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RN,RM,MAN, EdD (c)


• Planning may be defined as a deciding
in advance what to do; Who is to do
it; and how; when, and where it is to
be done.
• Therefore all planning involves a
choice : a necessity to choose from
among alternatives.
• This definition implies that planning
is proactive and deliberated process

• Planning is concerned with the future
impact of today's decisions.
• It is the fundamental function of
management from which the other
four stem.
• The organizing, staffing, leading and
controlling functions stem from the
planning function


the determination of whether or not goals are being accomplished and standards met is based on the planning function. • Finally. 4 . depends on the goals to be achieved. • The planning function provides the goals and standards that drive the controlling function. the leading function. influencing the behavior of people in the organization. in the controlling function.PLANNING • The manager is ready to organize and staff only after goals and plans to reach the goals are in place. • Likewise.

Importance of Planning Planning leads to achievement of goals and objectives Planning gives meaning to work Planning provides for effective use of available resources and facilities (best use of personnel and material resources prevents wastage) Planning helps in coping with crisis 5 .

including daily dressings. oversupply or pilferages (taken by other person) 6 .Importance of Planning  Planning is cost –effective – costs can be controlled through planning for efficient operation  Projecting the number of operations in a given day. helps in determining accurately the needed weekly supplies in the surgical units so as to prevent undersupply.

basis for evaluating the accomplishment of a program 7 . schedule and activities whether successful or not prevent and/or reduces the recurrence of problem and provides better ideas in modifying or avoiding them Planning leads to the realization of the need for change – establishment of OPD rather than admission can greatly reduced days in hospital Planning provides the basis for control .Importance of Planning Planning is based on the past and future activities – evaluation of programs.

Importance of Planning • Planning is necessary for effective control – nurse manager 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. 8 .


Formulate a planning statement (means) • 4. Evaluate the present situation and predict future trends and events • 3. Convert the plan into an action statement 10 .Four Stages of Planning • 1. Establish objectives (goals) • 2.

Planning Terminology • Vision -Statement that outlines the organization’s future role and function – Gives the agency something to strive for – Nonspecific directional and motivational guidance for the entire organization. – It is the most emotional of the four levels in the hierarchy of purposes. 11 . – Top managers normally provide a vision for the business.

ER) – Mission reflects the culture and values of top management. middle and upper class). and what services will be provided (in-patient. out-patient. the needy.Planning Terminology • Mission – statement that outline’s the agency’s reason for existing (whether hospital or health care) – It is concerned with scope of the business and what distinguishes this business from similar businesses (includes: who the target clients are ( the poor. 12 .

it is the sense of purpose of the organization and the reason behind its structure and goals • It’s a written statement of philosophy that explains the belief that shape how the mission or purpose will be achieved 13 • It gives direction towards the attainment of the .Planning Terminology • Philosophy – describes the vision • It is a statement of belief and values that direct one’s life or one’s practice • In an organization.

and untimed. 14 . – They are stated in terms of results to be achieve and should focus on the production. health care services to patients.Planning Terminology • Objectives – Objectives refine the mission and address key issues within the organization – They are concrete and specific in nature – They are expected to be observable. – They are action commitments through which san organization’s mission and purpose will be achieved and the philosophy or belief sustained. challenging.

and Timed. Attainable. Measurable. 15 . Rewarding.Planning Terminology • Goals – Goals are general statements of anticipated results – They are expected to be SMART: Specific.

provide the basis for planning • Includes: – Environment – in which the plan will be executed – Who the client is – their customs. dialect barriers. – The number and kind of personnel required – The necessary resources 16 . the kind of care they will receive.Planning Terminology • Forecasting - helps manager look into the future and decide in advance where the agency would like to be and what is to be done in order to get there. Public attitude and behavior. language. • With estimates. belief. severity of` condition or illnesses.

Planning Terminology • Development of tactics is a fifth level of planning. the most specific and narrow plans. • Tactics. 17 . describe who. when. where and how activities will take place to accomplish a goal. what.

• Its purpose is to create an image of the desired future and design ways to make those plans a reality. planning.refers to the process of continual assessment. and evaluation to guide the future. 18 .TYPE OF PLANNING • Strategic Planning .

it has to be very practical and ample. • For management to do this efficiently.Strategic Planning • In strategic planning. opportunities and threats. 19 . management analyzes inside and outside factors that may affect the company and so objectives and goals. • Here they should have a study of strengths and weaknesses.

Tactical Planning • Tactical planning deals primarily with the implementation phase of the planning process • Tactical planning turns strategy into reality • Tactical planning usually has a 1-2 year time horizon • Tactical planning is usually tightly integrated with the annual budget process 20 .

Elements of tactical planning • • • • • Project plans Project budgets Project reviews Monthly reports Annual reports 21 .

Operational Planning • Deals with the day-to-day and week-toweek work routine • Focus is on routine operational tasks and long-term projects • Primary goal is to communicate • In many organizations. people are asked to do both • Weekly meetings are often used to coordinate efforts and review progress • Weekly or monthly summaries are often used to inform others 22 .

teams are more ad-hoc in nature. so a mechanism must be put in place to insure communication 23 .Structure The structure of operational planning is closely related to organizational structure • In a traditional hierarchical organization. team leaders usually assemble with a senior manager on a regular basis to share information • Additional periodic meetings are often required to coordinate efforts with other units • In a process-oriented organization.

MISSION OR PURPOSE – identifies the basic function of the organization  Defining specific task to be perform 2. GOALS AND OBJECTIVES – are the results or achievements toward which effort is directed. leading and controlling are aimed. These two concepts represent not only the end point of the planning but also the end toward which organizing. 24 .KINDS OF PLAN 1. staffing.

25 . Goals comprises mission and purpose statements of the organization in a wider perspective Objectives are goals expressed in concrete terms that are readily measurable.KINDS OF PLAN Cont.

KINDS OF PLAN 3.involves a plan or a series of maneuvers for obtaining a specific goal -can be defined also as the determination of the basic long-term objectives of an organization and the use of course of action and allocation of resources necessary to attain these goals 26 . Strategies .

Rules – are usually the simplest type which spell out specific required action or non-action. Procedures – are plans spelled-out in a detailed manner in which certain activities must be accomplished 6. 27 .  are regulations promulgated by the agency governing conduct observed by employees without specifying a time sequence. Policies - basically general statements that guide or channel the thinking of managers in decision-making 5.KINDS OF PLAN 4.

tasks. steps to be taken. rules. Programs – plans or schedules to be followed  comprised goals. policies. assignment. resources to be used and other medium necessary to carry out one as a given course of action supported by budget 8.KINDS OF PLAN 7. Budget – itemizes estimate of expected outcome and expenses 28 . procedures.

including desired results and methods for evaluation 2. Be precise and clearly-worded objectives. Be guided by policies and /or procedures affecting the planned action 29 .Characteristics of a Good Plan • A well developed plan should: 1.

equipment. and 7. Perv ades the whole organization 30 . Develop (actions that are flexible) a logical sequence of activities 6. include the most practical methods for achieving each objective. facilities and time 5. Indicate priorities 4. Develop actions that are flexible and realistic in terms of available personnel.Characteristics of a Good Plan 3.

mission. Planning is always based and focused on the vision. Planning is a continuous process – provision for proper analysis would indicate revision of flexibility to be done to make it more effective 31 . philosophy and clearly defined objectives of the organization 2.PRINCIPLES OF PLANNING 1.

Planning be pervasive within the entire organization covering the various department. services and the various levels of management to provide maximal cooperation and harmony 4. Planning utilizes all available resources 32 .PRINCIPLES OF PLANNING 3.

5. Planning must be precise in its scope
and nature – it should be realistic and
focused on its expected outcomes.
6. Planning should be time-bounded
(e.g. with short and long range plans)
7. Projected plans must be documented
for proper dissemination to all
concerned for implementation and
evaluation as to the extent of its



Forecasting or estimating the future
Defining the philosophy and objectives
Identifying strategies
Forsetting the time frame
Preparing the budget



• Forecasting -

helps manager look into the
future and decide in advance where the agency
would like to be and what is to be done in order to
get there.
• With estimates, provide the basis for planning
• Includes:

– Environment – in which the plan will be
– Who the client is – their customs, belief, language,
dialect barriers. Public attitude and behavior, severity
of` condition or illnesses, the kind of care they will

– The number and kind of personnel required
– The necessary resources


 The philosophy flows from the purpose or mission
statement and delineates the set of values and
belief that guide all actions of the organization.
 It is the basic foundation that directs further
planning toward a mission.
 Societies and organizations have philosophies or
sets of beliefs that guide their behavior which
called VALUES.
 Values – quality having intrinsic worth for a
society or an individual and identifies
individualism, the pursuit of self-interests, and


1. It must be freely chosen from among the
alternatives only after due reflection
2. It must be prized and cherished
3. It is consciously and consistently repeated
(part of a pattern)
4. It is positively affirmed and enacted

Manager should have a value system consistent with the organization All philosophies must be translated into specific goals and objectives if they are to result in action.DEFINING THE PHILOSOPHY AND OBJECTIVES Individual values should not conflict with the organization. 38 . goals and objectives “operationalize” the philosophy. Thus.

observable or retrievable and obtainable.DEFINING THE PHILOSOPHY AND OBJECTIVES • A goal may be defined as the desired result toward which effort is directed. measurable. • Goals. 39 . change with time and require periodic reevaluation and prioritization. • Objectives are similar to goals in that they motivate people to a specific end and are explicit. much like philosophies and values. • it is the aim of philosophy. • Objectives however are more specific and measurable than goals because they identify how – And when the goal is accomplished.

be behaviorally stated.DEFINING THE PHILOSOPHY AND OBJECTIVES • Objectives can focus either on the desired process or the desired result. • Processed objectives are written in terms of the method to be used. and identify positive rather than negative outcomes. 40 . whereas resultfocused objectives specify the desired outcome • Objectives should have a specific time frame. be objectively evaluated.

assigning priorities. • Taking time to plan time saves time. • Nurse-leaders who learn to manage time effectively will be more productive. in both their professional and their personal lives. 41 . and using managerial techniques to reach goals efficiently.FORSETTING THE TIME FRAME • TIME MANAGEMENT – is a technique for allocating one’s time through the setting of goals. identifying and eliminating wasted time.

• Job enlargement – occurs when a flatter organizational structure causes positions to be combined and results in mangers having more employees to supervise. time management is a misnomer: what is managed is how time is used. the pressure to do more in less time has increased. • In today’s downsized health care organization.TIME MANAGEMENT • In some ways. 42 .

43 . • Time can be used proactively and reactively • Proactive approach – when energy is focus on people and events over which the manager have direct or indirect control • Reactive approach – if majority of the manager’s time is spent on what concerns him most about other people and events that troubles him which makes his efforts less effective.Time Management • In a horizontal organizational structure few formal channels for communication exist so the time needed to communicate with staff increases.

• Common Time waster: – Interruptions such as telephone calls and dropin visitors – Meetings both scheduled and unscheduled – Lack of clear-cut goals.TIME WASTER • It is something that prevents a person from accomplishing the job or achieving the goal. objectives. and priorities – Lack of daily/weekly plans – Lack of personal organization and self discipline 44 .

working on routine tasks – Ineffective communication – Waiting for others. – Lack of knowledge about how one spends one’s time – Failure to delegate.Cont. not using transition time effectively – Inability to say no 45 .

TIME ANALYSIS • The 1st step is to analyze how time is being used.places emphasis on ensuring that time is spent wisely and that the right individual is correctly assigned the responsibility for tasks. Time Logs. 46 . • The 2nd is to determine whether time use is appropriate to your role ( some time may be used in doing things that seem to be “busywork” rather than activities that contribute to a particular outcome) Job redesign.useful in analyzing the actual time spent on various activities.

HOW TO MANAGE THE MANAGER’S TIME 1.  Defining goals and time frames helps reduce stress by preventing the panic people often feel when confronted with multiple demands. Setting Goals – it is establishing one’s own goals and time frames  Nurses are accustomed to setting both long and short. 47 . although typically such goals are stated in terms of what patients will accomplish rather than what the nurse will achieve.range goals.

activities may not lead to the outcomes that will help achieve the goals and meet the ideals of the individual or organization. • Without the future orientation. realistic.Cont. • Goal-setting . activities or operation s to the organization’s or individual’s long-range goals. and achievable goals 48 . • The focus is to develop measurable.helps to relate current behavior.

How to Manage Time • Determine priorities – Take into consideration both long-term and short–term goals as well as the importance and urgency of each activity • Daily planning and scheduling – Prepare a to-do list (planned for workday or workweek) – Flexibility must be a major consideration to allow to deal with emergency and crises – Focus is not on the activities or events but on the outcomes that can be achieved in the time available. 49 .

who will attend. time and place) – (Files are maintained by date so that they are readily retrievable when needed) 50 .cont. • Daily planning and scheduling – It is necessary to have a system to keep track of regular schedules (should be used when establishing the to-do list) – It should include calendar and files – (Calendar – includes information on the purpose.

– Group routine tasks. during the least productive time – Pick a task that can be successfully completed and save it for the end of the day. –can reduce a sense of overload and stress – Implementing the daily plan and daily follow-up is essential in managing time 51 . esp those that are not important or urgent. • Grouping activities and minimizing routine work – Work items that are similar in nature and require similar environmental surroundings and resources should be grouped within divisions of the work shift.Cont.

Cont. – These objectives are often related to those of many professionals. 52 . as well as to objectives of patients and their families. – Managers must have the ability to say NO – Taking on too much work can lead to overload and stress – Being realistic about the amount of work to which the manager commit is an indication of effective time management. • Personal organization and self-discipline – Managers must have clearly defined priorities based on a well-defined. measurable. and achievable objectives.

53 . – Managers should clean their desk. get out the materials needed to complete the most highest priority and start working on it immediately – FOCUS on one task at a time. and failing to set aside blocks of uninterrupted time to do important tasks also indicate a lack of personal discipline.Cont. • Personal organization and self-discipline – Be assertive in communicating own needs to others – A cluttered desk. working on too many tasks at one time. making sure to • Start with a high-priority task.

Time-saving techniques • Conduct inventory of the activities • Set goals and objectives and write them down • With the use of calendars. weekly or daily • Break down large projects into smaller parts. write what you expect to accomplish yearly. 54 . executive planners. monthly. logs or journals.

Time-saving techniques • Devote a few minutes at the beginning of each day for planning • Organize the work space so it is functional • Close the door when there is a need to concentrate • Learn organization /manager can delegate • Develop effective decision making skills in the agency • Make good use of the spare time 55 .

the importance of the topics.Controlling Interruptions • Keep an interruption log on an occasional basis – this should show who interrupted. nature of interruption. • Analysis of these data may identify patterns that can be use to plan ways to educe the frequency and duration of interruptions 56 . how long it lasted. what topics were discussed. and time-saving actions taken. when it occurred.

Controlling Interruptions – Phone Calls • Phone calls are major source of interruption • To handle telephone calls effectively. the managers must: – Minimize socializing and small talks – Plan calls – Set a time for calls – State and ask for preferred call times and the purpose of the call – Voice-mail is and excellent way to send and receive messages when real time interaction is not essential 57 .

Controlling Interruptions – E-mail • E-mail can enhance time management or it can be a time waster • Checking email too often can waste time • Set specific times of the day to check e-mail 58 .

referring the visitor to someone else. • Additional strategy – remain standing after greeting the visitors – gracious yet obvious enough to encourage a short visit • Arrange furniture – the nurse manager whose desk is arranged so that immediate eye contact is made with passersby or drop-in visitors for interruptions. arranging an alternative meeting. or redirecting the visitor’s problem-solving efforts. • Encouraging appointments – decreases interruptions 59 .Controlling Interruptions – Drop-in Visitors • Managers should direct the visit by identifying the issue or question.

Controlling Interruptions – Paperwork • Plan and schedule paperwork • Sort paperwork for effective processing • Send every communication electronically unless a paper memo. report. • Analyze paperwork frequently – review filing policies and rules regularly. and purge files at least once each year. when possible. 60 . or letter is required. means each time a paper is handled. Do not be afraid to recommend changes. • Do not be a paper shuffler – “handle a piece of paper only once”. formats can be revised if needed to. an action should be taken to further process it.

Respecting TIME • The key to using time management techniques is to respect one’s own time as well as that of others • People who respect their time are likely to find others respecting it also • Reciprocate by respecting the time needs of others • The effort to manage time is by: Determining priorities. 61 . organizing the workday and minimizing interruptions.

• It helps ensure that resources necessary to achieve these objectives are available at the appropriate time 62 . • Its purpose is to allow management to project activities into the future so that the objectives of the organization are coordinated and met.BUDGETING • Budgeting – is the process of planning and controlling future operations by comparing actual results with planned expectations • A BUDGET – is a detailed plan that communicates these expectations and serves as the basis for comparing them to actual results • The budget show how resources will be acquired and used over some specific time interval.

• The budgetary process allows the manager to visibly identify resource problems early and to adjust them to changing situations. – Well-managed budget uses the organization’s resources to best provide quality patient care. usually one year. and adjusting the budget accordingly for the next budget cycle. monitoring how well the plan is working during the budget time period. 63 .BUDGETING • Managing a budget is a process of planning for a specified time in the future.

64 . of the plans and expectations of a defined area over a specified period of time.The Budgeting Process • Budget – is a quantitative statement.allow management to project action plans and their economic impact on the future so that objectives of the organizations are coordinated and met.provide a foundation for managing and evaluating financial performance • Budget – detail how resources (money. • Budget. time. usually in monetary term. • Budget purpose . people) will be acquired and used to support planned services within the defined period of time.

Budgeting Process • Increases the awareness of costs and also helps employees understand the relationships among goals. • Budget performance provides management with feedback about resources management and the impact on the budget 65 . and revenues. • Budgets also help management control the resources expended through an organizational awareness of costs. expenses.

documenting. supplies) • Revenue Centers – managers are responsible for generating revenues (patient volumes) • Profit Centers – managers are responsible for generating revenues and managing costs so that the department shows a profit (revenue exceed costs) • Investment Centers – managers are responsible for generating revenues and managing costs and capital equipment (assess) 66 .Approaches to Budgeting • Cost Centers – managers are responsible for predicting. and managing the costs (staffing.

Incremental Budget • Incremental or line-by-line budget – each expense item or category is distributed in • • • • a budget worksheet Finance department distributes a budget worksheet listing each expense item or category on a separate expense line Expense line divided into salary and nonsalary items Advantage – simplicity of preparation Disadvantage – discourages cost efficiency 67 .

• Advantage – every expense is justified • Disadvantage – time consuming and may not be necessary 68 . • Managers are required to justify all activities and programs as if they were being initiated for the 1st time.Zero-based Budget • An approach that assumes the base for projecting next year’s budget is zero.

adjusted based on changes in revenues. such as patient volume or program activities • Variable budgets. utilization of supplies. patient census.Fixed or Variable Budgets • Fixed budgets.amounts are set without regard to changes that may occur during the year. and other expenses 69 .

Fixed or Variable Budgets • Budget that are categorized as fixed if the budget amount are set without regard to changes that may occur during the year.developed with the understanding that adjustments to the budget may be made during the year based on changes in revenues. 70 . that have an impact of the cost assumptions originally used for the coming year • Variable budgets. utilization. such as patient volume or program activities. and other expenses. patient census.

• A budget is a plan for future activities expressed in operational as well as financial or monetary terms. an expense budget.Preparing the Budget • A budget – is an annual operating plan. material and other resources to cover capital projects in the operating programs. revenue budget. – In a health care institution. a cash budget and a capital budget 71 . a financial “road map” and plan which serves a an estimate of future costs and a plan for utilization of manpower. this consists of 4 components: – 1.


shifts from inpatient to outpatient procedures. commercial insurance companies. and other influences. and discounts that will prevail during the budget period. • Projections are developed from historical volume data. and other 3rd party payers. 73 . • Revenue projections for the next year are based on the volume and mix of patients. HMOs.Revenue Budget • Represents the patient care income expected for the budget period. Medicaid. – Also taken into consideration are projected revenues derived from Medicare. rates. impact of new and modified clinical programs.

Cont. 74 . – Payments are made based on the assumption that patients with the same DRG use similar resources. – DRGs are based on primary and secondary diagnoses. • Medicare payments for inpatient services are made as a predetermined specific rate for each Medicare recipient based on the patient’s diagnosis • Care is classified into diagnosis-related groups (DRGs). age and treatment received.

75 . taking into consideration all available information regarding the next year’s expectations.Expense Budget • Consist of salary and nonsalary items • Expenses should reflect patient care objectives and activity parameters established for the nursing unit • It is comprehensive and thorough.

• Nursing managers are commonly given the responsibility for costs incurred by their department.Cost Centers • Nursing units bare typically considered cost centers • A cost center is described as the smallest area of activity within an organization for which costs are accumulated. but they have no revenue responsibilities. 76 .

Profit Center • If manager is responsible for controlling both costs and revenues and if their financial performance is measured in terms of profit (the difference between revenues and expenses) – then the manager is responsible for a profit center 77 .

More patient admitted. causing higher supply expenses. 78 . • Variable costs – depend on and change in direct proportion to patient volume and patient acuity. such as patient care supply expenses. more supplies used. such as rental payments and insurance premiums.Classification of Costs • Fixed costs – costs that will remain the same for the budget period regardless of the activity level of the organization.

Classification of Costs • Direct Costs – are expenses that directly affect patient care. • Indirect Costs – are expenditures that a are necessary but don’t affect patient care directly. • Example – salaries for nursing personnel who provide hand-on patient care are considered direct costs. • Example -Salaries for security or maintenance personnel 79 .

It anticipates future opportunities or problems and prepares for them.BENEFITS DERIVED FROM BUDGETARY PROCESS • Budgeting stimulates thinking in advance. • It leads to specific planning • Budget preparation stimulates action and intercation 80 .

etc 4. Physical layout of the hospital. Personnel policies 5.Factors in Budget Planning (in nursing) 1. the Nurses station. Grouping of patients 81 . Type of patient 2. Size of hospital and its bed capacity 3. treatment rooms. the size and plan of wards or units.

The method of performing nursing care whether simple or complex 8. The method of documentation 9.Factors in Budget Planning (in nursing) 6. The amount and quality of supervision available and provided 82 . Proportion of nursing care provided by professional nurse and those given by nonprofessionals 10. Standards in nursing care 7.

intercommunication systems 14.: clinics. ER 16. The amount of centralized service provided. Affiliation of nursing students 83 .Factors in Budget Planning (in nursing) 11. The amount and kind of labor-saving devices and equipment. Admitting office. The nursing service requirements of the ancillary dept. Efficiency of job description and job classification 12. Reports required by administration whether s simple or complex 17. Method of patient assignment 13. linen supply 15. sterile supply central oxygen service.

also known as Personnel budget – projects the salary costs that will be paid and charged to the cost center in the budget period.Determining the Salary (personnel) Budget • Salary Budget . • Managing the salary budget –is directly related to the manager’s ability to supervise and lead the staff. 84 .

holidays. personal days. and so on). personal days. • This factor can be calculated by determining the average number of vacation days. bereavement days.Benefits • FTEs or full-time equivalents are necessary to replace personnel for benefit time (vacations. or other days off with pay that the organization provides and the average number of sick days per employee as experienced by the cost center 85 . paid holidays.

Determining FTEs required for replacement • Determine hours of replacement time per individual • Then determine FTE requirement Benefit Time Hours/Shift Replacement Hrs 15 vacation days x 8 hours =120 8 holidays x 8 hours = 64 4 personal days x 8 hours = 32 5 sick days x 8 hours = 40 total = 256 86 .

12 – From the FTE calculations an FTE budget is calculated – This budget provides the base for the salary budget – However the shift differentials. • Divide replacement time by annual FTE base – 256 / 2.Cont.080 = 0. and bonuses or premium also may affect budget performance and need to be considered 87 . overtime.

Capital Budget • This budget identifies physical renovations. 88 . new construction. and new or replacement equipment planned within a specified time period. • Limited to a specified amount and decisions need to be made how best to allocate available funds • The nurse manager is responsible for assisting in selecting and determining the amount of equipment needed.

It is a challenge to be consistently cost conscious and to measure. • With the shift to managed care. the focus is decreasing the cost to maintain adequate profit margins in an era of diminishing compensation.Future Trends • A major trend in financial management of health care organizations is the shift from a revenuebased to a cost-based accounting system. not a source of revenue. 89 . manage and document nursing cost-effectiveness in this financial environment. • This trend has serious implications to nursing • Nursing has always been considered a cost.

90 .