CONTROL AND CO-ORDINATION

CONTROL

DEFINITION. Controlling is determining what is being

accomplished. That is, evaluating the performance and if necessary, applying corrective measures so that performance takes place according to plans

George TerryControlling consist of verifying whether every thing

occurs in conformity with the plan adopted, instructions and principles established

Henry FaolControl is the process of taking step in getting actual

results and desired results close together. Philip Kotler

PRE REQUISITES FOR EFFECTIVE CONTROLLING

plans Organisational structure

Principles of assuring of objectives Principle of efficiency of control: Principle of future control Principle of direct control Principle of reflection of plan Principle of organizational suitability Principle of individuality of control Principle of standard Principle of critical point control Exception principle Principle of action

PRINCIPLES OF CONTROL

Managerial function Circular process Forward looking Necessary at all levels of management The essence of control is action which

adjust performance to predetermined standards

Positive and constructive approach Wide scope Tool to achieve organizational goal Not an interference Remedial activities

CHARACTERISTICS OF CONTROL

Planning Control Provide a sense of direction Allocates the resources Anticipate problemsMotivates employees to achieve goalGives emphasis on impersonal, abstract and long range problemsIt is less structuredTop managers spend much of time  Evaluation of results is difficult Seeks consisted and integrated programmes

Guides activities toward organizational goalInsures the effective utilization of organizational processCorrect problemsReward employees for goal achievementGive more emphasis on personal, concrete and immediate problems.It is highly structuredOperating employees spend much timeResults are often soon visibleSeeks to compel events to confirm to plans

A COMPARISON BETWEEN PLANNING AND CONTROL

Growing size of business

Changing environment

Inherent part of managerial process

To facilitate the delegation

Efficient uses of resources

Prevent crisis and mistakes

Encourages success

Enhances employee morale.

Promotes coordination

NEED AND IMPORTANCE OF CONTROL

1. Establishment of goals and standards2. Measurement of performance3. Comparing performance against standard4. Taking corrective action

STEPS IN THE CONTROL PROCESS

Generally performance standards serve three important purposes

Standards reflect expected and planned results. They help employees understand what is expected of them and how their work will be evaluated.

They provide a basis for finding deviation from fixed targets

They help reduce the potential negative effects of goal incongruence

Establishment of goals and standards

On the basis of management levels Strategic control Tactical control Operational controlOn the basis of time of their operations1. Feedforward or steering control2. Concurrent control3. Feedback control

TYPES OF CONTROL

On the basis of activities Control on policies Control over organization Personnel control Wages and salary control Production control Inventory control Cost control Office control Overall control

General techniques of controlpersonal observationSetting examplesRecords and reportsPolicies and proceduresCharts and manuals Standing rules and limitations Written instructions Censure

TECHNIQUES OR METHODS OF CONTROL

Disciplinary action Control unit social control device Rewards Budgets Accounting Internal auditing Statistical data Break even analysis Self control

TECHNIQUES OR METHODS OF CONTROL

Human asset accounting Standard costing Cash flow analysis Management information system Cybernetic control system

II. Special techniques of control

Quantifications Long run result are unpredictable No control on external factors Difficulty in setting standards Difficulty in fixing responsibility Limits of corrective action Time consuming

PROBLEMS AND LIMITATIONS OF CONTROL

Leadership Roles 1.Encourage followers to actively be

involved in the quality control process. Clearly communicates expected standards

of care to the subordinates Encourage the setting of high standards to

maximise the qualities instead of setting minimum safety standards

Uses control as a method of determining why goals were not met.

LEADERSHIP ROLES AND MANAGEMENT FUNCTIONS ASSOCIATED WITH QUALITY CONTROL

Is active in communicating quality control findings and their implications to other health professionals and consumers

Act as a role model for followers in accepting responsibility and accountability for nursing actions

Distinguishes between clinical standards and resource utilization standards , ensuring that patients receive at least minimally acceptable levels of quality care.

Supports /actively participates in research efforts to identify and measure nursing sensitive patient outcomes

  .Establishes clear cut measurable standards of

care and determines the most appropriate methods to care and determines the most appropriate method for measuring if those standards have been met.

Selects and uses process, outcome , and structure audits appropriately as quality control tools.

Access appropriate sources of information in data gathering for quality control

Determines discrepancies between care provided and unit standards and seeks further information regarding why standards were not met.

Management Functions

Uses quality control findings in determining needed areas of staff education or coaching

Keeps abreast of current government , accelerating body , and licensing regulations that affect quality control.

Actively participates in state and national benchmarking and “Best Practices” initiatives

Continually assesses the unit or organizational environment to identify and categorize errors that are occurring and proactively reworks the process that led to the errors

Management Functions

Definition Quality assurance is a judgment concerning the process of care

based on the extent to which that care contributes to valued outcomes. -Donabedian 1982

Quality assurance is the measurement of provision against expectations with declared intention and ability to correct any demonstrated weakness. -Shaw

Quality assurance is a management system designed to give maximum guarantee and ensure confidence that the service provided is up to the given accepted level of quality, the standards prescribed for that service which is being achieved with a minimum of total expenditure. -British Standards Institute

QUALITY ASSURANCE

Objectives To successfully achieve sustained improvement in

health care, clinics need to design processes to meet the needs of patients.

To design processes well and systematically monitor, analyze, and improve their performance to improve patient outcomes.

A designed system should include standardized, predictable processes based on best practices.

Set Incremental goals as needed.

QUALITY ASSURANCE

Purposes/ Need Rising expectations of consumer of services. Increasing pressure from national, international, government

and other professional bodies to demonstrate that the allocation of funds produces satisfactory results in terms of patient care.

The increasing complexity of health care organizations. Improvement of job satisfaction. Highly informed consumer To prevent rising medical errors Rise in health insurance industry Accreditation bodies Reducing global boundaries.

QUALITY ASSURANCE

Principles Customer focus Leadership Involvement of people Process approach Continual improvement Factual approach to decision making Mutually beneficial supplier relationship

QUALITY ASSURANCE

Approaches General approach Specific approach

General approach Credentialing Licensure Accreditation Certification Recognition Academic degree

Specific approach Audit Direct observation Appropriateness evaluation Peer review Bench marking Supervisory evaluation Self-evaluation Client satisfaction Control committees Services Staging Sentinel

Outpatient department Emergency medical services In- patient services Specialty services Training

Areas of QA

Chart audits Failure mode and effect analysis:

prospective view Root- cause analysis: retrospective view  Flow charts Pareto diagrams  Histograms Run charts Control charts

Quality tools

Quality assurance cycle

DEFINITION performance appraisal is a systematic, periodic and so far as

humanly possible, an impartial rating of an employee‘s excellence in matters pertaining to his present job and to his potentialities for a better job

Edwin flippo

The performance of an employee is compared with the job standards. The job standards are already fixed by the management for an effective appraisal.

Performance appraisal is a record of progress for apprentices and regular employees, as a guide in making promotions, transfer or demotions, as a guide in making lists for bonus distribution, for seniority consideration and for rates of pay, as an instrument for discovering hidden genius, and as a source of information that makes conferences with employees helpful‖.

scott, clothier and spriegal,

PERFORMANCE APPRAISAL

OBJECTIVES OF APPRAISAL. 1. To determine the effectiveness of

employees on their present jobs so as to decide their benefits.

2. To identify the shortcomings of employees so as to overcome them through systematic guidance and training.

3. To find out their potential for promotion and advancement.

1.To provide backup data for management decisions 2. To serve as a check on hiring and recruiting practices

and as validation of employment tests. 3. To motivate employees by providing feedback about

their work. 4. To discover the aspirations of employees and to

reconcile them with the goals of the organization, 5. To provide employees with recognition for

accomplishments. 6. To improve communication between supervisor and

employee, and to reach an understanding on the objectives of the job.

PURPOSES AND BENIFITS

7. To help supervisors observe their subordinates more closely, and to give supervisors a stronger part to play in personnel management and employee development

8. To establish standards of job performance. 9. To improve organizational development by identifying

training and development needs to employees and designing objectives for training programmes based on those needs,

10. To earmark candidates for supervisory and management developments

11. To help the organisation to determine if it is meeting its goals.

 

PURPOSES AND BENIFITS

1.Lack of support from top management. 2. Resistance on the part of evaluators because: a. Performance appraisal demands too much of

supervisors efforts in terms of time, paperwork, and periodic observation of subordinates performance.

b. Supervisors are reluctant to play god by judging others.

c. Supervisors do not fully understand the purpose and procedures of performance appraisal.

d. Supervisors lack skills in appraisal techniques. e. Performance appraisal is not perceived as being

productive.

The principal obstacles to effective performance appraisal

3. Evaluation biases and rating errors, which result in unreliable and invalid ratings.

4. Lack of clear, objective standards of performance. 5. Failure to communicate purposes and results of

performance appraisal to employees. 6. Lack of a suitable appraisal tool. 7. Failure to police the appraisal procedure effectively.

1. Single employee is rated by two ratters. Then, the comparison is made to get accurate rating.

2. Continuous and personal observation of an employee is essential to make effective performance appraisal.

3. The rating should be done by an immediate superior of any subordinate in an organization.

4. A separate department may be created for effective performance appraisal.

PRINCIPLES OF PERFORMANCE APPRAISAL

5. The rating is conveyed to the concerned employee. It helps in several ways. The employee can understand the position where he stands and where he should go.

6. The plus points of an employee should be recognized. At the same time, the minus points should not be highlighted too much, but they may be hinted to him.

7. The management should create confidence in the minds of employees.

8. The standard for each job should be determined by the management.

9. Separate printed forms should be used for performance appraisal to each job according to the nature of the job.

Ranking method if there are ten workers in the working group, the most efficient worker is

ranked as number one and the least efficient worker is ranked as number ten

Advantages a. Each employee or worker can be compared with the other person. b. A small organization can get maximum benefits through the ranking

method.   Disadvantages a. A big organization is not able to get sizable benefits from the ranking

method. b. Ranking method does not evaluate the individuality of an employee. c. It lacks objectivity in the assessment of employees.

KINDS OF PERFORMANCE APPRAISAL

Advantages   a. This method is suitable for big organizations. b. Individual traits are evaluated under this method.   Disadvantages a. The understanding of this method is difficult one. b. It involves considerable time.  

Paired Comparison Method

Forced distribution method Grading Checklist Forced choice method Critical Incident method Field review method Essay evaluation method

Other PA methods

1. Tell and sell interview 2.Tell and listen interview 3.Problem solving interview.  

Types of appraisal interview

Key behaviors for an appraisal interview 1. Put the employee at ease 2. Clearly state the purpose of the appraisal interview 3. Go through the ratings one by one with the

employee. 4. Draw out the employee reactions to the ratings. 5. Decide on specific ways in which performance areas

can be strengthened. 6. Set a follow up date. 7. Express confidence in the employee.

1. The performance appraisal methods are unreliable. 2. If an employee is well known to an employer, the

performance appraisal may not be correct. 3. The inability of supervision to appraise an employee does not

bring out the accurate performance appraisal. 4. Some qualities of an employee can not be easily appraised

through any performance appraisal method. 5. A supervisor may appraise an employee to be good to avoid

incurring his displeasure. 6. Uniform standards are not followed by the supervisors in the

performance appraisal.  

LIMITATIONS OF PERFORMANCE APPRAISAL

1. Leniency error: the tendency of a manager to over rate staff performance.

2. Recency error: the tendency of a manager to rate an employee based on recent events rather than over the entire evaluation period.

3. Halo error: the failure to differentiate among various performance dimensions when evaluating.

4. Ambiguous evaluation standards problem: the tendency of evaluators to place differing connotations on rating scale words

POTENTIAL ERRORS OF APPRAISAL

Definition "Nursing audit refers to assessment of the

quality of clinical nursing". Elison

The audit is a means by which nurses

themselves can define standards from their point of view and describe the actual practice of nursing. Goster Walfer

NURSING AUDIT

 Purposes of Nursing Audit 1. Evaluating Nursing care given 2. Achieves deserved and feasible quality of nursing

care 3. Stimulant to better records 4. Focuses on care provided and not on care provider 5. Contributes to research

Retrospective view The concurrent review

Methods of Nursing Audit

Method to Develop Criteria : 1. Define patient population. 2. Identify a time framework for measuring outcomes

of care, 3. Identify commonly recurring nursing problems

presented by the defined patient population, 4. State patient outcome criteria, 5. State acceptable degree of goal achievement, 6. Specify the source of information. 7. Design and type of tool

1. Outcome audit 2. Process audit 3. Structure audit

 Audit as a Tool for Quality Control

Advantages of Nursing Audit : Can be used as a method of measurement in all areas of

nursing. functions are easily understood Scoring system is fairly simple Results easily understood Assesses the work of all those involved in recording

care May be a useful tool as part of a quality assurance

programme in areas where accurate records of care are kept.

 Disadvantages of the Nursing Audit : Appraises the outcomes of the nursing process, so it is

not so useful in areas where the nursing process has not been implemented

Many of the components overlap making analysis difficult

It is time consuming requires a team of trained auditors deals with a large amount of information only evaluates record keeping. It only serves to

improve documentation 

DEFINITION Coordination is the orderly synchronisation of efforts to

provide the proper amount, timing and directing of execution resulting in harmonious and unified actions to a stated objectives.

Newman Coordination is the balancing and keeping the team together

by ensuring a suitable allocation of working activities to the various members , and seeing that these are performed with due harmony among members themselves.

Brech

Coordination is the integration of several parts into an orderly whole to achieve the purpose of undertaking

COORDINATION

Diverse and specialised activities Empire building Personal rivalries and prejudices Conflicts of interest

NEED FOR COORDINATION

Communication Orderly plans Supervision Leadership Departmentation Direct contact

TECHNIQUES OF COORDINATION

Planning Organisation Direction Control

Internal coordination

Three interested parties Other organizations. Government regulations Technological advancement

External coordination

The uncertainty of the future, as to the behaviour of the individuals and of people

The lack of knowledge, experience, wisdom and character among leaders and their confused conflicting ideas and objectives

Lac of administration skills and technique. The vast number of variables involved and competencies of

human knowledge , particularly to men and life. The lack of orderly methods developing, considering, perfecting

and adopting new ideas and programs. Size and complexities personalities and political factors. The lack

of leaders with wisdom and knowledge pertaining to public administration.

HINDRANCE TO COORDINATION

REFERENCES Basavanthappa BT. Nursing Administration.2nd edition. New

Delhi; Jaypee Brothers Medical publishers: 2009 Marquis BL,Huston CJ. Leadership roles and Management

function in Nursing.New Delhi;Wolter Kluwer Pvt Ltd:2009 Sakharkar BM. Principles of Hospital Administration and

Planning. 2nd edition.New Delhi; Jaypee Brothers Medical publishers: 2009

http://www.currentnursing.com/nursing_management/coordination.html

http://www.currentnursing.com/nursing_management/coordination.html

   

DEFINITION. Controlling is determining what is being

accomplished. That is evaluating the performance and if necessary, applying corrective measures so that performance takes place according to plans

George TerryControlling consist of verifying whether every thing

occurs in conformity with the plan adopted, instructions and principles established

Henry FaolControl is the process of taking step in getting actual

results and desired results close together. Philip Kotler