Nursiing Management WR. Whole Package
Transcript of Nursiing Management WR. Whole Package
Pamantasan ng Lungsod ng MaynilaPamantasan ng Lungsod ng Maynila(University of the City of Manila)(University of the City of Manila)
Intramuros, ManilaIntramuros, Manila
College of NursingCollege of Nursing
NURSING MANAGEMENTNURSING MANAGEMENTWritten Report onWritten Report on
Planning
1. Definition—Mission, Philosophy, Goal and Objective2. Purpose3. Steps/ Process
3.1. Forecasting or Estimating the future3.2. Defining the philosophy and objectives3.3. Identifying Strategies3.4. Setting time frame3.5. Preparing the budget
4. Types5. Resistancy to planning
Submitted to Professor Nemia VerameSubmitted to Professor Nemia Verame
Submitted by:Submitted by: Amisola, Jovic
Capindit, Ma. Rosalyn Cordero, Arlene
Hollero, Fermin RomuloLumanta, HoneylettePascual, Lea Pamela
Villa- Real, Ana Cristina
BSN III-4BSN III-4
17 November 2010
PLANNING
1. Definition—Mission, Philosophy, Goal and Objective
2. Purpose
By: Lumanta, Honeylette
WHAT IS 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 predetermining a course of action in order to arrive at desired results.
• It is the continuous process of assessing, establishing goals and objectives and
implementing and evaluating them, which is subject to change as new facts are
known
COMPONENTS OF PLANNING
PRINCIPLES OF PLANNING
1. Planning is always based and focused on the vision, mission, philosophy, and
clearly defined objectives of the organization.
2. Planning is a continuous process. Provision for proper analysis would indicate
a revision or flexibility to be done to make it more effective.
3. Planning should be pervasive within the entire organization covering the
various departments, services, and the various level of management to
provide maximal cooperation and harmony.
4. Planning utilizes all available resources.
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 with short and long range plans. .
7. Projected plans must be documented for proper dissemination to all
concerned for implementation and evaluation to the extent of its
achievement.
IMPORTANCE OF PLANNING
It leads to success in the achievements of goals and objectives. Workers
relate what they do to meaningful results since plans are focused on
objectives.
It provides meaning to work. Employee or workers experience greater
satisfaction if what they do becomes meaningful to them.
It provides for the effective use of available personnel and facilities. The best
use of personnel and materials resources prevents wastage.
It helps in coping with crises. Hospital should provide for disaster plan. This
allows the worker to function more clearly and efficiently when actual
emergencies occur such as fire, typhoons, and earthquakes or during New
Year celebrations and/or other occasions when more people are likely to get
hurt.
It is cost effective. Cost can be controlled through planning for efficient
operation.
It is based on past and future activities. Evaluation of programs, schedules
and activities whether successful or not, prevents and/or reduces the
recurrence of problems and provides better ideas in modifying or avoiding
them.
It leads to the realization of the need for change. It becomes the basis for
evaluating the accomplishments of the set programs/ activities.
It provide the basis of control
It is necessary for effective control. Nurse-managers evaluate the
environment or setting in which they work or where the patients are
confined and make necessary recommendations to make hospital conditions
more therapeutic not only for the patients but for workers as well.
CHARACTERISTICS OF A GOOD PLAN
1. Be precise with clearly-worded objectives.
2. Be guided by policies and/or procedures affecting the planned action.
3. Indicate priorities.
4. Develop actions that are flexible and realistic.
5. Develop a logical sequence of activities.
6. Include the most practical method for achieving each objective
7. Pervade the whole organization.
MISSION
• It is a statement that outlines the agency’s reason for existing, which the target
clients are and what services will be provided.
VISION
• It is a statement that outlines the organization’s future role and function.
• It gives the agency something to strive for.
PHILOSOPHY
• It is a statement of beliefs and values that directs one’s life or one’s practice.
• It is the sense of purpose of the organization and the reason behind its
structure and goal.
GOALS
• It is more general and covers a broad area than objectives.
OBJECTIVES
• More specific. It is concrete.
• It is actions commitments through which an organization’s mission and
purpose will be achieved and the philosophy or belief sustained.
3. Steps/ Process
3.1 Forecasting or Estimating the future
By: Capindit, Ma. Rosalyn
Forecasting or Estimating the Future
Forecasting helps the managers 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.
FACTORS TO BE CONSIDERED:
The environment in which the plan will be executed.
Who the client will be:
Their customers and beliefs
Language/ dialects barriers
Public attitudes and behavior
The severity of their conditions and illnesses
The kind of care they will receive
The number and kind of personnel required
The necessary resources:
Equipments
Facilities
Supplies
Forecasts and estimates provide the basis for planning.
3. Steps/ Process
3.2Defining the philosophy and objectives
By: Amisola, Jovic
DEFINING THE PHILOSOPHY AND OBJECTIVES
Philosophy refers to a statement of values and beliefs that directs behavior.
Goal refers to the end or outcome to be accomplished.
Objective refers to something aimed at or striven for; things done to achieve the goal.
Philosophy
The philosophy articulates a vision and provides a statement of beliefs and
values that direct one’s practice. It should be written, included in appropriate
documents such as the staff handbook and annual reports, and reviewed periodically. If
the philosophy stated is vague, abstract terms that are not easily understood, it is
useless. Conflicting philosophies between overlapping units cause confusion and should
be avoided. Workers are most likely to interpret the philosophy from the
pronouncements and actions of the leaders in the institution. Therefore conformity of
action to belief is important.
The philosophy of an organization is derived from its mission and incorporates
the organizational values that direct the behavior of the organization. The information
provided in the philosophy—the values and principles of the organization—provides the
framework for the decision-making process of the organization and shapes the social
and professional development of the organization. The philosophy serves to allow
employees to achieve common goals (Wendenhof & Strahley, 1995). The philosophy
underlies the goals and objectives of the organization, so it is imperative that nurses
understand and know their organization’s philosophy.
When developing or reevaluating a philosophy, the manager should consider the
following:
Theory
Education
Practice
Research
Nursing’s role in the organization.
Approaches that can be used to incorporate nursing theory into the philosophy
include an eclectic approach that selects ideas from various nursing theories and
incorporates them into the philosophy statements or a theory might be adopted and
integrated into the philosophy. Attaching an explanation of the theory to the philosophy
would also be useful. Secondary sources give an overview of various nursing theorist’s
work, reference the theorists’ extensive publications, and address work related to the
theorists’ work.
Levine and Orem focus on nursing therapeutics. Wholism, holism, integrity, and
conservation are major concepts in Levine’s conservation principles. Orem’s theories of
self-care and self-care deficits are particularly useful in community health and
promotion of health situations.
Johnson and Roy emphasize the client. Johnson used a behavioral model and
identified six subsystems as (1) attachment-affiliation, (2) achievement, (3) sexual, (4)
ingestive-eliminative, (5) aggressive, and (6) dependency. Sister Callista Roy’s adaptation
model is particularly useful in acute care settings.
King, Newman, Orlando, Patterson, Zderad, Travelbee,and Wiedebach discuss
interaction. King’s conceptual framework specifies personal, interpersonal, and social
system interactions. Her theory of foal attainment is particularly useful for nursing care
and nursing administration. Newman stressed purposeful interventions and a total
person approach. Orlando addressed deliberative nursing actions that purposefully
identify and meet the patient’s needs. She maintained that automatic actions may not
meet the patient’s needs. Patterson and Zderad developed a humanistic nursing theory
and indicated that the defining event in nursing is the interaction between the patient
and the nurse. Wiedebach developed a philosophy of nursing and a flow chart that
indentifies a need for help.
Rogers focused on the environment and interactions of human beings. Her
conceptual model of unitary human beings is very abstract and thought provoking.
Middle-range theories that are specific to a particular aspect of nursing practice may be
useful for agency units. Middle-range theories of nursing are proliferating.
It is appropriate to comment on:
Skill levels needed
Advanced preparation for certain positions
Need for continuing education
Provision of educational opportunities for students, and
Specific practice modalities
The value of applying research findings to practice, supporting research efforts,
and acknowledging nursing’s role in the overall organization could also be clarified in the
philosophy.
Goals and Objectives
Goals and objectives state actions for achieving the mission and philosophy. In
fact, if the mission or purpose and philosophy are to be more than good intentions, they
must be translated into explicit goals. The more quantitative the goal, the more likely its
achievement is to receive attention and the less likely it is to be distorted.
Goals are central to the whole management process – planning, organizing,
staffing, directing, and controlling/evaluating. Planning defines the goals; the institution
is organized and staffed to accomplish goals. Direction stimulates personnel toward
accomplishment of the objectives and control compares the results with objectives to
evaluate accomplishments.
Goals and objectives may address services rendered, economics, use of
resources – people, funds, facilities – innovations, and social responsibilities. Objectives
are selective rather than global, are multiple, and cover a wide range of activities. The
immediate, short-term, and long-term goals should be balanced, interdependent and
ranked in order of importance. It is common to have more short-term than long-term
goals.
Because goals are dynamic, they change over time. They should be reviewed
periodically so that they can be changed in an evolutionary rather than a radical
manner. Goals should be specific rather than vague, and challenging yet reachable.
Necessary support available should be available.
Goals help focus attention on what is more important and are broader
statements than objectives. Objectives are more specific ways to reach the goal. It is
recommended that objectives be achievable, specific, measurable, and outcome
oriented, starting with “to” followed by a verb. Each objective should be about a single
result with a target date. Strategies identify how an organization will attain the vision.
The development of long and short-term objectives is appropriate. A form with four
columns (one for goals/objectives, one for strategies/actions, one for target dates and
person or persons responsible, one for accomplishments) can be a helpful planning tool.
Sample Philosophy, Goal and Objective
Philosophy of General Hospital
General Hospital is committed to assessing and meeting the physical, emotional,
spiritual, environmental, social, and rehabilitative needs of the citizens in the region.
The worth, dignity, and autonomy of individuals (customers, employees, and others) are
recognized, as is each individual’s right to self-direction and responsibility for one’s own
life. Individual uniqueness will be considered when assessing needs and delivering
quality care. Educational pursuits, research, and public service programs will be used
toward innovations and improvement of health care in the region. General Hospital
Personnel will work in collaboration with customers and in partnership with other
organizations to provide cost-effective services.
Goal
Develop and implement staff development programs to meet the need for increased
knowledge
Objective
Develop and implement at least 12 staff development programs by the end of the fiscal
year
***References:
Jones, Rebecca. Nursing Leadership and Management: Theories, Processes and Practice.
USA: F.A. Davis Company, 2007.
Tomey, Ann Marriner. Guide to Nursing Management and Leadership. Singapore:
Elsevier Pte Ltd, 2009.
Venzon, Lydia and Nagtalon, Jennifer. Nursing Management towards Quality Care.
Quezon City: C&E Publishing Inc., 2006.
3. Steps/ Process
3.3Identifying Strategies
3.4Setting time frame
By: Pascual, Lea Pamela
Identifying Strategies
Strategy is the techniques, methods, or procedure by which the overall plan of
the higher management achieves desired objectives.
Programs are activities put together to facilitate attainment of some desired
goals.
Time Management is a technique for allocation of one’s time through the setting
of goals, assigning priorities, identifying and eliminating time wastes and use of
managerial techniques to reach goals efficiently.
Principles of Time Management
1) Planning for contingencies-planning anticipates the problem that will arise from
actions without thought.
2) Listing of task-task to be accomplished should be done in sequence which is
prioritized according to importance.
3) Inventory
4) Sequencing
5) Setting and keeping deadlines- and adhering to deadline is an excellent exercise
in self discipline.
6) Deciding on how time will be spent.
Setting the Time Frame
1. Conduct an inventory of your activities.
2. Set goals and objectives and write them down.
3. With the use of calendars, executive planners, logs or journals, write what you
expect to accomplish yearly, monthly, weekly or daily.
4. Break down large projects into smaller parts.
5. Devote a few minutes at the beginning of each day for planning.
6. Organize your work space so it is functional.
7. Close your door when you need to concentrate.
8. Learn to delegate.
9. In a meeting, define the purpose clearly before starting.
10. Take or return phone calls during specified time.
11. Develop effective decision-making skills.
12. Take rest breaks and make good use of your spare time.
3. Steps/ Process
3.5 Preparing the budget
By: Villa- Real, Ana Cristina
PREPARING THE BUDGET
1. A budget is the annual operating plan, a financial “road map” and plan which
serves as an estimate for future costs and a plan for utilization of manpower,
material and other resources to cover capital projects in the operating programs.
2. A nursing budget is a plan for allocation of resources based on preconceived
needs for a proposed series of programs to deliver patient care during one fiscal
year.
3. A hospital budget is a financial plan to meet future service expectations.
4. A budget is simply a plan for future activities expressed in operational as well as
financial or monetary terms. In health care institution, budget consists of four
components:
a. Revenue Budget- summarizes the income which the management
expects to generate during planning period
b. Expense budget- describes the operational and financial terms for a given
period of time.
c. Capital budget- outlines the programmed acquisitions disposals and
improvements in an institution’s physical capacity.
d. Cash budget- represents the planned cash receipts disbursements as well
as the cash balances expected during the planning period.
BEBEFITS DERIVED FROM THE BUDGETARY PROCESS
The major benefits of budgetary process can be categorized under the major
functions of planning, coordination and control.
1. Planning
a. Stimulates thinking in advance; anticipates future opportunities or
problems and prepares for them.
b. Leads to specific planning—volume and types of services to be
rendered and revenue to be delivered there from; number and type
of personnel required; cost, volume and type of supplies needed; cost
of fix asses when needed; cost and source of funds, cash collections
and disbursements.
c. Budget preparation stimulates action and interaction. Mechanical
budgeting process gives empirical information, additional benefits
result from the organizational thinking process that is generated and
the worthwhile interrelationships that develop.
2. Coordination
a. Balancing effect on the total organization—quantity and quality of
service to be given a patient should be closely equal to the expected
revenue; hospital departments are interrelated, future plans of one
department must complement the plans of other affected
departments.
b. Encourages exchange of information
c. Stimulates team play or team approach—enabling team member to
contribute to organizational planning as well as to see the results of
good team play, the budget becomes a stimulant to employee
commitment and efficiency, and as effective guide to proper
utilization of resources.
3. Comprehensive Control
a. Gives the administration an opportunity to evaluate thinking of the
budget contributor. Is the budget planning realistic? Are standards
too high or to low?
b. Comparisons between the actual expenditures and budgeted
standards can be made with no or little effort.
c. Cost consciousness.
FACTORS IN BUDGET PLANNING
1. Type of patient, length of stay in the hospital and acuteness of illness
2. Size of hospital and bed occupancy
3. Physical lay out of the hospital, size and plan of the wards, units, nurse’s
station, treatment rooms, etc
4. Personnel policies
a. Salaries paid to various type of nursing personnel including OT pay or
shift differential
b. Extent of VL, SL, holidays
c. Provision for staff development programs
5. Grouping of patients such as those in specialized areas
6. Standards of nursing care: kind and amount of care to be given as it affects
the number of hours of bedside care
7. The method of performing nursing care whether simple or complex;
8. the method of documentation
9. Proportion of nursing care provided by the professional nurses and those
given by non-professionals
10. Amount and quality of supervision available and provided;
11. the efficiency of job description and job classification
12. Method of patient assignment whether functional, case, team or primary
13. Amount and kind of labor-saving devices and equipments
14. Amount of centralized service provided: sterile supply , central o2 supply,
linen supply
15. Nursing service requirements of the ancillary departments: clinics, admitting
office, ER
16. Reports required by administration whether simple or complex
17. Affiliation of nursing students or medical students
Budgetary process
Budget committee
Assures orderly and timely development of the budget.
Assists the budget officer in budget preparation and in monitoring the
budget.
Chief Nurse or his/ her assistant
Usually a member of the budget committee.
Works with the supervisors and head nurses in preparing the budget for
the nursing service.
Compiles and completes the final draft of the budget and presents this to
the Budget Officer or Hospital Administrator
Nursing personnel
Their participation can lead to cost consciousness, awareness of
activities, and increased cost- effectiveness.
Past operations must be analyzed and the overall master staffing plan must be
reviewed—supervising nurse works with the head nurses to determine the staff
requirements for each unit.
Factors to be considered in budget preparation:
o Assurance of standards (philosophy and objectives of the hospital and the
division of nursing
o Past experiences in the unit
o Anticipated needs of the unit
o Percentage of the unit occupancy
Estimation of staff for each unit should be based on the following:
o number of patients
o the number of nursing care hours needed
o provision of vacation
o sick and other leaves
o holidays
o Average number of absences per staff member per year.
o Privileges—attendance in continuing education programs
New activities/ program should also be considered-- new patient services, staff
development programs or changes hospital services that affect the required
nursing services.
Ascertain the amount and kind of supplies needed for the operation of each
nursing unit.
o Review of past expenses and consumption provides data for planning
o Requests fort the replacement of capital equipment must be
supported with documented justification
Components of Budget
o Three major budgets of budgetary control program:
a. Cash Budget
o Forecast the amount of money received
o Consists of beginning cash balance, estimates of the receipts and
disbursement, and estimates balance for a given period
corresponding to that of the operating and capital budgets.
o Prepared by estimating the amount of money to be collected from
patients and allocating it to cash disbursement required to meet
obligations promptly as they come.
b. Operating Budget
o Deals primarily with salaries, supplies, contractual services,
employee benefits, laundry service, drug and pharmaceuticals, in
service education, travels to professional meetings, books,
periodicals, professional magazines and repair and maintenance
o Composed of the revenue and the revenue and expense budget.
c. Capital Expenditure budget
o Consist of accumulated data for fixed assets that are expected to
be acquired during the budgeted period.
o Includes estimated costs and sources of funds for expected
replacements, improvements and additions to fixed assets
o (cost of estimated requirements + anticipated dates of acquisition)
Individual report
=information about anticipated procurements, priorities and
timing as well as feasibility of acquisition
o Proposal for capital equipment must be accompanied by
complete description of the item—statement as to the reason of
purchase (addition, improvement or replacement), classification
(prioritized as urgent, essential, economically desirable, or just
desirable) and probable outcome of the purchase (improvement
of patient care, increase or decrease department revenue,
whether there will be charge for its use and if so, how much,
including a probability of the frequency of its use
4. Types
By: Cordero, Arlene
Types of Planning
1. Long range/ strategic :
It is usually a type of planning good for 3-5 years in the future. It is an in depth
analysis of the internal environments strength and weaknesses and the external
opportunities and threats so that realistic goals can be set for the preferred future. It
determines the direction of the organization, allocates resources assigns responsibilities
and determines time frames.
History: As the year goes by, the health care setting goes with the trend of form
curative to preventive, from individual based treatments to population based
treatments. From content mastery to process mastery, from being governed
professionally to being governed managerially, from paper health records to
computerized health records.
Purpose: Gives direction to the organization, improves efficiency, weeds out
poor underused programs. Eliminates duplication efforts, concentrates resources on
important services, improves communications and coordination activities, provides a
mind expanding opportunity, allows adaptation to the changing environment, sets
realistic and attainable yet challenging goals, and helps ensure goal achievement.
Goals: generic
2. Short range/Operational:
Nurse managers are more likely to be involved in this. It is done in conjunction
with budgeting, usually a few months before the new fiscal year. It develops
departmental maintenance and improvement goals for the coming year.
Purpose: It is more on developing and monitoring tactics, plans, and evaluation
plansfor a short term planning.
Goals: specific
Top level manages such as chief executive officers, presidents and division heads
do strategic planning for 3-5 years. Middle level managers such as supervisors and
clinical specialists do intermediate planning for 6 mos. to 2 years. Lower level managers
such as managers of nursing units, team leaders, case managers and primary care nurse
do operational planning 1 week to 1 year.
5. Resistancy to planning
By: Fermin, Hollero
Why manager fail to plan effectively?
Many nurse- managers fail to plan effectively for different reasons. They may
lack knowledge of the philosophy, goals and objectives of the agency or lack
understanding of the significance of the planning process. They may not know how to
manage their time to devote for planning. They may lack confidence in formulating
plans of may fear that planning may bring out unwanted changes that they are unwilling
to undertake or are unable to cope up with. Knowing these factors will help nurse-
managers to overcome their weaknesses and utilize planning as the key to success in
their work.