Critical Managers Research Articles

2010 Critical Care Transport Workplace and Salary Survey

Critical care transport (CCT) leaders and managers from 300 organizations were invited to participate in an online survey (participation rate, 34%) with approximately 150 questions covering a broad base of CCT organizational, workplace, personnel, and salary matters. In addition to medical team composition, recruitment and retention, training, education, and benefits, the survey presents CCT crew salary data by job class by Bowley's seven-figure summary, as well as average, minimum, and maximum hourly rates. Salaries are reported in a national aggregate and by Association of Air Medical Services region.

Critical pedagogy in a health service management development programme

Management development programmes available to NHS managers focus on a performance orientation and sustain a culture of managerial and medical domination. This paper aims to question whether it is possible to consider NHS management development from a critical (empowerment culture) perspective. Features of the critical management studies approach (CMS) are identified. A new MSc is evaluated against these characteristics, examining the teaching and learning processes and students' perceptions of the programme. The aim is to develop critical thinkers who can return to their organizations and challenge existing power structures and practices to change local cultures and enhance health services. Empirical research employed anonymous student questionnaires and a focus group. Student evaluations suggest the MSc can deliver a critical pedagogy and help managers understand issues of power and empowerment, challenge dominant cultures, innovate and effect small, local changes in the NHS culture. There is a need to continue evaluating the programme and include other stakeholders. Longitudinal research should assess the impact of the managers' changed values, attitudes and behaviours on colleagues, clients and the local cultures. The paper identifies some of the tensions of developing "critical" health service managers, and the problems they encounter back in the "uncritical" NHS context, as well as some of the challenges in "facilitating" a critical curriculum. It questions the ethics of developing (or not) a critical perspective in a local context unfamiliar with CMS. Management development in the NHS largely ignores critical pedagogy. This paper makes a small and unique contribution to understanding how developing "critically thinking" managers can challenge the dominant culture. However, the limitations of such a small-scale study and ethical implications are noted.

Graduate capabilities for health service managers: reconfiguring health management education @UNSW

The Master of Health Administration program at UNSW was extensively revised in 2006 to ensure that it effectively meets the challenging and dynamic environment of health service managers in local and global health contexts. This paper describes the innovative approach to the redesign of the health management program within the Faculty of Medicine. It outlines the method and considerations undertaken, particularly in identifying and embedding new graduate capabilities within the program. The paper concludes that using an outcomes-based approach and engaging with key stakeholders provides opportunity to identify and promote critical capabilities needed by managers to support the challenges confronting health services, including workforce flexibility. Further research is required on how such curriculum initiatives might impact on the performance of health service managers, but initial indications are that the health industry recognises the need and value of this approach.

Office Depot's E-Commerce Evolution

Office Depot Inc., founded in 1986, is currently known as one of the leaders in the office supplies industry. Office Depot’s distribution channels include stores, direct mail, contract delivery, and electronic commerce. In the mid-1990s, three major office supplies retailers (Office Depot, Staples, and Office Max) dominated the office supplies market. The entry barriers to the new entrants were extremely high due to the three retailers’ extensive distribution networks and physical stores. The competition among these retailers was also fierce in cities where all three stores existed. In 1997, Office Depot first introduced B2B e-commerce for larger corporate customers and realized that OfficeMax had already launched B2C e-commerce for the general public. In 1997, the executive committee of Office Depot worked with retail analysts and concluded that a full-scale move to e-commerce was an opportunity it must seize. To maintain the lead in the e-retailing race, Office Depot quickly launched B2C e-commerce in January of 1998. This case study investigates critical factors managers should take into consideration in adopting new e-commerce strategies and technologies that will leverage corporate resources.

Consensus meeting: management of the high risk surgical patient

An expanding body of evidence from a variety of sources has highlighted the significant mortality associated with high-risk major surgery. Increasingly we are able to identify patients who, due to a combination of the severity of the surgery they undergo and their pre-operation physiological condition, have a significantly higher, quantifiable risk of death and major morbidity. At the same time an increasing number of clinical trials have demonstrated that peri-operative manipulation of patient's physiology can reduce the mortality and morbidity associated with high-risk major surgery. However, it is also clear that clinical practise is not changing to reflect the availability of this information. Why is this? The Consensus Meeting at Christ's College, Cambridge, was convened to bring together interested parties, including patients representatives, surgeons, anaesthetists, critical care physicians and managers, to address the question posed above. The conference was planned to consider the evidence in support of the assertions that high-risk surgical patients exist and that their outcome after surgery can be improved. The meeting was designed to allow the parties involved to assess the data presented in an unbiased way under the control of a distinguished lay chairman. A panel comprising representatives from each group present (see Table 1 ) were charged with producing an independent consensus statement at the conclusion of the proceedings under the supervision of the conference chairman. Additionally it was hoped that the meeting would raise the profile of this field of work, serve as a forum to discuss the best ways to take it forward and influence clinical practise if appropriate. After a brief introduction, the following presentations were given. Each presentation was followed by a period of questioning from the panel then opened out to include the audience.

Critical care managers change views, change lives

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Cross-national comparisons on business management processes and managerial skill practices

The present study was conducted to explore managerial skills required formanagers working for the corporations in Japan, China and Taiwan. For thepurpose of comparing differences in the pattern of managerial skill practices, Chinese managers in state-owned (n=276) and joint venture (n=186) corporations, Japanese managers in Japanese corporations (n=377) and Taiwanesemanagers in Taiwanese corporations (n=139) were asked to respond the Managerial Skill Questionnaires (total N=978). The MSQ using the 22 skillitems asked managers to report how frequently they practice each skill based ona 5-point scale, and choose the five most important skills needed for them toimprove their managerial job performance in their organizations.Results of the comparative analyses indicated that both Chinese and Taiwanese managers were found practicing Human Management and Teamworkskills more frequently, while Japanese managers practicing Business Innovation skills relatively more than others. The analysis of critical skills forimproving managerial performance indicated that Japanese managers identifystrategic, problem identification and decision making skills to be most critical, while Chinese and Taiwanese managers do people-oriented and teamwork skillsmost critical for improving their job performance. These findings wereinterpreted based on differences in managing the cycle of business processes, culture, and the nature of market pressures in each country.

Critical Realism, Managers and Information

Many accounts of contemporary management raise the issue of the effective use of information, but little is said about how this is to be achieved. This paper sets notions of ‘information literacy’, drawn from higher education, against the reflections of a small group of managers. This indicates that there are a number of dimensions, notably the relationship of information use to organizational power, that are not adequately catered for in current conceptions of information literacy. It is argued that existing accounts focus excessively on the construction of meaning without taking into account the constraints on such construction. Drawing on resources from critical realism, these constraints are taken to relate both to the individual's embodied nature and to the structural dimensions of their practice. Exploration of these constraints is felt to require attention to the temporal dimension of social analysis and to an examination of the interrelationships between structure and agency.

Practices of Critical Managerial Skills: A Comparison among Japanese, Chinese and Taiwanese Managers

This study was designed to explore managerial skills required for managers working for the corporations in Japan, China and Taiwan. For the purpose of comparing differences in the pattern of managerial skill practices, Chinese managers in state-owned (n = 276) and joint venture (n = 186) corporations, Japanese managers (n = 377) in Japanese corporations and Taiwanese managers (n = 139) in Taiwanese corporations were asked to respond the Managerial Skill Questionnaires (total N=978) . The MSQ using the 22 skill items asked managers to report how frequently they practice each skill based on a 5-point scale, and choose the five most important skills needed for them to improve their managerial job performance in their organizations. Results of the data analyses indicated that the four major skill factors, namely Organizational Development (OD), Organizational Goal Attainment (OGA), Proper Use of Personnel (PUP) and Technical Skills (TS) are salient as common skill dimensions among sample managers. Particularly, both Chinese and Taiwanese managers were found practicing PUP and teamwork skills more frequently, while Japanese managers practicing OD skills relatively more than others. The analysis of critical skills for improving managerial performance indicated that Japanese managers identify strategic, problem identification and decision making skills to be most critical, while Chinese and Taiwanese managers do people-oriented and teamwork skills most critical for improving their job performance. But, Taiwanese were found different from Chinese managers in emphasizing the teamwork skill and technical expertise more than their Chinese colleagues who tend to choose fair treatment and quality control skills to be more critical. These findings were interpreted based on differences in culture and the nature of market pressures in which managers working in each country.

Esophageal cancer: multisystem nursing management.

Esophageal cancer is a challenging disease with a multisystem impact on patients. Critical care nurses, case managers, and advanced practice nurses manage these patients through an aggressive preoperative diagnostic phase, surgical intervention, and postoperative course. Coordination of care requires collaboration, with critical care and advanced practice nurses playing a central role. Patients need close post-operative assessments and interventions to minimize complications.

Skills Critical to Long-Term Profitability of Engineering Firms

A list of 20 skills was developed by the writers from a previous research list of skills that were indicated to be important to long-term profitability. From this list of skills that the writers believe to be important to engineering firms, a survey was assembled and mailed to 500 engineering firms throughout the United States. The survey addressed two issues: first, the identification of the skills that principals perceive to be most critical for their firms' long-term profitability; second, the identification of the preferred method of training for members of the organization. We find that communication is ranked as the most critical skill, for both principals and project managers, attributable to long-term profitability. “Listening” and “project management” skills were ranked second and third, respectively, for project managers, whereas “leadership management” and “vision” were ranked second and third for principals. We also find that “working with mentor” was ranked as the most desirable method of training for principals followed by off-site full-day seminar. Project managers also preferred working with mentor as the most desirable training method, followed by personal study.

Managerial Decision Making in Critical Care Areas: Accounting for the Effectiveness and Efficiency of New Technologies

This article reviews the possibilities to strengthen decision making among critical care nurse managers by explicitly accounting for the effects of new managerial technologies on the effectiveness and efficiency of nursing care. As a result, critical care managers, physicians, and other administrators may be in a better position to make decisions proactively about adoption of only those technologies that are likely to improve the effectiveness and efficiency of nursing care in the critical care setting.

Bidirectional Information Transfer: An Imperative for Network and Marketing Integration in a Canadian Telecommunications Firm

Market intelligence helps ensure that R&D efforts are focused on customer needs. In turn, R&D supplies the information necessary for gaining competitive advantage through advances in product and process technology. However, improved R&D–marketing integration means more than simply involving additional marketing personnel in product development. We must focus on identifying and achieving the desired level of integration.Jozée Lapierre and Brigitte Hénault present the results of a study examining the R&D–marketing interface in a large Canadian telecommunications company. Their study explores managers' perceptions of interfunctional integration during the planning and implementation of new services. The goal of this study is to identify the critical integration areas and managers' satisfaction with the organization's current level of integration.Network (i.e., technical) and marketing managers differ substantially in their perceptions of the required level of integration. However, they agree on the five most important areas of interfunctional integration: marketing involvement in establishing service development schedules; information transfer from marketing to network on competitors' moves; information transfer from marketing to network on customer requirements for new services; information transfer from network to marketing on network availability for providing evolved services; and information transfer from network to marketing on network restrictions affecting performance, after‐sales servicing levels, and service pricing. In other words, network and marketing managers view information transfer between their groups as requiring the highest integration level. Both groups agree that their budgeting activities do not require as much integration as other activities.Managers from both groups are generally dissatisfied with the current level of interfunctional integration. Marketing managers are far more dissatisfied than network managers in most areas of integration explored in this study. However, network managers are more dissatisfied than their marketing colleagues in all areas involving the transfer of information from marketing to network.

Bidirectional information transfer: An imperative for network and marketing integration in a Canadian telecommunications firm

Market intelligence helps ensure that R&D efforts are focused on customer needs. In turn, R&D supplies the information necessary for gaining competitive advantage through advances in product and process technology. However, improved R&D-marketing integration means more than simply involving additional marketing personnel in product development. We must focus on identifying and achieving the desired level of integration. Jozée Lapierre and Brigitte Hénault present the results of a study examining the R&D-marketing interface in a large Canadian telecommunications company. Their study explores managers' perceptions of interfunctional integration during the planning and implementation of new services. The goal of this study is to identify the critical integration areas and managers' satisfaction with the organization's current level of integration. Network (i.e., technical) and marketing managers differ substantially in their perceptions of the required level of integration. However, they agree on the five most important areas of interfunctional integration: marketing involvement in establishing service development schedules; information transfer from marketing to network on competitors' moves; information transfer from marketing to network on customer requirements for new services; information transfer from network to marketing on network availability for providing evolved services; and information transfer from network to marketing on network restrictions affecting nerformance, after-sales servicing levels, and service pricing. In other words, network and marketing managers view information transfer between their groups as requiring the highest integration level. Both groups agree that their budgeting activities do not require as much integration as other activities. Managers from both groups are generally dissatisfied with the current level of interfunctional integration. Marketing managers are far more dissatisfied than network managers in most areas of integration explored in this study. However, network managers are more dissatisfied than their marketing colleagues in all areas involving the transfer of information from marketing to network.

Critical Care Medicine: Opportunities and Strategies for Improvement

Like other areas of health care, critical care faces increasing pressure to improve the quality while reducing the cost of care. Strategies drawn from the literature and the authors' experiences are presented. Ten process- or structure-related areas are targeted as strategically important focuses of improvement: (1) restructuring administrative lines to better suit key processes; (2) physician leadership in critical care units; (3) management training for critical care managers; (4) triage; (5) multidisciplinary critical care; (6) standardization of care; (7) developing alternatives to critical care units; (8) timeliness of care delivery; (9) appropriate use of critical care resources; and (10) tracking quality improvement. Whatever the root cause(s) of unnecessary delays, the result is inefficient use of critical care resources-and ultimately either a need for more resources or longer wait times. Innovations designed to reduce wait times and waste, such as the establishment of a microchemistry stat laboratory, may prove valuable. Possible strategies for the appropriate use of critical care resources include better selection of well-informed patients who undergo procedures. Reduction in variation among physicians and organizations in providing therapies will also likely lead to a reduction in some high-risk procedures offering little or no benefit, and therefore a reduction in need for critical care services. Better preparation of patients and families should also make end-of-life decisions easier when questions of "futility" arise. Better information on outcomes and cost-effectiveness and consensus on withdrawal of critical care treatments represent two additional strategies.

The social context of crtical care clinical judgment

Clinical judgment in critical care is supported by a rich social network of care providers. The purpose of this study was to describe the social context in which the process of critical care clinical judgment occurs from the nurse's perspective. An ethnographic study was conducted that included interviews with 10 nurses and participant observation in an open heart surgery unit with 59 nurses and two surgical teams during a 2-year period. Nurses and physicians were organized in hierarchies of nurse manager, resource nurse, charge nurse, and staff nurse or attending surgeon, fellow, chief resident, and resident. These parallel hierarchies allowed for checks on judgment both within and across professional lines. Rituals, such as nursing report, physician rounds, and flow sheet use, provided a context for a critique on judgment processes. Communication of judgment was frequently a casual, open conversation. At other times, differences in perspective could result in conflict. Communication between nurses and physicians has been associated with better patient outcomes. Critical care unit directors and managers can use an analysis of communication patterns to develop supports to clinical judgment.

Correlates of turnover propensity of software professionals in small high tech companies

AbstractThe intent of this study is to shed some empirical light on the turnover propensity of software professionals in small software companies. Different sized firms were included to examine whether organizational size affected the relationships between the time the employees expected to stay in their present company, and a range of personal and organizational characteristics. A sample of 339 employees completed a questionnaire on their experience of and reactions to working in their current firm. None of the usual demographic indicators, e.g. age or tenure, was related to turnover propensity. The more time spent on programming, debugging or implementation, the shorter the time expected to stay. Satisfaction with both job and senior management was strongly related to expecting to stay longer, although satisfaction with project team or immediate boss showed virtually no relationship at all. The effect of organizational size occurred primarily with different company atmosphere qualities and certain work conditions. A warm atmosphere, fun and enjoyment, and friends in the company were important correlates only for the companies with below 50 people. Autonomy was a critical theme in the companies with 150–250 people, and recognition and advancement were important in the large company with approximately 2,000 employees. This suggests that the critical issues managers are confronted with would be different in organizations of different sizes.

The company, product and market dimensions of new product decision scenarios

Studies show that managers synthesize information and make strategic decisions in a situation-specific mode. Making effective new product decisions is a critical problem and managers are urged to improve their performance by adjusting their decision approach to fit the type of situation. Identifying situation-specific new product scenarios is, therefore, an important prerequisite. This article identifies five basic new product decision scenarios using a cluster analysis of factor scored company, product and market data. These provide insights about the situations managers typically face when evaluating new products.