NCM 105 2010

Comes from old French term ´MENAGEMENTµ ´the directingµ From Latin word ´mau agereµ ´ to lead by the handµ The process of leading and directing all or part of an organization through the manipulation of resources One role of leadership Emphasize control

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working with and through others to achieve organizational objective in a changing environment Obtaining and organizing resources and of achieving objectives through other people Getting work through others Leadership Giving direction Developing staff Monitoring operations Giving rewards Representing both staff and administration as needed

Planning, directing, coordinating and controlling, including:
† † † † † †

The process of:
† Coordinating

action † Directing action † Assigning resources

Purpose: to perform the tasks in order to achieve the objectives/desired outcomes of an organization

cure and comfort to patients .NURSING MANAGEMENT The process of working through nursing staff members to provide care.

money. decision making and analysis. the environment. time and other resources to achieve organizational goals Direct willing and unwilling subordinates . and results Manipulate people.MANAGERS HAVE:    Assigned position within the formal organization Legitimate source of power due to delegated authority that accompanies their position Greater formal responsibility and accountability for rationality and control Are expected to carry out specific functions. duties and responsibilities Emphasize control.


and promoted based on their technical competence and abilities Workers should be able to view how they ´fitµ into the organization and how they can contribute to overall organizational productivity The relationship between managers and workers should be cooperative and interdependent. Taylor ² father of scientific management † ´if workers could be taught the ´one best way to accomplish a task ´ productivity would increase Traditional ´rule of thumbµ means of organizing work must be replaced with scientific method Scientific personnel system must be established so that workers can be hired . trained. and work should be shared equally Principles: † † † † .SCIENTIFIC MANAGEMENT (1900 ² 1930) Frederick W.

MANAGEMENT FUNCTION HENRI FAYOL (1925) Identified management function of: † Planning † Organizing † Command † Coordination † Control .

MANAGEMENT FUNCTION Luther Gulick (1937) † ´seven activities of managementµ † POSDCRB Planning  organizing  Staffing  Directing  Coordinating  Reporting  Budgeting  .

rather than over. attempting to increase whatever behavior they feel will continue to warrant the attention † Informal work group and socially informal work environment were factors in determining productivity † Recommended more employee participation in decision making † .HUMAN RELATIONS MANAGEMENT (1930-1970) Mary Parker Follett: Par ticipative Management Participative decision making † Managers should have the authority with. employees † Elton Mayo (1953): Hawthorne effect Indicated that people respond to the fact that they are being studied.

THEORY X AND THEORY Y DOUGLAS McGREGOR Theory X: managers believe that their employees are: † Basically lazy † Needs constant supervision and direction † Indifferent to organizational needs Theory Y: managers believe that their workers: † Enjoy their work † Are self-motivated † Are willing to work hard to meet personal and organizational goals .

EMPLOYEE PARTICIPATION CHRIS ARGYRIS (1964) Stress the need for flexibility within the organization and employee participation in decision making .

coordinating. command. organizing. directing. staffing. control Planning.MANAGEMENT THEORY THEORIST Taylor THEORY Scientific management If person can be taught the one best way to accomplish a task. formal authority. organizing. and consistent rules and regulation for personnel in different position Planning. budgeting Managers should have the authority with rather than over employees Weber Bureaucratic organizations Fayol Gulick Follet Management functions Activities' of management Participative management . productivity will increase Need for legalized. reporting. coordination.

self motivated and willing to work hard to meet personal and organizational goals Employees participation in decision making Mc Gregor Theory X and theory Y Argyris Employee participation . attempting to increase what ever behavior they feel would warrant attention Employees are basically lazy.MANAGEMENT THEORY THEORIST Mayo THEORY Hawthorne effect People respond to the fact that they are being studied. needs constant supervision and direction indifferent to organizational needs Employees enjoy their work.

executive vice president Coordinate the nursing activities of several units.LEVELS OF MANAGERS LEVEL TOP MANAGERS RESPONSIBILITY Responsible for the overall operations of nursing services. establish objectives. business arrangement and negotiations Typical titles: director of nursing service. supervisor. chairman. policies. team leader. primary care nurse MIDDLE MANAGERS FIRST-LINE MANAGERS . overall strategies and policies from top manager and translate them into specific objectives and programs. and strategies Represents the organization in community affairs. Receives broad. coordinator. clinical nurse managers and case managers are included at this level as they use collaborative management to move patient·s through the system Directly responsible for the actual production of nursing service. act as links between higher level managers and non-managers Typical titles: nurse manager.. typical titles.

Trouble shooter 3. As spokesperson of the organization 1. designer to improve projects that direct and control change in the organization 2. An entrepreneur or innovator. As a symbol because of the position he/she occupies 2. fires. problem discoverer. remunerates and judges 3. encourages. trains. Disseminate information from both external and internal sources 3.ROLE OF MANAGERS ROLE INTERPERSONAL DESCRIPTION The manager : 1. As one who monitors information 2. As a liaison between outside contact such as community. As a leader who hires. supplier and organization The manager 1. Negotiator when conflict arise INFORMATIONAL DECISIONAL .

and . controlled. rational. and regulations Maintain an orderly. rules.SIMILARITIES & DIFFERENCES BETWEEN LEADERS AND MANAGERS LEADERS May or may not have official appointment to the position Have power and authority to enforce decisions only as long as followers are willing to be led Influence others towards goal setting Interested in risk taking and exploring new ideas MANAGERS Appointed officially to the position Have power and authority to enforce decision Carry out predetermined policies.

SIMILARITIES & DIFFERENCES BETWEEN LEADERS AND MANAGERS LEADER Relate to people personally in an intuitive and empathic manner Feel rewarded by personal achievements MANAGER Relate to people according to their roles by enabling others to act Feel rewarded when fulfilling organizational mission or goals by fostering collaboration .

SIMILARITIES & DIFFERENCES BETWEEN LEADERS AND MANAGERS LEADER May or may not be successful as managers MANAGERS Are managers as long as the appointment holds .

weaknesses.EFFECTIVE LEADERSHIP & MANAGEMENT Understanding of individual strengths. and potential + Knowledge of basic ingredients for leadership and management + Learning from other people and experiences + Systematic use of self to get the right things done at the right time .


DECISION MAKING The process of establishing criteria by which a leader can develop and select course of action from a group of alternatives † One of the criteria on which management expertise is judged † The innermost leadership activity and the core of management † Choosing a particular course of action † Triggered by a problem. but is handled in a manner that does not focus on eliminating the underlying problem † May or may not be the result of a problem .

Little-Stoetzel.Characteristics of Decision Making Not linear or totally logical process. 1992. may involve intuition Often the result of many incremental steps rather than one large steps Smaller choices may be impacted by many factors other than rationality and analytical thought (Sullivan & Decker. 2003) .

Characteristics of Successful Decision Makers Learn to emphasize the tools and techniques that help make decision-making effective and efficient Minimize the technique or events that can sidetrack the critical thinking/decision making process Ability to engage in critical thinking .

relevant. whether it is:  Precise. consistent. and unbiased † Able to assume another person·s perspective or point of view in order to see all sides of an issue . accurate.CRITICAL THINKING Analyzing the way one thinks Must be incorporated into all steps of problem solving and decision making EFFECTIVE CRITICAL THINKERS † † † Constantly generate new ideas and alternatives Do not rely on ´we·ve always done it this wayµ Able to step back from issues and analyze its component  Often ask:    What are the underlying assumptions of this point of view? Where does the evidence come from and how is it being interpreted? How does the logic and argument hold together? † Can discern the quality of information that underlies ideas. complete. logical.

Strategic Steps in Decision Making Identify need for decision † Consider: What needs to be determined  Why a decision is needed  All information available  State issues in broader term rather than narrower term  Determine desired goal or outcome † Goal  should be: Clear and specific  Stated in a sentence or two .

based on each action·s benefits and consequences Evaluate the action by asking: † Was the goal achieved completely or partially † Was the goal not achieved .Strategic Steps in Decision Making Identify any other actions that exist. identify: Possible consequences  Possible benefits Decide which action to implement. † For  each alternative action.

Steps in Managerial Decision Making Models Determine the importance and context of the decision † Consider possible consequences of the decision Determine the objective for the decision List all options Explore promising options Establish decision making criteria Evaluate the options against criteria Select option to pursue Analyze the risk .

IDEALS MODEL Identify the problem Define the context Enumerate the choices Analyze options List reasons explicitly Self correct .

poor quality lesion is likely Gather data carefully Generate many alternatives Think logically Choose and act decisively .Critical Elements in Decision Making Define objective clearly † Decisions with out clear objective.

Decision Making Tools Decision Grids † Allows one to visually examine the alternatives and compare each against the same criteria Alteranti Financia Political ves l effect effect 1 2 3 Depar tm Organiz ental ational effect effect time .

Decision Making Tools Decision Tree Consequence Tables † List the objectives for solving a problem down one side of a table and rates how each alternatives would meet the desired objective Payoff Tables † Have a cost-profit-volume relationship † One must determine probabilities and historical data such as: Hospital census  Report on numbers of operating procedures performed  .

Decision Making Tools Logic Models Schematics or pictures of how program are intended to operate † Includes: † resources  Processes  Desired outcomes  † Depicts exactly what the relationship are between the 3 components PERT ² Program Evaluation and Review Technique A popular tool to determine the timing of decisions † Developed by Booz-Allen Hamilton organization and the US navy in connection with the Polaris missile program † A flow chart that predicts when events and activities must † .

Conditions that may Affect Decision Making Conditions of CERTAINTY Alternatives and existing conditions are well known † Decisions can be made with full knowledge of what the outcome will be † Conditions of RISK Alternative and conditions are not very well known † Decision outcomes can only be expressed as probability rather than certainty † Different levels of probability † Objective probability = like hood that an event will or will not occur based on the facts and reliable information  Subjective probability = like hood that an event will or will not occur based on a leader·s personal judegement or belief  .

Conditions that may Affect Decision Making Conditions of UNCERTAINTY † † † † Alternatives and conditions are complex and variable Person making the decision may not be even aware of all possibilities Decision making may be occurring in a rapidly changing environment Decision outcome cannot be expressed even as probability 3 approaches for dealing with UNCERTAINTY † † Maximax approach ²most optimistic   Select alternative with best possible outcome for all alternatives Choose the worst possible outcome for each possible alternative then choose the least objectionable worst outcome Select the alternative that has the fewest variable among its possible outcomes Maximin approach ² most pessimistic Minimax approach /Risk averting approach  † .

DECISION MAKING WITHIN GROUPS Group decisions must include the stakeholders who will be affected by the decision Advantages of group decision making: More people involved † More input and feedback † More stake holders who can ´buy inµ to decisions and outcome and support group·s decision † persons Disadvantages: Time consuming † Can lead to increased conflict and sabotage of the group·s decision † .

Methods of Group Decision Making CONSENSUS building † † † † All group members can live with and fully support the decision Consensus does not mean that everyone agrees. it just mean that they can live with it Advantage ² greater support for decision made Disadvantage s:   Time needed for decisions People wanting to block a decision can use consensus to delay decisions NOMINAL group technique † † † Nonverbal technique in which group members write out their ideas Ideas and their pros and cons are presented on a flip chart or board Group discusses ideas and puts them into a private vote. highest rating wins Group members receive questionnaires Results are summarized and redistributed Process of questions followed by summary continues until group reaches concensus DELPHI group technique † † † .

Do·s and Don'ts of Decision Making DO Make only decision that are yours to make Write notes and keep ideas visible about decisions to utilize all relevant information Write down pros and cons of an issue to help clarify our thinking Makes decision as you go along rather than letting them accumulate Consider those affected by the decision Trust your self DON·T Make snap decision Waste your time making decisions that do not have to be made Consider decision a choice between right and wrong but a choice between alternatives Prolong deliberation about decisions Regret a decision Always base decision made on the ´way things have always been doneµ .

the patient is 15 years old and his single mother is with his 10 year old brother because she did not have anyone else to stay with the younger boy What would be the desired goal What are the things to be taken into considerations . However.Group Work Situation: †A visiting policy may allow only one family member to be with a patient at a time.

DECISION MAKING Goal: † To decide if making an exception to hospital policy is in this patient·s best interest † Determine if the hospital·s goal concerning patient care and privacy can be met if an exception to the policy is allowed Pros and cons † Benefit  : allowing the brother is additional support for the patient since he and the brother are close  Not having a 10 year old boy by himself in a waiting area † Consequence:  Possible loss of privacy and inconsistency with other patient·s visitors .

DECISION MAKING Actions to implement based on pros and cons † Depending on liability and other issues nursing staff may: Rank issues of consistency with all other visitors and privacy for other patient in the room higher or  Staff may decide that patient comfort and keeping the family together higher  Evaluate † If  the decision was to allow the visitor Did having the brother·s presence make the patient less anxious  Did it not seem to make a difference  Did having the brother makes the patient more anxious .

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