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Management Process

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Planning

Planning involves no actual or physical tasks, and is merely a management tool used to conceptualized what is to be done in a future time. It is a future projection of the group’s goal and allows for the team to decide (form a blueprint) in advance. There are different types of plans:

  • Standing/Operational Plan: a plan used for regular or daily activities.
  • Strategic/Contingency Plan: a plan used during emergencies or crises.
  • Long-Term Plan: a plan utilized and revised or amended as necessary over weeks, months, or even years to accomplish and evaluate.

Planning involves multiple elements that outline the organization’s concept:

  • Mission: the present reason for establishing the organization, and the actual function and purpose of its existence.
  • Vision: what the organization wishes to achieve in the future; the prospective reason for its establishment.
  • Philosophy: the set of values and beliefs in an organization to promote unity in the fulfillment of their respective goal.
  • Goal: the general statement of the purpose of the organization.
  • Objective: the specific and measurable statement of the purpose of the organization.
  • Policies: a general statement on the course of action to be undertaken in fulfilling the organizational goals.
  • Procedure: the specific statement of a step-by-step process in undertaking the goal of the organization.
  • Rules: punitive steps in the event of any misdemeanor or omissions in the organization.

Budgeting is a tool used by a nurse manager during planning when allocating future resources in their respective health care units.

  • Personnel Budget: allocated expenses for compensation and remuneration of staff or workers, and is the most important budget.
  • Operational Budget: allotted expenses for day-to-day activities undertaken by an institution to operate, e.g. electricity, medical-surgical supplies, and other equipment for short-term use.
  • Capital Budget: capital expenditures; major equipment and facilities that can be utilized for long periods of time. It is the most expensive form of budget.
  • Other forms include a zero-based budget (all expenses equal all income), fixed-ceiling budget (a budget is set and does not move despite any changes in activity), and flexible budget (budget depends on organizational activity).

Organizing

Organizing is a management tool that determines the right people and their tasks to perform to achieve common objectives. It normally utilizes an Organizational Chart that structurally outlines the various parts and areas of an organization, and how they are interrelated with one another. It determines organizational control, the policy and decision-making process, and evaluates the strong and weak areas in an organization.

Staffing is a tool to determine the appropriate and adequate ratio of health care personnel to perform their respective organizational tasks for the benefit of the clients. These are schedules which the staff follows, and take various forms/types:

  1. Traditional: an 8-hours/day schedule (40 hour week)
  2. Non-Traditional: >8 hours/day schedule
  3. Baylor Plan: the division of a schedule to both traditional and non-traditional schedules (8 hour shifts during weekdays, 12 hour shifts during weekends)
  4. Part-Time: flexible (elective) and shorter schedules
  5. On-Call: the worker may be called to work when necessary, but is otherwise off-work.

Staffing can take on different patterns, depending on how schedules are decided/change:

  1. Centralized Staffing Pattern: schedules are decided and approved by top-level administrators.
  2. Decentralized Staffing Pattern: schedules are discussed and submitted by unit managers to administrators, who then approve the schedules.
  3. Permanent Schedule: an unchanging schedule.
  4. Self-scheduling: the operational-level workers decide on their shifts.
  5. Cyclical: definition needed

Nursing Care Delivery Methodologies enumerate the methods that a nursing staff team can respond to patient needs:

  1. Case Method: total patient care is given by an individual nurse to a specific case or diagnosis of a client. The nurse informs the nurse-manager regarding the patient’s concerns (private duty nurse).
  2. Functional Method: also commonly known as “task-based nursing”, wherein nurses are assigned specific tasks for patients. It is the poorest method of nursing care delivery, but is highly utilized when nurses are scarce or patients are abundant.
  3. Team Nursing: teams are formed from the group, and appoint a team leader or “charge nurse”. They assume responsibilities from the nurse manager for their members, and coordinates and supervises all the care provided by members of the team.
  4. Primary Nursing: direct patient care formulated by a primary nurse (and their team, if also utilizing team nursing) from the moment of admission until discharge. This is practically 24-hour continuous care, and demands an increase in accountability, responsibility, planning, communication, and coordination.

Directing/Delegation

Delegation is a management function wherein a task, procedure, or obligation is done by another person who accepts it. Effective delegation is done by:

  1. Determine the task to be delegated.
  2. Choose a delegee to perform the task.
  3. Match staff competency with the task. There must be capacity and acceptance to perform the delegated task.
  4. Provide open and continuous communication with the delegee.
  5. Obtain constant feedback and evaluation from your subordinate during and after performing the task. As such, only tasks that the delegator can best perform, assess and evaluate may be delegated.

There are many principles and characteristics to follow for delegation to be effective:

  • Provide a complete and continuous instruction for the delegated task.

  • Assume a face-to-face position and utilize proper eye contact when delegating.

  • Provide a calm environment when providing instructions.

  • Do not delegate during an emergency situation, as this should normally take time. Rushing delegation may result in errors and miscommunication.

  • Responsibilities may be delegated, but not accountability. Any errors by the delegee will be shared by the delegator.

  • Delegation should not breach confidentiality.

  • There must be a periodic and constant evaluation of tasks completed.

  • Give appropriate assistance and supervision.

Coordinating/Collaboration

Quality care is provided by multiple members of the health care team. Continuous communication, relationship, and interaction with other professionals is required for holistic care. There are three kinds of coordination/collaboration:

  • Intradepartmental/Interpersonal Coordination occurs within the same unit.
  • Interdepartmental Coordination occurs between departments under the same institution.
  • Interinstitutional/Agency Coordination occurs between institutions.

Evaluation/Controlling

The final step of the management process wherein the nurse manager determines whether the desired goal was met or achieved in accordance with organizational standards. It also involves management of possible outcome risk. Evaluation can be on-going, intermittent, terminal, or routine. Evaluation can be done through:

  1. Self-appraisal
  2. Checklist System
  3. Peer Review
  4. Nursing Audit
  5. Performance Appraisal
  6. Customs/Client Evaluation
  7. Benchmarking
  8. GANTT Charting
  9. Program Evaluation and Review Technique (PERT)
  10. Nursing Rounds
  11. Sentinel Event Review

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