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ORGANIZATION

A group of person with specific responsibilities who are acting together for the achievement of a specific purpose determined by the organization (Huber, 2000, p.454)

ORGANIZING

Arranging of component parts into functional whole

Determination of how it (PLAN) will be accomplished

PURPOSE - to coordinate activities so that a goal can be achieved

I. ORGANIZATIONAL THEORY

Aims to understand the structure within organizations

The study is intended to find out if there is a superior method of structuring organizations, or if it varies based on the situation

Purpose: solving problems, maximizing efficiency and productivity, and meeting the needs of members

CATEGORIES:

One of the oldest theories regarding organizational structure

Focus: structure of the formal organizations: if examined the efficiency of the organization as a by-product of the

Concept: people of an organization will be productive if they given a well defined task to complete.

A. Classical Organization theory (1980's)

Taylorism (Scientific Time Studies) reducing process time and worked at its most basic level, breaking down each job into component parts.

1. Scientific Management theory

Weber: father of organization all theory

Explains the importance of hierarchy, rules, procedures and making impartial personnel decisions.

WEBER'S MODELdivision and specialization of laborchain of commandorganizational structurespan of control

2. Bureaucratic Approach (Max Weber)

Set of planning, organizing, commanding and coordinating functions

3. Administrative approach (Henri Fayol)

CATEGORIES:

One of the oldest theories regarding organizational structure

Focus: structure of the formal organizations: if examined the efficiency of the organization as a by-product of the

Concept: people of an organization will be productive if they given a well defined task to complete.

B. Neoclassical theory (HUMANISTIC THEORY)

Became popular in the 1930'sPlaced emphasis on cooperation and

participation in the workplace (Sullivan and Decker, 2001)

Key factor: motivation: a motivated employee will produce better output in the job setting

Links with a democratic style of leadership

B. Neoclassical theory (HUMANISTIC THEORY)

Focuses on social aspects if organizational design

Views social relationships, group pressure, and search for personal fulfillment as motivators

Says formal authority only works with willing participants

B. Neoclassical theory (HUMANISTIC THEORY)

CATEGORIES:

Organization is an adaptive system that adjust to changes in its environment

C. Modern Theory

System is interrelated parts arranged in a unified whole

Systems can be open or closedOrganization is a recurrent cycle of

input-throughput-ouputManager is the catalyst for the

process

1. System Theory

Performance is enhanced by matching the organization's structure to its environment

Environment includes people, objects, and ideas outside the organization that influence it

Optimal form of the organization depends on the environment in which it operates

2. Contingency Theory

Organizations are living, self-organizing systems that are complex and self-adaptive

Creativity and flexibility are necessary to adapt to change

Leader’s roles is to build resilience, maintain balance and encourage creativity

3. Chaos Theory

Random events interfere with expectations

No linear cause and effect to explain outcomes

The system interacts and adapts to change

Managers must encourage the flow of information in all directions, not just top to bottom

4. Complexity Theory

II. STEPS IN ORGANIZING

• 6 steps in organizing process1. Establish overall objectives2. Formulate supporting objectives,

policies and plans3. Identify and classify activities

necessary to accomplish the objectives4. Group the activities in light of the

human and material resources available and the best way of using them under the circumstances

II. STEPS IN ORGANIZING

5. Delegate to the head of each group and the authorities necessary to perform the activities

6. Tie the groups together horizontally and vertically, through authority relationships, and information systems

III. ORGANIZING CLIENT CARE/ MODALITIES OF CARE

• Manner in which nursing care is organized and provided

Oldest mode of organizing patient care

Nurses assume total responsibility during their time on duty for meeting all the needs of assigned patient

Care was provided in the patients home and the nurse was responsible for cooking, cleaning and other activities specific to the patient and family (on top of nursing care)

A. Total patient care

ADVANTAGES DISADVANTAGES

• Provided with nurses high autonomy and responsibility

• Each nurse caring for the patient can modify the care regimen, which can lead to different approaches to care shift

• The lines of responsibility is clear with the patient (theoretically) receiving holistic and ungrateful and during the nurses time on duty

• Requires highly skilled personnel

• Trust is developed between the RN and the patient’s family

• May cost more than other forms of care

• The nurse inadequately prepared or too inexperienced to provide total care for the patient

Patient careThe RN plans

organizes, and performs all care

RN 8 hour shift

Developed after the WW II as a result of severe nursing shortage when ancillary personnel were needed to assist inpatient care

Relatively unskilled workers were trained to perform certain simple tasks rather than care for specific patients

RN’s, LPN’s, and UAP’s are assigned different tasks

RN’s assess patients

B. Functional Nursing

Other staff give baths, make beds, take vital signs, administer treatments

B. Functional Nursing

ADVANTAGES DISADVANTAGES

• Staff become efficient at performing assigned tasks

• Uneven continuity

• Time saving • Lack of holistic understanding of patient

• Problems with follow-up

Evolved in the 1950’s to improve patient satisfaction

RN as leader coordinates care of group patients

Goal was to reduce fragmented care Common use areas- most impatient

and outpatient areas Team of nursing personnel provides

total care to a group of patients RN leads team that may include

other RN’s, LPN’s and UAP’s

C. Team Nursing

Team leaders must be skilled in delegating, communicating, problem solving

All members are effective teams are good communicators

C. Team Nursing

NURSE MANAGER

RN team leader, LPN’s/LVN’s, Nursing

assistants

RN team leader, LPN’s/LVN’s, Nursing

assistants

Assigned patient care

Assigned patient care

ADVANTAGES DISADVANTAGES

• High-quality, comprehensive care with a proportion of ancillary staff

• Continuity suffers if daily team assignments vary

• Team members participate in decision making and contribute their own expertise

• Team leader must have good leadership skills

• Insufficient time for planning and communication

• Requires a team spirit and commitment to succeed

Modular nursing uses a mini team approach with members sometimes being called care pairs

The model’s goal is that every area will serve the same number of patients and the patient in the same room will always be assigned to one nurse

D. Modular Nursing (District Nursing)

NURSE MANAGER

Geographic Patient UnitPatient care

team:RN’s

LPN’s/LVN’sNurse aides

Meds Supplies Linens

ADVANTAGE DISADVANTAGE

• Continuity of care is improved

• RN more involved in planning and coordinating care

• Geographic closeness and efficient communication

• Long corridors not conducive to modular nursing

The primary nurse assumes 24-hr responsibility for planning the care of one or more patients from admission to discharge

During work hours the primary nurse provides total direct care for that patient

When the primary nurse is not on duty, associate nurses follow the plan of care established by the primary nurse

E. Primary Nursing

Primary Nurse 24-hour

responsibility for planning, directing, evaluating patient

care

Physician and other members of

the health care team

Associate nurses provide care

when primary nurses is off duty

Patient

ADVATAGE DISADVANTAGE

• Establish rapport with patient • More RN needed; not cost effective

• High-quality, holistic patient care

• RN must accept 24-hour responsibility

• RN feels challenged and rewarded

• Primary nurse must be able to practice with high degree of responsibility autonomy

RN and partner( UAP, LPN, or less experienced RN) work together on same schedule with same group of patients

F. Practice Partnership

ADVANTAGE DISADVANTAGE

• Improved continuity of care and accountability for care

• Decreased ratio of RN’s to nonprofessional staff

• Potential for junior team members to assume much responsibility

IV. TIME MANAGEMENT

Time was absolute and that it occurred whether the universe was there or not (Newton)

Time has no independent existence apart from the order of events by which people measure it- Einstein (Smith 1994)

IV. TIME MANAGEMENT

Principles of Management Time management is based on the

principles of:A. Communicating: effective

communication facilitates time management

B. Planning: ability to plan effectively is essential to the effective use of time

C. Delegation: empowers a subordinate to make decisions.

IV. TIME MANAGEMENT

Time Management TechniquesA. Organization: organize and systematize

things, task and people.B. Keep focused on goals assembled a

prioritized “to do” lists based by goals daily

C. Tool usage: Use tools such as the bar code scanner

D. Time management plan: Develops a personal time management plam immediately

IV. TIME MANAGEMENT

Time Wasters VS. Time SaversTIME WASTERS:• Meetings without a clear purpose• Goals objectives, and priorities that are

not measurable• Plans without time parameters• Disorganized files and papers• Time logs, not analyzed• Tasks/activities that can be delegated• Waiting for others• Inability to say no

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IV. TIME MANAGEMENT

TIME SAVERS:• Learning to set priorities and objectives

organizing work• Allowing co-workers to perform duties

listed in job description or teaching them

• Avoiding interruptions whenever possible

• Avoiding procrastination• Evaluating all paper work and

procedures

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IV. TIME MANAGEMENT

D. Time Management Strategies• Know how to spend your time• Set priorities• Use a planning tool• Get organized• Schedule your time appropriately• Delegate: get help from others• Stop procrastinating• Manage external time wasters• Avoid multi-tasking• Stay healthy

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IV. TIME MANAGEMENT

E. Advantage of Time management• Gain time• Motivates and initiates• Reduces avoidance• Promotes review• Eliminates cramming• Reduces anxiety

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