1. 2. 3. 4. 5.

The Value of Management Thought Relevance to managerial practice (managers) Improving practice (consultants) Increasing capability to do research (teachers and students) Adding to the existing body of knowledge (researchers) Understanding and appreciation of basic management concepts (general public) The meaning and usefulness of management thought can be judged on the basis of its ability to generate, transfer, disseminate and apply information about management. The usefulness of management thought can be judged on the basis of its adherence to the norms/characteristics of science. 1. Language/vocabulary for defining and describing the nature of management

2. As a cumulative and adaptive body of knowledge and practice that builds on and/or corrects the deficiencies of past experience and helps predict future trends. 3. Transferability of management thought. 4. Translation of principles of management to particular problems. 5. Management thought and the design of management processes. Elements of a literature review A literature review should include:

An overview of the subject, issue or theory under consideration, along with the objectives of the literature review Division of works under review into categories (e.g. those in support of a particular position, those against, and those offering alternative theses entirely) Explanation of how each work is similar to and how it varies from the others Conclusions as to which pieces are best considered in their argument, are most convincing of their opinions, and make the greatest contribution to the understanding and development of their area of research

Steps to prepare a literature review Preparation of a literature review may be divided into four broad stages: 1. 2. 3. 4. Define your topic: you must define your topic and components of your topic Search for materials: use search tools (such as the library catalogue, databases, bibliographies) to find materials about your topic Evaluate what you have found: read and evaluate what you have found in order to determine which material makes a significant contribution to the understanding of the topic Analysis and interpretation: provide a discussion of the findings and conclusions of the pertinent literature Return to top

Evaluating material In assessing each piece, consideration should be given to:

Provenance: What are the author's credentials? Are the author's arguments supported by evidence (e.g. primary historical material, case studies, narratives, statistics, recent scientific findings)? Objectivity: Is the author's perspective even-handed or prejudicial? Is contrary data considered or is certain pertinent information ignored to prove the author's point? Persuasiveness: Which of the author's theses are most/least convincing? Value: Are the author's arguments and conclusions convincing? Does the work ultimately contribute in any significant way to an understanding of the subject? Return to top

Uses and purpose of a literature review A literature review may constitute an essential chapter of a thesis or dissertation, or may be a self-contained review of writings on a subject (such as a journal article). In either case, its purpose is to:

Place each work in the context of its contribution to the understanding of the subject under review Describe the relationship of each work to the others under consideration Identify new ways to interpret, and shed light on any gaps in, previous research Resolve conflicts amongst seemingly contradictory previous studies Identify areas of prior scholarship to prevent duplication of effort Point the way forward for further research Place one's original work (in the case of theses or dissertations) in the context of existing literature

Sample of a Literature Review The following example is taken from a paper which addressed the following topic: Enabling (preparatory) programs into higher education play a major role in providing and enhancing educational opportunities for educationally disadvantaged students. Literature Review Enabling programs are a common and successful strategy for improving educational opportunities and subsequent success for disadvantaged students in the USA (Tripodi 1994), UK (Davies & Parry 1993), New Zealand (James 1994) and Australia (Postle, Clarke & Bull 1997). In the USA these tend to be intensive summer programs offered prior to enrolment for at risk' minority' (sic) (meaning racial minority') students; while for the UK, New Zealand and Australia they tend to be pre -enrolment programs that facilitate access to higher education by mainly mature students who lack conventional entry qualifications, generally because of a background of disadvantage. (A distinction will be drawn here to smaller scale bridging programs' that address only very specific aspects of preparedness, for example, bridging Mathematics programs for enhancing the Maths skills of students entering technical fields. Although these often represent important equity initiatives, their tight focus and relatively short duration serve to distinguish them from the broader and more intensive enabling programs that are the focus of this paper.) In an extensive study of the Scottish Wider Access (SWAP) Programs, Munn, Johnstone & Robinson (1994) noted that such access programs have been: 'remarkably successful in attracting traditionally under-represented groups in higher education' (p.73). The need for enabling programs as an access pathway for Australian higher education is demonstrated by a consideration of retention rates to Year 12. Although secondary school completion rates significantly improved during the 1980s - with 35% of the 1961 birth cohort' completing high school by 1980, rising to 55% for the 1970 cohort' by 1989 (Williams et al. 1993) and rising to peak at nearly 80% during the 1990s - the legacy of the period before the mid-to-late 1980s when the majority of Australian children failed to complete secondary studies remains. There still exists a high proportion of Australian adults and a very significant proportion of young adults who lack the qualifications and level of educational preparedness generally accepted as being necessary to enter and progress through an undergraduate program with a reasonable expectation of success. It is not surprising that a high proportion of students enrolled in enabling programs are the first members of their families to attempt tertiary study and are frequently the members of recognised disadvantaged groups that are at high risk of experiencing educational disadvantage - such as the socio-economically disadvantaged, and people living in rural and geographically isolated areas (Williams et al. 1993; Bull & Clarke 1998). A further consideration is the likelihood that recent changes in government policy, such as those relating to Austudy and HECS entitlements, will recreate the class distinctions in higher educational opportunities. Birrell & Dobson (1997) reported that: 'Information on the class characteristics and financial support of commencing Monash students indicates that students from moderate to low income families will face increasing difficulties in

accessing university places' (p. 49). This, coupled with the easing off of high school completion rates that has been observed during the last half of the 1990s, could mean that there will be an increasing need for enabling programs in the future to address the inadequate preparedness of an increasing number of the current crops of school leavers. As well as providing a physical access pathway for educationally disadvantaged students, enabling programs have been proven to be effective in improving future student retention and success. It is well documented that educationally disadvantaged students entering undergraduate programs from tertiary preparation courses typically perform as well as or better than their peers entering through other pathways (Beasley 1997; Lewis 1994; Tripodi 1994; Wisker, Brennan & Zeitlyn 1990). Ramsay et al. (1996) reported that the basis for attrition of indigenous students at the University of South Australia relate strongly to factors that can be addressed in enabling programs - uncertainty as to expectations in lectures and tutorials', poor organisation of time', d ifficulties with transition into university', and a lack of prerequisite knowledge and basic skills'. These findings were supported by Bourke, Burden & Moore (1996) who also identified isolation' and motivational problems' as major reasons for student withdrawal that may be addressed through participation in enabling programs. These authors noted that some study within 12 months of university entry greatly reduced the risk of attrition for indigenous students. In accordance with these observations, Ramsay et al. (1996) reported that indigenous students entering higher education study through enabling programs often had higher success rates and lower attrition than indigenous students entering through other admissions pathways - although considerable annual variation in student performance between groups was observed. (~750 words) H&HN: Value-Based Leadership: Is your hospital management team prepared for the future? It is essential to determine now if your board and executive team have the skill sets needed to shepherd the organization away from the fee-for-service culture and into healthcare's new value-based model. This article highlights seven steps to a valuestructured hospital and the new skills management, physicians and trustees will need to be successful. Marty Stempniak, for H&HN Magazine

B. E. Smith Articles_H&HN_Value-Based Leadership.pdf It is essential to determine now if your board and executive team have the skill sets needed to shepherd the organization away from a fee-for-service culture. Those who lie low to see how others succeed will spend too much time catching up down the line, says Brian Fuller, senior vice president of the consulting firm Kaufman Hall. The words of advice are, Dont wait, Fuller says. The markets around the country are beginning to move fast and are accelerating. You can quickly find yourself at a disadvantaged position if you dont h ave a clear vision of what you aspire to be in the future, and an understanding of the path to take you there. Some of the biggest missteps Fuller sees from providers in making the shift to the second curve are a lack of leaders with experience in risk management and other value-related skill sets, bloated board structures that dont allow hospitals to change swiftly, and a dearth of outcomes-related data needed to drive change. Putting physicians in leadership roles is critical to making the shift toward value, says John Combes, M.D., president and chief operating officer of the American Hospital Associations Center for Healthcare Governance. Much of the Affordable Care Act is focused on rewarding hospitals for their medical, not operational, performance. These are clinical issues, so you need clinical leadership to help guide the programs and implement the practices that will get you improved outcomes, he says. Preparation can come in any form, from sending doctors back to school, to building in-house physician leadership institutes, to having physicians co-manage service lines and build their expertise through experience. The relationship with the physician community is changing, says Richard Lofgren, M.D., senior vice president and chief clinical officer at UHC. At one point they were customers, then they were partners, then they were competitors, and now they really have to be part of the integrated whole. The challenge is how you bring physician leadership into the senior management team. Executive incentive structures need to shift to rewarding for value-based measures such as the number of covered lives or cost-effectiveness of treatments. Fuller says. Lofgren cautions not to rely too heavily on incentives as the motor for transformation, since they can sometimes bring about unsustainable change. This gatefold will explore the competencies that boards and executives must have to lead in a value-driven organization, ways to bolster your leadership team with physicians, and incentive and governance structures to sustain second-curve change. 7 Steps to a Value-Structured Hospital or Health System While theres no one-size-fits-all approach to retooling your hospitals governance, management and incentives structures toward value-based care, Kaufman Hall has found seven strategies that can be adopted by providers both large and small. Brian Fuller, senior vice president of the consulting firm, says board and execs shouldnt obsess about the minutiae to the point of inertia, but they do need a plan. Typically, it takes about four to six months to devise a strategy, and another four to six months to roll it out. You cant overthink or overanalyze this stuff, but you also

cant not act on it, Fuller says. Just because you might not be feeling the chall enge of a burdensome structure, it doesnt mean that you wont. And by the time you do, its usually late in the game and hard to make changes that are going to be felt and really move your organization in the market. 1. Understand the core organizational competencies required for success, and assess your readiness with these. Physician-hospital integration A well-aligned medical staff that has shared goals, contracts based on outcomes, input on planning and is represented in organizational governance Care coordination/management capability Use of certain tools to coordinate care by an empowered and integrated workforce to meet regularly measured and reported performance goals Information systems sophistication An IT platform that supports clinical decision-making, information management; simple communication and access by everyone involved (physicians, patients, administration) to allow for proper treatment and strategic decision-making Service distribution system effectiveness A rational system of serving patients that has easily accessible primary care and easy access (both physically and through referrals) across the care continuum, delivered in contemporary facilities with contemporary equipment Cost-management A right-sized, organizationwide cost structure, highlighted by appropriate levels of staffing, capital spending, overhead support and supply chain costs, and constantly reviewed based on other providers best practices Scale and market essentiality Sufficient scale to attract competitive clinical and administrative talent, realize economies, drive marketplace innovation and be an essential provider to health plans and patients Brand identification Well-recognized and respected, associated with high quality and service excellence Payer relationships/contracts Maintaining strong relationships with payers and the ability to negotiate support for new era business practices Financial strength/capital capacity Strong appeal to capital markets through sustained operations, revenue growth and balance sheet strength 2. Identify the core leadership skill sets required for the future and assess the strengths and weaknesses of those skill sets. Strategic focus Leaders must move decisively to build their team and find opportunities. Network development and management skills Leaders need the ability to build relationships, shape networks or find partners to join in the dance. Expertise in managing and governing nonhospital operations With the need to manage across the continuum, leaders need to have expertise outside their normal comfort zone, from home health to hospice, labs, skilled nursing or long-term care. Ability to attract and retain physician leaders Many hospitals dont have a high proportion of physician leaders in exec roles or on boards or committees, despite the fact that theyre essential to population health management. Expertise with population health management and its associated risk This is an entirely different mindset from episode-based care, with the need for patient-population mastery, a team-based care approach, coordinated care and physician incentive programs. Depth and breadth of expertise related to IT Technologies are changing rapidly, and board members and trustees need to have some sense of the ever-changing landscape. 3. Determine the organizations desired and achievable position for the future. Kaufman Hall says there are three types of provider organizations emerging in the new industry, and leaders need to determine which they are now and which theyd like to become under a value-based model. Class 1 CONTRACTED PROVIDERS Smaller, niche providers; important, but not critical components Class 2 MAJOR PARTICIPANTS Community hospitals and systems working within a network managed by a population health manager to efficiently provide a broad portfolio of services; will be critical components of PHM networks Class 3 POPULATION HEALTH MANAGERS Large, regional health systems that will be able to provide, either directly or through managed relationships, a full continuum of services, across all service lines and levels of acuity 4. Evaluate current governance and management structures; identify structures that best support goals. Kaufman Hall says a hospital or health systems ideal structure is one that allows it to go further faster toward reaching its goals. providers can start by developing a core multidisciplinary group empowered by the CEO and board chair to evaluate governance and management structures transparently with communication to leadership at defined

levels. Key, according to Kaufman, is figuring out whether structures enable or impede achieving the aforementioned competencies. As hospitals go through rounds of mergers and acquisitions, they sometimes can gather different committees and boards like barnacles, making governance complex and transformation more difficult. The consulting firm says providers must find the appropriate structures that are centered around systems and organizational models, rather than the hospitalcentric or sitecentric ways of the past. Hospitals leaders must decide whether they want one board to govern a single hospital in a system, or an entire organization. And should committees be formed that focus on new-era needs that the organization lacks, such as a care and risk management committee related to population health management. 5. Evaluate current management incentive plans; develop alternatives that would better support organizational goals. Kaufman Hall notes that as much as 50 percent of executive pay, in some organizations, is based on incentives. And thus, those bonuses need to be based on value-related metrics, rather than the volume-tied numbers of the past. But as providers move from the first to the second curve, boards need to have a plan for incentives to transition from one realm to the next. Some are using long-term incentives that look two or three years down the line using such value metrics as readmission rates, while also accounting for volume metrics, like the number of patient visits for currentyear incentives. 6. Understand the obstacles to change, and develop and implement potential mitigating strategies. The hurdles that pop up along the way will vary from provider to provider, but Kaufman Hall says every leader should expect and plan for them. Shifting toward servicecentric organizations will shift the power base and make some executives feel threatened. Management and governmental layers will need to be peeled away, and those left behind could be upset. Physicians who may have had an adversarial relationship with the hospital in the past may take on leadership roles. Providers can be prepared by putting in place strong leaders who are ready to drive the change required for transformation. 7. Learn from leading providers with organization structures and incentive plans suited to value-based care. https://www.besmith.com/thought-leadership/articles/hhn-value-based-leadership-your-hospital-management-teamprepared-future