Controlling - Leadership and Management Process PDF

# CONTROLLING ## LEADERSHIP AND MANAGEMENT PROCESS - An ongoing function of management which occurs during planning, organizing and directing activities. - Process wherein the performance is measured and corrective action is taken to ensure the accomplishment of organizational goal. # PURPOSES OF...

# CONTROLLING ## LEADERSHIP AND MANAGEMENT PROCESS - An ongoing function of management which occurs during planning, organizing and directing activities. - Process wherein the performance is measured and corrective action is taken to ensure the accomplishment of organizational goal. # PURPOSES OF CONTROLLING - Open opportunities for improvement - Compare performance against set standard - Provides information about how well processes and people function # Steps in Control Process - Establish standards and criteria - Measure performance - Compare results with standards - Match with standards? - YES - do nothing to improve - NO - take corrective action # REASONS FOR CONDUCTING EVALUATION - Ensures that quality services is provided - Allow for setting of sensible objectives and ensures compliance - Provides standards for establishing comparisons - Promotes visibility and means for employees to monitor own performance - Highlights problem related to quality care and determines areas that require priority attention - Provides an indication of the cost of poor quality - Justifies the use of resources - Provides feedback for improvement # EVALUATION PRINCIPLES 1. Must be based on behavioral standards of performance with the position requirement 2. There should be enough time to observe employee's behavior 3. Employee should be given a copy of the ff. Before scheduled evaluation - Job description - Performance standards - Evaluation forms 4. Performance appraisal should include both satisfactory and unsatisfactory results 5. Areas needing improvement must be prioritized 6. Should be scheduled and conducted at a convenient time for both evaluator and employee 7. Should be structured in such a way that it is perceived and accepted positively as a means of improving job performance # CHARACTERISTICS OF EVALUATION TOOL - **OBJECTIVE** - Free from bias - **RELIABLE** - Accurate and precise that it will produce the same results if administered twice - **SENSITIVE** - Instrument can measure fine lines of differences among criteria being measured - **VALID** # TYPES OF PERFORMANCE STANDARDS 1. **STRUCTURE** - Focus on the management system or structure used by the agency in the delivery of care - Includes: - Number and categories of nursing personnel - Education - Personal and professional qualities - Function - Physical facilities - Equipments 2. **PROCESS STANDARDS** - Decision and actions of the nurse relative to the nursing process - INCLUDES: - Assessment - Plan of care - Nursing intervention 3. **OUTCOME STANDARDS** - Designed to measure the results og care provided in terms of: - Changes in health status of client served - Changes in level of their knowledge, skills and attitude. - Satisfaction of those served # BUDGETING # INTRODUCTION - Budget is defined as statement of anticipated results during stipulated period expressed in financial and nonfinancial terms. - Three essential steps in the control process include standards, comparing results with standards and taking the required corrective action. - Budget covers stipulated time period - usually a year. - The budgeting process starts when the top management sets the strategies and goals for the organization. # DEFINITIONS: - Budget is financial plan of the government for definite period. - Budget can be defined as numerical statement expressing the plans, policies, and goals of organization for definite period in future. - Budget is concrete precise picture of the total operation of enterprise in monetary terms. # PURPOSE OF A BUDGET: - To provide quantitative expression of the plans of the hospital or the institution. - To evaluate financial performance in accordance with the plans. - To control costs. - To supply mechanism for translating fiscal objectives into projected monthly spending pattern. - To enhance fiscal planning and decision making. - To clearly recognize controllable and uncontrollable cost area. - To provide useful format for communicating fiscal objectives. - To allow feedback of utilization of moneys spent. - To identify problem areas and facilitate effective solutions. - To provide means for measuring and recording financial success in accordance with the objectives of organization. # TYPES OF BUDGET - Programme budget - Production budget - Cash budget - Flexible budget - Rollover budget - Open ended budget - Fixed ceilinging budget - Performance budget - Sales budget - Sunset budget - Zero based budget - Incremental budget - Capital expenditure budget - Revenbue and expense budget # Programme budget - This is one where costs are computed for entire programme. - Ex. Maternal and child health programme. # Incremental budget - This is based on estimated changes in the present operation, allowing for percentage increase for inflation. # Open ended budget - This is financial plan in which each operating manager presents single cost estimate for optimal activity level for each programme in the unit. # Flexible budget - This comprises several financial plans, each for different level of programme activity. # Revenue or expense budget - This is expressed in financial terms and takes the nature of a proforma income statement for the future. # Zero based budget - This requires the nurse manager to examine and justify each cost of every programme. # Sales budget - This is the starting point in budgetary programme, since sales activities give shape to all other activities. # Rollover budget - This one forecasts programme, revenues and expense for period more than a year, to accommodate programme that are larger than the annual budget cycle. # Fixed ceiling budget - This is financial plan in which the uppermost spending limits are set by the top executive. # Production budget - This is budget that aims at securing economical manufacturing of products and maximizing the utilization of product resources. # Performance budget - This is a based on functions not divisions. - E.g. direct nursing care, nursing research # Capital expenditure budget - This is prepared for assuring planned timely capital investment in the business to ensure the availability of capital at the right time over longer period. # Cash budget - This is prepared by way of projecting the possible case receipts and payments over budget period. # Sunset budget - This is designed to “self destruct" within a prescribed time period to ensure the expenditure is stopped by predetermined date. # PRINCIPLES OF BUDGETING: - Sound financial management - Based on objectives & policies - Planned on advance - Coordinating effort - Under directions & supervision - Quality & quantity evaluation - Flexibility - Interpretation - Appropriate to the nature - Adequate check & balance - Consistent delegation - Financial & nonfinancial resources # STEPS IN BUDGETING - Assessment of the goals of the institutes & hospital. - Assessment of the objectives of the present & proposed programmers. - Assessment of all old & new programmers for manpower, capital & operating expense. - Identify alternative methods for realizing the objectives. - Compare alternatives to determine the most cost effective. - Develop a budget request that details a fiscal plan for the preferred programme. # FUNCTIONS OF BUDGET: - Budget explains and documents unit needs to higher administrative levels. - Budget recognizes the importance of and develops short and long range fiscal plans. - It estimates the internal and external environment of the organization. - It articulates unit level fiscal planning towards organizational goals and objective. - It ensures that documents that the client needs are rendered clearly and completely. - It coordinates and monitors the different aspects of budget control. - It provides opportunities for subordinates to participate in relevant fiscal planning. - It precisely assesses personnel needs, using predetermined standards or established patient classification system. - It underlines the use of appropriate technique. # ADVANTAGES OF BUDGETING PROCESS: - A budget helps plan for detailed programme activities. - It helps fix accountability. - It states goals for all units, offers standard of performance and stresses the continuous nature of planning. - It encourages managers to make careful analysis of operations and base decisions after careful consideration. - Weakness in the organization can be revealed. - Staffing, equipment and supply needs can be projected and waste minimized. - Financial matters can be handled I an orderly fashion. - Agency activities can be coordinated & balanced. - Budget help managers in integrating personnel efforts within the organization towards common goals. - Budget controlling devices to correct any excessive expenditure. - Budgets help in just measurement of performance. - Budgeting helps the management learn from past experience. - Budget improves communication. - Budget helps new staff and lower level managers. # DISADVANTAGES OF BUDGETING : - A budget may become an end in itself instend of the means to achieve an end. - Budgetary goals may curb agency and gain autocratic control of the organization. - Over budgeting is big danger and become meaningless. - Skill & experience are essential for successful budgetary control. - Budgetary planning is expensive and time consuming. # PERFORMANCE APPRAISAL - A control process in which employee's performance is evaluated against standards. - The most valuable tool in controlling human resources and productivity. - Reflects how well a personnel have performed during a specific period of time # PURPOSE OF PERFORMANCE APPRAISAL 1. Determine salary and merit increases. 2. Select qualified individual for promotion or transfer. 3. Identify unsatisfactory employees for demotion or termination. 4. Make inventories of talents within an institution. 5. Determine training and developmental needs of employees. 6. Improve performance of work group. 7. Improve communication between supervisors and employees. 8. Establish standards of supervisory performance. 9. Provide recognition of employee for accomplishments 10. Inform employees "where they stand" # METHODS OF MEASURING PERFORMANCE - **ESSAY** - The appraiser writes paragraph about the workers strength, weaknesses, and potentials. - **CHECKLIST** - A compilation of performances expected of a worker. - **RANKING** - Evaluator ranks according to how Employee fared with co-workers. - **RATING SCALE** - Includes a series of items representing the different tasks or activities in job description or the absence or presence of desired behaviors. - **FORCED-CHOICE COMPARISON** - The evaluator is asked to choose the statement that best describes the employee being evaluated. - The evaluator is forced to choose from favorable as well as unfavorable statement - **ANECDOTAL RECORDING** - Describe experience with a group or person, or in validating technical skills and interpersonal relationship. - Anecdotal report should include: 1. Description of the particular occasion. 2. Delineation of the behavior noted including: WHO, WHAT, WHY, WHEN, WHERE AND HOE 3. The evaluator's opinion or assessment of the incident or behavior # QUALITY ASSURANCE - **Assurance** - achieving sense of accomplishment and implies a guarantee of excellence. - **Quality** - the degree of excellence. - **QUALITY ASSURANCE:** - A process of evaluation that is applied to the health care services b health workers. - Focuses on the care and services the patient receives than on how well the professionals performs the duties that the position required. # PRINCIPLES UPON WHICH QUALITY ASSURANCE PROGRAM ARE BASED 1. All health professionals should collaborate in the effort to measure and improve care. 2. Coordination is essential in planning comprehensive QAP. 3. Resource expenditure for QA activities is appropriate. 4. There should be focus on critical factors. 5. Quality patient care is accurately evaluated through adequate documentation. 6. The ability to achieve nursing objectives depends upon the optimal functioning of the entire nursing process and its effective monitoring. 7. Feedback to practitioners is essential to improve practice. 8. Peer pressure provides the impetus to effect prescribed changes based on the result of assessment and needed improvements on the quality of care. 9. Reorganization in the formal organizational structure may be required if assessment reveals the need for different pattern of health care. 10. Collection and analysis of data should be utilized to motivate remedial action. # QUALITY IMPROVEMENT PROGRAM - The umbrella program that extends the many areas for the purpose of accountability to the consumer. - A continuous, on-going measurement & evaluation process that includes structure, process and outcome. # TOTAL QUALITY MANAGEMENT (TQM) - A way to ensure customer satisfaction by involving all employees in the improvement of the quality of every product or service. - Aims to reduce waste and cost of poor quality. - It is structured system for involving entire organization in continuous quality improvement process targeted to meet and exceed customer expectations. # CONTINIOUS QUALITY IMPROVEMENT (CQI) - A process of continuously improving a system by: - gathering data or performance - Using Multi-disciplinary team to analyze system. - Collect measurements. - Propose changes. # PRINCIPLES OF CONTINOUS QUALITY IMPROVEMENT (CQI) 1. Customer focus. 2. Identification of key processes to improve quality. 3. Use of quality tools and statistics. 4. Involvement of all people in problem solving. # QUALITY ASSURANCE - Focuses on the care and service the patient receives than on how well the professional performs the duties that the position requires. - **METHODS USED** - Patient care audit. - Patient care profile analysis. - Peer review. - Quality circles. # NURSING AUDIT COMMITTEE - Composed of representative from all levels of the nursing staff. - The audit team designates a day within week to be the audit day. - The nurses do not know which unit will be audited. # PATIENT CARE AUDIT - **CONCURRENT PATIENT CARE AUDIT** - One in which patient care is observed and evaluated. - Done during rounds or patient interview. - Given through: 1. Review of patient chart while the patients are still confined in the hospital. 2. Observation of the staff as patient care is given. 3. Inspection of patient or observation and/or observation of the effects of patient care where the focus is on the patient. - **RETROSPECTIVE PATIENT CARE AUDIT** - **ONE IN WHICH PATIENT CARE IS EVALUATED THROUGH:** 1. A REVIEW OF DISCHARGED PATIENTS' CHART 2. QUESTIONAIRES SENT TO OR INTERVIEW CONDUCTED ON DISCHARGED PATIENTS # QUALITY CIRCLES - One of the most publicized approaches to quality control introduced by the Japanese. - A group of workers doing similar works who: - Meet regularly. - Voluntarily. - On normal working time. - Under the leadership of the supervisor. - **TO:** - Identify, analyze, and solve work related problem. - Recommend solution to management - quality circle members should implement the solution themselves # CONTROL OF RESOURCES - Consumption of supplies and materials should be proportionate to the number of patients served. - Requisition or stock of large numbers of supplies and materials should be avoided to prevent misuse or spoilage. - A high turnover inventory is desired. - A low turnover is: - The result of poor purchasing policies. - Overstock or decreased demand for the item. - Equipment utilization report should be made including frequency of breakdown. - Help to evaluate the: - Quality of equipment purchased. - The way it was handled. - Preventive maintenance - requires the regular inspection of equipment to prevent breakdown or detect needed repairs. - Breakdown results in more expenses and non productivity of personnel. - **Human Resource:** - Absences due to leaves, whether scheduled or not, should be analyzed. - Provision for relievers should be included in staffing pattern to maintain quality service. - Unusual number of unscheduled absences should be investigated - this may necessitate disciplinary action. # SELF DISCIPLINE: - A constructive and effective means by which employees take personal responsibility for their own performance and behavior # FACTORS THAT INFLUENCE SELF DISCIPLINE 1. Strong commitment to the vision, philosophy, goals, and objectives of the institution. 2. Laws that govern practices of all professionals and the respective Codes of Conducts. 3. Understanding of the rules and regulation of the agency. 4. Atmosphere of mutual trust and confidence. 5. Pressure from peers and organization. # DISCIPLINARY ACTION - Any employee charge with breach of the rules and regulation, policies, norms of conducts should be given due process. - There must be existing rules of conduct governing his behavior and documentation of actual violation. - The charged employee must be notified in writing about the violation and be given the right counsel. - **Principles of disciplinary action** 1. investigate carefully 2. be prompt 3. protect privacy 4. focus on the act 5. enforces rules consistently - Be flexible - **Components of disciplinary action program** - Code of conduct - Employees must be informed of the nature and meaning of codes of conduct. - Must understand that the rules are reasonable and directly related to efficient, effective operation of agency. - Authorized penalties. - Records of offenses. - Right of appeal # DISCIPLINARY ACTION - Should be progressive in nature. - CONSELLING AND ORAL WARNING - Best given in private and in informal atmosphere. - Employee is given fair chance to air his side. - Relevant facts are analyzed and evaluated against past performance. - **SUSPENSION** - **DISMISSAL** - Invoked only when all other disciplinary efforts have failed. - Disciplinary Committee should be very sure that the cause for dismissal conforms with criteria of major discipline violations as contained in policy manual. - Review is done by higher management. # THANK YOU - The image contains a cartoon thank you note.