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

In Support of Evidence-Based Healthcare Management_________________________________________________________________________________________researchers who have used approaches relying on the ‘absolute or relative frequency of observedbehaviours’ rather than the ‘quality of specific behaviours’.The results of the NHS research reported in this article support to some degree the findings ofAmerican researchers such as Shipper, (1991 & 2000), Atwater and Yammarino (1992), Tsui andAshford (1994) and, of European researchers such as Van Der Velde et al (1999), who argue that thejudgements and perceptions of behaviour constituting managerial effectiveness of superiors andsubordinates often differ from the self-perception and judgement of managers themselves. Howeverthe differences in judgement that have emerged from the study are very limited in number across thefull range of manager and non manager perspectives. The vast majority of the criteria appear to beheld in common, not only within the two respective organisations, but also between them. This pointsto a significant amount of generalisability of the identified criteria of managerial effectiveness.Over the past two decades there has been considerable debate and controversy within the UKconcerning the notion of the ‘universally effective manager’. Some believe that “a set of universallyapplicable management competence criteria - independent of function and organisational context” canbe derived as epitomised by the work of Boyatzis (Training Agency, 1988). Other expertcommentators such as John Burgoyne, have argued that this approach is misconceived and “auniversal mechanism is inappropriate” (Bennett & Langford, 1983; Herriot, 1988; Smith et al 1989;Jacobs, 1989; Willcock, 1992; Hamlin & Stewart, 1998). In a similar vein Flanagan (1990) andFlanagan & Spurgeon (1996) assumed for their research into managerial effectiveness in the NHS thatmanagerial effectiveness is a subjective vision determined by factors within each organisation, andthat managerial competencies are situationally dependent, contingent upon the organisational contextand therefore ‘organisation-specific’. They argue that “for any one organisation there is merit inreinventing the wheel in terms of identifying the particular skills and behaviours that are perceived bymanagers to represent effective management in that organisation at that time”, and that “borrowingsets of words or competencies from another organisation, even a common set derived from a range oforganisations, is only useful if they are debated in terms of meaning and value to the organisation inquestion, and then internalised and operationalised by its managers”.However, the high degree of similarity, coincidence and potential generalisability revealed by thepresent study challenge these ‘contingent’ and ‘organisation-specific’ models of managerialeffectiveness, and point towards the existence of the ‘universally effective manager’ as reported byBennett & Langford (1983) and previously evidenced by Hamlin (1988). Although at the‘behavioural level’ many of the critical incidents and behavioural items identified by the research areclearly specifically related in their detail to the organisational setting of the NHS and HM Customs &Excise respectively, and at the ‘factorial level’ a number of the identified criteria of managerialeffectiveness are ‘organisation-specific’ and/or ‘perspective-specific’, the large majority of behavioursand factors (criteria) are held in common across all perspectives and between organisations. Thissuggests these criteria possess ‘universal’ characteristics. Whilst at a behavioural level the researchlends a degree of support to the ‘contingent model of managerial effectiveness’ adopted by Flanaganand Spurgeon (1996), at the factorial level the results overall support more strongly the notion of the‘universally effective manager’. This challenges Flanagan and Spurgeon’s view that there can be ‘nosingle clear picture of effective management or effective managers.’Limitation of the StudyOne limitation of the study is that it was undertaken in a single NHS Trust hospital. Therefore thecriteria of managerial effectiveness identified cannot yet be regarded categorically as generalised toany population of healthcare managers beyond those in the study. Similar research needs to be carriedout in other types of NHS Trust healthcare settings including both acute and community hospitals.However, the high degree of similarity and coincidence revealed between the two studies suggestsmany of the positive and negative criteria identified are likely to be generalisable and ‘universal’. Asecond limitation is the comparative lack of equivalent or near equivalent empirical case studyresearch in other organisations and other sectors against which to compare the findings.19 Management Research Centre 2001