Leadership and Management

Planning
DR. CRESENCIO C. QUINTO JR.
PROGRAM COORDINATOR-CON
Planning
- is deciding in advance what to do, how to do a particular task, when to do it, and who is to do.
- it is cognitive process for decision-making, based on facts and information as opposed to a
managers preferences or wishes.

- it must be adaptable and flexible to current realities to ensure that the desired result is
achieved
 Planning:
Predetermined action

What to do: How to do it: Who is to do it:

Nursing Activities Technique, principle Professional, non-professional
Good Planning
- Involves a continuous process of assessment,
establishment of goals and objectives,
implementation and evaluation.

Poor Planning
- is the failure to set goals, make assessments or provide
for implementation or to anticipate any possible change in circumstances.
Some indicators of poor planning as are follows:

1. Delivery dates are not met.

2. Machines are idle.
3. Materials are wasted.
4. Some nurses are overworked, others are underworked.
5. Skilled nurses doing unskilled work.
6. Nurses are fumbling on jobs for which they have not been
trained.
7. There are quarreling, bickering, buck-passing, and confusion.
Plans
- is a living document which can be changed
based on the prevailing circumstances.
- it is a predetermined course of action intended
to facilitate the accomplishment of a task, work or
mission.
Characteristics of Plan
- a well developed plan requires, first and foremost, creative and foresight.

3 Characteristics:
1. It must involve the Future
2. It must involve Action
3. It must have an Organizational Identification of the action which will be undertaken either by
the planner or someone designated by or for her.

Types of plan:
4. strategic or long term plan
5. Short term operational plan and continuous/rolling plans.
1. Strategic Plan
- is the sum total or outcome of the process by which on organization engages in work analysis,
goal setting and strategy formulation for the purpose of organizational growth and development.

A strategic plan is one that asks the vital question:

“ what are the right things to do “

- they are usually around 3-5 years, long in nature and are based on explicit assessments of the
competitive strengths and weaknesses of the organization. This type of plan defines the direction and
growth of the organization.
- are usually prepared in the upper levels of management and serve as the basis for operational
plans. In a nursing care setting, a strategic plan would be one which calls for increasing diversity in
nursing and more aggressive recruitment.
 Steps in strategic planning:

A. Assess the environment

- this requires a broad area of the organizations current environment.
Example:
- planning a program that would incorporate increasing emphasis in safety and patient centered care. Hence, nurses will be made to understand that a new
models for clinical Teaching are needed to impress and expect linkages between education and practice.

B. SWOT Analysis
- A tool frequently used to conduct environmental assessments; such as new equipment and technology, escalating cost and prestige of the company and its
impact to society. This stands for:

S- strengths
- refers to assessment of internal environment.

W- Weaknesses
- unmet goals and objectives of the organization as a result of inadequate planning and controlling.
 O- Opportunities
- assessment of external environment that provide sources of improvement or change.

T- Threats
- these are factors that may pose hazards, barriers to improvement or change.

Examples:

S- new equipment and laboratory

W-escalating cost;
O-prestige in the community
T-unionization
C. Assessment of the community as stakeholder
- a stakeholder is any person, group or organization that has vested interest in the program or project under
review. All potential stakeholders must be considered to ensure that their needs are incorporated in the plans.

D. Other methods of Assessment such as:

 focus group interaction- consists of small group of individuals selected due to common characteristics.
 Surveys and questionnaires that will be used to gather ideas and opinions.
 Advisory boards that are selected from various constituents affected by a proposed program.
 Review of literature and similar programs in order to identify potential problems, pitfalls and success.
 Review of best practices that will be used for evidences-based innovations and successes coming from the other
organization.
2. Operational Plans
- usually pertain to activities in specific departments of an organization. The plan’s main question is
“how does one do things right”? It deals with tactics or techniques for accomplishing these things.
They are generally shorter in time frame (e.g One year), and usually involve the middle and lower
level managers.
- although coordinated with each other, operational plans are prepared separately by the managers
of the functional sub-units of an organization.

Example:
- the department budget is prepared by the head nurse of a pediatrics unit. Operations planning
focuses on timetables, target quantities and specifies the persons responsible for the tasks.
3. Continuous or Rolling Plans
- involves mapping out the day-to-day activities. This is the tsk of the staff nurse who has to device
and implement the nursing care plan for the patients, alerting or modifying the plan as necessary
depending n the needs and problems of the patients and the unit to where the plan is applicable.
 Reasons of Planning:
1. It leads to success in the achievement of goals and objectives.
a. it brings about behavior that leads to desired actions and outcomes.
b. it makes performance of tasks more meaningful.
c. it helps the nurse relate to what they are doing and their professional goals.
2. It provides for effective use ag available personnel and facilities
Example:
- projecting the number of nurses needed to care for group of patients or ordering enough supplies for a unit.
3. It helps nurses cope with crises and problems calmly and efficiently
- planning is well-through process of predicting future activities, anticipate future problems, and plan for alternatives prevent or cope with potential
problems.
4. It reduce the element of change
a. studying what has been successful or unsuccessful can give the manager a better idea of what to do in the future.
b. through planning one can discover the need for change and innovation, trends and practices to meet current expectations of stakeholders and the
community.
5. Overall, it is necessary for effective control
- this will ensure effective management and capability of workers to meet local and global demands.
 Resistance to Planning
- despite the many benefits of planning, many nurse-management avoid it:

1. Lack of knowledge of the philosophy, goals and operations of the organization;

2. Lack understanding of the significance of planning, that success or failure of work activities relate directly to
the quality of plan;
3. Lack of proper appreciation of use of time for planning; they erroneously perceive that time spent on
planning would be better spent on addressing day-to-day concerns;
4. Lack of confidence and fear of failure;
5. Lack of openness to change that they believe planning may entail;
6. Lack of willingness to engage in new activities that planning produces;
7. Exigencies of the situation, they prefer to act on immediate problems that give them immediate feedback.
 Elements / Scope of Planning
1. Forecasting or estimating the future;
2. Setting goals and objectives;
3. Developing strategies and setting the time frame;
4. Preparing the budget and allocation of resources;
5. Establishing policies, procedures and standards.
 Forecasting or Estimating the Future
- is looking into the future.
- It is weighing the unknown values in the situation. Prediction is a similar, but more general term,
and usually refers to estimation of time series, cross-sectional or longitudinal data.

3 types of making forecasts:

1. The agency where the planner is working.
2. The community being served by the agency
3. The goals of care
 2. Set goals/ objective and Determine Results Desired
Goals- are broad statements of intent derived from the purposes of the organization.
Objectives- are specific behavior or tasks set for the accomplishment of a goal.
 3. Develop and Schedule Strategies, Programs/Projects/Activities;; Set the time Frame
- a planner must develop schedules, strategies, programs, projects and/ or activities, and set the time
frame for their completion in order to achieve the objectives and goals of the organization.
Strategy – is the techniques, methods, or procedure by which the overall plan of the higher management of
the agency achieve desired objectives.
Programs – are activities put together to facilitate attainment of some desired goals, such as staff
development programs, outreach programs, discharge teaching programs and the like.
 Time Management
- the manager’s single most important resource is time. Since time is infinite, the manager should
allocate it as efficiently as possible, which he can do by setting, assigning priorities, and identifying
and avoiding all possible waste of time.

 Good time management

- founded upon intelligent planning and decision-making, and a thorough assessment of the tasks
which need to be done.

 Mismanagement of time
- severely compromises an organization’s productivity and result in negative effects across the
board, from the manager to the rank-and-fire.
- When time is mismanaged, work is rushed and becomes substandard, deadlines ate missed,
bad choices are made, employees suffer from fatigue, and even the nurse’s personal lives and
relationships are adversely affected by the lack of time or energy to devote to them.
 Principles of Time Management
- “ There is always time for everything if you like to find time”

There are a number of basic principles that managers can use to cultivate good time-management
habits.
1. Planning for contingencies. Think of other option or alternative, if the desired option is not possible.
2. Listening of tasks. Calendar all activities.
3. Inventory. Looking at task done and not done.
4. Sequencing. Prioritizing activities to be done.
5. Setting and keeping deadlines. Do not procrastinate or else noting is done.
6. Deciding on how time will be spent. Indicate time allotted for each activity, set the targets.
7. Delegate. A portion of the tsk can be given to another who can equally accomplish the task on
time.
 Multitasking
- results when time is not enough or properly allocated to be able to finish task.
- is a part of daily life. Whether you are driving while talking on the cellphone , sending e-mails
during a meeting or listening to music during work or study, multitasking has become a way of life.
 Tools in Project Management
- various tools in project management have been devised such as GANTT CHART, performance
Evaluation and Review Technique and Critical Path Method allow the manager to set the time frame
of the project or activity meant to achieve the goals of organization.

Gantt Chart
- show task and schedule information. The tasks are numbered and listed vertically. A bar shows the
starting date and projected completion date of each task. Color or shading is sometimes used to show
how much of each task has been completed. It is both a management tool and a communications
tool.
 Performance Evaluation and Review Technique(PERT)
- is a network system model for panning and control which involves identifying key activities,
sequence them in a flow diagram ang assigning a specific duration for each phase of work.
- a PERT system involves extensive research and development. Multiple time estimates are used
for each activity that allow for variation in activity times, which are assumed to be random, with
assumed probability distribution(“probabilistic”)
 Critical Path Method or CPM
Can calculate time and cost estimates for each activity.
This method is used to create a cost estimate using either “ normal”
or “ crash” operating conditions.

NORMAL OPERATIONS:
 are those involving the least cost
 CRASH OPERATIONS
 Have much less available time than under normal

conditions.

CPM
 Is useful where time and cost are significant

factors because both can be estimated based on

past experience.
 To analyze a project and determine duration,
 Based on identification of a “critical path” through an activity
network.

 Knowledge of the critical path can permit management of the change

duration.
Prepare the Budget and Allocation
of Resources
BUDGETING

 Is defined as a systematic financial translation

of a plan, the allocation of scarce resources on
the basis of forecasted needs for proposed
activities over a specified period of time. It is a
tool for planning, monitoring and controlling cost
and meeting expenses.
 A nursing budget- allocates resources and
nursing programs to deliver patient care during a
fiscal year.

 A hospital budget- is designed to meet future

service expectations, to provide quality care
minimum cost.

 A budget plan- for health care institutions,

which is simply a plan for future activities.
FOUR COMPONENTS OF BUDGET
PLAN
A revenue budget-summarizing the income, management to generate
1.
during the planning period.

2. An expense budget- describing expected activity in operational financial

terms for a given period of time.
3. A capital budget- which outlines the programmed acquisitions, disposals
and improvements in the institution’s physical capacity.

4. A cash budget- consisting of money received, cash receipts and

disbursement expected during the planning period.
Approaches in Budgeting

2 basic approaches:

 Centralized Budget
 Decentralized Budget
 CENTRALIZED BUDGET

 is developed and imposed by the comptroller, administrator and/or director

of nursing with little to no consultation with lower level managers.
 DECENTRALIZED BUDGET

 Has the middle level manager involved in the planning and budgeting process
with ARA (authority, responsibility, and accountability) place on the
practitioner level.
 COMPONENTS of TOTAL
INSTITUTIONAL BUDGET

 MANPOWER BUDGET
 CAPITAL EXPENDITURE BUDGET
 OPERATIONAL BUDGET
MANPOWER

 This consists of the wages and salaries o the regular employees and the fees
paid to outside registries through the institution contracs short-term
employees
 CAPITAL EXPENDITURE
BUDGET

 This involves the large expense of furchasing of lands, buildings, and major
equipment meant for the long-term use.
 OPERATIONAL BUDGET

 This includes the cost of supplies,minor equipment repair and maintenance as

well as other overhead expenses.
 Types of Institutional Budget
Depending on Management Philosophy

 Open-Ended Budget
 Fixed Ceiling Budget
 Flexible Budget
 Performance Budget
 Program Budget
 Zero-Based Budget
 Sunset Budget
Open-Ended Budget
 Is characterized by a single cost estimate for each program in the
proposed unit.

Fixed Ceiling Budget

 is one in which the uppermost spending limit is set by the top executive
who then asks managers to develop budget proposals for individual units.
Flexible Budget
 A flexible budget, in contrast, contains several financial plans for each
level of activity or for different operating conditions.

Performance Budget
 Is based on the functions involved in the operation budgeted. In nursing
care management this may refer to direct nursing care supervision, and
quality control, among other things.
Program Budget
 On the other hand, in a program budget costs are computed for a program as
a whole or the entire program it self (e.g a home care program, an outreach
program), rather than for individual activities functions.
Zero-Based Budget
 Justifies in detail the cost of all programs, both old and new, in every
annual budget preparation.

Sunset Budget
 Is designed to “self-destruct” with in a prescribed period to ensure
cessationof the funded program at a predetermined date.
 BENEFITS OF THE BUDGETING
PROCESS

 PLANNING
Budgeting stimulates thinking in advance. It lead to specific planning such as the
volume and type of services, the number and type of personnel as well as the
volume and type of equipment and supplies required, as well as the
corresponding cost.
 COORDINATION

 Budgeting also encourages coordination among the

different persons involved in the process, from the
top to bottom. It has a balancing effect on the total
organization, in particular the quantity and quality
of service and the expected revenue. The
continuous exchange of information up and down
the organizational ladder is encourage, and in many
instances the team approach is stimulated or
developed.
COMPREHENSIVE CONTROL

 A budget fosters comprehensive control for those responsible for managing it.

 In assessing whether a budget is realistic or not, an administrator is able to

evaluate quality and initiative in performance.
FACTORS IN BUDGET
PLANNING
Is determined by the specific type of activity for which it is implemented.


Basic factors to be considered in Budget Planning are:

 Patient
 Hospital or Health Care Facility
 Personnel
 Standard Of Nursing Care and Supervision
 Establish Policies Procedures and Standards
1. Patient

 Is a primary consideration in budget planning.

These needs are determined by the condition of
the patient, the length of stay in the hospital and
the acuteness of the illness.
Categorizing the patient is made through the
type of care given by the physician:

 Medical
 Surgical
 Maternity
 Pediatric
 Geriatric
Method patient assigned:

 functional
 case
 team
 Primary

The severity of the illness serves as the basis for

length of stay in the hospital.
2.Hospital or Health Care Facility

 In
nursing management, these concerns include
the size of the hospital, specifically its bed
occupancy and capacity.

 BedCapacity must be enough to accommodate

the possible number of patients.

 Others aspects of a hospital to be considered

include its physical layout, the size of wards or
units, the Nurses Station, the treatment rooms,
and other relevant facilities and resources
available such as equipment and supplies.
3.Personnel

 Theses facilities would be useless without the personnel to utilize them,

and so it is important to be well-acquainted with personnel policies in
place, such as the salaries paid to nursing personnel, leave benefits
enjoyed by the personnel.

4.Standard of Nursing Care and Supervision

 This consists of the cost of training and maintaining personnel and
acquiring equipment that will be needed by the health care facility,
based on the volume of patients and the nature of their needs.
 TOOLS IN BUDGETING AND
MANAGEMENT OF RESOURCES

1. The budgeting process of the organization.

2. Determined the number of full-time equivalent of nurses necessary of the
staff the unit.
3. Compute the salary and non-salary budget including salary increases and
other various factors.
4. Monitor the variances over the budget period and
identify negative variances responding promptly
and appropriately.

5. Understand the extraneous factors such as

changes in technology or direct or indirect
cost that may be assigned to their budget.

6. Encourage the staff to monitor resources used

including time and supplies.
5. Establish Policies Procedures and Standards
POLICIES
-defined as standing plans used repeatedly, or
guides or basic rules that govern action at all
levels in the organization. They stem from the
goals of the organization.
PROCEDURES
 As a more specific guide to action than policy,

where each step is listed in the process of doing

the procedures.
STANDARDS
-indicate the minimal level of achievement
acceptable to meet the set objectives.
MODEL OF PLANNING
 SOME OF THESE MODELS ARE:

1. “Basic” Strategic Planning

-this model is suited to small organizations with a
high volume of work. This requires time frame.
Page 159
 Purpose or mission statement

a. Goals to be accomplished to fulfill the purpose

statement.
b. Specific approaches or strategies needed to
reach each goal.
c. Specific action plans to implement each strategy
for achieving goals.
d. Consistent monitoring and updating of the plan.
 ISSUE-BASED or GOAL-BASED
PLANNING

a) External/ Internal assessment to identify

“SWOT” ( Strengths and Weaknesses and Opportunities and Threats).
b) Strategic analysis to identify and prioritize major issues or goals.
c) Designing major strategies or programs to address these.
d) Designing or updating the organization’s vision, mission, and values.
e)Establishment of action plans based on the organizations objectives,
resource needs, roles and responsibilities for implementation.

f)Documentation of issues, goals, strategies or programs, and whenever

applicable, an updated mission and vision, action plans in a Strategic Plan
document, and SWOT.

g)Development of the yearly Operating Plan document from year one of the
multi-year strategic plan.
h)Development and implementation of the Budget for year one allocation of
funds needed to fund year one.

i)The conduct of the organizations year-one operations.

j)Monitoring/reviewing/evaluating and updated the Strategic Plan document.

 ALIGNMENT MODEL

 This particular model is geared towards ensuring that the organization’s

resources are aligned with its mission and vision in order to ensure effective
operation.
 SCENARIO PLANNING

 Identifying possible scenarios or situations that the organization may face.

 Identifying strategic issues and goals and may be used to used to ensure truly
concrete solutions to problems
 “ORGANIC” or SELF-ORGANIZING PLANNING
 Requires repeated reference to common cultural values within the
organization.

FUNCTIONAL PLANNING

 This model deals with both the actual activities of the organization and
the administrative or internal matters such as work, cost, and resources.
  CROSS-SECTIONAL PLANNING

Focuses on managing the external effects on outputs of

a function. Is geared towards moving work from one
functional to another.

 OPERATIONAL PLANNING

One to look at the development of decisions being

made as they relate effectiveness of work on the
health care facility. Incorporates all other plans, past
and present, to come up with a holistic
implementation of the plan.
THANK YOU
NCM-107

Leadership and Nursing

Management
Leadership

Leader – person who influences and guides

direction, opinion and course of action.

Leadership
a process of influence
a point of polarization for group
cooperation (Chapin)
a management skill that focuses on the development and
deployment of vision, mission and strategy as well as the creation
of a motivated workforce (Bitpipe)
Leadership Roles

• Decision maker
• Communicator
• Evaluator
• Facilitator
• Risk taker
• Mentor
• Energizer
• Coach
• Counselor
Other characteristics of leaders:

• Leaders often do not have delegated authority

but obtain their power through other means,
such as influence.
• Leaders have a wider variety of roles than do
managers.
• Leaders may or may not be part of the formal
organization.
• Leaders focus on group process, information
gathering, feedback and empowering others.
Characteristics associated with Leadership

• Intelligence
• Knowledge
• Judgment
• Decisiveness
• Oral fluency
• Emotional intelligence
• Independence
• Personable
• Adaptability
• Leadership Theories:
• 1. Great Man Theory
• From Aristotelian philosophy.
• Asserts that some people are born to lead
whereas others are born to be led.
• Suggests that great leaders will arise
when the situation demands it.
•  Ex. Kings of great
Britain,Aristotle,Abraham Lincoln
• 
• 2. Trait Theory
• Assume that some people have certain
characteristics or personality traits that
make them better leaders than others.
• They have ambition,great oratory
skills,good looks,and persuasive.
• Ex. Pope John Paul, Mother Theresa,
Margaret Thatcher,Gandhi because of the
special traits they possess
Common TRaits of Leaders
• 1. Positive Traits-They bring people to progress.
Transcend their own traits to people who will
become positive leaders themselves. They are
cheerful,intelligent,and good looking
• 2.Negative Traits-They take people to
destruction. They destroy rather than build.
They are not able to grow good leaders but
followers, who go after each other. They are
bitter, aggressive, loud mouth and ugly people
• 3. Behavioral Theory
• Developed by Kurt Lewin, White and
Lippitt
• Leadership styles: Authoritarian,
Democratic and Laissez-faire
Leadership Assumed Leader
style employee characteristic
motivator
Autocratic External forces -Task accomplishment
(authoritarian) (power & rather than
authority) relationship
-use directive behavior
-makes decision alone
-exercises power w/
coercion
-expect respect &
obedience fr. staff
Leadership Assumed Leader
style employee characteristic
motivation
Democratic Internal drives -primarily concerned
(participative) and impulses w/ human relations &
team work
-communication is
open & two way
-spirit of collaboration
& joint effort that result
to staff satisfaction
Leadership Assumed Leader
style employee characteristic
motivation
Permissive Internal drives & -Few established
(laissez-faire) impulses policies
-abstain from leading
-not useful in highly
structure organization
Bureaucratic External force -Lack sense of security
-Tends to relate
impersonally to staff
-Apply fixed & inflexible
rules
-avoids decision making
w/o standards or norms
for guidance
• 4. Situational Theory/Contingency Theory
• Situational theories propose that leaders
choose the best course of action based
upon situational variable.
• Different styles of leadership may be
more appropriate for certain types of
decision-making.
Situational Theory/Contingency
Theory
• It is also called Contingency theory because the
leadership style will be dependent on the
situation that a leader is faced at the moment.
Among the proponents are Paul Hersey,
Kenneth Blanchard,Fred Fiedler,Vroom and
Yetton and Robert House
4 Leadership Styles(S1-S4)-D1-D4
• S1: Directing/Telling Leaders- The leader
defines the role and tasks of the follower and
supervises them closely. Decisions arew made by
the leader and announced, so communication is
largely one-way
• S2: Coaching/ Selling Leaders-The leader still
defines roles and tasks, but seeks ideas and
suggestions form the followers. Decisions
remain the leaders’s prerogative, but
communication is much more two -way
• S3-Supporting/Participating Leaders
• -The Leader passes day-to-day decisons such as
task allocation and processes to the follower. The
leader facilitates and takes part in decisions but
control is with the follower.
• S4-Delegating Leaders
• Leaders are still involved in decisions and
problem solving, but control is with the follower.
The follower decides when and how the leader
will be involved.
Levels of maturity:
M1 – person is unwilling and unable to perform the job.
M2- person is unable but willing to perform the job.
M3 – person is able but unwilling to perform the job.
M4 – person is able and willing to perform the job.
• 5. Contingency Theory
• Contingency theories of leadership focus
on particular variables related to the
environment that might determine which
particular style of leadership is best
suited for the situation.
• According to this theory, no leadership
style is best in all situations.
• Success depends upon a number of
variables, including the leadership style,
qualities of the followers, and aspects of
the situation.
CONTINGENCY THEORIES
- suggests that managers adapt their leadership
styles in relation to changing situation.

A. Fiedler’s Contingency Theory

- leader is most effective when he/she matches
leadership styles to situational factors.

3 Situational Factors of leadership

1. Manager – follower relationship (good – poor)

2. Task structure ( high – low)
3. Manager power ( strong to weak)
• 6. Kanter Theory
• Organizational structure shapes leader
effectiveness
• Asserted that title and position authority
were no longer sufficient to mold a
workplace where subordinates are
encouraged to think for themselves and
instead managers must learn to work
synergistically with others.
• 7. Contemporary Leadership Theories-It
describes relationship between leaders
and followers in which a distinct set of
competencies is used to allow the
relationship to achieved shared goals.
• 
• Transactional Leader=the leader
functions as a caretaker and sets goal for
the followers. They focus on the
maintenance and management of on
going and routine work.Focuses on
management tasks

• Example:Hospital owners exchange

• Example:Hospital owners exchange status and
wages for the work effort of the nurse employee.
• Transformational Leader=
• Identifies common values
• A person with this style is a true leader, who
inspires her team constantly with a shared vision
of the future.
• Motivates followers to perforn their full potential
over time by influencing change.
• 8. The Integrated Leader-Manager Theory
• Managers and leaders were integrated to
function at their greatest potential.
• 6 distinguishing traits:
• 1. They think longer.
• 2. They look outward, toward the larger
organization.
• 3. They influence others beyond their own
group.
• 4. They emphasize vision, values and
motivation.
• 5. They are politically astute.
• 6. They think in terms of change and
renewal.
9. Charismatic Theory

According to House, leaders who have charisma

(leadership qualities that inspire follower’s
allegiance and devotion) are able to make
emotional connection with their followers,
display enormous self-confidence and are able
to get others to have confidence in them.
10. Motivational Theories

Sometimes called process theories because they

are designed to do more than just explain
behavior.

4 key motivational theories:

A. Reinforcement theory

• Based on the research of B. F. Skinner, views

motivation as learning, person becomes
conditioned to associate a behavior with
consequence (either positive or negative
reinforcement).
B. Expectancy theory

• People’s expectations about a situation also

help determine their behavior, in nursing, the
“expectation” is often one of being taken for
granted, being overworked and not receiving
recognition for extra effort or a job well done.
C. Equity theory

• The degree of perceived fairness in the work

situation is the key to job satisfaction and
workers effort.
D. Goal setting theory

• In contrast to expectancy and equity theory,

suggests that people don’t spend effort for
rewards or task outcomes, but to accomplish
the goal itself.
11. Wheatley’s “new leadership” concept

Developed by Margaret Wheatley, the

organization is a living entity whose different
parts are interdependent on each other for the
entire organization to thrive.
Kinds of influence:

Assertiveness – able to stand up for her own rights without

violating those of others.
Ex. The nurse clarifies orders if in doubt before carrying out

Ingratiation – makes another feel important or good before

making a request.
The person acts humbly or is friendly before making a request

Rationality – involves convincing someone of the merits of a

detailed plan which is usually supported by
information,reasoning or logic
Blocking – a hostile form of influence where an
individual achieves the goal of influencing another
person either with the threat of or the actual act of
cutting off from communication or interaction the
other person intended to be influenced.
Coalition – collective form of influence where a person
gets several co-workers
to “back her up” when making a request. The person
is said to coalesce with other individual to show a
strong front of solidairy
6. Sanction – influence hinged on the promise of
punishment in case of non-cooperation and
reward in case of cooperation. This is the kind
of influence that is behavior based
7. Exchange – offering a favor or a personal
sacrifice as an incentive for the performance of
the request.
8. Upward appeal - obtaining support from a
higher-up to push someone into action.
Ex. A nurse talk to the manager to make sure that
Efficient leadership

The ability to maximize time and use of

resources in achieving organizational objectives
which will yield maximum output.
It is doing things right the first time.
It is more concerned with the 7 M’s
The 7 M’s

1. Money- refers to the budget that would be

allocated for an undertaking
Ex. How much would it cost to buy a latex gloves
for a medical mission
2. Men-refer to the human resources that are
needed to achieve the goal.
Ex. How many additional nurses will be added to
complete the nursing staff unit?
The 7 M’s
3. Machine-devices that help the organizations by
either performing tasks faster or doing work that
humans cannot.
- anything that makes work easier
ex. mechanical ventillator, microscope, ultrasounds,
computers
4. Materials- these are physical resources used as
inputs in any care process. They can be raw
materials or finished materials.
Ex. Cottons,syringes, stethoscope
The 7 M’s
5. Methods- refer to the body of techniques for
investigating phenomena acquiring new knowledge.
Ex. methods of preventing ill healthand/or treating ill
health such as methods to prevent ulcers, hip
fractures due to falls,constipation.
6. Moment- refers to the time as a resource.If healing
takes time,then a time constraint will greatly
reduced the amount of time to recover from
sickness.
The 7 M’s
• 7. Manager -is another important resource. A
manager is the person responsible for planning and
directing the work of the group individuals,
monitoring their work and taking corrective action.

• The above 7M’s are important to the fullfillment of

personal goal,group and organizational goal.Said
goals will not be achieved when any of these 7
resources are lacking.
Effective leadership

The ability to determine appropriate objectives

for the group or organization to ensure
appropriate and accurate results.
Concern with output or results of performance.
It is doing the right thing at the right time.
Types of followers adapted from Kellerman:

1. Alienated – independent and critical yet

passive; potentially disruptive and a threat to
the health organization.
2. Sheep – are dependent and uncritical; they
simply do as they are told.
3. Yes people – dependent or uncritical but very
active behavior; the most dangerous because
they most likely give a false positive reaction.
4. Survivors – the least disruptive and lowest risk
followers; their motto “Better safe than sorry”
5. Effective followers – self-leaders and do not
require close supervision.
4 essential qualities of effective followers:
• self-management
• commitment
• competence
• courage
Management

 The process of leading and directing all part of

an organization, often a business, through the
deployment and manipulation of resources.
 The act, manner or practice of managing,
handling, supervision or control is another
description of management.
Managers then typically:

 Have an assigned position within the formal

organization.
 Have a legitimate source of power due to the
delegated authority that accompanies their
position.
 Are expected to carry out specific functions,
duties and responsibilities.
 Emphasize control, decision making, decision
analysis and results.
 Manipulate people, the environment, money,
time and other resources to achieve
organizational goals.
 Have a greater formal responsibility and
accountability for rationality and control than
leaders.
 Direct willing and unwilling subordinates
Management Theories:

1. Scientific Management
 Established by a mechanical engineer
Frederick Taylor, the “Father of scientific
management”.
 Postulated that if workers could be taught the
“one best way to accomplish a task”,
productivity would increase.
4 Overriding principles of scientific management:

1. Traditional “rule of thumb” means organizing

work must be replaced with scientific
methods.
2. A scientific personnel system be established so
that workers can be hired, trained and
promoted based on their technical
competence and abilities.
3. Workers would be able to view how they “fit”
into the organization and how they contribute
to overall organizational productivity.
4. The relationship between managers and
workers should be cooperative and
interdependent and the work should be
shared equally.
2. Bureaucratic Organizations

 Developed by a German sociologist, Max

Weber, studied large-scale organizations to
determine what made some workers more
efficient than others.
3. Management Functions

 Developed by a French mining engineer Henri

Fayol, the “Father of Modern Management”.
 Identified the management functions of
planning, organization, command, coordination
and control.
4. Activities of Management

 Luther Gulick, expanded on Fayol’s

management functions.
 Introduced the 7 activities of management as
denoted by mnemonic POSDCORB.
POSDCORB

P – Planning
O – Organizing
S – staffing
D – Directing
CO – Coordinating
R – Reporting
B – Budgeting
5. Human Relations Management

 Human relation era developed the concepts of

participatory and humanistic management,
emphasizing people rather than machines.

A. Participative management or Participative

decision making
 Suggested by Mary Parker Follett, believes that
managers should have authority with, rather
than over, employees.
B. Hawthorne effect

 The studies, conducted by Elton Mayo and his

Harvard associates.
 Indicated that people respond to the act that
they are being studied, attempting to increase
whatever behavior they fell will continue to
warrant the attention.
C. Theory X and Theory Y

 Reinforced by Douglas Mc Gregor, that the

managerial attitude about employees can be
directly correlated with employees satisfaction.
 Theory X employees:
 avoid work if possible
 dislike work
 must be directed
 have little ambition
 avoid responsibility
 need threats to be motivated
 need close supervision
 are motivated by rewards and punishments
 Theory Y employees:
 like and enjoy work
 are self-directed
 seek responsibility
 are imaginative and creative
 have underutilized intellectual capacity
 need only general supervision
 are encouraged to participate in problem
solving
D. Employee Participation
Chris Argyris stressed the need for flexibility
within the organization and employee
participation in decision-making.

6. Motivational theory
 Emphasized that worker output was best when
workers were treated humanely.
 Most well-known motivation theories:
A. Maslow’s hierarchy of needs
 Stated that people are motivated to satisfy
certain needs, ranging from basic survival to
complex psychological needs.

B. Skinner’s operant conditioning and behavior

modification
 People can be conditioned to behave in a
certain way based on a consistent reward or
punishment system.
C. Herzberg’s hygiene or maintenance factors
 Maintained that motivators or job satisfiers are
present in the work itself and encourage people
to want to work and to do that work.

D. Vroom’s expectancy model

 People’s expectations about their environment
or a certain event will influence their behavior.

E. McClelland’s studies
 Motivated by 3 basic needs: achievement,
affiliation and power.
F. Gellerman’s stretching
 To energize people to enjoy the beauty of
pushing themselves beyond what they think
they can do.

G. McGregor’s Theory X and Theory Y

 Shows the importance of manager’s
assumptions about workers on the intrinsic
motivation of the workers.
H. Ouchi’s Theory Z
 The best way to motivate is through collective
decision-making, long- term job security, use of
quality circles and humanistic management
style.

I. Theory M
 For management, people are motivated to
work highly complex factors that maybe
biological, psychosocial, social or economic.
7. Total Quality Management (TQM)
 Emphasizes doing the right thing for customers
and the end result of this method is to satisfy
customer.
 Japanese criteria of TQM:
1. monetary incentives for workers
2. things will work out as they are supposed to
3. user’s feedback as basis for product
improvement
4. things should have aesthetic quality
8. Management By Objectives (MBO)
 A process of agreeing upon objectives within an
organization so that management and
employees agree to the objectives and
understand what they are.

Principles of Management
According to Fayol:
1. Division of work – specialization of labor;
encourages continuous improvement in skills
and methods.
2. Authority – the right to give orders and the
power to exact obedience.
3. Discipline – no slacking, bending of rules.
4. Unity of command – each employee has one
and only one boss to give instructions or
assignments.
5. Unity of direction – a single mind generates a
single plan and all play their part in that plan
but only one person is in-charge of the group’s
activities.
6. Remuneration – wage for the services rendered
to the organization.
7. Subordination of individual interests to the
general interest – an employee or group of
employee’s interests should not precede over
the interests of the whole organization.
8. Centralization – decisions are made at the top;
produces uniformity of action.
9. Decentralization – increases motivation of
nurses at lower levels since they are asked to
participate in decision-making.
10. Scalar chain – interconnectedness of people
within the organization from top to bottom.
11. Order – people and materials are in the right
place at the right time.
12. Equity & justice – fair and just treatment
13. Stability of tenure – limited turnover of
personnel.
14. Initiative – thinking out a plan and do what it
takes to make it happen.
15. Esprit de corps – promotion of team spirit
builds harmony and unity within the
organization.
Nursing Management
 A set of activities with a group of people which
involves managerial functions.
 Is establishing vision and goals, communicating
and guiding others in accomplishing these vision
and goals.
 Is facilitative, participative and empowering
others on how visions and goals are established
and carried out.
General Principles of Nursing Management:
1. Is planning
2. Is the effective use of time
3. Is decision-making
4. Meeting patient’s nursing care needs is the
business of the NM
5. Is the formulation and achievement of social
goals
6. Is organizing
7. Is the active organ of the division of nursing, of
the organization and of the society in which it
functions
8. Denotes a function, social position or rank, a
discipline and a field of study.
9. Organizational cultures reflect values and
beliefs
10. Is directing and leading
11. A well-managed division of nursing motivates
employees to perform satisfactorily
12. Is efficient communication
13. Is controlling and evaluating
Comparison of Leadership and Management
Leadership Management
Motto Do the right Do things right
things
Challenge Change Continuity
Focus Purposes Structures and
procedures
Time frame Future Present
Methods Strategies Schedules
Questions Why? Who, what,
when, where and
how?
Outcomes Journeys Destinations
Human Potential Performance
DEFINITION/
DESCRIPTION OF
MANAGEMENT
Management

 The process of leading and directing all part of

an organization, often a business, through the
deployment and manipulation of resources.
 The act, manner or practice of managing,
handling, supervision or control is another
description of management.
Managers then typically:

 Have an assigned position within the formal

organization.
 Have a legitimate source of power due to the
delegated authority that accompanies their
position.
 Are expected to carry out specific functions,
duties and responsibilities.
 Emphasize control, decision making, decision
analysis and results.
 Manipulate people, the environment, money,
time and other resources to achieve
organizational goals.
 Have a greater formal responsibility and
accountability for rationality and control than
leaders.
 Direct willing and unwilling subordinates
Nursing Management
 A set of activities with a group of people which
involves managerial functions.
 Is establishing vision and goals, communicating
and guiding others in accomplishing these vision
and goals.
 Is facilitative, participative and empowering
others on how visions and goals are established
and carried out.
•UNIVERSAL PRINCIPLES
OF MANAGEMENT
General Principles of Nursing Management:
1. Is planning
2. Is the effective use of time
3. Is decision-making
4. Meeting patient’s nursing care needs is the
business of the NM
5. Is the formulation and achievement of social
goals
6. Is organizing
7. Is the active organ of the division of nursing, of
the organization and of the society in which it
functions
8. Denotes a function, social position or rank, a
discipline and a field of study.
9. Organizational cultures reflect values and
beliefs
10. Is directing and leading
11. A well-managed division of nursing motivates
employees to perform satisfactorily
12. Is efficient communication
13. Is controlling and evaluating
8. Management By Objectives (MBO)
 A process of agreeing upon objectives within an
organization so that management and
employees agree to the objectives and
understand what they are.

Principles of Management
According to Fayol:
1. Division of work – specialization of labor;
encourages continuous improvement in skills
and methods.
2. Authority – the right to give orders and the
power to exact obedience.
3. Discipline – no slacking, bending of rules.
4. Unity of command – each employee has one
and only one boss to give instructions or
assignments.
5. Unity of direction – a single mind generates a
single plan and all play their part in that plan
but only one person is in-charge of the group’s
activities.
6. Remuneration – wage for the services rendered
to the organization.
7. Subordination of individual interests to the
general interest – an employee or group of
employee’s interests should not precede over
the interests of the whole organization.
8. Centralization – decisions are made at the top;
produces uniformity of action.
9. Decentralization – increases motivation of
nurses at lower levels since they are asked to
participate in decision-making.
10. Scalar chain – interconnectedness of people
within the organization from top to bottom.
11. Order – people and materials are in the right
place at the right time.
12. Equity & justice – fair and just treatment
13. Stability of tenure – limited turnover of
personnel.
14. Initiative – thinking out a plan and do what it
takes to make it happen.
15. Esprit de corps – promotion of team spirit
builds harmony and unity within the
organization.
•ROLE OF MANAGER
• MINTSBERG- Groups the basic roles performed
by managers as Interpersonal, informational, and
decisional.

• INTERPERSONAL ROLE shows the manager

• 1. as a symbol because of the position he/she
occupies and consists of such duties as signing
papers/documents required by organization
• 2. AS A LEADER- who hires, trains, encourages,
fires, remunerates and judges
• 3.AS A LIAISON between outside contacts such
as community, suppliers and the organization

• B. INFORMAL ROLE-
• 1. as a Manager-as a. one who monitors
information, b. dessiminates information c. as
spokesperson or representative of the
organization
•STRATEGIC
•PLANNING
 PLANNING

Critically important to and precedes all other

management functions.
 Without adequate planning, the management
process fails and organizational needs and
objectives cannot be met.
 Deciding in advance what to do; who is to do it;
and how, when and where it is to be done.
 All planning involves choosing among
alternatives.
 A proactive and deliberate process that reduces
risk and uncertainty.
Encourages unity of goals and continuity of
energy expenditure.

4 Planning modes:
1. Reactive – occurs after a problem exists.
2. Inactivism – seeking the status quo and
spending energy preventing change and
maintaining conformity.
3. Preactivism – utilizing technology to
accelerate change and are future oriented.
4. Interactive or Proactive – considers the past,
present and future and attempting to plan the
future of their organization rather than react
to it.
Steps in planning:
1. Determining objectives
2. Collecting data
3. Developing a plan of action
4. Evaluation
Types of planning:
A. According to duration
1. Strategic or long range planning
2. Operational or short range planning
B. According to approach
1. Top-down
2. Bottom-up
C. Other types
1. One type planning
2. Stand by planning
3. Back-up planning
4. Functional planning

Effective tools that assist in Strategic planning:

1. SWOT Analysis – most commonly used in
health organizations; also known as TOWS
analysis, developed by Albert Humphrey at
Stanford University in the 1960’s and
1970’s.
S – Strengths – are those internal attributes that
help an organization to achieve its
objectives.
W – Weaknesses – are those internal attributes
that challenge an organization in
achieving its objectives.
O – Opportunities – are external conditions that
promote achievement of
organizational objectives.
T – Threats – are external conditions that
challenge or threaten the
achievement of organizational
objectives.
Simple Rules for SWOT Analysis:
Be realistic about the strengths and
weaknesses of your organization.
 Be clear about how the present
organization differs from what might be
possible in the future.
 Be specific about what you want to
accomplish
 Always apply SWOT in relation to your
competitors.
 Keep SWOT short and simple.
 Remember that SWOT is subjective.
2. Balanced Scorecard
 developed by Robert Kaplan and David
Norton in the early 1990’s, this is highly
assistive in strategic planning.
 develop metrics (performance
measurement indicators), collect data and
analyze that data from four organizational
perspectives: financial, customers,
internal business processes and learning
and growth.
 avoids an overemphasis on financial
results as the primary measure of an
organization’s health and performance.
Organizational Planning: The Planning
Hierarchy

1. Vision – used to describe future goals or

aims of an organization.
2. Purpose or Mission – brief statement
identifying the reason that an organization
exists.
3. Philosophy – delineates the set of values and
beliefs that guide all the actions of the
organization; can be found in policy manuals
at the institution or is available on request.
 Organizational philosophy – provides the
basis for developing nursing philosophies at
the unit level for nursing service as a whole.
 Nursing service philosophy – should
address fundamental beliefs about nursing
and nursing care; the quality, quantity and
scope of nursing services; and how nursing
specifically will meet organizational goals.
 Unit philosophy – specifies how nursing
care provided on the unit will correspond
with nursing service and organizational goals.
 Values – beliefs that guide behavior.
4. Goals – the desired result toward which
effort is directed; measurable and ambitious
but realistic.
5. Objectives – motivate people to a specific
end and are explicit, measurable, observable
or retrievable and obtainable.
 Strategies – identify how the organization
will attain the vision.
6. Policies – are plans reduced to statements or
instructions that direct organization in their
decision-making; a statement of expectation
that sets boundaries for action taking and
decision-making.
 Implied policies – neither written nor
expressed verbally, have usually developed
over time and follow a precedent.
 Expressed policies – delineated verbally or
in writing.
7. Procedures – are plans that establish
customary or acceptable ways of
accomplishing a specific task and delineate a
sequence of steps of required action.
8. Rules and regulation – are plans that define
specific action or non-action.