Org and Behavior

Theory Y

( positive/optimistic) managers created opportunities, removed obstacles, and encouraged growth and learning for their employees. McGregor stated that participative or Theory Y managers supported decentralization and delegation of decision making, job enlargement, and participative management because they allowed employees degrees of freedom to direct their own activities and to assume responsibility, thereby satisfying their higher-level needs.

Content theories of motivation

(Also referred to as needs theories) explain the specific factors that motivate people. The content approach focuses on the assumption that individuals are motivated by the desire to satisfy their inner needs. Content theories answer the question "what drives behavior?" Content theories help managers understand what arouses, energizes, or initiates employee behavior.

. Employee motivation and organization performance

- Has a direct impact on a health service organization's performance; therefore, managers need to understand what motivates employees. By understanding what motivates employees, managers can assist them in reaching their fullest potential. There are some factors the manager can control (e.g., extrinsic factors such as salary, working conditions, interpersonal relationships). -

Leader-member relationships

- Not surprisingly, in-group members report fewer problematic issues with leader-member interactions and higher levels of responsiveness with the leader than do members of the out-group. - The mere nature of the high quality of the leader-member relationship that occurs with the in-group generates individuals who accept greater responsibility and exhibit higher levels of contribution to organizational goals. - The Leader-Member Exchange (LMX) theory takes VDL one step further. LMX examines the characteristics of individuals belonging to the in-group, noting similarities that exist between in-group members and the leader in the dyadic relationship. Individuals with high self-efficacy will tend to form in-group relationships with the leader.

Path-goal theory contingency factors

- environmental contingency factors. These factors include: (1) clarity of the task to be performed, (2) hierarchical authority systems, and (3) group dynamics (i.e., work-group members' relationships). - The second set of contingency factors, considered internal dynamics, is referred to as subordinate contingency factors. These factors include the employee's locus of control; knowledge, skills, and abilities (real or perceived); and experience. Subordinate contingency factors are characteristics exhibited by the employees.

Inequity Resolution Methods

1. Altering Inputs: Reduce productivity, take longer break times, and use sick days for personal activities. 2. Altering Outcomes: Try to obtain an increase in pay, a bonus, or a new job title or resort to taking supplies from the company for personal use (i.e., stealing). 209 3. Cognitively Distorting Inputs or Outcomes (self): Describe how much harder he or she is working. 4. Leaving the Field: Transfer to another department or quit the organization. 5. Distorting the Inputs or Outcomes of the Comparison Other: Describe the other person's job as routine and unchallenging. 6. Changing the Comparison Other: Find someone in the organization more like himself or herself—another high-performing worker.

Communication Barriers

Classify these barriers into two categories: environmental and personal.

Consensus

Consensus relates to whether an employee's performance is the same as or different from that of other employees.

Dependency and Power

David Mechanic (1962) found that employees without formally defined power positions exercise significant personal power within an 260 organization by creating a sense of dependency. Employees create this dependency by controlling access to: 1. Instrumentalities, which includes any aspect of the physical plant of the organization or its resources (e.g., equipment, materials, budgets). 2. People, including anyone within the organization or anyone outside the organization upon whom the organization is in some way dependent. 3. Information, which includes knowledge of the norms, procedures, and techniques of doing business within the organization. - The most effective way for lower-level employees to achieve power is to have higher-ranking employees dependent upon them. Thomas Scheff's research (1961) provides us with an illustration of this dependency relationship and the power associated with it. - Increasing complexity within organizations has made the expert or staff person more powerful as a result of the organization's dependency on his or her specialization, knowledge, and skills. Experts have tremendous potentialities for power by withholding information or providing incorrect information.

Instrumental Aggression

Describes behaviors targeted at obtaining a goal that the employing organization is not providing. For instance, an employee who feels he is underpaid and steals from his employer is performing instrumental aggression.

How employees gain power

Employees also gain power because others have delegated responsibilities to them that they themselves do not want to do, but which are accompanied with a certain amount of power.

Grapevine

Employees have always relied on the oldest communication channel—the corporate grapevine. The grapevine is an unstructured and informal network founded on social relationships rather than organizational charts or job descriptions. According to some estimates, 75 percent of employees typically receive news from the grapevine before they hear about it through formal channels.

Leadership and Management

Establishment of measurable leadership and management objectives to hold managers accountable to top leadership for achieving these objectives. - The leadership and management traits and behaviors that work in one organizational context may not be effective in another.

Medical procedures race and equal treatment

Even when insurance status, income, age, and severity of conditions are comparable. This research indicated that U.S. racial and ethnic minorities receive even fewer routine medical procedures and experience a lower quality of health services than the majority of the population.

Expectancy Theory

Expectancy Theory suggests that for any given situation, the level of a person's motivation (force in Vroom's conceptualization) with respect to performance is dependent upon (1) the desire for a certain outcome; (2) the perception that individual job performance is related to obtaining the desired outcome; and (3) the perceived probability that individual effort will lead to the required performance. The theory may be expressed as M = V × I × E - Vroom (1964) explains that the force that drives a person to perform is dependent upon three factors: valence, instrumentality, and expectancy

Experts and Power

Experts have tremendous potentialities for power by withholding information or providing incorrect information.

Referent Power

Stems from P's affective regard (i.e., attraction) for, or identification with, O. Interestingly, O has the ability to influence P even though O may be unaware of this referent power. Also, because P desires to be associated with or identified with O, P will assume attitudes, beliefs, or behavior displayed by O. Therefore, the greater the attraction, the greater the identification and the greater the referent power.

Tannenbaum and Schmidt Situational Factors

Tannenbaum and Schmidt (1958, 1973) conducted one of the first studies that indicated a need for leaders to evaluate the situational factors prior to the implementation of a particular leadership style (Ott, 1996). The Continuum of Leadership Behavior model is based on the variety of behaviors noted in earlier leadership studies, particularly the distinction of task versus human relations orientation. This model identifies two styles of leadership that occur across a continuum, from boss-centered (task) through subordinate-centered (relationship). - The Tannenbaum and Schmidt (1958) model covers a range of leadership behaviors. The model identifies the amount of authority (boss-centered) used by the manager and the amount of freedom afforded to employees (subordinate-centered). At one end of the continuum (boss-centered), the manager takes complete control of the situation, makes a decision, and announces it to the employees.

Affordable Care Act & Medicare

The Affordable Care Act (ACA) is the comprehensive healthcare reform signed into law by President Barack Obama in March 2010. Formally known as the Patient Protection and Affordable Care Act—and simply Obamacare—the law includes a list of health-related provisions intended to extend health-insurance coverage to millions of uninsured Americans. The Act expanded Medicaid eligibility, created health insurance exchanges, and prevents insurance companies from denying coverage (or charging more) due to pre-existing conditions. It also allows children to remain on their parents' insurance plan until age 26. Medicare is the federal health insurance program for: -People who are 65 or older -Certain younger people with disabilities -People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD) -Medicare Part A (Hospital Insurance) Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. -Medicare Part B (Medical Insurance) Part B covers certain doctors' services, outpatient care, medical supplies, and preventive services. Medicare Part D (prescription drug coverage) -Part D adds prescription drug coverage to: Original Medicare Some Medicare Cost Plans Some Medicare Private-Fee-for-Service Plans Medicare Medical Savings Account Plans

Frustration-Regression Theory

The frustration-regression principle explains that when a barrier prevents an individual from obtaining a higher-level need, a person may "regress" to a lower-level need (or vice versa) to achieve satisfaction.

Leader that operates in environmental uncertainty

The leader who is able to respond to ever increasing levels of environmental uncertainty through the utilization of more than one style of leadership will be most likely to increase employees' levels of motivation, satisfaction, and productivity.

Leadership Traits

The most important qualities of a good leader include integrity, accountability, empathy, humility, resilience, vision, influence, and positivity. "Management is about persuading people to do things they do not want to do, while leadership is about inspiring people to do things they never thought they could." - "The characteristics identified by respondents describe leadership traits rather than management skills. None of the respondents identified the traditional managerial skills of planning, organizing, coordinating, directing, and controlling.

Optimistic attribution style

This term reflects the fact that people with an optimistic attribution style often feel good about themselves and their capacity for success.

Unstable internal forces and attribution

Unstable causal factors, such as the amount of effort exerted toward a task, are comparatively easy to change.

Horn effect

Whereby a person evaluates another as low on many traits because of a belief that the individual is low on one trait that is assumed to be critical

Virtual Integration

Which emphasizes coordination of health care services through patient management 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.

Aggression

refers to a state of heightened motivation. The problem is that this motivation is focused on an undesirable behavior or goal.

Longest Rakich and Darr communication barriers

some cultures believe in "don't speak unless spoken to" or "never question elders" (Longest, Rakich, & Darr, 2000). These beliefs inhibit communication. Others accept all communication at face value without filtering out erroneous information. - Provide us with several guidelines for overcoming barriers: 1. Environmental barriers are reduced if receivers and senders ensure that attention is given to their messages and that adequate time is devoted to listening to what is being communicated. 2. A management philosophy that encourages the free flow of communication is constructive. 3. Reducing the number of links (levels in the organizational hierarchy or steps between the sender in the health care organization and the receiver, who is an external stakeholder) diminishes opportunities for distortion. 4. The power/status barrier can be removed by consciously tailoring words and symbols so that messages are understandable; reinforcing words with actions significantly improves communication among different power/status levels. 5. Using multiple channels to reinforce complex messages decreases the likelihood of misunderstanding.

Levels Of Reinforcement

- There are four types of reinforcement: positive, negative, punishment, and extinction.

Expectancy Theory Criticisms

- is that it does not take into account the relationship between employee performance and job satisfaction. - Based on Assumptions

Rationality Tactic

Consists of using reason, logic, and compromise in attempting to influence others. This also includes attempts to convince others that certain actions are in their own best interests.

French and Raven perspective on power

John French and Bertram Raven (1959) identified five bases or sources of social power: reward power, coercive power, legitimate power, referent power, and expert power. An individual is not limited to one source of power; individuals may hold and exercise multiple sources of power simultaneously.

Non-resilient and attributions

People who are non-resilient are likely to err in their attributions and are prone to blame others or themselves for their failures.

Task Structure

The extent to which job assignments are clear through the implementation of formalization and policy. This factor relates to whether the structure of the work task is highly structured, subject to standard procedures, and subject to adequate measures of assessment. Certain tasks are easy to structure, standardize, and assess, such as the operation of an assembly line. (Rating: high or low.)

Hawthorne Studies Interviewing Program

A major outcome of these interviews was that the researchers discovered that workers were not isolated, unrelated individuals; they were social beings and their attitudes toward change in the workplace were based upon (1) the personal social conditioning (values, hopes, fears, expectations, etc.) they brought to the workplace, formed from their previous family or group associations, and (2) the human satisfaction the employees derived from their social participation with coworkers and supervisors. What the researchers learned was that an employee's expression of dissatisfaction may be a symptom of an underlying problem in the workplace, at home, or in the person's past.

Ohio State Study Weaknesses

A weakness noted in the Ohio State studies was that situational factors were absent from the research.

Cultural Competency

Able to understand, communicate with and effectively interact with people across cultures.

Cultural differences provider-patient relationship

Affects the provider-patient relationship.

Hygiene Factors

Are those that lead to dissatisfaction (salary, work conditions, fringe benefits, job security, status, insurance, and vacations) Hygiene factors are the maintenance factors, being the external factors of work (supervisory practices, company policies, and salary).

Attribution

Attribution theory was first introduced by Heidler (1958) as "naive psychology" to help explain the behaviors of others by describing ways in which people make causal explanations for their actions. Heidler believed that people have two behavioral motives: (1) the need to understand the world around them and (2) the need to control their environment.

Fiedler's Research

Fiedler's research and the identification of leadership style were based upon a questionnaire known as the Least Preferred Coworker (LPC) Scale. Fiedler (1970) developed the LPC by asking the participants to describe their most and least preferred coworkers. Each participant was asked to think of all others with whom he or she had ever worked and then to describe the person with whom he or she worked best (i.e., most preferred coworker) and then the person with whom he or she worked least well (i.e., least preferred coworker or LPC). From the items identified, Fiedler created a scale that contains contrasting adjectives (such as pleasant/unpleasant, supportive/hostile, considerate/inconsiderate, and agreeable/disagreeable) to measure whether a person was task-or relations-oriented. Fiedler believed that the ratings individuals ascribed to their least preferred coworker, a person they least enjoyed working with, reflected more about themselves than the person they chose to describe.

Flows of communication network

Flows of communication can be combined into patterns called communication networks. These networks are interconnected by communication channels. A communication network is the interaction pattern between and among group members. A network creates structure for the group because it controls who can and should talk to whom. Groups generally develop two types of communication networks: centralized and decentralized. Various flows of communication can be combined to form communication networks, such as the chain, Y, wheel, circle, and all-channel.

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, long-term care, and home health care, as well as a health plan.

Herzberg job satisfaction and dissatisfaction

From Herzberg's research (1966), five factors stood out as strong determiners of job satisfaction (i.e., motivator factors) and are related to job content: (1) achievement, (2) recognition, (3) work itself, (4) responsibility, and (5) advancement. The determinants of job dissatisfaction (i.e., hygiene factors) that are related to job context were found to be: (1) company policies, (2) administrative policies, (3) supervision, (4) salary, (5) interpersonal relations, and (6) working conditions. It is important to note that Herzberg used the term "hygiene" to describe factors that are necessary to avoid dissatisfaction, but that by themselves do not provide satisfaction or motivation

Human Resources Management

HRM can be viewed as a micro-approach to "managing" people. HRM emphasizes systems, processes, procedures, and so forth for personnel management and is usually housed in a functional unit within organizations.

Geriatric patients medical providers ageism

Health care professionals often make assumptions about their older patients on the basis of age rather than functional status.This may be due to the limited training physicians receive in the care and management of geriatric patients.

Preconceived Thoughts

In any case, people are selective in what they perceive and tend to filter information on the basis of the capacity to absorb new data, combined with preconceived thoughts.

Price Waterhouse v. Hopkins legal case

In the case of Ann Hopkins, she was a high-performing but masculine-acting prospective partner at Price Waterhouse. When she was denied a partnership at Price Waterhouse, she charged that gender stereotyping had played a role in the decision. In response to the suit, Price Waterhouse countered that Ms. Hopkins had interpersonal problems and was considered too "macho" for the position. The person responsible for explaining the board's decision to Ms. Hopkins advised her that in order to improve her chances for partnership she "should walk more femininely, talk more femininely, dress more femininely, wear make-up, have her hair styled, and wear jewelry."Ms. Hopkins brought her gender discrimination lawsuit all the way to the Supreme Court and won.

Chain communication network

In the chain network, communication occurs upward and downward and follows line authority relationships.

Vroom VIE Theory

One widely cited theory of motivation is Victor Vroom's (1964) Expectancy Theory (also referred to as the VIE Theory). Expectancy Theory suggests that for any given situation, the level of a person's motivation (force in Vroom's conceptualization) with respect to performance is dependent upon (1) the desire for a certain outcome; (2) the perception that individual job performance is related to obtaining the desired outcome; and (3) the perceived probability that individual effort will lead to the required performance. The theory may be expressed as M = V × I × E

Alderfer's ERG Theory

Introduced an alternative needs hierarchy, referred to as the ERG Theory. Alderfer's hierarchy relates to three identified categories of needs: existence, relatedness, and growth. - The ERG Theory allows for an individual to seek satisfaction of higher-level needs before lower-level needs are satisfied. In other words, the ERG Theory does not require an individual to satisfy a lower-level need for a higher-level need to become the driver of the person's behavior. Although the ERG Theory retains the concept of a needs hierarchy, it does not require a strict ordering, as compared to Maslow. - The ERG Theory accounts for differences in need preferences between cultures; therefore, the order of needs can be different for different people. This flexibility allows the ERG Theory to account for a wider range of observed behaviors. - The most important aspect of the ERG Theory, is the frustration-regression principle. The frustration-regression principle explains that when a barrier prevents an individual from obtaining a higher-level need, a person may "regress" to a lower-level need (or vice versa) to achieve satisfaction.

Organizational Behavior

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 within an organization setting.The discipline of OB attempts to understand these interactions so that managers can predict behavioral responses and, as a result, manage the resulting outcomes

Stereotype

Is defined to mean a conventional image applied to whole groups of people, and the treatment of groups according to a fixed set of generalized traits or characteristics.

Hawthorne Effect

Is the bias that occurs when people know that they are being studied.

Great Man Theory

It was believed, were born with the personality, social, and physical characteristics that set them apart—traits that made them distinct from non leaders.

Equity Theory

J. Stacy Adams (1963, 1965) proposed his Equity Theory, stating that a person evaluates his or her outcomes and inputs by comparing them with those of others. Adams's theory is based in the social-exchange theories that center on two assumptions. First, that there is a similarity between the process through which individuals evaluate their social relationships and economic transactions in the market. Social relationships can be viewed as exchange processes in which individuals make contributions (investments) for which they expect certain outcomes (Mowday, 1983). The second assumption concerns the process through which individuals decide whether a particular exchange is satisfactory. If there is relative equality between the outcomes and contributions of both parties to an exchange, satisfaction is likely to result from the interaction (Mowday, 1983). If an inequality is perceived, then dissatisfaction occurs, which triggers an internal tension within one or more of the individuals.

Least Preferred Co-Worker Scale

Least Preferred Coworker (LPC) Scale. Fiedler (1970) developed the LPC by asking the participants to describe their most and least preferred coworkers. Each participant was asked to think of all others with whom he or she had ever worked and then to describe the person with whom he or she worked best (i.e., most preferred coworker) and then the person with whom he or she worked least well (i.e., least preferred coworker or LPC). From the items identified, Fiedler created a scale that contains contrasting adjectives (such as pleasant/unpleasant, supportive/hostile, considerate/inconsiderate, and agreeable/disagreeable) to measure whether a person was task-or relations-oriented. - Fiedler believed that the ratings individuals ascribed to their least preferred coworker, a person they least enjoyed working with, reflected more about themselves than the person they chose to describe. Thus, individuals who scored the LPC in relatively positive terms were labeled "relations oriented," while individuals who scored the LPC in relatively unfavorable terms were labeled "task-oriented."

Middle of the road manager

Located directly in the middle of the grid, at the (5,5) position, is the middle-of-the-road manager. This manager appears to balance the concern for task and the concern for people in an effort to boost morale and satisfaction. On the surface this may seem to be a very effective approach to management, but this balancing act is often difficult to sustain over time. One might consider the middle-of-the-road manager the perfect politician. These managers play both sides of the field, depending upon situational factors. They will tell you exactly what they think you want to hear and then, in contradictory fashion, tell someone else exactly what they want to hear despite their earlier stance. This is not to suggest that the middle-of-the-road manager operates exclusively on political alliances, but it should be clear that under the best of circumstances it is difficult to balance an equal concern for people and an equal concern for production.

Maslow's Theory

Maslow concluded that human behavior is not controlled only by internal or external factors (e.g., needs), but by both, and that some factors have precedence over others. From this concept, Maslow created his five-tier Hierarchy of Needs. - According to Maslow, humans have five levels of needs and are driven to fulfill these needs. The most basic needs are physiological, such as the need for air, water, and food. After the basic physiological needs are achieved, an individual moves toward satisfying safety and security needs. - At this lower level of the hierarchy, individuals are interested in having a home in a safe neighborhood, job security, a retirement plan, and health/medical insurance. Because employees are concerned about satisfying these external or "extrinsic" needs, these motivators need to be addressed by employers, such as by providing employees with an adequate benefits package. - Maslow described the preceding four levels (physiological, safety, belonging, and self-esteem) as deficiency needs (D-needs) because if any of these motivators are not satisfied, they create an inner tension within the individual that must be relieved

Minority patients provider preference

Minority patients who have a choice are more likely to select health care professionals of their own racial or ethnic background. Moreover, racial and ethnic minority patients are generally more satisfied with the care that they receive from minority professionals, and minority patients' ratings of the quality of their health care are generally higher in racially concordant than in racially discordant settings.

Nonverbal Communication

Nonverbal communication is sharing information without using words to encode messages.There are four basic forms of nonverbal communication: proxemics, kinesics, facial and eye behavior, and paralanguage.

House's Path Goal Leadership Theory

Path-Goal Leadership Theory was first introduced by Evans (1970) and further developed by House (1971). House (1971) suggests that effective leaders provide the path, the support, and resources to assist subordinates in attaining organizational goals. This theory combines elements of the Ohio State studies (i.e., consideration and initiating structure) with expectancy theories of motivation. - Four separate, but fully integrated, components make up House's Path-Goal Leadership Theory: Leadership Behaviors, Environmental Contingency Factors, Subordinate Contingency Factors, and Outcomes. The first component, Leadership Behavior, identifies four specific leadership styles:

Perception

Perception is closely related to attitudes. Perception is the process by which organisms interpret and organize sensation to produce a meaningful experience of the world (Lindsay & Norman, 1977). In other words, a person is confronted with a situation or stimuli. The person interprets the stimuli into something meaningful to him or her on the basis of prior experiences. However, what an individual interprets or perceives may be substantially different from reality. - The perception process follows four stages: stimulation, registration, organization, and interpretation

Porter-Lawlet Satisfaction Performance Model

Porter and Lawler (1968a) stated that job satisfaction is generated when an employee receives rewards for his or her performance. These rewards can be intrinsic (e.g., sense of accomplishment) or extrinsic (e.g., bonus). An employee's degree of satisfaction will be proportionate to the amount of rewards he or she believes he or she is receiving. - The Porter and Lawler model reflects that satisfaction results from performance itself, the rewards for performance, and the perceived equitability of those rewards - An important aspect of Porter and Lawler's theory is the fact that the amount of the reward an employee receives may be unrelated to how well he or she has performed (e.g., pay increases based on seniority or labor union agreements). As such, for employees whose rewards are tied to factors that are beyond their control versus receiving rewards based on how well they perform, there will be little or no correlation between satisfaction and job performance.

Hofstede research power distance

Power Distance is the measure of how a society deals with physical and intellectual inequalities, and how the culture applies power and wealth relative to its inequalities. People in large Power Distance societies accept hierarchical order in which everybody has a place, which needs no further justification. People in small Power Distance societies strive for power equalization and demand justification for power inequalities. Hofstede (1983) indicated that group-interest cultures (e.g., Collectivism) have large Power Distance.

B F Skinner and reinforcement

Reinforcement Theory is based primarily on the work of B. F. Skinner (1953), who experimented with the theories of operant conditioning. Skinner's research found that an individual's behavior could be redirected through the use of reinforcement. Reinforcement Theory suggests that an employee's behavior will be repeated if it is associated with positive rewards and will not be repeated if it is associated with negative consequences. Although Reinforcement Theory is not a motivation theory (at least not in the context we have been discussing), it does help managers understand and influence, when necessary, behavioral change by the reinforcements used. Reinforcement is a behavioristic approach, which argues that reinforcement conditions behavior - There are four types of reinforcement: positive, negative, punishment, and extinction.

Sublimation

Relates to human urges and behaviors.

University of Michigan Leadership Study

Researchers at the University of Michigan were also conducting research in an attempt to determine the most effective style of leadership based on two dimensions of leadership behavior: an employee-centered focus or a production-centered focus. Employee-centered leaders emphasized interpersonal relations, took a personal interest in the needs of their subordinates, and accepted individual differences among members. Production-centered leaders emphasized the technical aspects of the job, focused on accomplishing the tasks, and saw the members as a means to an end—that is, achievement of the tasks. The researchers found that general supervision (i.e., providing support and direction without being authoritarian) created higher levels of productivity than did production centered supervision and that low-producing supervisors placed an emphasis on production, displaying little concern for their employees.