notarized affidavit of continuous compliance, landing goin to find

11. Photocopy of the business/mayor's permit or SEC/DTI registration of the facility,

12. Photocopy of the latest License to Operate (For renewal application only).

13. Photocopy of a valid vehicle LTO registration (For mobile x-ray units).

Chapter Summary

The radiology department is a complex operation. All radiology personnel is expected to establish and
maintain quality patient care, process improvement, safety, and good customer service. Every member
of the department needs to be aware of the responsibilities and organizational structure of the
department. It is this awareness, coupled with the dedicated, cooperative performance of these
responsibilities on the part of radiology personnel that can make patients' visits to radiology as pleasant
and employees' service to the department as meaningful and satisfying as possible.
 Chapter 7

Supervision

Objectives: At the end of the topic, the student should be able to do the following

1. Discuss the different functions of supervision.

2. Enumerate the levels of supervision

3. Discuss the importance of supervision

4. Enumerate the functions of supervisors.

5. Discuss the role of the radiologic technologist supervisor

6. Describes the role of supervision in the Imaging department.

Every person under your supervision is different. They're all different. They're identical in most ways,
but not in all ways. You Have to study and analyze every individual under your supervision and try to
work with them in a way that will be most productive

- John Wooden

Supervision is a process of training, mentoring guiding, and encouraging healthcare stall to improve their
performance to provide high-quality healthcare services. One of the responsibilities of a supervisors to
monitor the quality of care and services provided by the healthcare staff. The supervisor plays a critical
role in effecting change both at the facility and within the healthcare system. Introducing interventions
to improve the performance and quality of healthcare services

involves change, and people are not a ways comfortable with change.

It is not enough to design solutions for improving the quality of care. The best ideas can fail because the
people who are supposed to implement them are resistant to change. To Improve performance and
services, one must know how to manage the change process. This requires the complete involvement of
all stakeholders. Therefore, supervision becomes a team effort to make these improvements happen.

The system for delivering healthcare services is complex with the healthcare system because they are

• different types of Healthcare Facilities

• different levels of care,

• different types of providers,

• different types of services being provided, and

• different ways to pay for those services

The system for the delivery of healthcare services may vary for several reasons but what they have in
common are

• the people who need healthcare services, and

• the people who provide healthcare services.

Supervision

Supervision is widely misunderstood term. Many people believe it applies only to people who oversee
the productivity and development of entry-level workers. That's not true.

The term "supervisor typically refers to one's immediate superior in the workplace, that is, the person
whom you report directly to in the organization. For example, a middle manager's supervisor typically
would be a top manager. A first line manager's supervisor would be a middle manager. A worker's
supervisor typically would be a first-line manager.

Supervision is performed at all levels of management 8 it means guiding the efforts of employees and
other resources to achieve a certain goal. Supervision means carrying out managerial functions of
planning organizing directing controlling and staffing at various levels of management.

Managers at the top supervise the activities of lower-level managers who supervise the activities of
lower-level managers who finally supervise the conduct of the rank-in-file employees.

The term 'supervisor' is generally associated with managers at the lowest level who supervise the
activities of the workers. They interact face-to-face with the employees. They act as the link between
managers and the workforce

Directions issued by managers at the top reach the workers through supervisors and workers grievances
complaints reach the higher levels through supervisors.

The term supervisor" typically refers to one's date superior in the workplace, that is, the person whom
you report directly to in the organization. For example, a middle manager's supervisor typically would be
a top manager. A first line manager's supervisor would be a middle manager. A worker's supervisor
typically would be a first-line mange.

Supervisors typically are responsible for their direct reports' progress and productivity in the
organization Supervision often includes conducting basic management skills (decision making problem-
solving planning, delegation, and meeting management), organizing teams, noticing the need for and
designing new job roles in the group, hiring new employees, training new employees, employee
performance management (setting goals, observing and giving feedback, addressing performance
issues, firing employees, etc.) and ensuring conformance to personnel policies and other internal
regulations. Supervisors typically have a strong working knowledge of the activities in their group, c...
how to develop their product, carry out their service, etc.

Importance of Supervision

1. Ensures Issuing of instructions

The supervisor makes sure that all the instructions are communicated to each employee. The top-level
and middle level plans out all instructions but the instructions are issued only by the supervisory level
management,
2. Facilitates Control

Control means a match between actual and planned output. Whenever the workers are under constant
supervision or monitoring then step by step is kept and if they are deviating from the plan then
immediate instructions are issued by the supervisory level.

3. Optimum Utilization of Resources

When workers are constantly monitored or observed then they ways use the resources in the best
possible manner which leads to minimum wastage. But if there is no supervision or check on workers
they may result in wastage of resources.

4. Feedback

The supervisors are directly dealing with the subordinates. So, they are the best persons to give
feedback to subordinates. They report the working of every worker which becomes the base for the
performance appraisal for the employees. The supervisor gives feedback regarding complaints,
grievances, and problems of subordinates to superiors.

Feedback is about the quality on one-to-one between and the employee, and it provides the best
opportunity to provide avenues for improvement in terms of work performance and professional
development.

5. Discipline

The strict supervision and guidance of the supervisor encourage the employees and workers to be more
disciplined in their activities. Under the guidance of the supervisor, the workers follow a fixed or strict
time-table and execute the plans in the right directions,

6. Improves Communication

Supervisors issue instructions and orders to all subordinates and make sure that these instructions and
orders are clear to all members.

7. Improves Motivation

The relationship with the supervisor is a very good incentive to improve the motivation level of the
employees.

While guiding the employees the supervisors encourage the subordinates to perform to their best
capacity.

Levels of Supervision

The level of supervision is determined by how work is assigned when it is reviewed, how it is reviewed,
and what protocols are available. Further, levels of supervision are used in determining supervisory
training requirements.

1. Direct Supervision
The supervisor gives specific instructions on all assignments. Work is reviewed and accuracy or the
employee's platforms tasks provides inherent checks built into the nature of work.

2. General Supervision

The supervisor provides continuing or individual assignments by indicating generally what is to be done,
limitations, quality, quantity expected, deadlines ad priorities. Additionally, specific instructions are
given for new, difficult, or unusual assignments. The employees use initiative in carrying out recurring
assignments. The supervisor assures that the work is technically accurate and in compliance with
instructions or established procedures.

3. Intermittent Supervision

The supervisor makes assignments by defining objectives, priorities, and deadlines, and assists the
employee with unusual situations that do not have clear objectives. The employee plans and carries out
successive steps and resolves problems and deviations following

instructions, policies, and accepted practices. The supervisor reviews the work for technical adequacy
and conformance with practice and policy,

4. Administrative Supervision

The supervisor sets the overall objectives and resources available. Supervisor and employees in
consultation, develop deadlines, projects, and work to be done. The employee's plan interprets policy
on the initiative. The employee keeps the supervisor informed of progress, potentially controversial
matters, or far-reaching implications.

5. General Directions

Assignments are made in terms of broad practice, precedents, policies, and goals. Work may be
reviewed for the fulfillment of program objectives and conformance with departmental policy and
practice.

6. Long-Range Administration Direction

The employee generally proceeds independently following general plans, policies, and purposes of the
department. Results of works are considered technically authoritative and are normally accepted
without significant change.

Span of Control

A span of control refers to the number of subordinates that can be managed effectively and efficiently
by supervisors or managers in an organization. Typically, it is either narrow or Wide resulting in a flatter
or more hierarchical organizational structure. Each type has its inherent advantages and disadvantages.

Narrow Span

Advantages

 Have more levels of reporting in the organization, resulting in a more hierarchical organization
 Supervisors can spend time with employees and supervise them more closely
 Creates more development, growth, and advancement opportunities

Disadvantages

 More expensive (high cost of management staff, office, etc.)

 More supervisory involvement in work could lead to less empowerment and delegation and
more micromanagement
 Tends to result in communication difficulties and excessive distance between the top and
bottom levels in the organization.

Wide Spann

Advantages

 Have fewer levels reporting in the organization, resulting in a more flexible, flatter
organization
 Ideal for supervisors mainly responsible for answering questions and helping to solve
employees' problems
 Encourages empowerment of employees by giving more responsibility, delegation, and
decision-making power to them

Disadvantages

 Tends to result in greater communication efficiencies and frequent exposure to the

top level of the organization
 This may lead to overloaded supervisors if employees require much task direction,
support, and supervision
 May not provide adequate support to employees leading to decreased morale or
job satisfaction

How Supervisors Acquire Skills

Most supervisors find it relatively easy to acquire skills, whether physical, mental, or
interpersonal- although the latter is by far the most difficult. Interpersonal skills that
supervisor should strive to develop and refine include building trust, emotional
intelligence, empathy vulnerability, and listening skills. Trust between supervisors and
team members are crucial.

On the other hand, researchers in his training have concluded that the acquisition of
supervisory skills occurs in three phases.

1. The knowledge phase, wherein the new supervisors learn what to know, what to
expect, how to do it, how well it must be done, and most of all, where things might go
wrong, and how to avoid having them go wrong. Good performance should be
reinforced, but supervisors should also be alerted to the pitfalls involved in practicing
the skills
2. The acquisition phase, wherein the new supervisors learn the correct patterns of
behavior, mainly through demonstration of the skill and through imitating and
practicing it until it is fixed in the mind and reflexes. The success of behavioral modeling
of interpersonal skills for supervisors is based on such demonstration and imitation
rather than on knowledge and comprehension.

3. The automatic phase, wherein the new supervisors gradually pick up speed and
accuracy and then, through practice, develop consistency and rhythm. Feedback about
performance is especially important at this phase.

Otherwise, new supervisors may get a mistaken idea about how good they are. They
need correction and help Identifying ways to strengthen these areas through practice
on or off the job. Unfortunately, the automatic phase of supervisory training is more
often than not outside the realm of the professional trainer's control. It is more likely to
be the supervisor's bosses who must make certain the practices take place and be on
hand to coach and counsel

In general, training programs for developing supervisory skills should always:

• Provide a clear-cut pattern to follow. Step-by-step procedures are just helpful for
supervisory skills.

• Provide opportunities to practice the skill without penalty for mistakes. Class or
workshop exercises, such as case analysis and role-play, enable supervisors to discover
points of misunderstanding or shortcomings and to remedy them before attempting to
apply the learning back on the job.

•Provide prompt feedback on the result. In learning complex skills like those associated
with supervisory development, the communications and feedback process is essential.

Supervision in the Imaging Department

Clinical supervision plays a vital role in the welfare of the patients. The radiologic
technologist supervisor is responsible for clinical and non-clinical staff (receptionists
and clerks).

As a radiologic technologist supervisor, it is one’s task to oversee patient diagnostic

imaging. The responsibilities are to coordinate radiology services, oversee staff during a
procedure, and train employees in the use of diagnostic imaging equipment.

A skilled supervisor builds and works with a team to improve performance. The
radiologic technologist supervisor has many responsibilities. They are responsible for

• planning, supervising, and assigning work schedules to subordinate

radiology services personnel;
• ensuring that sufficient numbers of trained staff are
• maintained to provide high-quality services.
• implements and maintains a system for monitoring levels of radiation
exposure to staff;
• procures supplies and equipment;
• maintains records of testing and repair;
• arranges maintenance and repair of equipment and prepares reports with
recommendations for the disposal of equipment;
• resolves radiology service delivery problems
• monitor and evaluate staff performance;
• submits weekly and monthly operation reports,
• reviews and makes modifications of clerical procedures and processes;
• ensuring that imaging units are regularly calibrated and that they function
properly, and
• Perform diagnostic exams as required by work assignments.

Chapter Summary

Supervision is an accountable, two-way process, which supports, motivates,

and enables the development of good practice for individual social care
workers. As a result, this improves the quality of service provided by the
organization. Supervision is a vital part of individual performance management.

One essential task of supervision is that it ensures issuing of instructions,

facilitates control, optimum utilization of resources, discipline, and feedback
improves communication and improves motivation. The level of supervision is
direct supervision, general supervision, intermittent supervision, administrative
supervision, general direction, and long-range administration direction.

Some of the radiologic technologist supervisor functions are planning,

supervising, and assigning work schedules to subordinate radiology services
personnel. As a supervisor, it is important to have good communication skills
and have the capability to deal with people because one of their job
descriptions is to handle people under their care. And as healthcare
supervisors, their priority is to monitor the healthcare staff and to ensure
quality health care to patients.
Helping Mary

Mary is one of the most reliable radiologic technology staff in the radiology
department. She has been a valuable employee to the unit and one of the
respected experts in the CT-Scan field. You notice lately, though, that she is
more reserved and is occasionally late in reporting for duty. You hear her
quietly crying or having a fight with someone on the phone frequently. She is a
bit jumpy while she is at work and sometimes caught arguing with patients.

You ask her to report to your office and voice your concern. Mary says she is
having some marital problems but there is nothing to worry about and that she
can handle them herself. Several weeks later, Mary's behavior escalated, that
is, when she found out that her husband is leaving her and her three children.
Her work becomes erratic and sometimes she breaks down in the middle of the
shift. You are very concerned and since her problem has affected her job, her
relationship with co-workers, and the department, you have decided to make a
plan of action.

Case Questions:

1. Since you are her direct superior, what is the immediate action that you will
do?

2. What are the appropriate interventions in this situation?

Enumerate it in bullet form and give the reason for

intervention.

3. If Mary is going to be on leave for several weeks, what are your plans in
terms of manpower? Take note that you are already short of radiology staff.

POINTS TO REMEMBER

• Supervision is a process of training, mentoring, guiding, and

encouraging healthcare staff to improve their performance to
provide high-quality healthcare services.
• The term supervisor typically refers to one's immediate superior in
the workplace, that is, the person whom you report directly to in
the organization.
• Supervision means carrying out managerial functions of planning,
organizing, directing, controlling, and staffing at various levels of
management.
• The term 'supervisor' is generally associated with managers at the
lowest level who supervise the activities of the workers.
• The term “supervisor” typically refers to one's immediate superior
in the workplace, that is, the person whom you report directly to in
the organization
• The level of supervision is determined by how work is assigned
when it is reviewed, how it is reviewed, and what protocols are
available.
• In direct supervision, the supervisor gives specific instructions on
all assignments.
• In general supervision, the supervisor provides continuing
or individual assignments by indicating generally what is to be
done, limitations, quality and quantity expected, deadlines ad
priorities.
• In intermittent supervision, the supervisor makes assignments by
defining objectives, priorities, and deadlines, and assists the
employee with unusual situations that do not have clear objectives.
• In administrative supervision, the supervisor sets the overall
objectives and resources available.
• In general direction, assignments are made in terms of broad
practice, precedents, policies, and goals.
• The span of control refers to the number of subordinates that can
be managed effectively and efficiently by supervisors or managers
in an organization.
 Chapter 8
Leadership Objectives: At the end of the topic, the student should be able to do the following:
1. Define leadership.
2. Discuss the nature of leadership.
3. Discuss the history of leadership.
4. Enumerate the characteristics of a leader and leadership principles.
5. Explain the importance of leadership in healthcare.
6. Enumerate the different leadership approaches.
"The key to successful leadership is influence, not authority." -Kenneth Blanchard
A successful manager must be capable of leading one group of subordinates. Leadership is a
process by which a person influences others to accomplish an objective and directs the
organization in a way that makes it more cohesive and coherent. Leaders carry out this process
by applying their leadership attributes, such as beliefs, values, ethics, character, knowledge,
and skills.
The Nature of Leadership
For the last eight years, the area of leadership has been object of analysis and study. During
this time, behavioral scientists and practicing managers alike sought to analyze and define what
leadership is. It is important to distinguish between management and leadership. Management
is the process of getting things done through people. Leadership is part of the manager's job
and be defined as the process of influencing people to direct their efforts toward the
achievement of some particular goals. This influence comes from two basic sources. One the
source is the leader's position power, which is the formal authority that accompanies a particular
job. For example, a vice president of manufacturing is empowered to give orders to
subordinates. The same is true for a hospital administrator, a chief radiologic technologist, chief
radiologist, chief of police, a college dean, etc. To some degree, all leaders are influenced by
their position.
The second source of leadership influence is the subordinate's willingness to comply. Is
someone a leader? One way to answer this question is to see who is following the individual.
Subordinates must be willing to obey the superior's command.
The task of the leader is to determine which method of leadership will work best given a) his
personality, experience, and knowledge; b) the background, training, and expectations of his or
her followers; and c) the particulars of the situation in which everyone is functioning. This
requires the leader to analyze each situation very carefully.
History of Leadership
Historical Leaders
Throughout the centuries, there have been leaders. We are social animals who bond together,
but we look for an order against the chaos of life. We look to be organized to accomplish tasks
as a society that we cannot perform individually. As a result, someone inevitably ends up in
charge.
Leaders in the past have generally belonged to one of the three categories: political, military,
and religious.
Political

Around 1790 B.C, Babylonian ruler Hammurabi created the codified laws which unified his
empire in what was seen as a fair order as all people were subject to the same rules.
Military
Sun Tzu was a military general in China from 500 B.C. He wrote the Art of War, and although he
was a great military leader, his book is actually about how to not use armies except as a last
resort, focusing more on wise political policies and strategies to prevent war.
Religious
It may be said that religious leaders have the greatest impact on their societies, which results
from that last for centuries.
Modern Leaders
With the rise of the industrial revolution, a new kind of leader emerged: Economic. The so-called
Captains of Industry found they could build an empire based on modern technology instead of
swords. Oil Barons, railroad magnates, and factory owners built large fortunes without the
benefit of armies; it was often at the expense of the people they employed. This gave rise to
Union leaders and various movements designed to promote justice where abuses were
perceive to exist
The Industrial Revolution also increased the number of Scientific Leaders, as scientists now had
easy access to a wide range of new materials for their work. Studies have shown consistently
that workers are more productive when they are in a "positive work environment". The attitude
and influence of the manager is major factor in this productivity. If employees feel they are
happier in their work and perform better than those who feel they are disrespected and
unappreciated.

Definition of Leadership
Leadership may mean different things in different situations. Although definitions may differ, the
overall sentiments are frequently similar. Leadership may be defined as the overall process
which influences others to follow one's direction or to accomplish a goal.
Leaders typically demonstrate integrity vision that inspires and a developed core values people.
Inherent in the definition of leadership is the notion that a leader has followers. Those followers
are inspired to accomplish a goal. In the healthcare setting, those goals often revolve around
improving care and achieving positive patient outcomes.
Leaders help their followers feel empowered to solve problems and to be innovative and
creative. Leaders provide the direction and use their management abilities to assist people in
the proper path. Leadership is not about authority or power nor is it about the individual's
position or title. Rather, leadership is derived from social influence.
Leadership requires the assistance of other people who help reach goals. Leadership is a
learned skill achieved through developing a high level of self-awareness. Leaders can expand
their knowledge and skills through education and practice.
Characteristics of a Leaders
The mark of a true leader is not a position or title held but it is how many people are willing to
follow them. Santa Clara University and the Tom Peters group outline the following leadership
characteristics:

 Honest
 Competent
 Forward-looking
 Inspiring Intelligent
 Fair-minded
 Broad-minded
 Courageous
 Straightforward
 Imaginative

Leadership Principles
Leadership principles are the set of actions or guiding beliefs that leaders can implement to
them toward success. How well an organization performs is directly related to how effectively
leader motivates and guides his employees. following are the 11 leadership principles
1. Know yourself and seek self-improvement
2. Be technically proficient
3. Develop a sense of responsibility among your subordinates.
4. Make sound and timely decisions
5. Lead by example.
6. Know your people and look for their welfare
7. Keep your people informed.
8. Seek responsibility and take responsibility for your actions
9. Ensure assigned tasks are understood, supervised, and accomplished.
10. Train your people as a team.
11. Employ your team following its capabilities.
Leadership in Healthcare

Leadership is the accomplishment of a goal through the direction of human assistants (Prentice,
2004). Leadership involves working through individuals and groups to accomplish goals.
Healthcare leadership involves an individual effort's effort to influence the behavior of others in
providing direct, individualized care.
Radiologic technologist leaders who mentor others the personal benefit of feeling a sense of
pride and other benefits of radiologic technology to patients and the organization. For example,
radiologic technology leaders benefit patients by improving patient care, safety, outcomes, and
satisfaction. In addition, effective radiologic technology leaders benefit the organization by
enhancing work processes, decreasing errors. and reducing waste, all of which help healthy
work environment.
Teamwork and productive leadership are important in a healthcare organization. Photo by:
iStock
Why Study Leadership?
Radiologic technologists study leadership to prepare themselves for the essential expectations
of the registered radiologic technologists.
Leadership competencies are viewed as a fundamental human activity and a critical component
of radiologic technologists. Radiologic technologists' roles have expanded making leadership
skills more important than ever. Leadership skills are needed because the field needs intra-
professional skills in teams to solve urgent issues at the individual (micro) level, and also at the
greater systems (macro) level. Many radiologic technologists enter the profession given their
desire to make a positive difference in the world.
Leadership competencies help them make that difference because leaderships skills are
needed to facilitate and implement beneficial change. Radiologic technologist make a positive
difference with patients because they lead the interdisciplinary team to help improve patient
outcomes. Radiologic technologist leadership skills and abilities have many improved outcomes
such as quality patients care, limiting patients from unnecessary radiation dose job satisfaction
and driving cultural change.
Leadership skills enable radiologic technologists to become good role models among their
colleagues because they help to lead change and inspire others within the organization.
Benefits of Being a Leader
There are many benefits of being a leader. Being a leader has many benefits like being
controlled in the job, more decision-making power, and more autonomy at work. Some of the
benefits impact the radiologic technologists personally. For example, a radiologic technologist
leader does his job all the time with competence in dealing with patients and was noticed by the
management; this gives an increased opportunity for career advantage. A good radiologic
technologist leader is expected not just to perform and deliver, but also to inspire others to
perform well in good and bad situations.
Theories of Leadership
The Great Man Theory
The Great Man Theory of leadership refers to an idea dating back to the nineteenth century.
According to this idea, history, and everything that is happening to the world can be explained
by identifying the impact that great men or heroes have. This concerns highly influential and
unique individuals who due to their natural attributes, such as superior intellect, heroic courage,
extraordinary leadership abilities, or divine inspiration.
This theory was developed by a Scottish philosopher and historian, Thomas Carlyle. According
to him, a leader is a person who is blessed with unique qualities that capture the public's
imagination. The Great Man Theory of leadership assumes that great leaders are born, not
made or trained. Individuals are born with certain traits or characteristics, and these
characteristics are different in natural-born leaders compared to others who only gained
leadership through training and experience. As natural-born leaders, these specific traits or
characteristics enable them to lead people while they shape the pages of history.
The Trait Theory
Unlike the Great Man Theory, Trait Theory argues that leadership qualities can be acquired;
however, a good leader has certain characteristics that allow learning the skills to be much
easier. The Trait Theory suggests that certain inborn innate qualities and characteristics make
someone a leader. These qualities might be personality factors, physical factors,
Intelligence factors, and so on. In essence, Trail Theory proposes that the leader and leader’s
trait are central to the organization’s success. The assumption here is that finding people with
the right traits will increase organizational performance
Path Goal Theory
The Path-Goal Theory was developed in 1971 by psychologist Robert House (1971). It factors
into leadership style two separate pieces of work concerning motivation goal and expectancy
theory. Path- goal Theory is concerned with the level of worker motivation required to achieve
organizational goals. The motivating force set forth by organization depends on the value of the
goals to the worker and whether the worker believes she can achieve the goals. According to
the path goal theory, the leader’s major responsibilities include clarifying what needs to be done,
removing roadblocks to accomplishment, and increasing opportunity for follower satisfaction at
work. In the framework of this theory, the leader is expected to work employee’s behalf to
ensure that they have what they need to meet the goals.
The path-goal theory of leadership emphasizes the importance of effectiveness for healthcare
organization operations. It also alerts the leader to numerous leadership styles that can be
mixed and matched depending on the group to be led and the task being undertaken. In
addition, it is a valuable model for thinking about leadership because path goal theory aids in
understanding the importance of matching the leader's style with the situation. For example, the
approach to providing leadership in a modem operating room or emergency department differs
greatly from providing
leadership today in most other departments in hospital. Although this is a complicated theory, it
is w consideration because it supports the prevail recommendations for empowering employees
when the prepared for the responsibility
Fiedler's Contingency Theory
Fred Fiedler (1967) developed the Contingency Theory of leadership, which essentially posits
that no single best way exists to structure an organization. Contingency Theory help decision-
makers factor in the situation at hand when selecting a leader and it aids leaders in determining
which leadership style or behavior to use. This theory also is based on two factors for analysis:
relationship-motivated factors and task motivated factors. Contingency Theory includes three
important situational variables that can affect the success or failure of a leader: (1) leader-
member relations, 21 task structure, (3) position power.
Bolden and colleagues (2011) interpret contingency theory to mean that managers who take a
task-oriented approach perform better than those with a relationship orientation in situations that
already have in place good leader-member relations, structured tasks, and either weak or strong
position power. He pointed out that leadership results in the best outcomes when the leader is
placed in a situation that closely matches his style.
Leadership Styles

Kurt Lewin, a psychologist, offered a strong foundation in the 1930s for the discussion of
leaders' behavior to come later. His research uncovered three major styles of to come
leadership: (1) autocratic, (2) democratic, (3) laissez-faire.
The autocratic style entails all power being kept by the leader in forcing his or her will on the
followers, sometimes through rewards but mostly by frightening followers with potential
punishments. The democratic leader shares his or her power equally with followers. The leader
who uses a laissez-faire style gives virtually all power to the followers-and by granting that
power relinquishes any responsibility for organizational success or failure. One of Lewin's early
studies was conducted at the University of lowa. It concentrated on characterizing two of the
aforementioned leadership styles, autocratic and democratic. The autocratic style involves the
leader making all decisions and telling the lower-level employees what to do and how to do it.
This leadership style may be seen as similar to a manager using organizational power to get the
work done. It is an excellent style to bring into a discussion about leadership in healthcare
facilities because many of these organizations still struggle to preserve the power of the
executive suite. Further along, the continuum of leadership styles is the democratic style of
leadership.
Leaders practicing democratic leadership are much more likely than autocratic leaders to
advocate for participatory decision-making. The followers are requested by the leader to share
with her their thoughts regarding impending decisions. Leading with an initiating structure
approach was assigning tasks, clarifying expectations, and defining how work should be done.
Leadership Approaches
How one approaches leadership depends on experience and expectations. Many leadership
theories and styles have been described. Two of the most popular theory-based approaches are
transactional and transformational leadership.
Transactional Leadership
A transactional leader is the traditional "boss" image. In a transactional leadership environment,
employees understand that there is a superior who makes the decisions with little or no input
from subordinates. Transactional leadership relies on three methods to more followers:
1. Offering rewards to the staff of followers for desired work
2. Monitoring work performance and correcting followers when a problem is noted, and
3. Waiting until a problem occurs and then dealing with the issue retrospectively.
Transactional leadership relies on the power of organizational position and formal authority to
reward and punish performance. Followers are fairly secure about what will happen next and
how to "play the game" to get where they want to be. The transactional leader is more likely to
opt for the status quo and is usually found in stable environments.
Transformational Leadership
A transformational leader seeks and welcomes input from followers as goals are formulated and
decisions are made, Transformational leadership is a style described by Markham (1998) as
collaborative, consultive, consensus- seeking, and ascribing power to interpersonal skills and
personal contact
Convey (1992) states. “The goal of transformational leadership is to transform people and
organizations in a literal sense to change them in mind and heart; enlarge vision, understanding;
clarify purposes; make behavior with beliefs, principles, or values; and bring about that are
permanent, self-perpetuating, and momentum building”
The Concept of Best Leadership Practices
What style is best for leading a service-producing organization? Does one best style of
leadership apply in the majority of healthcare organizations? Many organizations have been
plagued by failed attempts to adopt a comprehensive leadership approach in the past few
decades. Coleman (2000) identified six leadership styles typically assumed by organizations,
concluding that successful leaders do not rely on one style but rather use multiple styles in a
given period.
Kotter (1999) notes that both management and leadership attributes are necessary for success
in an increasingly complex business environment. He argues that organizations today are
overmanaged and under led. Assuming this is an accurate assessment, what should be the
compromise or balance between management and leadership in the delivery of healthcare
services in this volatile environment? Healthcare leaders must spend more time setting the
direction for the organization and give managers the responsibility to plan operations and
budgets.
Stevenson and Kaafarani (2011) conclude that healthcare organizations and their top leadership
team must become focused on innovation to deliver profitable growth while eliminating waste
and improving the quality of all services delivered to a now highly informed consumer. The
catalyst for a change in the healthcare delivery model must be innovative leadership that,
executed appropriately, eliminates the confusion currently seen who work in healthcare. This
level of leadership can be among many effective in convincing people that they can accomplish
goals they previously believed were impossible. This is a good lesson for healthcare
organizations to learn as they go about changing the design of the organization and training
their leaders for an unknown future. and
Leadership Skills Differ from Management
In this book, we not only address leadership skills but also consider management skills. As we
have discussed, leadership skills involve the development of a vision, setting goals effectively,
and motivating others to reach those goals. Leadership requires the ability to influence to
achieve desired outcomes. Management skills, on the contrary, involve overseeing operations
and processes. Management skills involve handling the day-to-day operations of the unit and
helping people to work together efficiently and harmoniously. It helps to understand those with
whom you work and what motivates them so you can identify the right approach.
Self-Assessment: Are you are a leader?
This is not a scientific self-assessment but rather is intended to foster reflection. Please answer
"yes" or "no" to the following questions:

 Do people ask you to help resolve conflicts?

 Do people confide in you?
 Do people turn to you for guidance in for guidance in unclear situations?
 Do people find what you have to say as important even though they might disagree
 Do people consider you a role model?
 Do you solve problems in your work environment?
 Do you develop solutions to workplace issues?
 Do you have a vision for how things should be done?
 Do you bring out the best in people?
 Do you encourage the growth and development of your colleagues?
 Do you currently driven by a set of career goals?
 Are you persuasive?
 Are you approachable?
 ls your communication style clear and direct?
Scoring Interpretation. If you answered "yes" to most of these questions, you are most likely
already a leader in your area. Do not worry if you did not answer "yes" to many of these
questions. Sometimes it is easier to learn evidence-based skills the first time rather than having
to relearn skills that might not be backed by any evidence. Remember, leadership is a learned
skill you can hone through education and practice.
Chapter Summary
Leaders are needed at the bedside to help inspire others to achieve patient outcomes.
Leadership is not just about the position a radiologic technologist hold but about self-awareness,
knowledge of processes, and relationships with others. In addition to improving patient care,
leadership abilities can potentially benefit personally as well as professional satisfaction.
In recent years, the study of leadership has become popular in part to address the turmoil
caused by globalization, disruptive innovation, technology, and intense competition from
nontraditional sources. This threatening environment has forced a large number of businesses
to change their bureaucratic organizational structure to a more organic one; this needs for
change in the healthcare delivery system as well.
Many styles or behaviors of leaders should be considered as healthcare delivery moves from
bureaucracy to a decentralized structure. These styles of leadership have been identified by
research projects looking at different variables that seem to affect one's ability to lead followers.
The overriding themes of the majority of studies include concern for people versus concern for
production or task. The implication of all this research seems to successful leadership typically
depends on the particular be that leader, followers, and situation in which the leader is placed.