Description
Module 04: Critical Thinking Assignment
Work Teams
Imagine that you have been charged with transforming the performance of a team at your workplace. Specifically, it is under-performing, and your supervisor wants the team to be high-performing within six months. Based on the information in Chapter 18 of Organizational Behavior in Health Care and your own research develop a presentation for your supervisor that addresses the following:
Discuss reasons that healthcare teams under-perform.
Outline best practices for team performance.
Discuss the various organizational barriers that exist in your organization that affect team effectiveness.
Describe motivational strategies that address team level performance.
Present your team performance improvement plan making sure to include specific time-bound goals.
Provide examples from the organization and from current research to support your comments and ideas.
Your presentation should meet the following structural requirements:
Organized, using professional themes and transitions.
It should consist of nine slides, not including the title and reference slides.
Each slide must provide detailed speaker’s notes, with a minimum of 100 words per slide. Notes must draw from and cite relevant reference materials.
Provide support for your statements with in-text citations from a minimum of six scholarly articles. Two of these sources may be from the class readings, textbook, or lectures, but the other four must be external. The Saudi Digital Library is a good place to find these references.
Follow APA 7th edition and Saudi Electronic University writing standards.
You are strongly encouraged to submit all assignments to the Turnitin Originality Check prior to submitting them to your instructor for grading. If you are unsure how to submit an assignment to the Originality Check tool, review the Turnitin Originality Check Student Guide.
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FOURTH EDITION
Organizational Behavior
in HEALTH CARE
Nancy Borkowski, DBA, FACHE,
FHFMA
Professor
Department of Health Services Administration
School of Health Professions
University of Alabama at Birmingham
Birmingham, AL
Katherine A. Meese, PhD
Assistant Professor
Department of Health Services Administration
School of Health Professions
University of Alabama at Birmingham
Birmingham, AL
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Brief Contents
Preface
About the Authors
PART I Introduction
CHAPTER 1
Overview and History
of Organizational
Behavior
CHAPTER 2
Diversity, Equity, and
Inclusion in Health
Care
CHAPTER 3
Diversity
Management and
Cultural Competency
in Health Care
CHAPTER 4
Attitudes and
Perceptions
CHAPTER 5
Workplace
Communication
PART II Understanding Individual
Behaviors
CHAPTER 6
Content Theories of
Motivation
CHAPTER 7
Process Theories of
Motivation
CHAPTER 8
Attribution Theory
and Motivation
PART III Leadership
CHAPTER 9
Power, Politics, and
Influence
CHAPTER 10 Trait and Behavioral
Theories of
Leadership
CHAPTER 11 Contingency Theories
and Situational
Models of Leadership
CHAPTER 12 Contemporary
Leadership Theories
PART IV Intrapersonal and
Interpersonal Issues
CHAPTER 13 Stress in the
Workplace and Stress
Management
CHAPTER 14 Decision Making
CHAPTER 15 Conflict Management
and Negotiation Skills
PART V Groups and Teams
CHAPTER 16 Overview of Group
Dynamics
CHAPTER 17 Groups
CHAPTER 18 Work Teams and
Team Building
PART VI Managing Organizational
Change
CHAPTER 19 Organization
Development
CHAPTER 20 Managing Resistance
to Change
Index
© Valex/Shutterstock
Contents
Preface
About the Authors
PART I Introduction
CHAPTER 1 Overview and History of
Organizational Behavior
Overview
Why Study Organizational Behavior in Health
Care?
The Health Care Industry
History of Organizational Behavior
The Hawthorne Studies
Theories X and Y
Related Disciplines
Discussion Questions
What Do You Know About Organizational
Behavior?
Scoring
Interpretation
References
CHAPTER 2 Diversity, Equity, and
Inclusion in Health Care
Overview
Diversity, Equity, and Inclusion Defined
Changing U.S. Population
Race/Ethnicity
Age
Gender
Sexual Orientation, Gender Identity, and Gender Expression
Implications for the Health Care Industry
Summary
Discussion Questions
Exercise 2-1
Exercise 2-2
Exercise 2-3
References
Other Suggested Readings
CHAPTER 3 Diversity Management
and Cultural Competency in Health
Care
Diversity Management
The Future Workforce
Diversity in Health Care Leadership
Cultural Competency
Summary
Discussion Questions
Exercise 3-1
Exercise 3-2
Exercise 3-3
References
CHAPTER 4 Attitudes and
Perceptions
Overview
Attitudes
Cognitive Dissonance
Formation of Attitudes
Measurement of Attitudes
Changing Attitudes
Perception
Attribution Theory
Social Perception
Halo Effect
Contrast Effects
Projection
Stereotyping
Pygmalion Effect
Impression Management
Employee Selection
Summary
Discussion Questions
Case Study and Exercises
References
Other Suggested Readings
CHAPTER 5 Workplace
Communication
Overview
Communication Process
Feedback
The Johari Window
Communication Channels
Verbal Communication
Electronic Communication
Nonverbal Communication
Barriers to Communication
Environmental Barriers
Personal Barriers
Overcoming Barriers to Improve
Communication
Effective Communication for Knowledge
Management
Strategic Communication
Flows of Intraorganizational Communication
Upward Flow
Downward Flow
Horizontal Flow
Diagonal Flow
Communication Networks
Informal Communication
Cross-Cultural Communication
Communicating with External Stakeholders
Summary
Discussion Questions
Case Studies
References
PART II Understanding Individual
Behaviors
CHAPTER 6 Content Theories of
Motivation
Overview
Maslow’s Hierarchy of Needs Theory
Alderfer’s ERG Theory
Herzberg’s Two-Factor Theory
Job Design
McClelland’s Three-Needs Theory
Achievement
Power
Affiliation
Summary
Discussion Questions
Case Studies and Exercises
References
Other Suggested Readings
CHAPTER 7 Process Theories of
Motivation
Overview
Expectancy Theory
Equity Theory
Satisfaction–Performance Theory
Goal-Setting Theory
Reinforcement Theory
Summary
Discussion Questions
Case Studies
References
CHAPTER 8 Attribution Theory and
Motivation
Overview
Attribution Theory
Attribution Style
Attributions and Motivational States
Learned Helplessness
Aggression
Empowerment
Resilience
Promoting Motivational Attribution Processes
Screening for Resilience
Attributional Training
Immunization
Increasing Psychological Closeness
Multiple Raters of Performance
Conclusion
Discussion Questions
Case Studies and Exercise
References
Other Suggested Reading
PART III Leadership
CHAPTER 9 Power, Politics, and
Influence
Overview
Sources of Power
Other Sources of Power in an Organization
Uses of Power
Developing a Power Base
Organizational Politics
Upward Influence
Conclusion
Discussion Questions
Case Studies
References
CHAPTER 10 Trait and Behavioral
Theories of Leadership
Overview
Trait Theory
Lewin’s Behavioral Study
Ohio State Leadership Studies
University of Michigan Studies
Blake and Mouton’s Leadership Grid
Conclusion
Discussion Questions
Case Study and Exercises
Exercise 10-1
Exercise 10-2
Exercise 10-3
Exercise 10-4
Exercise 10-5 Leadership Questionnaire
References
CHAPTER 11 Contingency Theories
and Situational Models of Leadership
Overview
Fiedler’s Contingency Theory
House’s Path–Goal Leadership Theory
Tannenbaum and Schmidt’s Continuum of
Leadership Behavior
Hersey and Blanchard’s Situational Leadership
Model
Leader–Member Exchange Theory
Conclusion
Discussion Questions
Exercise 11-1
References
CHAPTER 12 Contemporary
Leadership Theories
Overview
Transformational Versus Transactional
Leadership
Transactional Leadership
Transformational Leadership
Transformational Leadership: A Contradictory
View
The Implications of Transformational
Leadership for the Health Care Industry
Other Contemporary Leadership Approaches
The Charismatic Leader
Servant Leadership
Collaborative Leadership
Another Look at Traits and Behavior
Big Five Personality Factors
Emotional Intelligence
Behavioral Competencies
Summary
Discussion Questions
Exercise 12-1
Exercise 12-2 Are You a Charismatic Leader?
Exercise 12-3 What Is Your EQ?
Exercise 12-4
Appendix 12-A Traits and Skills of Collaborative
Leaders
Appendix 12-B Six Key Practices and Necessary
Steps for Leaders to Guide Successful
Collaborations
References
Other Suggested Readings
PART IV Intrapersonal and
Interpersonal Issues
CHAPTER 13 Stress in the Workplace
and Stress Management
Overview
Work-Related Stress
Workplace Violence
Stressors
Positive and Negative Stressors
Internal or External Stressors/Acute or Chronic
Individuals and Stress
Personalities
Underrepresented Populations
Gender
Beliefs About Stress
Burnout
Presenteeism
Causes of Workplace Stress
Coping with Stress
Organizational Coping Strategies
Joy in Work
Job Design
Individual Coping Strategies
Learned Optimism
Stress Management Programs
Summary
Discussion Questions
References
Other Suggested Readings
CHAPTER 14 Decision Making
Overview
Rational Approach
Bounded Rationality Model
Intuition
Heuristics or Biases Approach
Escalation of Commitment and Framing Heuristics
Decision-Style Model
Vroom-Yetton Decision-Making Model
Conclusion
Discussion Questions
Exercise 14-1
Exercise 14-2
Exercise 14-3
References
Other Suggested Readings
CHAPTER 15 Conflict Management
and Negotiation Skills
Overview
Types of Conflict
Levels of Conflict
Intrapersonal Conflict
Interpersonal Conflict
Intragroup Conflict
Intergroup Conflict
Interorganizational Conflict
Conflict Management
Conflict Negotiation Models
Distributive Model
Integrative Model
Interactive Model
Benefits of Skilled Conflict Resolution and
Negotiation
Conclusion
Discussion Questions
Case Studies
References
Other Suggested Readings
PART V Groups and Teams
CHAPTER 16 Overview of Group
Dynamics
Overview
What Is a Group?
Group Interaction
Why Do People Join Groups?
Roles of Group Members
Group Norms
Cohesiveness
Size of the Group
Social Loafing
Experience of Success
Group Status
Outside Threats to the Group
Conformity
Groupthink
Conclusion
Discussion Questions
Exercise 16-1
Exercise 16-2
Be the Best We Can Be Team Norms
Exercise 16-3
References
CHAPTER 17 Groups
Overview
Types of Groups
Primary Groups
Secondary Groups
Reference Groups
Informal or Formal Group Structure
Informal Groups
Formal Groups
Group Development
Group Decision Making
Rational Decision-Making Processes
Brainstorming
Nominal Group Technique
The Delphi Technique
Irrational Decision-Making Processes
The “Garbage Can” Decision-Making Process
Conclusion
Discussion Questions
Exercise 17-1
Exercise 17-2
References
CHAPTER 18 Work Teams and Team
Building
Overview
Teams and Teaming
Types of Teams
Virtual Teams
Building Team Performance
Common Characteristics of Successful Teams
Barriers to Effective Teamwork
Conclusion
Discussion Questions
Exercise 18-1
Exercise 18-2
Exercise 18-3
References
Other Suggested Readings
PART VI Managing Organizational
Change
CHAPTER 19 Organization
Development
Overview
Organization Development
The Organization Development Professional
Action Research
Steps in the Organization Development Process
Entering and Contracting
Diagnosis
Planning and Implementing Change
Evaluating and Institutionalizing Change
Organization Development Interventions
Appreciative Inquiry
Conclusion
Discussion Questions
References
CHAPTER 20 Managing Resistance
to Change
Overview
Drivers of Change
Resistance to Change
Individuals’ Barriers to Change
Discomfort with Uncertainty
Perceived Negative Effects on Interests
Perceived Breach of Psychological Contract
Lack of Clarity as to What Is Expected
Excessive Change
Lewin’s Change Model
Transformation of Health Care Organizations
Summary
Discussion Questions
Case Study
References
Other Suggested Readings
Index
© Valex/Shutterstock
Preface
In the first edition of this book, Chapter 1 stated that
“the U.S. health care industry has grown and
changed dramatically over the past twenty-five
years.” That was an understatement! Since that
time, the industry has experienced some of the most
dynamic changes that health care managers have
seen. In the coming years, more system-wide
changes will occur as we continue our push forward
to achieve patient-centered, value-based health
care. Health care managers are quickly learning that
what worked in the past might not work in the future.
This was the compelling reason to write an
organizational behavior book specifically for health
care managers who are on the front lines every day,
motivating and leading others in a constantly
changing, complex environment. This is not an easy
task, as we know firsthand!
The purpose of this book is to provide health care
managers and other professionals with an in-depth
analysis of the theories and concepts of
organizational behavior while embracing the
uniqueness and complexity of the industry. Although
health care is similar to other industries, it is also
very different. As the nation’s largest industry,
health care employs more than 16 million people in
numerous interrelated and interdependent
segments.
Using an applied focus, this book provides a clear
and concise overview of the essential topics in
organizational behavior from the health care
manager’s perspective. It is our goal to give you a
greater understanding of why and how people and
groups behave as they do in the workplace. With
this knowledge, you will be able to predict and
effectively influence the behavior of the people you
lead. Please let me know if we accomplish our goal!
You can reach us at nborkows@uab.edu or
kameese@uab.edu.
We have tried to ensure that we referenced all the
individuals whose work contributed to the
development of this book. However, if by chance we
failed to give credit to someone along the way,
please contact us so that we can make the
necessary correction.
At this time, we wish to thank our families for their
patience, understanding, and support over the
years. Finally, we wish to thank the many wonderful
and caring people employed throughout the health
care industry with whom we have had and will
continue to have the opportunity to work with. Our
lives continue to be blessed by these dedicated
individuals!
Thank you for purchasing (and reading) our book.
We welcome your comments and suggestions, and
we wish you the best on your health care
management and leadership journey.
With personal regards,
Nancy Borkowski, DBA, FACHE, FHFMA
Katherine A. Meese, PhD
© Valex/Shutterstock
About the Authors
Nancy Borkowski, DBA, FACHE, FHFMA, is
Professor in the Department of Health Services
Administration at the University of Alabama at
Birmingham. She received her DBA with
specializations in health services administration and
accounting from Nova Southeastern University. Dr.
Borkowski has over 25 years’ experience in the
health care industry and is a two-time past recipient
of the American College of Healthcare Executives’
(ACHE) Southern Florida Senior Career Healthcare
Executive Award, which recognizes individuals who
have made significant contributions to the
advancement of health management excellence.
A nationally recognized author, Dr. Borkowski is
also board certified in health management and is a
Fellow of both the American College of Healthcare
Executives and the Healthcare Financial
Management Association. The first edition of her
book, Organizational Behavior in Health Care,
referred to as “one of the most significant advances
in the field of health services administration,” was
honored with the American Journal of Nursing’s
2005 Book of the Year Award for nursing leadership
and management. Dr. Borkowski is the author of
three textbooks that are widely used in graduate
and undergraduate health administration and
nursing programs both nationally and internationally.
Dr. Borkowski’s work has been published in the
Journal of Ambulatory Care Management,
Leadership in Health Services, Group &
Organization Management, Organizational Behavior
and Human Decision Processes, Health Care
Management Review, Journal of Health
Administration Education, Journal of Health and
Human Services Administration, International
Journal of Public Administration, and various other
journals.
Her teaching interests are leadership, organizational
behavior, and strategic management. Dr. Borkowski
is a past recipient of the ACHE’s Excellence in
Teaching Award, which is given to faculty who
engage in furthering academic excellence and the
professional development of health management
students.
Over the past three decades, Dr. Borkowski has
served in various leadership roles for the
Association of University Programs in Health
Administration, Academy of Management’s Health
Care Management Division, the American College
of Healthcare Executives’ Southern Florida Regent’s
Advisory Council, the South Florida Healthcare
Executive Forum, the Alabama Healthcare
Executive Forum, and various other health-related
organizations. In 2013, Dr. Borkowski received the
Jessie Trice Hero Award for her leadership and
commitment to improving the lives of underserved
and minority populations. She has also been
honored with the Exemplary Service Award from the
American College of Healthcare Executives (2012)
and the Frederick T. Muncie Gold Award from the
Healthcare Financial Management Association
(2017).
Katherine A. Meese, PhD, is an Assistant
Professor in the Department of Health Services
Administration at the University of Alabama at
Birmingham. She earned her PhD in Health
Services Administration with a specialization in
strategic management from the University of
Alabama at Birmingham in 2019. Dr. Meese has
seven years of industry experience, encompassing
work in ten countries on four continents, including
management positions for a large academic medical
center. Her work has been published in Anesthesia
& Analgesia, Health Services Management
Research, Journal of Health Administration
Education, and various other journals. Her research
interests are in wellness, burnout, quality and
safety, and delivery models that enhance
organizational learning.
PART I
Introduction
Part I includes four different but related topics. In
Chapter 1, the history of organizational behavior
and its importance to today’s health care managers
are discussed. Chapter 2 describes the changing
environment in which health care managers find
themselves. The chapter examines the numerous
issues that have emerged within the health care
industry because of the nation’s changing
demographics. Chapter 3 focuses specifically on
cultural competency and the skills that managers
need to adapt to the changing environment explored
in Chapter 2. Chapter 4 deals with attitudes and
perceptions, which are the foundation for
understanding organizational behavior. You will find
the terms “attitude” and “perception” frequently
referred to in the various organizational behavior
theories. Finally, Chapter 5 discusses the
importance of communication. Recent surveys have
revealed that 70% of small- to medium-sized
businesses claim that ineffective communication is
their primary problem. Sentinel event data from The
Joint Commission estimated that communication
failure was the root cause for patient harm 70% of
the time in 2400 reported negative outcomes
studied. No wonder the ability to communicate
effectively is considered an essential job skill for
today’s health care managers and leaders.
CHAPTER 1
Overview and History of
Organizational Behavior
LEARNING OUTCOMES
After completing this chapter, the student should
understand:
The definition of organizational behavior.
The major challenges facing today’s and
tomorrow’s health care organizations and
health care managers.
The importance of the Hawthorne Studies to
the study of organizational behavior.
The importance of McGregor’s Theory X and
Theory Y to the study of organizational
behavior.
The differences between organizational
behavior, organization theory, organizational
development, and human resources
management.
▶ Overview
Organizational behavior (OB) is an applied
behavioral science that emerged from the
disciplines of psychology, sociology, anthropology,
political science, and economics. OB is the study of
individual and group dynamics in an organizational
setting. Whenever people work together, numerous
and complex factors interact. The discipline of OB
attempts to understand these interactions so that
managers can predict behavioral responses and, as
a result, manage the resulting outcomes.
According to Ott (1996, p. 1), OB asks the following
questions:
1.
Why do people behave the way they do when
they are in organizations?
2.
Under what circumstances will people’s
behavior in organizations change?
3.
What impacts do organizations have on the
behavior of individuals, formal groups (such
as departments), and informal groups (such
as people from several departments who
have lunch together regularly)?
4.
Why do different groups in the same
organization develop different behavior
norms?
From Ott. Classic Readings in Organizational Behavior, 2E. © 1996
South-Western, a part of Cengage Learning, Inc. Reproduced by
permission.
OB has three goals. First, OB attempts to explain
why individuals and groups behave the way they do
in organizational settings. Second, OB tries to
predict how individuals and groups will behave on
the basis of internal and external factors. Third, OB
provides managers with tools to assist in the
management of individuals’ and groups’ behaviors
so that they willingly put forth their best effort to
accomplish organizational goals. In the health care
industry, OB has become more important because
people with diverse backgrounds and cultural values
have to work together effectively and efficiently.
▶ Why Study Organizational
Behavior in Health Care?
The largest U.S. industry is health care, which
currently employs over 20 million individuals. The
industry will account for almost a third of the nation’s
projected job growth through 2026, adding over 2
million jobs. The projected 1.9% per year growth
rate is the fastest among all industry sectors
(Bureau of Labor Statistics, 2019).
Each segment of the health care industry (e.g.,
hospitals, home health, rehabilitation facilities)
comprises a different mix of health-related
occupations, ranging from highly skilled licensed
professionals, such as physicians and nurses, to
those with on-the-job training. Furthermore, each
segment of the industry has various economic
structures (e.g., for-profit, not-for-profit,
governmental). Therefore, today’s health care
managers need to have the skills to communicate
effectively with, motivate, and lead diverse groups of
people within a large, dynamic, and complex
industry. Communication, motivation, and
leadership are all concepts in the discipline of OB.
Furthermore, managers need to understand the
causes of workplace problems, such as low
performance, turnover, conflict, and stress, so that
they may be proactive and minimize these
unnecessary negative outcomes. With a greater
understanding of OB, managers are better able to
predict and therefore influence the behavior of
employees to achieve organizational goals.
Given the service-related intensity of the health care
industry, understanding individuals’ behavior and
group dynamics within health service organizations
is critical to a health care manager’s success.
Research indicates that the primary reasons why
managers fail stem from difficulty in handling
change, not being able to work well in teams, and
having poor interpersonal relations. There is a
saying that employees don’t leave organizations,
they leave managers!
▶ The Health Care Industry
Changes within the health care industry over the
past 30 years have been powerful, far reaching, and
continuous. Because readers are probably familiar
with most of these changes either from their own
experiences or from a previous health care delivery
system course, the discussion will address some of
the trends or future concerns that will affect
tomorrow’s health care industry.
Past changes and future trends are interrelated
forces that have shaped or will shape tomorrow’s
health care organizations at both the system level
and the organizational level. Declining
reimbursement and changes in payment schemes
for services have had, and will continue to have, two
of the deepest impacts on the industry. Technology
has also caused significant changes within the
industry. Biomedical and genetic research,
advances in information technology, and use of “big
data” are producing rapid changes in clinical
treatments. In addition, the industry has
experienced more government mandates and
substantial legislative changes, such as the
Medicare Prescription Drug, Improvement, and
Modernization Act of 2003; the American Recovery
and Reinvestment Act of 2009; the Patient
Protection and Affordable Care Act of 2010 (ACA)
and subsequent legislation to repeal portions of the
act; and the Medicare Access & Chip
Reauthorization Act of 2015 (MACRA). With an
increased focus on chronic disease management,
patients are living longer, and requiring more longterm and home health care services now and in the
future. Patients’ and health care workers’
characteristics are also changing. Both populations
are becoming older and more diverse. Patients are
better informed and have increasingly high
expectations of health care professionals. This trend
has changed the way in which health care services
are delivered, with a focus on patient satisfaction
and safety as well as on the quality and value of
services provided. Physician–patient relationships
have changed because patients are beginning to
understand that much of the responsibility for
wellness lies with them and have easy access to
health-related information. A growth in highdeductible insurance plans places a larger financial
responsibility on patients to manage their own
health and reduce unnecessary health spending.
The economics of health care are in a state of flux.
For example, reimbursements are moving toward
value-based payments; therefore, we see an
increase in the use of evidence-based medicine.
There are continuing shortages of staff, especially in
the areas of primary care physicians, nurses,
imaging technicians, and pharmacists, leading to
competition for well-qualified people. Changes are
also taking place in the disease environment. Many
factors of modern life are contributing to the
emergence of new diseases, reemergence of old
ones, and evolution of pathogens that are immune
to many of today’s medications. In addition,
because of potential terrorism attacks, health care
providers are concerned with biodisaster
preparedness. Finally, even with some states’
Medicaid expansion programs and the ACA, there
continues to be the issue of caring for the uninsured
which can contribute to the overuse and misuse of
hospital emergency departments.
To deal with these changes, a number of health
care organizations have adapted their
organizational forms by restructuring themselves
into integrated delivery networks, which may be part
of a local, regional, or national system. We have
seen increased vertical, horizontal, and virtual
integration. Vertical integration focuses on the
development of a continuum of care services to
meet the patient’s full range of health care needs.
This integration model, in which a single entity owns
and operates all the segments providing care, may
include preventive services, specialized and primary
ambulatory care, acute care, subacute care, longterm care, and home health care, as well as a
health plan. Recently, we have seen the creation of
accountable care organizations (ACOs), in which
groups of doctors, hospitals, and other health care
providers have joined together to provide
coordinated care to predetermined patient
populations. Horizontal integration usually occurs
through mergers, acquisitions, and/or consolidation
within one segment of the industry. For example,
during the 1990s, numerous hospitals were
acquired by the large, for-profit, publicly held
hospital chains of Hospital Corporation of America
(HCA), Tenet Healthcare, and Health Management
Associates (now part of Community Health
Systems), and these acquisitions continue today.
Consolidation in health care began to rise rapidly in
2009 and doubled between 2011 and 2015 (Health
Care Financial Management Association, 2017).
In addition, not-for-profit hospitals have merged with
for-profit health systems as a result of competition
and the need to reduce cost through economies of
scale. Virtual integration, which emphasizes
coordination of health care services through patientmanagement agreements, provider incentives,
and/or information systems, has increased. This
virtual integration has evolved to meet the need for
better technology and information infrastructures
that allow for information sharing, patient care
management, and cost control.
Because of the dramatic changes and the future
trends in the health care industry, most managers
have had to change the ways in which they and
other employees carry out their job responsibilities.
These changes have been forced on the industry by
the need to increase productivity, due to decreasing
reimbursement and increasing competition. At the
same time, health care providers must deliver
patient-centered, value-based care. These are not
easy tasks to balance. As a result, many health care
providers are breaking down their traditional
hierarchical structures and moving toward
multidisciplinary team-managed environments.
Employees are finding themselves in new roles with
new responsibilities. All of these changes cause
disruptions in the workplace. The study of OB will
assist health care managers to minimize the
negative effects (such as stress and conflict) related
to this “new” environment and to maximize their
ability to motivate staff and lead their organizations
effectively.
▶ History of Organizational
Behavior
The beginnings of OB can be found in the human
relations/behavioral management movement, which
emerged during the 1920s as a response to the
traditional or classic management approach.
Beginning in the late 1700s, the Industrial
Revolution was the driving force for the
development of large factories employing many
workers. Managers at that time were concerned
“about how to design and manage work in order to
increase productivity and help organizations attain
maximum efficiency” (Daft, 2004, p. 24). This
traditional approach included Frederick Taylor’s
(1911) well-known framework of scientific
management, or “Taylorism,” as it is now labeled.
Taylor believed that efficiency was achieved by
creating jobs that economized time, human energy,
and other productive resources. Through his timeand-motion studies, Taylor scientifically divided
manufacturing processes into small, efficient units of
work. Through Taylor’s work, productivity greatly
increased. For example, Henry Ford developed his
assembly line according to the principles of
Taylorism and was able to churn out Model Ts at a
remarkable and economical pace (Benjamin,
2003).
Although the classic approach to management
focused on efficiency within organizations, Taylor
did attempt to address a human relations aspect in
the workplace. In his book The Principles of
Scientific Management, Taylor stated that:
in order to have any hope of obtaining the initiative
(i.e., best endeavors, hard work, skills and knowledge,
ingenuity, and good-will) of his workmen, the manager
must give some special incentive to his men beyond
that
