Key Management and Leadership Concepts

Key Management and Leadership Concepts

• Leadership involves motivating individuals toward a shared objective.
• Management entails directing an organization using available resources.
• Planning determines philosophy, goals, objectives, and procedures while managing change and resources
• Organizing establishes a structure to execute plans and meet unit goals.
• Staffing includes recruitment, interviewing, hiring, and orientation.
• Leading/Directing incorporates motivation, conflict resolution, delegation, and communication.
• Administration is the strategic management of staff, patient care, and facilities via policies.
• Controlling includes performance reviews, fiscal and quality accountability, as well as ethical, legal, and professional oversight.

Planning Essentials

• Planning is a detailed course of action to achieve specific objectives and goals.
• Planning involves deciding in advance what to do, who will do it, how, when, and where.
• Planning is critical and precedes other management functions.
• Planning includes evaluation, re-evaluation, and prioritization steps.
• Those affected by a plan should be included in its development.
• Planning occurs at all organizational levels, formally or informally.
• Planning can be carried out by individuals, committees, professional planners, or agencies.
• Vision statements describe the future aim of the organization.
• Mission statements define the organization's reason for being.
• Organizational philosophy stems from the mission, guiding actions with values and beliefs.
• Company philosophy distinguishes how work is approached.
• Goals are desired results toward which effort is directed.
• Objectives are specific and measurable goals.
• Policies are statements guiding organizational decision-making.
• Procedures establish customary steps for specific tasks.
• Rules define specific actions or non-actions within policies and procedures.

Stages and Benefits of Planning

• Review the planning hierarchy.
• Evaluate the current situation and predict future trends.
• Create and convert a planning statement into an action statement.
• Planning helps managers meet standards and utilize resources effectively.
• Planning ensures unity of goals and continuity of energy and resources.
• Planning acts as a control measure, reduces stress, and saves time.
• Planning ensures adequate coverage in various units.

Principles of a Good Plan

• Clearly defined objectives (SMART)
• Proactive approach
• Reliable and flexible
• Realistic resource allocation
• Clearly stated activities and outcomes
• Consideration/involvement of all affected parties

Different Types of Planning

• Reactive planning addresses problems after they occur, focusing on crisis management.
• Reactive planning can lead to stress, disorganization, and higher costs.
• Inactive planning resists change, maintaining the status quo with slow, rigid adjustments.
• Inactive planning can cause inefficiency, resistance to progress, staff dissatisfaction, and turnover.
• Preactive planning anticipates future needs using technology and trends, often overestimating benefits; can lead to resource wastage and ignores current issues.
• Interactive/proactive planning combines past experiences, current needs, and future goals, addressing potential issues effectively; promotes efficiency, adaptability, and better patient results.
• Long-range planning (5+ years) focuses on strategic future goals and healthcare alignment.
• Intermediate planning (1-5 years) targets objectives within a shorter timeframe, bridging long-term vision and daily tasks.
• Short-range planning (daily to 1 year) focuses on immediate priorities, involving operational activities to ensure smooth operations and quick decisions.

Organizational Level Planning

• Planning occurs at different hierarchical levels to achieve strategic goals, which include: corporate, divisional, and functional.
• Corporate (strategic) planning sets the long-term vision and objectives, focusing on 5+ years into the future, led by executives.
• Divisional (tactical) planning occurs at the department level to achieve corporate goals within 1-5 years, managed by mid-level leaders.
• Functional (operational) planning involves short-term, day-to-day activities for smooth operations, generally completed in less than a year and completed by unit supervisors.

Strategic Planning Tools

• SWOT Analysis lists and analyzes strengths, weaknesses, opportunities, and threats.
• SWOT helps uncover strategic improvements for any aspect of a business.
• Balanced Scorecard measures company management performance using KPIs from financial, customer, internal processes, learning, and growth perspectives.

Steps for Strategic Planning

• Define the organization's purpose.
• Establish realistic goals.
• Identify stakeholders and assess their views.
• Communicate goals clearly.
• Develop ownership and strategies.
• Ensure effective resource use.
• Provide a basis for progress measurement.
• Build consensus on the organization's direction.

Factors Impacting Healthcare Planning

• Information technology
• Demography (patient & staff)
• Cultural diversity (patient & staff)
• Economics & providers
• Shift to wellness
• Patient demand for accountability
• Information continuity (across providers)

Planning Barriers

• Failing to set goals
• Inflexibility
• Working in isolation
• Vagueness
• Poor timing
• Failure to evaluate
• Fear of failure

Budget Basics

• A budget is a financial plan with estimated expenses and income.
• budgeting allocates resources based on forecasted needs for specific programs/activities.
• Different budget types include personnel, operating, and capital.

Budgeting Process

• Review previous budget
• Assess requirements
• Set goals
• Get approval
• Implement budget
• Monitor and evaluate

Budgeting Methods

• Flexible budgeting allows switching between budget levels.
• Performance budgeting emphasizes outcomes over activities.
• Incremental/flat budgeting uses percentage increases.
• Zero-based budgeting requires a fresh look at all programs annually.

Budget Process Monitoring

• Cost accounting tracks costs of nursing, staffing, and hospital operations.
• Supply inventories manage medical supplies to prevent excessive spending.
• Recording tracks financial transactions for discrepancy prevention.
• Reporting generates financial reports to assess budget performance.

Organizing as a Key Management Function

• Organizing follows planning; if not organized, failure is inevitable.
• Organizing creates a formal structure and management hierarchy to achieve goals.
• Organizing defines relationships, outlines procedures, and assigns tasks.
• Fayol stated that an organization needs a supervisor when there are enough workers.
• An organization is a group of people working together to achieve a specific purpose.
• All organizations have purpose and structure that can be formal or informal.

Types of Organization

• Formal organization is designed and approved by management
• Informal organization is social in nature, arising from within the formal organization.

Organizing Goals

• Division of labor
• Clarity of relationships
• Optimum resource utilization
• Effective administration
• Adaptation and personnel development
• Greater satisfaction, expansion, and growth

Essential Structures

• The framework within which people work and utilize financial and physical resources in an effective and efficient manner is the organizational structure.
• Way in which a group is formed, its lines of communication, and its means for channeling authority and making decisions
• The organizational culture involves values, communications and other factors affecting operations.

Bureaucratic Organizational Theory

• Max Weber’s Bureaucratic Organizational Theory emphasizes structured hierarchy, clear roles, and formal rules.
• Clear chain of command with structured leadership is known as hierarchy of Authority.
• Standardized policies ensure consistency in formal rules.
• Decisions are made based on rules, not personal preference means there is impersonality.
• Merit-Based Advancement is when hiring and promotions are based on qualifications and performance.
• Division of Labor is when work is divided into specialized tasks.

Advantages & Disadvantages of Weber's Model

• The advantages are consistency, role clarity, accountability, and efficient management.
• The disadvantages are slow decision-making, limited flexibility, and burnout.

Fayol's 14 Principles of Management

• French management theorist, Henri Fayol created the 14 principles for effective leadership and administration.
• Application in Nursing is specialized work increasing efficiency.
• Authority and Responsibility means nurse managers oversee staff.
• Discipline means nurses adhere to hospital policies.
• Unity of Command means that a staff nurse reports to a charge nurse, not multiple managers.
• Unity of Direction means a hospital's patient care strategy aligns all departments toward quality.
• Subordination of Individual Interest means nurses prioritize patient safety.
• Remuneration means that nurses receive competitive salaries, bonuses, and recognition.
• Centralization and Decentralization means hospital administrators set policies, while nurse managers handle day-to-day decisions.
• Scalar Chain (Hierarchy) starts with: Staff nurses → Charge nurses → Nurse managers → Directors of Nursing.
• Order means: Proper allocation of resources, organized workflows, and inventory managemen
• Equity means nurses receive equal opportunities regardless of background.
• Stability of Tenure means hospitals offer continuing education.
• Initiative is encouraging employees to take ownership of tasks.
• Esprit de Corps is encouraging collaboration among healthcare workers for better patient care.

Organizational Charts

• Span of control
• Managerial levels (top, middle and lower)
• Centrality – speaks to distance from the very top of organization

Lines on Organizational Charts

• Solid, horizontal lines equal responsibility with different functions.
• Solid, vertical lines show the chain of command.
• Unbroken represents reporting and accountability.
• Broken lines represent limited authority.

Key Organizational Structures Overview

• Rigid, hierarchical structure with top-down authority is a line / bureaucratic structure.
• A pros is accountability and a con is slow decision making
• Multiple supervisors characterize matrix structure.
• The pros are innovation, while the cons are confused authorities
• A multi-level hierarchical system with centralized authority is tall/bureaucratic structure
• Tall/bureaucratic pros: Control, and a con is reduced decision making from staff
• Flat / Decentralized Structure pros are empowerment, while cons is in role confusion
• A temporary structure for a specific project is An Ad Hoc Structure. The pros are flexible and adaptive, while the cons is lacking long ter stability
• Functional Structure groups employees by specialty. Pros increase the expertise and cons is limited cross department collaboration.
• Divisional structure divides the organization and pros are focus of expertise while the cons are duplicates.
• The mechanistic structure is rigid and focused on the pros of predictability.
• Organic structure focuses on adapting and pros is flexibility
• Traditional structure balances hierarchy and teamwork.

Decentralized Organizational Features in Jamaica

• Regional Health Authorities (RHAs) are a decentralized structure.
• RHAs manage health services at the regional level and provide autonomy to adapt and respond to communities' needs.
• Health services are delivered locally, improving accessibility, especially in rural areas.
• Each RHA is directly accountable to its regional population, improving service delivery and patient satisfaction

Jamaica's RHAs Focuses

• RHAs focus on regional health challenges (e.g., chronic disease management, infectious diseases, or maternal health).
• Responsibility Level and examples include: Northeast Regional Health Authority (NERHA), District & Parish and Health Facility.
• District & Parish has the St. Andrew Health District example.
• Health Facility has the Kingston Public Hospital example.
• Emergency level specialized departments, radiology, pharmacy.
• The unit level is the intensive care unit and maternity unit.

Unit-Level Care Delivery Systems

• In the Case Method, one nurse/worker is assigned to a specific patient. The pros is personalized care, while the con isn't mentioned.
• The patients given tasks divide into functions in the functional method, while the pros is efficiency.
• In Team nursing, the pros is working together for a group of patients to share the care.
• With modular nursing, there's a specific and the focus is patient and improving.
• Total patient care means there is there the worker needs to care to the aspects through stays.
• Primary nursing means the nurse that there will be a nurse primarily for patient care.
• Partenship nursing with work in pairs and can include technical skills.
• A case manager coordinates care for patients, ensuring they receive appropriate services across various healthcare providers.

Guiding Organizational Functions

• Policies, Protocols, and Procedures, Standards of care assist in organisation.
• Identify all activities includes listing the steps to organize.
• Factors Impacting Organizational Performance are from Infrastructure, Enviorment, Planning hierarchy, Culture and Generational divides.

Power & Influence Basics

• Legitimate power based on position.
• Coercive power is control undesirable.
• Reward Power arises the ability to positives.
• Power derives from being charismatic and leaders.
• Expert power comes from trust from person