s health, efficiency, and effectiveness in effecting change, reaching decision, and taking advantage of the full potential of the organization's most valuable resource: its people (Boss, 1989, p. 18).
Historically, two major schools of thought have guided the development of organization and management theory: classical theory and human relations theory (Charns & Schaffer, 1983, p. 13). Classical theory was developed first and continues to have the greatest influence on management practice (Charns & Schaffer, 1983, p. 13), although its influence is under tremendous challenge from new theories, most notably the theory of total quality management to be discussed later. Classical theory is characterized by a mechanical-rational view of human organizations and a focus on the relationships between management and workers (Charns & Schaffer, 1983, p. 14). This is due to the influence of the Industrial Revolution and its resulting mechanistic, machinistic worldview. One of its most important principles is specialization. Classical theorists believed that grouping workers performing similar tasks would increase efficiency, accuracy, and skill development (Charns & Schaffer, 1983, p. 14). In addition, this theory yields organizations resembling the shape of a pyramid; a hierarchy of power to make decisions and to implement them was implicit in the classical model (Charns & Schaffer, 1983, p. 14). Finally, classical theory is concerned with authority-responsibility relationships. Responsibility is considered a corollary of authority. Generally, the classical theorists believed that one either has authority or not, authority is delegated from on high, superiors have superior knowledge and, therefore, should have more authority (Charns & Schaffer, 1983, p. 15).
Classical theory has had a major impact on management of health care organizations. In many instances, however, its underlying assumptions do not hold and its use is inappr...