Module-35_SC.pdf

Module 3-5 LM 1  It is a systematic process and requires knowledgeable activity based on sound managerial theory. Being the first element of management defined by Fayol, planning is making a plan of action to provide for the foreseeable future. This plan of action must have unity, continuit...

Module 3-5 LM 1  It is a systematic process and requires knowledgeable activity based on sound managerial theory. Being the first element of management defined by Fayol, planning is making a plan of action to provide for the foreseeable future. This plan of action must have unity, continuity, flexibility, and precision. Module 3-5 LM 2  Planning is a continuous process, beginning with the setting of goals and objectives and then laying out a plan of action for accomplishing them, putting them into play, reviewing the process and the outcomes, providing feedback to personnel, and modifying plans as needed. Module 3-5 LM 3  In nursing, planning helps to ensure that clients or patients will receive the nursing services they want and need and that these services are delivered by satisfied nursing workers. Module 3-5 LM 4  PURPOSES OF PLANNING The following are some reasons for planning: 1. Planning increases the chances of 5. It includes day-to-day and future- success by focusing on results, not on focused managing. activities. 6. It helps to avoid crisis management 2. It forces analytic thinking and and provides decision-making evaluation of alternatives, therefore flexibility. improving decisions. 7. It provides a basis for managing 3. It establishes a framework for organizational and individual decision making that is consistent with performance. top management objectives. 8. It increases employee involvement 4. It orients people to action instead of and improves communication. reaction. 9. It is cost-effective. Module 3-5 LM 5 TYPES OF PLANNING STRATEGIC PLANNING OPERATIONAL PLANNING TACTICAL PLANNING Module 3-5 LM 6  Drucker defines strategic planning as "a continuous, systematic process of making risk- taking decisions today with the greatest possible knowledge of their effects on the future; organizing efforts necessary to carry out these decisions and evaluating results of these decisions against expected outcome through reliable feedback mechanisms”. Strategic planning in nursing is concerned with what nursing should be doing. Strategic planning provides strategic forecasting from one year up to more than twenty years. It serves as the blueprint for the future. Module 3-5 LM 7 How Strategic Planning Can Be Used to Improve Nursing Management To provide accountability and monitoring of performance; to tie merit to performance. To set up more formal planning programs and require divisional and unit planning. To integrate strategic plans with operational and financial plans. To improve knowledge of and training in strategic planning. To increase top management involvement and commitment. To improve focus on competition, market segments, and external factors. To improve communication from top administration and nursing management. To allow better execution of plans. Module 3-5 LM 8 How Strategic Planning Can Be Used to Improve Nursing Management Module 3-5 LM 9  MISSION STATEMENTS The purpose or the mission statement encapsulates the intent and goal of the organization. It explains, in a short statement, the core reasons behind the organization’s existence and a primary focus on a single strategic thrust for the organization Sample Mission Statement: Provide a personal approach to the services offered by demonstrating a commitment to quality health care and offering services that promote well-being of the community through education and advanced technology Sample Mission Statement: USL USL sustains a Catholic academic community that nurtures persons for community, church and society anchored on CICM’s Missio et Excellentia. Module 3-5 LM 10 VISION STATEMENTS The vision statement incorporates an organization’s mission and values. Sample Vision Statement: To be the premier leader in quality health-care education and service. Sample Vision Statement: USL USL is a global learning community recognized for science and technology across all disciplines, strong research, and responsive community engagement grounded on the CICM mission and identity for a distinctive student experience. Module 3-5 LM 11  ORGANIZATIONAL PHILOSOPHY The philosophy of an organization is derived from its mission and incorporates the organizational values that direct the behavior of the organization. Module 3-5 LM 12 Sample Philosophy: Hospital and Health-Care Organization in conjunction with the Board of Trustees and entire health-care staff, believe that human beings are unique and holistic, having value and worth as individuals with individualized healthcare needs. The health-care team at Hospital believes in providing the best possible care and education (using enhanced technology) to the community it serves. Each client has diverse learning needs and individualized goals to meet health-care needs. The focus of care is on wellness, caring, and the highest standards of customer service and quality Sample Philosophy: USL The University of Saint Louis upholds the philosophy that education is for building of self and persons for the Church and the Society. Wisdom builds. To these ends, the following are University of Saint Louis’s core values integral in the formation of every member of the Louisian community. Module 3-5 LM 13  ORGANIZATIONAL GOALS AND OBJECTIVES The specific goals and objectives of the organization provide more concrete information on what and how the Sample List of Goals: organization plans to provide/act, under the An environment will be established that guiding hands of its established mission and is conducive to patient teaching and philosophy learning. Nursing staff will identify the patient’s need for independence and foster relationships to develop this. Quality nursing care will be provided within all levels of the organization. Annual development and assessment plans will be implemented with all employees of Hospital. Module 3-5 LM 14  OPERATIONAL PLANNING Operational management is the organization and directing of the delivery of nursing care. It includes such planning as creating a budget, creating an effective organizational structure that encompasses a quality monitoring process, and directing nurse leaders, an administrative staff, and new programs. Module 3-5 LM 15  TACTICAL PLANNING is intermediate-range (one to three years) planning that is designed to develop relatively concrete and specific means to implement the strategic plan. Module 3-5 LM 16  It is a form of identifying roles and relationships of each staff on order to delineate specific tasks or functions that will carry out organizational plans and objectives. As a process, it refers to the building of Process of identifying and grouping the a structure that will provide for the work to be performed, defining and separation of activities to be performed delegating responsibility and authority and for the arrangement of these and establishing relationships for the activities in a framework which purpose of enabling the people to work indicates their hierarchal importance more effectively together in accomplishing and functional association. objectives. Module 3-5 LM 17  ORGANIZATION An organization can be defined as “a group of persons with specific responsibilities who are acting together for the achievement of a specific purpose determined by the organization” (Huber, 2000, p. 454). It is “the structure that supports the organizational processes,” according to Yoder- Wise (2003). Module 3-5 LM 18 ORGANIZATIONAL THEORIES Max Weber - Father of Organizational Theory Module 3-5 LM 19  ORGANIZATIONAL THEORIES Adopting Max Weber concept on Organizational structure-workers CLASSICAL THEORY were placed into departments in relation to the work they were is one of the oldest theories regarding assigned to complete organizational structure Division and specialization of labor-the work of the organization The focus of this theory was on the structure of be divided into tasks and the formal organization: it examined the employees be assigned a specific efficiency of the organization as a by-product of task to complete. the design of the system. Chain of command-the formal line of authority and responsibility within the organization. Span of control-refers to the number of employees who report to a manager or a supervisor Module 3-5 LM 20  NEOCLASSICAL THEORY (HUMANISTIC THEORY) It placed emphasis on cooperation and participation in the workplace (Sullivan & Decker, 2001) The key factor in this theory is motivation. A motivated employee will produce better output in the job setting Module 3-5 LM 21  SYSTEMS THEORY is based on the work of Von Bertalanffy This theory asserts that systems are a whole and that organizations should be viewed as a whole, considering the relationships within the structure of the organization. Module 3-5 LM 22  CHAOS THEORY stresses the importance of change within organizations. Change is the stimulation of the organization, and it is constant in health care today. This theory works well with healthcare organizations today. Module 3-5 LM 23 CONTINGENCY THEORY the organization’s structure must match the working of the environment The organizational structure based on this theory is flexible and varies based on the needs of the organization and the leader. Module 3-5 LM 24  MANAGEMENT FUNCTIONS Organizing Process Includes 1.Identifying and defining basic tasks. 2.Delegation of authority and assigning responsibility 3.Establishing relationships Module 3-5 LM 25  Three Forms of Authority 1. Line authority Chain of Command – unbroken line of reporting relationships that extends through the entire organization. Unity of Command – each person in the organization should take orders and reports only to one person. Span of Control 2. Staff Authority – authority that is based on the expertise 3. Team Authority – is granted to committees or work teams involved in an organization’s daily operations. Module 3-5 LM 26  ORGANIZATIONAL CHART The organizational chart outlines the formal The organization chart establishes the following: working relationships and the way people interact Formal lines of authority within the given structure. Responsibility Accountability Module 3-5 LM 27  ORGANIZATIONAL CHART 1.Dotted or Unbroken line – represents staff positions/staff authority 2.Centrality – refers to the location of a position on an organizational chart where frequent and various types of communication occur. 3.Solid Horizontal Line 4. Solid Vertical Line – Module 3-5 LM 28  Managerial Level Level Scope of Responsibility Examples 1.Generally make decisions with the Top Level help of ►few guidelines or structure. CEO, President, V-President, Managers 2.Coordinates internal and external Chief Nursing Officer influences Middle Level 1.They conduct day-day operations Head Nurse, Department Head, with some involvement, long term Managers Unit Supervisor/Manager planning and policy making. 1.Concerned with specific unit First Level workflows. Charge Nurse, Team Leader, Managers 2.Deals with immediate day-day Primary Nurse, Staff Nurse problems. Module 3-5 LM 29  TYPES OF ORGANIZATIONAL STRUCTURE 1. Line Organization/Bureaucratic/Pyramidal superior-subordinate relationship Module 3-5 LM 30 2. FLAT/DECENTRALIZED STRUCTURE flat in nature, and organizational power is spread out throughout the structure Communication patterns are simplified, and problems tend to be addressed with ease and efficiency at the level at which they occur. Module 3-5 LM 31 3. FUNCTIONAL ORGANIZATION Permits a specialist to aid line position within a limited and clearly defined scope of authority Module 3-5 LM 32 4. AD HOC ORGANIZATION The organic or adhocracy structure of organization is an open, free-form system. This system has resulted from behavioral research based on job satisfaction and efficiency. Module 3-5 LM 33 5. MATRIX STRUCTURE The matrix structure is a combination of two structures, consisting of the product (output) and the function, linked into one structure. The function consists of all of the activities and duties needed to produce an end product, and the product is the result of the function. Function oriented Module 3-5 LM 34 Referrences TEXTBOOK: Patronis, R. (2007) Nursing Leadership and Management: Theories, Processes, & Practices Other References: Whitehead, D; et al (2010) Essential of Nursing Leadership and Management 5th edition Module 3-5 LM 35 Create an organizational chart of a health care facility (USL Medical Center) to appreciate the types of organizational structure Module 3-5 LM 36  STAFFING PROCESS 1.Preparing to Recruit 2.Attracting a Staff 3.Recruiting and Selecting a Staff – interview ►induction ►orientation ►job order ►pre-employment testing ►signing of Contract Staffing Pattern –staff needed/shift or per day in ►unit or in ►department. Module 3-5 LM 37  TWO WAYS OF DEVELOPING A STAFFING PATTERN 1.Determine the # of nursing care hours needed/patient Generating the full-time equivalents of an employee 2.Determine the nurse-patient ratio in providing nursing care FTE – measure of work committed of full-time employee 1.0 FTE = works 5 days/week, 8 hours/day 0.5 FTE = part time employee who works 5 days/2 week Module 3-5 LM 38  CONSIDERATIONS IN STAFFING PATTERN 1. Benchmarking 3. Skill Mix – percent or ratio of professionals to Management tool for seeking out the best non- professional practice in one’s industry so as to improve one’s Ex: 40 FTE (20 RN + 20 non RN) = 50% RN mix performance. Process of measuring products, practices and 4. Staff Support – staff support in place for the services against best performing organization as a operations of the units or department. tool for identifying desired standards of organizational performance. 5. Historical Information – review of any data on quality or staff perception regarding the 2. Regulatory Requirements – mandated by RA effectiveness of the previous staffing pattern 9173 Module 3-5 LM 39  Patient Classification System Measuring tool used to articulate the nursing workload for specific patient or group of patients over a specific time Patient Acuity Module 3-5 LM 40 Module 3-5 LM 41 PATIENT CARE IS CLASSIFIED ACCORDING TO: 1. Self care or minimal care patients are capable of carrying ADLs 2. Intermediate or moderate care requires some help from the nursing staff with special treatments or certain aspects of personal care 3. Total care patients are those who are bedridden and who lack strength and mobility to do average daily living. 4. Intensive care patients are those who are critically ill and in constant danger of death or serious injury. Module 3-5 LM 42  SCHEDULING Issues to consider in scheduling staff: 1.Patient type and acuity 2.Number of patients 3.Experience of Staff 4.Support available to the staff Module 3-5 LM 43  Shifting Variations Traditional Shifting Patterns 3 shift (8 hr shift) Forty Hour Week Law – based 12 hr shift on RA 5901 10 hr shift No work, no pay Weekend option Entitled to 2-week sick leave and Rotating work shift off duty for 2 days Self-scheduling – staff makes their own Special Holidays – with pay schedule Permanent work shift Floaters – “on-call” Module 3-5 LM 44 MODALITIES OF CARE Module 3-5 LM 45  Functional Nursing Model functional nursing method is a decades-old, traditional form of patient care. The team leader, nurse collaborates with physicians to determine the needs of a patient. The head nurse then delegates tasks to nurses under her supervision. EX: 1 shift: charge nurse, medication nurse, bedside nurse This nursing model works well in periods of high demand, such as wartime or during epidemics. Functional nursing applies an assembly-line method of patient care, which can offer economic advantages for the hospital because it maximizes each team member’s skill set. Module 3-5 LM 46  Team Nursing Model Developed in the 1950s, the team nursing model is similar to the functional nursing method, but provides care on a larger scale. Surveys of nurses have yielded high marks for the team nursing model. Inexperienced nurses appreciate the opportunity to work with and learn from their experienced colleagues. Likewise, experienced nurses report that they feel more supported in their duties under a team nursing model. The team nursing approach also benefits medical facilities by enabling inexperienced nurses to learn more quickly, giving them increased value as employee assets. The method also promotes and improves communication among team members, which can result in improved patient care. Module 3-5 LM 47 Primary Nursing Model The primary nursing method developed in the 1970s and quickly gained popularity. Primary nursing has proven particularly successful in meeting the needs of patients with complex medical conditions. The hallmark of this modality is that one nurse cares for one group of patients with a 24-hour accountability for planning their care. In other words, a Primary Nurse (PN) cares for her primary patients every time she works and for as long as the patient remains on her unit. For example, a patient with diabetes might have heart problems, tissue damage and dietary restrictions, which require the type of comprehensive care a primary nurse can provide. Patients respond well to the primary nursing model, because it provides them with a knowledgeable medical contact and a sense of continuous care. Generally, nurses appreciate the feeling of autonomy primary nursing offers, while enabling them to provide patients with a high level of care. Module 3-5 LM 48 Total Patient Care Model/ Case Method Total patient care is the grandfather of nursing models. It requires a patient to receive all nursing care from one nurse. In today’s medical industry, total patient care can only be applied in certain types of situations, including critical care and home health care. In the total patient care model, the attending nurse typically provides care for the patient from the beginning to the end of his medical care episode. Total patient care requires nurses to assume all care for their patients. They must closely monitor the patient’s condition and communicate closely with the patient’s physicians. Module 3-5 LM 49  Case Management Case management focuses on the administrative issues of health care, rather than the actual delivery of health care. An RN case manager evaluates a patient’s care to determine her healthcare costs and the likelihood that An RN case manager evaluates a patient’s care to determine her the insurer will provide coverage. Case managers follow healthcare costs and the likelihood that the insurer will provide the progression of a patient’s care to determine the coverage. Case managers follow the progression of a patient’s likely discharge date and her care needs after discharge. care to determine the likely discharge date and her care needs after discharge. For example, a case manager must keep track of the number of days a patient’s insurance company will pay for inpatient care. If a patient experiences a discharge delay due to a rescheduled surgery, the case manager must communicate with the third party payer and coordinate new surgery and discharge dates with health-care staff. Module 3-5 LM 50  Modular Nursing (District Nursing) This is a modification of team and primary nursing. It is a geographical assignment of patient that encourages continuity of care by organizing a group of staff to work with a group of patients in the same locale. Module 3-5 LM 51 Module 3-5 LM 52