The Appreciation of Numerical Ideas by Health Service Managers

Abstract

This research originated from the Department of Health and Social Security's concern at the presentation of numerical ideas on management courses since health service managers complained that, unlike most other subjects, the numerical ideas presented were irrelevant to their work. The intention was to develop teaching materials, to evaluate their use with health service managers, and to suggest alternative approaches to the Department. As the research progressed, it became clear that the numerical ideas presented on courses had been selected without reference to the actual ways health service managers used the ideas in their work. Therefore, an analysis was made of the factors influencing the teaching of numerical ideas, which indicated that the actual use of numbers in health service management differed considerably from the views expressed in the literature on the subject. A model of the use of numbers in health service management consistent with their actual use was proposed and justified by reference to detailed studies of three areas of health service activity. A hypothesis was proposed concerning the teaching methods which would encourage managers to transfer numerical ideas learnt in one context to other job-related situations. The use of such methods highlighted the need to understand what is meant by an ‘appreciation’ of numerical ideas by health service managers. A model of such appreciation was therefore proposed based on Vickers' analysis of social systems; this was shown to be consistent with the actual use of numbers in management and the evidence of the use of the teaching materials developed. Finally, the following are reviewed: the reasons for training managers in the use of numerical ideas, the criteria for judging the success of such training, and other issues not directly related to training but necessary if training is to be successful. Suggestions are also made about the content of numerical sessions, and the learning theories useful as a basis for constructing teaching methods are reviewed.