Controlling

Definitions
Controlling is the use of formal authority
to assure the achievement of goals and
objectives. Here, performance is
measured and corrective action is taken to
ensure the accomplishment of
orgazational goals. It also involves
assisting, regulating, monitoring, and
evaluating individual and group
performance.
Some people react strongly against the phrase “
management control” . The word itself can have a
negative connotation, e.g., it can sound dominating,
coercive and heavy-handed. It is now preferred to
use the term “coordinating” rather than
“controlling”. But, for all intents and purposes,
coordinating is controlling.

The control or coordinating function of

management can be a critical determinant of
organizational success.
 Function of Control
Control serves both as means and an end.
It promotes effective use of resources,
provides professional reinforcements, and
maintains activity and expectations.
 Principles of Controlling
 There must be
1. A Critical Few, meaning that fewer people
involved in control brings about the best results.
The principles unity of direction or unity of
command is at play.
2. A defined Point of Control or a centralization or
decentralization of authority. The level of ARA
designated to a nurse leader or manager in terms
of problem solving and decision making.
3. Self-control or Discipline, which translates to
personal acceptance of responsibility and
accountability
 Kinds of Formal Control
1. Pre-action Control : This is controlling by
means of personal supervision and utilizing
control checks consisting of policies and
procedures for any given task or function.
2. Post-action Control : This is controlling as
the task or function is being performed or
may have been performed and correcting
deviations from standards or plans.
 Types of Control
 Controls are most effective when they are applied at
key places. Supervisors can implement controls
before the process begins, during the process or after
it ceases.

 1. Feed forward Control :focus on operations before

they begin. Their goal is to prevent anticipated
problems. An example of feed forward control is
preparing all supplies and equipment for a scheduled
wound dressing, or bedside lumbar tap, intravenous
insertion, among others in order to determine what is
lacking and other things to be done. Other ex. Include
safety systems, training programs, and budgets.
2. Concurrent Controls : apply to processes as they
are happening. Concurrent controls enacted while
work is being performed. This include any type of
material or supplies for therapeutic care which
requires direct supervision or the use of automated
systems such as computers programmed to inform
the user when they have issued the wrong
command, and organizational quality programs and
resources.
3. Feedback Controls
Feedback controls focus on the results of
operations. They guide future planning, inputs, and
process designs. Examples of feedback controls
include timely (weekly, monthly, quarterly, annual)
reports so that almost instantaneous adjustments can
be made .
 Characteristics of Effective Control
1. Control systems must be designed appropriately
to be effective.
2.When control standards are not flexible or
unrealistic, employees cannot focus on the
organization’s goals
3. Control systems must be prevent, not cause, the
problems they were designed to detect.
 Designing effective control system
 Anything that can be planned can be controlled. Controls
should primarily serve the need for which they are intended.
Here are the guidelines for designing effective control
systems.
1. Control at all levels in the health care delivery system. All
nursing units must have a standard control system.
2. Acceptability of those who will enforce the decisions. The
nurse manager’s manner of influence on her staff to comply
with the policies or procedures.
 3. Flexibility of the enforcers and the implementors to enforce
decisions based on practical situations.
 4. Accuracy. Steps or mechanisms of control must be clear and
vivid with significant implications.
 5. Timeliness. Activities are planned with time target set.
 6.Cost effectiveness. Resources used are well maintained
and enough or adequate to meet the needs of the unit.

 7. Understanding . Policies and procedures are simple, easy

to understand and can be implemented with less difficulty.

 8.Balance between Theory of the objectivity and

subjectivity, and practice- based system.

 9. Coordinate with planning , organizing and leading.

 The Control Process
STEPS IN THE CONTROL PROCESS
Assuming that both plans or standards and
organization structure are clearly known and that the
personnel to perform the task, work, or job know the
extent of their authority and responsibility, the control
technique and system that may be used to evaluate the
same throughout the organization.
The control process is a continuous flow between
measuring, comparing and action. There are four steps
in the control process; establishing performance
objective and standards, measuring actual performance,
comparing measured performance against established
objectives, and taking necessary corrective action.
1. Establish and specify criteria and performance standards
Control process serve as the criteria against which
performance is measured, and give an idea of the level of
performance that managers can expect of a person.
This consists of the following.
a. Standards
Standards are created when objectives are set during the
planning process. A standard is any guideline established as basis
for measurement. It is a précised, explicit statement of expected
results for a product, service, machine, individual, or organization
unit. It is usually expressed numerically and set for quality,
quantity, and time.
b. Time Control
Time controls relate to deadlines and time constraints. Material
controls relate to inventory and materials needed. Cost controls
help ensure that cost standards are met. Employee performance
controls focus on actions and behaviors of individuals and group of
employees. Examples includes absence, tardiness, accidents,
 and quality of the work. Budget control refer to cost or
expense related standards. They identify the quality of
materials used and the production output.
 c. Financial controls
 Financial control facilitate achieving the
organization’s profit motive. One method of financial
control is budgeting. Budgets allocate resource to
important activities and provide supervisors with
quantitative standard against which to compare resource
consumption.
 d. Operations Control
 Operation control methods assess how efficiently
and effectively an organization's transformation processes
creates goods and services. Methods of transformation
controls include Total Quality Management (TQM),
statistical process control and the inventory management
control .
e. Statistical process control
statistical process control is the use of statistical or
mathematical methods and procedure to determine
whether production operations are being performed
correctly, to detect any deviations, and to find and
eliminate their causes.
f. The Just-in-Time (JIT) System
The Just-in-Time System is the timely application
of materials for use in case nurses need it for patient
care such as giving of medication for the illness of a
patient. It helps minimize inventory cost.
2. Monitor and Measure Performance of Nursing
Care Services and Evaluate it against the Standard
through Records, Reports and Observation
There are different techniques for monitoring and
measuring service.
a. Nursing Rounds Nurses pay particular attention to
issues of patient care and nursing practice. This will
also find out if the needs and problems of patient are
met or unmet.
b. Quality Assurance monitors compliance of nursing
personnel with established standards in terms of
nursing care given to patients.
c. Nursing Audit consists of documentation of the
quality of nursing care in relation to standards
established by the nursing department
A Nursing Audit, in particular, serves many purposes.
 It prioritizes nursing care by promoting optimum nursing
care.
 It can identify deficiencies in the organization and
administration of nursing care, and may be used to correct
such deficiencies through continuing education and
administrative change.
 It may also be used to increase performance to assure that
improvements have been maintained.
 Written data might include time cards, production tallies,
inspection reports and sales tickets
 Personal observation, statistical reports, oral reports and
written reports can be used to measure performance.
 Management by walking around or observation of
employees working, provides unfiltered information,
extensive coverage and the ability to read between the lines.
While providing insight, this method might be misinterpreted
Computers give supervisors direct access to real
time, unaltered data and information. Online
system enable supervisors to identify problems
as they occur. Database programs allow
supervisors to query, spend less time gathering
facts and be less dependent on other people.
Supervisors have access to information on their
fingertips. Employees can supply progress
reports through the use of office networks and
electronic mail. Computers are very important
tools for measuring performance. In fact , many
operating processes depend on automatic or
computer- driven control systems. Impersonal
measurements can count, time, and record
employee performance
 3. Compare Performance with Standards,
Models or Criteria to Determine Deviations or
Differences in Performance
Evaluation of the performance is necessary to ensure that
tasks are being carried out as planned. Here the actual
accomplishment is matched with the acceptance standard
to check if there are delays or deviation from the standard.
comparing performance with standards determines
variation. Some variation can be expected in all activities
and the range of variance, has to be established.
Management by exception let operations continue as long
as they fall within the prescribed control limits.
Deviations or differences that exceed this range would
alert the supervisor to a problem
There are ways or techniques for such corrections and
their improvements of performance based on
feedback.
a. The program Evaluation and Review Technique
(PERT) employ a matrix that uses network or
activities represented in a chart, including the goals
or product desired, time management, budget and
estimation of critical paths
b. Benchmarking seeks out the best so as to improve
its performance. It provides a standard or point of
reference in measuring or judging such factors as
quality, values and cost.
 4. Enact Remedial Measure or Steps to Correct
Deviation or Errors
a. Correction of deviations or errors. In the performance of
any given function or task, correction may be made by
modifying the plan either by changing the number of
personnel, or by better selection and training of
subordinates, or by changing the other factors of
production or by adding more materials or resource to
minimize or eliminate errors or any deviations.
b. A Master Control Plan may be used by mangers
depicting its functions, goals and objectives to be
accomplished and its specific activities to ensure quality of
performance and products.
c. Take necessary action. The supervisor must find the
cause of performance deviation from standard. Then he or
she takes action to remove or minimize the cause.
An example of the control process is a thermostat.
Standard: The room thermostat is set 20 degrees Celsius.
Measurement: The temperature is measured.
Corrective Action: If the room is too cold, the heat comes on.
If the room is too hot, the heat goes off.
Effective control involves keeping the process continues for
all areas. This includes management of the nursing division
and each sub-unit, performance of personnel and the final
Product: the Nursing process.
The process that guarantees plans are being implemented
properly is the controlling process. Controlling is the final link
in the functional chain of management activities and brings the
functions of management circle into full circle.
Control allows for ease of delegating task to team members
and as managers may be held accountable for the performance
of subordinates, they may be wise to extend timely feedback of
the employee accomplishments.
 CHARACTERISTICS OF THE
CONTROL PROCESS
1. The control process is cyclical which means it is never finished.
Controlling leads to identification of new problems that in turn need
to be addressed through establishment of performance standards and
measuring performance among others.
2. Controlling often leads to management expecting employee
behavior to change.
Employees often view controlling negatively, no matter how
positive the change may be for the organization.
3. Control is both anticipatory and retrospective.
The process anticipates problems and takes preventive action. With
corrective action, the process also follows up on problems.
4. Ideally, each person in the health care delivery views control as
his or her responsibility.
The organization culture should prevent a person walking away from
a small, easily solvable problem because “that isn’t my responsibility.”
In a service driven profession, each staff cares about
each client.
5. Controlling builds on planning, organizing and leading.
Controlling is related to each of the other function of
management.

MANAGEMENT CONTROL STRATEGIES

Managers can use one or a combination of four (4) control
strategies or styles, such as Market control, which first relies
primarily on budgets and rules. Bureaucratic control, Clan control
and Self-control.
Each serves a different purpose. Market control is made up of
external forces. Without external forces to bring about needed
control, managers can turn to internal bureau tic or clan control.
One relies on employees wanting to satisfy their social needs
through feeling a valued part of the business.
Self control, sometimes called adhocracy control, is
complementary to market, bureaucratic and clan control. By
training and encouraging individuals to take initiative in addressing
On their own, there can be a resulting sense of individual
empowerment, which plays out as self-control. Self-
control then benefits the organization and increase the
sense of worth of the business, industry and individual.

ELEMENTS OF CONTROLLING
I. PERFORMANCE APPRAISAL
A performance appraisal is a method of acquiring
and processing information needed to improve the
individual’s performance and accomplishments.
It consists of setting standards and objectives
against determined standards and objectives; reviewing
progress; having on-going feedback between the
appraiser and the one being appraised planning for
reinforcement, deletion or correction of identified
 PERFORMANCE APPRAISAL
TOOLS
Some of the tools used to evaluate performance are trait rating scale, job
dimension scale, Behaviorally Anchored Rating Scale (BARS), Checklist, Peer
review, and self-appraisal.
1. Trait Rating Scale
This is a method of rating a person against a set standard which may be the
job description, desired behavior and personal trait.
2. Job Dimension Scale
It focuses on the job requirements and the quality work performance .
3. Behaviorally Anchored Rating Scales (BARS)
This focuses on the desired behaviors to improve performance.
4. Checklist
It is composed of behavioral statements that represent desirable
behavior.
5. Peer Review
It is a collegial evaluation of the performance done to promote
excellence in practice and offer information, support, guidance,
criticism and direct to one another.
6. Self-Appraisal
This tool allows the employee to evaluate his own
performance.

COMMON ERRORS IN APPRAISAL

It is not unusual to encounter errors during the appraisal. Some
of these common errors are halo effects, logical errors, central
tendency errors, leniency errors, Hawthorne effect and Horn’s
effect.
7. Halo Effect
This has a tendency to overrate staff based on the rater's
first impression of the ratee. The evaluation is based on the good
traits or good things ones sees in a person.
2. Logical Error
It is often based on the first impressions of the rater to the ratee.
The first encounter may provide the rater the qualities or specific
traits which serves as bars to the quality of performance of the
3.Central Tendency Error
This rates the staff as average. This Is used by the
rater when feedback tools are inadequate and when
there’s no sufficient time for the rater to observe the
ratee.
4. Leniency Error
There is the propensity to overlook or observe the
weakness and mistakes of the person being evaluated
leading to an inaccurate picture of the job performance.
5. Hawthorne Effect
The behavior of the ratee changes simple because he
is observed by the ratee.
6. Horn’s Effect
This occurs when rating an employee very low
because of an error committed.
 DYSFUNCTIONAL CONSEQUENCES
OF CONTROL
Managers expect people in an organization to change their behavior in
response to control. However staff resistance can easily make control
efforts dysfunctional. The following behaviors demonstrates means by
which the manager’s control can be frustrating:
1. Game Playing
Control is something to be beaten, a game between the “boss and me
and I want to win.”
2. Resisting Control
A passive aggression or negative reaction to too much control will
lose track on what is suppose to be done. Resisting control may occur
when thee is poor relationship or lack of communication between the
manager and the staff. Inability of the manager to lead wisely will also
result to staff aggression.
3. Providing Inaccurate Information
A lack of understanding of why the information is needed and
important leading to “you want numbers, we will give you numbers.”
4. Following Rules to the Letter
People following dumb and unprofitable rules in
reaction to “do as I say.” this blatant command from
the manager may instill a negative reaction which may
lead to lack of staff motivation to act accordingly. This
may even lead the staff to do things contrary to what is
expected.
5. Sabotaging
Stealing, discrediting other workers, chasing
customers away, gossiping about firm to people in the
community.
6. Playing One Manager Off Against Another
Exploiting lack of communication among
managers, asking a second manager the staff does not
answer from the first manager
 CHANGE PROCESS
Change means substituting one thing for another, experiencing a
shift in circumstances that causes difference or becoming different
from before e.g. Changing methods and systems to improve the
accomplishments of objectives.
CHANGE PROCESS
Emotional Stages of Change
1. Equilibrium - there is sense of balance and inter peace before
change occur.
2. Denial - Energy is drained by the denial of the reality of
change.
3. Anger - Energy is used to ward off the change.
4. Bargaining - Energy is used to eliminate the change.
5. Chaos - Energy is diffused with loss of identity and direction
6. Depression - No energy is left to produce results.
7. Resignation – Energy is expended to accept change passively.
Openness – Renewed energy is available.
9. Readiness – There is willingness to use energy to
explore new events.
10. Reemergence – Energy is rechanneled producing
empowerment.

FACTORS THAT INFLUENCE CHANGE

There are several forces, both external and internal,
that influence change. External forces are events or
happenings that influence the organization as a whole
or its top administration. Example : population
explosion, legislation or economic forces. Internal
forces originate primarily from inside operation or are
the result of external changes, such as the composition
of staffing pattern and quality of life of the staff.
 STEPS IN THE CHANGE
PROCESS
The change process begins or is initiated when one perceives a need
for change.
2. This person then initiates group interaction, which is to identify
external and internal forces for change.
3. During this interaction, the beneficial activities are:
a. To state the problem;
b. Identify constraints;
c. List change strategies or possible approaches to problem-
solving
d. To select the best change strategy; and finally
e. Formulate as a group a plan for implementation and or
develop or select tools for evaluation.

Wholesale change of a system is never a good idea. It is important

 STRATEGIES FOR MANAGING
CHANGE
1. Empirical – Rational
Empirical-rational strategies for change management are based on
the assumption that people are rational and behave according to rational-
self interest. They assume that people are willing to change if justified.
The ‘power ingredient’ of the strategy is knowledge.
2. Normative-Reeducative
Normative-reeducation strategies are based on the assumption that
people are consistent to their commitment to socio-cultural norms and
values. E.g. a group may foster development of staff through personnel
counseling and training groups.
3. Power-coercive
Power-coercive strategies involve the compliance of the less powerful
with leadership, plans and direction of the more powerful. These
strategies use sources of power to bring change such as strikes, sit-ins,
negotiations, conflict, confrontation and rulings. The application of
power is done by either by legitimate authority, economic sanction or
 RESISTANCE TO CHANGE
Resistance to change is expected for a number of reasons
such as lack of trust, vested interest in the stats quo, fear of
failure, loss of status or income, misunderstanding and
belief that change is not necessary. The manager may then
take steps to handle this resistance, such as the following:
1. Communicate with those who oppose change and
understand the reasons for the opposition.
2. Clarify information and provide accurate feedback.
3. Be open to revisions but firm and clear about what must
remain.
4. Present negative consequences of resistance
5. Maintain a climate of trust, support and confidence.
6. Create a different disturbance to distract the attention of
those involve.
 II TOTAL QUALITY MANAGEMENT
Total Quality Management ( TQM) Is a management
approach for an organization, focused on quality, based on the
participation of all its members and aimed at long-term success
through customer satisfaction and benefits to all members of the
organization and society. TQM is aimed at embedding
awareness of quality in all organization processes.
For the Japanese, the secrete to success was implementation of
systematic quality efforts to meet or exceed customers
requirements and expectations the first time and every time.
The three basic principles of TQM are to:
1. Focus on achieving customer satisfaction;
2. Seek continuous and long-term improvement in all the
organization’s process and outputs; and
3. Take steps to ensure the full involvement of the entire work
TQM is composed of three paradigms:
1. Total: involving the entire organization, the entire chain,
and/or product or outcome life cycle.
2. Quality: With its usual characteristics, with all its
complexities to meet total client satisfaction.
3. Management: The system of managing, controlling,
leading, staffing , provision and the like.
In Japan, TQM comprises four process namely:
4. Kaizen - Focuses on “continuous Process Improvement”. To
make process visible, repeatable and measurable.
2. Atarimae Hinshitsu- The idea that “things will work as they
are supposed to “ for example, a pen will write.
3. Kansei – Examining the way the user applies the product
leads to improvement in the product itself.
4. Miryokuteki Hinshitsu- The idea that “ things should have
an aesthetic quality” e.g. , a pen will write in a way that is
pleasing to the writer”.
III DEVELOPMENT OF STANDARDS
A standard is not an arbitrary measure of performance. It is a pre
determined level of excellence that serves as a guide to practice. It
is established by authority communicated and accepted by the
standard
Standard are used to monitor and measure performance of nursing
care services and evaluate it against the standards through records,
reports and observations.

TYPES OF STANDARDS
1. Structure Standards
Standards that focus on the structure or management system used
by an agency to organize and deliver nursing care, including the
number and categories of number and categories of nursing
personnel who provide that care. (e.g. a team leader is responsible
for no more than 20 patients, with no fewer than 3 teams memberd
2. Process Standards
Standards that refer to actual nursing care
procedures or those activities engaged in by
nurses to administer care.
3. Outcome standards.
These are standards that are designed for
measuring the results of nursing care