\"What are your assumptions (implicit as well as explicit) about the most effective way to manage people?\" So began Douglas McGregor in this 1960 management classic. It was a seemingly simple question he asked, yet it led to a fundamental revolution in management. Today, with the rise of the global economy, the information revolution, and the growth of knowledge-driven work, McGregor's simple but provocative question continues to resonate-perhaps more powerfully than ever before. Heralded as one of the most important pieces of management literature ever written, a touchstone for scholars and a handbook for practitioners, The Human Side of Enterprise continues to receive the highest accolades nearly half a century after its initial publication. Influencing such major management gurus such as Peter Drucker and Warren Bennis, McGregor's revolutionary Theory Y-which contends that individuals are self-motivated and self-directed-and Theory X-in which employees must be commanded and controlled-has been widely taught in business schools, industrial relations schools, psychology departments, and professional development seminars for over four decades. In this special annotated edition of the worldwide management classic, Joel Cutcher-Gershenfeld, Senior Research Scientist in MIT's Sloan School of Management and Engineering Systems Division, shows us how today's leaders have successfully incorporated McGregor's methods into modern management styles and practices. The added quotes and commentary bring the content right into today's debates and business models. Now more than ever, the timeless wisdom of Douglas McGregor can light the path towards a management style that nurtures leadership capability, creates effective teams, ensures internal alignment, achieves high performance, and cultivates an authentic, value-driven workplace--lessons we all need to learn as we make our way in this brave new world of the 21st century.

The Human Side of Enterprise.

Background: Professional nurses play a vital role in the provision of health care globally. The performance of health care workers, including professional nurses, link closely to the productivity and quality of care provision within health care organisations. It was important to identify factors influencing the performance of professional nurses if the quality of health care delivery was to improved. Objectives: The aim of the present study was to identify factors affecting the performance of professional nurses in Namibia. Method: A quantitative, descriptive survey was used to collect data by means of a questionnaire. A random sample of 180 professional nurses was selected from six hospitals in three regions of Namibia. Results: Factors affecting the performance of nurses negatively were identified such as: lack of recognition of employees who are performing well, quality performance outcomes and an absence of a formal performance appraisal system and poor working conditions. Various factors contribute to both the positive and negative performance of professional nurses in Namibia. Strategies were developed for addressing the negative factors that could positively affect the performance of professional nurses in Namibia. Conclusions: This study emphasises the importance of developing strategies to promote the performance of nurses; build knowledge and expertise; develop mechanisms for improving the performance of nurses; expand leadership and management capacity; and generate information and knowledge through research.

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Factors affecting the performance of professional nurses in Namibia

This paper argues that the past decade has seen significant changes in the nature of medical work in general practice in the UK. Increasing pressure to use normative clinical guidelines and the move towards explicit quantitative measures of performance together have the potential to alter the way in which health care is delivered to patients. Whilst it is possible to view these developments from the well-established sociological perspectives of deprofessionalisation and proletarianisation, this paper takes a view of general practice as work, and uses the ideas of Lipsky to analyse practice-level responses to some of these changes. In addition to evidence-based clinical guidelines, National Service Frameworks, introduced by the UK government in 1997, also specify detailed models of service provision that health care providers are expected to follow. As part of a larger study examining the impact of National Service Frameworks in general practice, the response of three practices to the first four NSFs were explored. The failure of NSFs to make a significant impact is compared to the practices' positive responses to purely clinical guidelines such as those developed by the British Hypertension Society. Lipsky's concept of public service workers as 'street-level bureaucrats' is discussed and used as a framework within which to view these findings.

National Service Frameworks and UK general practitioners: street-level bureaucrats at work?

Today, in 21st century healthcare at least 10% of hospitalised patients are subjected to some degree of unintended harm as a result of the treatment they receive. Despite the growing patient safety agenda there is little empirical evidence to demonstrate that patient safety is improving. Patient Safety Leadership Walk Rounds (PSLWR) were introduced to the UK, in March 2005, as a component of the Safer Patients Initiative (SPI), the first dedicated, hospital wide programme to reduce harm in hospital care. PSLWR are designed, to create a dedicated ‘conversation’ about patient safety, between frontline staff, middle level managers and senior executives. 

This thesis, explored the use of PSLWR, as a proactive mechanism to engage staff in patient safety discussion and detect patient harm within a Scottish healthcare system- NHS Tayside. From May 2005 to June 2006, PSLWR were held on a weekly basis within the hospital departments. A purposive sample, (n=38) of PSLWR discussions were analysed to determine: staff engagement in the process, patient safety issues disclosed; recognition of unsafe systems (latent conditions) and actions agreed for improvement. As a follow-up, 42 semi-structured interviews were undertaken to determine staff perceptions of the PSLWR system. A wide range of clinical and non-clinical staff took part (n=218) including medical staff, staff in training, porters and cleaners, nurses, ward assistants and pharmacists. Participants shared new information, not formally recorded within the hospital incident system. From the participants perspectives, PSLWR, were non threatening; were easy to take part in; demonstrated a team commitment, from the Board to the ward for patient safety and action was taken quickly as a result of the ‘conversations’. 

Although detecting all patient harm remains a challenge, this study demonstrates PSLWR can be a useful tool in the patient safety arsenal for NHS healthcare organisations.

Looking for harm in healthcare : can Patient Safety Leadership Walk Rounds help to detect and prevent harm in NHS hospitals? A case study of NHS Tayside

Objectives

This paper explores whether the Business Plan Competition [BPC], as a characteristically causational mechanism for extracurricular entrepreneurship education, can provide the resources which underpin an effectual approach to new venture creation. 

Prior Work

Extracurricular BPCs assume a presence in 69% of English HEIs (NCEE, 2013). This is symptomatic of continued preference for a rational and causal business plan approach to entrepreneurship education but negates a growing appreciation that entrepreneurs often assume an effectual approach to new venture creation (Bridge and Hegarty, 2013; Read et al, 2011; Sarasvathy, 2008). This broader effectual turn places a new emphasis on the need for entrepreneurship education participants to be encouraged to assume an effectual approach and questions the real value of traditional approaches that centre upon production and judgement of a business plan (Williams, 2013). 

Approach

The paper draws insight from in-depth, open-ended qualitative interviews undertaken with competitors of a regional university-based extracurricular BPC at the start, end and six months after their participation. This multiple sequential interviewing approach (Charmaz, 2003) served as an advantageous way of gaining longitudinal accounts of BPC participation which would allow any identification of effectual means within this experience. 

Results

The BPC explored was facilitative of the means which could be used to assume an effectual approach. In terms of ‘who you know’ the competition afforded valuable networking opportunities and collaborative contacts. The competition enhanced ‘what they know’ through enabling the acquisition, development and application of key competencies. Participants were able to gain and project a confident sense of ‘who they are’ as a venture, changing perceived identity from a student project toward a credible and viable business prospect. Indications of these acquired means enduring in the six months following participation was strong.

Implications

A plan dominant education context does not automatically impede utilisation of an effectual approach. Attention needs to be given as to how it can consciously be promoted to participants so that resources acquired in such a context can be used effectually. 

Value 
The paper is novel in its exploration of effectuation within what might be deemed an anti-effectual context. This of interest to those seeking to incorporate an effectual agenda within entrepreneurship education provision without the resources, radical change and support needed to overhaul business plan centricity.

Leveraging effectual means through business plan competition participation

Achieving high performance in an organization is a complex business. Most approaches are too piecemeal, unidimensional or iatrogenic. Healthy working is an approach to managing performance that attempts to overcome these problems by aiming, in a holistic manner, to harmonize those factors which affect, either separately or jointly, individual physical, mental and emotional health and individual and organizational performance. The approach is based on a set of values and a series of steps. The first step has to be establishing an information base‐line – the four key indicators. A survey was undertaken by PBS to establish the availability and usefulness of data in NHS organizations; summarizes some of the issues raised. Although a worryingly small number keep useful data or produce useful information, much can be done in making critical links if available data is fully used.

Healthy Working and Performance Management

Management of the NHS is necessary and vital to effective delivery of health services. It is not a process that can be avoided, whoever does it. New Labour needs effective managers in the NHS if they are to bring about the changes they want to see. Manager bashing, which New Labour is showing signs of continuing, is counter productive and encourages a climate of threat for managers which subsequently translates into bad management practice with its inevitable consequences for service quality and productivity. The NHS badly needs a positive long‐term strategy of serious investment in individual and organizational development. It is a question of balanced investment between the long‐term management capability of the NHS and immediate patient care. The major issues of rationing, priorities and the balance between health and health services will always be part of the difficult national and local management task. Some move by politicians in the direction of open recognition of these difficulties and the burden they place on the skill, will and courage of managers could go a long way to building a caring management culture.

What chance a caring management culture

Acknowledges that business planning in the NHS frequently disappoints. Reasons for this are found in the tendency for managers to view the production of a plan as an end rather than a means. A further difficulty resides in the perception managers have of their world. Argues that marketing is the most appropriate paradigm for understanding and structuring this world at present. However, an adaptive cognitive style is necessary to allow constant reframing within the dominant paradigm or even reframing of the paradigm itself. In adopting these approaches, the probability of achieving competitive advantage is heightened. If they are ignored, however, it is likely that training and development techniques, however sophisticated, will have little lasting impact.

Beyond the business plan.

Discusses an exploratory study of the impact of NHS reforms on the management of staff. Argues that “management” has moved from a view that staff should be provided with a secure and comfortable working environment to “labour” being viewed simply as a factor of production. The result seems to be an unprecedented sense of alienation among significant numbers of NHS staff. Proposes possible ways forward. The first focuses on the “means”, accepting that the “ends” of the NHS will, for the foreseeable future, be dominated by the market. The second examines more closely the market‐driven, business “end” or purpose and challenges the unitary view of the NHS Trust as a coherent business entity. Beyond these short‐ to medium‐term responses, concludes that a return to a somewhat more flexible and less hard‐edged human resources philosophy is a longer‐term investment as the labour market tightens and skilled staff become scarcer in the later 1990s.

Managing people: the breakfast menu.

Explores the introduction and development of Service Level Agreements (SLAs) in relation to Human Resource Departments. Considers approaches to SLAs and highlights four dimensions necessary for the completion of an SLA. Stresses that Human Resource Specialists should have a thorough understanding of how directorates and other departments relate to one another to provide added value in terms of contribution to the organizational outcomes. Suggests the idea of adding value is an integral part of the SLA process which ensures that it operates as a means to an end and does not become an end in itself. Examines the degree of devolved freedom given to a department to seek work or sell its products outside its Trust/Unit. Scrutinizes the format of SLAs and concludes that the benefits of SLAs for users of Human Resource Departments and the benefits to the Human Resource Departments are similar.

Hugh Flanagan

Papers

Healthy Working and Performance Management

What chance a caring management culture

Beyond the business plan.

Managing people: the breakfast menu.

Positioning the Human Resource Business Using Service Level Agreements