– Involves determining philosophy goals, objectives, policies, procedures rules, and fiscal planning & managing changes.
2- Organization (Organizing):
Includes establishing the structure of organization to carry out the plan, determine the most appropriate type of patient care delivery system & grouping activities to meet unit goals.
Includes recruiting, interviewing, hiring, orienting staff, scheduling and staff development.
Includes motivating, managing conflict, delegation, communication and facilitating collaboration.
Includes performance appraisal, fiscal accountability, quality control, professional and collegial control.
– Is the process of planning determining in advance the objectives to be accomplished and the means by which these objectives are to be attained.
– It is the first function of management and all other function dependant on planning.
– It is largely conceptual but the results of planning are visible.
– The manager (nurse) needs to be familiar with decision making process and tool so that he/she can identify the purpose of organization, state the philosophy, define goals and objectives policies and procedures, prepare budgets to implement the plans effectively and mange the time.
1- Mission Statement:
– It is a brief statement identifying the reasons that an organization exists as well as it’s future aim or function.
– So, clarification of purpose is the first priority in planning because it influences the development of organization’s philosophy, goals, objectives, policies, procedures and rules.
– Most nursing services exist to provide quality of care to client, some encourage teaching and research.
– Each especiality area has it’s own purpose contributes to the overall organization and purpose.
– EX: The purpose of in service education department is to orient staff to the job and provide educational programs to improve the quality of staff work.
– EX: The purpose of burn unit is to provide quality-nursing care to patients suffering from burns.
– Flows from mission statement.
– It is a statement of beliefs and values that directs practice.
– It should be written, placed in appropriate document and reviewed periodically.
– There should be a philosophy for the institution and philosophy for each department (ICU, lab.)
Benefits of Philosophy:
– Translate writing into practice.
– Lead to holistic approach in practice since hospitals are multi-disciplinary system.
– Used as a justification of quality of service provided.
– Provides framework for development of nursing care model (functional, primary, team).
– Provides a form of control.
– Deals with fundamental long-range goals and value.
Example of Nursing Service Philosophy:
– The philosophy of nursing department at hospital (x) is based on respect for individual’s dignity and work.
– We believe that all patients have the rights to receive effective nursing care. This care is a personal service that is based on patient’s needs and their clinical disease. Recognizing the obligation of nursing to help restore patients to the best possible state of physical, mental and emotional health to maintain patients sense of spiritual and social well being.
3- Goals and objectives:
– They state actions for achieving the purpose and philosophy.
– All philosophies must be translated into specific goals and objectives, if they are to result in actions.
– Thus, goals and objectives operationalize philosophy.
– Defined as the desired result toward which effort is directed.
– It is the aim of philosophy.
– It should be:
– Specific enough to clearly delineate the desired end product.
– Measurable and realistic.
– Change over time, so they require periodic re-evaluation and prioritization.
Goal Should be: SMART
- S: Specific
- M: Measurable
- A: Achievable or Attainable
- R: Realistic
- T: Time pounded
– More specific and measurable than goals, they identify (HOW) and (WHEN) the goal is to be accomplished.
– They invite the individuals to a specific end and are explicit, measurable, observable and obtainable.
– One goal is usually have many objectives (each is accompanied by a target completion date).
Objectives should include:
– Who will do the work.
– Write the word (To) followed by action verb.
– Write single key result to be achieved.
– Write the word (By) and the date for accomplishment.
– Write the maximum cost in terms of money or time.
4. Policies and Procedures:
– Defined as broad general statement of expected actions that serve as guides to managerial decision making or to supervising the actions of subordinates.
– They are plans reduced to statement or instruction that directs organization in their decision making.
– Polices use purpose, philosophy, goals and objectives as a guide.
– It directs individual behavior toward organization’s mission and defines broad limits and desired outcomes of commonly recurring situations.
– It serves as a basis for future decision and actions, help co-ordinate plans, control performance and increase consistency of actions by increasing the possibility that different manager will make similar decisions when independently facing similar situation.
– Policy formation is a continuous process so that should be re-evaluated and re-stated as necessary.
– EX: annual leave, working hours, shifts, vacations, maternity leave.
– It should be written, clear, every employee should know it. Policy gives feeling of fairness.
– Are plans that have been reduced to sequence of steps of required action.
– Procedures identify process needed to implement a policy and generally found in manuals at unit level.
– Procedure manual provides basis for orientation and staff development and ready reference.
– Procedure manual standardized procedure and equipment and can provide basis for evaluation.
– Good procedures reflect quality of care.
– Save times, facilitate delegation, reduce cost, and increase productivity, provide a mean of control.
5- Rules & Regulations:
– Included as part of policy and procedure statement.
– Rules describe situations which allow one choice of action.
– Rules are the least flexible part of planning.
Decision making and problem solving
Because managers spend much time making decisions and solving problems, developing skills in these areas is essential to increasing effectiveness
Nurse manager is confronted by a variety of situations. Hospital or agency policies provide guidelines for dealing with routine situations. But exceptional instance can make decisions more difficult and require a mature sense of judgment.
– Decision : is a solution chosen from among alternatives .
– Decision-making process : is the process of selecting an alternative course of action that will solve a problem.
– Problem solving: is the process of taking corrective action in order to meet objectives.
Definition 0f DM
– D.M: a complex, cognitive process.
– Choosing from alternatives a particular course of action
– WEBSTER: To arrive at a solution that ends uncertainty.
– Is a choice made between two or more available alternative
– Both definitions imply that: uncertainty—choosing one alternative.
– is a part of decision making ( it’s a systemic process that focus on analyzing a difficult situation)
– Problem solving: Always involves a decision making
Theoretical approaches to problem- Solving and D.M.
– How do people become successful problem-solver and decision maker
– Successful decision-making can be learned through life experience ,but not every learns to solve problem and judge wisely by this trial and error method because much is left to chance.
– So ,there should be some process or models to be used as a theoretical base for learning and practice to improve decision making skills.
The Traditional Problem Solving Model, includes 7 steps
1- Identify the problem
2- collecting data
3- explore alternative
4- evaluate the alternatives
5- select the appropriate alternative
6- implement the solution
7- evaluate the results
Managerial Decision-Making Model:
Include 6 steps:
– Set objective.
– Search for alternatives.
– Evaluate alternative.
– Choose appropriate one.
– Implement the alternative.
– Follow up and control.
The Decision Making Process
(3) The Nursing Process
Includes 4 steps:
Individual variations in D.M.
– If each person receives the same information and uses the same scientific approach to problem solving ,will they makes the same D.?
– People make decision by perceiving and evaluation …they perceive by sensation and intuition and they evaluate their perception by thinking and feeling
– Other factors that influence D.M. (value, life experience ,preference, risks and way individual think)
Critical element in problem solving & D.M.
A- Clearly defined objectives, decision makers often go a head in their problem solving process; without first determining their goal which result in poor quality decisions.
B- Careful data gathering one must learn how to obtain accurate information and avoid bias .
C- Generate many alternatives:
Do not limit your choice to tow possible judgments when there are more options available .
– Increasing the number of people working on a problem will increase the number of alternatives that can be generated .
– Brain storming: thinks of all possible alternatives even those that may seem off target .
D- Think logically:
– Draw inference from information.
– Careful thinking through the information and alternatives.
– Faulty logic leads to poor quality decisions.
E- Choose and act decisively:
– Many people become vulnerable at this point in problem _solving process and choose to delay acting because they lack the courage to do so .
– Good decision _makers seem to have some sort of antenna that makes them particularly sensitive to situations than others.
Decision Making Techniques
– The techniques help you to make the best decisions possible with the information you have available.
– With these tools you will be able to map out the likely consequences of decisions, work out the importance of individual factors, and choose the best course of action to take.
I. Pareto Analysis: Selecting the most important changes to make.
II. Plus – Minus – Implications (PIM): Weighting the Pros and Cons of a decision.
III. Cost / Benefit Analysis: is carried out using only financial costs and financial benefits.