Controlling - Nursing management
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Transcript of Controlling - Nursing management
CONTROLLINGLEADERSHIP AND MANAGEMENT PROCESS
CONTROLLING
An on going function of management which occurs during planning, organizing and directing activities
Process wherein the performance is measured and corrective action is taken to ensure the accomplishment of organizational goal
PURPOSES OF CONTROLLING
Open opportunities for improvement
Compare performance against set standard
Provides information about how well processes and people function
Steps in Control Process
Establish standards and criteria
Measure performance
Compare results with standards
Match with standards? YES - do nothing to improve NO - take corrective action
REASONS FOR CONDUCTING EVALUATION
Ensures that quality services is provided
Allow for setting of sensible objectives and ensures compliance
Provides standards for establishing comparisons
Promotes visibility and means for employees to monitor own performance
Highlights problem related to quality care and determines areas that require priority attention
REASONS FOR CONDUCTING EVALUATION
Provides an indication of the cost of poor quality
Justifies the use of resources
Provides feedback for improvement
EVALUATION PRINCIPLES
1. Must be based on behavioral standards of performance with the position requirement
2. There should be enough time to observe employee’s behavior
3. Employee should be given a copy of the ff. Before scheduled evaluation
Job descriptionPerformance standardsEvaluation forms
EVALUTAION PRINCIPLES
4. Performance appraisal should include both satisfactory and unsatisfactory results
5. Areas needing improvement must be prioritized
6. Should be scheduled and conducted at a convenient time for both evaluator and employee
7. Should be structured in such a way that it is perceived and accepted positively as a means of improving job performance
CHARACTERISTICS OF EVALUATION TOOL
OBJECTIVE Free from bias
RELIABLE Accurate and precise that it will produce the same
results if administered twice
SENSITIVE Instrument can measure fine lines of differences
among criteria being measured
VALID
TYPES OF PERFORMANCE STANDARDS
1. STRUCTURE Focus on the management system or
structure used by the agency in the delivery of care
Includes: Number and categories of nursing personnel Education Personal and professional qualities Function Physical facilities Equipments
TYPES OF PERFORMANCE STANDARDS
2. PROCESS STANDARDS Decision and actions of the nurse relative
to the nursing process
INCLUDES : Assessment Plan of care Nursing intervention
TYPES OF PERFORMANCE STANDARDS
3. OUTCOME STANDARDS Designed to measure the results og care
provided in terms of: Changes in health status of client served
Changes in level of their knowledge, skills and attitude
Satisfaction of those served
PERFORMANCE APPRAISAL
A control process in which employee's performance is evaluated against standards
The most valuable tool in controlling human resources and productivity
Reflects how well a personnel have performed during a specific period of time
PURPOSE OF PERFORMANCE APPRAISAL
1. Determine salary and merit increases
2. Select qualified individual for promotion or transfer
3. Identify unsatisfactory employees for demotion or termination
4. Make inventories of talents within an institution
5. Determine training and developmental needs of employees
PURPOSE OF PERFORMANCE APPRAISAL
6. Improve performance of work group
7. Improve communication between supervisors and employees
8. Establish standards of supervisory performance
9. Provide recognition of employee for accomplishments
10. Inform employees “where they stand’
METHODS OF MEASURING PERFORMANCE
ESSAY The appraiser writes a paragraph about the
workers strength, weaknesses and potentials
CHECKLIST A compilation of performances expected of a
worker
RANKING Evaluator ranks according to how
Employee fared with co-workers
METHODS OF MEASURING PERFORMANCE
RATING SCALE Includes a series of items representing the
different tasks or activities in job description or the absence or presence of desired behaviors
FORCED-CHOICE COMPARISON The evaluator is asked to choose the statement
that best describes the employee being evaluated
The evaluator is forced to choose from favorable as well as unfavorable statement
METHODS OF MEASURING PERFORMANCE
ANECDOTAL RECORDING Describe experience with a group or a person,
or in validating technical skills and interpersonal relationship
Anecdotal report should include:1. Description of the particular occasion2. Delineation of the behavior noted including:
WHO, WHAT, WHY, WHEN, WHERE AND HOE
3. The evaluator’s opinion or assessment of the incident or behavior
QUALITY ASSURANCE
Assurance achieving sense of accomplishment and implies a guarantee of excellence
Quality the degree of excellence QUALITY ASSURANCE:
A process of evaluation that is applied to the health care services b health workers
Focuses on the care and services the patient receives than on how well the professionals performs the duties that the position required
PRINCIPLES UPON WHICH QUALITY ASSURANCE PROGRAM ARE BASED
1. All health professionals should collaborate in the effort to measure and improve care
2. Coordination is essential in planning a comprehensive QAP
3. Resource expenditure for QA activities is appropriate
4. There should be focus on critical factors5. Quality patient care is accurately evaluated through
adequate documentation6. The ability to achieve nursing objectives depends
upon the optimal functioning of the entire nursing process and its effective monitoring
PRINCIPLES UPON WHICH QUALITY ASSURANCE PROGRAM ARE BASED
7. Feedback to practitioners is essential to improve practice.
8. Peer pressure provides the impetus to effect prescribed changes based on the result of assessment and needed improvements on the quality of care
9. Reorganization in the formal organizational structure may be required if assessment reveals the need for a different pattern of health care
10. Collection and analysis of data should be utilized to motivate remedial action
QUALITY IMPROVEMENT PROGRAM The umbrella program that extends the
many areas for the purpose of accountability to the consumer
A continuous, on-going measurement & evaluation process that includes structure, process and outcome
TOTAL QUALITY MANAGEMENT (TQM)
A way to ensure customer satisfaction by involving all employees in the improvement of the quality of every product or service
Aims to reduce waste and cost of poor quality
It is a structured system for involving entire organization in a continuous quality improvement process targeted to meet and exceed customer expectations
CONTINIOUS QUALITY IMPROVEMENT (CQI)
A process of continuously improving a system by : gathering data or performance Using Multi-disciplinary team to analyze the
system Collect measurements Propose changes
PRINCIPLES OF CONTINOUS QUALITY IMPROVEMENT (CQI)
1. Customer focus2. Identification of key processes to
improve quality3. Use of quality tools and statistics4. Involvement of all people in problem
solving
QUALITY ASSURANCE
Focuses on the care and service the patient receives than on how well the professional performs the duties that the position requires
METHODS USED Patient care audit Patient care profile analysis Peer review Quality circles
NURSING AUDIT COMMITTEE Composed of a representative from all
levels of the nursing staff The audit team designate a day within
the week to be the audit day The nurses do not know which unit will
be audited
PATIENT CARE AUDIT
CONCURRENT PATIENT CARE AUDIT One in which patient care is observed and
evaluated Done during rounds or patient interview Given through:1. Review of patient chart while the patients are
still confined in the hospital2. Observation of the staff as patient care is given3. Inspection of patient or observation and/or
observation of the effects of patient care where the focus is on the patient
PATIENT CARE AUDIT
RETROSPECTIVE PATIENT CARE AUDIT ONE IN WHICH PATIENT CARE IS
EVALUATED THROUGH:1. A REVIEW OF DISCHARGED PATIENTS’
CHART2. QUESTIONAIRES SENT TO OR INTERVIEW
CONDUCTED ON DISCHARGED PATIENTS
QUALITY CIRCLES
One of the most publicized approaches to quality control introduced by the Japanese
A group of workers doing similar works who: Meet regularly Voluntarily On normal working time Under the leadership of the supervisor
QUALITY CIRCLES
TO: Identify, analyze, and solve work related
problem
Recommend solution to management quality circle members should implement the solution themselves
CONTROL OF RESOURCES
Consumption of supplies and materials should be proportionate to the number of patients served
Requisition or stock of large numbers of supplies and materials should be avoided to prevent misuse or spoilage
A high turnover inventory is desired A low turnover is:
the result of poor purchasing policies Overstock or decreased demand for the item
CONTROL OF RESOURCES
Equipment utilization report should be made including frequency of breakdown help to evaluate the:
quality of equipment purchased The way it was handled
Preventive maintenance requires the regular inspection of equipment to prevent breakdown or detect needed repairs Breakdown results in more expenses and non
productivity of personnel
CONTROL OF RESOURCES
Human Resource: Absences due to leaves, whether
scheduled or not, should be analyzed Provision for relievers should be included
in the staffing pattern to maintain quality service
Unusual number of unscheduled absences should be investigated this may necessitate disciplinary action
DISCIPLINE
Rigid obedience to rules and regulations
SELF DISCIPLINE: A constructive and effective means by which employees take personal responsibility for their own performance and behavior
FACTORS THAT INFLUENCE SELF DISCIPLINE
1. Strong commitment to the vision, philosophy, goals and objectives of the institution
2. Laws that govern the practice of all professionals and the respective Codes of Conducts
3. Understanding of the rules and regulation of the agency
4. Atmosphere of mutual trust and confidence5. Pressure from peers and organization
DISCIPLINARY ACTION
Any employee charge with breach of the rules and regulation, policies, norms of conducts should be given due process
There must be existing rules of conduct governing his behavior and a documentation of actual violation
The charged employee must be notified in writing about the violation and be given the right counsel
Principles of disciplinary action
1. investigate carefully 2. be prompt 3. protect privacy 4. focus on the act 5. enforces rules consistently Be flexible
Components of disciplinary action program
Code of conduct Employees must be informed of the nature and
meaning of codes of conduct Must understand that the rules are reasonable and
directly related to efficient, effective operation of the agency
Authorized penalties
Records of offenses
Right of appeal
DISCIPLINARY ACTION
Should be progressive in nature
CONSELLING AND ORAL WARNING Best given in private and in an informal
atmosphere Employee is given fair chance to air his
side Relevant facts are analyzed and
evaluated against past performance
DISCIPLINARY ACTION
COUNSELLING Employee is counseled regarding:
Expectations of improved behavior/performance Ways of correcting the problem Warning that a repetition of the same offense
may warrant disciplinary action The employee must commit to correct the
behavior He should be informed of any follow-up
action that may be taken
DISCIPLINARY ACTION
WRITTEN WARNING The second step in disciplinary action Preceded by an interview similar to oral warning Employee is told after the interview that he will
be given a written warning WRITTEN WARNING: includes
Statement of the problem Identification of the rule that was violated Consequence of the continued deviant behavior Employees commitment to take corrective action Any follow-up action to be taken
DISCIPLINARY ACTION
SUSPENSION DISMISSAL
Invoked only when all other disciplinary efforts have failed
Disciplinary Committee should be very sure that the cause for dismissal conforms with the criteria of a major discipline violations as contained in the policy manual
Review is done by higher management