HEALTH SERVICES MANAGEMENT

And Nursing Service Administration

BY: Nurilign Abebe (BSc, MPH)

For fourth year Extension nursing students
Oct, 2014
 Unit one
• INTRODUCTION TO MANAGEMENT
Objectives: @ the end of this unit students are expected to:
 Define health service management
 Mention the importance of management
 List levels of management
 List function, role and skills of management/managers
 State the concepts and principles of management
 Describe theories of management
 Group dynamics and Team work
 OUTLINE
• Definition of Management
• Elements of management
• Management Functions
• Levels of Management
• Management Skill
• Managerial Roles
• Principles of Management
• theories of Management
• Group dynamics and Team work
3
 MANAGEMENT
Definitions
 Several ways
 WHO “On Being in Charge”

- Getting things done through people.

- The efficient use of resources.

- Getting people to work harmoniously

together and to make efficient use of
resources in order to achieve objectives.
 Definitions….
Samuel C. Certo: “Modern Management”

- It is the process of reaching organizational

goals by working with and through people
and other organizational resources.
 Definitions….
• Management is the process of working with
and through others to achieve organizational
objectives in a changing environment.

• Central to this process is the effective and

efficient use of limited resources.
 Definitions….
Management is defined as a process,
composed of interrelated social and technical
functions and activities, occurring in a formal
organizational setting for the purpose of
accomplishing predetermined objectives
through the use of human and other resources.
 Definitions….

• Management is the process of Planning,

Organizing, Leading, and Controlling the
efforts of organizational members and of
using all other organizational resources to
achieve stated organizational goals.
Goals are broad statements where an organization
strives to reach.
 Organizational goals are important for at least four
reasons:
1. Goals Provide A Sense Of Direction.
2. Goals Focus Our Efforts.
3. Goals Guide Our Plans And Decisions.
4. Goals Help Us Evaluate Our Progress.
 Health Management
It is essentially a system of administration
Roles, Functions and Tasks carried out by
individuals at various levels of administration
in order to improve the Health of the People.
(WHO 1977).
 In summary

Resources Management Output

Human The process Objective

Finance Whereby these Accomplishment
Material resources are
Information Integrated into
Time A total system
 MAIN ELEMENTS

Management at all levels has the following

MAIN ELEMENTS
1. It is a process- a set of interactive and
interrelated on going functions and
activities.
2. It involves accomplishing organizational
objectives/goals.
3. It involves achieving these objectives
through people and the use of other
resources. Commitment to achievement.
 MAIN ELEMENTS….
4. It needs balancing effectiveness and efficiency
Effectiveness: entails promptly achieving stated
objectives.
Efficiency: enters the picture when the resource
required to achieve an objective are weighted
against what was actually accomplished.
The more favorable the ratio of benefits to costs, the
greater the efficiency.
 Element…

5. Coping with the changing environment.

6. It occurs in a formal organizational

setting whether a single, independent
organization or a system of organizations;
organizations invariably exist in the context of
larger external environments.
KEY ASPECTS OF THE MANAGEMENT PROCESS

Getting
the most
Out of
Limited Resources
Achieving
Organizational
Objectives
Balancing
Working with
Effectiveness
and through
And
others
Efficiency
 MANAGEMENT FUNCTIONS
Function
- is defined as a broad area of responsibility
composed of many activities aimed at achieving
a predetermined objectives.
- Functions of management are put in different
ways by different experts/scholars; (3, 4, 5,
6, 8 functions).
 MANAGEMENT FUNCTIONS cont…
The management functions as interrelated like the pieces of
a puzzle

Planning Organizing
Relationships
Deciding in advance
Among people &
What is to be done
Other resources
Decision Making
Choosing between/
Controlling Among alternatives Staffing
Regulating activities Acquiring, maintaining,
In accordance with Directing & retaining Human
plans resources
Initiating work
In the organization
 MANAGEMENT FUNCTIONS cont…

8 Functions
Controlling Planning

Leading Organizing
Managing for
Effectiveness
& Efficiency
Motivating Staffing

Decision
Communicating Making
 MANAGEMENT FUNCTIONS cont…

Planning, Implementation, Evaluation (PIE)

Communication

E I

Decision Making
 MANAGEMENT FUNCTIONS cont…

Interrelation of the Four Functions of Management to

attain Organizational Goals

Organizational Goals

Planning

Controlling Organizing

Influencing
Major management functions are:
1. Planning
2. Organizing
3. Staffing
4. Leading
5. controlling
1. Planning “… Planning is not simply a technical
exercise... It is an ongoing process of learning,
adapting to change, and educating.”
Taylor and Reinke

See in planning chapter!

22
 Management functions…
2. Organizing:
• creates a structure to facilitate the accomplishment of
goals-the management hierarchy-and all management
positions that support it.
• It is the process of defining and grouping the activities of
the organization and establishing the authority relationship
among them.
• The manager differentiates and integrates the activities of
his organization.
• By differentiation is meant the process of
departmentalization or segmentation of activities
• Integration is the process of achieving unity of effort among
various departments.
23
 Management functions…
3. Staffing:
• acquiring and placing of qualified people.
• It is the process of filling and keeping filled the positions
required by the organizational structure with right
people, at right places, and at the right time.
• It includes several sub-function like;
– Recruitment
– Selection
– Hiring
– Transfer and promotions
– Training
24
 Management functions…
4. Leading:
• According to Peter Drucker, “It is the lifting of man’s
visions to higher sights, the raising of mans performance
to a higher standard, the building of man’s personality
beyond its normal limitations”.
• According to Keth Davis, “leadership is the ability to
persuade others to seek defined objectives
enthusiastically.”
• It is the human factor which binds a group together and
motivates it towards goals.

25
 Management functions…
5. Controlling:
• According to EFL Brech, “controlling is checking current
performance against predetermined standards
contained in the plan, with a view to ensuring adequate
progress and satisfactory performance”.
• George R Terry, “controlling is determining what is being
accomplished, that is evaluating the performance and if
necessary applying corrective measures so that the
performance takes place according to plans”.

26
 Levels of management
• Managers are people formally appointed to positions of
authority in organizations or systems who enable others
to do their direct or support work effectively, who have
responsibility for resource utilization, and who are
accountable for work results.
• Although all managers perform the same set of
functions, they actually do so on only three
organizational levels. Generally managers are
categorized into three levels.
– Top level
– Middle level
– First line: sometimes called as supervisory, front-line and
operating level of management.

27
 Levels…

Top
Middle
Front line
28
 Levels…
Top management:
 the CEO and/or president and his/her immediate
subordinates usually called vice-presidents.
 Top management is responsible for overseeing the
entire organization.
 It establishes long term goals and oversees the work
of middle level management.
 Top management also creates and coordinates
alliances and partnerships with outsiders.

29
 Levels…
Middle level management:
• includes managers above the rank of supervisory level.
• they develop objectives to implement top-
management goals.

First line management:

• supervisors, team leaders and team facilitators who
oversees the work of non-management people often
called operating employees.
• They plan for a short term, involving scheduling
employees and establishing detailed procedures to
perform worker tasks.
Give example from hospital system
30
 Levels of management…
Top management

president

Vice-president Vice-president Vice-president Vice-president

manufacturing marketing finance Human resources

31
 Levels of management…
Middle level management
Vice president
marketing

Northern Southern
Central
Regional Regional
Regional
manager manager
manager

East Central Southern East Central Southern

district District District District District District
manager manger manager manager manager manager

32
 Levels of management…
First line management
Central
central
Group
group
manager
manager

Area Area Area Area Area

Area
manager manager manager manager manager
manager

workers workers

33
 Levels…
• Classification schemes typically identify managers as top or
senior management, middle level management and supervisory
or first line management.

• Sometimes the classification are policy level, administrative or

coordinative level, and operations level.

• Griffith distinguishes as decision oriented and implementation

oriented managers.

• Decision oriented managers are typically positioned higher in

HSO/HS and help to establish its objectives and address its most
sensitive and difficult decisions, weighing the importance and
permanence of environmental changes, recommending budget
guidelines and resolving serious disputes.

34
 Levels…
• Implementation-oriented managers focus more on
getting thing done, often through direct supervision of
others or through leading teams.
• Regardless of title, level or orientation, managers have
several common attributes:
– They are formally appointed to positions of authority,
– They are charged with directing and enabling others
to do their work effectively,
– They are responsible for utilizing resources,
– They are accountable to superior for results.

35
 Levels…
 The primary differences between levels of managers
are the degree of authority and the scope of
responsibility at each level.

 E.g. senior managers, presidents or chief executive

officers and vice –presidents in HSOs have authority
over and are responsible for entire organizations---all
staff, resources and individual and organizational
results.
 CEO are accountable to the governing body.

36
 Levels…
• Middle level managers report to senior managers.
• Each of whom is responsible for smaller segments of
the organization.
• Middle level managers, such as College deans and
Heads of Processes have authority over and are
responsible for a specific segment.
• First level managers, who generally report to middle
level managers, have authority over and are
responsible for overseeing specific work and
particular group of workers.

37
 Levels…
• Senior-middle- and first level managers are
responsible for very different types of
activities.

• But all of these activities are important and no

organization can be successful unless the
management work at each level is done well
and unless the work at each level is carefully
integrated with that done at the other levels.

38
 Management skills
• are competencies a manager holds to undertake the roles
effectively. (Katz (1955), Hersey and Blanchard (1988))
• ability to translate knowledge into action.
• => manifested in an individuals performance.
• not necessarily inborn.
• developed through practice and experience.
• all levels of managers need some skills and competencies
and the roles that they play in carrying out their work
within an organization.
• A manager should posses 3 major skills; these are
conceptual skill, human relation skill, and technical skill.

39
 Managerial skills
1. Conceptual skill:
 understand the complexities and issues within an
organization and the role and strength of management
within it
 involves the formulation of ideas.
 Managers understand abstract relationships, develop
ideas, and solve problems creatively.
 ability of a manager to take a broad and farsighted view
of the organization and its future.
 enable managers to act according to the goals of the
organization as whole,
 allow the manager to view an organization as a whole
and to see how its parts relate to and depend on one
another.
40
 Management skills…
2. Human relation skill:
• consists of the abilities to interact and communicate
successfully with other persons.
• deals with people.
• include leadership of subordinates and faculty in
intergroup relationships.
• A manager must be able to understand, work with and
relate to both individuals and groups to build a team
environment.
• The managers ability to work effectively as a group
member and to build cooperative effort within the group
depends on human relation skills.
41
 Management skills…
3. The technical skills;
• the ability to use knowledge, methods, techniques
and equipment necessary for the performance of a
specific task.
• deals with things.
• It is the managers understanding of the nature of job
that people under him have to perform.
• Such skills can be acquired through training,
education and work experience.

42
 Managerial skills
Management skills by levels of management (Katz 1955)

Technical Human relation Conceptual

Top

Middle

Front
line

43
 The managerial ‘myths’
(uncovered by Mintzberg)
• Managers are often not rational planners who think ahead;
their decision-making is often characterized by intuition,
discontinuity
• Managers spend little time actually managing operational
activities but more time negotiating with staff, developing
and providing information, and holding meetings.
• Managers tend not to rely on aggregated or quantified data
on which to make decisions, but tend to rely more on
information such as gossip, hearsay and speculation.
• Management is not solely a scientific task, but involves a
considerable amount of judgment and intuition.

44
 Management roles
• A role is an organized set of behaviors.
• is a set of expectations that managers should
play.
• Henry Mintzberg defines 10 roles that
managers are expected to play and group
them in to 3 categories.
1. Interpersonal roles
2. Informational roles
3. Decisional roles

45
 Managerial Roles cont…
Intrapersonal
Decisional role roles
• Entrepreneur
• Disturbance handler
Figurehead
• Resource allocator Leader
• Negotiator Liaison

Informational role
Monitor
Disseminator
Spokesperson
 Management roles…
1. Interpersonal roles
 Interpersonal roles provide managers with
opportunities to gather information based on the use
of formal authority.
1.1. Figurehead:
◦ performs symbolic routine duties of legal or social
nature.
◦ As a figurehead, a manager routinely performs
certain ceremonial duties including attending
inauguration ceremony, addressing the media or
taking people to dinner, entertaining visitors,
officiating a luncheon, etc.
47
 Interpersonal roles…
1.2. Leader:
• motivates subordinates, ensures hiring and training of staff.
• As a leader, manager creates the environment, works to improve
employees performance and reduce conflicts, provides feedback
and encourages individual growth, set an example for others to
follow.
1.3. Liaison:
• involves dealing with people outside the organization, such as key
partners with whom good working relationships are required
• maintains self developed network of contacts and informers who
provide favors and information.
• In addition to superiors and subordinates, managers interact with
others-peer level managers in other departments, staff specialists,
suppliers and clients.

48
 Management roles…
2. Informational roles
• flow from the interpersonal roles
2.1. Monitor:
– Managers gather information from their network of
contacts, including those established in their liaison roles
– seeks and receives wide variety of special information to
develop through understanding of the organization and
environment.
– As a monitor, a manager should constantly monitoring
the environment to determine what is going on.
– He/she should collect information both directly and
indirectly.
49
 Informational roles…
2.2. Disseminator
• Transmits information received from outsiders or
subordinates to members of the organization, that
would not ordinarily be accessible to them.
• Involving knowledge transfer among staff in the
workplace
2.3. Spokesperson
• Transmits information to outsiders about organizations
policies, plans, actions, results.
• Deals with external clients, professionals and interested
parties
50
 Management roles…
3. Decisional roles
3.1. Entrepreneur:
– Searches organization and its environment for
opportunities and initiates projects to bring about
change.
– Sharing and initiating new ideas or methods that may
improve the work units operations.
– He should implement strategy and review sessions
involving improvement.
– the initiator of change, often taking risks

51
 Decisional roles…
3.2. Disturbance handler:
 Dealing with disputes and strikes
 Initiates corrective action when organization faces important,
unexpected disturbances.
 Implementing strategy to resolve disturbances and crisis
3.3. Resource allocator:
 Fulfills responsibility for the allocation of organizational resources of
all kinds-in effect, makes or approves all significant decisions.
3.4. Negotiator:
 Represents the organization in major negotiations.
 Items to be negotiated include contracts with suppliers, trade-off
for resources inside organization and agreements with labor
organizations.
52
 Why do organizations need managers?
1. To ensure the organization serves its purpose and is
efficient in the production of goods or services;
2. To design and maintain the stability of the operations of
the organization;
3. To take charge of strategy-making and ensure the
organization can adapt to its environment;
4. To ensure the organization meets the ends of its bosses
and clients;
5. To serve as the informational link between the
organization and the outside world;
6. To act as a formal authority in operating the organization’s
‘status system’.
53
 The three fundamental ‘rules’ of mgt

• There are three tasks of such fundamental importance

to managing other people effectively that you can think
of them as rules. These are:
– Agree with them precisely what it is you expect them to
achieve;

– Ensure that both you and they are confident that they
have the skills and resources to achieve it;

– Give them feedback on whether they are achieving it.

54
 Means of implementing those fundamental
rules
• Understanding the three rules is simple, but they are
hard to put into practice because they require time,
energy and courage.

• Good management requires an understanding of two

types of concepts:
– Those that are complicated but easy to implement because
they involve brains but not emotions
– Simple hard concepts, like the three rules, which require
more courage and discipline than intelligence.

55
 SUCCESSFUL MANAGER
 Successful managers have certain features in
common,
 The qualities they possess include:
A. Bias for Action
- Preference for doing something – anything
rather than nothing in time of direct need.
- Take action rather than refusing.
- Learn from the actions they take from time
to time and thereby improve their strategies
for success.
 SUCCESSFUL MANAGER
B. Keep Abreast with Developments in their
own field
- Curious about new ideas.
- Do not think it is below their dignity to
learn from other people – even from their
own ignorance about a specific area in
the presence of someone from whom
they learn something good.
 SUCCESSFUL MANAGER
- Should have good knowledge about
competitive market, technological
advancement and social change that may
affect his/her organization or its
environment.
 SUCCESSFUL MANAGER
C. Decisiveness
- Quick and right decisions are very
important.
- Know the facts.
- Should possess conceptual logical
ability, intuitive and courageous
judgment and ability to analyze the
problem by breaking it into parts and
identifying the nature and effect of each
part.
 SUCCESSFUL MANAGER
D. Ability to Handle Conflict
- Calm, able to listen, is positively
responsive to criticism and is able to
handle conflicts and differences in a
constructive manner.
- In order to handle conflicts properly, a
manager must be confident, self-
assertive, fair and dominant.
 SUCCESSFUL MANAGER
- Should be highly tolerant of stress, for
conflicts generally lead to stress.

E. Productive though People

- Ability to motivate employees to give in
their best and enhance productivity.
 SUCCESSFUL MANAGER
F. Emotional Stability
- Calm and calculated reaction to
undesirable situations and obstacles.
- Normal acceptance of success as well as
failure.
- Emotional instability often leads to
wrong and impulsive decisions with dire
consequences.
 SUCCESSFUL MANAGER
G. Ability to Flexibility
- All situations may not be similar, strict
adherence to certain methods and
techniques, may not be
desirable/effective.
- Knowing when to be flexible and when
to be stern, is an art which can spell the
difference between and failure.
 SUCCESSFUL MANAGER
H. Responsibility
- Must take full responsibility for all the
organization or unit does or fails to do and for
its failures as well as its successes.
- Should be prompt in passing the credit and
commendations to all the subordinates who
contributed to it.
- Expected to take corrective action to remedy
any bad situations.
- should look for the opportunity for bigger
and higher responsibilities.
 SUCCESSFUL MANAGER
I. Avoid Waste of Time on Work that
Belongs Others
- When a manager shows faith in
people’s ability to do the job, he/she
will find that the persons concerned
need less supervision.
 SUCCESSFUL MANAGER
J. Assess Performance Honestly and
Realistically
- Evaluate himself/herself so that he/she
will know his/her strengths and
weaknesses.
 SUCCESSFUL MANAGER
K. Ability to earn Respect
- Should have the ability to earn respect
from his/her employees as a result of
what he/she can does.
- To earn respect, the manager should be
able to plan and organize work. Must
order, direct and supervise others to
make sure that the work is done
properly.
 SUCCESSFUL MANAGER
Three General Preconditions for
Achieving Lasting Success as a Manager
are:
Ability (A): demonstrated capacity to
achieve organizational objectives with
specific skills and competencies.
Ability to manage includes leadership,
communication skill, planning,
organizing, decision-making, etc.
SUCCESSFUL MANAGER cont…
Motivation to manage (M): measures ones’
desire to a manger, desire to exercise
power and authority over others, etc.
Opportunity (O): right combination of
ability and motivation to manage.
SUCCESSFUL MANAGER cont…
Together, they consist a basic formula for
Managerial Success (S)

S=AxMxO

Success depends on a balanced combination of

ability, motivation to manage, and opportunity.
A total absence of one factor can cancel out
strength in the other two.
 THE 21 CENTURY MANAGER
• Ten Major Moving
Away from Toward
Changes
1.Administrative Boss/Superior/ Team member/
Leader Facilitator
Teacher/Sponsor
Advocator/Coach
2. Cultural Monoculture/ Multilanguage/
Orientation Monolingual Multilingual
3.Quality/Ethics After thought Fore thought
/Environmental (or no thought) (Unifying
Impacts Themes)
 THE 21 CENTURY MANAGER cont…

Moving
• Ten Major
Away from Toward
Changes 4. Power Basis Formal Knowledge;
authority; Relationship;
Reward, & Rewards
Punishment
5. Primary Individual Team
Organizational
Unit
6. Interpersonal Competition; Cooperation;
Dealings Win-Lose Win-Win
 THE 21 CENTURY MANAGER cont…

Moving
• Ten Major
Away from Toward
Changes 7. Learning Periodic Continuous
(Preparatory; (Life long; Learner
Curriculum - Driven)
driven)
8. Problems Threats to be Opportunities
avoided For learning and
Continuous
Improvement
9. Change & Resist/React/ Anticipated/Seek/
Conflict Avoid Channel
10.Information Restrict Access/ Increase Access/
Hoard Share
Session two
 CHALLENGES
Managers in the HSOs/HSs are accustomed to
Challenges result from many forces:
 Scientific and technological advances in
medicine;
 New organizational forms and relationships
through which to provide health services;
 New policies and programs for financing the
provision of health services;
 High expectations by consumers/patients,
clinicians, and by those who pay for health
care.
 Principles of Management
1.Management by Objective:
- Management sees that objectives are
specified and then if they are achieved.

2.Learning from experiences:

-Analysis of the results between the objectives
and achievements made. For better
performance there should be feedback to
learn from the experience gained.
Principles of Management cont…
3.Division of labor:
- Management attempt to bring about balance
of work among the different people
concerned.
4.Substitution of resources: often when the
resources that are normally used to provide
services become scares or too expensive,
different resources may be used to provide the
intended results.
Principles of Management cont…
5.Convergence of work:
Working relations should contribute to
the success of each activity and so to
general effectiveness.

6.Functions determine structures:

When the work is defined, the exact
nature of the authority will be clearly
delineated on the structure.
Principles of Management cont…
7.Delegation: takes place when some body’s authority
is lent, to enable that person to take responsibility
when the occasion arises.
8.Management by Exception: do not be overloaded
with the routine, unnecessary information and be
selective. Make big decisions first.
– Priority in decisions.
9.Shortest Decision Path: decision must be made as
closely as possible in time and place to the object of
decisions and to those affected by it.
Principles of Management cont…

 Other Principle
- Management By Walking Around
(MBWA)
Principles of Management cont…
Henri Fayol (1841 - 1925)
- An early attempt, pioneered by H.F. to
identify the principles and skills that
underline effective management.
- He developed the 14 Principles of
Management
Principles of Management cont…
1. Division of Labor
2. Authority: Mangers must give orders so that
they can get things done.
3. Discipline: Members in an organization need
to respect the rules and agreements that
govern the organization.
4. Unity of Command: Each employee must
receive instructions from only one person. If
an employee reported to more than one
manager, conflicts in instructions and
confusion of authority would result.
Principles of Management cont…
5. Unity of Direction: should be directed by only
one manager using one plan.
6. Subordination: of individual interest to the
common good.
7. Remuneration: Compensation for work done
should be fair to both employees and
employers.
8. Centralization: Managers should retain final
responsibility, but should at the same time
give their subordinates enough authority to do
their jobs properly.
Principles of Management cont…
9. The Hierarchy: the line of authority in an
organization should be created.
10. Order: Materials and people should be
in the right place and the right time.
11. Equity: managers should be both
friendly and fair to their subordinates.
12. Stability of Staff: A high employee
turnover rate undermines the efficient
functioning of an organization.
Principles of Management cont…
13. Initiative: Subordinates should be
given the freedom to conceive and carry
out their plan, even through some
mistakes may result.
14. Espirit de Corps: Promoting team spirit
will give the organization a sense of
unity.
Leader:
- Help identify dragons nest but do not
eliminate dragons by themselves.
They design the appropriate climate.
Create the right tools and enable others
to act.
Create new knowledge.
Shape organizational climate &
structures.
Looks after everyone's welfare.
Nurture values and learning.
Leadership:
1. The ability to use power effectively and in a
responsible manner.
2. The ability to comprehend that human beings
have different motivation forces at different
times and in different situations.
3. The ability to inspire.
4. The ability to act in a manner that will develop
a climate conducive to responding to and
arousing motivations.
 - People tend to follow those whom they
see as providing a means of achieving
their own desires wants and needs.
- The process of influencing people so that
they will strike willingly and
enthusiastically towards the achievement
of group goals.
- The essence of leadership is follower ship.
 Leadership Theories/ Approaches
1. Great Man Theory
Assumptions:
• Leaders are born and not made
• Great leaders will arise when there is a great need.
Description:
- Early research on leadership was based on the study of
people who were already great leaders. These people were
often from the aristocracy, as few from the lower classes
had the opportunity to lead. This contributed to the notion
that leadership had something to do with breeding.
 Leadership Theories cont…
- The idea of the Great man also strayed into the mythic
domain, with notions that in times of need, a easy to
verify, by pointing to people such as Eisenhower and
Churchill, let alone those further back along the
timeline, even to Jesus, Moses, Mohammed and the
Buddha.

Discussion:
Gender issues were not on the table when the ‘Great
Man’ theory was proposed. Most leaders were male
and the thought of a Great Woman was generally in
areas other than leadership.
 Leadership Theories cont…
2. Trait Theory
Assumptions:
• People are born with inherited traits. Some traits are
particularly suited to leadership. People who make good
leaders have the right (or sufficient) combination of traits.
Description
- Early research on leadership was based on the psychology
focus of the day, which was of people having inherited
characteristics or traits. Attention was thus put on
discovering these traits, often by studying successful
leaders, but with the underlying assumption that if other
people could also be found with these traits, then they,
too, could also become great leaders.
THE TRAIT APPROACH
• Tries to identify the personal
characteristics of leaders
• Assumes leaders share certain inborn
personality traits (leaders are born, not
made)
• Traits compared between those who are
leaders and non leaders
Many studies of traits approach to leadership
found out the following traits factors
1. Physical traits
– Energy
– Appearance
– Height
2. Intelligence and ability traits
3. Personality traits
– Adaptability
– Aggressiveness
– Enthusiasm
– Self-confidence
4. Task related characteristics
– Achievement drive
– Persistence
– Initiative
5. Social characteristics
– Cooperativeness
– Interpersonal skills and administrative
ability
 Leadership Theories cont…
Stogdill (1974) identified the following traits and
skills as critical to leaders.

Traits
Skills
• Adaptable to situations
• Clever (intelligent)
• Alert to social environment
• Conceptually skilled
• Ambitious & achievement
• Creative
oriented
• Diplomatic & tactful
• Assertive
• Fluent in speaking
• Cooperative
• Knowledgeable about
• Decisive
group task
• Dependable
• Organized (administrative
• Dominant (desire to
ability)
influence others)
 Leadership Theories cont…

Traits Skills
•Energetic (high activity • Persuasive
level) • Socially skilled
• Persistent
• Self-confident
• Tolerant of stress
• Willingness to assume
responsibility
 Leadership Theories cont…
McCall and Lombardo (1983) researched both success and
failure identified four primary traits by which leaders
could succeed or ‘derail’

• Emotional Stability and Composure: Calm,

confident and predictable, particularly when under
stress.
• Admitting Error: Owning up to mistakes, rather than
putting energy into covering up.
• Good Interpersonal Skills: Able to communicate and
persuade others without resort to negative or coercive
tactics.
• Intellectual Breadth: Able to understand a wide range
of areas, rather than having a narrow (and narrow-
minded) area of expertise.
 Leadership Theories cont…
Discussion
There have been many different studies of leadership
traits and they agree only in the general saintly qualities
needed to be a leader.
For a long period, inherited traits were sidelined as
learned and situational factors were considered to be far
more realistic as reasons for people acquiring leadership
positions.
 Leadership Theories cont…
3. Behavioral Theory
Assumptions:
Leaders can be made, rather than are born.
Successful leadership is based in definable, learnable
behavior.
Description
Behavioral theories of leadership do not seek inborn
traits or capabilities. Rather, they look at what leaders
actually do.
If successful can be defined in terms of describable actions, then it
should be relatively easy for other people to act in the same way.
This is easier to teach and learn then to adopt the more ephemeral
‘traits’ or ‘capabilities’.
The behavioral approach
• Studied behavioral characteristics of
leaders;
• What they do and how they interact with
the subordinates;
• Explored leadership functions (task-
related & group- maintenance);
• leadership styles (task-oriented and
employee oriented.
Discussion
Behavioral is a big leap from Trait Theory,
in that it assumes that leadership
capability can be learned, rather than being
inherent.
 Leadership Theories cont…
4. Role Theory
Assumptions:
- People define roles for themselves and others
based on social learning and reading.
- People form expectations about the roles that
they and others will play.
- People subtly encourage others to act within
the role expectations they have for them.
- People will act within the roles they adopt.
 Leadership Theories cont…
Discussion
- Role expectations of a leader can vary from very
specific to a broad idea within which the
leader can define their own style.
- When role expectations are low or mixed, then
this may lead to role conflict.
The Managerial Grid
Description
- Leaders may be concerned for the people
and they also must have some concern for
the work to be done.
- The question is, how much attention to
pay to one or the other?

This is a model defined by Blake and

Mouton in the early 1960s.
 High Country Team
Club managem
Managemen
ent
t
Concern Medium Middle of
for the Road
people manageme
nt
Low Impoveris Authority
hed Complia
Managem nce
ent
Low Medium High
Concern for Production (Task)
 The Managerial Grid cont…

Impoverished Management
- Minimum effort to get the work done. A
basically lazy approach that avoids as
much work as possible.
- Authority – Compliance
Strong focus on task, but with little
concern of people. Focus on efficiency,
including elimination of people
whenever possible.
 The Managerial Grid cont…
Country Club Management
- Care and concern for the people, with a
comfortable and friendly environment and
collegial style. But a low focus on task may
give questionable results.
Middle of the Road Management
- A weak balance of focus on both people and
the work. Doing enough to get things done,
but not pushing the boundaries of what may
be possible.
Team Management
- Firing on all cylinders: people are committed
to task and leader is committed to people (as
well as task).
 The Managerial Grid cont…

Discussion
- This is a well known grid that uses the
Task vs. Person preference that appears
in many other studies.
- The Managerial Grid was the original
name. It later changed to the Leadership
Grid.
 Leadership Theories cont…
The contingency approach
• leadership could vary with the situation or
circumstance
• The theory focuses on:
– Task requirements
– Peer’s expectation and behavior
– Employees’ characteristics, expectations and
behavior
– Organizational culture and policies
 Leadership Theories cont…
The Path-Goal approach to leadership
effectiveness
The path-goal theory suggests that the
main functions of the leader :
 to clarify and set goals with subordinates
 help them find the best path for achieving
the goals, & remove obstacles.
 Leadership Theories cont…
Path Goal Approach to leadership effectiveness
• Leader behavior is categorized into four groups
1. Supportive leadership behavior
2. Participative Leadership
3. Instrumental leadership
4. Achievement-oriented leadership involves
 Leadership Theories cont…
1. Supportive leadership behavior
• gives consideration to the needs of
subordinates,
• shows a concern for their well-being,
• creates a pleasant organizational climate.
• It has the greatest impact on subordinates’
performance when they are frustrated and
dissatisfied.
 Leadership Theories cont…
2. Participative Leadership
Allow subordinates:
• to influence the decisions of their superiors.
• can result in increased motivation.
 Leadership Theories cont…
3. Instrumental leadership
Gives subordinates:
• rather specific guidance
• clarifies what is expected of them:
this includes aspects of planning and
organizing
• coordinating
• controlling by the leader.
 Leadership Theories cont…
4. Achievement-oriented leadership involves
• Setting challenging goals
• Seeking improvement of performance
• Having confidence that subordinates will
achieve high goals.
 Manager Leader
Administers Innovates
A copy An original
Maintains Develops
Focuses on systems & Focuses on people
structure
Relies on control Inspires trust
Short- range view Long-range perspective
Asks how and when Asks what and why
Eye on the bottom line Eye on the horizon
Imitates Originates
Accepts the status Challenges the status
Does things right Does the right thing
 Theories of Motivation
1. Maslow’s needs hierarchy theory
2. Herzberg’s two-factor theory
3. Expectancy theory
4. Goal-setting theory
 Maslow’s Needs Hierarchy Theory
• People have needs, and when one need is relatively
fulfilled, other emerges in predictable sequence to take
its place.
• Maslow’s hierarchy of needs:
• Physiological needs: food, water, sleep, and sex.
• Safety needs /Security needs: safety from the ailments,
threat and enemies.
• Love and belongingness needs/ social needs: desire for
love, affection, and belonging.
• Esteem needs: self-perception as a worthwhile person.
• Self-actualization: becoming all that one can become.
 Self-Actualizing Managers
• Have warmth, closeness, and sympathy.
• Recognizes and shares negative information and feelings.
• Exhibit trust, openness, and candor.
• Do not achieve goals by power, deception, or manipulation.
• Do not project own feelings, motivations, or blame onto
others.
• Do not limit horizons; uses and develops body, mind, and
senses.
• Are not rationalistic; can think in unconventional ways.
• Are not conforming; regulates behavior from within.
Relevance of Maslow’s Theory for Managers

• A fulfilled need does not motivate an individual.

• Effective managers can anticipate emerging needs
based on individual need profiles and provide
opportunities for fulfillment.
• The esteem level of needs satisfied by jobs and
recognition provides managers with the greatest
opportunity to motivate better performance.
 Herzberg’s Two-Factor Theory
• A theory of motivation based on job satisfaction.
• “A satisfied employee is motivated”
• A dissatisfied worker is not self-motivated to work.
• Conclusion: Enriched jobs are the key to self-
motivation.
• Dissatisfies - factors associated with the job context
or work environment.
• Satisfiers: factors associated with the nature of the
task itself (job content).
 Herzberg’s Two-Factor Theory
dissatisfies satisfiers
• Company Policy& administration • Achievements
• Supervision • Recognition
• Relationship with supervisor • Work itself
• Work condition • Responsibility
• Salary • Advancement
• Relationship with peers • Growth
• Personal life
• Relationship with subordinates
• Status
• security
 Implications of Herzberg’s Theory
• Satisfaction is not the opposite of dissatisfaction.
• There is a need to think carefully about what motivates
employees.
• Meaningful, interesting, and challenging (enriched)
work is needed to satisfy and motivate employees.
• Problems with Herzberg’s theory
• Assumption of job performance improving with
satisfaction not strong support.
• One person’s dissatisfied is another person’s satisfier.
 3. Expectancy Theory
• A model that assumes motivational strength is
determined by perceived probabilities of success.
• Expectancy: one’s subjective belief or expectation
that one thing will lead to another.
• A basic expectancy model: One’s motivational
strength increases as one’s perceived effort
performance and performance-reward probabilities
increase the likelihood of obtaining a valued
reward.
Relevance of Expectancy Theory to Managers:

• Employee expectations can be influenced by

managerial actions and organizational experience.
• Training increases employee confidence in their
efforts to perform.
• Listening provides managers with insights into
employees’ perceived performance-reward
probabilities.
 Goal-Setting Theory
• Goal setting: the process of improving performance
with objectives, deadlines, or quality standards.
• A General Goal-Setting Model
• Properly conceived goals trigger a motivational process
that improves performance.
• Personal Ownership of Challenging Goals
• Characteristics of effective goals:
• Specificity makes goals measurable.
• Difficulty makes goals challenging.
• Participation gives personal ownership of the goal.
 How Do Goals Actually Motivate?
• Goals are exercises in selective perception.
• Goals encourage effort to achieve something specific.
• Goals encourage persistent effort.
• Goals foster creation of strategies and action plans.
• Practical Implications of Goal-Setting Theory:
• The developed ability to effectively set goals can be
transferred readily to any performance environments.
 Motivation through:
• Job Design
• Motivation through Rewards
• Motivation through Employee Participation
 Group Dynamics and Teamwork

• What Is a Group?
• Two or more freely interacting individuals who share a
common identity and purpose.
• Types of Groups
• Informal groups: a collection of people seeking
friendship and acceptance that satisfies esteem
needs.
• Formal groups: a collection of people created to do
something productive that contributes to the success
of the larger organization.
 Six Stages of Group Development
• Stage 1: Orientation
• Uncertainty about most everything is high.
• Stage 2: Conflict and change
• Subgroups struggle for control; roles are undefined.
• Stage 3: Cohesion
• Consensus on leadership, structure, and procedures is
reached.
• Stage 4: Delusion
• Members misperceive that the group has reached
maturity.
• Stage 5: Disillusion
• Subgroups form; disenchantment, diminished
cohesiveness and commitment to the group.
• Stage 6: Acceptance
• A trusted and influential group member steps
forward and moves the group from conflict to
cohesion so that it becomes highly effective and
efficient.
• Member expectations are more realistic.
 TEAM
Team
- A team is a small number of consistent people
committed to a relevant shared performance
goal.
 TEAM cont…
 It is a special type of group.
 Preferably 2 – 8 people.
 Interacting and influencing each other.
 The members have attitudes of willingness
to work and active participation.
 TEAM cont…
 The members stimulate each other, are
independent and show no domination
of one member over another.

 There is continuous coordination

and collaboration among team
members.
 TEAM cont…
 The members have a shared approach to
common goals and are trustworthy and honest.
 The success of the team is more
important than individual achievement,
and
 Consistent people committed to a
relevant shared performance goal/work
for a common goal.
 TEAM cont…
The heart of a true Team
 Respect each other,
 Be Flexibility,
 Communicate, and
 Trust each other.
 TEAM cont…
Characteristics of and Effective Functioning
Team
1. A clear, understandable and elevating goal.
2. The team should be driven by the result of
their efforts.
3. Competent members.
 TEAM cont…
4. Unified Commitment:
- strong, energetic, and personal
commitment to reach the goal.
5. A collaborative climate
- helps to increase trust, honesty,
openness, consistency, respect.
6. Standards of Excellence.
 TEAM cont…
7. External support and recognition, and

8. Principal leadership: The leader

- is responsible for sustaining the vision
of the goal,
- must have high energy and intellect as well
as social skills to relate the team members,
and
- encourages participatory decision-making.
 TEAM cont…
Types of Teams
1. Formal Team
- Deliberately organized by managers; e.g.
command team, committee, task force/project
team
2. Informal Team
- Emerge whenever people come together and
interact regularly
 TEAM cont…
Stages of Team Development
1. FORMING
• Development acceptable to the group.
• Period of orientation or acclimation.
2. STORMING
• Members oppose the formation of the
structure.
• Become hostile and fight to the ground rules.
3. NORMING
• Conflicts are addressed and resolved.
• Group unity emerges.
 TEAM cont…

4. PERFORMING
• Structural issues resolved.
• Structure supports group dynamics and
performance.
•Structure used for task accomplishment
 TEAM cont…
THE DANGER TO “Team Work”

• There were four people named EVERYBODY, SOMEBODY, ANYBODY,

NOBODY.

• There was an important task to be done and EVERYBODY asked to do

it.EVERYBODY was sure SOMEBODY would do it. SOMEBODY got angry

about that, because, it was EVERYBODY'S job, but NOBODY realized that

EVERYBODY thought ANYBODY could do it. It ended up that Everybody

blamed Somebody when Nobody did what Anybody could have done it.
 TEAM cont…
Health Team
- Defined as a group of people who share a
common health goal and common objectives,
determined by community needs, to the
achievement of which each member of the
team contributes, in accordance with the
functions of others.
 TEAM cont…
A Health Team must
- Understand and communicate with the
community;
- Encourage community participation in
identifying problems and seeking
solutions; and
- Work in the community, i.e. in H/centers,
community meeting places, work places,
schools, at home, etc.
 TEAM cont…
To establish good relations with the
community a health worker or H/Team
follows four steps.
1. Listen, Learn and Understand
2. Talk, Discuss and Decide.
3. Encourage, Organize and Participate.
4. Inform
 TEAM cont…
Leading a Health Team
1. Setting and sharing objectives with the team
members,
2. Motivating team members,
A team leader must understand what
motivates/de-motivates people to
apply their ability and energy to work.
3. Delegating authority and responsibility.
 Group

Fundamental of Group Dynamics

What Is a Group?
• Two or more freely interacting individuals
who share a common identity and
purpose.
 Group cont…
Types of Groups:
1. Informal groups: a collection of people
seeking friendship and acceptance that
satisfies esteem needs.
2. Formal groups: a collection of people created
to do something productive that contributes to
the success of the larger organization.

What Does It Take to Make a Group?

 Two or more people,
 Free interaction among members,
 Common characteristics,
 Common purpose.
 Team versus Group
Team Group
Common goal Self interest, individual
goals
Defined responsibilities No role definitions
Works together Act independently
Has a leader Does/does not have a leader
Communicates Communicates if necessary
continuously
Takes responsibility Blames others
Relies on one another Relies on self