Noorhaliza Binti Ali 870504305000

MASTER OF NURSING

SEMESTER MAY / 2019

NMNC5104

HEALTHCARE MANAGEMENT
ASSIGNMENT 1

MATRICULATION NO : CGS01928721
IDENTITY CARD NO. : 870504-30-5000
TELEPHONE NO. : 017-2966303
E-MAIL : noorhaliza@oum.edu.my
LEARNING CENTRE : PETALING JAYA

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1.0 INTRODUCTION
The strategic plan has been developed to align the vission and mission of the organization
with long and short term goals and objective. In this assignment, the nurse manager require to
initiate a few strategic initiative planned for overall medical surgical department expansion. The
purpose for planning the expansion of medical and surgical unit department is for cover and cater
the overwhelming numbers of patient come everyday in the government hospital. This statement
is proved by (Ringgit Plus, 2018), the overwhelming number patients to treat each day in
government hospital effect the insufficient bed and this is slow the system of the turn over bed rate
in hospital. The overwhelming number of patient in government hospital is because that
government healthcare facilities are subsidized.

The strategic plan for expansion new medical surgical unit must parallel in accordance with
the vision of ministry of health which is “the country pumps energy in the direction to the better
health” (Ministry of Health Malaysia, 2019) and also with the medical and surgical unit policy
such as healthcare policy is making and planning to ensure the effective, efficient and equitable
delivery of medical services to the citizen stated by (MIDA, 2012), . The initiatives requiring the
nurse as a manager to consider the new technology or treatments, technically trained staffs,
creation of special care environments and budget monitoring for the medical surgical unit.

According to the (Sharon & Nancy, 2017), the big issues and problems of government
hospital facing from the first until now is not enough bed to cater all the patient. This is proved by
report from (Bernama, 2019), stated that government hospitals nationwide need 16,000 more beds
and the Deputy Health Minister Dr Hilmi Yahaya said Malaysia now had a ratio of 1.85 hospital
beds to every 1,000 population.
Firstly, to initiate a few strategic initiatives plan, the deep understanding by the nurse
manager in the management will be emphasized. The definition of management according to the
(Linda, 2013) is the process, comprised of social and technical functions and activities, occurring
within organizations for the purpose of accomplishing predetermined objectives through human
and other resources. Management also can be defines as a process of coordinating actions and
allocating resources to achieve organizational goals. For example, the nurse as a manager must set
up their action by step to step to organized their work.

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Secondly, the definition of health care management based on (Sharon & Nancy, 2017) is
the profession that provides leadership and direction to organizations that deliver personal health
services and to divisions, departments, units or services within those organizations. According to
(Sharon & Nancy, 2017), the health care manager have an authority by making the important
decision making for example, to recruitment and development of staff, acquisition of technology,
service additions and reductions, and allocating and spending of financial resources.

There have two domain that must be considered by a manager when they do a task or make
decision making. Explained by (Buchbinder, S.B., & Thompson, J. M., 2010), the two domain are
external and internal domain which is the external domain refers to the influences, resource and
activities exist outside the boundary of the organization but affect the organization. For example
community demographic or needs, licensure, accreditation, regulations, stakeholder demands,
competitors, Medicare and Medicaid and lastly the managed care organizations or insurers.
Meanwhile, the internal domain refers to those thing that managers need to address on a daily
basis, such as ensuring the appropriate number and types of staff, financial performance,
budgeting, quality services, patient satisfaction, physician relations, technology acquisition and
new service development. So,

The management process have six process based on (Longest, Rakich & Darr, 2010),
firstly, is the planning which is in this first process requires the manager to set a direction and
determine what needs to be accomplished. Secondly, the organizing is the next process of
management. This management function refers to the overall design of the organization or the
specific division, unit, or service for which the manager is responsible. The manager determine the
positions, teamwork assignments and distribution of authority and responsibility are the most
important components. Third, staffing is the next process in the management where it is refer to
acquiring and retaining human resources. It is also refers to developing and maintaining the
workforce through various strategies and tactics.

Fourth, the controlling process refers to monitoring staff activities and performance and taking
the appropriate actions for corrective action to increase performance. Fifth, the next process of
management is directing which is initiating action in the organization through effective leadership,

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motivation and communication with subordinates. Sixth, the decision making the manager make
decision making based on consideration of benefits and the drawbacks of alternatives.

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2.0 THE NURSE MANAGER STRATEGIC COMMITTEE INITIATIVE PLANNED FOR
NEW TECHNOLOGY OR TREATMENTS, TECHNICALLY TRAINED STAFFS,
CREATION OF SPECIAL CARE ENVIRONMENTS AND BUDGET MONITORING
FOR THE MEDICAL SURGICAL UNIT

The nurse manager must know how to create the strategic initiatives plan. So, firstly, the
manager must have deep understanding about strategic planning which is (Susan, 2017)
considering the strategic planning is the process of identifying a desired future state that means,
there must have the short term and long term outcome, achievement and goal for an organization.
For example, in view of medical-surgical department want to expand their unit, there must have a
strategic plan for short term and long term outcome or goal such as stated by (Mu'taman, J.,
Hamzah, A.R. & Mohammad, S.D., 2016), the short term goal of medical-surgical unit in most of
the government hospital according to their policy, is to optimizing medical treatment and surgical
intervention through the best of practice and procedure while the long term goal is to optimizing
the quality of care and patient safety in Malaysia.

According to (Sharon & Shelley, 2015), a strategic initiative plan identifies the strategies,
or initiatives that a manager will undertake to accomplish the identified goals and objectives. As
an initial step for the nurse manager initiate the strategic plan, there must have a planning process
to manage the finance or budget, quality and the workflow to dealing with other team and unit.
Supports by (Seth, B., 2014) the planning process involves a series of steps that include the
identification of strengths, opportunities, weaknesses and threats (SWOT) analysis, the creation
of goals and objectives, the development of strategies and tactics, and the use of measures and a
process to evaluate results.

A SWOT analysis helps to bring forth the strengths and minimize the weaknesses of the
medical-surgical unit department. A book by (Sharon & Nancy, 2017), stated that the SWOT
analysis provides a basis for development that serves two important function. First function is to
gather a snapshot of how the organization is currently interacting with the market in comparison
to the internal potential and ability, also intended organization’s strategic. In the other second
function, to identify market opportunities and threats that the organization must be alert in future
strategic efforts. Proved by (Stewart, 2019), a SWOT analysis is useful for hospitals, medical

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groups, and individuals in private practice because it is helps focus your marketing in areas that
harbor the strongest benefits. Here are a few ideas to maximize the value and generate effective
strategies from this exercise.

Table 2.0: SWOT Analysis for expansion of Medical-Surgical Department

STRENGTHS WEAKNESSES
INTERNAL 1. Budget - The government already 1. Lack of physical infrastructure such as
have budgets to upgrade and improve bed, monitor, & medical equipment.
the quality of health services at 2. Lack of new technology such as
hospitals. computerization system in
2. Market assessment: documentation.
- Power of the experienced and 3. May require additional financial funding
trained staff. depends on current market price of
- Good cooperation from internal and equipment, material in construction new
external stakeholders. unit.
- Offer specialized procedures. 4. High turnover utility bed and turnover
3. Good support from staff (understaffed).
administration.

OPPORTUNITIES THREAT
EXTERNAL 1. New services, technology 1. Adverse government policy
facility and procedures. - political changes in
2. Innovation in technology. government changing policies
3. Increase patient satisfaction regarding health care.
level and awareness for 2. A competitor has an innovative
services provided. product or service.

The table 2.0 above shows the analysis of Strength, Weaknesses of the Medical-Surgical
Unit, along with the Opportunities and Threats of the external market. In the strengths column,
there already have budget given by Ministry of Malaysia and the nurse manager can use the
budget through quotation and price list included the new technology and equipment, the material
involve in construction, labour paid, new facility and etc. that approved by Head of Department
of Medical and Surgical unit and also from the financial department.

The next strength is they have the power of the experienced and trained staff which is
important to conduct training needs and continuing professional development programme for

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health care such as Basic Life Support workshop, Advanced Life Support and etc. Moreover,
supported by (Pamela, 2018), the trained staff that have specialisation in practice and knowledge
can give good advantage to the medical surgical unit such as, the Medical Specialist and
Surgeons that private hospital do not have the experienced one. Trained staff with Advanced
Diploma Intensive Care that can functioning to conduct an emergency situation and post basic
renal course staff can initiate the haemodialysis machine and manage the patient who on this
treatment.

This management of expansion medical-surgical unit have strength from good cooperation
from the internal and external stakeholders. According to (Seth, B., 2014), the management focus
by a nurse manager will aligns, deals and liaise with internal stakeholder such as administration,
professionals, and operations. Described by (Anne B., Savina S. & Kathleen V., 2014), the
internal stakeholders are people who are already committed to serving your organization as board
members, staff, volunteers, and donors. While external stakeholder as well include the financial
stakeholder, strategic partners, government, media, vendor’s health policy, law and regulations
and also the community groups. Supported by (Anne et. al, 2014), external stakeholders are people
who are impacted by your work as clients or constituents, community partners, and others

Next, followed by the column that show the internal of department own weaknesses for
example the lack of infrastructure such as functional negative pressure room system or isolation
room for infection case, good air conditioner and ventilation. Other than that, lack of bed,
monitor and medical equipment can cause the bad effect to the organization, staff and patient.
Health care system should have a strong Medical records filing and regular monitoring and
supervision, so that it minimizes issuance of incomplete data entry and misfiling. Supported by
(Teviu, Aikins, Abdulai et. al., 2012), health facilities must first assess the situation of the medical
records by carrying out a situation analysis to obtain the direct and indirect factors leading to
issuance of misfiling.

Next weaknesses assessment may require additional financial funding depends on current
market price of equipment, material in construction new unit. So, to overcome this weaknesses,
the budgeting planning from the beginning must have the accounting system report tools that
contain information of price list and back up financial planned for any management risk that

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may appear soon. Last weaknesses based on SWOT analysis is the high turnover utility bed and
turnover staff which is understaffed. This problem of not enough staff and high patient admission
will make the managers to push of manpower that already have such as put their staff on double
duty job. According to (Huston, 2006), overtime mandated by the hospital often results in high
levels of fatigue and an increased number of errors.

Next column in SWOT analysis from the external market described the opportunities that
the medical-surgical department will get upon opening new unit which is the unit will have the
new services, new technology facility and procedures, current innovation and updated in
technology, increase patient satisfaction level and awareness for services provided.

The assessment of threat that medical-surgical unit will face are the adverse government
policy which is political changes in government will change the policies and budget. For example
the new government that win in the Election Day in the year of 2018 impact the all ministry
included Ministry of Health. According to (Roger, 2018), the emergence of new policies led to the
creation of new act and law. Nevertheless, the competitor has an innovative product or service also
become a threat to the government hospital such as the private hospital also have their own
strength. For example, the private hospital buildings and facilities have high advanced technology,
sophisticated area and conducive environment.

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2.1 TECHNICALLY TRAINED STAFFS
The strategic plan to get the technically trained staff, firstly, the nurse manager must
implement the mentoring programs for junior nurse that includes the participation of senior nurse.
A study by (Finley, Ivanitskaya & Kennedy, 2007) had shown that mentoring programs had been
successful in molding the junior staff to be an expertise, experience, trained from technically and
theoretically and also dedicated to their nursing job.

Secondly, sent the staff for the special course such as Continuous Veno-Venous
Hemodialysis machine by GAMBRO vendor. The trained staff will teach the other staf how to
initiate this machine and to operating this CVVHDF machine from the beginning until the end of
treatment. Foremost, send the staff nurse by turn followed their seniority to the Post Basic,
Advanced Diploma, Degree and Master program to facilitate technically trained staff. According
to (Linda, 2013), the good leader or manager will advise and encourage their staff to continue
learning and study.

Thirdly, develop continuous nursing education that involve or participate the staff by assign
the staff to do the CNE and bedside teaching. According to (Amer, Alden & Michael, 2016), the
bedside teaching is a valuable instructional method that facilitates the development of history and
physical examination skills, the modeling of professional behaviors, and the direct observation of
learner.

Fourthly, the nurse manager must trained their staff to do multitasking job such as an
administrative which is function when patient discharge from hospital to give date of next
appointment. The nurse manager also can delegate their job to the staff nurse to trained them as a
leader that can manage anything happen such as needle prick injury, patient or staff fall event and
emergency situation. The medical-surgical nurses coordinate and innovate patient care every day.
This is proved by (Academy of Medical-Surgical Nursing, 2019) the medical-surgical nurses apply
sophisticated skills to help reduce hospital readmissions and prevent complications like falls and
pressure ulcer. For example, a medical-surgical nurse is juggling care for several patients such as
administering medications, educating families, discharging patients and admitting new ones, all
while keeping the entire health care team on the same page. So, when medical-surgical department

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unit have the multitasking nurse, the readmission patient to the hospital will reduce and at the same
time can reduce the burden of hospitalization for its patients.

2.2 NEW TECHNOLOGY OR TREATMENTS

The new technology is a costly requirement in any work setting such as new ventilator
machine, portable vital signs monitor, patient-centered monitor at nursing counter and etc. The
new medical and surgical equipment are especially expensive for the modern health care facility
stated by (Caroline et. al., 2019). Hence, the manager must have a good dealing with the supplier
or the vendor’s company. Furthermore, the manager should work closely with architect and
technology vendors, nurses, physicians and personnel in other caregiving departments such as
those in pharmacy, lab, housekeeping and administration department to take all idea,
recommendation, suggestion, and opinion of others to take into account all aspects for create new
technology and treatments.

Supported by (Robert, W., 2018) to consistently provide the highest quality care to patients,
the vendor partnership must have collaboration with other team or unit in order to ensure system-
wide approach to meeting patient needs. Besides, the physical design of medical-surgical units
should be completely integrated with caregivers work processes and the technologies they use, so
caregivers always have the right medication, materials and information, in the right place, at the
right time.

According to (Ministry of Health Malaysia , 2018), Malaysia usually imports higher

classification or category of medical devices not manufactured locally. This is because, the
Ministry of Health Malaysia want to standardize the health equipment and technology parallel with
the globally, world health system and updated.

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2.3 CREATION OF SPECIAL CARE ENVIRONMENTS
The strategic plan to create the special care environment in medical and surgical unit need
the manager to deal with vendors. According to (Meyer, P., 2018), hospital and technology design
should be organized around patient needs or patient-centered design. For example, the high
dependency ward (HDW) must be created in the medical unit, aim for patient that in critical
medical illness and needs intensive care. For example, the placement of cubicle for the critically
ill patient that on ventilator machine support located in one cubicle ratio to two bed of critical ill
patient which is the staff nurse in charge of the cubicle only have to take care of two critical ill
patient that can help the nurse to closely monitor the condition of the patient.

According to the (Linda, 2013), utilize a multidisciplinary approach to patient care that
encourages team work between Physicians, Nursing Staff, Therapy Staff, Social Work and a
variety of other consulting disciplines to provide the most comprehensive care for the patients. For
example, the X-ray portable, the Occupational therapy and the Physiotherapy will come to the
medical surgical ward to do procedure for accelerate and facilitate the treatment and intervention.

The acute Medical Surgical patients who are experiencing Cardiac, Respiratory,
Gastrointestinal and Neurological diseases and a variety of the surgical procedures that requires
monitoring and care during their procedural phases (Academy of Medical-Surgical Nursing, 2019).
New environment must be creating in strategic planning to improve the quality of care such as
creating of new special unit for dementia patient. Apart from that, for the confusion and
disorientation elderly patient, can alternatively be exacerbated or helped by environmental
interventions.

Moreover, elderly persons in chronic care settings are likely to suffer from comorbid
conditions that may affect muscle, knee and ankle strength, gait, balance, vision, and blood
pressure; they may be using medications that cause orthostatic hypotension or other side effects
that exacerbate risk factors for falls. So, in this special unit, all the facilities such as the anti-
slippery floor of the ward, good lightening source, create the grab bars or guard rails must be
planned under construction budget to build such of therapeutic environment of the new medical-
surgical ward.

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For post operation patient after surgical intervention, the new technology of medical
surgical ward bed with press button for ease the patient to do positioning, patient safety bed railed
and patient friendly ripple mattress must be provided for developed new technology and treatment.
The rehabilitation chair are also the one of the furniture that can help patient to do early ambulation
during post operation day.

2.4 STRATEGIC COMMITTEE INITIATIVES PLAN FOR BUDGET

MONITORING FOR THE MEDICAL SURGICAL UNIT

According to (Caroline et. al., 2019) all health service providers and funders want to get
the most out of big benefits from their investments and through the good manager, the funders and
the ministry of health who responsible to give the budget, are satisfied because the funds provides
are well managed. To enable them to do so, they need to do the budget monitoring for actively
manage health service assets, ensuring that they are used efficiently and optimally.

Cost information is important for efficient allocation of healthcare expenditure, estimating

future budget allocation, and setting user fees to start new financing systems. A study by (Thet,
Yu, Moe et. al., 2017) had proved that the highest cost of health financial expenditure was medical
equipment and medicine. So, the nurse manager must monitor the price of this two component
which is variable depending on the market level.

The nurse manager must list the medical item, device, equipment, and tools followed by
the current price and for long term preparation on budgeting, the nurse manager must know or
assume how long the complete project for expanding the medical-surgical unit will accomplish or
finish. From the time frame given, for example, the project take one and a half year to complete,
the nurse manager can expect the increase of all medical items price for the next two years.

The budget monitoring for the medical surgical expanding unit proposal must have the
accounting system report. According to (Linda, 2013), various technique have been described for
monitoring the budget such as accounting system report. However, all budget objectives should
contain procedures for quality review, including identification of a team to perform such as review.
Part of the information furnished to the nurse manager and cost-centre manager is in the form of
reports, which include statistical reports of revenue and expenditures for the current years. For

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example, the accounting system report for monitoring budget for the medical-surgical unit must
have the illustration of financial information needed such as actual budget approved, financial
transaction, account balance, budget of overtime job labor’s salary which is will claim under
department budgeting account, expenditure or purchasing item outflow for medical-surgical
supplies and equipment, events and compulsory course that medical-surgical unit must conduct to
achieve their Key Performance Indicator (KPI).

According to (Kathleen, M. & Kathleen, B. , 2017), the organizational budget cascades

down to individual departments and units. Budgets are usually developed annually for a 12 months
of period. The budget cycle is based on organization’s definition of the fiscal year. For example
the budget cycle of new medical-surgical unit follow the calendar which is from 1st January until
31st December.

Apart from that, there are two major types of budgeting process which is the first process
is zero-based budgeting (ZBB) requires the entire budget to be recreated annually starting from
zero. According to (Julia, 2019) ZBB allows top-level strategic goals to be implemented into the
budgeting process by tying them to specific functional areas of the organization, where costs can
be first grouped and then measured against previous results and current expectations. Because of
its detail-oriented nature, zero-based budgeting may be a rolling process done over several years,
with a few functional areas reviewed at a time by managers or group leaders. Zero-based budgeting
can help lower costs by avoiding blanket increases or decreases to a prior period's budget. It is,
however, a time-consuming process that takes much longer than traditional, cost-based budgeting.
The practice also favors areas that achieve direct revenues or production, as their contributions are
more easily justifiable than in departments such as client service and research and development.

The second budgeting process according to (Kathleen, M. & Kathleen, B. , 2017), is

incremental budgeting where more traditional approach, building on the previous on the previous
year’s budget. For example, if a 10 percent increase in fund available, the budget also may be
increased by 10 percent. This is an easier process but at times it allows budget to become bloated
with minimal justification, the budget will overflow.

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3.0 IDENTIFY ADDITIONAL FUNDING IN CREATING A NEW
ENVIRONMENT OR BEST PATIENT EXPERIENCE

Described by (Linda, 2013), the additional funds needed (AFN) is a financial concept used
when a business looks to expand its operations. Since a business that seeks to increase its sales
level will require more assets to meet that goal, some provision must be made to accommodate the
change in assets. To phrase it another way, the business must have some plan to actually finance
the new assets that will be needed to increase sales.

Capital funding sources allow for investment in healthcare infrastructure, including

the construction, renovation, or expansion of the medical-surgical unit expansion. The additional
funding in creating a new environment or best patient experience can be identified earlier in the
planning stages when the quotation and budgeting are present in the proposal. Developing a plan
for identifying local needs and resources can help the manager to find more fund. According to
(Sharon & Nancy, 2017), resources, or assets, can include individuals, organizations and
institutions, buildings, landscapes, equipment such as anything that can be used to improve the
quality of patient’s care.

According to (Anne et. al., 2014), to identify additional funding in creating new environment
or best patient experience, the manager must deal with the vice president of finance at the hospital
to do the budget analysis with the chief accountant. For example, the Head of Department of
Medical Surgical unit, specialist, medical officer, the nurse manager and the clerk of the
department must set time to discuss in several times of meeting incorporate with other unit such
as the hospital director, financial unit, hospital supervisor and the vendors or company who
involved in the construction works.

Reported by (Azreen, 2014), studies have also shown that patients suffer less pain, sleep better
and have better moods if placed in a ward with a view of nature compared to a ward with no
windows. So, with air-conditioning being among the highest energy users in a hospital, to create a
new environment or best patient experience, the nurse manager must include budget for the
contactors to install the windows of patient’s rooms that automatically turn off the air conditioning
if the patient opts to open the window for some fresh air at once can also save the expenditure of
electricity bills that will leads to additional funding.

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According to (The Star, 2018), under the budget 2019 presentation by Lim Guan Eng,
Ministry of Finance, the Government will be allocating nearly RM29 billion for Ministry of
Health, which is an increase of 7.8% compared to the previous year. This includes an allocation of
RM10.8 billion to provide medicine, to upgrade and improve the quality of health services at our
clinics and hospitals. So, from the budget, a nurse manager can give a quotation to the financial
department for propose to buy new technology and other material that need for new expansion
area for medical and surgical unit after final discussion with the head of medical and surgical
department, other physician and all staff.

Therefore, successfully funding a capital project can require blending multiple sources and
types of funding, including public grants and low-interest loan programs, as well as private sources
such as foundations and local donors. Blending funding sources can be especially effective for this
expansion of medical-surgical unit projects, expansion of hospital building and the new
renovations.

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4.0 KEY COMPETENCIES AS CHANGE AGENT, ADMINISTRATIVE AND LEADER
IN IMPLEMENTING PLANNED CHANGE IN WORK ENVIRONMENT

The term of competency according to (Michael, B. & Patrick, H., 2018) refers to a state in
which an individual has the requisite or adequate ability or qualities to perform certain functions.
According to (Katz, R. L., 1974), the manager must possess the several key of competencies to
conquering the process of management. The key competencies of the effective manager are
conceptual, technical and interpersonal skills. The conceptual skills are those skills that involve
the ability to critically analyze and solve complex problems. For example, a manager conduct an
analysis of the best way to provide a service and to develop strategy to reduce patient’s complain
regarding poor nursing service in the medical ward. This conceptual skills stated by (Paulina, M.,
2019), it is also called human relations skills.

The technical skills are those skills that reflect expertise or ability to perform a specific
work task (Ross, Wenzel & Mitlyng, 2012). For example, the manager of High Dependency Ward
under Medical Unit developed the continuous nursing education about calibration of the
Continuous Veno-Venous Hemodiafiltration machine every day after morning shift to develop
good technical skill among the critical care nurses.

Next, the interpersonal skills are those skills that enable a manager to communicate with
and work well with other individuals, regardless of whether they are peers, supervisors, the
superiors or the subordinates (Katz, R. L., 1974). For example, a nurse manager discuss with the
head of medical-surgical department about the strategic planning of the expansion of this unit must
do in the best way such as new bed with the current technologies and must crate the patient’s room
with very conducive state without worried the budget and the expenses to meet the high satisfaction
level of client.

Organizational culture which is beliefs, attitudes, and behaviors that are shared among
organizational members such as the vision by (Ministry of Health Malaysia, 2019) is a nation
working together for better health and mission Ministry of Health Malaysia is to facilitate and
support the people to attain fully their potential in health, appreciate health as a valuable asset and
take individual responsibility and positive action for their health. Besides that, the mission of

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Malaysian Ministry of Health also to ensure a high quality health system with emphasis on
professionalism. So, in order to smooth the way of changes that the nurse manager will bring, there
must have the key competencies as change agent, administrative and leader in implementing
planned change in work environment.

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5.0 CONCLUSION

Strategic planning is a basic management function undertaken in most hospitals and it is often
considered to be a goal setting process that is largely carried out by top management. The
objectives that sets by nurse manager in the strategic planning are concrete statements describing
the major accomplishment nurses desire to achieve. Strategic planning is a critical component for
effective governance and management of a NGO. In simple words, Strategic planning is a
systematic process of deciding key decisions for an organization to thrive successfully in the next
few years.

In other words, planning within the nursing organization is intended to assist in fulfilling the
mission of health care facility. Planning also supports the organization’s objectives, meshes with
the plans of all other departments contributing to provision of total healthcare needs, and ultimately
provides for optimum support of the nursing.

5013 WORDS COUNT

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6.0 REFERENCES

Academy of Medical-Surgical Nursing. (2nd July, 2019). Medical-Surgical Nursing. Retrieved

from www.amsn.org: https://www.amsn.org/practice-resources/what-medical-surgical-
nursing
Amer, Alden & Michael. (21st March, 2016). Bedside Teaching in the Emergency Department.
Retrieved from sites.uci.edu: https://sites.uci.edu/medicaleducator/files/2015/07/Bedside-
Teaching-in-the-ED_2006.pdf
Anne B., Savina S. & Kathleen V. (2014). Health Care System Transformation for Nursing and
Health Care Leaders: Implementing Culture of Caring. America: Springer Publishing
Company.
Azreen, H. (2014). Malaysia’s 1st green hospital opens in August. Malaysia: Mole.my.
Bernama. (2019). Government hospitals need 16 000 of beds. Malaysia: FMT Media Sdn. Bhd.
Buchbinder, S.B., & Thompson, J. M. (2010). Career opportunities in health care management:
Perspectives from the field. Sudbury: Jones & Bartlett.
Caroline et. al. (16th June, 2019). How to Plan and Budget for your Healthcare Technology.
Retrieved from www.who.int:
https://www.who.int/management/plan_budget_healthcare.pdf
Finley, Ivanitskaya & Kennedy. (2007). Mentoring junior healthcare administrators: A
description of mentoring practices in 127 U.S. hospitals. Journal of healthcare
Management , 260-270.
How to Plan and Budget for your Healthcare Technology. (16 June, 2019). Retrieved from
www.who.int: https://www.who.int/management/plan_budget_healthcare.pdf
Huston, C. (2006). Professional Issues in Nursing Challenges and Opportunities. Philadelphia:
Lippinkott Williams and Wilkins.
Julia, K. (8th April, 2019). Zero-Based Budgeting (ZBB). Retrieved from
www.investopedia.com: https://www.investopedia.com/terms/z/zbb.asp
Kathleen, M. & Kathleen, B. . (2017). Nursing Delegation and Management of Patient Care.
New Jersey: Elsevier.
Katz, R. L. (1974). Skills of an effective administrator. Harvard Business Review, 90-102.
Keith, H. (2013). Selecting and Applying Methods for Estimating the Size and Mix of Nursing
Teams. United Kingdom: Nuffield Institute for Health.

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