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Kenneth Arrow's 1951 doctoral thesis launched a new wave of research on the mathematics of social choice. As with Nash's Equilibrium Theorem in game theory, Arrow's Impossibility Theorem has become the centerpiece of modern social choice theory, inspiring countless extensions, variants, alternate proofs, and responses.
We prove Arrow's Theorem (Theorem 18.19) in this chapter following the elegant argument given by Amayarta Sen. We begin by reviewing the basic ingredients of the statement (social welfare methods and their fairness criterion). Next, we introduce the idea of a dictating set and characterize the Pareto Criterion in terms of this notion. We then state Arrow's Principle, which asserts that dictating power passes from a set of voters to some proper subset. The Impossibility Theorem is then deduced as a direct consequence of Arrow's Principle. Our main work consists of proving Arrow's Principle. We prove this result using two further principles called the Power Contraction and Power Expansion Principles.
We conclude with some developments in social choice theory appearing after Arrow's thesis. We prove a theorem of Sen, called the Sen Coherence Theorem, that gives conditions on a preference table that ensure that the social preference relations are transitive. When the voters have Sen-coherent preferences, Condorcet's ideal of majority rule can be realized. We also introduce two voting methods that have attracted recent interest, Approval Voting and Majority Judgment. These methods do not fit neatly into our framework for voting methods. We briefly discuss the fairness properties of these methods.
Social Welfare and Fairness
Recall that a social welfare method is a mechanism that takes a preference table and produces a ranking of the candidates called the social welfare. We assume that ties are broken (see Convention 5.9) so that the ranking is strict, first to last. Recall that each of our social choice methods extend to a social welfare methods.
I was born in what is often referred to in the south as the Far North of Queensland. My ancestors came from the Western Torres Strait and I am of mixed Torres Strait Islander and Aboriginal descent. As with the many people from the Torres Strait Islands born and living on the mainland, I am often referred to as a Mainlander. My interest in law and the English language was sparked by reading the Alex Haley biography of Malcolm X, who said that people of colour needed to understand the colonial legal system and the language of the colonial laws to be able to overcome the burdens of history. I received much of my formal schooling from what is popularly known as the school of the air, although once I learned to read I found whatever I could to read. I also found an old portable radio in my youth and greatly benefitted from the marvellous, informative, often insightful and thoughtful programs on ABC Radio. I was fortunate to do reasonably well in my studies and went on to complete secondary and further studies. I studied science and then law and worked in that fi eld both in Australia and overseas for several years. My wife and I had three children who were born close together when we were both still very young. I practised in many areas of law in the private, community and government sectors. I returned to academia after my children had grown up and completed a PhD in the area of comparative law, examining the aspects of constitutions in the development of laws, particularly criminal laws. Legal history has always fascinated me and I have followed this interest to trace notions such as the discovery of ‘new’ lands by the colonial powers of the 18th century. I was particularly interested in how these notions led to the subjugation and decimation of many groups of people who possessed inferior weapons of war and who were not militaristic in their ordinary lives.
define management and leadership in healthcare organisations?
distinguish between the functions of top-level, middle-level and first-line managers?
understand the concept of power and how it is used in management and leadership?
determine the skills I would need for effective running of healthcare facilities?
Introduction
Intense debate surrounds the differences between the roles, functions and even superiority of leadership and management (Lease, 2006). Leadership is not something wholly different from management; indeed, it is a component of management and a responsibility of management, especially for senior managers. The present situation in health systems suggests that effective managers need to be effective leaders, and that the most effective leaders are also good managers.
Definitions
Most people think they know what management is. However, if they are asked to explain or describe the term management, they will give different answers. Some of them will say that it is a science; others will argue that it is an art; still others will vote for its being a practice. In addition to these answers, they will give examples of successful entrepreneurs like Jack Welch or world-class companies like Apple. It is also tough to explain differences between management and leadership. In many non-English-speaking countries, there is no term for leadership. This suggests that common words like management and leadership could have confused meaning for many of us. Therefore, it is important to discuss the defi nitions and functions of management and leadership.
recognise the types and origins of conflict in my workplace?
determine which is the best approach to managing conflict?
develop my skills to be more successful in managing conflict within my workplace?
analyse conflict situations and design an appropriate conflict management strategy?
Introduction
Dana (2001) claims that over 50 per cent of voluntary resignations from organisations can be directly attributed to unresolved conflict. Managers need to understand that conflict does not resolve itself; rather, it tends to gather intensity and energy. Gupta, Boyd and Kuzmits (2011, p. 395) have found that ‘employees spend as much as 42 percent of their time engaging in or attempting to resolve conflict and 20 percent of managers’ time is taken up by conflict-related issues’. Managing conflict is one of the prime responsibilities of managing staff and teams. It is critical, then, that managers are able to detect initial symptoms of conflict and adopt the most effective behaviours to resolve it (Vivar, 2006). In this chapter, different types and origins of conflict are discussed, as well as approaches to managing and resolving conflict.
Types and origins of conflict
Conflict is best defined as unresolved, protracted disagreements between individuals or groups that negatively impact on staff, organisations and working relationships.
understand the importance of ethics in the health manager’s decision-making process?
understand the different perspectives of the four schools of moral philosophy and how they can influence a health manager’s decision-making?
understand the concepts of moral courage and whistleblowing?
identify the main factors that influence ethical decision-making?
identify the eight steps in the decision-making framework?
Introduction
This chapter explores the notion of ethics and ethical decision-making frameworks in leading and managing health services. Chapter 1 outlined the four sets of skills, or functions, that every manager should possess, which are usually summarised under the acronym POLC: planning, organising, leading and controlling. With leadership being one of the four functions of management, it is important to understand both the management and the leadership aspects of ethical decision-making.
Ethical decision-making
For managers, ethical decision-making incorporates the development and dissemination of frameworks to assist staff to make decisions in line with the organisation’s direction and values, ensuring current staff understand these frameworks and recruiting staff who will work within the frameworks. For leaders, ethical decision-making is about taking action when it is needed, guiding others in working through difficult and complex decision-making processes and being a role model for other staff.
This book is a culmination of over 30 years of studying, practising, researching and observing leadership and management within the Australasian healthcare industry. Over this period, a range of industry and system factors has made working, managing and leading in health services more challenging and complex. These factors include greater scrutiny of the spending on health and the resulting outcomes, which has led to substantial reform initiatives; recognition of the importance of good governance and individual, organisational and system accountability; reliance on technology to support clinical and non-clinical healthcare decision-making; workforce shortages and role substitution; and better understanding of the ways to improve clinical safety and quality, and overall health outcomes. These factors have been driven by greater public interest and political scrutiny of the healthcare system, focused on quality and safety, access and equity, and the roles of the various levels of government and private operators. We have seen funders, regulators and other agencies requiring increasing levels of effectiveness, efficiency and better health outcomes.
To navigate the complexity of the industry and national and international factors, it is not enough to just be a good manager or a good leader. Being successful as a manager or a health professional requires a combination of both management and leadership skills and aptitudes. Leading and managing health services: An Australasian perspective provides a critical and concise overview of the important skills, aptitudes and content areas required to successfully lead and manage in a wide range of healthcare settings, no matter where you sit in the organisational structure. It provides insights into aspects of healthcare leadership and management applicable to Australasian health systems from highly experienced healthcare managers, leaders and academics.
develop my skills in respect to influencing tactics and strategies?
choose key influencing tactics and strategies that might be used in engaging internally in my organisation, as well as outside the organisation?
understand the importance of influencing strategically as a leader?
help my department and organisation achieve strategic goals through the use of influencing tactics and strategies?
Introduction
Everyone creates influence during their lives. This may be consciously or unconsciously, through communication, actions or behaviours. A person can be influential through who they are or what they do, such as through their creativity, dependency, vulnerability, position and example.
A critically important element of creating change, growth and renewal in health service organisations is the need for strong and effective leadership, of which influencing skills are an integral part. Healthcare organisations are complex entities with large numbers of internal and external stakeholders. Strategic influence is an important aspect of the leadership and management of these organisations, as leaders and managers rely on the ability to enhance the effectiveness of those working in all parts and levels of the organisations as well as those outside the organisations in the broader system. Healthcare managers can increase their impact and achievements through understanding and applying infl uence, and key aspects of healthcare leadership relate to the processes of influence.
reflect for action, reflect in action and reflect on action?
enhance my leadership abilities through reflective practice?
choose a reflective technique that works for me?
Introduction
Humberto Maturana (1998) claims that ‘to know with full confidence is the enemy of reflection. Reflection is when what we claim to know has the ability to step back and take another look’. Reflection is not a new concept in the health sciences. Contemporary conceptions of reflective practice are underpinned by the works of John Dewey (1910, 1916, 1933, 1938), Carl Rogers (1951, 1969), Paulo Freire (1995) and Donald Schön (1983, 1987). Today, reflection is a core component of healthcare education and is evident in the governing codes and guidelines that underpin professional practice in many health disciplines in Australasia. References to reflection appear in each health discipline’s code of professional practice or code of conduct, and effective and purposeful reflection is seen to be a core component of proficiency and ongoing professional development. Despite this, students, practitioners and healthcare leaders often struggle with reflection and critical reflective practice.
This chapter explores what is meant by reflection and critical practice, how to adopt a critically reflective attitude and foster skills in leadership, and how leaders can use critical reflection to support growth and change at personal, team and organisational levels.
identify the main sources of power in organisations?
critically analyse the positive and negative aspects of power and influence?
understand how political processes operate in organisations?
understand the consequences of political activities in organisations?
enhance my skills in the various tactics that can be used to shape political outcomes in organisations?
Introduction
Politics is an inevitable feature of organisation life, particularly in large bureaucratic organisations such as hospitals. Political activities arise when there is a lack of consensus about how an organisation should be managed. They are typically employed in an attempt to reconcile these divergent interests, which may be the result of competition for resources within the organisation, the pursuit of personal goals by individuals or a high level of uncertainty within the organisation.
Traditionally, political activities have been concerned with obtaining, developing and exploiting power to infl uence others in order to achieve desired outcomes (Pfeffer, 1981 ). Consequently, decisions shaped by political activities are not always rational - they do not always produce optimum outcomes, as individuals seek to satisfy their own wants and needs, often at the expense of others (Kumar & Ghadially, 1989). However, more recently, organisational behaviourists have conceptualised organisational politics as the perception that an individual or group is using infl uence and tactics to serve their own personal agenda (Ferris & Kacmar, 1992 ). One person may consider a co-worker’s behaviour to be a typical rational response, whereas another colleague may view the same behaviour as self-serving and highly political. Therefore, what is deemed to be political or normal behaviour ultimately depends on the opinion of the observer.
understand the purpose of networking and where it sits on the partnership continuum?
use the three levels of networking?
learn to appreciate the personal and organisational benefits of networking for leadership development?
enhance my skills in networking?
overcome the challenges to achieve the potential of intraorganisational and interorganisational networking?
Introduction
Networks, which are defined as groups or systems of interconnected people or things, can be formal and informal in nature and can be applied for different purposes. The capability to network can build influence in groups and organisations to support change or generate new ideas. The process of networking can be seen as a supportive system of sharing information and services among individuals, groups and organisations with a common interest. Networking can be applied at a personal level for career and leadership development, at an intraorganisational level for organisational development, and at an interorganisational level for research, knowledge management, process improvement and relationship development.
Definitions
Networking is a key leadership capability. Besides being a supportive system of sharing information, it can develop trust or sharing of turf between partners and is a useful strategy for individuals and organisations in the initial stages of working relationships. It is a useful skill in environmental scanning and managing change.
decide whether I should accept the proposed solution?
Introduction
Negotiation is an important skill for a healthcare manager. According to Mealiea and Latham (1996), many managerial activities, such as budget development, performance appraisal and review, planned change, team-building, complaint-handling and resource allocation require negotiating skills. Other authors have suggested that great leaders need to be great negotiators (Nanus & Dobbs, 1999). This chapter introduces negotiating theory and tactics that can assist readers to develop their skills for use in personal and professional negotiations.
Concepts
Once two or more parties agree to enter into a negotiation, they may use either an integrative approach (win–win) or a distributive approach (win–lose). An example of an integrative approach might be the creation of a preferred health service provider relationship, in which the provider wins because they have negotiated a steady cashflow, while the organisation also wins because it has the guarantee of health services of a certain quality at an agreed price. In integrative approaches, the negotiation involves more than one factor. In the example used here, while price would be an important factor, other factors such as volume, availability, quality and mode of delivery would also be included in the negotiation.
consider the Australian health workforce in relation to the structures, processes and trends in global health workforce-planning?
take into account workforce issues in the Australian healthcare sector in workforce-planning?
Introduction
Workforce-planning in the healthcare system is becoming a politically charged issue in many countries due to a looming shortage of various health professional groups and the subsequent costs and liabilities to governments hoping to generate improvements and efficiencies. In 2010 the World Health Organization (2010) released Models and tools for health workforce planning and projections in an attempt to optimise the sharing of countries’ experiences and best practices worldwide. Subsequently, both developing and developed nations are attempting to establish more sophisticated approaches to workforce-planning at national and regional levels (DalPoz, Gupta, Quain & Soucat, 2009; Dussault, Buchan, Sermeus & Padaiga, 2010; Lacerda, Caul Liraux, Spiegel & Neto, 2013).
The policy direction on health workforce sustainability set out in the World Health Organization’s (2008) code on international recruitment of health workers recommends countries aim for workforce self-suffi ciency with regard to workforceplanning. This requires a defi ned population base, such as a region or country, to facilitate the ongoing production of health workers at a volume sufficient to meet its own healthcare needs.
understand the meaning behind the models of emotional intelligence?
enhance my emotional intelligence?
improve my skills in self-awareness as a major component of emotional intelligence?
compare intelligence quotient and emotional intelligence?
use the concepts of emotional intelligence in the workplace to improve my own performance and that of staff working with me?
Introduction
Emotional intelligence (sometimes called EI or EQ) is a psychological construct that has attracted a lot of attention in the past 20 years. There have been many astonishing claims regarding emotional intelligence, many without scientific support. One popular claim is the notion that emotional intelligence is the most important factor for achieving success in life: in the workplace, at home or at school (Schulze & Roberts, 2005). Emotional intelligence – the ability to manage, understand, express and appraise emotions – is the theme of scientific controversy and investigation in spite of its huge appeal in business, education and popular literature.
Definitions
Intelligence has been defi ned in many different ways; however, most people associate it with the concept of testing for intelligence quotient (or IQ) and cognitive function. Throughout history, there have been attempts to recognise the importance of other forms of intelligence beyond the traditional intelligence quotient. In the 1920s, psychologist E. L. Thorndike (1920) coined the term social intelligence, referring to the skills of understanding and managing other people as well as engaging in adaptive social interactions and negotiating complex social relationships and environments. Sixty years later, developmental psychologist Howard Gardner (1983) described the idea of multiple intelligences, suggesting that all people have the capacity to possess different kinds of intelligences and that intelligence testing may be biased to certain types of individuals. He identified eight different types of intelligences, which may allow educators to identify differing strengths and weaknesses in students and provide suitable teaching and learning methods for them. Many experts believe that social intelligence, rather than quantitative intelligence, is important for quality of life and makes us what we are. It also appears that emotional intelligence can be developed rather than being biologically based (Goleman, 2000).
increase my understanding of the elements of critical thinking?
counteract the barriers that might limit my critical thinking?
improve my skills in decision-making?
identify common decision-making errors?
make better use of evidence in healthcare decision-making?
Introduction
It is important for managers and leaders to be able to critically analyse their own thinking and decision-making processes. Aspects of thinking and acting that managers and leaders should understand include their personal preferences, prejudices and cultural beliefs, and their personal motivations and desires. It is also important for them to understand the way these shape the biases they take to decision-making. To achieve success, leaders and managers require the ability to analyse, synthesise and establish their thoughts in a logical argument to reach a convincing conclusion.
Critical thinking
When faced with challenging management situations, the capacity to ask the right questions in order to clarify the situation helps managers to formulate appropriate responses. Critical thinking is a rational, systematic process that involves the assessment of statements and arguments, and the formulation of questions.
A statement claims that something is, or is not, the case and is not necessarily an argument. For example, three different statements that by themselves do not form an argument are: ‘Smoking tobacco is bad for your health’, ‘Clinicians without management education make poor managers’ and ‘Healthcare is too expensive’. Critical thinking helps us decide if there is suffi cient information to accept these statements.
synthesise strategic planning and management concepts to adopt strategic management in my position?
improve the strategic planning and management processes within my organisation?
plan the implementation of my organisation’s strategic plan for my area?
set and evaluate my achievement of meaningful goals?
Introduction
Effective strategic planning, implementation and management drive organisational performance (Rudd, Greenley, Beatson & Lings, 2008). Healthcare managers have recognised the increasing importance of strategic planning and management as the healthcare industry has become more dynamic and complex (Subramanian, Kumar & Yauger, 2011). However, development of feasible strategy can be difficult, and implementation of even well-developed strategy is often challenging. This chapter provides advice on leading and improving strategic planning and management in health service organisations.
Use of strategic planning
Strategic planning is a specific type of planning. Strategic planning was identified decades ago as essential for organisations competing in a variety of industries, with most of the seminal literature arising in the 1980s. More recently, strategic planning has been linked to successful operations in public sector healthcare organisations (Zuckerman, 2006 ) when applying previously developed concepts.
The Australian Commission on Safety and Quality in Healthcare ( 2011 ) defines 10 safety and quality standards for health services.