Classical Management Theories in Healthcare

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CLASSICAL MANAGEMENT THEORIES
The classical perspective emerged during the nineteenth and twentieth centuries, and emphasized a rational, scientific approach to the study of management. The factory system of the 1800’s faced challenges such as tooling plants, organizing managerial structure, training non-English speaking employees (immigrants), scheduling, and resolving strikes. These new problems and the development of large complex organizations demanded a new perspective on coordination and control. The classical perspective contained three subfields, each with a slightly different emphasis – scientific management, bureaucratic organizations and administrative principles.

A. SCIENTIFIC MANAGEMENT
Scientific management was developed by Frederick Winslow Taylor (1856 – 1915) at the end of the nineteenth century to improve labor productivity by scientifically analyzing and establishing optimal workflow processes. Taylor believed that in the same way that there is a best machine for each job, so there is a best working method by which people should undertake their jobs. He considered that all work processes could be analyzed into discrete tasks and that by scientific method it was possible to find the “One Best Way” to perform each task. Each job was broken down into component parts, each part timed and the parts rearranged into the most efficient method of working.

Taylor was a believer in the rational–economic needs concept of motivation. He believed that if management acted on his ideas, work would become more satisfying and profitable for all concerned. Workers would be motivated by obtaining the highest possible wages through working in the most efficient and productive way. Taylor was concerned with finding more efficient methods and procedures for co-ordination and control of work. He set out a number of principles to guide management. These four principles of scientific management process are;

1. Replace rule of thumb work methods based on a scientific study of the tasks.
2. Select, train, teach, and develop the most suitable person for each job, again scientifically, rather than passively leaving them to train themselves.
3. Managers must provide detailed instructions and supervision to each worker to ensure the job is done in a scientific way.
4. Divide work between managers and workers. The managers apply scientific management principles to planning and supervising the work, and the workers carry out the tasks.
According to Braverman (1974), “scientific management starts from the capitalist point of view and method of production, and the adaptation of labor to the needs of capital. Taylor’s work was more concerned with the organization of labor than with the development of technology”. A distinctive feature of Taylor’s thought was the concept of management control. Braverman suggests Taylor’s conclusion was that workers should be controlled not only by the giving of orders and maintenance of discipline, but also by removing from them any decisions about the manner in which their work was to be carried out. By division of labor, and by dictating precise stages and methods for every aspect of work performance, management could gain control of the actual process of work. The rationalization of production processes and division of labor tends to result in the de-skilling of work and this may be a main strategy of the employer.

Cloke and Goldsmith (2002), also suggest that Taylor was the leading promoter of the idea that managers should design and control the work process scientifically in order to guarantee maximum efficiency. He believed in multiple layers of management to supervise the work process and in rigid, detailed control of the workforce.

Other contributors to scientific management are: Henri Gantt who developed the ‘Gantt Chart’, a bar graph that measured planned and completed work. Frank B. and Lillian M. Gilbreath pioneered ‘Time and Motion...
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