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When watching certain managers or supervisors in meeting and they ask for the employees to suggest what they can do better to help everyone. Most bosses don't want to know what they can do to make work easier they just want the work done correctly.

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In module 1 we learned about the different levels of management anf how each one of them are different.

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we learned about the social responsibility that managers learn and go through when they are taking over a company.

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CESC Limited is a socially responsible company, which aims at contributing towards the upliftment of the poor and underprivileged residing in its area of operation, along with its focus on generating profits, protecting the interests of investors and shareholders, and, serving its customers with utmost satisfaction. The Company is aware of its duties towards the society and environment in which it operates and recognizes its role in managing the social, economic and environmental challenges confronting society.

Vision

To be a socially responsible Indian Company empowering lives by providing access to education, healthcare, art facilities, skill development, livelihood opportunities etc. to improve the overall quality of life.

To actively contribute to the social and economic development of the communities in which the Company operates. It wishes to build a better, safer and sustainable way of life for the weaker sections of society and contribute to the overall human development.

To promote inclusive growth fired by free-spirited entrepreneurship and community development

To be recognized for the Company's strong commitment towards the community and to uphold the values of community service.

Mission

The Company's mission is to implement CSR programmes and projects that assist in creating an empowered environment in the Indian society for inclusive growth leading to social and economic development of the community. Through a series of interventions, it seeks to reach out to various sections of society and provide them opportunities that empower their lives.

The Company's strategy is to integrate the activities in community development, social responsibility and sustainable livelihoods, and encourage each business unit or function to include these considerations into its operations. To achieve the same, the Company will constantly strive to review and improve its efforts to positively contribute towards the well-being and welfare of the people across the country, especially across its area of operation. It would ensure the same by continually reviewing and improving its efforts to conduct responsible business practices, uphold the highest ethical standards in all its engagements, and take the extra initiative to reduce damaging impacts on the environment and to nurture a workplace of diversity and inclusion.

Objectives

To integrate social, environmental and ethical responsibilities into business governance to ensure long-term success and create shared value

To go beyond a giving back to society' and create sustainable social impact in CESC operational areas

To demonstrate leadership in corporate citizenship

Focus

The CSR projects of CESC are designed in alignment with the Millennium Development Gaols (MDGs), the National Voluntary Guidelines on Social, Environmental and Economic Responsibility of Business (NVGs) and the national development goals. CESC believes in supplementing and contributing to the nation's development process through its CSR initiatives.

Stakeholder Engagement

CSR is often associated with the theme of the social contract' or alternatively of license to operate'. A social contract perspective enables a firm to act responsibly not because it is in its commercial interest, but because it is part of how society implicitly expects business to operate. CESC has always endeavoured to create a platform for different partners/stakeholders to share and discuss for building strong, open and lasting relationships. All the CSR projects of the Company are designed in alignment with stakeholder needs and concerns.

CESC regularly interacts with government officials, local administrators, non-government agencies, and communities to plan and execute its CSR projects.
Our Development Partners

Centre for Environment Education (CEE)

City Level Action for Street and Working Children (CLPOA)

Child in Need Institute (CINI)

WASH Institute

NSHM Udaan Skills Pvt. Ltd.

CESC is committed to making continuous improvement in the management of its environmental impact through technological innovations and community interventions. CESC is the first thermal power utility in the world to be registered with UNFCCC for Carbon Credits. In line with its commitment to conserve the environment, CESC has brought in a change in its power mix from solely thermal to solar, wind and hydel power as well. Some of the renewable energy projects are already in commission or underway. The Company has launched several community-based initiatives to generate awareness on environment issues as initiate action on the same.

Urja Chetana

The Urja Chetana Programme is being conducted in 26 schools in and around Kolkata in partnership with Centre for Environment Education (CEE). The Project aims at generating awareness on energy conservation and efficient use of energy. Energy clubs have been formed in the selected schools. These clubs consist of about 25-30 students from classes VI to IX with a teacher-in-charge. The energy clubs drive the activities of the Urja Chetana Programme within and outside the school. The activities include conducting energy audits in schools, paper re-cycling, composting, rain water harvesting, wall art painting, creating educational material based on school curriculum, theme-based contests and competitions, rallies and campaigns, community outreach, observation of Urja week and Urja Diwas, among others.

Initiatives with the Kolkata Municipal Corporation

CESC has partnered with the Kolkata Municipal Corporation for beautification of the city of Kolkata. It has taken over the maintenance of median strips (green verge) in certain city roads.

Development of Parks and Playgrounds

Developing parks and playgrounds for children around Generating Stations is perceived as an important environmental initiative by CESC. Not only do such initiatives help in reclamation and beautification of public spaces, they also have a positive impact on the development of children and residents of the surrounding communities.

Initiatives in Public Institutions

CESC has taken several environmental initiatives at Medical College & Hospitals for the beautification of the premises. It has developed a park for children suffering from Thalassemia and other critical diseases.

CESC's education initiatives focus on facilitating access, equity and quality of education, thereby, to create enabling environments for children and youth.

Nirmal Abhiyan

The Programme seeks to improve child health through provision of safe drinking water and appropriate sanitation facilities in government and government-aided schools. The Programme is being implemented through City Level Programme of Action for Street and Working Children (CLPOA). The approaches followed are - child friendly toilets and school led total sanitation through formation of child cabinets, teacher training and parents' orientation. The Project is being implemented in govt schools in Kolkata.

School Build Programme

Quality of education is determined to a large extent by the availability of appropriate infrastructure in schools. Schools, particularly government and municipal schools, not only have an adverse teacher-student ratio but also lack in basic infrastructure such as classrooms, toilets, drinking water facility, benches, libraries, etc. Therefore, CESC has been focusing on infrastructure development of schools around its Generating Stations.

Roshni

Roshni is an integrated project on child rights and entitlements by facilitating access to government schemes and services. Through the Project we reach out to pregnant women, lactating mothers and children in the age group of 0-18 years. The Project facilitates underprivileged children in urban slums to acquire quality education with level-appropriate reading and writing ability, and mainstreaming drop-out children through in-school and out-of-school interventions. The Project focuses on their right to life, survival, health and education by intervening with them from 0-18 years. The Project is being implemented in Topsia-Tiljala area.

Health has been a key social indicator in determining the well-being of communities. CESC is committed to improving the health of the communities among which it works.

Infrastructure Upgradation of Government/Municipal Hospitals

CESC is focused upon improving the public health infrastructure around its Generating Stations. CESC has been working extensively for the development of Titagarh Municipal Hospital by upgrading its Maternity Ward and Operation Theatre, and setting up the ENT and Ophthalmology Wards. It also supported the setting up of a Neo-natal Intensive Care Unit (NICU) at the Hospital. A dialysis unit has also been set up in the previous year at the hospital.

Suswasthya

The Suswasthya Project is being implemented by CESC in partnership with CLPOA in Kamarhati Municipality. The project seeks to bring about an improvement in maternal and child health status, reduction in mortality and morbity of pregnant women, lactating mothers and children by increasing health seeking behaviour, improving awareness on health, nutrition, hygiene and establishment of linkage between formal health service delivery systems and beneficiaries.

Economic and Community Development

CESC believes in building social capital through its CSR initiatives. The Company has launched several projects to create income generating opportunities for communities and to make an overall improvement in their quality of life.

Community Sanitation Project

The Nirmal Sankalp Project is a Community Sanitation and Hygiene Project which has been implemented in Titagarh Municipality since 2014. Over the years, the project has been implemented in 5 Wards under the Municipality. Under the Project, pay and use community sanitary complexes have been constructed, which are wholly run and managed by community-based Water and Sanitation (WATSAN) Committees. The Project seeks to improve availability usage, quality and sustainability of water sanitation facilities by involving community members as change agents.

Hamari Awaaz

Hamari Awaaz is a comprehensive community sensitisation Project on child protection in urban slums, which is being implemented in the Tiljala area. The aim of the Project is to create child friendly communities in urban slums by mobilising, sensitising, and empowering communities to fight against child labour and other forms of child abuse and foster child protection. The Project is being implemented through CINI.

Jagriti

The Jagriti Project is a skill development and employment generation programme being implemented in partnership with NSHM Skills Pvt. Ltd. Foundation in Titagarh Municipality. Courses offered are Basic Computer, Tally and GST.

Organisation of Sports Activities

As a responsible corporate citizen, CESC is committed to promote the overall development of the communities among which it operates, particularly that of children and youth. Apart from developing parks and playgrounds, CESC organises community sports activities to encourage youth and children.

Saksham

Saksham is a skill development and livelihood generation project, which is being implemented in Topsia - Tiljala area in partnership with NSHM Skills Pvt. Ltd. Courses offered are Basic Computer, Tally & GST, AC & Refrigerator repairing, Driving, Tailoring, Beauty and Wellness.

Shishu Suraksha Mela Organised in Tiljala under Hamari Awaaz Project of CESC

Hamari Awaaz is a CSR initiative of CESC Limited on child protection and child rights in Topsia-Tiljala area of Kolkata. The Project is being implemented in partnership with CINI since March, 2017.
A Shishu Suraksha Mela was organised on January 16, 2018, at the New Star Club ground in Tiljala. The aim of the Mela was to motivate children and community members to address and act against social evils, such as, child marriage, child labour, child trafficking, and other forms of child abuse. The Mela was preceded by a rally starting from Topsia Sports Federation in which around 150 children apart from community members, CESC officials, Child Protection Committee (CPC) members and officers from the local police stations participated. Children walked with placards displaying messages on child protection issues and safe use of electricity. The rally culminated at the New Star Club ground.
Ms. Sudeshna Roy, noted actress-filmmaker and Member of West Bengal Commission of Protection of Child Rights was the Chief Guest at the Mela. The other Guests included Ms. Seema Sarkar, District Child Protection Officer, Mr. Tapan Chatterjee, Labour Inspector, Dr. Swati Chakraborty, Assistant Director-CINI, and Ms. Neepa Saha Sharmaa, Head-CSR, CESC Limited.
A street play and dance performance on child marriage and child rights was performed by children from the community.
In the last one year under the Project, 79 child labourers have been identified out of which 50 children have been enrolled in schools and the rest have been rehabilitated appropriately. Four child marriages were prevented and eight missing children were found through the initiatives taken under the Project. 25 such children were felicitated at the Mela.

Urja Chetana makes its mark at the 191st Annual Flower Show organised by the Agri-Horticultural Society of India

An Urja Chetana stall was put up at the Annual Flower Show organised by the Agri Horticultural Society of India from February 8th to 11th, 2018. The Stall gave an overview about the environment sustainability initiatives undertaken by students under the Project. The Stall had informative standees, students' photo gallery depicting various activities, compost and handmade paper product samples on display, a signing banner, and visitors' feedback notebook. Eco Club members and teachers from various schools volunteered in the Stall and interacted with visitors giving insights about the programme, the sustainable actions they have been taking, particularly about waste recycling. There was active participation of CESC Volunteers as well who shared inputs with visitors about the initiatives taken by CESC Ltd on nurturing young minds towards conserving nature and natural resources. Many visitors enquired from the students about the composting and waste paper recycling processes. They appreciated that CESC has been supporting such initiatives over the years. The Urja Chetana Stall had nearly 270 footfalls wherein 137 have shared feedbacks and 105 signed on the signature campaign in support of such initiatives in the region.

'Save Energy Championship Tournament - Kabaddi for Girls' organised under Urja Chetana Initiative of CESC Limited

Under the Urja Chetana Project of CESC Limited, a 'Save Energy Championship Tournament - Kabaddi for Girls' was organised from 24th February to 21st April, 2018 in which four schools participated. The objective of the Tournament was to motivate students to adopt healthy lifestyles, be physically active and practice habits which ensure conservation of natural resources and reduce carbon emissions.
The final match of 'Save Energy Championship Tournament - Kabaddi for Girls' was played between Sir Ramesh Mitter Girls' School, Bhowanipore, and Shyamsundar Children's High School, Bhadreswar at the St. Paul's Mission School grounds on the occasion of World Earth Day.
The score of the final match was 88 is to 41 points in favour of Sir Romesh Mitter Girls' School with Shyamsundar Children's High School being adjudged as Runners-up. The tournament led to saving 3410.4 kg* carbon emissions contributing towards climate change mitigation. (*Considering a person playing for 2 hours saves 61.7 kg carbon emissions from a 32" LCD TV and 19.2 kg carbon emissions from usage of fan).
Source: Low Carbon Lifestyles - Conceived, designed and produced by Centre for Environment Education

Breast Feeding Week Observed under CESC's Roshni Project

As part of the Breast Feeding Week observation, sensitisation programmes on correct breastfeeding practices were organised under CESC's Roshni Project between August 2 and 7, 2018 in its various centres for pregnant women, lactating mothers and other caregivers of children. Apart from the beneficiaries, the Child Development Project Officer (CDPO) of Tiljala, Anganwadi Supervisors and Workers, and CESC CSR Volunteers actively participated in the events. Through this programme, the beneficiaries learnt about the importance of exclusive breastfeeding of infants till the age of six months, as it helps to protect them from various kinds of infections. A video on colostrum feeding, exclusive breastfeeding, and introduction of complementary feeding was shown to the beneficiaries to enhance their knowledge. Quizzes were also conducted to assess beneficiary understanding.

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CESC Limited is a socially responsible company, which aims at contributing towards the upliftment of the poor and underprivileged residing in its area of operation, along with its focus on generating profits, protecting the interests of investors and shareholders, and, serving its customers with utmost satisfaction.

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Social Responsibility: A New Paradigm of Hospital Governance (Module 2)

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Social Responsibility: A New Paradigm of Hospital Governance (Module 2)

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This was a good article because it showed the social responsibility that a hospital goes through when it is first beginning.

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Abstract

Changes in modern societies originate the perception that ethical behaviour is essential in organization's practices especially in the way they deal with aspects such as human rights. These issues are usually under the umbrella of the concept of social responsibility. Recently the Report of the International Bioethics Committee of UNESCO on Social Responsibility and Health has addressed this concept of social responsibility in the context of health care delivery suggesting a new paradigm in hospital governance. The objective of this paper is to address the issue of corporate social responsibility in health care, namely in the hospital setting, emphasising the special governance arrangements of such complex organisations and to evaluate if new models of hospital management (entrepreneurism) will need robust mechanisms of corporate governance to fulfil its social responsiveness. The scope of this responsible behaviour requires hospitals to fulfil its social and market objectives, in accordance to the law and general ethical standards. Social responsibility includes aspects like abstention of harm to the environment or the protection of the interests of all the stakeholders enrolled in the deliverance of health care. In conclusion, adequate corporate governance and corporate strategy are the gold standard of social responsibility. In a competitive market hospital governance will be optimised if the organization culture is reframed to meet stakeholders' demands for unequivocal assurances on ethical behaviour. Health care organizations should abide to this new governance approach that is to create organisation value through performance, conformance and responsibility.

Keywords: Corporate governance, Health care, Hospital, Social responsibility

Introduction

Changes in modern societies were driven by several factors, namely economic and cultural globalization, scientific and technological progress, increased access to information, or the acknowledgement of consumers' rights. All these changes originate the perception that ethical behaviour is essential in organization's practices especially in the way they deal with aspects such as human rights. These issues are usually under the umbrella of the concept of "social responsibility". By social responsibility it is meant that organizations can meet its fundamental goals of accomplishing a particular public endeavour or of increasing shareholders' profits, but at the same time fulfilling other important objectives namely with regards the satisfaction of stakeholders' interests. Sometimes "social responsibility" is also associated with environmental concerns and the protection of the commonwealth of life [ 4].

Recently this concept of social responsibility has been addressed in the context of health care delivery suggesting a new paradigm in hospital governance. Namely the Report of the International Bioethics Committee of UNESCO on Social Responsibility and Health, commenting on the right to health care access, states that "What is at stake is a fundamental right, together with the awareness of a limit of attainability. The novelty and the importance of this article is that it explicitly widens the concept of social responsibility, applying it not only to the private sector but also to the public domain. That's why the task of social responsibility is to be shared by the private sector and States and governments, which are called to meet specific obligations to the maximum of the available resources in order to implement and progressively achieve the full realization of this right." [ 27]. Indeed, there is a growing conviction that the deliverance of health care, just like other aspects of social life, should be driven in accordance with universal ethical principles, respecting the human being and its fundamental rights [ 19]. The concept of social responsibility implies that a shared vision of the common good is universally accepted among health care professionals, other stakeholders and the overall social matrix.

The objective of this paper is to address the issue of corporate social responsibility in health care, namely in the hospital setting, emphasising the special governance arrangements of such complex organisations and to evaluate if new models of hospital management (entrepreneurism) will need robust mechanisms of corporate governance to fulfil its social responsiveness.

Social Responsibility and Social Responsiveness

The number of organisations that embrace a socially responsible conduct is becoming increasingly larger, meaning that citizens, and investors, are deeply aware that profit and ethical values (namely with regards protection of human rights) are not incompatible [ 2]. Embracing a socially responsible conduct can be seen as strategic in a global market, contributing to the competitiveness of a company and protecting its external image. It implies an adaptive effort of many corporations due to market rules and public expectations. Involving the public in such decisions will lead to the promotion of universally shared values namely with regards the intervention of large companies and banks in nations were law is difficult to apply. However, social responsibility should be implemented voluntarily out of beneficence values and not only, as suggests Amir Barnea, for the private benefit of the managers to improve their own reputation [ 1].

The reconciliation between profit and social responsibility of corporations leads us to a new market that accounts for more than 10 % off all the investments at the New York Stock Exchange. At the beginning of 2010, professionally managed assets following Social Responsible Investments strategies stood at $3.07 trillion, a rise of more than 380 % from $639 billion in 1995, the year of the Social Investment Forum Foundation's first Trends Report [ 25]. Indeed, the empowerment of responsible citizens is nuclear and fundamental. For instance, public and democratic accountability would be a determinant in the bioevaluation of new technologies like genetic engineering in animals and food (transgenic).

There is a latent tension between social responsibility and profit making because traditional business ethics determines quite clearly that the business of business is business, which implies that the main goal of private corporations is to increase the profits of its shareholders. In this perspective any use of corporations' resources to other goals than profit making would be unethical because that use is not legitimated by shareholders. However, in the last decade there is a growing social awareness that profit is a necessary condition but not a sufficient one. There are other laudable goals that major corporations should pursue besides profit. Moreover, shareholders consent could be presumed if those goals are clearly stated in the corporation mission. It follows that the concept and practice of social responsibility could be easily commended to a profit making company because it would not only increase its external image but, more importantly, shareholders in a modern society would know that a specific corporation manages its internal and external operations with other goals beyond profitability.

Also, in developed societies, integration of social responsibility into business practice is an expected policy and there are many good examples of this change. Both in local communities as well as at a global level social responsibility is a practice expected by many shareholders and by most stakeholders. There are plenty of good examples of social responsibility projects in local communities, such as in education, in social inclusion or even in cultural areas.

In health care, corporate social responsibility means that there is an ethical obligation that requires hospitals and other organizations to do something beneficial in issues such as delivering quality health care to everyone who is entitled to it. It is not easy to practice social responsibility because the satisfaction of some stakeholders' interests may be opposed to the fundamental goal of most health care systems. In spite of this paradox, that can originate some difficulty in the management of health care organizations, many hospitals (for profit and not for profit) have applied the concept of social responsibility through explicit interventions in management decisions. To accomplish this ideal, companies should define objectives (the mission) and social programmes that integrate ethical principles not only in strategic planning but also in its daily activity.

Therefore, social responsibility is concerned with the way a particular organisation manages its internal operations, as well as the impact of its activities in the social environment. From this perspective a distinction can be drawn between passive and active social responsibility (Table ).

Table 1

Passive social responsibility

1. Creating wealth and promoting employment

2. Protecting the investment of all shareholders (namely the government in public hospitals)

3. Protecting the interests of all stakeholders

4. Respecting human rights

5. Abstention of environmental damage (namely in dealing with toxic waste)

6. Abiding to the law

Active social responsibility

1. Implementing ethical codes of conduct

2. Promoting reverse discrimination policies (affirmative action)

3. Public accountability of management decisions and performance indicators

4. Protecting animal interests (namely in research)

5. Contributing actively for environmental protection

6. Engaging in national or international solidarity programs

What is, then, the scope of this responsible behaviour? Put quite simply, passive social responsibility only requires hospitals to fulfil its social and market objectives, in accordance to the law (national and international) and general ethical standards, even if they could do more good or improve society by other set of goals. Respecting human rights is the paradigm of social responsibility and should be a goal of any health care organization. Non-discriminatory policies at work or protecting privacy rights are examples of such a responsible behaviour. Policies that protect society against toxic waste or prevention of animal damage in research are also within the scope of this concept. This type of social responsibility also includes aspects like lawful behaviour, abstention of harm to the environment or the protection of the interests of all the stakeholders enrolled in the deliverance of health care.

Active social responsibility requires organizations-namely hospitals-to do something beneficial (out of beneficence duties) and not only abiding to the law or to general ethical principles. It follows that interest and values of all stakeholders are taken into consideration [ 12]. Again the Report of the International Bioethics Committee of UNESCO on Social Responsibility and Health suggests that "Social responsibility should be understood as being part of what has traditionally been called moral obligations. These obligations cannot be imposed by others or by the State. The difference between legal and moral obligations does not imply that the latter are less important. It simply implies that there is no legal coercion to fulfill them. Nonetheless, the more significant the consequences for failure to conform to these norms, the greater is the moral obligation to do so. This is especially so when we consider the duties deriving from a fundamental right."

The existence of a right to health care, as a positive social right, emphasises this perspective and the need for hospital active social responsibility. It implies that organizations contribute with its resources or skills to the common good. For instance, the implementation of ethical conduct codes, affirmative action policies at the workplace (reverse discrimination of minority groups) or the active contribution in promoting the environment, are good examples of this kind of social responsibility. Re-interpreting the concept of social responsibility means that an organization should not only fulfil its economic and legal obligations but also actively contribute to the social good. A good example of an ethical behaviour insofar as the common good is at stake is the fact that many teaching hospitals have developed guidelines for animal welfare in research and have even created specific ethics committees for dealing with these issues.

In short, hospitals and other health care organisations should abide to common ethical principles that include aspects like:

1. Avoiding precarious labour and supporting flexible labour policies, namely with regards women during the breast-feeding period;

2. Creating assistance services for the handicapped;

3. Creating assistance services to satisfy spiritual or religious needs;

4. Supporting programs of social well-being and solidarity;

5. Implementing marketing strategies that abide to ethical standards;

6. Treating with caution toxic, poisonous residues, potentially dangerous to humans and animals;

7. Protecting animal rights;

8. Preserving the environment;

9. Promoting policies that enrol in the decision-making process specific groups of patients and Non-Governmental Organisations (NGOs).

It is disputable however the nature of social responsibility in the sense of who are relevant stakeholders and what their interests are. Also it can be questioned what is the role of investors, employees, customers, tax payers, as well as more impersonal bodies such as the environment and how their competing interests are fairly balanced. Corporate social responsibility is accomplished only if a new model of corporate governance is implemented. New governance arrangements mean that there are internal mechanisms of control that take into consideration all stakeholders interests and valid claims. Public and stakeholders' accountability is also an imperative of good corporate governance so that any decision that goes beyond the managers/shareholders contract is not an arbitrary one but is taken in accordance with societal expectations. A dual board with a formal overseeing authority of the executive board is also a fundamental step towards good social performance.

National and international law related to social responsibility is already in practice, but law by itself is insufficient to promote such an ethical behaviour. A different approach is needed because ethical rules do not exist in many instances. Legislation is just a minimum that guides organizations conduct. But, many providers are willing to do more than this minimum demanded by law, requesting their certification of social responsibility under international norms-Social Accountability SA 8000 and ISO 26000. These are international norms that intend to implement better work conditions based in the principles of the International Labour Organisation, the United Nations Convention on Children's Rights and the Universal Declaration of Human Rights.

Legal regulation is a necessary condition for good corporate social performance but an insufficient one. In modern societies legislation and its application ensure the legality of management decisions. But there are many aspects of corporate performance that are beyond strict legality. For instance apparel industry is not legally required to engage in national or international solidarity programs for the elderly or migrant communities. But many do so. Law only serves to ensure that a corporation acts responsibly in the passive sense previously described but not in a proactive manner to do more than it is usually expected (Fig. ).

There is a vast array of social goods towards which social responsibility strives. The values can be considered as universally shared: promoting freedom and equal opportunities or protecting the environment and the commonwealth of life are values that any corporation should pursue, although public discussion about specific programs should be promoted by any socially responsible organisation. In the health care setting there is no doubt whatsoever about the set of values that should be pursued. Equity in access, universal coverage, and efficient resource allocation is the ethical platform of modern health care systems. Again, public accountability of any management decision would legitimise it and would also promote public awareness in a more enlarged societal debate.

The concept of social responsibility means that it is not enough for a health care organisation to bet in the quality of its services, in competitive prices or in advanced technology, but it is also important to be respected by its customers, professionals and society at large [ 3]. Therefore, the adoption of a socially responsible conduct could be an important step for a hospital to increase its competitiveness and to protect its external image. For example, a social responsible hospital should analyse and find which way to treat or to discard safely a waste product that can contaminate the environment. It should be remembered that developed countries are responsible for 75 % of the world energy production and resource consumption and create a large proportion of toxic waste. But their level of pollution is relatively low due to severe laws, industrial concern about ecology and the relocation of polluting activities into emerging markets.

It is usually accepted that health care organisations that are socially responsible are more prone to be in favour of supporting local communities [ 30]. Also it is more likely that solidarity programs are put forward, because many hospitals are engaged in the organisation of social projects for the least advantaged, in the promotion of employment and in the implementation of reverse discrimination policies to protect cultural minorities. Lastly, self-regulation is promoted due to social pressure and financial investment.

The more an organisation has closer community links the more it will be possible to engage in social responsibility. Community linked management models adapt best to these practices because, in spite of its public nature, they appear to be more and more competitive and, therefore, will tend to focus on achieving added value, concentrate on the different stakeholders, emphasize result optimization and performance evaluation, as well as value innovation and entrepreneurism. Furthermore, attributes such as greater autonomy, a participative structure, a high degree of flexibility and openness, national and global coverage integrated in an interdependent network strengthens this governance model.

Corporate Social Responsibility in health care includes all involved agents namely pharmaceutical Industry [ 15]. However, due to the specificities of these corporations and notwithstanding the fact that in some areas (like orphan drugs) their social responsiveness should be optimized, this article will emphasize especially hospital social responsibility [ 13]. It seems clear that organisations, namely hospitals, need to balance conformance with performance and corporate responsibility. It is instrumental to meet stakeholders' demands for unequivocal assurances on efficiency, ethical behaviour and value. Adequate corporate governance and corporate strategy are therefore the gold standard of social responsibility.

Hospital Corporate Governance

Pressure from globalisation is leading to a redefinition of the social function of many health care organisations. Indeed, some of them have as a social goal delivering quality health care and as an economical goal to increase wealth and employment in a particular community and also to contribute to the development of new technologies. However, what is expected today from a hospital is also its contribution to a fairer society and a safer environment. Health care organisations trying to act in a socially responsible way should do what is right, minimizing the potential damage to the stakeholders (Fig. ). Corporate governance is the operational paradigm of this dimension of social responsibility [ 10].

Indeed, health care organizations face new challenges in modern societies. The lack of economical sustainability of most health care systems led to the introduction of the new public management to guarantee the survival of the welfare state. The corporatisation of public hospitals was accomplished through many organizational changes, namely creating a split between purchasing and provision using output-based contracts for which private and public firms compete, giving managers' greater autonomy and experimenting with incentive payments and other ways of improving worker productivity [ 14]. The introduction of the private finance initiative (PFI) perspective-in which a private group delivers health services (including sometimes clinical services) on a contractual basis-is sometimes thought to be another way to increase the value for money [ 26]. This transformation of many health care systems in Europe as elsewhere led to creation of robust mechanisms of regulation, to guarantee the pursuit of the public good [ 28]. It follows that a new organizational culture is deemed necessary to overcome the market failures that can arise with the entrepreneurialism in health care [ 18].

The concept of social responsibility emerges with reference to privately owned, profit making organisations, so it might be assumed that social responsibility is already incorporated into the governance of public health care provision. However, there is scope for some social intervention beyond strict statutory provision. Non-profit, publically owned corporations that are managed as private corporations (such as private finance initiative or corporate public hospitals) should also promote policies of social responsibility. Not only to avoid unethical practices such as cream skimming and induced demand (passive responsibility) but also to proactively promote activities such as implementing ethical codes of conduct for managers or engaging in solidarity or cultural programs. Also, public accountability of management decisions and performance indicators is an ethical and social imperative that usually is not obliged by law. This is another example of active social responsibility that should be implemented whatever the institutional nature of the health care organization.

The increase in corporate benchmarking indices and the growth of stakeholder activism in most economical activities makes it an imperative to increase its social responsiveness and health care organisations, such as hospitals, must also address the issues of balancing corporate governance with corporate strategy. This social responsiveness implies organizational changes in mechanisms, procedures, arrangements and behavioural patterns that collectively make health care organizations capable to respond to social pressures [ 5].

But it should remain clear that new governance strategies are in accordance with a framework of quality assurance based on the evaluation of structure, process and outcome and should try to reinterpret this perspective in light of the social responsibility of health care organizations. As stated by Avedis Donabedian [ 8] "Traditionally, in health care, quality assurance has been meant to apply predominantly, or even exclusively, to health care itself as provided directly to patients by legitimate health care practitioners. Removed one level, we include other services that directly affect the ability of practitioners to perform well, meaning such things as radiological, pharmaceutical, and laboratory services. In recent years, under the rubric of "total quality management", it has become popular to include in the idea of quality assurance almost every function or activity of a health care organization or system, including such things as the performance of housekeeping crews, secretarial and clerical services, the billing and fee-collecting office, and so on. It is reasonable to say that the quality of the immediate environment of health care, including the managerial activities in it, have an influence of the quality of care-either directly, by influencing the performance of practitioners or indirectly, by influencing the convenience, comfort, or safety of patients." It follows that in any health care organization quality assurance is a presupposition for adequate social responsibility.

In accordance with McSherry and Pearce [ 17] health care governance should unite three different elements of health service governance: corporate governance (management), clinical governance (clinical practice) and non-clinical supporting services (controls assurance). We will focus in corporate governance in health care organizations as we feel that good corporate governance is instrumental for clinical governance and controls assurance to succeed. Corporate governance is an evolving area and its development has been driven by the need to restore confidence in management decisions in liberal markets (Table ).

Table 2

1. Goals of hospital corporate governance: to increase its performance, to assure its social responsibility namely concerning the search for the common good, and to promote conformance with regards accountability arrangements in a fair and transparent way [ 9]

2. External controls

(a) Public accountability: Explicit, public detailed procedures for evaluating hospital performance with full public report (use reports, performance reports, compliance reports, consultants), global budgeting, fair grievance procedures (legal, non-legal), and adequate privacy protection (adapted from [ 7])

(b) Stakeholders accountability: External mechanisms of reporting, public disclosure of the processes and rationale adopted in management, external audit, financial account and annual report (published at internet)

3. Internal controls

(a) Self-regulation: Internal audits, ethical codes and disclosure of directors' performance and remuneration

(b) Board: Unitary versus dual board, mechanisms of appointment to the board, performance evaluation (adapted from [ 16])

Indeed, health care has traditionally been delivered in many countries through public organisations and the search for equity in access and distribution has been the main goal of public providers of most public systems. In the last decades the costs of health care, including essential public health functions, have increased steadily due to biomedical research (e.g., genetics), emerging diseases (e.g., AIDS), medical malpractice and increased life expectancy. Increasing efficiency became then another driver of most health care systems. The growing dilemma of most developed countries is how to assure that equity, efficiency and quality are simultaneously delivered to the population. The balance between those values is frequently difficult to accomplish but, nevertheless, public providers try to be responsive to public expectations.

Efficiency is frequently addressed by the introduction of entrepreneurialism in health care but this evolution can affect equity as well as quality standards (quality shading). Therefore there has been a growing concern over aspects of quality assurance of health care organizations. The delivery of care is progressively fuelled by concepts such as evidenced based medicine, controls assurance, clinical governance all trying to achieve a continuous improvement in health care and a satisfying risk management control. New governance arrangements of health care originations, such as central hospitals, are therefore necessary to reinterpret the meaning of quality care beyond classical definitions centred only in the system (structure), the organised activities (process), and the final outcome. The modern hospital should measure the outcome also by the impact of the hospital as a complex organization in the environment, particularly in the surrounding society because, as claimed by Cecile Renouard, an anthropological perspective of social responsibility is more prone to promote sustainable human development than a strict utilitarian one [ 22].

The main drivers of corporate governance are to increase the performance of the organisation and assuring its social responsibility and responsiveness namely concerning the search for the common good, and to promote conformance with regards accountability arrangements in a fair and transparent way. To accomplish these purposes, a complex system of external and internal controls is usually developed. Public accountability is the genetic print of good corporate governance through the existence of public detailed procedures for evaluating the health care organization activity, with full public report, global budgeting, fair grievance procedures, adequate privacy protection, external audit, financial account and annual report [ 7], as well as internal audits, ethical codes, disclosure of directors' performance and remuneration and performance evaluation. For instance, codes of ethics are an integrant part of the ethics program of most modern hospitals. This instrument is usually supplemented by other measures such as the existence of an ethics committee and ethical training [ 24]. However, a hospital code of ethics should promote the empowerment of all health care professionals in order to develop even further professional ethical norms and obligations [ 31].

In public health care systems-both Beveridge and Bismarck systems alike-the entrepreneurialism needs robust governance arrangements because corporatisation aims to increase efficiency and the value for money [ 21]. As stated by Preker and Harding "with increasing frequency, autonomization and corporatization are being considered and applied to improve performance of publicly run health services, similar to recent innovations in organizational reform elsewhere in the public sector" [ 20]. Entrepreneurism led to many different models and it is expected that all of them fulfil the values embraced by modern democracies but a participative hospital management model makes the process of accountability even more visible. Indeed, trust is a fundamental aspect of the moral treatment of stakeholders within an organization-stakeholder relationship [ 11].

In a competitive market, good hospital governance will prevent unethical practices such as cream-skimming and induced procurement of care practices strongly regulated by independent regulatory agencies [ 29]. Other goals could also be optimised if the organization culture is reframed to meet stakeholders' demands for unequivocal assurances on ethical behaviour. Health care organizations should abide to this new governance approach that is to create organisation value through performance, conformance and responsibility.

Conclusion

The expansion of the concept of social responsibility from the private sector to public organizations is a challenge and an opportunity that should be clearly embraced [ 23]. Social responsibility and social responsiveness in health care imply both a new social dimension of care as well as new organizational patterns of hospitals and other health care organizations. Indeed, bad governance can destroy an organisation, in particular a hospital or other health care organization. It is also true that good corporate governance should be balanced with effective strategic management if sustainability is to be achieved.

Corporate social responsibility in health care does not apply only to hospitals and other health care organizations, but also to multi-national companies namely pharmaceutical companies. In this context social responsibility has a wider field of intervention because issues such as human rights, gender equality, child labour, and environment protection have different meanings in different cultures. Nevertheless in a globalised culture and economy, social responsibility is a concept that transcends local moralities and should promote transnationally values that are in accordance with international conventions of human rights and environmental protection. Namely the pharmaceutical industry could reinterpret the concept of social responsibility by allowing the access of particularly vulnerable populations of the underdeveloped world to medicines that are lifesaving to many people but that particular circumstances make it very difficult to provide in a fair and systematic way.

If economic freedom determines and is determined by the rules of the competitive market, there is no doubt that in modern societies-governed by a sense of citizenship and civic consciousness-there is a search for social responsible organizations [ 6]. Hospitals can and should be the first ones to follow this path, helping to shape public policies and consumer behaviour, because incorporating ethical concerns presupposes the assumption that organisations need to balance conformance with performance and corporate responsibility. Health care organisations should try to understand their mission in a global society, promoting shared values and common ethical principles in new patterns of hospital governance.

Open Access

This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.

References

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Social Responsibility: A New Paradigm of Hospital Governance?

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Changes in modern societies originate the perception that ethical behaviour is essential in organization's practices especially in the way they deal with aspects such as human rights. These issues are usually under the umbrella of the concept of social responsibility.

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This was an interesting website to read and learn about the most common factors that seem to affect a company and its global organization. This gives great examples and breaks down all 6 challenges.

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As a big baseball fan (Go Red Sox!), one of the most fascinating aspects of the sport is how international it has become. Across Major League Baseball, more than a quarter of the players on big-league rosters were born outside the United States and this percentage is increasing. Baseball, the most American of institutions, went global to find new talent, expand its brand and introduce its business to new customers. Its international success should serve as a lesson to any enterprise, old or young. If your business is looking for growth, going global is the natural next step.

There will be roadblocks. I should know. At one time, I was vice president of international finance for an American supplier of telecommunications networking equipment, where I was responsible for the accounting, tax and finance functions for 30 foreign subsidiaries. In addition, I spent considerable time helping support their HR and legal needs. I have the battle scars to prove that managing a global organization presents challenges.

Although individual companies respond differently to international opportunities, my experience finds that they face a common set of challenges when managing a global footprint.

1. HR: People are an asset and a challenge. Many companies find recruiting and developing talent abroad hard to accomplish. There are language and cultural differences to overcome, and you often don't have HR personnel on the ground in satellite offices. Identifying an onboarding program for international employees that works for you is a critical success factor.

At-will employment, which allows businesses to terminate workers for any reason, is a U.S. construct. Outside the U.S., employment relations are handled by contracts, and host country labor laws may supersede certain elements of what we, in the U.S., think of as a typical employment agreement. Penalties for noncompliance can be significant. In France, for example, the maximum damages for unfair termination is set at 20 months of gross salary for employees with at least 30 years of service. Companies with global workforces often deal with multiple payroll and HR administration systems too. No wonder HR leaders struggle to find the time to be strategic.

2. Taxes: Complexity is increasing. The list of countries initiating a value-added tax, which is collected at each stage of production, in growing, most recently in the United Arab Emirates and other Gulf states. As more sales go online and are fulfilled by third parties, compliance has become tricky for these e-commerce businesses. You need to know the local tax rules and have a plan in place so that the risks of running into trouble are reduced.

It's also a new day in tax information reporting. Globalization, emerging markets, greater transparency and increased regulation are transforming the global tax framework. Seeking to combat tax evasion, governments are sharing information on residents' assets and income, which has increased the compliance burden on business.

3. Cash management: Businesses need to be prepared for the age of digital cash. In developing countries, digital cash has become physically safer than carrying or storing cash or buying gold or silver. It makes bank transfers faster and cheaper and allows smaller businesses to engage more efficiently in global e-commerce. Working with one or two global banking partners versus a myriad of banks from country to country will make things easier and more effective.

Treasurers still have to deal with volatile foreign currencies, as well as compliance with anti-money laundering know-your-client regulations, which have made it more difficult to do seemingly simple things, like open an overseas bank account.

4. Market entry: When entering a new market, there's always the need for local knowledge. How do you make those contacts? How do you avoid common mistakes? What are the best practices? Over time you would like to think market entry becomes less complicated, but it doesn't.

The common barriers to entry include government regulation, forecasting startup costs, product differentiation, access to suppliers and distributors, and competitive response. But the speed of innovation might require a new business model or new approach to pricing and marketing. Identify a primary, experienced in-country expert to serve as your guide to launching new operations successfully.

A good first step to gaining a baseline understanding of a potential international business expansion destination is accessing a number of reputable, free resources, like this country profile library, which is available for businesses to take the first step towards informed and successful expansion.

5. Transaction support: The volume of global mergers and acquisitions is increasing. Companies and investors have loads of cash and interest rates remain low. But cross-border transactions present a unique set of issues that are compounded by the scale and geographic scope of the deal. Parties to the transaction often come from divergent cultural backgrounds and have multiple language requirements, conflicting strategic objectives, and different business practices. Early recognition of these obstacles is vital. Your "deal team" should include the right internal leadership, lawyers, financial advisors and in-country experts who are able to work in harmony with one another.

A key to making these deals work is getting the transition right at the front end and successfully integrating operations. Once the transition services agreement expires, you need to have the right people and systems in place to keep operating.

6. On-call expertise: When a problem arises halfway around the world, who are you going to call? Who do you trust? The best companies have access to a robust lineup of experts, from lawyers to accountants to consultants, they can call anytime.

For reprint and licensing requests for this article, click here.

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Six common challenges in managing a global organization

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As a big baseball fan (Go Red Sox!), one of the most fascinating aspects of the sport is how international it has become. Across Major League Baseball, more than a quarter of the players on big-league rosters were born outside the United States and this percentage is increasing.

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This article here goes on to show the challenges and what it takes to run a healthcare industry that deals with the global market place.

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The world is getting "flatter"; people, information, technology, and ideas are increasingly crossing national borders. U.S. healthcare is not immune from the forces of globalization. Competition from medical tourism and the rapid growth in the number of undocumented aliens requiring care represent just two challenges healthcare organizations face. An international workforce requires leaders to confront the legal, financial, and ethical implications of using foreign-trained personnel. Cross-border institutional arrangements are emerging, drawing players motivated by social responsibility, globalization of competitors, growth opportunities, or an awareness of vulnerability to the forces of globalization. Forward-thinking healthcare leaders will begin to identify global strategies that address global pressures, explore the opportunities, and take practical steps to prepare for a flatter world.

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Managing healthcare services in the global marketplace.

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The world is getting "flatter"; people, information, technology, and ideas are increasingly crossing national borders. U.S. healthcare is not immune from the forces of globalization. Competition from medical tourism and the rapid growth in the number of undocumented aliens requiring care represent just two challenges healthcare organizations face.

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In this module we learned about the different steps and processes that go into planning so i searched for the steps in bettering a hospital since I currently work in a hospital.

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Opening a new hospital or healthcare facility is a huge undertaking. One of the top priorities is crafting and delivering tailored messages to key stakeholders -healthcare leaders, government officials, donors, hospital employees, volunteers and patients and their families - in order to make that all-important first impression and to gain enthusiastic buy-in from the community in which the new facility is located.

In this white paper, " 10 Steps to a Better Hospital Opening," agencyEA offers strategic considerations based on more than 15 years of experience partnering with hospitals and healthcare systems across the U.S. Here is a brief summary of key points:

Set goals

Strategic goals are the foundation for planning a new hospital opening event. These goals must be identified at the project's inception and built upon during each step of the planning process. This enables planners to establish metrics and schedule periodic checkpoints to measure progress and allow for real-time adjustments along the way.

Reinforce the brand

A cohesive communications and brand strategy is essential to a hospital opening's success. Often, a complete rebranding is needed to reflect the institution's new identity.
RELATED TOPIC: How to promote your hospital's brand message
Engage the community

Messaging should emphasize the public's role as important stakeholders in the enterprise. This helps set a positive tone that's both respectful and welcoming to the local community.

Leverage volunteer services

Drawing on the resources of clinical, staff and community volunteers enables planners to gain a unique perspective on internal culture.

Involve donors

As a priority audience, donors should feel they play a pivotal role in the hospital opening.

Encourage employee involvement

Engaging employees throughout the planning stages helps to ensure a cohesive, collaborative effort. Planners can gain valuable, high-level feedback by hosting meetings with each department.
RELATED TOPIC: How hospital CEOs can keep their best employees
Cater to doctors

Physician buy-in is essential to success. Invite doctors to take part in the conversation and offer suggestions on new hospital features and technology. Plan to highlight their efforts and contributions during the hospital opening.

Manage and customize tour logistics

New building tours involve a dizzying number of logistical details. Hiring an experienced professional who understands how to customize the tour makes it possible for large groups of people to experience the new facility in a short time.

Extend the reach

Use social media and public relations to maximize every touch point throughout the new facility's opening. Media relations should focus on generating awareness and driving attendance to public events.

Evaluate success

A meaningful evaluation of the hospital opening depends upon accurate reporting and the collection of relevant data. Also, post-event communications represents the best opportunity to publicly thank everyone involved and to solicit future involvement in hospital- and community-related events.

Learn more about the critical elements of a successful new hospital opening. We invite you to download this free white paper at agencyEA.com.

Let's connect!
Read the latest edition of Healthcare Global magazine!

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Opening a new hospital or healthcare facility is a huge undertaking. One of the top priorities is crafting and delivering tailored messages to key stakeholders -healthcare leaders, government officials, donors, hospital employees, volunteers and patients and their families - in order to make that all-important first impression and to gain enthusiastic buy-in from the community in which the new facility is located.

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When reading this weeks modules and completing the work i found out that i really liked the way that the Matrix Organizational Structure worked. This article shows how it would work in a hospital and how each department would be broken down.

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Communication between a supervisor and the employee is the biggest thing and if the communication isn't there then work can get messed up so easily.

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we learned about the different styles of leadership and how each type of manager might show a different style. This website shows how each one is different.

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Which of the leadership styles are you?

Do you make sure everyone follows the rules, or are you easy-going and put a lot of trust in your employees?

Are you getting complaints about your leadership style either from your boss or your team?

There are many different leadership styles that people tend to use and sometimes it is best to change your leadership style depending on the situation and the people that work for you.

So, what kind of leader do you want to be?

Do you want to change your current style of leadership or are you satisfied with how you lead?

Just knowing the kind of leader you are can help you be a better leader. It's time to think about your leadership skills, what works for you and what doesn't, and what is working for your team.

1. Laissez-Faire Leadership

This leader is NOT directly involved in decision making and puts a lot of trust into the team. The leader with this style will know what's going and gives feedback when needed.

Laissez-faire is French, and it means "hands-off." One positive feature for this style of leadership is your employees feel appreciated and confident that they can make good decisions.

One downside of this style, employees may take your hands off approach too far and begin slack off or take advantage of your approach.

2. Pace-Setter Leadership

Just like the pace car in a race, a pace setter leader is one that sets the bar high and expects work to be done fast and right. This is perfect for highly energized professionals who know what they are doing and are driven to succeed.

The biggest downside to this style is that some employees, no matter how driven, can become over-stressed and burned out.

This is a leadership style that will work the best when introducing an exciting new product or service to the world.

3. Autocratic Leadership

As the name implies, this leadership style is one person in control of everything. This person makes the decisions, and that is final. Also, there is no input from other people in decision making.

While this can be great in times of crises, or when there are safety concerns of the employees, it may not always be the best because your employees will feel devalued and look for work somewhere else.

This type of leadership is best-applied to circumstances where there is little or no time for group decision-making or where the leader is the most informed or knowledgeable member of the group.

4. Democratic Leadership

Democratic Leadership is the middle ground between Laissez-faire and Autocratic. This leader will listen to others' opinions but will make the final decision.

The leader still is very involved in day to day activities but will allow for more creative thinking to flourish. The downside of this style is when a decision has to be made right away.

5. Servant Leadership

In this style, the leader is second to the employees. This model follows a people or idea first premise. The leader highlights the individual or the team as opposed to him or herself.

This is one of the best styles for nonprofit or other humanitarian business because the people are as important as the mission.

Servant Leadership is also good to use when the team is suffering from low morale.

6. Transformational Leadership

Do you have a vision and share it with your team to get them excited about your vision? Then you might be a transformational leader.

This leader is self-aware, authentic, empathetic and humble. These leaders want everyone to succeed and accomplish the shared vision.

And when people feel they are sharing in something great, they will make every effort to be the best and do the best work.

7. Transactional Leadership

Transactional Leadership is a reward/punishment model. For example, if one of your team members sells the most cars in one month, he or she will be rewarded with a gift card to their favorite restaurant.

Another example would be a promotion for a certain person-should they get the project done before the deadline.

On the other hand there is the punishment side such as if someone doesn't sell their quota, they could lose working hours, be demoted or other punishments.

This leadership style may inspire some to do better because something they want is on the line. Yet, this leadership may also lower morale because of the punishments.

8. Charismatic Leadership

Charismatic Leadership is the leadership style that comes with a personality that people just love. These leaders inspire, motivate and energize the team.

The Center for Association Leadership says this style may increase team morale and success. Oprah Winfrey is a charismatic leader.

Of course, not everyone is born with natural charisma but you can learn to be motivational and inspiring, and you could become charismatic with a little effort over time.

Leadership Styles

It is in your best interest as a leader to learn about a variety of leadership styles. What may have worked ten years ago may not be as effective today. Not every situation will call for the same leadership style, and you need to stay flexible and informed to lead your people the right way.

If something is not working with your leadership style and you are changing, be aware that your people may take a little longer to accept your new style so be patient.

Also, being a leader is an ever evolving skill which takes knowing who you are, who your people are and what task needs to be done.

A good piece of wisdom is to be consistent with your leadership styles and situations.

To be the best leader you can, you need to grow and adjust your leadership styles for overall success.

Which Leadership Style Are You?

If you have ideas you feel like sharing that might be helpful to readers, share them in the comments section below. Thanks!

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Which of the leadership styles are you? Do you make sure everyone follows the rules, or are you easy-going and put a lot of trust in your employees? Are you getting complaints about your leadership style either from your boss or your team?

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We learned about the different styles of motivation in this module. The Maslow's hierarchy was my personal favorite as it shows the breakdown in a pyramid theme .

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Maslow’s hierarchy of needs is a motivational theory in psychology comprising a five-tier model of human needs, often depicted as hierarchical levels within a pyramid.

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We learned all the different aspects that go into the human resource departments of companies, meaning the ins and outs of what should be asked during the interviews, what proper job offer letters should look like and even job training's after the person is hired on to the company.

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This was a great way to learn how to make the different types of organizational charts depending on what company you trying to make them for.

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Click a template below to start creating an organizational chart now.

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The Halo effect really caught my eye out of all the other cognitive basis thinking ways. It made the most sense to me, since that is how most people think daily.

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The halo effect is a type of cognitive bias in which our overall impression of a person influences how we feel and think about their character. Essentially, your overall impression of a person ("He is nice!") impacts your evaluations of that person's specific traits ("He is also smart!"). Perceptions of a single trait can carry over to how people perceive other aspects of that person.

One great example of the halo effect in action is our overall impression of celebrities. People perceive them as attractive, successful, and often likable, so people also tend to see them as intelligent, kind, and funny.

What Is the Halo Effect?

The halo effect is also sometimes referred to as the "physical attractiveness stereotype" and the "what is beautiful is also good" principle.

Physical appearance is often a major part of the halo effect. People who are considered attractive tend to be rated higher on other positive traits as well.

However, this effect doesn't just affect our perceptions of people based on their attractiveness. It can also encompass other traits as well. People who are sociable or kind, for example, may also be seen as more likable and intelligent. The halo effect makes it so that perceptions of one quality lead to biased judgments of other qualities.

The term itself uses the analogy of a halo to describe how it can affect perceptions.

When you see someone through the lens of the halo effect, you are seeing them cast in a similar light. That "halo" created by your perception of one characteristic covers them in the same way.

In religious art, a halo is often portrayed over a saint's head, bathing the individual in a heavenly light to show that that person is good.

The History of the Halo Effect

Psychologist Edward Thorndike first coined the term in a 1920 paper titled "The Constant Error in Psychological Ratings." In the experiment described in the paper, Thorndike asked commanding officers in the military to evaluate a variety of qualities in their subordinate soldiers. These characteristics included such things as leadership, physical appearance, intelligence, loyalty, and dependability.

Thorndike's goal was to determine how ratings of one quality bled over to assessments of other characteristics. He found that high ratings of a particular quality correlated to high ratings of other characteristics, while negative ratings of a specific quality also led to lower ratings of other characteristics.

"The correlations were too high and too even," Thorndike wrote. "For example, for the three raters next studied the average correlation for physique with intelligence is .31; for physique with leadership, .39; and for physique with character, .28."

So why do our overall impressions of a person create this halo that influences our evaluations of specific traits? Researchers have found that attractiveness is one factor that can play a role.﻿﻿

Several different studies have found that when we rate people as good-looking, we also tend to believe that they have positive personality traits and that they are more intelligent. One study even found that jurors were less likely to believe that attractive people were guilty of criminal behavior.

However, this attractiveness stereotype can also be a double-edged sword. Other studies have found that while people are more likely to ascribe a host of positive qualities to attractive people, they are also more likely to believe that good-looking individuals are vain, dishonest, and likely to use their attractiveness to manipulate others.

Impact of the Halo Effect

The halo effect may have an impact on a number of real-world settings.

In Education

Research has found that the halo effect may play a role in educational settings. Teachers may interact with students differently based on perceptions of attractiveness. Older research, for example, found that teachers had better expectations of kids that they rated as being more attractive.﻿﻿

Another study that looked at academic records of more than 4,500 students. A group of 28 people then rated the attractiveness of the students (based on a student ID photo) on a scale of 1 (very unattractive) to 10 (very attractive).﻿﻿ Students were then divided into three groups based on these attractiveness assessments: below-average, average, and above-average.

Researchers then compared students' grades between classes taken in a traditional face-to-face classroom setting and those taken online. Researchers found that students who were rated as above-average in appearance earned significantly lower grades in online courses than they did in their traditional classes.

The halo effect can influence how teachers treat students, but it can also impact how students perceive teachers. In one study, researchers found that when an instructor was viewed as warm and friendly, students also rated them as more attractive, appealing, and likable.

In the Workplace

There are a number of ways that the halo effect can influence perceptions of others in work settings. For example, experts suggest that the halo effect is one of the most common biases affecting performance appraisals and reviews. Supervisors may rate subordinates based on the perception of a single characteristic rather than the whole of their performance and contribution. For example, a worker's enthusiasm or positive attitude may overshadow their lack of knowledge or skill, causing co-workers to rate them more highly than their actual performance justifies.

The halo effect can also have an impact on income. A study published in the Journal of Economic Psychology found that, on average, attractive food servers earned approximately $1,200 more per year in tips than their unattractive counterparts.﻿﻿

Another study found that physical attractiveness has a positive effect not only on a person's self-confidence but also on their overall income and financial well-being.﻿﻿

Job applicants are also likely to feel the impact of the halo effect. If a prospective employer views the applicant as attractive or likable, they are more likely to also rate the individual as intelligent, competent, and qualified.

In Marketing

Marketers take advantage of the halo effect to sell products and services. When a celebrity spokesperson endorses a particular item, our positive evaluations of that individual can spread to our perceptions of the product itself.

The Reverse Halo (or Horn) Effect

As the name implies, the reverse halo effect occurs when a person judges another negatively based on only one known characteristic. That single trait colors all of the others for someone experiencing the reverse halo effect. For example, a person might assume that someone they view as unattractive is also unkind.

A Word From Verywell

So, the next time you trying to evaluate another person, whether it is deciding which political candidate to vote for or which movie to see on a Friday night, consider how your overall impressions of them might influence your evaluations of other characteristics.

Does your impression of a candidate being a good public speaker lead you to feel that they are also smart, kind, and hard-working? Does thinking that a particular actor is good-looking also lead you to think that they are a compelling actor?

Of course, being aware of the halo effect still doesn't make it easy to avoid its influence on our perceptions and decisions. The halo effect is just one of many biases that allow people to make snap decisions but also contributes to errors in judgment.

Additional Reading

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How the Halo Effect Influences the Way We Perceive Attractive People

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Learn about the halo effect, a cognitive bias that can have a powerful influence on the impressions we form of others.

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Quality management we learned that six sigma was one of the total management techniques. This image shows the breakdown in the pyramid from the top to the bottom.

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There are different types of score cards that can lead to ways of fixing things in management. In my opinion the scorecard method seems to be one that is more realistic so that upper management can personally see what customers, employees and other think that can help a company run better.

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Measuring and sustaining outcomes improvement in healthcare is a top priority for industry leaders. But when it comes to the best tools for the job, healthcare leaders find themselves in a scorecard-versus-dashboard debate. This blog settles the debate with the recommendation to use both. Healthcare dashboards and scorecards used in tandem (sometimes referred to as "scoreboards") is the best way to measure and sustain outcomes improvement-scoreboards marry a scorecard's big picture overview with a dashboard's capacity to drill down to the details.

Click to View Infographic

The Who, What, When, and How of Healthcare Scorecards and Dashboards (A Side-By-Side Comparison)

Using scorecards and dashboards in tandem is critical for outcomes improvement, but knowing what they do, when to use them, how to use them, and who should use them is just as important. This blog provides a side-by-side comparison of scorecards and dashboards to ensure leaders use the right tool at the right time with the right people.

Scorecards: Strategic, High-Level, and Long-Term

Scorecards provide a high-level, one-page overview of a health system's long-term, strategic outcomes improvement goals (e.g., reduce readmissions, increase average patient satisfaction, and reduce average OR turnaround times).

Scorecards are long-term-slow to change as goals change over time (weeks, months, or years). They leverage an Enterprise Data Warehouse (EDW), which combines EMR, financial/billing, and patient satisfaction data, to track strategic goals. The data latency caused by daily or weekly goals is perfectly fine for the long-term strategic goals captured in a scorecard.

Scorecards are typically organized by clinical program or specialty and measure performance against these goals (e.g., on target, at risk, off target) using simple visualizations (e.g., raw numbers, arrows, and stoplights). Scorecards are web accessible, mobile-friendly (e.g., tablet, smartphone), and ever-present because they aren't pushed or pulled reports.

Sample Hospital Scorecard

Dashboards: Operational, In-Depth, and Real-Time

Unlike their long-term, strategic scorecard counterparts, dashboards provide real-time or near real-time operational information encompassing tactical scenarios. Scorecards tell health systems how they're doing overall; dashboards tell systems what's happening now using interactive metrics with drill-down capabilities.

Dashboard visualizations are more in-depth (e.g., gauges, charts, and graphs), making them great tools for tracking AIMs that support systemwide outcomes improvement goals. They create connections directly to live systems and EDW data to enable comparisons of current and historical healthcare data and allow for daily, constant monitoring of items affecting AIMs (e.g., view today's readmissions, view triage wait times, and view current OR turnaround time).

Sample Hospital ED Dashboard

Know Your Audience-Scorecards for Leaders; Dashboards for the Frontline

Even the most effective tools are useless without a solid understanding of their intended audience. Presenting a dashboard to a system's executive leadership, for example, might result in a tactical drill-down more appropriate for the frontline staff responsible for day-to-day operations. Similarly, presenting a high-level scorecard to the frontline won't provide them with the actionable data they need; nor will it enforce accountability.

Scorecards for Leaders

Healthcare leaders use scorecards to enforce ownership and accountability by assigning key stakeholders to each strategic goal (leaders who have influence over employees and processes).

Dashboards for the Front Line

Front line staff (e.g., admissions staff, OR coordinators, and nurse managers) use dashboards to monitor their daily progress in achieving systemwide outcomes improvement goals. For example, a health system Director of Support Services uses a dashboard to monitor call volume, wait times, and reported issues so he can react immediately.

Using Scorecards and Dashboards Effectively to Improve Outcomes

The best approach for measuring and sustaining outcomes improvement is pairing the long-term, big-picture nature of scorecards with the real-time, tactical capabilities of dashboards to enforce individual accountability and track performance at a timely cadence. But this two-pronged approach won't work unless healthcare leaders truly understand the who, what, when, and how for each tool.

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Healthcare Dashboards vs. Scorecards to Improve Outcomes

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Measuring and sustaining outcomes improvement in healthcare is a top priority for industry leaders. But when it comes to the best tools for the job, healthcare leaders find themselves in a scorecard-versus-dashboard debate. This blog settles the debate with the recommendation to use both.