MANAGEMENT

NCM 105 2010

MANAGEMENT
Comes from old French term MENAGEMENT the directing From Latin word mau agere to lead by the hand The process of leading and directing all or part of an organization through the manipulation of resources One role of leadership Emphasize control

MANAGEMENT
PROCESS of:

working with and through others to achieve organizational objective in a changing environment Obtaining and organizing resources and of achieving objectives through other people Getting work through others Leadership Giving direction Developing staff Monitoring operations Giving rewards Representing both staff and administration as needed

Planning, directing, coordinating and controlling, including:

MANAGEMENT
The process of:
Coordinating

action Directing action Assigning resources

Purpose: to perform the tasks in order to achieve the objectives/desired outcomes of an organization

NURSING MANAGEMENT The process of working through nursing staff members to provide care, cure and comfort to patients

MANAGERS
HAVE:
  

Assigned position within the formal organization Legitimate source of power due to delegated authority that accompanies their position Greater formal responsibility and accountability for rationality and control

Are expected to carry out specific functions, duties and responsibilities Emphasize control, decision making and analysis, and results Manipulate people, the environment, money, time and other resources to achieve organizational goals Direct willing and unwilling subordinates

MANAGEMENT THEORIES

SCIENTIFIC MANAGEMENT (1900 1930)

Frederick W. Taylor father of scientific management

if workers could be taught the one best way to accomplish a task productivity would increase Traditional rule of thumb means of organizing work must be replaced with scientific method Scientific personnel system must be established so that workers can be hired , trained, and promoted based on their technical competence and abilities Workers should be able to view how they fit into the organization and how they can contribute to overall organizational productivity The relationship between managers and workers should be cooperative and interdependent, and work should be shared equally

Principles:

MANAGEMENT FUNCTION
HENRI FAYOL (1925) Identified management function of:
Planning Organizing Command Coordination Control

MANAGEMENT FUNCTION
Luther Gulick (1937)
seven

activities of management POSDCRB

Planning  organizing  Staffing  Directing  Coordinating  Reporting  Budgeting


HUMAN RELATIONS MANAGEMENT (1930-1970)

Mary Parker Follett: Par ticipative Management
Participative decision making Managers should have the authority with, rather than over, employees

Elton Mayo (1953): Hawthorne effect

Indicated that people respond to the fact that they are being studied, attempting to increase whatever behavior they feel will continue to warrant the attention Informal work group and socially informal work environment were factors in determining productivity Recommended more employee participation in decision making

THEORY X AND THEORY Y

DOUGLAS McGREGOR Theory X: managers believe that their employees are:
Basically

lazy Needs constant supervision and direction Indifferent to organizational needs

Theory Y: managers believe that their workers:

Enjoy

their work Are self-motivated Are willing to work hard to meet personal and organizational goals

EMPLOYEE PARTICIPATION
CHRIS ARGYRIS (1964) Stress the need for flexibility within the organization and employee participation in decision making

MANAGEMENT THEORY
THEORIST Taylor THEORY Scientific management If person can be taught the one best way to accomplish a task, productivity will increase Need for legalized, formal authority, and consistent rules and regulation for personnel in different position Planning, organizing, command, coordination, control Planning, organizing, staffing, directing, coordinating, reporting, budgeting Managers should have the authority with rather than over employees

Weber

Bureaucratic organizations

Fayol Gulick Follet

Management functions Activities' of management Participative management

MANAGEMENT THEORY
THEORIST Mayo THEORY Hawthorne effect People respond to the fact that they are being studied, attempting to increase what ever behavior they feel would warrant attention Employees are basically lazy, needs constant supervision and direction indifferent to organizational needs Employees enjoy their work, self motivated and willing to work hard to meet personal and organizational goals Employees participation in decision making

Mc Gregor

Theory X and theory Y

Argyris

Employee participation

LEVELS OF MANAGERS
LEVEL TOP MANAGERS RESPONSIBILITY Responsible for the overall operations of nursing services, establish objectives, policies, and strategies Represents the organization in community affairs, business arrangement and negotiations Typical titles: director of nursing service, chairman,, executive vice president Coordinate the nursing activities of several units; Receives broad, overall strategies and policies from top manager and translate them into specific objectives and programs, typical titles; supervisor, coordinator, clinical nurse managers and case managers are included at this level as they use collaborative management to move patients through the system Directly responsible for the actual production of nursing service; act as links between higher level managers and non-managers Typical titles: nurse manager, team leader, primary care nurse

MIDDLE MANAGERS

FIRST-LINE MANAGERS

ROLE OF MANAGERS
ROLE INTERPERSONAL DESCRIPTION The manager : 1. As a symbol because of the position he/she occupies 2. As a leader who hires, trains, encourages, fires, remunerates and judges 3. As a liaison between outside contact such as community, supplier and organization The manager 1. As one who monitors information 2. Disseminate information from both external and internal sources 3. As spokesperson of the organization 1. An entrepreneur or innovator, problem discoverer, designer to improve projects that direct and control change in the organization 2. Trouble shooter 3. Negotiator when conflict arise

INFORMATIONAL

DECISIONAL

SIMILARITIES & DIFFERENCES BETWEEN LEADERS AND MANAGERS

LEADERS May or may not have official appointment to the position Have power and authority to enforce decisions only as long as followers are willing to be led Influence others towards goal setting Interested in risk taking and exploring new ideas MANAGERS Appointed officially to the position Have power and authority to enforce decision Carry out predetermined policies, rules, and regulations Maintain an orderly, controlled, rational, and

SIMILARITIES & DIFFERENCES BETWEEN LEADERS AND MANAGERS

LEADER Relate to people personally in an intuitive and empathic manner Feel rewarded by personal achievements MANAGER Relate to people according to their roles by enabling others to act Feel rewarded when fulfilling organizational mission or goals by fostering collaboration

SIMILARITIES & DIFFERENCES BETWEEN LEADERS AND MANAGERS

LEADER May or may not be successful as managers MANAGERS Are managers as long as the appointment holds

EFFECTIVE LEADERSHIP & MANAGEMENT

Understanding of individual strengths, weaknesses, and potential + Knowledge of basic ingredients for leadership and management + Learning from other people and experiences + Systematic use of self to get the right things done at the right time

DECISION MAKING

DECISION MAKING
The process of establishing criteria by which a leader can develop and select course of action from a group of alternatives
One

of the criteria on which management expertise is judged The innermost leadership activity and the core of management Choosing a particular course of action Triggered by a problem, but is handled in a manner that does not focus on eliminating the underlying problem May or may not be the result of a problem

Characteristics of Decision Making

Not linear or totally logical process, may involve intuition Often the result of many incremental steps rather than one large steps Smaller choices may be impacted by many factors other than rationality and analytical thought (Sullivan & Decker, 1992; Little-Stoetzel, 2003)

Characteristics of Successful Decision Makers

Learn to emphasize the tools and techniques that help make decision-making effective and efficient Minimize the technique or events that can sidetrack the critical thinking/decision making process Ability to engage in critical thinking

CRITICAL THINKING
Analyzing the way one thinks Must be incorporated into all steps of problem solving and decision making EFFECTIVE CRITICAL THINKERS

Constantly generate new ideas and alternatives Do not rely on weve always done it this way Able to step back from issues and analyze its component


Often ask:
  

What are the underlying assumptions of this point of view? Where does the evidence come from and how is it being interpreted? How does the logic and argument hold together?

Can discern the quality of information that underlies ideas, whether it is:


Precise, accurate, relevant, consistent, logical, complete, and unbiased

Able to assume another persons perspective or point of view in order to see all sides of an issue

Strategic Steps in Decision Making

Identify need for decision
Consider:

What needs to be determined  Why a decision is needed  All information available  State issues in broader term rather than narrower term


Determine desired goal or outcome

Goal


should be:

Clear and specific  Stated in a sentence or two

Strategic Steps in Decision Making

Identify any other actions that exist.
For


each alternative action, identify:

Possible consequences  Possible benefits

Decide which action to implement, based on each actions benefits and consequences Evaluate the action by asking:
Was

the goal achieved completely or partially Was the goal not achieved

Steps in Managerial Decision Making Models

Determine the importance and context of the decision
Consider

possible consequences of the decision

Determine the objective for the decision List all options Explore promising options Establish decision making criteria Evaluate the options against criteria Select option to pursue Analyze the risk

IDEALS MODEL
Identify the problem Define the context Enumerate the choices Analyze options List reasons explicitly Self correct

Critical Elements in Decision Making

Define objective clearly
Decisions

with out clear objective, poor quality lesion is

likely

Gather data carefully Generate many alternatives Think logically Choose and act decisively

Decision Making Tools

Decision Grids
Allows

one to visually examine the alternatives and compare each against the same criteria
Alteranti Financia Political ves l effect effect 1 2 3 Depar tm Organiz ental ational effect effect time

Decision Making Tools

Decision Tree Consequence Tables
List

the objectives for solving a problem down one side of a table and rates how each alternatives would meet the desired objective

Payoff Tables
Have

a cost-profit-volume relationship One must determine probabilities and historical data such as:
Hospital census  Report on numbers of operating procedures performed


Decision Making Tools

Logic Models
Schematics or pictures of how program are intended to operate Includes:

resources  Processes  Desired outcomes



Depicts exactly what the relationship are between the 3 components

PERT Program Evaluation and Review Technique

A popular tool to determine the timing of decisions Developed by Booz-Allen Hamilton organization and the US navy in connection with the Polaris missile program A flow chart that predicts when events and activities must

Conditions that may Affect Decision Making

Conditions of CERTAINTY
Alternatives and existing conditions are well known Decisions can be made with full knowledge of what the outcome will be

Conditions of RISK
Alternative and conditions are not very well known Decision outcomes can only be expressed as probability rather than certainty Different levels of probability

Objective probability = like hood that an event will or will not occur based on the facts and reliable information  Subjective probability = like hood that an event will or will not occur based on a leaders personal judegement or belief


Conditions that may Affect Decision Making

Conditions of UNCERTAINTY

Alternatives and conditions are complex and variable Person making the decision may not be even aware of all possibilities Decision making may be occurring in a rapidly changing environment Decision outcome cannot be expressed even as probability

3 approaches for dealing with UNCERTAINTY

Maximax approach most optimistic

 

Select alternative with best possible outcome for all alternatives Choose the worst possible outcome for each possible alternative then choose the least objectionable worst outcome Select the alternative that has the fewest variable among its possible outcomes

Maximin approach most pessimistic Minimax approach /Risk averting approach



DECISION MAKING WITHIN GROUPS

Group decisions must include the stakeholders who will be affected by the decision Advantages of group decision making:
More people involved More input and feedback More stake holders who can buy in to decisions and outcome and support groups decision

persons

Disadvantages:
Time consuming Can lead to increased conflict and sabotage of the groups decision

Methods of Group Decision Making

CONSENSUS building

All group members can live with and fully support the decision Consensus does not mean that everyone agrees, it just mean that they can live with it Advantage greater support for decision made Disadvantage s:
 

Time needed for decisions People wanting to block a decision can use consensus to delay decisions

NOMINAL group technique

Nonverbal technique in which group members write out their ideas Ideas and their pros and cons are presented on a flip chart or board Group discusses ideas and puts them into a private vote; highest rating wins Group members receive questionnaires Results are summarized and redistributed Process of questions followed by summary continues until group reaches concensus

DELPHI group technique

Dos and Don'ts of Decision Making

DO Make only decision that are yours to make Write notes and keep ideas visible about decisions to utilize all relevant information Write down pros and cons of an issue to help clarify our thinking Makes decision as you go along rather than letting them accumulate Consider those affected by the decision Trust your self DONT

Make snap decision Waste your time making decisions that do not have to be made Consider decision a choice between right and wrong but a choice between alternatives Prolong deliberation about decisions Regret a decision Always base decision made on the way things have always been done

Group Work
Situation:
A

visiting policy may allow only one family member to be with a patient at a time. However, the patient is 15 years old and his single mother is with his 10 year old brother because she did not have anyone else to stay with the younger boy

What would be the desired goal What are the things to be taken into considerations

DECISION MAKING
Goal:
To

decide if making an exception to hospital policy is in this patients best interest Determine if the hospitals goal concerning patient care and privacy can be met if an exception to the policy is allowed

Pros and cons

Benefit


allowing the brother is additional support for the patient since he and the brother are close  Not having a 10 year old boy by himself in a waiting area
Consequence:


Possible loss of privacy and inconsistency with other patients visitors

DECISION MAKING
Actions to implement based on pros and cons
Depending

on liability and other issues nursing staff

may:
Rank issues of consistency with all other visitors and privacy for other patient in the room higher or  Staff may decide that patient comfort and keeping the family together higher


Evaluate
If


the decision was to allow the visitor

Did having the brothers presence make the patient less anxious  Did it not seem to make a difference  Did having the brother makes the patient more anxious