Cookie-Cutter Management

Cookie-cutter management is what results when someone, usually with the best of intentions, attempts to express essential management processes in the form of rules, guidelines, and procedures.

Think about what occurs when you roll out a batch of cookie dough and apply a cutter. You get a desired shape, but you also get some material leftover. Sure, the leftover dough is usually rolled out and cut again, again producing a desired shape and some leftover material. Keep recycling what remains, and keep getting desired shapes-right up until you are left with a remaining lump of dough that fails to fit the desired shape.

Whenever effort is applied to produce a desired shape from some form of input, some material is cut, ground, trimmed, shaved, and squeezed away to leave the desired shape. Most of the time, the material that falls away during the shaping process-like the dough left outside the cookie cutter-is ignored, for all practical purposes lost to future consideration. This is what happens when we attempt to apply specifically named management techniques or "kinds" of management often cynically described as "flavors of the month."

It is reasonable for us to seek order in our approach to work. However, we sometimes tend to look beyond simple order-and-seek formula approaches, recipes for performing this or that task, or handling particular kinds of problems. We look for cookie cutters, unconsciously willing to settle for the neat boundaries created by the instruments and equally willing to ignore what falls outside. However, management's problems cannot be consistently and adequately addressed by processes that by their very nature attempt to force issues into certain configurations.

Cookie-cutter management abounds. It is especially prevalent in the management literature. Numerous authors have named their own approaches to management using labels that each hopes will catch on and become the next "flavor of the month." This sells books, attracts speaking engagements, and enhances an author's value as a consultant.

Consider, for example, the "excellence" movement inspired by In Search of Excellence by Peters and Waterman.1 Although this very good book did not itself espouse a cookie-cutter approach to management, the concepts it advanced were taken up by others who did just that-created numerous approaches as they attempted to formularize and proceduralize these concepts into "excellence programs." Much the same happened years earlier with management by objectives (MBO). The entire MBO movement sprang from a single chapter of an excellent book written by Peter F. Drucker in the 1950s.2 As presented by Drucker, MBO was largely honesty and common sense; it was not the periodic exercise with forms and notebooks that it became for so many managers. Drucker himself even cautioned against allowing such a process to become a paper mill, yet many of those who picked up on his work and ran with it turned it into one of the biggest wastes of time and paper managers have ever had to face.

The major cookie cutters of more recent years have also included quality circles, many permutations of the principles of total quality management, and other quality-related movements such as Six Sigma. There have also been many less notable approaches that have come and gone as author after author has attempted to originate the next "flavor of the month" to be the person who takes off with the next MBO or total quality management.

The good news about the cookie cutters is that to a greater or lesser extent they all contain information of potential value to managers at all levels. The bad news is that none of the cookie cutters includes everything that every manager might need to know because the nature of the cookie cutter is to always leave some material outside. Also, none of the cookie cutters can instill in the individual the qualities and characteristics of a successful manager. Common sense, honesty, pride, and enthusiasm emanate from people and must permeate the organization both from top down and bottom up. If those qualities are not there in sufficient quantity to influence the organization overall, the best that can be obtained by applying the latest cookie cutter is a brief burst of improvement, perhaps real but perhaps only perceived, to be washed away in a returning tide of cynicism or indifference.

This issue of The Health Care Manager (34:1, January-March 2015) offers the following articles for the reader's consideration.

* "Value-Based-Purchasing, Efficiency, and Hospital Performance" examines the relationship of hospital efficiency to hospital characteristics using the hospital value-based purchasing program that links Medicare payments to quality of care and to which hospital efficiency will be added in 2015.

* "Nursing Leaders' Perceptions of a Transition Support Program for New Nurse Graduates" reports on a study undertaken to explore the nursing leadership teams' perceptions of their role and the benefits and challenges of the Genesis Transition Support Program for New Nurse Graduates at the McGill University Healthcare Centre, Quebec, Canada.

* "A Ministudy of Employee Turnover in US Hospitals" reports on a limited study conducted to examine self-reported employee turnover rates in US hospitals and approximate the extent to which many hospitals may be struggling with high employee turnover rates.

* "A Comprehensive Model for Executing Knowledge Management Audits in Organizations: A Systematic Review" reports on a study undertaken to investigate how knowledge management audits are performed systematically in organizations and present a comprehensive model for performing knowledge management audits based on a systematic review.

* The Case in Health Care Management, "The Incompatible Employees," asks the reader to consider how to approach the problems presented by 2 otherwise capable employees who seem unable to get along with each other in the workplace.

* "A Regional Approach to Healthcare Reform: The Texas Border" presents an analysis of health insurance disparities related to labor environmental factors in the Texas-Mexico border region.

* "Prevalence of Neurogenic Heterotopic Ossification in Traumatic Head and Spinal Injured Patients Admitted to a Tertiary Referral Hospital in Australia" reports on a study undertaken to investigate the prevalence of neurogenic heterotopic ossification in patients with traumatic brain injury or traumatic spinal cord injury admitted to nonspecialized units.

* "The Ethical Leadership Challenge for Effective Resolution of Patient and Family Complaints and Grievances: Proven Methods and Models" addresses the ethical leadership challenge health care leaders face in ensuring the effective resolution of patient and family complaints and grievances.

* "The Simulation Model of Teleradiology in Telemedicine Project" reports on a study undertaken to propose a model for planning resource capacities and allocating human and operational resources to promote the efficiency of telemedicine project by investigating the process of teleradiology and information technology applications.

* "An Analysis of the Management and Leadership Roles of Nurses Relative to HIPAA" describes the vital role that nurses play in conveying to patients knowledge of their privacy, security, and confidentiality of patient health information rights under the Health Insurance Portability and Accountability Act (HIPAA).

* "Exchanging Honest Employment References: Avoiding the Traps of Defamation and Negligent Hiring" explores today's tendency of many organizations to supply little or no information in response to reference requests for fear of legal action and suggests how truthful reference information can be provided with minimal risk if it is provided in good faith, given only to those who have a legitimate need to know, is strictly job related, and is not communicated maliciously

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