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Lecturer : Prof. Joseph R. Domingo Date : February 16, 2021

Subject : Leadership and Management Pages : 5

Lecture Coverage Summary IV. Controlling

I. Planning A. How do managers exercise “control”?
A. Types of Planning 1. Establish standards.
1. Strategic (Fiscal) 3. Program Planning 2. Measure actual performance VS standards.
2. Operational 4. Nursing Care Plan 3. Correcting deviations.
B. Elements of Planning
1. Forecasting B. Objective and Method
2. Defining the Philosophy / Objectives of the 1. Task Analysis
Nursing Service 2. Quality Control
3. Budgeting
4. Establish Standard, Policies, and
Procedures C. Evaluation
5. Developing and Scheduling Programs 1. Performance Appraisal
2. Nursing Audit
II. Organizing
A. Organizational Principles D. Steps of Progressive Discipline
1. Unity of Command 1. Counselling
2. Requisite Authority 2. Verbal
3. Continuing Responsibility 3. Written
4. Departmentation 4. Preventive Suspension
(Homogeneous Assignment) 5. Penalty Suspension
5. Span of Control 6. Discharge / Dismissal
6. Exception
B. Elements of Organizing
1. Organizational Structure
2. Staffing I. Planning
3. Job Description
4. Placement Definition
5. Scheduling ● The process of pre-determining a course of action in
order to arrive at a desired result.
C. Patient Classification System ● The most basic and essential activity of
1. Minimal 3. Total management.
2. Moderate 4. Critical ● Thinking ahead and making future projections.
● Done by the Top Managers.
III. Directing
A. Elements of Directing Purpose of Planning
1. Delegation ● Analytical thinking
2. Supervision (Leading) ● Focus on the result
3. Motivation ● Attainment of goals
4. Communication ○ Goals - desired outcomes
5. Coordination ○ Objectives - stated outcome
6. Staff Development ● Avoids crisis
7. Decision Making ● Employee involvement and better communication
8. Conflict Resolution ● Cost-effective
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Basic Points in Planning 2. Defining the Philosophy / Objectives of the
1. Proactive Nursing Service
2. R-U-M-B-A Involves the V-M-Ph-G-O.
a. Reasonable - a clear indication of doing it ● Vision. It is what the organization wants to be
b. Understandable - simple and direct to the point in the future.
c. Measurable - specific and time bound ● Mission. The reason for existing.
d. Believable ● Philosophy. The core beliefs of the
e. Acceptable - within acceptable practice of the organization.
organization; following the culture ● Goal. The outcome to accomplish.
3. Flexible ● Objectives. Steps taken to reach the goal.
4. Midcourse correction
5. Projected plans 3. Budgeting
● Plan for allocation of resources.
● Setting operating cost limits.
A. Types of Planning ● Components of Budgeting:
1. Revenue - the income which the
1. Strategic (Fiscal Planning) management expects to generate
● Long-term planning (takes years) 2. Expense - the amount invested / spent
● It covers the whole plan of the organization. 3. Capital - main investments; outlines the
● Includes the V-M-P-h-G-O. programmed acquisitions, disposals and
● Tool used: SWOT improvements
4. Cash / Petty Cash - Money that is ready to
2. Operational be utilized. A small amount of cash kept on
● The daily planning or needs of the institution. hand to pay for minor expenses.
● A day-to-day basis of planning. ● Types of Budget
1. Personnel (Human Resources)
3. Program Planning - worker’s salary and labor expenses
● Intended for staff development, orientation, and - the most expensive type of budget
training. 2. Operational (Daily Expenses)
● Involves teamwork among members. - budget intended for daily use
● Encourages team building to help the staff - food, transportation, electricity,
improve. daily supplies and maintenance
● Methods of staff development: 3. Capital
1. Orientation - rules and regulations - assets and equipment used long-term
2. In-service training - paid by the hospital
● Budgetary Process
3. Continuing education - eg. Master’s
1. Planning
4. Specialized training - developing certain
2. Preparation
skills (eg. IV insertion, Dialysis Nursing)
3. Modification / Approval
4. Monitoring / Liquidation
4. Nursing Care Plan (NPC)
● Specific nursing care provided by the nurse.
4. Establish Standard, Policies, and
Procedures
B. Elements of Planning 1. Standard. A minimum requirement. It is the
desired quality of the level of performance.
1. Forecasting 2. Policy. Broad guidelines for managerial
● Looking into the future (projections) and decision-making.
deciding in advance what the agency would like 3. Procedures. A specific direction for
to do in order to get there. implementing written policies.

5. Developing and Scheduling Programs

● Time management
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II. Organizing B. Elements of Organizing

Definition 1. Organizational Structure

● The process of organizing and establishing formal ● Defines the formal relationships within the
authority. institution and the process by which the group
● Involves department managers. (Top, Middle, Low) is formed.
● Types of Lines:
A. Organizational Principles 1. Solid lines
➔ A direct connection to team members.
1. Unity of Command 2. Broken lines
● Following only one boss or employee. ➔ Staff positions
● Types of Lines: ➔ Intended for communication only.
1. Upward line 3. Vertical lines
- (top to low) following the boss or giving ➔ Follows the unity of command.
feedback ➔ The staff reports to the head nurse.
2. Downward line 4. Horizontal lines
- (low to top) boss gives instruction ➔ The same sphere of power.
2. Requisite Authority ➔ Similar position and limitations.
● Never by-pass the hierarchy. Major Characteristics
● Report first to your immediate superior. ● Division of Work
3. Continuing Responsibility ● Chain of Command
● Refers to endorsements. ● Type of Work to be Performed
● Responsibility. The obligation to perform the ● Grouping work Segments
assigned work. ● Levels of Management
● Accountability. Taking full responsibility for
the quality of work and behavior while engaged 2. Staffing
in the practice of the profession. ● The process of determining and providing the
acceptable number and mix of nursing
4. Departmentation personnel to produce the desired level of care
(Homogeneous Assignment) to meet patient demands.
● Workers performing similar assignments are ● Involves:
grouped together for a common purpose. 1. Selection of Personnel
● Promotes specialization of activities and 2. Staff Development
simplifies the administration works, helps 3. Scheduling
maintain effective control. 4. Giving of Assignments
5. Span of Control
● The number of workers a manager can 3. Job Descriptions
effectively handle. It should be limited ● A statement that sets duties and responsibilities
depending upon the pace and pattern of the of a specific job.
working area. ● Includes the qualifications and characteristics
of the person to perform successfully.
6. Exception ● Negligence could result from not knowing your
● Recurring decisions should be handled in a job or responsibilities.
routine manner by lower managers. ● Contents of a job description:
● This enables the subordinates to learn how to 1. Job title
make decisions on their own. 2. Position classification
3. Salary grade
7. Decentralization (Proper Delegation) 4. Job summary (how you differ from
● The process of allowing the lower-level others)
management or staff to make decisions on their
own.
● Involves delegation and assignment.
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4. Placement III. Directing
● Where you will be placed in the organization
and what type of job they will be assigned to. Definition
● Fosters personal growth and provides a ● The management involves the staff.
motivating climate for employees to maximize ● The issuance of orders, assignments and
productivity. instructions that enable the nursing personnel to
understand what are expected of them.
5. Scheduling ● Involves supervision and guidance.
● RA 7375 - 40 hours a week maximum ○ Guidance. Instructions and things to follow.
● Assigning working days and offs to a personnel ○ Supervision. Checking and monitoring the staff
with a time table of planned workdays and while they are doing the procedure or task.
shifts. ● Actuates efforts to accomplish goals.
● Types of scheduling:
1. Centralized A. Elements of Directing
➔ One person designates assignments.
➔ Usually done by the Chief Nurse. 1. Delegation
2. Decentralized ● Entrusting a task to another person who serves
➔ Done by the Head Nurse or Supervisor. as a representative.
● The managers can delegate to the staff but not
assign their work.
C. Patient Classification System ● Purpose:
The system of categorizing patients based on their ○ Saves time
clinical needs observed by the nurse. ○ Develops others for their future roles
○ Motivates subordinates
1. Minimal ○ Free themselves from managing
● Patients who are:
1. Stable 3. Ambulatory
2. For discharge 4. Very independent Person Who Person Delegated
DELEGATION Delegated To a Task
2. Moderate (Manager) (Staff)
● Patients who need minimal assistance.
Authority ✓ ✓
● They are stable but not yet for discharge.
3. Total Responsibility ✓ ✓
● Patients who are:
Accountability ✓ ✘
1. Fully dependent
2. Non-ambulatory
3. In immediate danger Person Who Person Who Was
4. 50% stable and 50% unstable ASSIGNMENT Assigned Assigned To
5. Possible chance of deterioration (Manager) (Fellow Manager)

4. Critical Authority ✓ ✓
● Patients who are:
1. Fully dependent Responsibility ✓ ✓
2. Care needed is 1-on-1
3. Newly admitted
Accountability ✘ ✓
4. Unstable
5. Possible death
6. For immediate surgery
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A. Elements of Directing - continued
IV. Controlling
2. Supervision (Leading)
Definition
● Providing guidelines (Do’s and Don’ts) for the
● Evaluating the results and resources of the
accomplishment of tasks or activities.
organization. Occurs during planning, organizing,
● Monitoring while the staff is doing the task.
and directing activities.
● The staff is motivated to perform independently.
● It opens opportunities for improvement and
3. Motivation compares performance against set standards.
● An innate force within the individual that
influences strength or direction of behavior. A. How do managers exercise “control”?
● The 3 landmarks in the field of motivation: 1. Establish Standards
1. Power. The need to make others behave in ● The minimal ideal results and outcome criteria.
a way they would behave.
2. Affiliation. Desire for a friendly and close 2. Measure Actual Performance VS Standards
relationship. ● Compare the performance against the set
3. Achievement. The need to excel. minimum ideal results and baseline outcome
criteria.
4. Communication
● The transmission of information between or 3. Correct Deviations
among individuals. ● Involves processes to improve performance
● Facilitates work and effects change. and reach the set standards or goals.
● Can be verbal or non-verbal. B. Objectives and Methods
● Good communication is open and effective.
1. Task Analysis
5. Coordination ● Identifying the tasks are done and notdpme.
● Involves asking help from other departments.
● The conscious activity of assembling and 2. Quality Control
synchronizing differentiated work efforts so that ● A team assigned to stop what is not good or
they function harmoniously. continue what is good.
6. Staff Development C. Evaluation
● Preparing the staff to be competent in taking on 1. Performance Appraisal
their tasks, duties and responsibilities. ● Refers to evaluating an employee’s
● Involves: performance against the standards.
1. Orientation ● Valuable in controlling human resources and
2. Specialized training productivity.
3. Continuing education
2. Nursing Audit
7. Decision Making ● Refers to documentation.
● Making decisions for the organization. ● The process of collecting information from
● Steps of decision making: nursing reports and other documented
1. Definition of the problem evidence about patient care and assessing the
2. Analysis of the problem quality of care by the use of quality assurance
3. Development of alternative solution programmes.
4. Selection of a solution
D. Steps of Progressive Discipline
5. Implementation and evaluation of results
1. Counselling
8. Conflict Resolution 2. Verbal
● Members have a negative relationship with one 3. Written
another. It needs to be resolved. 4. Preventive Suspension
5. Penalty Suspension
6. Discharge / Dismissal