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Health Organizations: Theory, Behavior, and Development

Edited by

James A. Johnson, PhD

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Library of Congress Cataloging-in-Publication Data Health organizations : theory, behavior, and development / [edited by] James A. Johnson.

p. ; cm. Includes bibliographical references and index. ISBN-13: 978-0-7637-5053-4 (pbk.) ISBN-10: 0-7637-5053-0 (pbk.) 1. Health services administration. 2. Organizational behavior. 3. Organizational soci-

ology. I. Johnson, James A., 1954- [DNLM: 1. Health Facilities--organization & administration. 2. Models, Organizational.

3. Organizational Culture. WX 100 H4345 2008] RA971.H398 2008 362.1068--dc22

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Many thanks to the talented and tireless authors who contributed to this book and to the publisher, Michael Brown, for encouraging me to do it. As always, I remain grateful to my three children, Allen, Adam, and Elizabeth for the inspiration they provide me everyday, simply by being who they are.

A C K N O W L E D G M E N T S

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Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvii About the Editor . . . . . . . . . . . . . . . . . . . . . . . . . xxi

PART I ORGANIZATION THEORY AND FOUNDATIONS

Chapter 1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

James A. Johnson and Peter C. Olden

Studying Organizations . . . . . . . . . . . . . . . . . . . . . 4 Beyond the Classroom . . . . . . . . . . . . . . . . . . . . . . 8 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Chapter 2 Anatomy and Physiology of Theory . . . . . . . . . . . . 9

M. Nicholas Coppola

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 What Is Theory? . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Anatomy of Theory . . . . . . . . . . . . . . . . . . . . . . . 13 Physiology of Theory . . . . . . . . . . . . . . . . . . . . . . 18 Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . . 24 Review/Discussion Questions . . . . . . . . . . . . . . . . 24 Learning Activities . . . . . . . . . . . . . . . . . . . . . . . . 25 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Chapter 3 Classical Theories of Organization . . . . . . . . . . . . 29

Peter C. Olden and Mark L. Diana

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Scientific Management . . . . . . . . . . . . . . . . . . . . . 30 Administrative Principles . . . . . . . . . . . . . . . . . . . 33 Bureaucratic Principles . . . . . . . . . . . . . . . . . . . . . 36 Human Relations . . . . . . . . . . . . . . . . . . . . . . . . . 39 Administrative Behavior . . . . . . . . . . . . . . . . . . . . 41 Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . . 43 Review/Discussion Questions . . . . . . . . . . . . . . . . 44 Learning Activities . . . . . . . . . . . . . . . . . . . . . . . . 44 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

C O N T E N T S

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Chapter 4 Modern Theories of Organization . . . . . . . . . . . . 47

Mark L. Diana and Peter C. Olden

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47 General Systems Theory . . . . . . . . . . . . . . . . . . . . 48 Contingency Theory . . . . . . . . . . . . . . . . . . . . . . . 50 Transaction Cost Economics . . . . . . . . . . . . . . . . . 51 Resource Dependence Theory . . . . . . . . . . . . . . . . 53 Institutional Theory . . . . . . . . . . . . . . . . . . . . . . . 55 Population Ecology . . . . . . . . . . . . . . . . . . . . . . . 57 Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . . 59 Review/Discussion Questions . . . . . . . . . . . . . . . . 60 Learning Activities . . . . . . . . . . . . . . . . . . . . . . . . 60 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

Chapter 5 Complexity and Postmodern Theory . . . . . . . . . . 63

Reuben R. McDaniel, Jr. and Michele E. Jordan

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 Shared Notions and Common Focus . . . . . . . . . . . 66 Characteristics of Complex Adaptive Systems . . . . 69 Managing Healthcare Organizations as

Postmodernist Complex Adaptive Systems . . . . 71 Decision Making and Sensemaking . . . . . . . . . . . . 72 What Does This All Mean? . . . . . . . . . . . . . . . . . . 77 Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . . 78 Review/Discussion Questions . . . . . . . . . . . . . . . . 78 Learning Activities . . . . . . . . . . . . . . . . . . . . . . . . 79 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82

PART II ORGANIZATION BEHAVIOR AND DYNAMICS

Chapter 6 Individual Behavior and Motivation . . . . . . . . . . . 87

Mary S. O’Shaughnessey

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 Theories of Motivation . . . . . . . . . . . . . . . . . . . . . 88 Motivation in the Work Environment . . . . . . . . . . 97 Changes in Motivation . . . . . . . . . . . . . . . . . . . . 100 Motivation and Learning . . . . . . . . . . . . . . . . . . 101 Impact of Age and Cultural Factors on

Motivation and Learning . . . . . . . . . . . . . . . . 102 Motivation and Sports . . . . . . . . . . . . . . . . . . . . 103 Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 104 Review/Discussion Questions . . . . . . . . . . . . . . . 104 Learning Activities . . . . . . . . . . . . . . . . . . . . . . . 105 Case Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106

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Chapter 7 Group Dynamics . . . . . . . . . . . . . . . . . . . . . . . . 109

Lana V. Ivanitskaya, Sharon Glazer, and Dmitry A. Erofeev

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109 Groups and Teams . . . . . . . . . . . . . . . . . . . . . . . 110 Groups and Teams in Healthcare

Organizations . . . . . . . . . . . . . . . . . . . . . . . . 111 Roles, Diversity, and Trust . . . . . . . . . . . . . . . . . 112 Group Processes . . . . . . . . . . . . . . . . . . . . . . . . . 114 Group Formation . . . . . . . . . . . . . . . . . . . . . . . . 115 Group Phenomena . . . . . . . . . . . . . . . . . . . . . . . 116 Application of Crew Resource Management

(CRM) to Healthcare . . . . . . . . . . . . . . . . . . . 118 Performance and Group Effectiveness . . . . . . . . . 119 Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 128 Review/Discussion Questions . . . . . . . . . . . . . . . 129 Learning Activities . . . . . . . . . . . . . . . . . . . . . . . 130 Case Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133

Chapter 8 Power and Politics . . . . . . . . . . . . . . . . . . . . . . . 137

Lee W. Bewley

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 Sources of Power . . . . . . . . . . . . . . . . . . . . . . . . 138 Politics in Health Organizations . . . . . . . . . . . . . 143 Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 145 Review/Discussion Questions . . . . . . . . . . . . . . . 147 Learning Activities . . . . . . . . . . . . . . . . . . . . . . . 147 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147

Chapter 9 Conflict and Interpersonal Relations . . . . . . . . . 149

Gerald R. Ledlow

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150 Conflict Management . . . . . . . . . . . . . . . . . . . . . 151 Interpersonal Relationships . . . . . . . . . . . . . . . . 158 Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 163 Review/Discussion Questions . . . . . . . . . . . . . . . 163 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164

Chapter 10 Leadership Theory and Influence . . . . . . . . . . . . 167

Gerald R. Ledlow and M. Nicholas Coppola

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167 Defining Leadership . . . . . . . . . . . . . . . . . . . . . . 169 A Chronological Review of Leadership Theory . . 171 Leadership Phase Evolution . . . . . . . . . . . . . . . . 174

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Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 185 Review/Discussion Questions . . . . . . . . . . . . . . . 190 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190

Chapter 11 Leadership and Transformation . . . . . . . . . . . . . 193

Gerald R. Ledlow, M. Nicholas Coppola, and Mark A. Cwiek

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193 Prescription One: The Dynamic Culture

Leadership Model . . . . . . . . . . . . . . . . . . . . . 194 Prescription Two: The Omnibus

Leadership Model . . . . . . . . . . . . . . . . . . . . . 201 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208 Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 209 Review/Discussion Questions . . . . . . . . . . . . . . . 209 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210

Chapter 12 Decision Making and Communication . . . . . . . . 213

Gerald R. Ledlow and James Stephens

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214 Decision Making . . . . . . . . . . . . . . . . . . . . . . . . 214 Tools of Decision Making . . . . . . . . . . . . . . . . . . 221 Communication . . . . . . . . . . . . . . . . . . . . . . . . . 223 Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 229 Review/Discussion Questions . . . . . . . . . . . . . . . 230 Case Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231

Chapter 13 Culture Values and Ethics . . . . . . . . . . . . . . . . . . 233

Rupert M. Evans, Sr.

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233 What Is Corporate Culture? . . . . . . . . . . . . . . . . 234 The Healthcare Setting . . . . . . . . . . . . . . . . . . . . 234 How Are Culture and Climate Different? . . . . . . 235 What Is the Theory Behind Culture and Climate? . . 236 Values and Beliefs That Support

Organizational Goals . . . . . . . . . . . . . . . . . . . 238 The Ethics and the Social Responsibility

of Management . . . . . . . . . . . . . . . . . . . . . . . 245 Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 250 Review/Discussion Questions . . . . . . . . . . . . . . . 250 Learning Activities . . . . . . . . . . . . . . . . . . . . . . . 251 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 252

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Chapter 14 Stakeholder Dynamics . . . . . . . . . . . . . . . . . . . . 255

M. Nicholas Coppola, Dawn Erckenbrack, and Gerald R. Ledlow

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255 Stakeholders (Actors) in Healthcare . . . . . . . . . . 256 Utility of Parity of Healthcare in

Stakeholder Dynamics . . . . . . . . . . . . . . . . . . 260 The SARFIT Model . . . . . . . . . . . . . . . . . . . . . . 267 Parity in Policy and Strategy . . . . . . . . . . . . . . . . 268 Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 269 Review/Discussion Questions . . . . . . . . . . . . . . . 269 Learning Activities . . . . . . . . . . . . . . . . . . . . . . . 269 Case Study: The Dilemma of the Uninsured

in the United States . . . . . . . . . . . . . . . . . . . . . 269 Case Study: Overburdened Emergency

Departments Threatened by the Problem of Uninsured . . . . . . . . . . . . . . . . . . . . . . . . . 271

Case Study: Business Feels the Consequences of the Uninsured Problem . . . . . . . . . . . . . . . . 273

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275

Chapter 15 Organizational Dysfunction and Pathology . . . . 279

David R. Graber

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279 Healthcare Organizational Groups . . . . . . . . . . . 281 Complexity and Work Intensity . . . . . . . . . . . . . 282 Ambiguous and Conflicting Cultures . . . . . . . . . 283 Healthcare Management and

Organizational Dysfunction . . . . . . . . . . . . . . 285 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 286 Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 287 Review/Discussion Questions . . . . . . . . . . . . . . . 287 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 288

PART III ORGANIZATION DEVELOPMENT AND CHANGE

Chapter 16 Transformational Change and Development . . . . 291

James Whitlock

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291 Organizational Development: Framework

for Change . . . . . . . . . . . . . . . . . . . . . . . . . . . 293 Creating the Capacity to Change . . . . . . . . . . . . 298 Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 308 Review Questions . . . . . . . . . . . . . . . . . . . . . . . . 309 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309

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Chapter 17 Team Building and Development . . . . . . . . . . . . 311

Jo-Ann Costa

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 312 Types of Teams . . . . . . . . . . . . . . . . . . . . . . . . . . 312 The Team Advantage . . . . . . . . . . . . . . . . . . . . . 313 Benefits of Teams . . . . . . . . . . . . . . . . . . . . . . . . 314 Team Composition . . . . . . . . . . . . . . . . . . . . . . . 315 Team Evolution . . . . . . . . . . . . . . . . . . . . . . . . . 316 Stages of Team Development . . . . . . . . . . . . . . . 318 Building Team Functionality . . . . . . . . . . . . . . . . 318 Ongoing Training = Sustainable Knowledge . . . . 321 Problem Solving . . . . . . . . . . . . . . . . . . . . . . . . . 321 Continuous Reinforcement: The Value of the

Team’s Work . . . . . . . . . . . . . . . . . . . . . . . . . 322 Getting Down to Business . . . . . . . . . . . . . . . . . . 322 Defining Success . . . . . . . . . . . . . . . . . . . . . . . . . 324 Beyond Metrics . . . . . . . . . . . . . . . . . . . . . . . . . 324 Selling the Solution: Management Buy-In . . . . . . 325 Back on the Everyday Job . . . . . . . . . . . . . . . . . . 326 Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 326 Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 329 Review/Discussion Questions . . . . . . . . . . . . . . . 329 Learning Activity . . . . . . . . . . . . . . . . . . . . . . . . 329 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 330

Chapter 18 Physician Leadership and Development . . . . . . . 331

Sudha Xirasagar

Clinical Performance: The Key to Healthcare Reform . . . . . . . . . . . . . . . . . . . . . 331

Why Physician Leadership Is Needed . . . . . . . . . 333 Understanding Physician Behavior . . . . . . . . . . . 333 From Clinician to Leader—Essential Changes

in Mindset . . . . . . . . . . . . . . . . . . . . . . . . . . . 336 Leadership Development Models . . . . . . . . . . . . 337 Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 344 Review/Discussion Questions . . . . . . . . . . . . . . . 344 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 345

Chapter 19 Governance and Board Development . . . . . . . . . 349

Dennis G. Erwin and Andrew N. Garman

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 349 Board Organization . . . . . . . . . . . . . . . . . . . . . . 350 Board Officers . . . . . . . . . . . . . . . . . . . . . . . . . . 351 Board Committees . . . . . . . . . . . . . . . . . . . . . . . 351 Board Meeting Format . . . . . . . . . . . . . . . . . . . . 353

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The Relationship Between Senior Management and the Board . . . . . . . . . . . . . . . . . . . . . . . . . 355

Fiduciary Duties . . . . . . . . . . . . . . . . . . . . . . . . . 355 Financial Oversight . . . . . . . . . . . . . . . . . . . . . . 356 Operating Oversight . . . . . . . . . . . . . . . . . . . . . . 356 Strategic Oversight . . . . . . . . . . . . . . . . . . . . . . . 358 Oversight of Patient Care and Resource

Utilization . . . . . . . . . . . . . . . . . . . . . . . . . . . 360 Changing Board Models . . . . . . . . . . . . . . . . . . . 361 Effective Governance: Cultures and Activities . . . 362 Board Assessment . . . . . . . . . . . . . . . . . . . . . . . . 362 Board Member Education . . . . . . . . . . . . . . . . . . 364 Current Issues and Controversies . . . . . . . . . . . . 366 Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 366 Review/Discussion Questions . . . . . . . . . . . . . . . 367 Learning Activity . . . . . . . . . . . . . . . . . . . . . . . . 367 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369

Chapter 20 Organization Development for Terrorism and Natural Disasters . . . . . . . . . . . . . . . . . . . 371

Ahmed Adu-Oppong, Gerald R. Ledlow, Mark A. Cwiek, James A. Johnson, and M. Nicholas Coppola

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 372 Significance to Healthcare Leaders . . . . . . . . . . . 372 The Threat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 374 Business Involvement: What Should Be Done . . . 383 A Preparedness Plan . . . . . . . . . . . . . . . . . . . . . . 385 Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 392 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 392

Chapter 21 Organization Development and the Future . . . . . 395

James A. Johnson

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 395 Development Practice and Philosophy . . . . . . . . 396 Development in a Changing World . . . . . . . . . . . 397 Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 398 Review/Discussion Questions . . . . . . . . . . . . . . . 399 Learning Activities . . . . . . . . . . . . . . . . . . . . . . . 399 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 399

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 401

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During the last ten years in my work, I have had the privilege of visiting numerous healthcare organizations; some expansive healthcare organi- zations with unlimited resources, others, small community hospitals with limited resources; all have endured significant new demands and unex- pected challenges.

The world has witnessed unprecedented events that have affected the foundation of health care. The September 11th terrorist attacks and mul- tiple natural disasters, such as Hurricane Katrina, have impacted differ- ent healthcare organizations in ways that we never envisioned. With globalization and the push for universal care in many states, there has been a ripple effect throughout society.

Other new requirements have surfaced for healthcare organizations. Much is known about the impact of medical errors on the patient popu- lation. As an effort to develop a body of basic rules of engagement to im- prove the care provided to the patient population and to guarantee safety to the patients, the National Patient Safety Goals have been instituted to address some of the concern. Only the healthcare organizations with well- developed organization structures have succeeded with its implementation. Others, not so well organized, are still struggling with such tasks.

Finally, much is known about the limited human resources (ex. nurses shortage), the aging healthcare infrastructure, and the struggle organi- zations go through in an attempt to adjust to various regulations im- posed by the agencies that govern the industry. Some organizational behaviorist has described misalignment between human resources and cap- ital resources as the factors that have lead to a less than desirable out- come in health care. Those, with sound and sometimes adaptable organizational structures, who have integrated their human and capital resources by aligning all of their resources, have succeeded in the face of the various stressors we have seen.

Healthcare organization theory has often focused on extending the concepts of business organizations applied to the healthcare field. Much of the knowledge about healthcare organization theory has been an ex- trapolation of the concepts developed to explain how businesses or- ganize. Until now, there has been no integrated view on healthcare organization theory.

This book comes as a much-needed initiative of Dr. James Allen Johnson and a group of scholars and experts in an attempt fill a void existent in health administration education. It provides an integrated view of Organi- zation Theory; Organization Behavior; and Organization Development

F O R E W O R D

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making it one of the first books on the integration of these three critical in- terconnected domains.

Integrated knowledge and understanding is needed in health care in or- der to prepare organizations for an uncertain future. This compendium of knowledge will attract significant attention from the healthcare adminis- tration and public health academic communities with its potential to en- hance the professional development and education of our future leaders.

Lorenzo Gonzalez, MD The Joint Commission

xiv Foreword

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This book was written to address a significant need in health adminis- tration education. While there are many textbooks available for courses in organizational behavior, there are few that address organization the- ory and even fewer that discuss organization development in any signifi- cant way. Many university professors and instructors prefer to have a text that addresses all three domains. Drawing upon the expertise and expe- rience of colleagues in various disciplines from universities, government, and corporations, I have brought these three interconnected domains to- gether in this book. It is comprised of three sections: Part I Organization Theory; Part II Organization Behavior; and Part III Organization Development; each containing key chapters that address foundations, re- search, and new directions. A summary of these themes follows:

Organization Theory: Health organizations are complex human systems that have evolved over time and continue to do so. There have been many theories drawing from the fields of psychology, sociology, economics, political science, anthropology, and, lately, physics in an attempt to ex- plain the phenomenon of organization. Each of the theories has changed as social science and behavioral research offered new findings and per- spectives on human behavior in groups and larger aggregates. The clas- sical theories of organization were primarily mechanistic and relied heavily on the knowledge advanced in the industrial age. Modern organization theory takes more of a contingency approach and accounts for human dynamics. Today, emerging theories draw upon new insights from biol- ogy and physics where organizations are seen as systems interconnected with the larger environment. Postmodern theory and our increasing un- derstanding of complexity take us even further.

Organization Behavior and Dynamics: By virtue of their distinct care mission, health organizations have unique behavioral qualities. This book examines power, influence, conflict, motivation, group dynamics, val- ues, communication, and leadership in the context of care giving. Additionally, organization dysfunction and stakeholder dynamics is ad- dressed. Health organizations are comprised of highly credentialed pro- fessionals who function under considerable scrutiny within many prescribed guidelines. The challenge of managing in this environment is great. The bases of any level of effectiveness come from the understanding of indi- vidual, group, and organization behavior.

P R E F A C E

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Organization Change and Development: Lastly, health organizations are not static. The one constant seems to be change. Leaders and managers are tasked to facilitate and manage the change that is inevitable in mod- ern organizations. This can be done in a systematic planned way utiliz- ing approaches found in organization development and team building. This section of the book helps the student and practitioner put to use theories of organization and knowledge of organization behavior in ways that foster change in productive and sustainable ways resulting in better outcomes. Team development, board development, physician develop- ment, and organization development and learning are all addressed. Likewise, current challenges such as disaster preparedness, globalization, and sustainability are discussed.

As you read the book and engage in the discussions and exercises recom- mended in each chapter, it is important to remember the significant re- sponsibility you have as a current or future healthcare manger and leader. You will have a responsibility to yourself, co-workers, the organization, and the individuals and communities you serve. Part of this responsibil- ity can be met by committing to life-long learning and continuously seek- ing to better understand physical and social phenomena. This includes an understanding of organizations as human created systems. As our in- sightful colleague, Margaret Wheatley once said, “Rather than thinking of organization as an imposed structure, plan, design, or role, it is clear that in life, organization arises from the interactions and needs of individuals who have decided to come together.” It is in this coming together that purpose manifests and then demonstrates the great potential of health or- ganizations in making the world a better place for all.

James A. Johnson, PhD

xvi Preface

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xvii

Ahmed Adu-Oppong, PhD Program in Health Services Administration Jiann-Ping Hsu College of Public Health Georgia Southern University

Lee W. Bewley, MHA, PhD, FACHE US Army Medical Department Army-Baylor Program in Health and Business Administration Baylor University

M. Nicholas Coppola, MHA, PhD, FACHE US Army Medical Department Army-Baylor Program in Health and Business Administration Baylor University

Jo-Ann Costa Hughes Corporation (Retired)

Mark A. Cwiek, MHA, JD, FACHE Doctoral Program in Health Administration Herbert and Grace Dow College of Health Professions Central Michigan University

Mark L. Diana, MBA, MSIS, PhD Department of Health Systems Management School of Public Health and Tropical Medicine Tulane University

Dawn Erckenbrack, MHA, EdD, FACHE Health Program Analysis and Evaluation Office of the Assistant Secretary for Health Affairs US Department of Defense

Dmitry A. Erofeev, MA, PhD Express Personnel Services

C O N T R I B U T O R S

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Dennis G. Erwin, MST, DHSc, CPA E2 Consulting Group

Rupert M. Evans, Sr., MPA, DHA, FACHE Division of Health Administration College of Health Professions Governors State University

Andrew N. Garman, MS, PsyD Department of Health Systems Management College of Health Sciences Rush University

Sharon Glazer, MS, PhD Department of Psychology College of Social Sciences San Jose State University

Lorenzo Gonzalez, MD The Joint Commission

David R. Graber, MPH, PhD Department of Health Administration and Policy College of Health Professions Medical University of South Carolina

Lana V. Ivanitskaya, MA, PhD Doctoral Program in Health Administration Herbert and Grace Dow College of Health Professions Central Michigan University

James A. Johnson, MS, MPA, PhD Doctoral Program in Health Administration Herbert and Grace Dow College of Health Professions Central Michigan University

Michele E. Jordan, EdD School of Education University of Texas at Austin

xviii Contributors

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Gerald R. Ledlow, MHA, PhD, FACHE Program in Health Services Administration Jiann-Ping Hsu College of Public Health Georgia Southern University

Reuben R. McDaniel, Jr., MS, EdD Department of Information, Risk, and Operations Management McCombs School of Business University of Texas at Austin

Peter C. Olden, MHA, PhD Department of Health Administration and Human Resources Panuska College of Professional Studies University of Scranton

Mary S. O’Shaughnessy, MS, MHSA, DHA Department of Health Services Administration College of Health Professions University of Detroit Mercy

James H. Stephens, DHA, FACHE Program in Health Administration College of Health and Human Services Ohio University

James Whitlock, DHA, FACHE Healthcare Management Program Department of Business Administration Brenau University, Georgia

Sudha Xirasagar, MD, PhD Department of Health Policy and Management Arnold School of Public Health University of South Carolina

Contributors xix

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xxi

Dr. James Allen Johnson, Jr. is a Professor in the Herbert and Grace Dow College of Health Professions at Central Michigan University. He is also a medical social scientist working in international health development. He has published 10 books and over 100 articles on a wide range of healthcare and management issues. His most recent book is Managing Health Education and Promotion: Leadership for the 21st Century pub- lished by Jones and Bartlett of Sudbury, MA. Dr. Johnson is the past Editor of the Journal of Healthcare Management published by the American College of Healthcare Executives and was Senior Editor for the Journal of Management Practice. He is the founding editor of the Carolina Health Policy and Management Review and has been a Special Issue Editor for the Journal of Management Development; the Journal of Health and Human Services Administration; the Organizational Ethics Journal; and the Journal of Health Administration Education. Additionally, he is the Senior Editor of the Praeger series, Community Preparedness, and Co- Editor of the Handbook of Health Administration and Policy. Dr. Johnson’s work and travels have taken him to 21 different countries including work with the World Health Organization and organization development con- sultation with numerous hospitals, government agencies, and health or- ganizations. He has chaired and served on many non-profit boards, most recently the National Diabetes Trust Foundation. Dr. Johnson was pre- viously on the faculty of the Medical University of South Carolina where he served as Chair of the Department of Health Administration and Policy for many years and was the founding director of the Doctor of Health Administration Program. He has also lectured at Oxford University in England; Beijing University in China; the University of Colima in Mexico; the University of Dublin in Ireland; and is an Adjunct Professor at Auburn University Montgomery. His PhD is from Florida State University.

A B O U T T H E E D I T O R

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