4 Major Steps of the Management Process

PLANNING Is deciding in advance what to do, how to do it, when to do it, and who is to do it Is the principal duty of all managers Involves determining objectives, strategies, programs, procedures, and rules to accomplish It is a cognitive proves for decision making. Decision making and planning are closely intertwined. However, a decision is not a plan but basically a resolution of alternative choices In general, planning is an intellectual process based on facts and information, not on emotion or wishes In nursing, planning helps to ensure that patients will receive the nursing services that they want and need and that these services are delivered by nursing workers Planning is such a primary and essential element of management that managers cannot be effective without it It has to be approached logically and calmly, it may threaten the insecure and may even threaten the administrator who must provide total support in terms of giving resources to accomplish divisional planning Planning is a continuous process, beginning with the setting of the goals and objective slaying out a plan of action to accomplish them, put them into play, review the process and the outcome, provide feedback and modify as needed

Planning organizing directing controlling Planning Controlling is also evaluating

4 Orientations to Planning Reactivism o o o o Looks to he past and considers technology an enemy Supports the old organizational forms of authoritarian, parternalistic hierarchy Planning is considered prerogative Prevents change by using crisis management which goal is to control discomfort without addressing its goal

Inactivism

Effective instrument is committee, to keep people busy until the work is outdated by insufficient resources

Preactivism o o Change is accelerated through technology Associated with science, technology, and future Future can be created an invented Technology is valued depending on how it is used, Experience reveals problems and experiment leads to their solutions

Interactivism o o

A Plan has 3 Characteristics It must involve the future It must involve action There is an organizational identification of the future course of action that will be taken by a particular planner or someone designated by him or for him in the organization Characteristics of a Good Plan Be precise with clearly-worded objectives including desired results and methods for evaluation Be guided by policies/procedures affecting the plan Indicate the 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 Pervade the whole organization

Reasons for planning Planning leads to success & achievement of goals and objectives. Brings about behaviors that lead to desired action and outcomes. Employees can see the result of their labor Planning gives meaning to work, knowing that objectives help the employees relate what they are doing to Planning helps in coping with crisis. Plans anticipate emergencies, they allow the worker to function more calmly in efficiently when an actual crisis occurs Planning is cost effective. Some costs can be contained through planning of nurse. Example: projecting the number of nurses needed to care for a group of patients or ordering enough supplies for a unit Planning is based on the past and future helps reduce the element of change. Studying what has been successful or unsuccessful can give the manager a better idea of what to do in the future By planning, one discovers the need for change. Planning can point out opportunities or different services Planning is necessary for effective control. Mangers can evaluate the environment, resources and employees effectiveness

Resistance for planning

Planning is something that many managers avoid. Failure to plan may be attributed to the following factors: Managers may lack knowledge of the philosophy, goals and workings of the organization Managers may not understand the significance of planning, that success or failure of work activities relate to the quality of the plan Time spent on planning often seems distracted in relation to the day-to-day doings of ones job Some managers may lack confidence, fearing failure Some managers prefer to act on immediate problems because they generate immediate feedback Planning may bring unwanted change. Reluctant may exist because implementation of plans may require new activities that the individual is unwilling to engage in

The Planners Top Management (Chief Nurses and Assistants, Nursing Directors)

set the over-all goals and policies of the organization. Their responsibility covers the over-all management of the nursing service

Middle Management or Nursing Supervisors o o Direct the activities to actually implement the broad operating policies E.g., staffing and delivery of services to the units Formulation of policies, plans, rules and regulation, methods and procedures for activities and projects in coordinating

Lower of First-level Management o Do the daily and weekly plans for the administration of direct patient care in their respective units

Scope of Planning Forecast or Estimate of the Future It describes the ultimate condition or projections that provide the general incentive and direction to planning Should consider the: o o o plans Agency Community Goals of care

Forecast must be supported by facts, reasonable estimates, and accurate reflection of policies and

Set Objectives/Goals determine results desired Goals o Are statements of intent derived from the purposes of the organization and they are stated broadly and in general terms Objectives o Specific behavior or task set for accomplishment of a goal

Develop and schedule strategies * Programs o o Are series of activities that function together to facilitate attainment some desired goals Example: staff development programs, outreach programs, discharge teaching program

Strategic Planning Tactical Planning Unit planning Planning extents to the operational units of any healthcare agency Should be done on a daily basis * Is short term planning Converts objectives into actions and include activities, assignments, deadlines and provision for accountability It is considered as daily, weekly, and monthly planning Objectives for long term nursing activities of one to five years longer It has generally been understood that top administrators in nursing focus on strategic planning, whereas operational nurse managers focus on tactical planning.* Types of Plans (according to the * Long term plans: 3-5 years

IV. Prepare Budget Allocating resources Allocation of scarce resources on the bass of forecasted needs for proposed activities over a specific period of time A tool for planning, monitoring and controlling cost or a systemic plan for meeting expenses Budgeting and Planning o Is an ongoing activity in which revenues and expenses are managed to maintain *

Nurse manager has: Budgetary Planning in Nursing Expense Budgeting Is the process of forecasting, recording and monitoring the manpower, materials and supplies, and monetary needs of an organization in such a manner that operation of various components of the organization can be controlled Types of Expenses/Costs Fixed Costs o Remain constant as volume increases and decreases over a period of time Helps ensure that patients receive the nursing service they want Helps maintain needs from satisfied nursing workers Financial responsibility and accountability for managing the nursing budget Makes decision on adjusting the nursing budget to manage programs and costs e.g. adding and dropping programs, modifying revenues and expenses within the nursing unit

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E.g., depreciation of equipment and buildings Do relate to volume and census like meals and linens Are fixed expenses that cannot be recovered even if program is cancelled E.g, advertising Direct cost Are the costs of providing the product or service directly related to patient care Personnel costs, variable cost of supplies

Variable Costs Sunk Costs

Other Costs

Indirect costs Are those incurred in the *

Systems/Approaches of Budgeting Centralized budgeting o o The budget are developed and imposed by the controller, administrator and the director or nursing with little or no consultation with lower level managers This top-down approach leaves the implementers of the bud without autonomy or the rights to appropriate or control ex* Decentralized Budgeting o Middle level manager becomes involved in the planning *

Components of Total Institution Budget

Manpower Budget o Includes wages and salaries paid to regular employees and fees paid to outside registries thru whom the institution contracts for temporary workers

Capital Expenditure Budget o Includes purchases of land, building, and major equipment of consideration expense and long life

Operating Budget o Includes the cost of supplies, minor equipment of considerable expenses

Types of Institutional Budget depending upon Management Philosophy Open-ended o Is a financial plan in which each operating manager presents a sing cost estimate for what he considers the optimal activity level for each program in his unit, without indicating how * Flexible Budget o o Consists of several financial plans, each of a different level of activity or for different operating conditions Top management can select the budget ot can shift the spending level up or down to permit higher or lower levels of productivity Performance Budget o o o Is based on functions such as direct nursing care supervision, quality control, etc. One in which cost are computed for an entire program Example: Home care program, outreach program, etc. Program Budget

Zero based Budget o Requires managers to justify in detail the cost of all programs, both old and new, with every annual budget preparation

Sunset Budget o Is designed to self-destruct within a prescribed period to ensure cessation of the funded program by a predetermined date

V. Establish Policies, Procedures/Standard Policies Procedures Provide a more specific guide to action than a policy. It is a step by step guide Indicate the minimal level of achievement acceptable to meet objective A technique for allocating ones time through the setting of goals, assigning priorities, identifying and eliminating wasted time and using managerial technique to reach goals efficiently Ones personality, education and culture influence how he or she manages time Standards Time Management Are referred to as standing plans and are used repeatedly Are guides or basic rules that govern action at all levels in the organization. It seems for the goals of the agency

Symptoms of Time Management Time Management Principles: Planning anticipates the problems that arise from actions without thought. It anticipates the crises* Rushing, fatgue, and listlessness with hours of non-productivity Constan*

Setting deadlines in ones work, adhering to them and excellent exercise in self-discipline Prevent procrastination deferring, postponing, or putting off actions and decision that cause lost opportunities and productivity

Time-saving techniques, Devices & Methods to Better Use of Time: Conduct an inventory of your activities o o o o o Log activities for 1 day Identify time problems Examine old habits of not using time well & understand why you are doing so Set priorities Plan on making things happen rather than reacting to crises

Set goals and objectives and write them down

Use calendars, executive planners, logs or journals, write what you expect to accomplish yearly, monthly, wekly or daily Breakdown * Devote a few minutes at the beginning of each day for planning o o At the end of the day, account for the tasks you have accomplished Prepare a list of what are to be done the following day

Organize you work space Close you door when you need to concentrate o o Agree on a period of quiet office time Avoid having an open door policy

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