Professional Documents
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5
WILLIAMS MCWILLIAMS
LAWRENCE WAHEDUZZAMAN
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5
WILLIAMS MCWILLIAMS
LAWRENCE WAHEDUZZAMAN
Copyright Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-300
MGMT5 © 2023 Cengage Learning Australia Pty Limited
5th Edition
Chuck Williams Copyright Notice
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First published in Australia by Cengage Learning Australia in 2010. aust.permissions@cengage.com
Second edition published in 2014.
Third edition published in 2017. National Library of Australia Cataloguing-in-Publication Data
Fourth edition published in 2019. 最新资料最新资料
ISBN: 9780170459587
A catalogue record for this book is available from the National Library of
Acknowledgements Australia.
Adaptation of MGMT, 12th edition by Chuck Williams, Cengage Learning US
[9780357137727]. Cengage Learning Australia
Level 7, 80 Dorcas Street
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BRIEF
CONTENTS
1 Management 2
PLANNING
7 Innovation and change 128
12 Motivation 256
PART 4
13 Leadership 277
LEADING
14 Managing communication 296
15 Control 319
PART 5
16 Managing information 336
CONTROLLING
17 Managing service and manufacturing operations 356
Endnotes 376
Index 404
Tear-out review cards
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Brief Contents iii
Operations, information, systems and
contingency management 38
Operations management 38
Information management 40
Systems management 40
CONTENTS
Contingency management 42
Changing environments 44
Environmental change 44
Environmental complexity 45
Resource scarcity 45
Environmental uncertainty 46
General environment 46
Economy 47
Technological component 48
Sociocultural component 48
Political/legal component 49
PART 1
INTRODUCTION TO Specific environment 49
Customer component 49
MANAGEMENT 1 Competitor component 50
Supplier component 51
1 Management 2 Industry regulation component
Advocacy groups
52
53
Management is … 2 Making sense of changing environments 55
Environmental scanning 55
Management functions 3
Interpreting environmental factors 56
Planning 4
Acting on threats and opportunities 56
Organising 5
Leading 5 Organisational cultures: creation, success
Controlling 6 and change 58
Creation and maintenance of organisational cultures 58
Kinds of managers 6
Successful organisational cultures 59
Top managers 6 最新资料最新资料
iv Contents Copyright Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-300
Experiential approach: managing innovation
during discontinuous change 136
Compression approach: managing innovation
PART 2 during incremental change 137
Organisational decline: the risk of not changing 139
PLANNING 87 Managing change 139
Managing resistance to change 141
5 Planning and decision making 88 What not to do when leading change 142
Change tools and techniques 144
Benefits and pitfalls of planning 89
Benefits of planning 89 8 Global management 147
Planning pitfalls 89
How to make a plan that works 90 Global business, trade rules and trade
Setting goals 90 agreements 148
Developing commitment to goals 91 The impact of global business 148
Developing effective action plans 92 Trade agreements 151
Tracking progress 92 Consumers, trade barriers and trade agreements 155
Maintaining flexibility 93 Consistency or adaptation? 156
Planning from top to bottom 94 Forms of global business 157
Starting at the top 94 Exporting 158
Bending in the middle 95 Cooperative contracts 158
Finishing at the bottom 96 Strategic alliances 160
Steps and limits to rational decision making 97 Wholly owned affiliates (build or buy) 161
Define the problem 98 Global new ventures 161
Identify decision criteria 98 Finding the best business climate 161
Weight the criteria 99 Growing markets 162
Generate alternative courses of action 100 Choosing an office or manufacturing location 163
Evaluate each alternative 100 Minimising political risk 164
Compute the optimal decision 101
Becoming aware of cultural differences 166
Limits to rational decision making 102
Preparing for an international assignment 169
Using groups to improve decision making 102
Language and cross-cultural training 169
Advantages and pitfalls of group decision making 102
Spouse, family and dual-career issues 170
Structured conflict 104 最新资料最新资料
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Contents v
10 Managing teams 197
vi Contents Copyright Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-300
Kinds of communication 301 Characteristics and costs of useful information 339
The communication process 301 Accurate information 340
Formal communication channels 304 Complete information 340
Informal communication channels 305 Relevant information 340
Coaching and counselling: one-on-one communication 306 Timely information 340
Non-verbal communication 307 Acquisition costs 341
Managing one-on-one communication 308 Processing costs 341
Choosing the right communication medium 308 Storage costs 341
Listening 309 Retrieval costs 342
Giving feedback 311 Communication costs 342
Productivity 356
15 Control 319 Why productivity matters 357
Kinds of productivity 358
The control process 320
Quality 359
Standards 320
Quality-related characteristics for products and
Comparison to standards 321
services 360
Corrective action 322
ISO 9000 and 14000 361
Dynamic, cybernetic process 322
Baldrige National Quality Award and the Australian
Feedback, concurrent and feed-forward control 322
Business Excellence Framework 362
Control isn’t always worthwhile or possible 323
Total quality management 363
Control methods 324
Service operations 364
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Copyright Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-300
Contents vii
Guide to the text
As you read this text you will find a number of features in every
chapter to enhance your study of management and help you
understand how the theory is applied in the real world.
PART ONE
The Part openers outline the INTRODUCTION TO
THE ORIGINS OF
chapters contained in each MANAGEMENT
part for easy reference.
1 Management
Managment ideas and practice
throughout history
2 History of management
2 Why we need managers today
3 Organisational environments and cultures
1 WHAT IS MANAGEMENT?
MANAGEMENT
Management issues are fundamental to any organisation:
Identify the key concepts you how do we plan to get things done, organise the company
to be efficient and effective, lead and motivate employees
will engage with through the and put in place controls to make sure our plans are
Learning objectives at the followed and our goals are met? Good management
is basic to starting a business, growing a business and
start of each chapter maintaining a business once it has achieved some
measure of success.
Explore the current and future directions of management Take a behind-the-scenes look at real-world
through the MGMT Trend boxes. management practices and their outcomes through the
Workplace and community boxes.
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Changes in any sector of the general environment working and wages are growing, and therefore
eventually affect most organisations. For example, consumers have relatively more money to spend.
when a country’s central bank (the Reserve Bank of More products are bought and sold in a growing
Australia, Reserve Bank of New Zealand, Bank Negara economy than in a static or shrinking economy.
in Malaysia or the Federal Reserve in the US) lowers Though an individual organisation’s sales will not
its prime lending rate, most businesses benefit because necessarily increase, a growing economy does provide
banks and credit card companies often pass on the an environment favourable to business growth. By
lower interest rates to their customers in the rates contrast, in a shrinking economy, consumers have
they charge for loans. Consumers can then borrow less money to spend and relatively fewer products are
money more cheaply to buy homes, cars, refrigerators bought and sold. Thus, a shrinking economy makes
and large-screen TVs. growth for individual businesses more difficult.
Each organisation also has a specific environment Because the economy influences basic business
that is unique
Examine interesting factstoabout
that contemporary
organisation’s industry
and and decisions,Key
Important suchterms
as whether to hire in
are marked more
boldemployees,
in the text and
historical management directly
with the affects Fact
MGMT the way it conducts
boxes. expandinproduction
defined the margin or when
take out
theyloans to purchase
are used for the first
specific
environment day-to-day business. The specific equ ipment, ma nagers sca n t hei r econom ic
time.
the customers, environment, which will be discussed environments for signs of significant change.
competitors,
suppliers, industry
in detail later in t h is chapter, Some managers try to predict future economic
regulations and includes customers, competitors, activity by keeping track of business confidence.
advocacy groups suppliers, industry regulation and Business confidence indices show how
that are unique to
an industry and advocacy groups. confident managers in organisations business confidence
indices
directly affect how Let’s take a closer look at the four are about future business growth. For indices that show the
a company does
business components of the general environment example, an Australian index that is level of confidence
that affect all organisations: widely cited is the National Australia managers have
about future
• the economy Bank (NA B) business confidence business growth
• technological trends index. Managers often prefer business
confidence indices to economic statistics because
• sociocultural trends
they know that managers make business decisions
• political/legal trends.
that are in line with their expectations concerning
the economy’s future. In Hong Kong, the Swedish
Economy Chamber of Commerce (Swedcham) collates a series
The current state of a country’s economy affects of business confidence surveys to present an annual
virtually every organisation doing business there. ‘summary of surveys’.16 So if the Swedchamsurvey or
In general, in a growing economy, more people are the NAB business confidence index in Australia are
Copyright Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-300
Guide to the text ix
FIGURE 3.2 GENERAL AND SPECIFIC ENVIRONMENTS
REVIEW FEATURES
Review your understanding of
the key chapter topics with the
Concept summary at the end
of each Part.
PART 1, What can you take from your progress
through this part of MGMT5?
CHAPTERS
1–4 1 Management
☑ You have developed your understanding of the four functions of
management and covered the different kinds of managers – including the
major roles and sub-roles that managers perform in their jobs.
☑ You can articulate what companies look for in managers and you will be
able to describe the transition that employees go through when they are
promoted to management positions.
Overall aim of Part 1
☑ You understand that companies can create competitive advantage through
To introduce management, its people.
history and its applications in
☑ You have learned that sometimes managers make mistakes, and you can
contemporary workplaces now identify and discuss the top mistakes that managers make in their jobs.
2 History of management
☑ You have developed your understanding of the history of management
and you have covered conceptual, theoretical and analytical aspects of
management
☑ You are able to discuss the origins of management, comparing them with the
ideas and practices of managers today.
☑ You have covered the history of human relations management and can apply
the lessons learned from
☑ You will be able to articulate and adopt certain processes that companies
use to make sense of their changing environments, and expand upon how
Consolidate your knowledge 最新资料最新资料
organisational cultures are created and how they can help companies be
successful.
with the Tear-out study cards
found at the end of the book
that summarise each chapter
REVIEW 1 MANAGEMENT
4
☑
Ethics and social responsibility
You have learned how to identify common kinds of workplace deviance,
LEARNING
and understand the role of the Australian Competition OBJECTIVES
and Consumer
for class preparation and Commission (ACCC) in the Australian business environment.
LO1 Management is …
Key definitions ☑
revision. Your study of ethical decision making has allowed you to discuss how
Good
companies aremanagement
encouraged to is working
behave through
ethically others
and how to accomplish
they may betasks that
Management Team leaders punishedhelp
for fulfil organisational
unethical behaviour.objectives as efficiently as possible.
Getting work done Managers responsible
through others. for facilitating team
LO2 Management functions
activities toward goal Henri Fayol’s classic management functions are known today as
Efficiency accomplishment. planning, organising, leading and controlling. Planning is determining
Getting work done with
a minimum of effort, Figurehead role organisational goals and a means for achieving them. Organising is
expense or waste. The interpersonal deciding where decisions will be made, who will do what jobs and
role managers play tasks and who will work for whom. Leading is inspiring and motivating
Effectiveness when they perform employees to work hard to achieve organisational
CHAPTER goals.
4 Ethics and socialControlling is 85
responsibility
Accomplishing ceremonial duties.
tasks that help monitoring progress toward goal achievement and taking corrective
fulfil organisational Leader role action when needed. Studies show that performing management
objectives. The interpersonal functions well leads to better managerial performance.
BK-CLA-MGMT_5E-220170-Chp04.indd 85 role managers play 05/08/22 2:22 PM
Planning when they motivate LO3 Kinds of managers
Determining and encourage
organisational goals and workers to accomplish There are four different kinds of managers. Top managers are
a means for achieving organisational responsible for creating a context for change, developing attitudes of
them. objectives. commitment and ownership, creating a positive organisational culture
through words and actions and monitoring their company’s business
Organising Liaison role
Deciding where The interpersonal role environments. Middle managers are responsible for planning and
decisions will be made, managers play when allocating resources, coordinating and linking groups and departments,
who will do what jobs they deal with people monitoring and managing the performance of subunits and
and tasks, and who will outside their units.
implementing the changes or strategies generated by top managers.
work for whom.
Monitor role First-line managers are responsible for managing the performance of
Leading The informational non-managerial employees, teaching their workers how to do their jobs
Inspiring and role managers play and making detailed schedules and operating plans based on middle
motivating workers to when they scan their
work hard to achieve environment for management’s intermediate-range plans. Team leaders are responsible
organisational goals. information. for facilitating team performance, managing external relationships and
facilitating internal team relationships.
Controlling Disseminator role
Monitoring progress The informational LO4 Managerial roles
towards goal role managers play
achievement and when they share Managers perform interpersonal, informational and decisional roles
taking corrective action information with others in their jobs. In fulfilling the interpersonal role, managers act as
when needed. in their departments or figureheads by performing ceremonial duties, as leaders by motivating
companies. and encouraging workers and as liaisons by dealing with people
Top managers
Executives responsible Spokesperson role outside their units. In performing their informational role, managers
for the overall direction The informational role act as monitors by scanning their environment for information, as
of the organisation. managers play when disseminators by sharing information with others in the company and
they share information
as spokespeople by sharing information with people outside their
Middle managers with people outside
Managers responsible their departments or departments or companies. In fulfilling decisional roles, managers act
for setting objectives companies. as entrepreneurs by adapting their units to incremental change, as
consistent with top disturbance handlers by responding to larger problems that demand
management’s goals Entrepreneur role
The decisional role
immediate action, as resource allocators by deciding resource recipients
and for planning and
implementing subunit managers play when and amounts, and as negotiators by bargaining with others about
strategies for achieving they adapt themselves, schedules, projects, goals, outcomes and resources.
these objectives. their subordinates and
their units to change. LO5 What companies look for in managers
First-line managers
Disturbance handler
Companies do not want one-dimensional managers. They want
Managers who
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train and supervise
be copied, scanned, or
role
duplicated,
managers in whole
with a balance or in
of skills. part.
They wantWCN 02-300
managers who know
the performance The decisional role their stuff (technical skills), are equally comfortable working with blue-
of non-managerial managers play when collar and white-collar employees (human skills), are able to assess
employees who are they respond to severe
the complexities of today’s competitive marketplace and position
Guide to the online resources
FOR THE INSTRUCTOR
MINDTAP
Premium online teaching and learning tools are available on the MindTap platform – the personalised eLearning
solution.
MindTap is a flexible and easy-to-use platform that helps build student confidence and gives you a clear picture of their
progress. We partner with you to ease the transition to digital – we’re with you every step of the way.
The Cengage Mobile App puts your course directly into students› hands with course materials available on their
smartphone or tablet. Students can read on the go, complete practice quizzes or participate in interactive real-time
activities.
MindTap for MGMT5 is full of innovative resources to support critical thinking, and help your students move from
memorisation to mastery! Includes:
• MGMT5 eBook
• Media quizzes
• Self assessments
• Revision quizzes
• Research activities and more!
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INSTRUCTOR’S MANUAL
The Instructor’s manual includes:
• Learning objectives • Lesson plans • Review questions with solutions
• Key terms • Video assignments and activities • And more!
POWERPOINT™ PRESENTATIONS
Use the chapter-by-chapter PowerPoint slides to enhance your lecture presentations and handouts by reinforcing the
key principles of your subject.
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Guide to the online resources xi
ARTWORK FROM THE TEXT
Add the digital files of graphs, tables, pictures and flow charts into your learning management system, use them in
student handouts, or copy them into your lecture presentations.
MindTap is the next-level online learning tool that helps you get better grades!
MindTap gives you the resources you need to study – all in one place and available when you need them. In the MindTap
Reader, you can make notes, highlight text and even find a definition directly from the page.
If your instructor has chosen MindTap for your subject this semester, log in to MindTap to:
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• Connect with your instructor and peers
• Study when and where you want, online and mobile
• Complete assessment tasks as set by your instructor
• When your instructor creates a course using MindTap, they
will let you know your course link so you can access the content.
Please purchase MindTap only when directed by your instructor.
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xii Copyright Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-300
Guide to the online resources
About the authors
Alan McWilliams
Alan is an Associate Professor in the College of Business at Victoria University where is he also the Deputy Head
of Community Engagement in the First Year College. In academia since 1990, Alan previously worked in various
management and HR roles in hospitality and within the Tasmanian State public service. Alan’s research interests
include team-based organisations, employee relations management and management issues within the hospitality
and events industries. Alan has published in numerous refereed journals and has presented at a variety of
discipline-related conferences. His teaching awards include Carrick Australia Award for University Teaching 2007:
Citation for Outstanding Contribution to Student Learning, Vice Chancellors citation for outstanding contribution
to student learning 2006 and a Vice Chancellors Award for programs which enhance the student experience 2006.
Alan is also a board member of the Australia and New Zealand Academy of Management (ANZAM).
Rob Lawrence
Rob Lawrence has many years of senior management experience with federal and state public services, working as
a project manager, ministerial adviser and speechwriter for Commonwealth and Victorian governments. He also
worked for three years as Manager (Learning and Development) for the Australian Public Service Commission.
Rob has a BA in economics, adult training certification and post-graduate qualifications in management. His
teaching experience includes lecturing in a range of management subjects at Monash and RMIT universities. In
recent years Rob has focused on teaching first-year Management at Victoria University. He teaches locally and
overseas, mainly in China.
Wahed Waheduzzaman
Wahed Waheduzzaman is currently a lecturer in the Faculty of Business and Law, Swinburne University of
Technology. He completed his PhD in comparative management and public service management from the
Victoria University. Wahed previously worked in different ministries as a deputy secretary to the Government
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of Bangladesh. Major areas of his research interests are management, human resource management, good
governance, and public-sector management. He has published articles in several refereed journals including
Public Administration and Society, Local Government Studies, Employee Relations and Australian Journal of Public
Administration.
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About the authors xiii
Acknowledgements
The authors would like to thank Rachael, Stephanie and Kylie for their valuable feedback to improve the chapters
in this book.
Cengage would like to thank Anjali Chhetri firstly for her valuable research on Chapters 14, 15 and 17, and
her writing on Chapter 5. We would also like to thank Gaby Grammeno for her writing on Chapters 14, 15 and 17.
Cengage Learning would like to thank the following reviewers for their valuable feedback in the development
of this text:
• Zoë Port – Massey University
• Dr Dhara Shah – Griffith University
• Mark Wickham – University of Tasmania
• Merran Renton – Bedford College
• Bruce Johnstone – Monash University
• Jess Co – Monash University
• Jing Ye – Deakin College
• Jason Yap – Scope Training
• Helen Parker – University of Sydney
• Nicole El Haber – La Trobe University
• Pheroza Daruwalla – Western Sydney University
• Elisa Uyen – The Pivot Institute.
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xiv Acknowledgements
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PART ONE
INTRODUCTION TO
THE ORIGINS OF
MANAGEMENT
1 Management
Managment ideas and practice
throughout history
2 History of management
2 Why we need managers today
3 Organisational environments and cultures
Copyright Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-300
1 WHAT IS MANAGEMENT?
MANAGEMENT
Management issues are fundamental to any organisation:
how do we plan to get things done, organise the company
to be efficient and effective, lead and motivate employees
and put in place controls to make sure our plans are
followed and our goals are met? Good management
is basic to starting a business, growing a business and
maintaining a business once it has achieved some
measure of success.
Determining what constitutes good management
for individual businesses is not always straightforward.
Companies in Australia pay management consultants
nearly $6.5 billion1 per year for advice on basic
Learning objectives
management issues, such as how to lead people
LO1 Describe what management is. effectively, organise the company efficiently, and manage
large-scale projects and processes.2 This textbook will
LO2 Explain the four functions of help you understand some of the basic issues that
management. management consultants help companies resolve (and it
LO3 Describe the different kinds of managers. won’t cost you billions of dollars).
After reading the next two sections, you should be
LO4 Explain the major roles and sub-roles that
able to:
managers perform in their jobs.
• describe what management is
LO5 Explain what companies look for in 最新资料最新资料
2 Copyright Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-300
as the guy who has to do everything or have all the
answers. Instead, he sees himself as ‘the guy who is
obsessed with enabling employees to create value’.
Rather than coming up with solutions himself,
Nayar creates opportunities for collaboration, peer
review and employees to give feedback on ideas and
work processes. Says Nayar: ‘My job is to make sure
Shutterstock.com/Sunflowerey
everybody is enabled to do what they do well.’ 3
Nayar’s description of managerial responsibilities
suggests that managers also have to be concerned
with efficiency and effectiveness in the work process.
Efficiency is getting work done with
efficiency
getting work done a minimum of effort, expense or waste.
Maersk is managing the use of shipping containers more
with a minimum of For example, if you drive along efficiently by using tracking software.
effort, expense or
Footscray road in Melbourne, or pass
waste
by Port Tauranga near Auckland,
you’ll see containers from many countries, with the LO2Management
logos of even more companies on their sides. Chances
are you will have seen a lot of containers with the
functions
name ‘Maersk’ on them. Maersk is the world’s largest Henri Fayol, who was a managing director (CEO) of a
container shipping company. The Chief Operating large steel company in the early 1900s, was one of the
Officer at Maersk, Soren Toft, says: ‘Cutting idle time founders of the field of management. You’ll learn more
at ports is a big priority and challenge. It’s like a about Fayol and management’s other key contributors
Formula One pit stop. The faster we come in and out, when you read about the history of management in
the more time and money we save.’4 So Maersk Chapter 2. Based on his 20 years of experience as a
digitally tracks each container (a 12-metre steel box CEO, Fayol argued that ‘the success of an enterprise
loaded onto a railway wagon or truck) and all the generally depends much more on the administrative
loading and unloading steps for its ‘Triple E’ ships, ability of its leaders than on their technical ability’.7
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which hold nearly 21 000 containers. Maersk’s ‘pit A century later, Fayol’s arguments still hold true.
stop’ system ties into mobile phone apps so ships During a two-year study code-named Project Oxygen,
can easily share data with shore crews who position Google analysed performance reviews and feedback
1815-tonne stacking cranes, shuttle carriers and surveys to identify the traits of its best managers.
‘truck-on’ loaders to efficiently move the right According to Laszlo Bock, Google’s Vice President for
container boxes on and off at each stop. 5 For example, People Operations: ‘We’d always believed that to be
the ship Madrid Maersk unloaded and reloaded 6500 a manager, particularly on the engineering side, you
containers in just 59 hours in Antwerp, Belgium. need to be as deep or deeper a technical expert than
By itself, efficiency is not enough the people who work for you. It turns out that that’s
effectiveness
to ensure success. Managers must absolutely the least important thing.’ 8 What was
accomplishing
tasks that help also strive for effectiveness, which most important? ‘Be a good coach.’ ‘Empower; Don’t
fulfil organisational is accomplishing tasks that help fulfil micromanage.’ ‘Be product and results-oriented.’
objectives
organisational objectives, such as ‘Be a good communicator and listen to your team.’
customer service and satisfaction. The renowned ‘Be interested in [your] direct reports’ success and
writer on management, Peter Drucker, puts it like this: wellbeing.’ 9 In short, Google found what Fayol
‘efficiency is doing things right, effectiveness is doing observed: administrative ability, or management,
the right things’.6 is key to an organisation’s success.
Copyright Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. WCN 02-300
CHAPTER 1 Management 3
According to Fayol, to be successful managers
FIGURE 1.1 T
HE FOUR FUNCTIONS OF
need to per for m f ive ma nager ia l f u nc t ion s:
MANAGEMENT
planning, organising, coordinating, commanding
and controlling.10 Today, though, most management
textbooks have dropped the coordinating function
a nd refer to Fayol’s com ma nd i ng f u nct ion as
‘ lead i ng ’. Consequent ly, Fayol’s ma nagement
functions are known today as planning, organising,
Planning Organising
SMART MGMT
successful as managers and to be promoted into
HAMBURGER U
upper levels of management.12
As McDonald’s looked to grow in the
The evidence is clear. Managers serve their
booming market of China, it knew that a
companies well by planning, organising, leading and
key to its success there was the quality of
its managers. That’s why in 2011 it opened controlling. (That’s why this book is organised around
up a training centre, Hamburger University, the four functions of management.)
in Shanghai, with the goal of recruiting and Now let’s take a closer look at each of these
retaining top employees. McDonald’s management functions in more detail.
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PART ONE Introduction to management
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Gastric Vertigo.—Trousseau certainly misled the profession as to the
frequency of this form, but he did little more than represent popular
medical views, and we may now feel sure that a good many so-
called gastric vertigoes are due to lithæmia or to troubles of ear or
eye. There are, I think, three ways in which the gastro-duodenal
organs are related to the production of vertigo. Acute gastric vertigo
arises in some persons inevitably whenever they eat certain articles,
and the limitations are odd enough. Thus, I know a gentleman who
cannot eat a mouthful of ice-cream without terrible vertigo, but
otherwise his digestion is perfect. I know another in whom oysters
are productive of vertigo within ten minutes; and a curious list might
be added, including, to my knowledge, milk, eggs, oysters, crabs,
etc. In these cases digestion is arrested and intense vertigo ensues,
and by and by there is emesis and gradual relief.
Single attacks are rare. It is apt to repeat itself, and finally to cause
all the distressing cerebral symptoms which characterize the worst
gastric vertigo, and at last to be capable of easy reproduction by
light, heat, over-exertion, and use of the mind or eyes, by emotion, or
by gastric disorder.
Even after the vertigo has ceased to exist the fear of loss of balance
remains, while perhaps for years the sense of confusion during
mental effort continues, and gives to the sufferer a feeling of what a
patient described to me as mental vertigo—some feeling of
confusion, lack of power to concentrate attention, loss of hold on
trains of thought, with now and then a sensation as if the contents of
the cranium moved up or down or swayed to and fro.
Vertigo from growths on the auditory nerve before it enters the inner
ear is rare in my experience. It is described as slow in its progress,
the deafness and tinnitus being at first slight, but increasing steadily,
while there is tendency to fall toward the side affected.7 In the cases
of disease attacking the seventh nerve within the cranium there is
usually so much involvement of other and important nerve-tissues as
makes the disorder of audition and equilibration comparatively
unimportant.
7 Burnett.
Then it is that even slight defects of the eye may cause vertigo,
which if usually slight and transient, coming and going as the eyes
are used or rested, is sometimes severe and incapacitating. I have
over and over seen vertigo with or without occipital pain or distress in
persons whose eyes were supposed to be sufficiently corrected with
glasses, but who found instant relief when a more exact correction
was made; and this is, I think, a matter which has not yet generally
received from oculists the attention it demands.
Vertigo in old age, if not due to the stomach or defective states of the
portal system, kidneys, or heart, is either caused by atheromatous
vessels or multiple minute aneurismal dilatations of vessels, or in
full-blooded people by some excess of blood or some quality of
blood which is readily changed by an alteration in the diet, of which I
shall presently speak. Whatever be its source, it is in the old a matter
of reasonable anxiety.
It is, however, worth recording here that I have more than once seen
enduring vertiginous status, with occasional grave fits of vertigo,
arise out of very prolonged sea-sickness. In the last example of this
sequence seen by me there was, after a year or more, some
deafness.
In these cases, after the eye has been corrected, the diet should be
regulated with care. In extreme cases it may become desirable to
limit it to milk, fruit, and vegetables where no obvious peculiarities
forbid such a regimen; and I have found it useful to insist also on
some food being used between meals.
I like, also, that these patients rest an hour supine after each meal,
and spend much time out of doors, disregarding their tendency to lie
down. Exercise ought to be taken systematically, and if the vertigo
still forbids it, massage is a good substitute. At first near use of the
eyes is to be avoided, and when the patient resumes their use he
should do this also by system, adding a minute each day until
attainment of the limit of easy use enjoins a pause at that amount of
reading for a time.
TREMOR.
Tremor is sometimes hereditary, and may exist from early life. I have
a patient in whom there is a trembling of the hands which has lasted
since childhood. This lady's mother and grandmother both had the
same form of tremor, and one of her own daughters also has it. In
this case the trembling is most marked when voluntary movements
are attempted, but it does not materially interfere with writing,
sewing, or any other act she wishes to accomplish. There is slight
tremor when the hands are at rest.
When tremor first begins it is slight in degree and extent, and occurs
generally only on voluntary effort. Later there may be a constant
trembling even when the part is at rest. Beginning usually in the
hands, it may extend to the head and legs. It is seen in the tongue
and facial muscles after the disease has lasted for some time.
In some cases the trembling can be controlled to some extent by a
strong effort of will. The tremor from alcohol or opium is most marked
when the individual has been without the use of the stimulant for a
short time, and the trembling may be temporarily checked by
renewing the dose of alcohol or opium as the case may be.
The tremor does not begin at once on section of the nerve, but
comes on after a few days. As the peripheral end of the nerve
undergoes degeneration the tremor increases. It may last months or
even years.
PARALYSIS AGITANS.