Health Organizations: Theory, Behavior, and Development

Health Organizations:Theory, Behavior, and Development

Edited by

James A. Johnson, PhD

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Library of Congress Cataloging-in-Publication DataHealth organizations : theory, behavior, and development / [edited by] James A. Johnson.

p. ; cm.Includes bibliographical references and index.ISBN-13: 978-0-7637-5053-4 (pbk.)ISBN-10: 0-7637-5053-0 (pbk.)1. Health services administration. 2. Organizational behavior. 3. Organizational soci-

ology. I. Johnson, James A., 1954-[DNLM: 1. Health Facilities--organization & administration. 2. Models, Organizational.

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Many thanks to the talented and tireless authors who contributed to thisbook and to the publisher, Michael Brown, for encouraging me to do it.As always, I remain grateful to my three children, Allen, Adam, andElizabeth for the inspiration they provide me everyday, simply by beingwho they are.

A C K N O W L E D G M E N T S

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Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiiiPreface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xvContributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . xviiAbout the Editor . . . . . . . . . . . . . . . . . . . . . . . . . xxi

PART I ORGANIZATION THEORY AND FOUNDATIONS

Chapter 1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

James A. Johnson and Peter C. Olden

Studying Organizations . . . . . . . . . . . . . . . . . . . . . 4Beyond the Classroom . . . . . . . . . . . . . . . . . . . . . . 8References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Chapter 2 Anatomy and Physiology of Theory . . . . . . . . . . . . 9

M. Nicholas Coppola

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9What Is Theory? . . . . . . . . . . . . . . . . . . . . . . . . . . 10Anatomy of Theory . . . . . . . . . . . . . . . . . . . . . . . 13Physiology of Theory . . . . . . . . . . . . . . . . . . . . . . 18Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . . 24Review/Discussion Questions . . . . . . . . . . . . . . . . 24Learning Activities . . . . . . . . . . . . . . . . . . . . . . . . 25References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

Chapter 3 Classical Theories of Organization . . . . . . . . . . . . 29

Peter C. Olden and Mark L. Diana

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29Scientific Management . . . . . . . . . . . . . . . . . . . . . 30Administrative Principles . . . . . . . . . . . . . . . . . . . 33Bureaucratic Principles . . . . . . . . . . . . . . . . . . . . . 36Human Relations . . . . . . . . . . . . . . . . . . . . . . . . . 39Administrative Behavior . . . . . . . . . . . . . . . . . . . . 41Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . . 43Review/Discussion Questions . . . . . . . . . . . . . . . . 44Learning Activities . . . . . . . . . . . . . . . . . . . . . . . . 44References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

C O N T E N T S

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Chapter 4 Modern Theories of Organization . . . . . . . . . . . . 47

Mark L. Diana and Peter C. Olden

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47General Systems Theory . . . . . . . . . . . . . . . . . . . . 48Contingency Theory . . . . . . . . . . . . . . . . . . . . . . . 50Transaction Cost Economics . . . . . . . . . . . . . . . . . 51Resource Dependence Theory . . . . . . . . . . . . . . . . 53Institutional Theory . . . . . . . . . . . . . . . . . . . . . . . 55Population Ecology . . . . . . . . . . . . . . . . . . . . . . . 57Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . . 59Review/Discussion Questions . . . . . . . . . . . . . . . . 60Learning Activities . . . . . . . . . . . . . . . . . . . . . . . . 60References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

Chapter 5 Complexity and Postmodern Theory . . . . . . . . . . 63

Reuben R. McDaniel, Jr. and Michele E. Jordan

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63Shared Notions and Common Focus . . . . . . . . . . . 66Characteristics of Complex Adaptive Systems . . . . 69Managing Healthcare Organizations as

Postmodernist Complex Adaptive Systems . . . . 71Decision Making and Sensemaking . . . . . . . . . . . . 72What Does This All Mean? . . . . . . . . . . . . . . . . . . 77Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . . 78Review/Discussion Questions . . . . . . . . . . . . . . . . 78Learning Activities . . . . . . . . . . . . . . . . . . . . . . . . 79References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82

PART II ORGANIZATION BEHAVIOR AND DYNAMICS

Chapter 6 Individual Behavior and Motivation . . . . . . . . . . . 87

Mary S. O’Shaughnessey

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87Theories of Motivation . . . . . . . . . . . . . . . . . . . . . 88Motivation in the Work Environment . . . . . . . . . . 97Changes in Motivation . . . . . . . . . . . . . . . . . . . . 100Motivation and Learning . . . . . . . . . . . . . . . . . . 101Impact of Age and Cultural Factors on

Motivation and Learning . . . . . . . . . . . . . . . . 102Motivation and Sports . . . . . . . . . . . . . . . . . . . . 103Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 104Review/Discussion Questions . . . . . . . . . . . . . . . 104Learning Activities . . . . . . . . . . . . . . . . . . . . . . . 105Case Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106

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Chapter 7 Group Dynamics . . . . . . . . . . . . . . . . . . . . . . . . 109

Lana V. Ivanitskaya, Sharon Glazer, and Dmitry A. Erofeev

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109Groups and Teams . . . . . . . . . . . . . . . . . . . . . . . 110Groups and Teams in Healthcare

Organizations . . . . . . . . . . . . . . . . . . . . . . . . 111Roles, Diversity, and Trust . . . . . . . . . . . . . . . . . 112Group Processes . . . . . . . . . . . . . . . . . . . . . . . . . 114Group Formation . . . . . . . . . . . . . . . . . . . . . . . . 115Group Phenomena . . . . . . . . . . . . . . . . . . . . . . . 116Application of Crew Resource Management

(CRM) to Healthcare . . . . . . . . . . . . . . . . . . . 118Performance and Group Effectiveness . . . . . . . . . 119Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 128Review/Discussion Questions . . . . . . . . . . . . . . . 129Learning Activities . . . . . . . . . . . . . . . . . . . . . . . 130Case Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133

Chapter 8 Power and Politics . . . . . . . . . . . . . . . . . . . . . . . 137

Lee W. Bewley

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137Sources of Power . . . . . . . . . . . . . . . . . . . . . . . . 138Politics in Health Organizations . . . . . . . . . . . . . 143Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 145Review/Discussion Questions . . . . . . . . . . . . . . . 147Learning Activities . . . . . . . . . . . . . . . . . . . . . . . 147References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147

Chapter 9 Conflict and Interpersonal Relations . . . . . . . . . 149

Gerald R. Ledlow

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150Conflict Management . . . . . . . . . . . . . . . . . . . . . 151Interpersonal Relationships . . . . . . . . . . . . . . . . 158Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 163Review/Discussion Questions . . . . . . . . . . . . . . . 163References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164

Chapter 10 Leadership Theory and Influence . . . . . . . . . . . . 167

Gerald R. Ledlow and M. Nicholas Coppola

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 167Defining Leadership . . . . . . . . . . . . . . . . . . . . . . 169A Chronological Review of Leadership Theory . . 171Leadership Phase Evolution . . . . . . . . . . . . . . . . 174

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Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 185Review/Discussion Questions . . . . . . . . . . . . . . . 190References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 190

Chapter 11 Leadership and Transformation . . . . . . . . . . . . . 193

Gerald R. Ledlow, M. Nicholas Coppola, and Mark A. Cwiek

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193Prescription One: The Dynamic Culture

Leadership Model . . . . . . . . . . . . . . . . . . . . . 194Prescription Two: The Omnibus

Leadership Model . . . . . . . . . . . . . . . . . . . . . 201Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 209Review/Discussion Questions . . . . . . . . . . . . . . . 209References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210

Chapter 12 Decision Making and Communication . . . . . . . . 213

Gerald R. Ledlow and James Stephens

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214Decision Making . . . . . . . . . . . . . . . . . . . . . . . . 214Tools of Decision Making . . . . . . . . . . . . . . . . . . 221Communication . . . . . . . . . . . . . . . . . . . . . . . . . 223Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 229Review/Discussion Questions . . . . . . . . . . . . . . . 230Case Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231

Chapter 13 Culture Values and Ethics . . . . . . . . . . . . . . . . . . 233

Rupert M. Evans, Sr.

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 233What Is Corporate Culture? . . . . . . . . . . . . . . . . 234The Healthcare Setting . . . . . . . . . . . . . . . . . . . . 234How Are Culture and Climate Different? . . . . . . 235What Is the Theory Behind Culture and Climate? . . 236Values and Beliefs That Support

Organizational Goals . . . . . . . . . . . . . . . . . . . 238The Ethics and the Social Responsibility

of Management . . . . . . . . . . . . . . . . . . . . . . . 245Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 250Review/Discussion Questions . . . . . . . . . . . . . . . 250Learning Activities . . . . . . . . . . . . . . . . . . . . . . . 251References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 252

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Chapter 14 Stakeholder Dynamics . . . . . . . . . . . . . . . . . . . . 255

M. Nicholas Coppola, Dawn Erckenbrack, and Gerald R. Ledlow

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255Stakeholders (Actors) in Healthcare . . . . . . . . . . 256Utility of Parity of Healthcare in

Stakeholder Dynamics . . . . . . . . . . . . . . . . . . 260The SARFIT Model . . . . . . . . . . . . . . . . . . . . . . 267Parity in Policy and Strategy . . . . . . . . . . . . . . . . 268Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 269Review/Discussion Questions . . . . . . . . . . . . . . . 269Learning Activities . . . . . . . . . . . . . . . . . . . . . . . 269Case Study: The Dilemma of the Uninsured

in the United States . . . . . . . . . . . . . . . . . . . . . 269Case Study: Overburdened Emergency

Departments Threatened by the Problemof Uninsured . . . . . . . . . . . . . . . . . . . . . . . . . 271

Case Study: Business Feels the Consequencesof the Uninsured Problem . . . . . . . . . . . . . . . . 273

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275

Chapter 15 Organizational Dysfunction and Pathology . . . . 279

David R. Graber

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279Healthcare Organizational Groups . . . . . . . . . . . 281Complexity and Work Intensity . . . . . . . . . . . . . 282Ambiguous and Conflicting Cultures . . . . . . . . . 283Healthcare Management and

Organizational Dysfunction . . . . . . . . . . . . . . 285Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 286Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 287Review/Discussion Questions . . . . . . . . . . . . . . . 287References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 288

PART III ORGANIZATION DEVELOPMENT AND CHANGE

Chapter 16 Transformational Change and Development . . . . 291

James Whitlock

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291Organizational Development: Framework

for Change . . . . . . . . . . . . . . . . . . . . . . . . . . . 293Creating the Capacity to Change . . . . . . . . . . . . 298Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 308Review Questions . . . . . . . . . . . . . . . . . . . . . . . . 309References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309

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Chapter 17 Team Building and Development . . . . . . . . . . . . 311

Jo-Ann Costa

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 312Types of Teams . . . . . . . . . . . . . . . . . . . . . . . . . . 312The Team Advantage . . . . . . . . . . . . . . . . . . . . . 313Benefits of Teams . . . . . . . . . . . . . . . . . . . . . . . . 314Team Composition . . . . . . . . . . . . . . . . . . . . . . . 315Team Evolution . . . . . . . . . . . . . . . . . . . . . . . . . 316Stages of Team Development . . . . . . . . . . . . . . . 318Building Team Functionality . . . . . . . . . . . . . . . . 318Ongoing Training = Sustainable Knowledge . . . . 321Problem Solving . . . . . . . . . . . . . . . . . . . . . . . . . 321Continuous Reinforcement: The Value of the

Team’s Work . . . . . . . . . . . . . . . . . . . . . . . . . 322Getting Down to Business . . . . . . . . . . . . . . . . . . 322Defining Success . . . . . . . . . . . . . . . . . . . . . . . . . 324Beyond Metrics . . . . . . . . . . . . . . . . . . . . . . . . . 324Selling the Solution: Management Buy-In . . . . . . 325Back on the Everyday Job . . . . . . . . . . . . . . . . . . 326Trends . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 326Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 329Review/Discussion Questions . . . . . . . . . . . . . . . 329Learning Activity . . . . . . . . . . . . . . . . . . . . . . . . 329References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 330

Chapter 18 Physician Leadership and Development . . . . . . . 331

Sudha Xirasagar

Clinical Performance: The Key toHealthcare Reform . . . . . . . . . . . . . . . . . . . . . 331

Why Physician Leadership Is Needed . . . . . . . . . 333Understanding Physician Behavior . . . . . . . . . . . 333From Clinician to Leader—Essential Changes

in Mindset . . . . . . . . . . . . . . . . . . . . . . . . . . . 336Leadership Development Models . . . . . . . . . . . . 337Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 344Review/Discussion Questions . . . . . . . . . . . . . . . 344References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 345

Chapter 19 Governance and Board Development . . . . . . . . . 349

Dennis G. Erwin and Andrew N. Garman

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 349Board Organization . . . . . . . . . . . . . . . . . . . . . . 350Board Officers . . . . . . . . . . . . . . . . . . . . . . . . . . 351Board Committees . . . . . . . . . . . . . . . . . . . . . . . 351Board Meeting Format . . . . . . . . . . . . . . . . . . . . 353

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The Relationship Between Senior Management and the Board . . . . . . . . . . . . . . . . . . . . . . . . . 355

Fiduciary Duties . . . . . . . . . . . . . . . . . . . . . . . . . 355Financial Oversight . . . . . . . . . . . . . . . . . . . . . . 356Operating Oversight . . . . . . . . . . . . . . . . . . . . . . 356Strategic Oversight . . . . . . . . . . . . . . . . . . . . . . . 358Oversight of Patient Care and Resource

Utilization . . . . . . . . . . . . . . . . . . . . . . . . . . . 360Changing Board Models . . . . . . . . . . . . . . . . . . . 361Effective Governance: Cultures and Activities . . . 362Board Assessment . . . . . . . . . . . . . . . . . . . . . . . . 362Board Member Education . . . . . . . . . . . . . . . . . . 364Current Issues and Controversies . . . . . . . . . . . . 366Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 366Review/Discussion Questions . . . . . . . . . . . . . . . 367Learning Activity . . . . . . . . . . . . . . . . . . . . . . . . 367References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369

Chapter 20 Organization Development for Terrorism and Natural Disasters . . . . . . . . . . . . . . . . . . . 371

Ahmed Adu-Oppong, Gerald R. Ledlow, Mark A. Cwiek, James A. Johnson, and M. Nicholas Coppola

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 372Significance to Healthcare Leaders . . . . . . . . . . . 372The Threat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 374Business Involvement: What Should Be Done . . . 383A Preparedness Plan . . . . . . . . . . . . . . . . . . . . . . 385Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 392References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 392

Chapter 21 Organization Development and the Future . . . . . 395

James A. Johnson

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 395Development Practice and Philosophy . . . . . . . . 396Development in a Changing World . . . . . . . . . . . 397Chapter Summary . . . . . . . . . . . . . . . . . . . . . . . 398Review/Discussion Questions . . . . . . . . . . . . . . . 399Learning Activities . . . . . . . . . . . . . . . . . . . . . . . 399References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 399

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 401

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During the last ten years in my work, I have had the privilege of visitingnumerous healthcare organizations; some expansive healthcare organi-zations with unlimited resources, others, small community hospitals withlimited resources; all have endured significant new demands and unex-pected challenges.

The world has witnessed unprecedented events that have affected thefoundation of health care. The September 11th terrorist attacks and mul-tiple natural disasters, such as Hurricane Katrina, have impacted differ-ent healthcare organizations in ways that we never envisioned. Withglobalization and the push for universal care in many states, there hasbeen a ripple effect throughout society.

Other new requirements have surfaced for healthcare organizations.Much is known about the impact of medical errors on the patient popu-lation. As an effort to develop a body of basic rules of engagement to im-prove the care provided to the patient population and to guarantee safetyto the patients, the National Patient Safety Goals have been instituted toaddress some of the concern. Only the healthcare organizations with well-developed organization structures have succeeded with its implementation.Others, not so well organized, are still struggling with such tasks.

Finally, much is known about the limited human resources (ex. nursesshortage), the aging healthcare infrastructure, and the struggle organi-zations go through in an attempt to adjust to various regulations im-posed by the agencies that govern the industry. Some organizationalbehaviorist has described misalignment between human resources and cap-ital resources as the factors that have lead to a less than desirable out-come in health care. Those, with sound and sometimes adaptableorganizational structures, who have integrated their human and capitalresources by aligning all of their resources, have succeeded in the face ofthe various stressors we have seen.

Healthcare organization theory has often focused on extending theconcepts of business organizations applied to the healthcare field. Muchof the knowledge about healthcare organization theory has been an ex-trapolation of the concepts developed to explain how businesses or-ganize. Until now, there has been no integrated view on healthcareorganization theory.

This book comes as a much-needed initiative of Dr. James Allen Johnsonand a group of scholars and experts in an attempt fill a void existent inhealth administration education. It provides an integrated view of Organi-zation Theory; Organization Behavior; and Organization Development

F O R E W O R D

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making it one of the first books on the integration of these three critical in-terconnected domains.

Integrated knowledge and understanding is needed in health care in or-der to prepare organizations for an uncertain future. This compendium ofknowledge will attract significant attention from the healthcare adminis-tration and public health academic communities with its potential to en-hance the professional development and education of our future leaders.

Lorenzo Gonzalez, MDThe Joint Commission

xiv Foreword

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This book was written to address a significant need in health adminis-tration education. While there are many textbooks available for coursesin organizational behavior, there are few that address organization the-ory and even fewer that discuss organization development in any signifi-cant way. Many university professors and instructors prefer to have a textthat addresses all three domains. Drawing upon the expertise and expe-rience of colleagues in various disciplines from universities, government,and corporations, I have brought these three interconnected domains to-gether in this book. It is comprised of three sections: Part I OrganizationTheory; Part II Organization Behavior; and Part III OrganizationDevelopment; each containing key chapters that address foundations, re-search, and new directions. A summary of these themes follows:

Organization Theory: Health organizations are complex human systemsthat have evolved over time and continue to do so. There have been manytheories drawing from the fields of psychology, sociology, economics,political science, anthropology, and, lately, physics in an attempt to ex-plain the phenomenon of organization. Each of the theories has changedas social science and behavioral research offered new findings and per-spectives on human behavior in groups and larger aggregates. The clas-sical theories of organization were primarily mechanistic and relied heavilyon the knowledge advanced in the industrial age. Modern organizationtheory takes more of a contingency approach and accounts for humandynamics. Today, emerging theories draw upon new insights from biol-ogy and physics where organizations are seen as systems interconnectedwith the larger environment. Postmodern theory and our increasing un-derstanding of complexity take us even further.

Organization Behavior and Dynamics: By virtue of their distinct caremission, health organizations have unique behavioral qualities. This bookexamines power, influence, conflict, motivation, group dynamics, val-ues, communication, and leadership in the context of care giving.Additionally, organization dysfunction and stakeholder dynamics is ad-dressed. Health organizations are comprised of highly credentialed pro-fessionals who function under considerable scrutiny within many prescribedguidelines. The challenge of managing in this environment is great. Thebases of any level of effectiveness come from the understanding of indi-vidual, group, and organization behavior.

P R E F A C E

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Organization Change and Development: Lastly, health organizations arenot static. The one constant seems to be change. Leaders and managersare tasked to facilitate and manage the change that is inevitable in mod-ern organizations. This can be done in a systematic planned way utiliz-ing approaches found in organization development and team building.This section of the book helps the student and practitioner put to usetheories of organization and knowledge of organization behavior in waysthat foster change in productive and sustainable ways resulting in betteroutcomes. Team development, board development, physician develop-ment, and organization development and learning are all addressed.Likewise, current challenges such as disaster preparedness, globalization,and sustainability are discussed.

As you read the book and engage in the discussions and exercises recom-mended in each chapter, it is important to remember the significant re-sponsibility you have as a current or future healthcare manger and leader.You will have a responsibility to yourself, co-workers, the organization,and the individuals and communities you serve. Part of this responsibil-ity can be met by committing to life-long learning and continuously seek-ing to better understand physical and social phenomena. This includes anunderstanding of organizations as human created systems. As our in-sightful colleague, Margaret Wheatley once said, “Rather than thinkingof organization as an imposed structure, plan, design, or role, it is clearthat in life, organization arises from the interactions and needs of individualswho have decided to come together.” It is in this coming together thatpurpose manifests and then demonstrates the great potential of health or-ganizations in making the world a better place for all.

James A. Johnson, PhD

xvi Preface

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Ahmed Adu-Oppong, PhDProgram in Health Services AdministrationJiann-Ping Hsu College of Public HealthGeorgia Southern University

Lee W. Bewley, MHA, PhD, FACHEUS Army Medical DepartmentArmy-Baylor Program in Health and Business AdministrationBaylor University

M. Nicholas Coppola, MHA, PhD, FACHEUS Army Medical DepartmentArmy-Baylor Program in Health and Business AdministrationBaylor University

Jo-Ann CostaHughes Corporation (Retired)

Mark A. Cwiek, MHA, JD, FACHEDoctoral Program in Health AdministrationHerbert and Grace Dow College of Health ProfessionsCentral Michigan University

Mark L. Diana, MBA, MSIS, PhDDepartment of Health Systems ManagementSchool of Public Health and Tropical MedicineTulane University

Dawn Erckenbrack, MHA, EdD, FACHEHealth Program Analysis and EvaluationOffice of the Assistant Secretary for Health AffairsUS Department of Defense

Dmitry A. Erofeev, MA, PhDExpress Personnel Services

C O N T R I B U T O R S

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Dennis G. Erwin, MST, DHSc, CPAE2 Consulting Group

Rupert M. Evans, Sr., MPA, DHA, FACHEDivision of Health AdministrationCollege of Health ProfessionsGovernors State University

Andrew N. Garman, MS, PsyDDepartment of Health Systems ManagementCollege of Health SciencesRush University

Sharon Glazer, MS, PhDDepartment of PsychologyCollege of Social SciencesSan Jose State University

Lorenzo Gonzalez, MDThe Joint Commission

David R. Graber, MPH, PhDDepartment of Health Administration and PolicyCollege of Health ProfessionsMedical University of South Carolina

Lana V. Ivanitskaya, MA, PhDDoctoral Program in Health AdministrationHerbert and Grace Dow College of Health ProfessionsCentral Michigan University

James A. Johnson, MS, MPA, PhDDoctoral Program in Health AdministrationHerbert and Grace Dow College of Health ProfessionsCentral Michigan University

Michele E. Jordan, EdDSchool of EducationUniversity of Texas at Austin

xviii Contributors

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Gerald R. Ledlow, MHA, PhD, FACHEProgram in Health Services AdministrationJiann-Ping Hsu College of Public HealthGeorgia Southern University

Reuben R. McDaniel, Jr., MS, EdDDepartment of Information, Risk, and Operations ManagementMcCombs School of BusinessUniversity of Texas at Austin

Peter C. Olden, MHA, PhDDepartment of Health Administration and Human ResourcesPanuska College of Professional StudiesUniversity of Scranton

Mary S. O’Shaughnessy, MS, MHSA, DHADepartment of Health Services AdministrationCollege of Health ProfessionsUniversity of Detroit Mercy

James H. Stephens, DHA, FACHEProgram in Health AdministrationCollege of Health and Human ServicesOhio University

James Whitlock, DHA, FACHEHealthcare Management ProgramDepartment of Business AdministrationBrenau University, Georgia

Sudha Xirasagar, MD, PhDDepartment of Health Policy and ManagementArnold School of Public HealthUniversity of South Carolina

Contributors xix

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Dr. James Allen Johnson, Jr. is a Professor in the Herbert and Grace DowCollege of Health Professions at Central Michigan University. He is alsoa medical social scientist working in international health development.He has published 10 books and over 100 articles on a wide range ofhealthcare and management issues. His most recent book is ManagingHealth Education and Promotion: Leadership for the 21st Century pub-lished by Jones and Bartlett of Sudbury, MA. Dr. Johnson is the pastEditor of the Journal of Healthcare Management published by the AmericanCollege of Healthcare Executives and was Senior Editor for the Journalof Management Practice. He is the founding editor of the Carolina HealthPolicy and Management Review and has been a Special Issue Editor forthe Journal of Management Development; the Journal of Health andHuman Services Administration; the Organizational Ethics Journal; andthe Journal of Health Administration Education. Additionally, he is theSenior Editor of the Praeger series, Community Preparedness, and Co-Editor of the Handbook of Health Administration and Policy. Dr. Johnson’swork and travels have taken him to 21 different countries including workwith the World Health Organization and organization development con-sultation with numerous hospitals, government agencies, and health or-ganizations. He has chaired and served on many non-profit boards, mostrecently the National Diabetes Trust Foundation. Dr. Johnson was pre-viously on the faculty of the Medical University of South Carolina wherehe served as Chair of the Department of Health Administration and Policyfor many years and was the founding director of the Doctor of HealthAdministration Program. He has also lectured at Oxford University inEngland; Beijing University in China; the University of Colima in Mexico;the University of Dublin in Ireland; and is an Adjunct Professor at AuburnUniversity Montgomery. His PhD is from Florida State University.

A B O U T T H E E D I T O R

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Documents

Health Organizations: Theory, Behavior, and Development