In Support of Evidence-Based Healthcare Management: an ...

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In Support of Evidence-Based Healthcare Management_________________________________________________________________________________________A comparison of the ‘negative’ factors across all three data sets also reveals a high degree ofsimilarity and coincidence. Two of the five ‘top-down’ rated criteria, namely ‘Lack of concern forstaff ‘ and ‘Abdicating from roles and responsibilities’, appear to be completely perspective-specific,as do two strands of two of the ‘self’ rated criteria, namely ‘Negative approach’ and ‘Exhibiting poororganisation’.Table 5. Comparison of the ‘bottom up’, ‘self’ and ‘top down’ rated criteria of managerialeffectivenessPOSITIVE FACTORSFactor ‘Bottom Up’ Rated Factor ‘Self’ Rated Factor ‘Top Down’ Rated1 Organisation Planning &Supporting2 Open & Personal ManagementStyle1 Active Supportive Leadership 1 Planning andOrganisation/Giving Support toStaff2 Inclusive Decision Making 2 Inclusive Decision making andPersonal Approach3 Organisation & Planning 3 Empowerment and Delegation4 Looking After the Interests and 4 Informing PeopleNeeds of StaffNEGATIVE FACTORSFactor ‘Bottom Up’ Rated Factor ‘Self’ Rated Factor ‘Top Down’ Rated1 Undermining andDictatorial/Autocratic Behaviour1 Dictatorial/AutocraticManagement and NegativeApproach1 Ignoring & AvoidingBehaviour/Intimidating Staff2 Avoidance (Ignoring) Behaviour 2 Not Informing People/ Exhibiting 2 Uncaring, Self ServingPoor OrganisationManagement Focus/Underminingof Others3 Failing to Inform Other People 3 Avoidance (Ignoring) Behaviour 3 Not giving, receiving or using4 Self Serving & UncaringManagementinformation4 Lack of Concern for Staff5 Abdicating from Roles andResponsibilitiesThese results in part support the findings of Atwater & Yammarino (1992) who found that superiorsoften appreciate and value different behaviours to those of subordinates, and of Foti (1990) who foundthat subordinates believed proactive managerial behaviour less important than supervisors. From astudy of the literature Van Der Velde et al (1999) suggest subordinates, supervisors, peers and selfperceptionsoften differ in their judgements of behaviour, which was confirmed from their ownresearch into middle managers’ perceptions of top managers versus top managers’ self-reports. Thiswas especially so with respect to activities generally being regarded important such as developingideas, motivating people, planning and decision making. In contrast, the present study suggests that avery strong common judgement exists between superiors, managers and subordinates on what isimportant in determining managerial effectiveness. All identified ‘Organisation & planning’ and‘Supporting staff’ as key criteria of managerial effectiveness, whilst both superiors and managersappear to value ‘Inclusive decision making’ and an ‘Open, personal approach or style’ to managingstaff. It should be noted, however, that the Van Der Velde et al (1999) study focused on middle andtop managers in a large insurance company, whereas the focus of this study was on non-managers/managers (bottom-up rated/subordinates’ perspective), front line managers/ middle managers (selfrated/managers’perspective) and middle managers/top managers (top-down rated/superiors’perspective) in a healthcare setting. The results suggest several criteria of managerial effectivenesshave been applying within the NHS Trust Hospital in question, as given in Table 6.Table 6. Criteria of managerial effectiveness applying within the NHS trust hospitalPOSITIVE CRITERIAOrganisation and planningActive supportive leadershipNEGATIVE CRITERIADictatorial/autocratic managementIntimidating staff14 Management Research Centre 2001
In Support of Evidence-Based Healthcare Management_________________________________________________________________________________________Giving support to staffOpen and personal management approach or styleInclusive decision makingLooking after the interests and needs of staffEmpowerment & delegationInforming peopleNegative approachUndermining of othersAvoidance and ignoring behaviourFailing to inform other peopleNot giving, receiving or using informationExhibiting poor organisationSelf serving and uncaring managementLack of concern for staffAbdicating roles and responsibilitiesGeneralisability of the Research FindingsComparison with the HM Customs & Excise research on managerial effectivenessTo determine whether or not the NHS trust hospital criteria of managerial effectiveness are‘organisational-specific’ or ‘universal’ a comparison has been made with criteria from a near identicalempirical research study carried out within the Anglia Collection of HM Customs & Excise, a majordepartment of the British Civil Service (Hamlin, Reidy & Stewart, 1998). Although a public sectororganisation like the NHS, its ‘business’ and ‘culture’ is radically different. The research focusedupon the management task of middle managers (Higher Executive Officers-HEOs) and first linemanagers (Executive Officers-EOs) who had within their respective roles significant amounts ofresponsibility for managing people. In the ‘Anglia’ study, over 130 managers in HEO and EO roleswere interviewed and over 1,200 critical incidents were collected and used to create the BIQ. Thiswas administered to the HEOs and EOs who were required not only to rate their immediatesubordinates (top down rated) but also themselves (self rated). Neither they, nor the non managerswho had taken part in the research, were asked to rate their immediate superiors (bottom up rating) ashad been the case in the NHS Trust Hospital research programme. The two sets of data from the BIQrating exercise were factor analysed using alpha factoring with varimax rotation to extract bothpositive and negative factors as shown in Table 7.15 Management Research Centre 2001
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