Management and Administration in Nursing PDF

# Management and Administration in Nursing By Janet Takyiwa Ama ## Administration and Management ### Definitions - **Management:** is a distinct process...performed to determine and accomplish stated objectives using human beings and other resources (GR Terry, 1993). - Management consists of all...

# Management and Administration in Nursing By Janet Takyiwa Ama ## Administration and Management ### Definitions - **Management:** is a distinct process...performed to determine and accomplish stated objectives using human beings and other resources (GR Terry, 1993). - Management consists of all organizational activities that involve goal formation and accomplishment, performance, appraisal and developing an operating philosophy that ensures the organization's survival within the social system. ## Management - This is the process of utilizing an organization's resources to manage people and their work towards a common goal. - They are professionals who utilize their skills to manage the organization's entire system. ## Administration - Administration is the systematic process of managing a business or an educational institution like a school, a government office, or a non-profit organization. - The administration is the highest level of management in an organization's hierarchy. - The primary role of administration is to establish objectives, create policies and procedures, and enforce regulations. ## Key Differences Between Management and Administration | MANAGEMENT | ADMINISTRATION | | ------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | | A systematic approach to managing both people and things within an organization. | A group of people collectively managing the entire organization. | | Focuses on policy implementation | Formulation policies | | Executive and governing | Responsible for legislation and determination | | A group of persons, who are employees of the organization | Represents the owners of the organization. | | makes decisions under the boundaries set by the administration | takes all the important decisions of the organization | | seen in profit-making organizations like business enterprises | Found in government and military offices, clubs, hospitals | | They decide who does the work and how the work should be done | They decide what and when a work should be done | ## Management Management performs seven key activities: planning, organizing, leading, motivating, controlling, coordinating, and decision-making. - Management unites the 5Ms of an organization: Men, Materials, Machines, Methods, and Money. The activity is geared towards achieving a specific result. It focuses on obtaining the desired output while ensuring all necessary steps are taken. ## Features of Management - **Universal**: applied in all institutions (social, religious, commercial, educational, political). - **Integrative**: harmonises individual goals with organizational goals. - **Make things happen**: organizing and employing resources to accomplish predetermined objectives. - **People-centred**: Takes place through people. - **Intangible Force**: Managerial ability is a social skill that cannot be seen with the eyes, but an organization's quality and level evidence it. - **Dynamic**: It is ongoing and changes from time to time, depending upon the circumstances of the business. - **Science and Art**: It is science because it makes use of underlying knowledge and an art because some essential management skills are unique to some individuals. ## Basic Management Actions - Identify the necessary actions or tasks that need to be completed. - Organize resources. - Ensure that all tasks are completed efficiently and effectively. - Plan for future requirements. - Deal with any problems that arise. ## Management Skills Various skills are essential in solving some of the complex problems of modern management. Robert L. Katz identified three MAIN, as follows: - **Technical**: Ability to work with resources in a particular area of expertise. - Technical knowledge and proficiency in special area to accomplish specialized tasks effectively. - **Human**: - Ability to interact effectively with people. - Lead, motivate manage conflicts and work with others. - Ability to work effectively as a group member and build cooperative - **Conceptual**: - The ability to see the organization as a whole and recognize how the various functions of the organization depend on one another. - Formation of ideas, understanding of relationships of the parts to the whole. - Visualising the relationship of the individual business to the industry, the community and the nation's political, social and economic forces as a whole. - **Other skills identified by AJ Dubrin are Diagnostic and Political** ### Diagnostic - Ability to investigate a problem and then decide on implementing a solution. - They require other skills including technical, human and conceptual skills to solve the problems they diagnose ### Political - Ability to acquire the power necessary to achieve objectives. - Establishing the right connections and impressing the right people. ## Managerial Roles 1. **Interpersonal Role** - **Figure Head**: symbolic head, represents the organization in all matters, e.g., conferences, ceremonies, etc. - **Leader role**: directing employees, staffing, promotion, motivating, etc. - **Liaison**: maintains a network of outside contacts, interaction with peers and colleagues outside the organization to gain favors, gives and receives information and develops and maintains external relationships. 2. **Informational** - **Monitor**: receives and communicates information e.g. briefing, brainstorming, reporting, data analysis, media relations etc. - **Disseminator**: receives and transmits information from internal sources to other parts of the organization. - **Spokesperson**: provides information concerning the work of the organization to internal/external groups, transmits information on plans, policies, actions, and results. 3. **Decisional** - **Entrepreneur**: initiates and designs change within the organization e.g. organizational structure, training and development programs, performance appraisals, work design, risk taker, and initiate changes. Look for opportunities. - **Disturbance Handler**: deals with threats and unplanned changes from politics, competition, unions, conflicts, etc. Responsible for corrective action when the organization faces unexpected disturbance. - **Decides on the allocation of resources e.g., money, equipment and personnel.** - **Negotiator**: negotiates on behalf of the organization both internally and externally e.g., unions, purchases, training, purchase and use of equipment. ## Functions/Principles of Management 1. **Controlling**: giving instructions to employees and ensuring that the instructions are followed as the management desires. ### Types of Management Control - **Feedback control**: involves gathering information about completed tasks, evaluating it, and using it to improve future tasks. - **Concurrent Control**: This real-time control mechanismdetects and addresses issues immediately to prevent losses. - **Predictive control**: This is where you can prevent problems by foreseeing them before they occur. - **Steering control**: is one which steers the process onto the right path. - **Yes/No Control**: this simple control decides whether an activity should proceed. - **Budgetary control**: this type of financial control controls organizational resources and budgets. - **Strategic Control**: Ensure company alignment with goals through strategic planning and direction. ### Check List for Effective Control - Controls should reflect the nature/needs of the activity - Should report deviations promptly - Should be forward-looking/future-looking. - Should point out exceptions at strategic points - Should be objective - Should be flexible - Should reflect the organizational structure - Should be economical - Should be understandable - Should indicate corrective action ### Two Basic Control Approaches - **The Traditional Approach**: - Set a standards, target, or goal - Measure actual performance against standards - Take corrective action - **The Commitment-Based Approach**: - Getting people to want to build quality - Hire the right people and invest in them - Foster self-control - People-centred, sense of community, shared fate - Guarantee organizational justice - Use financial rewards and profit-sharing - Encourage self-actualization ### Scope of Area of Control - Control over policies and procedures - Control over an organization - Control over staff - Control over methods - Control over expenditure/income - Control over research and development ### Processes of Controlling in Management - **Formation of standards**: This is the first step in controlling. The manager prepares a report stating the project standards and expected performance for employees. - **Measurement of actual performance**: The manager will analyze employee performance and request task reports upon completion. - **Comparison of actual performance with the standard performance**: Compare performance to a standard and generate a report based on the difference. - **Taking corrective actions if required**: Performance gaps are evaluated and addressed according to company policy and past performance. 2. **Directing**: This is guiding, inspiring, overseeing, and instructing people towards accomplishing organizational goals. ### Characteristics of Direction - **Pervasive Function**: Directing is necessary at all organizational levels. Each manager must provide guidance and motivation to their subordinates. - **Continuous Activity**: is a continuous activity as it is continuous throughout the life of an organization. - **Human Factor**: The Directing function is crucial in managing subordinates because it deals with the unpredictable nature of human behaviour. - **Creative Activity**: The function of direction transforms plans into performance, making physical resources meaningful and preventing inactivity. - **Executive Function**: All managers and executives at all levels throughout the enterprise carry out the direction function. A subordinate receives instructions from their superior only. ### Importance of Directing Function - **It Initiates Actions**: Subordinates' work performance starts with the Directions' function. Through this function, subordinates comprehend their tasks and complete them accordingly. - **It Ingrates Efforts**: Every department's efforts can be integrated through clear direction. Integration of efforts brings effectiveness and stability to a concern. - **Coping up with the changes**: Humans tend to resist change as a part of their behaviour. It is a directive function that is useful in adapting to internal and external changes. - **Efficient Utilization of Resources**: Direction finance clarifies subordinate roles and prevents waste and overlap. 3. **Planning**: The function of management involves setting objectives and devising a plan to achieve them. Managers must identify and anticipate environmental conditions to effectively plan. ### Steps in Planning - **Environmental scanning**: Planners must consider economic conditions, competitors, and customers to anticipate contingencies. Planners must then attempt to forecast future conditions. - **Establish objectives**: statements of what needs to be achieved and when and how. - **Identify alternative courses of action**: After setting objectives, planners should explore and determine other possible strategies. It is important to consider and evaluate multiple options before deciding. - **Decision-making**: planners must make decisions about the best courses of action for achieving objectives. They must then formulate the necessary steps and ensure the effective implementation of plans. - **Evaluation**: Planners must regularly assess the effectiveness of their plans and adjust as needed. ### Types of Planning - **Strategic planning**: To effectively compete in their environment, an organization must analyze their competitive opportunities and threats as well as their strengths and weaknesses before determining how to position themselves. - **Tactical planning**: Intermediate-range planning involves developing specific means to implement the strategic plan, is often carried out by middle-level managers as part of tactical planning. - **Operational planning**: Short-term planning (less than a year) that outlines specific steps to support strategic and tactical plans. ### Other Types of Planning - **Standing Plan**: established routine, formula, or set of procedures designed to be used in a reoccurring situation. - They standardize actions, reducing the supervisor's need to manage to ensure that workers meet standards and deal with unexpected events, known as management by exception. - These plans must be updated regularly. - **Single-use plan**: A one-time plan is developed for a single occasion or purpose. - The time you spend on it depends on its nature and importance. - Often, its purpose is a major change of some sort or budget. - **Day by day planning**: - Top priority of the first-line supervisor. - Primary concern is what will be done, who will do it, and adjusting various standing plans. - Plan before the day begins. - Establish routines to simplify planning. - Whenever possible, risks can be reduced by increasing predictability. ### Importance of Planning - **Planning aids decision-making**: It encourages the manager to look into the future and decide from several alternative action plans. - **Planning decreases the chances of risk**: Planning allows managers to anticipate changes and their consequences. - **Planning encourages innovative ideas**: Management's primary function is to develop plans. - **Planning provides directions**: Planning ensures that objectives are clearly defined, providing a framework for determining necessary actions and direction. - **Planning decreases overlapping and wasteful activities**: Planning is the foundation for organizing activities and goals within departments and among individuals. It assists in avoiding chaos and confusion. - **SET STANDARDS FOR CONTROLLING**: Planning provides standards against which actual performance is measured. ### Planning for Change - Planning for change must be done carefully and thoroughly. - It is very much like making other plans **but** the main differences are the extent of forecasting, the degree of risk, and providing for the impact of the change. #### Workers Response and Resistance - Workers respond to change through: resistance, insecurity, anxiety, resentment of personal losses, and rumors. - How to deal with resistance to change: - Establish open communication - Emphasize advantages (avoid overselling) - Involve the workers in planning and carrying out change 4. **Organizing**: Refers to distributing employees and allocating resources that promote productivity and efficiency and ultimately help the organization achieve its goals. ### It involves the following: - **Identification of activities**: All activities that must be performed in a concern must be identified first, e.g., record keeping and quality control. - **Departmentally organizing the activities**: Managers organize related activities into departments to improve efficiency. - **Classifying the authority**: After creating departments, the manager establishes a hierarchy by ranking the managerial positions and their powers. - **Co-ordination between authority and responsibility**: Various groups establish relationships to interact smoothly towards organizational goals. ### Importance of Organizing - **Specialisation**: The division of labour is beneficial in providing expertise in different areas of concern. - **Well-defined jobs**: Proper job definitions help to clarify the specific roles and responsibilities of everyone involved. - **Clarifies authority**: Having well-defined job roles and responsibilities can significantly improve the efficiency of managers' work. It is important to clarify authority to prevent the misuse of power. - **Coordination**: It emphasizes the importance of establishing clear-cut relationships between roles to ensure everyone works together effectively. - **Effective administration**: The roles of different managers are clarified, achieving specialization through the division of labour, leading to efficient administration. - **Growth and diversification**: A company's growth depends entirely on how efficiently and smoothly it operates. It's important to ensure that all aspects of the business are functioning effectively to achieve success. - **Sense of security**: Increasing the clarity of responsibilities improves mental satisfaction and a sense of security. ## Coordination ### Definition - Coordination is concerned with bringing together different types of activities. - Coordination is the orderly arrangement of group efforts to provide unity of action in pursuit of a common purpose. (Mooney and Reiley). ### Characteristics of Good Coordination - It must be timely and results-oriented. - It should be continuous. - It must be motivating and corrective as well. - It must be internal as well as external. - It must anticipate and prevent problems from occurring. ### Types of Coordination - **INTERNAL:** - Between different groups of employees of the same department or section. - Managers and workers at different levels. - Boards of directors and departmental managers. - Different Departments, branches, and other parts of the organization. - **External:** - This exists between the organization and the other stakeholders such as customers, suppliers, government, and members of the community. ### Need for Coordination - Through coordination, duplication of work and work at cross purposes can be eliminated. Factors which contribute to the complexity of coordination are as follows: - **Growth in size of the organization**: more employees and a more complex structure makes it more difficult. - **Growing specialization**: means more coordination because of the diversity of tasks to be undertaken and the persons to carry them out. - **Human nature**: managers are preoccupied with the work of their units and are unwilling to become involved in the work of other units or departments. ### Objectives of Coordination - **Reconciliation of goals of individuals with that of the organization**: Coordination is necessary to bring unity of action to the organization. - **Total accomplishment**: Through coordination, duplication of effort is prevented and the time and energy saved are utilized in more creative tasks. - **Economy and efficiency**: Coordination avoids duplication and thus economises on the use of labour and other resources and makes them more efficient. - **Good personal relations**: It prevents conflict between managers and staff through proper coordination of their efforts. - **Retention of managerial and other staff**: It leads to job satisfaction and thus helps to retain staff. ### Principles of Coordination - **Direct contact**: Direct personal contact helps in exchanging opinions and ideas in a better way and clarifying misunderstandings more easily. - **Early start**: Coordination is more easily achieved in the early stages of planning and policymaking. - **Reciprocal relationship**: There should be integration of all efforts and interests towards the same purpose. - **Continuity**: It should be a continuous process starting with planning through to the other management processes. ### How to Achieve Coordination - **Clearly defined goals**: The objectives of coordination should be clearly defined for each individual and the contribution of their post to achieve this. - **There should be precise and comprehensive programmes and policies.** - **There should be clear lines of responsibility.** - **There should be effective collaboration.** - **There should be effective leadership and supervision.** - **There should be cooperation among individuals in the organization.** ### Techniques of Coordination - **Coordination by common purpose**: ensuring all staff work efficiently by directing and motivating them. - **Coordination through managerial functions**, e.g., communication, leadership, and authority delegation. - **Coordination through simplified and lean organizational structures.** - **Having harmonised programmes and policies**: i.e., all plans add up to the unified programme. - **Group meetings**: Such meetings bring officials together and provide opportunities for coordination. - **Use of liaison officers/Personal Assistants**: Using liaison officers to maintain relations with government and other agencies. - **Others**: through other meetings, internet, e-mail, newsletters, teams, and committees. ## Benefits of Good Management in Health Service Organisation - High lights priority areas. - Adopts the service to the needs of a changing situation. - Makes use of the most limited resources. - Improves the standard and quality of services. - Maintain high staff morale. ## Nursing Service Administration - Nursing service administration involves a series of activities aimed at providing nursing care to clients. It includes establishing overall goals and policies aligned with the health agency's mission. - This process entails organizing personnel and facilities to achieve these goals effectively and economically. - It requires the collaborative efforts of all staff members and coordination with other departments within the institution. ### Primary Objective - **Primary objective of the role of nursing service administration**: is the provision for continuous individual, group, and community service, including whatever is necessary. - **The subsidiary objectives of this role are the professional activities of administration**: human relations, communications, teaching, research, and personal development, designed to further the primary objective-the optimum nursing care of patients. ## Primary Responsibilities of Nursing Administrator - Be the intermediary between the nurses, doctors, patients and different departments within a hospital. - For this reason, a qualified nurse administrator not only possesses extensive knowledge of medicine and patient care but also top-notch leadership and management skills. - Supervision of nursing staff. The nurse administrator schedules shifts, trains new nurses, provides a higher level of medical advice if needed, and allocates nurses to patients or departments as needed. - Supervision of all patients. Nursing administrators, rather than being assigned to particular patients, are responsible for overseeing the well-being and proper treatment of every single patient in her unit - This means nursing administrators need to be meticulous, detail-oriented, able to multi-task and capable of handling high stress situations. ## Types of Managers and Managerial Skills - Nursing service managers are people who are appointed to positions of authority, which enable others to perform their work effectively, who have responsibility for resource utilization and who are accountable for work results and can be proud of their organizations and what they do. ### Types of Managers - Classifications of managers are by level in the organizational hierarchy: - **Top Level**: such as board of directors, Presidents, and vice presidents. - **Middle Level**: such as directors of nursing, supervisory staffs, and department heads. - **First Line/Front Line/ or Supervisory Management**: such as head nurses and staffs. ### Attributes of Managers - Formally appointed to positions of authority. - Charged with directing and enabling others to do their work effectively. - Responsible for utilizing resources. - Accountable to superiors for results. ***NB:*** The primary differences between levels of managers are the degree of authority and the scope of responsibility and organizational activity at each level. - **For example, top-level managers such as nursing administrators have authority over and responsibility for the entire organization.** - **Middle level managers** such as department heads and heads of services have authority over and responsibility for a specific segment, in contrast to the organization as a whole and act as a liaison between top-level managers and first level managers. - **First line managers**, who generally report to middle level managers, have authority over, and are responsible for overseeing specific work for a particular group of works. ### Managerial Skills - Managers can also be differentiated by the extent to which they use certain skills: conceptual, human relations, and technical skills. - All managers use human relation skills because they accomplish work through people. - **Human relations skills**: motivation, leadership, and communication skills. - The degree to which each is used varies with the nature of the position, scope of responsibility, work activity, and number, types, and skills, of subordinates. - Senior managers use disproportionately more conceptual skills in their jobs than do middle-level or first-line managers. - Eg: recognizing and evaluating multiple complex issues; understanding their relationships; engaging in planning and problem solving; thinking globally about the organization and its environment. - First-line managers use job-related technical skills, or skills that involve specialized knowledge. ## Quality Assurance Quality assurance (QA) is a quality management process that establishes standards, guidelines and procedures to prevent quality issues and maintain the products or service's integrity throughout its development. - Quality assurance involves a systematic process to determine if products or services meet specific requirements. - Quality assurance has two principles: "fit for purpose," meaning the product or service meets its intended purpose, and "right first time," in which any mistakes are immediately addressed. ## Methods of Quality Assurance - **Total Quality Management (TQM)**: is a quality assurance approach that develops a company-wide quality management mindset. Staff involved in quality management are trained to maintain standards and strive for continuous improvement. - **Failure Testing**: testing the limits of products through extreme stress conditions such as temperature, pressure, and tension until they break. This process exposes product flaws. - **Process and Product Quality Assurance (PPQA)**: focuses on setting quality standards and procedures at an organizational level to measure, evaluate, and solve quality management issues. - **Statistical Process Control (SPC)**: using various statistical tools to identify quality issues and measure the effectiveness of business process and teams to improve any flaws in the production cycle then... - **Statistical Process Control (SPC):** Various statistical tools are utilized to identify quality issues, measure process and team effectiveness, and improve production cycle flaws. ***NB:*** Quality assurance differs from quality control (QC). QA is any systematic process for making sure a product meets specified requirements, while QC focuses on testing the quality of the output once the product or service has been delivered. ## Importance of QA - Companies can create products and services that meet customer needs, expectations, and requirements. - The company provides excellent products that are of high quality, resulting in the establishment of trust and loyalty with customers. - The implementation of a quality assurance program prevents product defects. ## Auditing Auditing is a systematic and disciplined approach to evaluating and improving processes and related controls. Auditing is performed according to professional standards by independent individuals with acknowledged certifications. ### Characteristics of Auditing - Completed by professionals independent of the operation. - Formal, systematic and structured approach. - Involves planning, sampling, testing, and validating. - Formal communication with recommendations and corrective action measures. - Audit accountability is typically to the Chief Audit Executive and the Audit Committee. ### Types of Audits - **Internal audits**: Employees of a company or organization perform internal audits exclusively for use by management and other internal stakeholders, with no distribution outside the company. - **External audits**: External organizations and third parties perform this task; this provides an unbiased opinion that internal auditors might not be able to give. - **Government audits**: Government audits are conducted to ensure accurate preparation of financial statements, preventing misrepresentation of taxable income. ## Importance of Auditing **DISCUSS** ## Monitoring and Evaluation Effective monitoring and evaluation are essential for successful projects. Organizations collect and analyze data to determine if goals are met. Monitoring is initiated at the beginning of the project and continues throughout its duration. The evaluation process, which comes after, is used to assess the performance of the program. ### Importance of Monitoring and Evaluation - Results in better transparency and accountability. - Helps organizations catch problems early. - Helps ensure resources are used efficiently. - Helps organizations learn from their mistakes. - Improves decision-making. - Helps organizations stay organized. - Helps organizations replicate the best projects/programs. ## Problem-Solving Problem-solving involves defining a problem, identifying the cause, prioritizing solutions, and implementing one. ### Step in Problem-Solving - **Define the problem**: When diagnosing a situation, focus on identifying the underlying problem, not just its symptoms. There is the need to differentiate fact from opinion, Specify underlying causes, consult each faction involved for information, and State the problem specifically. - **Generate alternative solutions**: It is recommended to delay choosing a solution until multiple alternatives for problem-solving have been presented. - **Generate alternative solutions**: there is the need to specify short- and long-term alternatives, specify alternatives consistent with organizational goals and brainstorm on others' ideas. - **Evaluate and select an alternative**: Skilled problem solvers use a series of considerations when selecting the best alternative. There is a need to evaluate both proven and possible outcomes and state the selected alternative explicitly. - **Implement and follow up on the solution**: Leaders may be called upon to direct others to implement the solution or facilitate the implementation with the help of others. - **Implement and follow up on the solution**: Leaders gather feedback from all affected parties and seek acceptance or consensus by all those affected. ***thank you***