Intro to Management Ch's 16 - 22

THE BASIC DECISION-MAKING PROCESS The six elements of the basic decision-making process are: (1) identifying the ____________, (2) gathering __________________ (3) analyzing _____________ and arranging it into alternatives, (4) choosing an __________, (5) implementing the chosen __________, and (6) _____________ up on implementation.

(1) identifying the problem, (2) gathering information, (3) analyzing information and arranging it into alternatives, ( 4) choosing an alternative, (5) implementing the chosen alternative, and (6) following up on implementation

1. Explain what is meant by flexible budget.

A flexible budget recognizes that certain costs can vary as the level of operations varies and attempts to account for this variation in the budget. A flexible budget may treat certain costs as fixed because they are in fact fixed or because this is simply the best way to handle them, but it will also identify and allow for costs that vary as departmental activity varies.

3. Why should the department supervisor be interested in challenging inappropriate unemployment compensation claims?

As the supervisor of the departed employee you will be most likely called upon to help determine whether the individual should or should not receive benefits. Some organizations have been sufficiently lax as too rarely if ever challenge an unemployment claim; this is an expensive practice because it usually results in paying undeserved benefits thus costing the organization money.

1. With a simple example, explain the difference between a practical constraint and an absolute constraint.

An absolute constraint clearly defines a limit beyond which you cannot go. Like I only have $100 for groceries, therefore I cannot spend over $100. More often than not, however, constraints present themselves by limiting the practicality of a decision. A certain condition becomes a constraint because it renders an alternative impractical under the circumstances. A practical constraint would be to drive to the other side of town to get a better deal on gas, you might save some money on gas but it isn't practical on your time, plus the miles you put on your car. Many constraints, then, are in effect not saying "You absolutely can't do this" but are rather saying "You're going to pass a point where you shouldn't do this because it's no longer practical"—like locating one function next door to another even though it costs a fortune, or locating it 5 miles away only because it is cheap. We need to assess the constraints inherent in the situation realistically, recognize our limitations, and focus our attention on realistic, practical alternatives. Alternatives that lie beyond the bounds of the constraints we have identified are really not alternatives at all.

4. Explain how coming in "under budget" might not always be a good sign for some budgeted expenses.

Answering to variances under budget is almost as important as answering to variances over budget. Being under budget for a period does not necessarily mean that money is being saved or that a favorable condition is emerging. It can often indicate that expenditures are occurring in a pattern inconsistent with the budget allocation, and it can sometimes indicate that certain necessary or desirable expenditures have been overlooked.

5. What do you consider to be the most important aspect of follow-up after a meeting?

As far as your authority over the problem extends, it is up to you to follow up to determine that what has been decided gets accomplished. It is also up to you to see that the minutes of the meeting, should they be necessary, are prepared and distributed; provide later assurance to all participants that what they decided has in fact been accomplished; and schedule a follow-up meeting should one be necessary. Basically that the reasons and goals for the meeting are either accomplished or addressed. That everyone does their part to achieve the goal and purpose of the meeting.

4. Why might some supervisors consider it risky to place decision-making authority in the hands of employees?

By giving authority to make decisions to an employee the supervisor will end up being the one in the end who will answer for any mistakes made by the employee. The supervisor should be the final say at the end.

4. Describe how you might attempt to draw a chronically silent individual into active participation in a staff meeting.

Do not allow the meeting to move in such narrow lines that valuable input is lost. Ask for clarification of comments that are offered. Consider requesting opinions and asking direct questions, particularly of the few "silent ones" who frequently populate your meetings. Remember, if you have structured your meeting wisely then everyone who is there is there for a good reason. It is part of your job as meeting leader to do everything you can to get those people talking who ordinarily tend to remain quiet.

4. How might you tell at a glance which emails you can safely delete without reading?

Emphasize deleting rather than reading. In most instances a quick look at the subject line along with your knowledge of the sender will indicate whether a message should be read in full. If a full reading is not needed, then delete it.

4. What ethical breach might a supervisor commit that will likely pave the way for similar breaches by the employees?

Every business should have a code of ethics actively modeled by top management. It's absolutely critical that the people at the top be visible models of ethical behavior. Whether they realize it or not—and if they fail to realize it, perhaps they are unsuited for their elevated positions—top management's behavior sets the tone for the rest of the organization. Every business should have a code of ethics actively modeled by top management. It's absolutely critical that the people at the top be visible models of ethical behavior. Whether they realize it or not—and if they fail to realize it, perhaps they are unsuited for their elevated positions—top management's behavior sets the tone for the rest of the organization.

2. Recognizing that many meetings take far too long and accomplish too little because they wander over a variety of subjects, suggest how to keep a meeting on track while still ensuring that any essential issues that arise are not lost forever.

First have a written agenda with key points on what needs to be discussed. Have a recorder and a time keeper, so everything is written down and the time keeper can keep you on track and let you know how much time you have. Try to keep discussion to a minimum or left towards the end of the meeting. Key things that need more discussion might need to be discussed at a future meeting.

5. Why is follow-up on implementation often described as the weakest part of the decision-making process?

Follow-up is usually the weakest part of the decision-making process, sometimes because the decision maker is lax and does not follow up in timely fashion, sometimes because conditions surrounding the decision have changed, and sometimes because of employee resistance to change.

Comment on the quotation from Blaise Pascal: "I have made this letter rather long because I have not had time to make it short."

He basically wrote his thoughts out as he was thinking them and has not had time to go back and edit it to make it less wordy and to have it more tailored.

3. What do you believe to be the minimum number of alternatives you should evaluate in preparing to make a large purchase? Why this many (or this few)?

I would want at least three alternatives to evaluate before making a large purchase. I think this is a large enough variety to compare without it being too overwhelming.

6. Do you believe that prohibiting all overtime is a potentially effective cost-saving move? Why or why not?

If overtime is prohibited all of the time it could have a negative affect when it comes to the amount of work that goes unfinished. There are occasions when overtime is necessary to keep the work flowing and getting projects time on time. I think it is not a good idea to ban it completely but it can be controlled and used only when necessary.

3. What are the primary advantages of editing and rewriting?

If you are thinking that better writing is too time consuming, that you would have to double your correspondence time to provide that extra reading through every letter and memo you write, think also of the cost of misunderstanding. Have you ever had to spend valuable time and effort smoothing out some problem that developed because a written message was misunderstood? You can edit many memos in the time it takes to solve a couple of knotty problems arising from missed communication.

3. Why is it important for the department supervisor to be a model of ethical behavior?

In managing a department or group, the supervisor should strive to model ethical behavior in all aspects of job performance. Thorough orientation and education notwithstanding, there is probably no more effective influence in shaping employee behavior than the supervisor's visible behavior. If the supervisor visibly observes and conscientiously adheres to the ethical standards of conduct, the employees are more likely to do the same. The supervisor's continued demonstration of ethical behavior is one of the most important dimensions of successful management in the modern healthcare organization.

1. What is always the first question that should be asked, or the first decision that should be made, when you are considering convening a meeting for some purpose?

Is this something we need to meet on or could an email or memo accomplish what is needed. Consider possible alternate means of accomplishing what the meeting would supposedly accomplish, and having concluded that a meeting is the best way to do what needs to be done, then plan, schedule, and conduct the meeting in such a manner that maximum possible output is obtained with the least possible time and effort.

5. What should be the principal guiding rule for determining who is allowed to see confidential information?

It is necessary to protect patient property and information in accordance with established policies requiring that patient information is to be shared only with those who are authorized to receive such information and have a legitimate need for it.

2. Why is change in the management of a department one of the most upsetting changes that can occur affecting the work group?

Management change usually gives rise to fears of changes in other areas including organization, methods and procedures, job restructuring, and the like. Often, changes in management can be the most upsetting kind of change in terms of impact on employees.

2. Explain how any of us become "self-programmed" to condense or compress steps of the decision-making process for decisions made regularly.

Most people are self-programmed to make some decisions, especially small decisions of little consequence and those decisions made regularly. You probably do not consciously think of yourself as making a decision when you decide what to have for lunch or decide which shoes you will wear to work, but you nevertheless are following the basic decision-making process: you are receiving information, forming and comparing alternatives and selecting one of these, and translating your choice into action. The more often we make certain kinds of decisions, the better we get at it. Similarly, you become self-programmed to make many decisions that come your way periodically. Regardless of preprogramming, however, and regardless of the existence of comprehensive policies and procedures, as a supervisor you are going to face numerous situations that require you to make original decisions.

5. In what way might an active quality improvement program come into serious conflict with an organization's reengineering effort?

One hand you are telling the employees how great they are and then you turn around and start letting them go.

1. In the present-day healthcare environment as you see it, what are the two or three changes that have been most upsetting to employees?

Organizational changes, in which departments are altered or interdepartmental relationships or management reporting relationships are changed Management changes, in which new management assumes control of an organization or subunit New methods and procedures, indicating that people are expected to do new and different work or accomplish old tasks in new ways Job restructuring, requiring that tasks be added to or be deleted from people's jobs New equipment, representing new technology or technological departures from equipment previously used

3. How can a change that may be considered positive, such as moving into new quarters or acquiring all new equipment, still be upsetting and create resistance from some?

People resist change primarily because it disturbs their equilibrium and threatens their sense of security. For the most part we all seek equilibrium with our surroundings, that balance of values, activities, and environment with which we can be most comfortable. To some people that equilibrium is a comfortable, dependable rut; to others, equilibrium is a pattern of change, but it is their change, ordered in their way. With equilibrium we find a measure of security, and we shift and move against daily forces in small ways to continually reestablish and maintain equilibrium just as surely as water continually seeks its own level. However, change coming from outside of the person intrudes, and equilibrium is disturbed and security is threatened, so resistance results.

7. One important part of the budget control process is your awareness of the differences between budgeted amounts and actual expenditures. What is the other essential part of the control process and why it this so?

Simply stated, today more than ever before continuing control of costs is an essential part of the first-line supervisor's role. The manager needs to make sure his department stays on budget and doesn't go over.

4. What should be the strongest force within your own department in getting your employees to actively work to improve both quality and productivity?

That crucial ingredient is top management commitment. This should come as no surprise; top management commitment to new ideas and approaches has been a prerequisite to complete success for as long as organized enterprise has existed. Without sufficient top management commitment most organized endeavors are destined to, at best, generate results that fall short of intentions or, at worst, fail altogether and cause harmful results or leave residual damage.

2. What is self-referral and why is it considered unethical as well as illegal?

The Self-Referral Law (the Stark law) prohibits a physician with a financial relationship with an entity providing any designated health service from referring Medicare and Medicaid patients to that entity unless the service or relationship falls within the Stark law's statutory exemption. The law also prohibits an entity from billing federal healthcare programs for items or services ordered by a physician who has a financial relationship with that entity. The Stark law, in other words, sought to eradicate the practice of some physicians of referring or sending patients to other provider organizations (e.g., clinical laboratories, radiological services, pharmacies, medical supply firms, etc.) of which they were owners in whole or in part.

3. Comment on this quotation from C. Northcote Parkinson: "The amount of work accomplished by a committee is inversely proportional to the number of members on the committee."

The amount of people in the meeting can control the amount of things accomplished. If you have too many people, it can lead to chaos with everyone wanting to voice their thoughts and opinions. If you don't have enough you may be missing some key people that could provide answers you need. It is best to tailor the size of your meetings by having 5 - 10 key people that have the information needed to accomplish the purpose of the meeting.

2. Profitability can be increased by increasing revenue or reducing expenses. Describe the effects on the bottom line of an increase in revenue and of a reduction in expenses (remembering that it takes money to make money, and that not all changes fall directly or fully to the bottom line).

The effects that can occur by increasing revenue and reducing expenses will help to improve or add needed things to your business. You can potentially hire a needed employee, or new office equipment, or put the additional revenue aside to be used on a as needed basis.

5. Why is it important for the employees to see a cost-conscious attitude on the part of the supervisor?

The employees must see a cost-conscious attitude demonstrated by the supervisor. If the supervisor's behavior communicates an honest interest in cost control, most of the employees are likely to take departmental cost control seriously.

5. Write a business-related sentence that includes one or more each of zero words, necessary words, and optional words, and show how it appears when trimmed down to necessary words only.

The stockholder meeting will be held at the luxurious offices of the famous lawyers, Franklin, Thompson and Jones. The stockholder meeting will be held at the offices of Franklin, Thompson and Jones.

(FTE) simply means the amount of labor input equivalent to one full-time employee.

The term full-time equivalent (FTE)

Assume, for example, that the basic work week in your organization is 40 hours; in your department 40 hours of personnel time constitutes one FTE. How else can this be broken up?

These 40 hours may belong to a single scheduled employee who works 40 hours per week, two part-time employees who each work 20 hours per week, or some other combination of hours and people that adds up to 40 hours per week. All these variations represent one FTE.

3. Why might it be possible to increase both quality and output without adding cost?

These reactions are founded on an implicit assumption that present methods are already as productive and cost-effective as they can be. This, however, is nearly always an erroneous assumption; there is room for improvement in most human activities, and it is often even possible to increase both quality and output at the same time by improving productive efficiency. By improving productive efficiency in turn you will be able to say cost.

5. With what sort of change are you likely to be in full agreement concerning all of its requirements?

Through involvement, change can become a positive force. Your employees will be more likely to comply because the change is partly "theirs." And there is another potential benefit to involvement as well: Your employees know the work in ways that you may perhaps never know it. You supervise a number of tasks, some of which you may have done once yourself. However, your employees do, in hands-on fashion, those tasks that you only supervise. Thus your employees know the details of the work far better than you and are in a much better position to provide the basis for positive change in task performance.

1. As far as involvement is concerned, what does total quality management (TQM) include that earlier approaches like management by objectives (MBO) did not encompass?

Total quality management is doing things as a team including all layers of personnel and doing it right the first time. Management by objective is just involving the management personnel, leaving them to make all the decisions.

2. Identify at least two advantages of cross-training and explain why these are potentially helpful to the supervisor.

When you have cross trained employees they are able to help out in other areas of a department when needed like covering for people who are on vacation or sick. They could also possibly job share with other employees. This could be helpful because they would have coverage when needed. Also, they could possibly have 2 employees share a job which cuts out benefit costs.

4. Why is involving employees in determining the form and direction of any particular change likely to be more successful than giving them carefully prepared, detailed instructions?

Whenever possible, and especially as it affects the way they perform their assigned tasks, involve your employees in shaping the details of the change. It has been proven that employees are far more likely to understand and comply when they have a role in determining the form and substance of the change.

1. Why is it necessary for a healthcare institution to have official written policies for addressing issues of medical ethics?

Whether written or unwritten, every organization has a system or code of morals based on how its leaders want to relate to customers and others and thus directing how the organization's employees should behave as well. An increasing number of organizations, within health care and otherwise, are issuing formal ethical standards of conduct for their employees. Individual occupations, notably the healthcare professions, likewise have published ethical standards proscribing the conduct of their members. In most instances, people admitted to membership in a profession agree to ascribe to these ethical standards of conduct as a condition of entry.

6. What is the first task you must consider in preparing to write a letter or memo, and why should it be first?

You need to consider who your audience and secondary audience are going to be so you write it so they can understand what you are trying to get across.

2. Would it make more sense to write so that anyone who picks up what you have written will understand it, rather than writing for a specific, possibly narrow, audience? Why or why not?

Your message may be going to one person, or it may be intended for several people. You will need to decide to whom, specifically, you are writing. The person who will receive your communication, that person for whom your message is primarily intended, is your primary audience. However, you may also have a sizeable secondary audience—others who will receive, read, and perhaps make use of your communication so you need to write it so those outside your primary audience can understand your thoughts.

The idea of fixed versus flexible budgeting

refers to the structural character of the budget relative to activity throughout the year. A fixed budget assumes a stable level of operations throughout the year and spreads all budgeted costs evenly across the 12 months. A flexible budget, however, recognizes that certain costs can vary as the level of operations varies and attempts to account for this variation in the budget. A flexible budget may treat certain costs as fixed because they are in fact fixed or because this is simply the best way to handle them, but it will also identify and allow for costs that vary as departmental activity varies.