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June 15, 2012 9:00 am
Conceptual Paradigm of Leadership & Management
Effective & Efficient Leadership
Theories & Principles
Management Process & Functions
- Usually established at the beginning of any planned undertaking - A desired aim or condition toward which one is willing to work. - Generally provides direction to an individual, group or organization.
Goals may be: INDIVIDUAL GOALS . GROUP GOALS – it pertains to what the individual members of the group or organization desire to achieve as a group or an organization.are personal goals. . usually based on one’s desires in life. ORGANIZATIONAL GOALS .are management goals of an organization that are established to justify its existence.
Rewarding .Efficient & Effective R .Time Bounded E .Specific M .Relevant T .GOALS GOALS MUST BE: S .Measurable A .Attainable R .
Organizational Theory 4.THEORIES & PRINCIPLES • Various theories & principles of leadership & management help provide the basis for accomplishing a goal. Systematic Management Theory 3. Scientific Management Theory 2. Hawthorne Effect 6. Social Process 5. Management by Objectives . • THEORIES • 1.
Managerial Roles 9. Management as Decision Making 8.THEORIES • • • • • • 7. Theory of X & Theory of Y 12. Hierarchy of Needs 10. Theory Z . Motivation Hygiene Theory 11.
MANAGEMENT PROCESSES & FUNCTIONS • It is the application of creative problem solving strategies. – 4 functions of management • • • • Planning Organizing Directing controlling .
-Performing or functioning in the best possible manner with the least waste of time and effort.EFFECTIVE & EFFICIENT • Leadership should be efficient & effective • EFFICIENT – ability to minimize the use of time and resources in achieving organizational objectives. • EFFECTIVE – ability to determine whether appropriate objectives are met. .
manager • 4. • 7 M’s • 1. machine 7. men 6.RESOURCES • Attainment of a goal usually precedes the use of resources. methods • 2. money 5. moment • 3. materials .
pre determining a course of action in order to arrive at a desired result. when to do it and who is to do it. • Deciding in advance what to do. • Concerned with defining goals for future organizational performance and deciding on the tasks and resources to be used in order to attain those goals.NURSING MANAGEMENT PROCESS • 1. PLANNING – the selection and sequential ordering of tasks required to achieve an organizational goal. how to do a particular task. • . .
COMPONENTS OF PLANNING PLANNING What to do? How to do it? Who is to do it? .
implementation and evaluation of change as new facts become known. • PROCESS OF GOOD PLANNING evaluation assessment “A well plan is half done” implementation Establishment of goals & objectives .GOOD PLANNING • – involves a continous process of assessment of goals and objectives.
bickering.POOR PLANNING • Is the failure to set goals make assessments or provide for implementation or to anticipate any possible change in circumstances. “Failing to plan is planning to fail” . others are underworked • Skilled nurses doing unskilled work • Nurses are fumbling on jobs for which they have not been trained • There is quarreling. buck-passing and confusion. INDICATORS OF POOR PLANNING • Delivery dates are not met • Machines are idle • Material is wasted • Some nurses are overworked.
philosophy & clearly defined objective of the organization. Planning utilizes all available resources Planning must be precise in its scope & nature Planning should be time. 1. . 3. 5.PLAN • Is a living document which can be changed based on the prevailing circumstances. 6.bounded Projected plans must be documented 2. 4. PRINCIPLES OF PLANNING Planning is always based & focused on the vision. Planning is a continous process. Planning should be pervasive within the entire organization. 7. mission.
6. Planning helps in coping with crises. Planning provides basis for control. 3. 5.IMPORTANCE OF PLANNING 1. 9. Planning is necessary for effective control . Planning is cost-effective. Planning leads to the realization of the need to change. . Planning provides for effective use of available resources. 4. 7. 2. Planning is based on past & future activities. Planning leads to the achievement of goals & objectives. 8. Planning gives meaning to work.
Include the most practical methods for achieving each objective. Develop a logical sequence of activities & time.CHARACTERISTICS OF A GOOD PLAN 1. Pervade the whole organization. Be precise with clearly. 2. 6. Develop actions that are flexible & realistic in terms of avail. Personnel. Indicate priorities. facilities & time.worded objective. 7. equipment. including desired results & method for evaluation. 5. . 3. Be guided by policies. 4. procedures affecting the planned action.
Objective/ goal setting 3. Means identification 4. Evaluation .STEPS IN PLANNING 1. Decision making 6. Tasking 7. Debate on proposals 5. Diagnosis 2.
more typically 3 to 5 years. It deals with at least one of the 3 questions: 1. What do we do? 2. How do we excel? . and making decisions on allocating its resources to pursue this strategy. For whom do we do it? 3. – It is a process for determining where an organization is going over the next year or.TYPES OF PLANS • STRATEGIC PLAN – the process of defining strategy or direction.
generally shorter in time frame -involve the middle & lower level managers • CONTINOUS OR ROLLING PLANS – involves mapping out the day to day activities.• OPERATING PLANS – pertain to activities in specific departments or organization. . . .this is the task of the staff nurse who has to devise & implement NCP for pts.
VISION – it outlines the organization’s future roles and functions. allows everyone to understand why an organization exists. what the organization want to be.KEY COMPONENTS OF STRATEGIC PLANNING 1. . it is a long term view and concentrates on the future. MISSION – defines the fundamental purpose of the organization. mission. Defining and understanding the vision. values & strategies of the institution.
FORECASTING – is looking into the future. weighing the unknown values in the situation and using them as basis for an educated guess about the future.PHILOSOPHY – statement of beliefs & values that direct the organization’s life or practice. . VALUES – are beliefs that are shared among the stakeholders of an organization.
Set objectives/ goals and determine results desired OBJECTIVES – is the backbone of one’s goals and philosophy .2. these are the battle plan GOALS – a specific aim to target to be attained within a short time span of a year. the end to be accomplished .
3.analysis of the internal factors attributed to the organization and external factors beyond control of the organization. S W O T • Distinct • Efficient • Skilled • Market share • Superior reputation • Vulnerability • Adequacy of resources • Technologies available • Possible new customers • Status of competitors • Possibilities of growth • New competitors • Shortage of resources • Changing needs of the customers • New regulations . Conduct a situation analysis ( SWOT ).
set the time frame STRATEGY – it is the course of action created to achieve a long term goal. Develop & schedule strategies.methods or procedure PROGRAMS – are activities put together to facilitate attainment of some desired goals. TIME MANAGEMENT – finding the most efficient way to do it. . techniques. the art of the general”. programs/ projects/activities.4. ( called as the road map).
monthly. 4. Set goals and objectives and write them down. Close your door when you need to concentrate.making skills 12. write waht you expect to accomplish yearly. logs or journals. Develop effective decision. Organize your workspace so it is functional. define the purpose clearly before starting 10. weekly or daily.TIME SAVING TECHNIQUES. executive planners. 6. DEVICES & METHODS TO BETTER USE OF TIME 1. . 2. 11. Take rest breaks and make good use of your spare time. Learn to delegate. Conduct an inventory of your activities. 8. 7. With the use of calendars. Devote few minutes at the beginning of each day for planning. In a meeting. 3. Break down large projects into smaller parts 5. Take or return phone calls during specified time. 9.
EFFECTS OF MISMANAGEMENT OF TIME • • • • • Work is rushed and becomes substandard Deadlines are missed Bad choices are made Employees suffer from fatigue Employees personal lives and relationships are adversely affected .
material and other resources. allocation of resources.5. a financial “road map” and plan which serves as an estimate of future costs and a plan for utilization of manpower. monitoring & controlling cost & meeting expenses. for planning. – A plan for future activities expressed in operational as well as financial or monetary terms. a tool.is the annual operating plan. . Preparing the Budget • BUDGET. BUDGETING – systematic financial translation of a plan.
. OPERATING BUDGET – composed of the revenue and the expense budget. 2. 4. CASH BUDGET – amount of money received. planned cash receipts & disbursements. cash balances. REVENUE BUDGET – summarizes the income which management expects to generate during the planning period. 3. CAPITAL BUDGET – consists of accumulated data for fixed assets that are expected to be acquired during the budgeted period.COMPONENTS OF BUDGET 1.
Practice by ANSAP 1981 . Establishing Nursing standards. policies & procedures STANDARDS – indicate the minimal level of achievement acceptable to meet the set objectives.6. • Nursing Standards Example: Standards of Nsg.
care of patients . • Nursing Service Policies Example : Admissions – receiving. or guides or basic rules that govern action at all levels in the organization. notifying doctor.• POLICIES – are defined as standing plans used repeatedly. consent.
• PROCEDURES – are defined as a more specific guide to action than policy. • Nursing Procedures Example: Discharge of Patient .
- it is the process of establishing formal authority. - it involves setting up the organizational structure through identification of groupings, roles & relationships. - it includes developing job descriptions by defining the qualifications and functions of personnel.
– consists of the structure & process which allow the agency to enact its philosophy & utilize its conceptual framework to achieve its goal. – it is the backbone of management. – it is the form of every human association for the attainment of a common purpose. – it is a form of identifying roles and relationships of each staff in order to delineate specific tasks or functions that will carry out organizational plans & objectives.
– is a line drawing that shows how the parts of an organization are linked.
ELEMENTS OF ORGANIZING I. Setting up the organizational structure - facilitates the development of roles & relationships to enable the achievement of goals.
– refers to the process by which a group is formed, its channels of authority, span of control & lines of communication. – is a process in which a group is formed including its Authority, Responsibility and Accountability ( ARA), span of control, and lines of communication.
PURPOSES OF SETTING UP AN ORGANIZATIONAL STRUCTURE
• It informs members of their responsibilities so that they may carry them out. • It allows the manager & the individual workers to concentrate on his/her specific role & responsibilities. • It coordinates all organizational activities so there is minimal duplication of effort or conflict. • It reduces the chances of doubt & confusion concerning assignments. • It avoids overlapping of functions because it pinpoints responsibilities. • It shows to whom & for whom the are responsible.
4. CHAIN OF COMMAND –lines indicate who reports to whom and by what authority.CHARACTERISTICS OF ORGANIZATIONAL CHART 1. . 2. Grouping of Work Segments – shown by the clusters of work groups. 3. 5. DIVISION OF WORK – each box represents the individual or sub-unit responsible for a given task of the organization’s work load. Levels of Management – indicate individual & entire management hierarchy. Type of Work to be performed – indicated by labels or descriptions for the boxes.
3. 2. . HOMOGENEOUS ASSIGNMENT/ DEPARTMENTATION – workers performing similar assignments are grouped together for a common purpose.authority & responsibility flow in clear lines from the highest executive to the lowest.PRINCIPLES OF ORGANIZING 1. SCALAR PRINCIPLES OF HIERARCHY. UNITY OF COMMAND – refers to the structure an employee has one superior & there is only one manager or leader.
PRINCIPLES OF ORGANIZING 4. SPAN OF CONTROL – member of workers that a supervisor can effectively manage. whereas problems involving unusual matters should be referred to higher level. 6. . 5. EXCEPTION PRINCIPLE – recurring decisions should be handled in a routine manner by lower level managers. DECENTRALIZATION/ PROPER DELEGATION OF AUTHORITY – process of conferring specified decision making to the lower levels of the organization.
TALL OR CENTRALIZED STRUCTURE/ VERTICAL – It is when the span of control is narrow and there are many management levels & there are many managers. .There are many levels of communication.Responsible for only a few subordinates. so there is a narrow span of control . .PATTERNS OF ORGANIZATIONAL STRUCTURE 1.
• There is mutual trust between superior and subordinates.Subordinate relations will improve. • Tall Organization encourages development of staff. • Discipline will improve. • Superior . • The manager gets more time to plan and organize the future activities. . • Control and Supervision will become easy and convenient. • The efforts of subordinates can be easily coordinated.ADVANTAGES OF TALL STRUCTURE • The quality of performance will improve due to close supervision.
There are many delays and distortion in communication. It is very costly because there are many managers. Tall Organisation is not suitable for routine and standardized jobs. Decisions and actions are delayed. It is difficult to coordinate the activities of different levels. managers may became more dominating. So the subordinates do not have any freedom. Here. There is strict supervision. The managers are paid high salaries. .DISADVANTAGES OF TALL STRUCTURE • • • • • • • • Tall Organization creates many levels of management.
SAMPLE OF TALL STRUCTURE .
• is characterized by fewer levels of management. low burearucratic costs.making is spread among many people. higher motivation of employees (empowerment). FLAT OR DECENTRALIZED/ HORIZONTAL STRUCTURE • Characterized by fewer levels and a broad span of control • Decision. • Communication from lower to higher levels is easy and direct. more communication between managers and employees .2.
• Fast and clear communication is possible among these few levels of management. • Subordinates are free from close and strict supervision and control. . • It is more suitable for routine and standardized activities.ADVANTAGES OF FLAT STRUCTURE • Flat Organization is less costly because it has only few managers. • Superiors may not be too dominating because of large numbers of subordinates. • Quick decisions and actions can be taken because it has only a few levels of management. • It creates fewer levels of management.
. • The discipline in the organization may be bad due to loose control. Close and informal relations may not be possible. • The relations between the superiors and subordinates may be bad. • There may be problems of team work because there are many subordinates under one manager.DISADVANTAGES OF FLAT STRUCTURE • There are chances of loose control because there are many subordinates under one manager. • Flat organization structure may create problems of coordination between various subordinates.
DISADVANTAGES OF FLAT STRUCTURE • Efficient and experienced superiors are required to manage a large number of subordinates. • It may not be suitable for complex activities. • The quality of performance may be bad .
SAMPLE OF FLAT ORGANIZATION STRUCTURE .
LINE ORGANIZATION/ BUREAUCRATIC/ PYRAMIDAL – This structure shows each position general authority over the lower position in the hierarchy.TYPES OF ORGANIZATIONAL STRUCTURE • 1. – Commonly found in large health care facility. – Clearly defined superior-subordinate relationship – ARA and power are concentrated at the top .
• Applicable only in smaller organizations or units within larger organizations . FLAT ORGANIZATION/ HORIZONTAL • It is a decentralized type.2. • Flattened scalar chain and fewer levels of position • Used for less complex organizations with authority decentralized and with several managers supervising large work groups.
FUNCTIONAL ORGANIZATION – permits a specialist to aid line position within a limited and clearly defined scope of authority. 5. AD HOC ORGANIZATION – modification of the bureaucratic structure and is used as a temporary basis to facilitate completion of a project within a formal line organization. .3. 4. STAFF ORGANIZATION • is by nature purely advisory to the line structure with no authority to place recommendations into action.
It has both the vertical and horizontal chain of command. .6.it is the most complex organizational structure. . MATRIX ORGANIZATION – designed to focus on both products and function.
7. 8. LATERAL ORGANIZATION – is one of coordination & colaboration between and among nursing staff and hospital staff. . SHARED GOVERNANCE ORGANIZATION – one of the most radical and idealistic type of organizational structure developed in 1980’s as an alternative to traditional pyramidal/ centralized structure.
II. selection & development. . STAFFING • Is the process of determining & providing the acceptable number and mix of nursing personnel to produce a desired level of care to meet the patient’s demand. • The process of assigning competent people to fill the roles designated for the organizational structure through recruitment.
STEPS IN STAFFING • Determine the number & types of personnel needed. • Recruit personnel • Interview • Induct or orient the personnel • Job offfer .
. PATIENT CLASSIFICATION SYSTEM ( PCS ) – a measurement tool used to articulate the nursing workload for a specific patient or group of patients over a specific period of time.STAFFING PATTERN • Is a plan that articulate how many & what kind of staff are needed by shift & day to staff in a unit or department.
“ SELF CARE” OR MINIMAL CARE PATIENTS – are capable of carrying activities of daily living ( ADL) 2. PATIENT CARE CLASSIFICATION 1. INTERMEDIATE OR MODERATE CARE – requires some help from nursing staff with special treatment or certain aspects of personal care .• PATIENT ACUITY – measurement of nursing workload that is generated for each patient.
3. TOTAL CARE PATIENTS – are usually those who are bedridden & who lack strength & mobility to do average daily living. . INTENSIVE CARE PATIENTS – are those who are critically ill and in constant danger of death or serious injury. 4.
RN is responsible for all aspects of care of one or more patients. 1.NURSING CARE MODELS • Is the framework for nursing care delivery in any setting or design that meets the particular needs of a group of health care givers & clients.original model of nursing care delivery . . THE CASE METHOD OR TOTAL PATIENT CARE .
the complete care includes treatment. medications & NCP.CASE METHOD / TOTAL PATIENT CARE .RN can better see & attend to the total needs of clients & the continuity of care can be facilitated with ease.RN gives total patient care within her shift.Client’s interaction & rapport with the nurse are well developed & client’s needs are monitored . ADVANTAGE: . . .
DISADVANTAGES: • RN spend more time doing tasks that could be done more cost – effectively by less – skilled person. .
SAMPLE OF TOTAL PATIENT CARE CHARGE NURSE STAFF NURSE STAFF NURSE STAFF NURSE STAFF NURSE PATIENT A PATIENT B PATIENT C PATIENT D .
THE FUNCTIONAL METHOD • Also called as “task Nursing” • Developed in response to national shortage in 1940’s • This gave way to widespread use of LPN & UAP to deliver nursing care. . UAP’s. • Needs of a group of patients are broken down into taks. LPN’s.2. which are assigne to RN’s.
FUNCTIONAL METHOD • This method is task & procedure oriente. • Used wherein there are too many patients in proportion to available RN. medication . • Nurses are assigned to different functions such as VS. Tx.
oriented approach improves both productivity & organization .ADVANTAGES : • Nurses who are oriented this way become skilled in performing assigned tasks. • Less equipment is neeed • Time is save • Task. • Individual aptitude & experience improves.
DISADVANTAGES: • Patients cannot identify who their nurse is CHARGE NURSE RN MEDICATION NURSE RN ADMISSION NURSE LPN TREATMENT NURSE PATIENTS ASSIGNED TO THEM .
TEAM NURSING • It evolved from functional nursing. • Team nursing personnel provides total patient care to a group of patients. • Comprehensive nursing care becomes the responsibility of the entire team. .3.
ADVANTAGES: • The constant group work fosters a feeling of participation and belongingness • The workload is balanced and shared with the division of labor • Each member of the team has the opportunity to learn from colleagues • There is also a variety in the daily assignment • Helps maintain interest in client’s well being and is cost effective. • Patient is able to identify personnel due to the continuity of care • Barriers between clients and nurses can be minimized • Everyone gets to contribute to the care plan .
UAP RN. UAP Patients Patients Patients . LPN. UAP RN. LPN. LPN.SAMPLE OF TEAM NURSING CHARGE NURSE Team Module Leader Team/ Module Leader Team/ Module Leader RN.
4. PRIMARY NURSING METHOD • Was designed to place RN back at the patients bedside. • This method represents total nursing care directed by a nurse on a 24 hour basis from the moment of admission to discharge with ARA . • Decentralized decision-making by staff nurses is the core principle of this method with ARA for nursing care allocated to staff nurses at the bedside.
ADVANTAGES: • Nurse sees the client and family as one system an ARA is increased. knowledge and expertise an develops creativity • Increases trust and satisfaction by the clients • Excellent communication between the primar nurse an associate nurses • Primary nurses are able to hold associate nurses accountable for implementing nursing care as prescribed. . • Nurse uses a wide range of skills.
.DISADVANTAGE • Critically ill patients may have several primary care nurses because of transfers to different units that may disrupt the continuity of care inherent in the model.
Other health provider PRIMARY NURSE Charge Nurse Patient Associate Nurse Associate Nurse .
5. • Care is directed by a case manager focused on achievement of outcome and appropriate time frame and resources. coordinating and monitoring the implementation of services needed to achieve desired patient care outcomes within a specified period of time. . CASE MANAGEMENT METHOD • Model for identifying. • Used to organize patient care according to diagnoses.
Case Manager Patient Caseload Caregivers Caregivers Caregivers .
6. . the RN & assistant agree to be practice partners. PRACTICE PARTNERSHIP • In this model.professional staff with differing levels of expertise. • They work together with the same schedule and the same group of patients. • It is an efficient way of using a mixture of skills of professionals & non.
professional staff • There is the potential for the junior member of the team to assume more responsibility than may be appropriate .ADVANTAGE: • Offer more continuity of care and accountability for patient care • Less expensive for the organization and more satisfying personally for the partners. • DISADVANTAGE: • Tends to decrease the ratio of professional nurses to non.
RN PARTNER PATIENTS .
GUIDELINES FOR DETERMINING THE NURSING PERSONNEL NEEDED • STEP 1 – Determine type of hospital whether it is primary. • STEP 3 – Categorize patients according to levels of care. secondary or tertiary • STEP 2 – Find the total number of nursing care hours ( NCH ) needed by the patients at each category level. .
• FULL TIME EQUIVALENT ( FTE ) – It is the formula that uses nursing care hours and annual hours of work provided by one Full –Time Equivalent. FORMULA: X = total Nursing care hours x days in a year total annual hours per one FTE . – Full time employee works 5 days a week or 40 hours per week for 52 weeks a year. It is a measure of the work commitment of a full-time employee.
Of working Hrs.• FORTY HOUR WEEK LAW – This formula is based on the National league of Nurses or R. 5901 otherwise known as the Forty Hour Week Law – FORMULA . ABO X NCH = TOTAL NUMBER OF PERSONNEL IN 24 HOURS No.A. .
• FORTY HOUR/ WEEK – for personnel working in hospitals with 100 bed capacity or over or which are located in a 1 Million population in the community. . • 48 HOURS / week – for personnel who work in agencies with lesser bed capacity or which are located in communities with less the 1 M population.
250 x . Needing moderate care 250 x .45 = 112.5 – pts.01 = 25 – pts.15 = 37.5 – pts need intensive care 250 x .STAFFING FORMULA • 1. Need highly specialized care .30 = 75 – patients needing minimal care 250 x . Categorize the patients according to levels of care needed.
5 ( NCH needed at Level I )=112. X 1. X 3 ( NCH needed at Level II )=337. X 4.5 NCH/ DAY 37.5 ( NCH needed at Level III) = 168.2. Find the number of nursing care hours (NCH ) needed by patients at each level of care per day.5 NCH/ DAY 112.5 pts.5 pts.75 NCH/DAY 25 pts x 6 ( NCH needed at Level IV ) = 150 NCH/ DAY TOTAL – 768. 75 pts.75 NCH/DAY .
Find the total NCH needed by 250 patients per year 768.593. Find the actual working hours rendered by each nursing personnel per year. 8 (hrs/day) x 213 ( working days/yr) = 1. 4.704 ( working hrs/yr) .75 x 365 ( days/year ) = 280.75 NCH/yr.3.
. a. Find the total number of nursing personnel needed. 593./ yr. Reliever x total nsg. 1. Number of days an employee is absent per year) by the number of working days per year that each employee serves. personnel Divide 33( ave. Total NCH /yr = 280.75 working hrs. 704 = 165 b.5.
190 x . . 190 x .165 x .65 = 124 prof. Total nursing personnel needed 165 + 25 = 190 6.15 = 25 ( relievers needed ) c.35 = 66 non prof. Categorize to professional & nonprofessional personnel.
37 = 24 – PM shift 66 attendants x . Distribute by shifts 124 nurses x .37 = 46 nurses on PM shift 124 nurses x .7.18 = 12 – night shift .18 = 22 nurses on night shift 66 attendants x .45 = 30 – AM SHIFT 66 attendants x .45 = 56 nurses on AM shift 124 nurses x .