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4 Managerial functions:4 Managerial functions:

1.1. PlanningPlanning provides the frameworkprovides the frameworkfor performancefor performance

2.2. OrganizingOrganizing in order to establishin order to establishorder and systematically achieve theorder and systematically achieve thegoalsgoals

3.3. DirectingDirecting focuses on leading thefocuses on leading thestaff in the most effective mannerstaff in the most effective mannerpossiblepossible

4.4. ControllingControlling evaluates performanceevaluates performance

against established standardsagainst established standards

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Henri Fayols ManagementHenri Fayols Management functions include:functions include:

1.1. PlanningPlanning2.2. OrganizationOrganization3.3. CommandCommand4.4. CoordinationCoordination5.5. ControlControl

Luther GulickLuther Gulick expandedexpandedFayols management functionsFayols management functionsinto: (POSDCORB)into: (POSDCORB)

1.1. Planning,Planning,2.2. OrganizingOrganizing3.3. StaffingStaffing

4.4. DirectingDirecting5.5. CoordinatingCoordinating6.6. Reporting , andReporting , and7.7. BudgetingBudgeting

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The Nursing Management ProcessThe Nursing Management Process

Organizing

Staffing

Directing

Planning

Controlling

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The Planning PhaseThe Planning Phase

1.1. Determining ObjectivesDetermining Objectives studystudyoutlineoutline

a.a. Influential factorsInfluential factors

b.b. Information needed for assessmentInformation needed for assessment

c.c. Sources of dataSources of data

d.d. Any special required studiesAny special required studies

2.2. Collecting DataCollecting Data a.a. Using existing dataUsing existing data

a)a) QuestionnaireQuestionnaire

b)b) InterviewInterview

c)c) observationobservation

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3.3. Developing the plan of actionDeveloping the plan of action

a.

a. S

pecify goals, objectives and policiesSpecify goals, objectives and policies

b.b. Phase activitiesPhase activities

c.c. Specify time spanSpecify time span

d.d. Provide method for evaluating progressProvide method for evaluating progress

4.4. Evaluating the planEvaluating the plan a.a. In line with a clearly stated objectiveIn line with a clearly stated objective

b.b. Indicates the procedural method of putting the plan intoIndicates the procedural method of putting the plan intoactionaction

c.c. Can be communicated effectivelyCan be communicated effectively

d.d. Is operational, professionally sound, and economicallyIs operational, professionally sound, and economicallyfeasiblefeasible

e.e. Represents an integrated whole and not an isolatedRepresents an integrated whole and not an isolatedentityentity

f.f. Allows for alternative action as changes occur andAllows for alternative action as changes occur andopportunities for new approaches ariseopportunities for new approaches arise

g.g. Wisely utilizes human talents, abilities, and skills to theirWisely utilizes human talents, abilities, and skills to theirmaximum potentialmaximum potential

h.h. Makes judicious use of material resources in order toMakes judicious use of material resources in order to

improve patient care and educate nursing staff.improve patient care and educate nursing staff.

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DECISION MAKINGDECISION MAKING-- Choosing options that areChoosing options that are

directed toward thedirected toward theresolution ofresolution oforganizational problemsorganizational problemsand the achievement ofand the achievement of

organizational goals.organizational goals.

Attributes of a decisionAttributes of a decisionmaker:maker:

1.1. Freedom to make theFreedom to make the

decision in questiondecision in question2.2. Capacity and ability toCapacity and ability to

make a wise decisionmake a wise decision

3.3. Will, motivation andWill, motivation andcommitment to choosecommitment to choose

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Types of decision:Types of decision:1.1. Considered decisionsConsidered decisions tend to be complicated and calltend to be complicated and call

for considerable reflection. Require interaction withfor considerable reflection. Require interaction withothers.others.2.2. Operational decisionsOperational decisions those made practically everyday.those made practically everyday.

They may prevent problems as well as solve them.They may prevent problems as well as solve them.3.3. SwallowSwallow hard decisionshard decisions often personallyoften personally

uncomfortable to make because they may result inuncomfortable to make because they may result in

discomfort or uneasiness for subordinates or others.discomfort or uneasiness for subordinates or others

.Decisions affecting relationships among people in anDecisions affecting relationships among people in an

organization.organization.4.4. TenTen--second decisionssecond decisions those we make during dailythose we make during daily

operation. Decisions that bring operation together, keepoperation. Decisions that bring operation together, keepit ready, alive and running well. The pressure to make itit ready, alive and running well. The pressure to make itquickly.quickly.

a.a. Determine if the situation really requires oneDetermine if the situation really requires oneb.b. Determine the major objective of the decision. Before leaping inDetermine the major objective of the decision. Before leaping in

and solving the problem, determine what you are trying toand solving the problem, determine what you are trying toaccomplish.accomplish.

c.c. After identifying the objectives, determine what alternatives areAfter identifying the objectives, determine what alternatives areavailableavailable

d.d. Once alternatives are considered, theOnce alternatives are considered, the last questionlast question concernsconcernsimplications.implications.

What could go wrong in the future if you pursue a given courseWhat could go wrong in the future if you pursue a given courseof action.of action.

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Decision making process:Decision making process:

1.1. Analyze and identify the situationAnalyze and identify the situation2.2. Develop alternativesDevelop alternatives

3.3. Compare alternativesCompare alternatives

4.4. Rate the riskRate the risk include theinclude theuncertainty factoruncertainty factor

5.5. Select the best alternative.Select the best alternative.Possibilities:Possibilities:

a.a. No alternative is desirableNo alternative is desirable

b.b. Merge two or more alternatives.Merge two or more alternatives.

c.c. The resources factorThe resources factor may swing yourmay swing yourdecisiondecision

6.6. Get into GearGet into Gear make it operative.make it operative.

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BUDGET:BUDGET:

Purpose OfBudgeting:Purpose OfBudgeting:1.1. Ensure the most effective use ofEnsure the most effective use of

scarce financial and nonscarce financial and non--financialfinancial

resources.resources.2.2. Coordinate efforts amongCoordinate efforts among

organizational departmentsorganizational departments

3.3. Establish a frame of reference forEstablish a frame of reference formanagerial decisionsmanagerial decisions

4.4. Provide a criterion for evaluatingProvide a criterion for evaluatingmanagerial performancemanagerial performance

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Types of Budget:Types of Budget:1.1. Manpower budgetManpower budget wages,wages,

salaries, and compensations paid tosalaries, and compensations paid topermanent employees, and fees topermanent employees, and fees totemporary or casual workers.temporary or casual workers.

2.2. Capital expenditure budgetCapital expenditure budget requires longrequires long--range plan. Purchaserange plan. Purchaseof land, equipment, buildings orof land, equipment, buildings orexpansion of existing buildingexpansion of existing building

3.3. Operating budgetOperating budget purchase ofpurchase ofminor equipments, repairs, suppliesminor equipments, repairs, suppliesand overhead expenses.and overhead expenses.

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The Budgeting Process:The Budgeting Process:

Phase 1Phase 1 PlanningPlanning

set shortset short-- and longand long-- term goalsterm goals

Form a budget committeeForm a budget committee

Prioritize objectivesPrioritize objectives

Analyze past performancesAnalyze past performances

Predict future costs and revenuesPredict future costs and revenues

Develop budget guidelinesDevelop budget guidelines

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Phase 2Phase 2 PreparationPreparation

1.1. Translate objectives into projectedTranslate objectives into projectedcosts and revenuescosts and revenues

2.2. Write justifications for all requestedWrite justifications for all requested

expensesexpenses3.3. Eliminate lowest priority objectivesEliminate lowest priority objectives

as necessaryas necessary

4.

4. P

resent proposed budgetPresent proposed budget

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Phase 3Phase 3 Modification and approvalModification and approval

Prepare preliminary master budgetPrepare preliminary master budgetfrom all department requestsfrom all department requests

Compare projected costs withCompare projected costs with

estimated revenuesestimated revenues Eliminate lowest priority items untilEliminate lowest priority items until

budget is balancedbudget is balanced

Approve final master budgetApprove final master budget

Communicate final budget to allCommunicate final budget to alldepartmentsdepartments

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Phase 4Phase 4 MonitoringMonitoring

1.1. Prepare monthly summaries ofPrepare monthly summaries ofdepartmental expenses anddepartmental expenses andrevenuesrevenues

2.2. Compare actual expenses withCompare actual expenses withbudgeted expensesbudgeted expenses

3.3. Investigate any variance above 5%Investigate any variance above 5%

4.4. Readjust budget and/or improveReadjust budget and/or improveperformance as necessaryperformance as necessary

5.5. Continue to monitor on monthlyContinue to monitor on monthly

basis.basis.

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ORGANIZINGORGANIZING

-- Is one way in whichIs one way in whichnursing managementnursing managementcoordinates the variouscoordinates the variousactivities of a departmentactivities of a department

or a unit so that the staffor a unit so that the staffcan get its work done in ancan get its work done in anorderly fashion.orderly fashion.

-- Having qualified peopleHaving qualified peopleand the right materials,and the right materials,information, andinformation, andequipment needed to dealequipment needed to dealwith contingencies.with contingencies.

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6 Steps in organizing:6 Steps in organizing:

1.1. EstablishingEstablishing enterprise objectivesenterprise objectives

2.2. FormulatingFormulating supporting objectives, policies andsupporting objectives, policies andplansplans

3.3. IdentifyingIdentifying andand classifyingclassifying activities necessaryactivities necessaryto accomplish the objectivesto accomplish the objectives

4.

4. G

roupingG

rouping these activities in the light of humanthese activities in the light of humanand material resources availableand material resources available

5.5. DelegatingDelegating the head of each group to performthe head of each group to performthe activitiesthe activities

6.6. Trying together theTrying together the group horizontally andgroup horizontally and

verticallyvertically, through authority relationships and, through authority relationships andinformation flows.information flows.

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1.1. Development of mission, philosophy, andDevelopment of mission, philosophy, andobjectivesobjectives

2.2. Development of organizational charts.Development of organizational charts.

-- indicates who has the legitimate powerindicates who has the legitimate powerto make decisions and who should giveto make decisions and who should give

and receive directionsand receive directions3.3. Development of job descriptionsDevelopment of job descriptions

-- a written account of the organizationala written account of the organizationalrelationships, responsibilities, and skillsrelationships, responsibilities, and skills

required for appointment and a resumerequired for appointment and a resumeof duties delegated to the position by topof duties delegated to the position by topmanagement.management.

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Organizational StructureOrganizational Structure

-- A framework in which theA framework in which themanagement process is carried outmanagement process is carried outin an organizationin an organization

Designed to:Designed to:

1.1. show clearshow clear lines of authoritylines of authority,,

2.2. flow of communicationflow of communication andand

3.3. relationshipsrelationships among departments,among departments,andand

4.4. toto pinpointpinpoint person/s responsibleperson/s responsible

and accountable.and accountable.

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Types of organizational structures:Types of organizational structures:

1.1. FormalFormal planned and made publicplanned and made public

a.a. Hierarchic or bureaucraticHierarchic or bureaucratic

b.b. Adaptive or organicAdaptive or organic

2.2. InformalInformal unplanned and covertunplanned and covert

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ORGANIZATIONAL CHARTSORGANIZATIONAL CHARTS

Is a drawing that shows how the parts of anIs a drawing that shows how the parts of anorganization are linked.organization are linked.

1.1. Outlines administrative controlOutlines administrative control

2.2. Used for policy making and planningUsed for policy making and planning3.3. Used to evaluate strengths andUsed to evaluate strengths and

weaknesses of the present structureweaknesses of the present structure

4.4. Shows relationships with otherShows relationships with other

departments and agenciesdepartments and agencies5.5. Used to orient new personnel to theUsed to orient new personnel to the

organization.organization.

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Types ofOrganizational ChartsTypes ofOrganizational Charts

1.1. Vertical orVertical or chartscharts depicts the chief executive at thedepicts the chief executive at thetop with lines of authority flowing down the hierarchy.top with lines of authority flowing down the hierarchy.

2.2. Horizontal or FlatHorizontal or Flat chartchart depicts the manager at thedepicts the manager at thetop with a wide span of control. Employees in this charttop with a wide span of control. Employees in this chartreport to one manager.report to one manager.

3.3. Circular or concentricCircular or concentric chartchart depicts top managementdepicts top managementin the center represented by the Board of Trustees orin the center represented by the Board of Trustees orDirectors, Chief ofHospital or Hospital Administrator andDirectors, Chief ofHospital or Hospital Administrator andthe ChiefNurse. This chart shows the outward flow ofthe ChiefNurse. This chart shows the outward flow offormal authority which is from center moving outward.formal authority which is from center moving outward.This minimizes or reduces the implication of status orThis minimizes or reduces the implication of status orposition.It represents a conceptual rather than aposition.It represents a conceptual rather than a

functional, view of the organization.functional, view of the organization.

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Directress

Dean

Clinical Coordinator

Clinical Instructors

RLE Supervisor

Clinical Instructors

Horizontal or Flat chart

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Line and staffrelationship:Line and staffrelationship:

1.1. Line authorityLine authority a chain of command, aa chain of command, amanagermanager--staff , associate or leaderstaff , associate or leader--follower relationship. The managerfollower relationship. The managerdelegates authority to an associate whodelegates authority to an associate who

in turn delegates authority to the staff.in turn delegates authority to the staff.Line authority is depicted by aLine authority is depicted by a solid linesolid lineon an organizational chart. Theon an organizational chart. Themanager in this line has the right to givemanager in this line has the right to giveorders, demand accountability, andorders, demand accountability, anddiscipline those who violate rules anddiscipline those who violate rules andpolicies.policies.

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2.2. Staff authorityStaff authority refers to a form ofrefers to a form of

influence by a specialized individualsinfluence by a specialized individualswho hold unique roles in thewho hold unique roles in theorganization and who, while notorganization and who, while not

directly responsible for employees,directly responsible for employees,are involved with the outcome of theare involved with the outcome of theemployees work. Staff authority isemployees work. Staff authority isdepicted by adepicted by a dashed linedashed line on anon an

organizational chart.organizational chart.

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Principles ofOrganization:Principles ofOrganization:

1.1. CommunicationCommunication communicate withcommunicate withdifferent people at different levels. It isdifferent people at different levels. It ispart of your responsibility.part of your responsibility. Guidelines to an effective communication:Guidelines to an effective communication:

a)a) Clearly define in writing the nature of eachClearly define in writing the nature of eachposition, its duties authority, responsibilities, andposition, its duties authority, responsibilities, andrelationships with other positions and make itrelationships with other positions and make itavailable to all concerned.available to all concerned.

b)b) Make clear the line of authority, from the supremeMake clear the line of authority, from the supremeauthority to every individual in the group.authority to every individual in the group.

c)c) Ensure that the channels of command are notEnsure that the channels of command are notviolated by staff units.violated by staff units.

d)d) Never criticize a subordinate in the presence ofNever criticize a subordinate in the presence ofexecutives or employees of equal or lower rank.executives or employees of equal or lower rank.

e)e) Promote the interests of those under you whenPromote the interests of those under you whenreporting to your superiors.reporting to your superiors.

f)f) Make and keep adequate reports.Make and keep adequate reports.

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2.2. Unity of commandUnity of command assign workersassign workers

to be responsible for a single areato be responsible for a single areaand report only to one supervisor.and report only to one supervisor. Observe the following:Observe the following:

a.a. Centralize authority and responsibility in theCentralize authority and responsibility in the

hand of the organizationhand of the organizationb.b. See that no person occupying a single position inSee that no person occupying a single position in

an organization is subjected to definite ordersan organization is subjected to definite ordersfrom more than one source.from more than one source.

c.c. Know whom you report to and who reports toKnow whom you report to and who reports to

you.you.

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3.3. Span of controlSpan of control the number ofthe number ofemployees that one supervisor managesemployees that one supervisor managesin an organization.in an organization. Factors to consider to manage effectively andFactors to consider to manage effectively and

efficiently:efficiently: Level of managerial experience of the managerLevel of managerial experience of the manager

Skill level of the employeesSkill level of the employees

Stability of the work unit or departmentStability of the work unit or department Level of morale among the employeesLevel of morale among the employees

Type of work managedType of work managed

To determine the span of control:To determine the span of control: Limit the number of subordinates that you canLimit the number of subordinates that you can

effectively inspire, animate, direct, and coordinateeffectively inspire, animate, direct, and coordinate Note that too few immediate subordinates result inNote that too few immediate subordinates result in

oversupervision; too many in undersupervisionoversupervision; too many in undersupervision

Be responsible for the actions of subordinates.Be responsible for the actions of subordinates.

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4.4. Delegation of authorityDelegation of authority some amountsome amount

of participation among lower levelof participation among lower levelmanagers.managers.

To be efficient in delegating:To be efficient in delegating:

Let a few people accomplish the taskLet a few people accomplish the task

Systematically align all personnel activities so thatSystematically align all personnel activities so that

you can delegate the authority and responsibility foryou can delegate the authority and responsibility forspecific and wellspecific and well--defined duties.defined duties.

Never give orders to subordinates who are under aNever give orders to subordinates who are under aresponsible superior.responsible superior.

Do not change the scope of responsibility of a positionDo not change the scope of responsibility of a positionwithout a definite understanding of the effects on allwithout a definite understanding of the effects on allpersons concerned.persons concerned.

See to it that there is no overlapping of authority (twoSee to it that there is no overlapping of authority (twoor more supervisors having the same control of theor more supervisors having the same control of thesame function)same function)

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5.5. Similar assignmentsSimilar assignments responsibilitiesresponsibilitiesassigned to a particular unit of anassigned to a particular unit of anorganization should be clearorganization should be clear--cut and wellcut and wellunderstood.understood. Guidelines to follow:Guidelines to follow:

Do not assign a function to more than oneDo not assign a function to more than one

independent unit of the organization. Overlappingindependent unit of the organization. Overlappingresponsibilities causes confusion and delayresponsibilities causes confusion and delay

Assign definite and clear cut responsibilities to eachAssign definite and clear cut responsibilities to eachmember of the organizationmember of the organization

Never permit an organization to grow so elaboratelyNever permit an organization to grow so elaboratelyas to hinder work assignmentas to hinder work assignment

Assign specific, clearAssign specific, clear--cut, and similar functions tocut, and similar functions tosubordinates.subordinates.

Assign every necessary function to a specificAssign every necessary function to a specificindividual.individual.

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6.6. Unity of purposeUnity of purpose definite plansdefinite plansmust be formulated based upon themust be formulated based upon theobjectives, policies, standards andobjectives, policies, standards andwork procedures previouslywork procedures previouslyaccepted by the organization.accepted by the organization.

Every component in an organizationEvery component in an organizationshould work toward unity of effortshould work toward unity of effortand authority and thatand authority and thatresponsibility for each action shouldresponsibility for each action should

be decentralized to the units andbe decentralized to the units andindividuals responsible for theindividuals responsible for theactual performance of operations.actual performance of operations.

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4.4. Organizing client careOrganizing client care--

4 methods to organize and deliver4 methods to organize and delivernursing care to clients:nursing care to clients:1.1. Case systemCase system one nurse is assigned to give totalone nurse is assigned to give total

nursing care to a single client while she is on duty.nursing care to a single client while she is on duty.(ICU)(ICU)

2.2. Functional systemFunctional system based on the concept ofbased on the concept ofdivision of labor.Assigned to do specific tasks ondivision of labor.Assigned to do specific tasks onseveral patients. (Medicating nurse, treatmentseveral patients. (Medicating nurse, treatmentnurse)nurse)

3.3. Team nursingTeam nursing team provides total nursing care toteam provides total nursing care toa specific client or patient. Team lead coordinates,a specific client or patient. Team lead coordinates,supervise and ensure the full participation andsupervise and ensure the full participation andcooperation of her cocooperation of her co--workers in planning andworkers in planning anddelivery of care to the patients.delivery of care to the patients.

4.4. Primary nursingPrimary nursing give total care to 4give total care to 4 6 patients.6 patients.Responsible for the care 24 hours a day throughoutResponsible for the care 24 hours a day throughoutthe period of hospitalization.Develop and updatethe period of hospitalization.Develop and update

nursing care plans, perform care and patientnursing care plans, perform care and patientteaching and provide discharge planning.teaching and provide discharge planning.

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TIME MANAGEMENT /MANAGING TIMETIME MANAGEMENT /MANAGING TIME

-- Is based on the principles ofIs based on the principles ofcommunicating, planning andcommunicating, planning anddelegating.delegating.

Principles of time management:Principles of time management:

1.1. Effective communicationEffective communication

2.

2.

The ability to plan effectivelyThe ability to plan effectively3.3. DelegationDelegation

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Time Wasters:Time Wasters:

A.A. External sources:

External sources: Interruptions by phone, staff, visitors, etcInterruptions by phone, staff, visitors, etc

Doing work that could be delegatedDoing work that could be delegated

Doing unnecessary paperworkDoing unnecessary paperwork

SocializingSocializing

B.B. Internal sources:Internal sources: Lack of objectivesLack of objectives

Failure to establish prioritiesFailure to establish priorities

Inability to make decisionsInability to make decisions

Failure to plan and organize workFailure to plan and organize work Inability to delegateInability to delegate

procrastinationprocrastination

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Time Savers:Time Savers:

Learning to set priorities and objectivesLearning to set priorities and objectives

and organizing workand organizing work Allowing coAllowing co--workers to perform dutiesworkers to perform duties

listed in job description or teaching themlisted in job description or teaching them Avoiding interruptions whenever possibleAvoiding interruptions whenever possible

Avoiding wasted motionsAvoiding wasted motions learning to belearning to bedexterousdexterous Evaluating all paper work, procedures,Evaluating all paper work, procedures,

etc, and eliminating unnecessary ones.etc, and eliminating unnecessary ones. Avoiding procrastinationAvoiding procrastination Using computer, tape recorder, etcUsing computer, tape recorder, etc

whenever possiblewhenever possible Using the waste basket.Using the waste basket.