Leadership and Management
midterm
Management functions of a nurse
Planning
Organizing
Directing
Controlling
Planning
A process beginning with objectives; defining strategies,
policies detailed plans to achieve them; achieving an
organization to implement decisions and including a
review of performance and feedback to introduce a new
planning style (Steiner,1969)
Pre-determining a course of action in order to arrive at a
desired result
A continuous process of assessing, establishing goals,
objectives, implementing and evaluating them
Largely conceptual however results are visible
Deciding in advance what to do, how to do it and who will
do it (Alexander,1978)
Planning functions:
Forecast - estimate future
Set objectives and determine results desired.
Develop and schedule programs -define activities needed
and set time frame.
Prepare budget – allocate resources
Establish policies, procedures, definite course of action
and methods.
Characteristics
Planning is purposeful
Planning is process oriented
Planning is hierarchical in nature
Planning is future directed
Planning is multi-dimensional
Importance of Planning
Planning leads to the achievement of goals and objectives
Planning gives meaning to work
Planning provides for effective use of available resources and facilities
Planning helps coping with crises
Planning is cost effective
Planning is based on past and future activities
Planning leads to realization of the need for change
Planning is necessary for effective control
Elements of Planning
Forecasting – looking into the future including the environment in which the
plan will be executed
Setting the Vision, Mission, Philosophy, Goals and Objectives
Mission statements - brief written descriptions of the purpose of the
organization
Vision Statements – are compelling description of how the organization
will or should operate at some point in the future and how the customers are
benefiting from the products and services of the organization
Philosophy - beliefs that shape how the mission or purpose will be achieved.
Developing and Scheduling program
programs are determined, developed and targeted with in a time frame to reach the set
goals and objective
done by utilizing planning formula (what, when, where, how, who, why)
Time Management
a technique for allocating one’s time through the setting goals, assigning priorities,
eliminating wasted time and using managerial techniques to reach goals efficiently.
Preparing Budget
Establishing Nursing Standards, Policies and Procedures
WHY MANAGERS FAIL TO PLAN
EFFECTIVELY?
Lack of knowledge of the philosophy, goals, and
objectives of the agency or lack of understanding of the
significance of the planning process.
They may not know how to manage their time to devote
for planning.
They may lack confidence in formulating plans or may
fear that planning may bring about unwanted changes that
they are unwilling to undertake or are unable to cope with.
SCOPE OF PLANNING
TOP management (Nursing Directors, Chief Nurses, Directors of Nursing and their assistants)
set the over-all goals and policies of an organization.
covers the over-all management of the organization’s Nursing Service
MIDDLE management (Nursing Supervisors)
direct the activities to actually implement the broad operating policies of the organization such as staffing
and delivery of services to the units.
the formulation of policies , rules and regulations, methods and procedures for intermediate level planning
for on-going activities and projects is done in coordination with top management and those in the lower
level.
LOWER OR FIRST-LEVEL management (Head Nurses or Senior Nurses including Charge Nurses or
Team Leaders)
do the daily and weekly plans for the administration of direct patient care in their respective units.
MAJOR ASPECTS OF PLANNING
Planning should contribute to objectives.
Planning precedes all other processes of management
(organizing, directing and controlling).
Planning pervades all levels.
Planning should be efficient.
CHARACTERISTICS OF A GOOD PLAN
Have clearly worded objectives, including desired results and
methods for evaluation
Be guided by policies and/or procedures affecting the planned
action
Indicate priorities
Develop actions that are flexible and realistic in terms of available
personnel, equipment, facilities and time.
Develop a logical sequence of activities
Include the most practical methods for achieving each objective
Types of Plans (may be long-term or short-term, directional
or specific)
A. Strategic – are organization wide, establish overall objectives and
position the organization with relation to its environment. This process
is continuous.
refers to defining and prioritizing long-term objectives of the
organization and developing strategies for implementation.
is future-oriented, focusing on plans for the next 2 to 5 years.
its purpose is to create an image of the desired future and design ways
to make those plans a reality.
it is a proactive process.
B. Contingency – refers to the identification and
management of the many problems that interfere with
getting work done.
- may be reactive, in response to a crisis, or proactive,
in anticipation of problems or in response to opportunities.
Contingency factors in planning:
Organizational level
Life cycle of the organization
Environmental uncertainty
Length of future commitments
Myths about planning:
that proves inaccurate is a waste of management’s time
can eliminate change
reduces flexibility
ORGANIZING
OBJECTIVES:
After the discussion, The students will be able to :
define what is an organizing, organization and organizational chart
know the different concepts, principles and elements of organizing
know the importance of organizational relationships
identify the types of organizational structure
determine the staffing formula and scheduling technique
discuss the types of Modalities of Patient care
ORGANIZING
Is the process of establishing formal authority.
It involves setting up the organizational structure
through identification of groupings, roles and
relationships, determining the staff needed by
developing and maintaining staff patterns and
distributing them in the various areas as needed.
It includes developing job descriptions by defining the
qualifications and functions of personnel.
Organization
is a planned grouping of people to accomplish a
specific purpose.
organized body, system or society where members
harmoniously work together to achieve
organizational goals.
P
Organizational e
o
Characteristics
p
l
e
Goals Structure
Organization
at
Work
Supervision Culture
J
o
b
ORGANIZATIONAL CHART
is a line drawing that shows how the parts of an
organization are linked.
It depicts the formal organizational relationship,
areas of responsibility, persons to whom one is
accountable, and channels of communication.
THE FUNCTIONAL MODEL OF LINE AND STAFF ORGANIZATIONAL
STRUCTURE
EXECUTIVE DIRECTOR
Assistant Executive
Director
Director of DIRECTOROF HUMAN Director of Other
Human Resources OPERATIONS Purchasing Directors
Unit 1 Unit 2
-------------------------
MANAGER MANAGER
Human Resources
OPERATIONS Purchasing /Personnel
OPERATIONS
Human Resources Purchasing
Other Other
ORGANIZATIONAL CHART
Advantages:
Contributes to sound organizational structure
Map lines of decision-making authority
Shows formal line of communication
Shows how people fit into the organization
Helps employees understand their assignments
Disadvantages:
Becomes obsolete quickly
Shows only the formal relationships
Does not show informal communications
May show how things are supposed to be rather than how
they are
May help confuse authority and status
Organizational Types of Authorities:
Line authority– the simplest and most direct type of
organization in which each position has general authority
over the lower positions in the hierarchy.
It is the traditional employee-employer authority
relationship that emanates from the top of the organization
to the worker population, following what is called the chain
of command.
Staff organization – support line-authority relationships
and are advisory or service oriented in nature.
2 categories of staff authority
Personal staff
Specialist staff
TYPES OF ORGANIZATIONAL CHART:
Tall or centralized structure
is developed along vertical dimensions by use of the scalar process to define
relationships between levels in an organization
Advantages:
An individual has the ability to be an expert in narrow area over which he/she
is responsible.
More skilled individuals are placed in positions where they supervise others.
Procedures are standardized.
Administrators have a great ideal of control over actions and are the primary
decision makers
Disadvantages:
Those who are very closely supervised may feel stifled and
in extreme cases even mistrusted.
Communication is difficult
Implementation of a decision may be excessively delayed
TRADITIONAL HIERARCHICAL STRUCTURE
CHIEF OF HOSPITAL
CHIEF NURSE
SUPERVISING NURSE
SENIOR NURSE
STAFF NURSE
NURSING
ATTENDANT
Organizational Chart of a Nursing Service showing several layers of positions between
Chief Nurse and Nursing Staff.
TYPES OF ORGANIZATIONAL CHART:
Hospital Director
Chief Nurse
Asst. Chief Nurse
Supervising Nurse
Senior Nurse
Staff Nurse This model is a typical
and traditional
Nursing Assistant
hierarchical structure.
Flat or Decentralized
is developed along horizontal dimensions according to the number of
organizational functions.
decision-making is commonly spread out among many people.
Advantages:
There cannot be close supervision
Manager relies on individuals to make independent decision
Communication from lower levels to higher levels is easy and direct
Individuals have an opportunity to develop their own abilities and
autonomy
The result is greater job satisfaction for the majority of individuals
Disadvantages:
The individual in charge may have such a broad span
of control
Managers may find that they cannot process all the
communication that arrives
Managers may lack expertise in the wide variety of
operations for which they are responsible, thus making
inappropriate decisions
Nursing Administrator
Nursing Nursing
Staff Primary Nurses
Staff
This MODEL depicts a decentralized
professional clinical structure
Five Major Characteristics of an Organizational Chart
Organizational Chart should show the following the following COMPONENTS:
Division of Work – each box represents the individual or sub-unit
responsible for a given task of the organization’s work load.
Chain of Command – lines indicate who reports to whom and by what
authority.
Type of work to be performed – indicated by labels or descriptions for the
boxes.
Grouping of Work Segments – shown by the clusters of work groups.
Levels of Management – indicate individual and entire management
hierarchy.
ELEMENTS OF ORGANIZING:
1. Setting up the organizational structure
2. Staffing
3. Scheduling
4. Developing job description
SETTING UP THE ORGANIZATIONAL
STRUCTURE
The creation of an organizational system compatible
with the philosophy, conceptual framework, and goals
of the organization provides the means for the
accomplishment of an organization’s purpose.
ORGANIZATIONAL STRUCTURE – Refers to the
process by which a group is formed, its channels
authority, span of control and lines of communication.
The successful setting up the organizational structure enables an
organization to achieve its purpose
It informs members of their responsibilities so that they may carry them
out.
It allows the manager and the individual workers to concentrate on
his/her specific role & responsibilities.
It coordinates all organizational activities so there is minimal
duplication of effort or conflict.
It reduces the chances of doubt and confusion concerning assignments.
It avoids overlapping of functions because it pinpoints responsibilities.
COMPONENTS OF ORGANIZATIONAL
STRUCTURE
Formal relationships, lines of communication and authority are
depicted on a chart by solid lines.
VERTICAL- denotes the official chain of command.
HORIZONTAL- represent communication between people with
similar spheres of responsibility an
The level of position on the chart signifies status and power
TOP LEVEL MANAGERS
MIDDLE LEVEL MANAGERS
FIRST LEVEL MANAGERS
Dotted or Broken Lines
On the chart it represents staff or advisory positions,
having no legitimate authority that accompanies the
line relationship.
Unity of Command
Is indicated by the vertical solid line between positions
on the organizational chart.
Span of control
Refers to the number of people reporting to any one
manager and the number of interactions expected of him or
her.
Types of Span of Control:
Narrow
Wide
NARROW SPAN OF CONTROL
DIRECTOR
ASSISTANT ASSISTANT
H/S H/S H/S H/S
W W W W
WIDE SPAN OF CONTROL
DIRECTOR
ASSISTANT ASSISTANT
DH DH DH DH DH
KEYPONTS:
1. TOO WIDE a span of control may mean that managers are overextending themselves and that
their subordinate are receiving too little guidance or control.
2. TOO NARROW a span of management may mean that managers are underutilized .
FACTORS TO CONSIDER IN DETERMINING THE
OPTIMAL SPAN OF CONTROL IN AN
ORGANIZATION
Manager’s abilities
Employee’s maturity
Task complexity
Level in the organization at which the work occur.
The number of people reporting to one supervisor must be
the number that maximizes productivity and worker
satisfaction.
CENTRALITY
Refers to the location of a position on an organizational
chart when frequent various types of communications
occur, and determined by organizational distance.
TYPES OF ORGANIZATIONAL STRUCTURES:
Informal – comprises personal and social relationships
that do not appear on the organizational chart
Formal – depicts the line authority and chain of command.
It is a framework where management process takes place.
2 BASIC FORMS OF FORMAL
ORGANIZATIONAL
1. HIERARCHIC OR BUREAUCRATIC MODEL
This model is designed to facilitate large- scale
administration by coordinating the work of many
personnel.
2. ADAPTIVE/ADHOCRACY OR ORGANIC MODEL
A newer organizational frameworks that are more free
form, open, flexible and fluid than the older bureaucratic
models.
Characteristics of an organic model:
1. Motivation is not derived from supervision but rather
from the needs of the system, peer pressure and task-
related factors.
2. Rewards and recognition is based on the results of
individual and group work rather than subjective
evaluations from supervisors or managers.
3. Management is participative.
Types of Adhocracy:
1. Free form – stresses open communication, consensus,
independent judgment and self regulation
2. Collegial Management –enhances democratic
management
3. Project Management – is useful for long range projects
that need much planning, coordination and research
4. Task Forces – are organized for special projects that are
short range
5. Matrix Organization
Matrix Organization
A design which tries to combine the advantages of project and
functional structures
Advantages:
Manages dual demands
Good for complex work
Collaborative management
Flexible, efficient use of scarce resources
Adaptive and Innovative
Improved interpersonal and conflict management leading to goal
achievement and job satisfaction
Disadvantages:
Complicated
May be viewed as confusing
Need well educated personnel
Complex communication
Advanced interpersonal relationship needed
Role conflicts and ambiguity
Requires frequent meetings
Time consuming
Special learning required in conflict management & interpersonal
relationships
Dean
Chairperson Chairperson Chairperson
Chairperson
MCH Mental Health Community
MS Nursing
Nursing Nursing Health Nursing
Assistant Dean
For under- --- Faculty ----- Faculty ---- Faculty ----- Faculty
Graduate
program
Assistant Dean
For Graduate --- Faculty ----- Faculty ---- Faculty ----- Faculty
program
Assistant Dean
For Continuing
Education
--- Faculty ----- Faculty ---- Faculty ----- Faculty
ORGANIZING PRINCIPLES:
1. Unity of Command
2. Scalar Principle or Hierarchy
3. Homogenous Assignment or Departmentation
4. Span of Control
5. Exception Principle
6. Decentralization or Proper Delegation of Authority
ORGANIZING PRINCIPLES:
1. UNITY OF COMMAND
Although employees may interact with many different
employees in the performance of their duties, they should be
responsible to only one superior.
This is to avoid confusion, overlapping of duties and
misunderstanding.
2. SCALAR PRINCIPLE OR HIERARCHY
Authority and responsibility should flow in clear
unbroken lines from the highest executive to the lowest.
“Chain of Command” is usually a military term
3. HOMOGENOUS ASSIGNMENT OR
DEPARTMENTATION
Workers performing similar assignments are grouped
together for a common purpose.
Departmentation promotes the specialization of
activities, simplifies the administrator’s work, and helps
maintain effective control.
4. SPAN OF CONTROL
The number of workers that a supervisor can effectively manage should
be limited, depending upon the pace and pattern of the working area.
It also refers to span of managerial responsibility and the number which
one superior can assist, teach and help to reach the objectives of their
own jobs.
If the workers are highly skilled and are working near each other, their
number may be increased.
At the top level of the structure, a 1:6 ratio of supervisor-workers is
common, while at the base of the organization, a 1:10 ratio is common.
5. EXCEPTION PRINCIPLE
Recurring decisions should be handled in a routine manner by lower-
level managers whereas problems involving unusual matters should be
referred to the higher level.
This will enable subordinates to learn how to make decisions at their
own level and free executives from being bogged down by routine
details that can be handled as well by subordinates.
6. DECENTRALIZATION OR PROPER DELEGATION
OF AUTHORITY
Decentralization is the process of conferring specified
decision making to the lower levels of the organization.
The amount of skills and competence of subordinates and
executives determines the success of any program of
decentralization
ASSIGNMENT
GOD BLESS !!!
