The management processes
2. It forces analytic thinking and evaluation of
PLANNING
Planning, a basic function of management, is a
principal duty of all managers, is a critically
important to and precedes all other management
functions. It is a systematic process and
requires knowledgeable activity based on sound
managerial theory. It entails forecasting
or setting the broad outline of the work to be
done.
Planning is defined as deciding in
advance, it directs our thinking on what we
expect to do, why it will be done, who is going
to do it, and how when and where to be done.
The first element of management defined by
Henry Fayol is planning in which he defines
as making a plan of action to provide
foreseeable future. According to him that plan
must have unity, continuity, flexibility, and
precision. The plan should be included annual
and 1o year forecasts, taking advantage of input
of others.
Planning improves experience,
gives sequence in activity, and protects business
against undesirable changes. His
concepts are that planning facilitates wise use of
resources and selection of best
approaches to achieving objectives.
PURPOSE OF PLANNING
1. Planning increase the chances of success.
alternatives
3. It establishes a framework for decision
making that is consistent with top Management
objectives.
4. It orients people to action instead or reaction.
5. It includes day-to-day and future-focus
managing.
6. It helps to crisis management and provides
decision-making flexibility.
7. It provides a basis of for managing
organizational and individual and individual
Performance.
8. It increases employee involvement and
improves communication.
9. It is cost effective.
IMPORTANCE OF PLANNING
Nurse Manager must know how to plan for the
following reasons:
1. Planning leads to the achievement of goals
and objectives.
Workers relate what they do to meaningful
results. It ensures alignment of nursing
unit/department and financial plans with the
strategic plan.
Thus, increase the probability of achieving
organizational goals, vision, and mission. Also,
it establishes a framework for decision making
consistent with top management objectives. oversupply or pilferages.

2. Planning is gives meaning to work.

Employees or workers experience greater
satisfaction if what they do becomes meaningful
to them. Ensures safe and quality care through
awareness of individual responsibility and
accountability.
3. Planning provides for effective use of
available resources and facilities.
The best use of personnel and material
resources prevents wastage.
6. Planning is based on past and future
activities.
Evaluation of programs. Schedules, and
activities whether successful or not, prevents
and/or reduces the recurrence of problems and
provides better ideas in modifying or avoiding
them.
7. Planning leads to the realization of the need
for change.

4. Planning helps in coping with crises.

Discovers the need for change that leads to
Hospitals must provide for disaster plans.
create new services and productivity.
It allows the workers to function more clearly
Many of the hospitals have found out that in-
and efficiently when actual emergencies occur
patient hospital days can greatly reduce by
such as fire, typhoons, earthquakes, or during
having the laboratory and diagnostic work up
New Year celebrations and or other occasions
in the Out-patient Department. Minor surgeries
when more people are likely to get hurt.
are also done at the OPD so that more hospital
Manages risk and copes with crisis situations.
beds can be allotted to critically-ill patients or
for those needing specialized services.
5. Planning is cost effective.
Cost can be controlled through planning for
8. Planning improves communication and team
efficient operation. Projecting
collaboration through people involvement in
the number of operations in a given day,
planning activities.
including daily dressings, helps in determining
accurately the needed weekly supplies in the
surgical units so as to prevent undersupply, 9. Planning provides the basis for control.
It becomes the basis for evaluating the
accomplishment of the set programs/activities.
10. Planning is necessary for effective control,
Nurse- managers evaluate the environment or
setting in which they work or where the patients
are confined and make necessary
recommendations to make hospital conditions
more therapeutic not only for the patients but
for the workers as well. Performance of
workers and evaluation of services to patients’
base on criteria set during the planning stage
will indicate whether standards of care are met
and whether changes are indicated.
SCOPE OF PLANNING
The Top Management or the Nursing Directors,
Chief Nurses or Directors of Nursing and their
assistants are the one who set the overall goals
and policies of an organization. It’s their
responsibility to covers the over-all
management of the organization’s Nursing
Service.
The Middle management or Nursing
Supervisors direct the activities to actually
implement the broad operating policies of the
organization such as staffing and delivery of
services to the units. The formulation of
policies, rules and regulations, methods and
procedures for intermediate level planning for
ongoing activities and projects is done in
coordination with top management and those in
the lower level.
At the lower or first –level management, the
Head Nurses or Senior Nurses (including
Charge Nurses or team Leaders) do the daily
and weekly plans for the administration of direct
patient care in their respective units.
MAJOR ASPECT OF PLANNING
1. Planning should contribute to objectives.
It should seek to achieve a consistent,
coordinated structure of operation focused on
desired ends. Actions without plans often result
to chaos and failure.
2. Planning precedes all levels other processes
of management.
Without plan there would be nothing to
organize, direct, and control. Planning leads to
easy accomplishment of the organizational
objectives which is necessary for group effort.
Planning and control are inseparable.
3. Planning pervades all levels.
It encompasses both higher and lower echelons
and vice versa and spreads horizontally through
peer levels and/or across services and members
of the health team.
4. Planning should be efficient. helps managers look into the future and decide
It should contribute to the attainment of in advance where the agency would like to be
objectives not only in terms of peso value, man and what is to be done in order to get there.
–hours, units of production but should also Forecasts and estimates provide the bases for
include individual values and group satisfaction planning. Forecast describe the ultimate
conditions or projections that provide the
general incentive and direction to planning. It
CHARACTERISTICS OF A GOOD PLAN
anticipates the environment or setting where the
1. Be precise with clearly-worded objectives, plan will be operationalized such as:
including desired results and methods of
The hospital, this includes the type of hospital
evaluation.
served (level 1, level 2, level 3, or level 4); the
2. Be guided by policies and/or procedures
kind of service it offers (general or special) its
affecting the planned actions.
philosophy mission and goals and categories of
3. Indicate priorities.
their budget 9 national or local).
4. Develop actions that are flexible and realistic
in terms of available personnel, equipment,
The community it serves, this includes the kind
facilities, and time.
of people served their needs, expectations,
5. Develop a logical sequence of activities.
literacy rate, economic levels, employment
6. Include the most practical methods for
rates, demographic statistics, cultural values,
achieving each objective.
values and services available in the community.
7. Pervade the whole organization.

The goals of care, vary according to the needs

The effectiveness of a plan is enhanced by the
of the community, agency, trends in technology
environment in which the nursing
and in changing needs of the community,
personnel work. A positive climate promotes
agency, trends in technology and in changing
good working relationships and leads toward
concepts of the nurses’ roles and functions.
achievement of identified goals.
A mistake common to novice managers is a
BASIS in PLANNING the Nursing Service
failure to complete adequate proactive planning.
A. Forecasting Instead, many managers operate in a crisis mode
and fail to use available historical patterns to
assist them in planning. Nor do they examine
present clues and projected statistics to
determine future needs. Forecasting involves
trying to estimate
how a condition will be in the future.
Forecasting takes advantage of input from
others, gives sequence in activity and protects
an organization against undesirable changes.
Changes in technology, payment structures, and
resource availability, the manager who
is unwilling or unable to forecast accurately
impedes the organization’s efficiency and the
unit’s effectiveness.
Forecast must be supported by facts, reasonable
estimates and accurate reflection of policies and
plans.
B. Setting the Vision, Mission, Philosophy,
Goals and Objectives.
Mission – statement outlines the agency’s
reason for existing, who the target clients
are and the services will be provided.
Vision – statement outlines the organization’s
future role and function. It gives the agency
something to strive for.
Philosophy – is a statement of beliefs and values
that direct one’s life or one’s practice.
Goals – are broad statements or objective that is
expected to be achieved.
Objectives – are the action commitments
through which an organization’s mission and
purpose will be achieved and philosophy or
belief sustained.
C. Developing and Scheduling Programs
Programs are determined, developed and
targeted within a time frame to reach the set
goals and objectives. Kron has developed a
planning formula which may be used for daily
duties, or for short-and long-range projects,
(Venson, 2016)
THE PLANNING FORMULA
1. WHAT
What has been done?
What should be done?
What equipment and supplies have been used
or are needed?
What steps necessary in the procedure?
What sequence of activities was previously
used?
What other efficient methods may be used?
2. WHEN
When should the job be done?
When was it formerly done?
When could it be done?
3. WHERE
Where is the job to be done?
Where does an activity occur in relation to
those activities immediately?
preceding and following it?
Where could supplies be stored, cleaned, and so
forth?
4. HOW
How will the job be done?
What are the steps to be followed in doing the
procedure?
How will the time and energy of personnel be
used?
How much will it cost?
How much time will it require?
5. WHO
Who has been doing the job?
Who else could do it?
Is more than one person is involved?
6. WHY
To each of the questions, ask why.
Why is this job, this procedure, this step
necessary?
Why is this done in this way, in this place, at
this time, by this person?
One more question can be added to make the
formula more helpful.
7. CAN
Can some steps or equipment be eliminated?
Can this activity be efficiently combined with
other operations?
Can somebody else do it?
Can we get a machine to help?
Can we get enough money?
FOUR PLANNING MODES:
Reactive planning occurs after a problem exists.
Because there is a dissatisfaction with the
current situation, planning efforts are directed at
returning the organization to a previous, more
comfortable state. Often times, in reactive
planning, problems are dealt with separately
without integration with the whole organization.
Because it is done in response to a crisis, this
type of planning can lead to hasty decision and
mistakes.
Inactivism is another type of conventional
planning. Inactivists seek the status quo, and
they spent their energy preventing change and
maintaining conformity. When changes do
occur, they occur slowly and incrementally.
Preactivism, preactive planners utilize
technology to accelerate change and are future
oriented. Unsatisfied with the past or present,
preactivists do not value experience and believe
that the future is always preferable to the
present.
Interactive or proactive planning. Planners who
fall into this category consider the past, present,
and future and attempt to plan the future of the
organization rather than react to it. Because the
organizational setting changes often,
adaptability is a key requirement for proactive
planning. This also occurs in anticipation of
changing needs to promote growth within an
organization and is required of all leader-
managers so that personal as well as
organizational needs and objectives are met.
TYPES OF PLANNING
Strategic Planning
Is a broad continuous systematic process that
emphasizes assessment of the organizational
environment both internally and externally such
as economic, political, social, and technological
factors.
It is a management tool that helps organizations
set long-term goals, a risk-taking decision with
knowledge of their effects in the future, and
evaluating the outcomes through reliable
feedback mechanism.
it focuses on performance improvement and
utilizes strategies to accomplish the
organization’s desired outcomes
Strategic planning forecasts the future success
of an organization by matching and aligning an
organization’s capabilities with its external
opportunities. An organization
could develop a strategic plan for dealing with
the nursing shortage, preparing succession
managers in the organization, developing a
marketing plan redesigning workload,
developing partnership, or simply planning for
organizational success.
SWOT Analysis
One effective tool that can assist in strategic
planning is SWOT analysis (identification of
strengths, weakness, opportunities, and threats)
is one of the most commonly used in health care
organizations. SWOT analysis is also known as
TOWS analysis was developed by Albert
Humphrey at Stanford University in the 1960s
and 1970s.
The first step in SWOT analysis is to define the
desired end state or objective. After the desired
objective defined, the SWOT are discovered and
listed. Decision makers must then decide if the
objective can be achieved in view of the
SWOTs. If the decision is no, a different
objective is selected and the process repeats.
With the results of your analysis the following
should be included: 1) working out what you
hope to achieve, 2) being objective, 3)
incorporating the findings into the action plan,
and 40 revisiting your findings on a regular
basis.

Perform correctly, SWOT allows strategic

planners to identify those issues most likely to
impact a particular organization or situation in
the future and then to develop an appropriate
plan of action

Strategic planning as management process

Operational Planning
1. Clearly define the purpose of the
Is a detailed work plan or written blueprint in
organization.
which the objectives of a nursing
2. Establish realistic goals and objectives
unit/department are put into measurable actions?
consistent with the mission of the organization.
3. Identify the organization’s external It provides a clear picture of how a team;

constituencies or stakeholders and then nursing unit or department will contribute to the

determine their assessment of the organization’s achievement of the organization’s strategic

purposes and operations. goals.

4. Clearly communicate the goals and objectives It is known a management plan.

to the organization’s constituents.
Some categorical areas for objectives are:
5. Develop a sense of ownership of the plan.
patient satisfaction, patient safety, internal
6. Develop strategies to achieve the goals.
process, staffing, training and education,
7. Ensure that the most effective use is made of research, and financial.
the organization’s resources.
It is also a specific plan that supports the
8. Provide a mechanism for informed change as
strategic plan by implementing Its strategies,
needed.
projects and programs. It provides detailed
9. Provide a mechanism for informed change as
information to direct its people to perform the
needed.
day to day tasks and activities in running the
10. Build a consensus about where the
nursing unit/organization. The operational
organization is going.
plan objectives are specific. These are concrete
statements that nurse managers seek
to accomplish in terms of results.
It includes the what (task to be undertaken),
who (person responsible), when (timeline for
task completion), and how much (amount of
financial resource to carry out the task).
Sample of Operational Plan
The difference between the strategic planning
and operational planning.
D. Establishing Nursing Standards, Policies, and
Procedures
Nursing Standards Institutions develop their
own standards of nursing practice, the standard
of Nursing Practice and Nursing Service
Administration formulated by the
Association of the Nursing Service
Administrators of the Philippines and revised
2008.
The established standards in an evaluation
provides provide professional desirable norms
against which department’s performance can be
measured. Areas of improvement are identified
and a plan of action to correct this is made and
implemented.
Nursing Standards, the philosophy shall be
based on the belief that the client is integral
whole and that he is a unique individual with
needs that can be met through nursing
interventions.
Nursing Service Policies are plans reduced to
statements or instructions that direct
organizations in their decision making. Its direct
individual behavior toward the organization’s
mission and define broad limits and desired
outcomes of commonly
recurring situations while leaving some
discretion and initiative to those who must carry
out that policy. Though, some policies required
by accrediting agencies, many policies are
specific to the individual institution, thus
providing management with a means to
internal control.
Policies may also be implied or expressed.
Implied policies neither written nor expressed
verbally, have usually developed overtime and
follow a precedent.
For example: a hospital may have an implied
policy that employees should be encouraged and
supported in their activity in community,
regional, and national health organizations.
Another example might be that nurses who limit
their maternity leave to 3
months can return to their former jobs and shifts
with no statue change.
Guidelines outlining the scope and standards of
practice for specialty practice areas.
Nurses must be careful to assure that the
procedures they perform and the process used
in performing them consistent within the limits
of state and national regulatory bodies.
In the mid-20th century Kurt Lewin (1951)
developed change theory, he identified
3 phases in which the change agent must
proceed before a planned change
becomes part of the system: unfreezing,
movement, and refreezing
Unfreezing is the first phase; this occurs when
the change- agent convinces members of the
group. To change or when guilt, anxiety, or
concern can be elicited. This is where employee
become discontented and aware of a need to
change. Change agent needs to have made a
thorough and accurate assessment of the
extent of and interest in change, for them to
become effective as change agent. The nature
and depth of motivation and environment where
change will occur must
also be considered by the change agent
Movement this is the 2nd phase of planned
changed change agent must identifies, plans, and
implements appropriate strategies, ensuring
driving forces exceed restraining forces.
Because changes are not that easy it’s a complex
process and it requires a great deal of planning
and intricate timing. Human behavior changes or
attitudes and values underlie that behavior, takes
some time.
Refreezing is the last phase, during this phase
the change agent assists in stabilizing the system
change so that it becomes integrated into the
status quo. If refreezing is incomplete, the
change surely ineffective and pre change
behaviors will be resumed. For this to occur, the
change agent must be supportive and reinforce
the individual adaptive behavior efforts of those
affected by the change,
(Marquis and Houston, 2017).
Budgeting, it is the financial guideline where is
the allocation of each resource such as money,
time and people will be acquired and used. It is
the financial “road map” which projects the
future costing and a plan for manpower
utilization, and other resources in line
with the operating programs.
A nurse manager uses his/her expertise to utilize
the efficient and effective budgetary planning
and processes. In budget preparation, the
nursing services purposely control and establish
the monthly as well as the annual financial
budget plan report.
NURSING BUDGET=is a plan for
allocation of resources based on
preconceived needs for a proposed series of
programs to deliver patient care during one
fiscal year.
A HOSPITAL BUDGET= is a
financial plan to meet future service
expectations. Budgeting translates these
needs to manpower, equipment and
supplies so that both services are provided at
the highest level of quality at a minimum
cost.
Normally, there are five types of Budgets; (1)
Personnel Budget said to be the workforce
budget because it is forecasting the volume of
operational staff. (2) Operating Budget which
the accounts for revenues and expenses were the
concerned needs, it is also reflects the costing of
the services on the supplies, utilities, repairs and
maintenance while the (3) Capital Budget
related to a long-term range planning of the
institution’s physical acquisitions, disposal and
improvement. (4) Cash Budget appears to make
an adequate funds available as needed and to
use an extra fund profitably. (5) Flexible
Budget, budgets that flex up and down over the
course of the year depending on volume.,
(Marquis and Huston, 2017).
Budgeting is also has Determining Factors for
Budgetary Requirements. This pertains with the
awareness of the nursing staff about the budget
planning and proceeds of the department., (DOH
Guidelines 2016).
PURPOSE OF BUDGETING
1. A forecast of income and expenditure
2. A tool for decision making, to provide
financial framework
3. Measured the financial report and its
statistical data.
IMPORTANCE OF BUDGET Nurse Manager
must know how to budget for the following
reasons:
To control the over spending of the Nursing
services. Budgeting helps you control the
spending beyond the means in related to
nursing activities.
To monitor income and expenses of the Nursing
services. Budgeting helps you keep on track of
the income and expenditures of the Nursing
services.
Rationalization of the financial transparency and
accountability of the Nursing services.
Budgeting gives you a precise report summary
of the financial responsibilities.
TYPES OF BUDGETS
Personnel Budget.
It monitors the personnel budget to determine
the needs of nursing staff either in short for long
term basis. The manager should aware of the
increasing or decreasing of patient’s volume per
day/per hour or per minute so as they would
know the number of staff nurses to be assigned.,
(Marquis and Huston, 2017)
Operating Budget.
It is an annual budget that includes the revenues
and expenses associated with the daily activities
of the Nursing department. Provides an over
view of an agency’s functions by projecting the
planned operations, usually for the
upcoming year
Capital Budget.
Considers the purchased related to the
acquisitions of the major equipment and
necessities involving the physical facilities of
the Nursing services.
Cash Budget.
Plan to make adequate funds available as
needed and to use an extra fund profitably.
Flexible Budget.
Budgets that flex up and down over the course
of the year depending on variables such as
volume of labor costs and capital expenditures.
BUDGETING PROCESS
The budgeting process involves four (4) distinct
phases:
Phase 1 Gathering Data
- Study the overall past performance based on
proposed goal.
- Gather environmental information
- Regulates the overall expenses and revenues
from the past reports to present based on
proposed budget.
Phase 2 Planning
1. Create a Budget Committee
2. Set Objectives based on strategic goals
3. Establish a program or project for future goals
4. Formulate a budget guideline to synchronize
with financial linkages
5. Settle an Operating and Capital Budget
6. Manage a budget hearing
7. Prioritize your budget based on necessity
8. Conclude your proposed budget plan
Phase 3 Approval and Execution
1. Summarized the proposed nursing service
budget plan and let the authorize finance budget
committee to review and approve the budget.
2. Make a budget plan ready for improvement in
order to calibrate any errands to the General
Appropriations Act (GGA).
3. Cascade the proposed budget plan accordingly
to all nursing unit staff and department.
Phase 4 Monitoring and Reporting
1. Observe the proper delivery or
implementation of the budget plan.
2. Make an analysis between the proposed
budget and the actual performance.
3. Clarify and justify the results to determine the
significant trends
4. Ready to make an adjustment based on the
required needs.
5. Present the financial report according to
hospital policy.
PRE-REQUISITES FOR BUDGETING
1. Sound organizational structure with clear
lines of authority and responsibility is needed.
2. Non-monetary statistical data – such as
number of admissions, average length of stay,
percentage of occupancy and number of patient
days – are used for planning and control of the
budgetary process.
3. Chart of accounts are designed to be
consistent with the organizational plan.
4. Managerial support is essential for a
budgetary program.
5. Formal budgeting policies and procedures
should be available in the budget manual.
FACTORS IN BUDGET PLANNING
Nursing service are determined to consider the
budget planning proceeds are;
1. Type of patient and the length of stay in the
hospital. Assess whether the patient is under
medical, surgical, maternity, surgical,
communicable disease or chronically ill and the
severity of its illness
2. Bed capacity and hospital size
3. Physical plant of the hospital, design and the
size of the wards/unit and other treatment rooms.
4. Personnel policies. Includes the salaries of the
personnel, overtime pays or shift differential;
extended leave of absence and holidays.
5. Grouping of patients
6. Standard of Nursing Care
7. Method of performing nursing care
8. Method of documentation
9. Proportion of nursing care providers
(professional / non-professional)
10. Amount and quality of supervision available
and provided
11. Competencies of job description and
qualification
12. Method of patient assignment
13. Amount and kind of labor-saving devices
and equipment
14. Amount of centralized service provided
15. Nursing service requirement ancillary
departments
16. Reports required by administration
17. Affiliation of nursing students or medical
students
BUDGETING METHODS
 INCREMENTAL BUDGETING – simplest
method for budgeting. Since the budget for the
next coming year may be projected, the
programs and services were not prioritized.
 ZERO-BASED BUDGETING – the method
does not automatically claim to be funded. A set
funding priority is the main purpose of this
method.
 FLEXIBLE BUDGETING – this method
calculates what the expenses should be specified
in the program
 PERFORMANCE BUDGETING –
emphasizes the outcomes and results
instead of activities and outputs.
FACTORS IN DETERMINING BUDGETARY
REQUIREMENT
 Asses the appropriate provision in the current
General Appropriation Act.
 Associate the sources of funds (General,
national, city, municipal...)
 Evaluate the current appropriations and actual
expenditures for the current year.
 Analyze the projected changes in other
department that will affect the nursing service
budget.
 Consider the required expenditures, supplies,
equipment and material, repair and replacement
for the next coming year.
 Projects the estimated personnel salaries and
benefits including their unusual leaves.
 Assess the cost of Human Resource
Development and Research Programs.
 Render this information into peso and submit
the official forms to the Medical Center Chief
for approval and inclusion in the general budget.
The efficiency of the budget management
resources determines the productivity goal of
the of the nursing service management. It
reflects the consistency of the budget costing
ability of the nurse manager.
TIME MANAGEMENT
...nothing is particularly hard if you divide it
into small jobs. -Henry Ford-
...things which matter most must never be at the
mercy of things that matter least. -Johann
Wolfgang von Goethe-
One of the strategies in managing the time is
learn to prioritize duties, managing and
controlling crisis, reducing stress and balancing
work and personal time, (Marquis and
Houston,2017).
It is a technique for allocating one’s time
through the setting of goals, assigning priorities,
and identifying and eliminating wasted time, and
using managerial techniques to reach goals
efficiently.
Time Management Principles
a. Planning anticipates the problem that arise
from actions without thought.
b. Tasks to be accomplished should be done in
sequence and should be prioritized according to
importance.
c. Setting deadlines in one’s work and adhering
to them is an excellent exercise in self-
discipline.
d. Deferring, postponing, or putting off
decisions, actions, or activities can become a
habit which oftentimes causes lost opportunities
and productivity, generating personal or
interpersonal crises.
e. Delegation permits a manager to take priority
for decision making and to assign tasks to the
lowest possible consistent with his/her
judgement, facts, and experience, (Venson,
2016).
Time-saving Techniques, Devices, and
Methods to Better Use of Time.
1. Conduct an inventory of your activities.
Logging your activities for one day would show
how much time is usually spent on each activity.
2. Set goals and objectives and write them down.
Set priorities. Plan on making things happen
rather than reacting to crises.
3. With the use of calendars, executive planners,
logs or journals, write what you expect to
accomplish yearly, monthly, weekly or daily.
4. Breakdown large projects into smaller parts.
5. Devote a few minutes at the beginning of each
day.
6. Organize your work space so its functional.
Sort paper work on your table according to
priority.
7. Close your door when you need to
concentrate. Agree on a period of quiet office
time.
8. Learn to delegate.
9. In a meeting, define the purpose clearly
before starting. Distribute the agenda in advance
and control interruptions during the meeting.
10. Take or return phone calls during specified
time. Maintain a telephone log so you can return
calls at a time.
11. Develop effective decision-making skills.
Do not afraid to say “no”.
12. Take a rest break and make good use of your
spare time. Reward yourself periodically,
(Venson, 2016)
Three Steps to Time Management
a. Allow time to planning and establish
priorities.
b. Complete the highest task whenever possible
and finish one task before beginning another.
c. Reprioritize based on the remaining tasks and
on new information that may have been
received.
ORGANZING
 ORGANIZATIONAL THEORY
AND BUREAUCRACY
Max Weber is known as the father of
organizational theory. According to him,
bureaucracy is an institutional method for
applying general rules to specific cases, making
the actions of management fair and predictable.
Other characteristics of bureaucracy are
the following:
 There must be a clear division of labor.
 A well-defined hierarchy of authority must
exist which separates the superiors from
subordinates. There must be remuneration for
work, recognition of authority, allotment of
privileges and conferring of promotion.
 There must be impersonal rules and
impersonality of interpersonal relationships.
 A system of procedures for dealings with work
situations must exist.
 A system of rules covering the rights and
duties of each position must be in place.
 Selection for employment and promotion is
based on technical competence.
Organizing is the process of establishing formal
authority and involves setting up the
organizational structure through identification of
groupings, roles and relationships, determining
the staff needed by developing and maintaining
staffing patterns and distributing them in the
various areas as needed. It includes developing
job descriptions by defining the qualifications
and functions of personnel.
An organizational chart is a line drawing that
shows how the parts of an organization are
linked. It depicts the formal organizational
relationships, areas of responsibility, persons to
whom one is accountable and channels or
organization.
ELEMENTS OF ORGANIZING
The elements of organizing include setting up
the organizational structure, staffing, scheduling,
and developing job descriptions. In this module,
the setting up of an organizational structure will
be discussed. The other elements will be
discussed in the succeeding modules.
A. SETTING UP THE ORGANIZATIONAL
STRUCTURE
The creation of an organizational system
compatible with the philosophy, conceptual
framework, and goals of the organization
provides the means for the accomplishment of
an organization’s purpose. Understanding the
organizational structure as a whole facilitates the
development of roles and relationships to enable
the achievement by goals. The organizational
structure refers to the process by which a group
is formed, its channels of authority, span of
control and lines of communication.
Departmentalization and division of work
provide orderliness in administration. Through a
breakdown of activities, each individual
becomes responsible for a specified set of
activities and performs such.
The successful setting up of the organizational
structure enables an organization
to achieve its purposes:
ORGANIZATION
consists of the structure and process which
allow the agency to enact its philosophy and
utilize its conceptual framework to achieve
its goals. It refers to a body or persons,
methods, policies and procedures arranged

1. It informs the members of their in a systematic process through the

responsibilities so that they may carry them out. delegation of function and responsibilities
2. It allows the manager and the individual
Types of Organization Classified by Nature of
workers to concentrate on his/her specific
Authority
role and responsibilities.
1. Lines organization is the simplest and the
3. It coordinates all organizational activities so
most direct type of organization in which each
there is minimal duplication of effort or conflict.
position has general authority over the lower
positions in the hierarchy.
4. It reduces the chances of doubt and confusion
Example: Clinical and Administration
concerning assignments.
2. Informal organizations refer to horizontal
5. It avoids overlapping of functions because it
relationships rather than vertical. This is
pinpoints responsibilities.
composed of small groups of workers with
6. It shows to whom and for whom they are
similar interests.
responsible.

Other individuals that the nurse may need to be

3. Staff organization is purely advisory to the
accountable to include the immediate
line structure with no authority to put
supervisor, the patient and family, central
recommendations into action.
administration, and the physician because all of
Example: Training and Research
them participate in the nurse’s work. The
4. Functional organization is one where each
organizational structure of the Nursing service
unit is responsible for a given part of the
should be updated, reviewed, approved, and
organization’s workload. There is clear
documented by the proper authority. Date of last
delineation of roles and responsibilities
review should be documented.
which are actually interrelated.
Example: All standing and ad hoc committees
Organizational Chart and Its Implication
An organizational chart is a line drawing
composed of boxes that shows the parts of
an organization are linked. It depicts the formal
organizational relationships, areas of
responsibility, persons to whom one is
accountable and channels of communication.
There are two lines in the organizational chart
a. Unbroken Solid lines are classified into
two. The solid horizontal lines represent
communication between people with similar
sphere of responsibility and power but different
functions. The solid vertical lines between
positions denote the official chain of command
and formal path of communication and
authority. Those having the greater decision-
making authority are at the top; those with the
least are at the bottom.
b. Dotted or broken lines it represents staff
position. Staff member provides information
and assistance to the manager but has limited
organizational authority. It also provides for
specialization but does not have legitimate
authority as it acts in an advisory capacity.
Five Major Characteristics of an
Organizational Chart
An organizational chart should show the
following components:
1. Division of work – each box represents
the individual or sub-unit responsible for a
given task the organization’s work load.
Ex: Medical Services, Hospital Operations and
Patient Support Services, Nursing Services,
and Finance Services.
2. Chain of Command – lines indicate who
reports to whom and by what authority
Ex: Flat (decentralized) or tall (centralized)
organizations.
3. Type of work to be performed – indicated
by labels or descriptions for the boxes.
Ex: Ancillary Services, Training and education
Department, and Patient Care Services.
4. Grouping of work Segments – shown by the
clusters of work groups (departments or single
units). Ex: Operating Room and Post Anesthesia
Care Unit, Labor Room and Delivery Room
Unit, Intensive Care and Coronary Care Unit.
5. Levels of Management – indicate individual
and entire management hierarchy. Hierarchy
refers to a body of persons or things organized
or classified in pyramidal fashion according to
rank, capacity or authority assigned to vertical
levels with the offices ranked in grades, orders,
or classes, one above the other.
Ex: Top management, middle management, and
front-line management.
Kinds of Organizational Chart
1. Structural chart shows the various
components of the organization and outlines
the basic interrelationships.
2. Functional chart reflects the functions and
duties of the components of the organization
and indicates the interrelationships of these
function. Within the boxes is the function
statement, which should be clear, inclusive and
written in the present tense.
3. Position chart specifies the names, positions,
and titles or ranks of the personnel.
purpose. This promotes the specialization of
activities, simplifies the administrator’s work,
and helps maintain effective control.
4. Span of Control. The number of workers that
a supervisor can effectively manage should be
limited, depending upon the pace and pattern of
the working area. It also refers to span of
managerial responsibility and the number which
one superior can assist, teach and help to reach
the objectives of their own jobs

Principles of Organization

1. Unity of Command. Although employees 5. Exception Principle. Recurring decisions

should be handled in a routine manner by lower-
may interact with many different employees in
level managers whereas problems involving
the performance of their duties, they should be
unusual matters should be referred to the higher-
responsible to only one superior. This is to avoid
level Subordinates should report only unusual
confusion, overlapping of duties and
from normal functioning, so that managers can
misunderstanding This method is modified by
limit their attention to significant events.
emerging organizational theory where nurses
and others are frequently engaged in matrix
organizations in which they answer for more 6. Decentralization or Proper Delegation of
than one supervisor Authority. Decentralization is the
process of conferring specified decision making
to the lower levels of the organization. Basic
2. Scalar Principle or Hierarchy. The
top-level decisions and policies must receive
authority and responsibility should flow in
attention at the top levels. Executives should be
clear unbroken lines from the highest executive
developed to handle situations delegated to the,
to the lowest. The other form for this is “chain
this delegation of authority is still subject to the
of command,” usually a military term
supervision and control of the delegating
3. Homogenous Assignment or
superior. Distribution of necessary information
Departmentation. Workers performing similar about critical issues is vital to any delegation
assignments are grouped together for a common
process. An executive should have sufficient
information to make a good decision.
7. The Principle of Requisite Authority. When
a particular task is delegated to a subordinate,
the latter must also be given authority over
resources needed for task accomplishment. He
She is accountable for the quality of his work.
8. The Principle of Organizational Centrality.
Nursing personnel interact with the greatest
number of other healthcare workers, receive the
greatest amount of work-related information and
become most powerful in organizational
structure.
9. The Principle of Esprit d’ Corps. This
means teamwork and implies that in unity,
there is strength.
ORGANIZATION OF THE NURSING
SERVICE/DIVISION:
•The nursing service as an organization
constitutes the single largest group of hospital
employees responsible of setting standards for
safe nursing practice, providing quality care to
the patients, and coordinating its services with
the various divisions/departments/services in the
hospital and community.
The Nursing Service is headed by the Chief
Nurse and may be called by other titles such as
Director of Nursing Services. As the
administrator of nursing services, the position
may also be called Assistant Director for
Nursing as in the Philippine General Hospital.
She has several Chief Nurses under her who
head their respective departments.
In specialty hospitals such as the Lung Center of
the Philippines, the National Kidney Institute,
and the Philippine Children’s Medical Center,
the heads of the Nursing Department are called
Department Managers.
The Chief Nurse (Nurse VII in DOH Hospitals)
is directly responsible to the Chief of Hospital or
Medical Center Chief. She is assisted by an
Assistant Chief Nurse. In some bigger hospitals,
there may be two Assistant Chief Nurses; one
for training and research and the other for
patient care services.
Supervising Nurses are in charge of two or more
nursing units. The Head Nurse or Senior Nurse
is responsible for the management of a nursing
unit.
The Staff Nurses provide direct patient care and
are assisted by nursing attendants who perform
simple, routine tasks for which they have been
trained.
The staff nurses, midwives, nursing attendants
and institutional workers are under the
supervision of the Senior or head Nurse.
FORMS OF ORGANIZATIONAL
STRUCTURE
1. Traditional Hierarchical Structure (tall,
centralized, bureaucratic)
This is commonly called line structure.
Authority and responsibility are clearly
defined leading to simplicity of relationships.
This is associated with the principles of
command, vertical control and coordination
levels, and downward communications.
2. Decentralized (flat, horizontal, participatory)
The authority is shifted downwards to its
divisions, services, and units. The decision
making can occur where the work is being
carried out, thereby professionals who do the job
can participate in managing the organization.
3. Matrix
This is designed to focus on both the product
and function. The manager of the unit
responsible for a service report both to a
functional and product manager.
4. Hybrid
A term applied to organizational structure that
operate with characteristics of different types of
structures.
ORGANIZATIONAL STRUCTURE FOR
DEVOLVED HOSPITAL
The legal basis to consider in operating
devolved hospitals is the Local
Government Code (LGC) of 1991. Local
government units are given full autonomy in the
exercise of their proprietary functions and in
their economic enterprises subject to
limitations provided in the code and other
applicable laws.
Section 18 of the Department of Health Rules
and Regulations Implementing the
Local Government Code of 1991 (the “DOH
Rules”) gives authority to Local Government
Units regarding the management and operation,
among others, of provincial, district, municipal,
and city hospitals. Funding shall come from the
share of the province or city in the national taxes
and other national funds and funding support
from the national government, its
instrumentalities and government-owned or
controlled corporations which are tasked by law
to establish and maintain health services and
facilities.
Accountability means taking full responsibility
for the quality of work and behavior while
engaged in the presence of the profession.
Authority is the right to act or make decisions
without approval of higher administrators.
It includes the right to extract obedience from
subordinates. In government hospitals, flow
of authority is from the Chief of Hospital down
to the Heads of the various Divisions such
as the Administrative Officer, the Chief of the
Nursing Division, and the Chief of Clinics.
Change agent a person skilled in in the theory
and implementation of planned changed
to deal appropriately with these real human
emotions and to connect and balance all
aspects of the organization that will be affected
by that change.
d. Staff personnel provides advice, counsel, or
technical support that may be accepted, altered,
or rejected by the line officer.
Responsibility is the obligation to perform the
assigned tasks.

Communication is the transmission of

information between persons.
Power is the ability to influence another to
behave in accordance with one’s wishes.
Relationships within Nursing Services can be
depicted through the organizational
chart.
Status is the rank a group bestows on a person
in accord with the group’s estimation of the
person’s value and significance to group goals.
The status of the Nursing Director or Chief
Nurse is equal to that of the Administrative
Officer and Chief of Clinics.
SWOT

a. Line relationship those that exists between Strength are those internal attributes that help
and organization to achieve its
the superior and subordinated immediately and
objectives.
directly responsible to him/her. Ex: Chief Nurse
Weakness are those internal attributes that
to Supervising Nurse, Head Nurse to all nursing
challenge an organization in achieving its
staff.
objectives.
b. Lateral relationship those that exists
Opportunities are external conditions that
between position in various divisions and
promote achievement of organizational
sections of an undertaking where no direct
objectives.
authority is involve. Ex: Senior Nurse and
Threat are external conditions that challenge or
Physician, Staff Nurse and Clinical Pharmacist.
threaten the achievement of organizational
c. Functional relationship those that arise objectives
when duties are divided on a
functional basis like when an individual
Organization is a group of people working
exercises authority on a particular subject by
together in achieving the organizational
special skill or knowledge. Ex: Chief Nurse
goal
with Administrative Officer, Staff Nurse with
Clinical Nurse Instructor.