Nursing Program Lecture (Planning) - KSIU 2024

Field of Nursing Studies Nursing Program Lecture : (Planning) Prof. Dr : Reem Mabrouk A. El-Rahman Date : 22 /10 /2024 [email protected]  Objectives At the end of the lecture, the student will be able to: Identify Planning. Discuss The Planning Process. List Characteristics' of a G...

Field of Nursing Studies Nursing Program Lecture : (Planning) Prof. Dr : Reem Mabrouk A. El-Rahman Date : 22 /10 /2024 [email protected]  Objectives At the end of the lecture, the student will be able to: Identify Planning. Discuss The Planning Process. List Characteristics' of a Good Plan. Discuss The Planning Process. Discuss Types of Plans and Planning. Identify Planning hierarchy.  Outline Definitions of Planning Types of Plans and Planning; Importance of planning in nursing Strategic Planning ( long-range) The Planning Process Practical Planning Characteristics' of a Good Plan Contingency Planning (Planning for Change) Planning hierarchy: The Single Use Plan Mission vision Day-by-Day Planning Philosophy Time Planning Goals Proactive planning Objectives Integrating Leadership Roles and Management Policies Functions in Planning. Procedures Applications of planning in nursing department Rules Overcoming Barriers to Planning  Introduction Planning phase of management process is critical and precedes all other functions. Without adequate planning the management process fails.  Concepts of Planning Planning, is looking ahead to chart the best courses of future action. Planning, is the process of deciding in advance what should be done, how, when, where and by whom it will be done. Forecasting, is predicting future needs on the basis of historical data, present conditions, and assured future. Forecasting controls staffing, purchasing, and production decisions. Importance of planning in nursing Planning is important in nursing because it helps in: 1. Setting organizational goals and develops alternative approaches to meet these objectives. 2. Developing strategies for achieving the goals. 3. Focus attention on objectives. 4. Providing & coordinating effort within organization. 5. Helps to gain economical operations by effective utilization of available resources. (manpower, equipment and supplies). 6. Facilitating control and change. 7. Dictates those activities to which employers are directed. The main activities in the planning are the formulation of strategies and setting the objectives. Strategy: is defined as the set of decisions that determine the character (size, scope and mix of services) of a health services organization and gives it the direction in the market place. In a real sense objectives are the key to the entire management process. Strategy Formulation Creation of a broad program for defining and meeting an organization’s goals  Characteristics of a Good Plan 1. Provides a workable solution and meets the stated objectives. 2. Is comprehensive; it raises all relevant questions and answers them. 3. Minimizes the degree of risks. 4. Is specific as to time, place, supplies, tools, etc. 5. Is flexible (can be adapted to a change in the situation). 6. Is logical, clear, simple and balanced. Planning hierarchy, (planning tools) MISSION VISION PHILOSOPHY GOALS OBJECTIVES POLICIES PROCEDURES RULES Mission statement Is a brief statement which identifies the reason for which an organization exists, and addresses its position regarding ethics, principles, and standards of practice. It is the highest priority in the hierarchy of planning because it influences all the other planning components in the pyramid. Mission Statement; is an organization’s statement of how it will achieve its purpose in the environment in which it conducts its services.  Vision statement (not written); is always future oriented while mission statement provides the foundation for organizational planning, an example of a vision statement would be “To become an exemplar for healthcare in the region”. Philosophy It flows from the mission statement. philosophy is defined as the set of values and beliefs that guide all actions of the organization, it is the basic foundation that directs all further planning toward the mission, a philosophy statement can usual be found in policy manuals and are available upon request. Goal The ends toward which the organization is working, it is the aim of the philosophy, it is what makes the philosophy operational The desired result toward which effort is directed Goals are measurable and ambitious, but realistic, just like the criteria we use in our nursing care plans to identify pt. outcomes. Objectives Identify how and when the goal is to be accomplished, they are more specific and measurable than goals.  Policies Policies Plans reduced to statements or instructions that direct organizations in their decision making. They are statements of expectations that set boundaries for action taking and decision making. Implied policies; Not written or verbally expressed, and usually are developed over time; for example a hospital may have a policy that employees should be encouraged and supported in their activities in regional, community, and national healthcare organizations. Expressed policies; Delineated verbally or in writing. They include a formal dress-code, a policy for sick leave or vacation time, and disciplinary procedures.  Procedures are series of steps in chronological sequence of required action. Plans that establish acceptable ways to accomplish a specific task and outline a sequence of steps for required actions. For example, the first line manager must provide a clearly written procedural statement regarding how to request vacation time.  Rules & Regulations Definition of rules: are plans that define specific action or non-action; describe situations that only allow one choice of action. Because rules are the least flexible type of planning; there should be as few rules as possible; however existing rules should be enforced to keep morale from breaking down; e.g. No smoking is allowed in patient room. Definition of regulations: are policies developed at the middle and first level position in organization. It is guidelines for action that apply to department.  Barriers to implement planning Omitting Goals or Objectives The organization can be more effective if it is directed at specified goals and objectives Goals and plans keep managers focused on the bigger picture and keeps them from getting lost in the minute details Patient goals should be established before making interventions Lack of Flexibility The plan must be flexible to reach a goal, and allow for readjustment as unexpected events occur Lack of Communication Manager should include in the planning process people and units that could be affected by the course of action. Although everyone will not want to contribute, they should all be invited.  Barriers to implement planning Unrealistic Expectations Plans should be specific, simple, and reasonable A plan that is vague or too global can be difficult or impossible to implement. Over- & Under-Planning Know when and when not to plan The under planner makes false assumptions that people and events will naturally fall into place and has difficulty prioritizing against real needs Failure to Execute the Plan If goals are not met, the manager must determine why and what needs to be changed. Types of plan & planning Strategic Planning (long- range.) Tactical Plans- (short- range). Contingency Planning (Planning for Change). The Single Use Plan. Day-by-Day Planning. Time Planning. Proactive planning.  Planners Top management makes strategic plans. Middle Management makes annual plans (Tactical Plans). For supervisors, the planning period is usually a week, day, or shift ( to deal with daily work). Strategic Planning – long-range Definition of Strategic planning: is a Long range plan (5-10 years) to set organizational goals, objectives, and policies to determine strategies, tactics, and programs for achieving them. Strategic Plans is reflecting decisions about resource allocations, organization priorities, and steps needed to meet strategic goals. Steps of Strategic planning: 1.Define clearly the purpose of the organization 2.Establish realistic goals and objectives consistent with the mission of the organization 3.Identify the organization’s external constituencies or stakeholders, and then determine their assessment of the organization’s purposed and operations. 4.Communicate clearly the goals and objectives 5.Develop a sense of ownership of the plan 6.Develop strategies to achieve the goals 7.Ensure that most effective use of resources is made 8.Provide a base from which progress can be measured 9.Provide a mechanism for informed change as needed 10. Build a consensus about where the organization is going. Key issues to consider in developing the strategic plan examples: Quality Sample Objective/Goal: “To reduce medication administration errors by 10%”. Information Technology; Consider implementation of electronic charting/drug administration system Staff Levels Analyze staff to patient ratios. Are nurses overworked? Access. Sample Objective/Goal: “Provide care to 15% more patients than we did last year” Assess resources available to achieve the objective How much additional staff will be needed? How much additional space will be needed? Will we need new construction? New wing or modular building? How will we pay for the addition – seek funding, charity or debt financing (taking out a loan)? Cost Sample Objective/Goal: “Decrease the unnecessary waste of supplies by 5%” Implement incentive-based motivation for staff to decrease wasted supplies Consider implementing a competition for the least amount of supplies wasted. Consider implementing additional policies for supply uses? (Example: Mandatory workshops or refresher courses on proper patient assessment) Many times supplies will be wasted because the patient was not properly assessed prior to getting the supplies – for example grabbing a male-sized catheter for a female and not realizing it until the procedure. Forces Affecting Long-Term Plans Changes in the future of the healthcare organization Change in information technology Will result in elimination of duplication and provide immediate access of information Change in patient demographics The increasing number of seniors will create enormous demands on the healthcare system Change in economics. Cost of drugs is highest in the world Changes in providers Nurses will continue to decrease in supply and some physician specialties will increase in supply. Tactical Plans Generally are short-range plans concerned with implementing specific aspects of a organizing strategic plans. Operational Plans Plans setting short-term targets for daily, weekly, or monthly performance. Standing Plan: are predetermined course of action. Established routine, formula, or set of procedures designed to be used in a reoccurring situation. They standardize actions so the supervisors need to manage is reduced to seeing that workers meet standards and dealing with unexpected events known as management by exception. Potential drawback: Rigidity must make them flexible enough to deal with daily realities. These plans must be updated regularly. Contingency Planning (planning for change): Alternative courses of action when the primary plans don’t achieve the goals. Contingency Planning Its planning for change to: Define problem and set objectives Gather past, present, and probable future data Evaluate pros and cons & generate alternatives Make the necessary decisions Implement the plan 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 in which a company will respond to changes.  The Single Use Plan A onetime plan developed for a single occasion or purpose. The amount of time spend on it depends on its nature and importance. Often its purpose is a major change of some sort or budgets.  Day-by-Day Planning Top priority of the first line nurse manager. Primary concern is what to be done, who will be doing it, and adjusting various standing plans. Plan before the day begins. Establish routines simplify planning. Whenever possible reduce risks by increasing predictability.  Proactive planning Reactive plan Planners respond to a crisis which can lead to hasty decision and mistakes. In activism These planners do not like change and put all of their efforts into maintaining conformity and the status quo. Pre activism These planners are unsatisfied with the past or present, believing the future is always preferable. Interactive or proactive These planners are dynamic, considering the past, present, and future. Leaders and managers must be adaptive in order to promote growth within their organization.  Time Planning Not a type of plan but, it's how to plan Track nurse present time use, and analyze nurse use of time. Get rid of activities that waste nurse time (socializing, poor organization, procrastination, etc.). Set priorities. Initiate long-range solutions. Set aside regular periods of time without interruption for interviews, etc. Integrating Leadership Roles and Management Functions in Planning Leader-Manager must be skilled in determining, implementing, documenting, and evaluating all types of planning in hierarchy The leader should demonstrate a proactive rather than a reactive planning (management style) to employees Manager draws on the philosophy and goals established to implement planning Manager appropriately assesses the constraints, assets, and resources available for planning Manager draws on leadership skills in creativity, innovation, and futuristic thinking to translate philosophies into goals, goals into objectives, and so on down the planning hierarchy  Leader-Manager will develop the interpersonal skills necessary for inspiration of employees Leader-Manager must be receptive to new and varied ideas The Leader-Manager’s final step in the process involved articulating identified goals and objectives clearly If the unit manager lacks management or leadership skills, the planning hierarchy fails. Managers who are uninformed about the legal, political, economic, and social factors affecting healthcare make planning errors that may have disastrous implication for the organization. Applications of planning in nursing department Applications of planning by the staff nurse Nursing care plan for each patient. Develop a daily time plan for her work during the shift. Determine the equipment which will be needed in intervention of care. Determine the time for providing and updating the nursing care plan. Applications of planning by the first line nurse manager; Assign each staff according to the level of her competency. Determine the equipment which will be needed in emergency situations. Determine the time for nursing round. Determine the time for nursing conference.