WEEK 2 CONTINUATION things.

-Shorter time frame.

TYPES OF PLANS - Usually involve the middle and lower levels of
managers.
1. STRATEGIC PLANS
-Long terms in nature- around 3-5 years.
DATA A NEEDED FOR PLANNING
-Based in explicit assessments of the competitive
strengths and weaknesses of the organization. Daily average patient census
- It defines the direction and growth of the -computed based on days of admission over
organization. patient days.
- Prepared in the upper levels of management and Bed capacity and percentage of occupancy
serve as the basis for operating plans. Average length of stay
- Vital quote: What are the right thing to do? Number of births
-Includes analysis of factors such as projected Number of operation
technological advances, the internal and external Trends in patient population
environments, the nursing and health care market Diagnosis
and industry, the economics of health care, Age groups
availability of human and material resources and Acuity of illness
judgments of top management. Minimal
Moderate
ELEMENTS OF STRATEGIC PLANNING Maximal
Intensive
1. Product/Marker Planning
Physical dependency
2. Business Unit Planning
Trends in technology
3. Shared Resource Planning
Diagnostic procedure
4. Shared Concern Planning
Therapeutic procedure
5. Corporate- Level Planning
Environmental Analysis
Internal forces
PHASES OF STRATEGIC PLANNING
Availability of nurses
1. The Mission and the Creed Turnover
2. Data collection and analysis Delivery system
3. Assess strength and weakness Physicians
4. Goals and objectives External forces
5. Strategies Government education
6. Timetable (scholarship)
7. Operational and Functional Plan Accreditation bodies
8. Implementation Third-party payers
9. Evaluate Trends in health care and in nursing
Threats to nursing profession
2. OPERATING PLANS Opportunities for nursing profession
-Usually pertains to activities in specific department
of an organization.
-Main question is How does one do the right
things?
-It deals with tactics or techniques for accomplishing
these
Week 3
BUDGETING
Terms:
Budget a plan or schedule adjusting expenses
during a certain period to the estimated or fixed
income for that period.
Budgeting is the process whereby objectives and
plans are translated into financial terms and
evaluated using financial and statistical criteria.
Revenue is the income or sales of products and
services.
Revenue budgeting or rate setting- is the process by
which an agency determines revenues required to
cover anticipated costs and to establish prices
sufficient to generate these revenues.
Expenses are the costs of providing services in
patients.
Costs- is money expended for all resources used
including personnel, supplies and equipment.
APPROACH TO BUDGETING
1. Zero- Base Budgeting
- is a method of budgeting used to control costs.
- Budgeting process starts from zero and everything
must be justified each new budget cycle.
- All labor power and cost are recalculated and
decisions are made about whether to continue
function and at what levels.
2. Program Budgeting
- is a part of budgeting planning.
- items such as continuing education programs
employee benefits, health promotion program
should be incorporated into the annual budget.
3. Expense Budgeting
- is the process of forecasting, recording, monitoring
the manpower, materials, supplies and monetary
needs of an organization in such a manner that the
operation of the various components of the
organization can be controlled.
PURPOSE OF EXPENSE BUDGETING
To predict labor hours, materials, supplies
and cash flow needs for future time
periods.
To establish procedure for making
comparative studies.
To provide a mechanism for determine
when changes in procedures need to be
made, provide gross information on the
kinds of changes needed, and provide
evidence that control has been established
or reestablished.
TYPES OF EXPENSES OR COSTS
Fixed Costs are not related to volume
(salaries, rentals, benefits, utilities.)
Variable Costs- do relate to volume
and census) patient days, supplies.)
Direct Costs- are the costs of providing
the product or service and are often
considered to be those directly related
to patient care such as personnel costs
or the variable costs of supplies.
Indirect Costs these measured in
supporting the provision of the product
or service and are not directly related
to patient care (utilities, housekeeping
maintenance.)
Junk Costs are fixed expenses that
cannot be recovered even if a program
is canceled.
TYPES OF BUDGET
Manpower Budget
- includes wages, salaries and
compensations paid to permanent
employers. It may also include fees paid to
temporary or casual workers.
Capital Expenditure Budget
- requires long range planning. It includes
purchases of land, equipment, buildings or
expansion of existing building or plant.
Phase 4- Monitoring
1. Prepare a monthly summary of departmental
expenses and revenues.
2. Compare actual expenses with budgeting
expenses.
3. Investigate any variances above 5%.
4. Readjust budget and/or improve performances
as necessary.
5. Continue to monitor on monthly basis.

Operating Budget
-includes purchase of minor equipment,
repairs, supplies or overload expenses.

BUDGETING PROCESS

Phase 1- Planning
1. Set sort and long-term goals.
2. Form and budget committee.
3. Prioritize objective.
4. Analyze past performance.
5. Product future cost of revenues.
6. Develop budget guidelines.

Phase 2- Preparation
1. Translate objectives into projected costs and
revenues.
2. Write justification for all requested expenses.
3. Eliminate lowest priority objective as
necessary.
4. Prevent proposed budget.

Phase 3- Modification and Approval

1. Prepare preliminary master budget from all
department request.
2. Compare projected costs with estimated
revenues.
3. Eliminate lowest priority items until budget is
balance.
4. Approve final master budget.
5. Communicate final budget to all departments.
Week 4
ORGANIZING
- Is the grouping of activities for the purpose of
achieving objectives, the assignment of such
groupings to a major with authority for supervising.
STEPS IN ORGANIZING
-Development of mission, philosophy and objectives.
-Development of organizational charts.
Organizational Chart- is a drawing that shows the
parts of an organizational relationships, areas is
accountable and channels of communication.
1. It outlines administrative control.
2. It issues for pulling, making and planning.
3. It is used to evaluate strengths and weaknesses of
the present structure.
4. It shows the relationships with other departments
and agencies.
5. It is used to orient new personnel to the
organization.
Organizational Structure- provides the framework in
which management process is carried out man
organization. Its designed to show cleanliness of
authority; flow of communication and relationship
among the various departments and to pinpoint
person/s responsible and accountable.
FORMS OF ORGANIZATIONAL STRUCTURE
1. Hierarchical
- (tall, centralized, bureaucratic structure.)
-is associated with the principle of chain of
command, bureaucracy and multitiered hierarchy
vertical control and coordination.
-levels differentiated by function of authority and
downward communication.
2. Decentralization
- (flat, horizontal, participatory) structure.
- Flat organizational structure are characteristics of
decentralization management.
- Decentralization is delegating decision- making
responsibilities to the ones doing the work-
participating management.
- People closest to the problem solve its resulting
in efficient of costs effective management.
- Conditions asserted for effective
decentralization.
1. Freedom to function effectively.
2. Support from peers and leaders
3. Concise and clear expectations of the work
environment
4. Appropriate resources
Matrix Structure
- It superimpose a horizontal program
management over the traditional vertical hierarchy.
- Personnel from various functional
departments are assigned to a specific program or
project and become responsible for two bosses.
- A program manager and their functional
department head.
CHARACTERISTIC OF MATRIX ORGANIZATION
1. Maintenance of old line authority structure.
2. Specialist resources obtained from functional
areas.
3. Promotion of formation of new organizational
units.
4. Decision making of the organizations level of
group consensus the first line management level.
5. The exercise of authority by the matrix manager
over the functional manager.
6. Cooperative planning, program development,
allocation of resources to accomplish program
objectives.
ADVANTAGES OF MATRIC ORGANIZATION
Improved communication through vertical
and horizontal control and coordination of
interdisciplinary patient care teams.
Increased organizational adaptability and
fluidity to respond environmental changes.
Increased efficiency of resource use with
fewer organizational levels and decision
making closer to primary care operations.
 Improved human response management
because of increased job satisfaction with
achievement and fulfilment, improved
communication, improved interpersonal
skills, and improved collegial relationships.
DISADVANTAGES OF MATRIX ORGANIZATION
Potential conflict because of dual or
multiple lines of authority.
Role ambiguity.
Loss of control over functional discipline as
a result of multidisciplinary approach.
STEPS IN ORGANIZING
2. Development of policies and procedures
Policies- are guidelines to help in the safe and
efficient achievement of organizational objectives
3 GENERAL AREAS IN NURSING THAT REQUIRE
POLICY FOUNDATION
1. Area in which confusion about the locus of
responsibility might result neglect to
malperformances of an act necessary to patient's
welfare. (wash hands, wear mask)
2. areas pertaining to the protection of patients and
families rights, such as right to privacy and right to
property. (knock first before you enter, not allowed
to see the chart)
3. areas involving matters of personnel management
and welfare. (file for leave)
Procedures- are specific directions for implementing
written policies
3 AREAS
1. Areas relation to job situations by giving such
disciplinary. (termination)
2. Areas involving the delivery of direct patient care
such as giving bed bath or administering oral
medications.
3. Job Descriptions- written account of the
organizational relationships, responsibilities, specific
duties and working condition of particular job. it
includes details of qualification such as education,
experience and skills required for appointment and a
resume of duties delegated to the position by top
management.
a. conduct a job analysis (can speak English
fluently)
2 stand points
the duties and responsibilities
associated with job
skills and personal attributes
required to perform the job
satisfactorily
b. conduct a job evaluation- is a systematic
method of appraising the work of each job
in relation to all other jobs in organization.
c. formulation of job description
begins with the active verb
written in a statement form
describing the principal duties and
scope of responsibility of the
worker
simple and direct narrative
Week 5
STAFFING
- process of determining and providing the
acceptable number and mix of nursing personnel to
produce desire level of care and to meet goals.
STAFFING PROCESS
1. Selection of personnel
Recruitment- the process of enlisting
personnel for employment (Job fair, walk in,
advertisement, and referral)
Screening- screen out appearance who do
not fit the image of agency, try to for the
job to a compromising applicant, usually try
to fit the application to the job (resume, no
typographical errors, neat, simplified and
font choice)
Interview- observes applicant, observe if
applicant show genuine interest in the job,
observe if well maintained (coat with
sleeves, haircut, eye contact)
Orientation- the process of becoming
familiar with a new environment and
adapting well to it.
Tour of physical facilities
Introduction to co-workers
Description of the organization
structure of the institution
Information on the philosophy,
goals and policies, and standards
of the institution
Function of the members of the
health team
Staff development
SYSTEMS OF ASSIGNMENT OR PATIENT CARE
DELIVERY
1. Case Method- each patient is assigned to a
nurse for total patient care including
medicine and treatment.
2. Functional Method- nurses are assigned to
perform specific task based on the
employees education and experience.
3. Team Method- Professional, technical and
ancillary nursing personnel are grouped
together as a team to give total care to a
selected group of patients. Team consists its
member are other staff nurses, nurses
aides and orderliness.
4. Primary Method the primary nurse is
given full of responsibility, planning,
implementing and evaluating the nursing
care for 4 to 6 patients. Nursing care
utilizing a written nursing care plan,
communicate with other members of
health team.
5. Modular Method- Combination of Team
and Primary.
STAFFING SCHEDULE
1. Centralized-based on master staffing
pattern carried out by one person who
plans and coordinates the schedule of
nurses.
2. Decentralized- allows the nurse manager to
staff her own unit.
3. Self- Scheduling- process by which the staff
nurses in a unit collecting to decide and
implement the monthly work schedules.
VARIABLES AFFECTING STAFFING
1. Patient Classification system
- Means of categorizing present patients
on the basis of certain care needs that
can be clinically observed by the nurse.
CATEGORY I: MINIMAL CARE (55-45) Levels of Care NCH Needed or Patient per day
-Convalescing patient and no longer require
intensive, moderate or maximum care. Levels Nursing Care Hours

Level I (minimal) 1.5 hours

CATEGORY II: MODERATE CARE (60-40)
-Patients who are moderately ill or are recovering Level II (moderate) 3.0 hours
from immediate effects of serious illness and
operation. Level III (maximum) 4.5 hours

CATEGORY III: MAXIMUM CARE (65-35) Level IV (intensive) 6 or 7 higher

-Patients who needs close attention throughout the
shift
Percentage of Patient in Various Level of Care
CATEGORY IV: INTESIVE CARE (70-30)
-Acutely ill person who have high level of nurse Types of Minim Modera Intensi Highly
dependency. Hospital al te ve Specializ
ed
NATIONAL LEAGUES FOR NURSES
Primary 70 25 5 -
Formula for Staffing- percent of professional to Non- (50 beds
professional capacity)

Area Professionals Non- Secondar 65 30 5 -

Professionals y
(provinci
MS 60 40
al)
Pediatrician 70 30
Tertiary 30 45 15 10
Nursery 55 45 (regional
, training
ICU 80 20 and
medical)

Specializ 10 25 45 20
Formula- Percent distribution per shift ed (Lung,
Kidney
Morning 45%
and Hear
Afternoon 37% Center

Night 18%
 Rights Privilege 40 48
hours/week hours/week 2. Find the total number of nursing hours
needed by patients/day at each categorized
Vacation Leave 15 15 level.
a. No. of patient at each level of care NC
Sick Leave 15 15
hour/day
Legal Holiday 10 10 For example: Tertiary
30 X 1.5= 45
Special Holiday 2 2
(election) 45 X 3.0= 135

Special Privilege 3 3 15 X 4.5= 67.5

(birthday/grad)
10 6= 60
Off Duties 104 52
b. Total No. of Nursing Care hours/day=
CPE 3 3 307.5 NCH/day
(seminar/orientation
3. Find the total number of nursing hours
Total Non-working 152 100 needed by the patient per year
days/year a. Total No. of Nursing hours/day X 365
days of the year
Total Working 213 265 307.5 X 365= 112, 237.5 NCH/year
days/year
4. Find actual number of working hours
Total Working 1, 704 2, 120 needed by each nursing personnel
hours/year each year.
a. Hours on duty/day X actual working days/
8 X 213= 1, 704 hours/year
FORMULA FOR STAFFING
4. Find the total nursing personnel needed
1. Categorize the number of patients a. Divide the total number of nursing
according to the level of care needed by the hours needed by the given number of
hospitals classification patient per year by the actual number
a. Total No. of patient X % of each level of of working hours/year
care 112, 237.5 / 1, 704= 66 personnel
For example: Tertiary Level
100 X .30= 30 b. Find the relief X the number of nursing
personnel
100 X .45= 45 Primary 66 X 6 relievers
.095=
100 X .15= 15
Tertiary 66 X .15= 10 relieves
100 X .10= 10
66 X .12= 8 relievers
100 number of
patients
 c. Add the number of relievers to the Week 6
nurse needed nursing personnel
Primary 66 + 6= 72 DIRECTING

-issuance of assignments, orders and instructions

Tertiary 66 + 10= 76
that permit the worker to understand what is
(personnel +
expected and give orders.
relievers)
DELEGATION
66+ 8= 74
-showing of responsibility and accountability with
subordinates and holding them account.
5. Categorized into professional or non-
Reasons:
professional
a. Multiply the number of nursing personnel Saves time and can develop others
according to ratio of professional to non- Maximizing the use of the talents of staff
professional associates
Uses talent abilities in personnel that
76 X .65= 49 Registered Nurses
contribute to their growth and
76 X .35= 27 Nursing Attendants development (tinatagong kakayahan)

GUIDELINES FOR EFFECTIVE DELEGATION

6. Distribute Shift
Gives a clear description of what is you
a. Registered Nurses
want the employed to do.
49 X .45= 22 Morning
Share with the employee the outcome you
49 X .37= 18 Afternoon are expecting
Discuss the degree of responsibilities and
49 X .18= 9 Night authority that the employee will have
Ask the employee to summarize the main
b. Nursing Attendants points of the task that has been delegated

27 X .45= 12 Morning AREAS FOR DELEGATION

27 X .37= 10 Afternoon Routine task (bed making, bed bath)

Tasks for with you do not have time (attend
27 X .18= 5 Night
meetings)
Problem-solving
Change in your own job emphasis
Capability building (develop employee)

AREAS NOT TO BE DELEGATED

The power to discipline (NCP, Health

Teachings, Skills)
Responsibility for maintaining morale
Overall control (scheduling)
The Hot Potato or Hot issues
BARRIERS TO DELEGATION
I can do it better myself (applicable to
feeling magaling)
Lack of ability to direct (walang sumusunod
sa leader)
Absence of controls that warn of impending
difficulties (iba diskarte, hindi koi to
delegate kasi iba sya gumawa ng solution)
Aversion to taking a risk (di ko to delegate
kasi baka may mangyari)
Week 7
CONTROLLING OR EVALUATING
-ongoing function of management which occurs
during planning, organizing and directing activities.
-it includes assessing and regulating performance in
accordance with plans that have been adopted, the
instructions, issues.
PURPOSES OF EVALUATION
Determine the progress and worthiness of
individual nurse for greater responsibilities.
Serve as basis for promotion and increase in
salary or other similar rewards.
Provide constructive feedback
PERFORMING APPRAISAL
-It is a control process in which employees
performance is evaluated against standards.
-the most valuable tool in controlling human
resources and productivity.
-it reflects how well the nursing personnel have
performed during a specific period of time.
Examples: Masters Degree, Research Conduct,
Advisers, Member of Organization, Member of PNA,
Certification, Book/RLE, S. Evaluation, P. Evaluation
Determine salary standards and merit
increases
Select qualified individuals for promotion or
transfer
Identify unsatisfactory employees for
demotion or termination
Make inventories of talents within the
institution
Determine training and development needs
Improving the performance of work groups
by examining, improving, correcting
interrelationship between members.
Improve communication between
supervisor and employees and reach an
understanding on the objectives of the job.
 Establish standards of supervisory
performance.
Discover the aspirations (ambition) of
employees and reconcile these with the
goals of the institutions
Provide employee recognition for
accomplishments
Inform employee where they stand