A.

Establishing Standards, Policies and Procedures

Standards - The function of established standards in an evaluation process is to supply professionally

desirable norms against which the department’s performance can be measured. Areas for improvement are
identified, and a plan of action to correct this be made and implemented.

Policies – are broad guidelines for the managerial decisions that are necessary in organizational and
departmental planning. They govern the action of workers and supervisors at all levels and are intended to
achieve and supervisors at all levels and are intended to achieve pre-determined goals. They serve as basis
for future actions and decisions, help coordinate plans, control performances and increase consistency of
action by increasing the probability that different managers will make similar decisions when independently
facing similar situations.

Characteristics of good policies

1. Policies should be written, must be known and understood by those who will be affected by them.
2. Policies should be comprehensive in scope, stable, flexible, so that they can be applied to different
conditions that are not so diverse that they require different set of policies.
3. Policies should be consistent to prevent uncertainty, feelings of bias, preferential treatment and
unfairness.
4. Policies should be realistic and must prescribe limits.
5. Policies should allow her discretion and interpretation by those responsible for it.

Procedures – are specific directions for implementing written policies. Two areas where procedures are needed are
those that are related to job situations such as incident reports and the other involves client/customer procedure
manuals.

B. Scheduling – the function of determining how soon an operation should begin and of establishing time
sequences to meet the due dates. It will provide an answer to the following questions:
 “ How soon an operation will begin and ends?”
 “ when will a task or a mission be accomplished?”

DECISION MAKING PROCESS (February 23, 2022)

Decision making – is the process of selecting one course of action from alternatives, it is a continuing responsibility of
manager.

Seven Steps of Decision Process

1. Define the problem – is the critical step.

2. Identifying the limiting or critical factors
3. Develop potential alternatives
4. Analyze the alternatives
5. Select the best alternatives
6. Implement the solution
 7. Evaluate the results

Kinds of Decisions

1. Whether Decisions – refers to the decisions made before the selection of one several alternatives, where
selection is made after weighing pros and cons.
Ex. Before figuring out the alternatives of what car to buy, the decision has to be made whether or not to buy
a car.
2. Which Decisions- this is the process of choosing from among several alternatives, which are measured
based on a set of predefined criteria.
3. Contingent decisions – these are decisions that have been done but put on hold until some conditions are
met like time, energy, price, availability, opportunity and encouragement.

Models of Decision Making

1. Win-Win - characterized by mutual willingness in the group to cope up with solutions that are acceptable to
all.
2. Win - Lose – some interests are advanced at the expense of others.
3. Disagreement and Collaboration – Decisions resulting in the following elements are made when conflicts
and disagreements are openly explored, using collaboration and cooperation.
4. Solution shaping – it is focused on how to modify or amend an unpopular proposed solution rather than
attempt to pressure people into changing their minds about the solution.

Tools in Decision Making

1. Probability Theory – was devised to address the presence of risk or uncertainty in a decision making
situation by looking for predictable patterns based on historical president, it becomes hard to apply the
theory and the risk remains unchecked.
2. Decisions Trees – it is more graphic in nature, enables to planner to visualize alternative courses of action
taking into account all factors involved like risks, information needs and outcomes for a problem over time.
3. Queuing Theory – problems are addressed one after another and after having determined the “best
balance” of factors related to service. It is a mathematical study of waiting lines.
4. Linear Programming – uses matrix algebra or linear mathematical equations to determine the best way to
use limited resources to achieve maximal results.

CRITICAL THINKING PROCESS IN PROBLEM SOLVING AND DECISION MAKING

Critical Thinking – is a cognitive process of examining underlying assumptions, interpreting and evaluating
arguments, imagining and exploring alternatives and developing a reflective criticism for the purposes of reaching a
justifiable reasoned conclusion and correct judgment.

Characteristics of an Expert Critical Thinker

1. Outcome-directed or goal-oriented
2. Open to new ideas or out-of-the-box thinker
 3. Flexible and adjustable
4. Willing to change and accepts challenges
5. Innovative ideas which result in new direction
6. Creative and conduct researches for new interventions
7. Analytical and reflective thinker
8. Communicator and expressive of ideas and concerns
9. Assertive, can influence people of her thoughts and ideas
10. Persistent with barriers and persevering
11. Caring, warm and friendly
12. Energetic and has the capacity to act consistent with norms
13. Risk-taker, trying all possible outcomes
14. Knowledgeable, rational and reasonable
15. Intuitive or clinical insights

Decision Making – is an end-point of critical thinking which leads to problem solution using these steps:

1. Define the problem

2. Assess all options
3. Weigh all options against a set of criteria or standards
4. Test possible options
5. Consider consequences of the decision
6. Make a final decision
 MODULE IV

ORGANIZING

Organizing – (Swansburg) is the grouping of activities for the purpose of achieving objectives, the assignment of such
groupings to a manager with the authority for supervising each group, and the defined means of coordinating
appropriate activities with other units, horizontally and vertically, that are responsible for accomplishing organizational
objectives.

- It involves the process of deciding the necessary levels of organization needed to accomplish the
objectives of a nursing division, department, or service and unit.
- It is the process of identifying and grouping the work to be performed, defining and delegating
responsibility and authority and establishing relationship for the purpose of enabling the people to work
most effectively together in accomplishing objectives. This simply means “Dividing work and
coordinating divided work”.

Elements of Organizing

1. Setting up the Organizational Structure

The creation of organizational system compatible with the philosophy, conceptual framework, and
goals of the organization provides the means accomplishment of purpose.
 Understanding of the organizational structure as a whole facilitates development of roles and
relationships enabling goal achievement. The organizational structure refers to the process a group is
formed, its channels of authority, span of control and lines of communication.

The successful accomplishment of the organizational structure makes it possible for an

organization to achieve its purposes:

a. It enables members what their responsibilities are so that they may carry them out.
b. It frees the manager and the individual workers to concentrate on their respective roles and
responsibilities.
c. It coordinates all organizational activities so there is minimal duplication of effort or conflict.
d. It reduces the chances of doubt and confusion concerning assignments.

2. Staffing
It is the process of determining and providing the acceptable number and mixture of personnel to
produce a desired level of care to meet the patients’ demand for care. Understaffing or improper
mixture of personnel will adversely affect the quality of work performed.

3. Scheduling
A schedule is a timetable showing planned work days and shifts for nursing personnel. The
objective in scheduling is to assign working days and days off to the nursing staff so that adequate
patient care is assured, a desirable distribution of off duties is achieved, the nurse are treated fairly
and that they know in advance what their schedules are.

4. Developing Job Descriptions

A job description is a statement that sets the duties and responsibilities of a specific job. It includes
the needed characteristics or qualifications of the individual to perform such duties successfully. It is an
important management tool to make certain that responsibilities are wisely delegated, work efficiently
distributed, talents fully used and morale maintained.

A Job description usually contains the following:

a. Identifying data
b. Job Summary- this will includes the essential feature of the job that distinguishes it from
others.
c. Qualification requirements-education preparation
d. Training and experience necessary to fill the position
e. Job relationships-source of workers
f. Specific and actual functions and activities

Uses of job descriptions are the following:

a. For recruitment and selections of qualified personnel.

b. To orient new employees to their jobs.
c. For job placement, transfer or dismissal.
 d. an aid in evaluation the performance of an employee.
e. For budgetary purposes.
f. For determining departmental functions and relationships to help define the organizational
structure.
g. For classifying levels of radtech functions according to skill levels required.
h. To identify training needs
i. As basis for staffing
j. To serve as channels of communication.

In summary, job descriptions provide data for job evaluation. It is used as basis for
planning manpower need, recruitment of personnel, selection and placement of new
employees and for orientation and evaluation purposes.

Steps in Organizing

Koontz describes 6 steps in organizing and they are:

1. Establishing enterprise objectives.

2. Formulating supporting objectives, policies and plans.
3. Identifying and classifying activities necessary to accomplish objectives of the enterprise.
4. Grouping this activities in the light of human and material resources available and the best way, under
the circumstances of using them.
5. Delegating the head of each group the authority necessary to perform the activities.
6. Tying together the group horizontally and vertically, through authority relationships and information
flows.

Principles of Organizing:

1. The Principle of Chain of Command – states that to be satisfying to members, economically effective,
and successful in achieving their goals, organizations are established with hierarchical relationship
within which authority flows from top to bottom.

2. The Principle of Unity of Command – states that a person in an organization should have only one
direct superior and one plan for a group of activities with the same objective .

This is to avoid confusion, overlapping of duties and misunderstanding.

To achieve unity of command , observe the following:

a. Centralize authority and responsibility in the head of the organization.
b. See that no person occupying a single position in an organization is subjected to definite orders
from more than one source.
c. Know whom you report to and who reports to you.

3. The Principle of Span of Control – states that a person should be supervisor of a group that he or she
can effectively supervise in terms of numbers, functions and geography.
 4. The Principle of Specialization – states that person should perform a single leading function. An
organizational unit becomes more efficient and the more it specializes in the performance of a set
similar or related activities over time.

5. Parity Authority and Responsibility – states that if a person is responsible for accomplishing a certain
task in the organization, he should be given a sufficient authority to accomplish that task.

6. Absoluteness of Responsibility – states that though a supervisor in an organization may delegate a

portion of his authority to his subordinates, he does not, in so doing, reduce his responsibility or
accountability for the performance of the tasks under his jurisdiction.

Organizational Structure – provides the framework in which the management process takes place. It should provide
an effective work system, a network of communications and identify to individuals and the organization and should
consequently foster job satisfaction.

Stoner defines organizational structure or design as the formal mechanisms through which the organization is
managed. In Chandler’s words, it includes first, the lines of authority and communication between the different
administrative officers, and second the information and the data that flow through this lines of communication and
authority. Such lines and data are essential to assure the effective coordination, appraisal, and planning to necessary
in carrying out the basic goals and policies and in uniting together the total resources of the enterprise.

There are two types of organizational structure:

1. Informal Structure – consists of personal and social relationships among the members of the organization. It
is not reflected in the organizational chart. It is through the informal structure that people with little or no
formal status or position may gain recognition. This unofficial personal relationships among workers may
influence their working effectiveness. It has also its own channel of communication called the grapevine,
where information is disseminated faster and may or may not be accurate.

2. Formal structure- it describes the positions, the responsibilities of those occupying the positions, and the
working relationships among the various units. These are the basic forms of formal organizational structure.

a. Hierarchic or Bureaucratic Model or Pure line Organization.

This model designed to facilitate large scale administration by coordinating the work of many
personnel. It is associated with subdivisions, specializations, technical qualifications, rules and
standards, impersonality, and technical efficiency.
Gillies describes a hierarchical structure or pure line as straight forward, and a direct chain
of command pattern that emphasizes superior-subordinate relationships. The line organization is
more efficient than another type of structure because it provides clear authority responsibility
relationships between workers at all levels and requires less information transmission between
managers and workers than do more complex organizations.
b. Line and staff organization – this pattern develops when a simple line organization is altered by
providing management specialists to support the top executive. The typical line and staff organization
 started out as a pure line organization to which staff specialists are attached to strengthen and improve
the management function. Thus, a line and staff organization develops from primary functional
differentiation downward through the structure.
The relationship between the line and staff are a matter of authority. Line has authority for direct
supervision of employees while staff provide advice and counsel.
c. Functional line and staff organization – this is where the staff officers that have been differentiated from
line organization are no longer purely advisory but have been given some command authority over line
employees.
Functional authority occurs when an individual or department is delegated authority over functions
in one or more other departments.
d. Matrix or Free-Form Organization – when project team or task force is superimposed upon and built
into fully functionalized hierarchical organization, the result is a matrix organization. In a matrix
organization, the efforts of numerous specialists are coordinated. Both vertically and horizontally.
Vertical coordination takes place though the hierarchical chain of command, in that efforts of
several specialized departments are integrated by the executives who supervises them all.
Horizontal coordination occurs through direct interaction among diverse members of the patient
care team, who represent different departments and occupational groups
A matrix organization differs from line, staff and functionalized line and staff organization
in that there were fewer hierarchy, greater decentralization of decision making, and less rigid
adherence to formal rules and procedures. The matrix organization designs enables timely
response to external competition and facilitates efficiency and effectiveness internally through
cooperation among disciplines.

ORGANIZATIONAL CHARTS

Organizational Chart – is a drawing that shows how the parts of an organization are linked. It depicts the formal
organizational relationships, areas of responsibility, persons to whom one is accountable, and channels of
communication.

Murray and Di Croce describe an organizational chart as a graphic representation of the chain of authority
from chief executive to each member of the organization. The organizational chart depicts the chain of command,
division of work, levels of management and functional communication pattern.

Uses of Organizational Chart

1. It outlines administrative control

2. It is used for policy making and planning
3. It is used to evaluate strengths and weaknesses of the present structure.
4. It shows the relationships with other departments and agencies.
5. It is used to orient new personnel to the organization.

Types of Organizational Charts

 1. Vertical Chart or Tall Structure – depicts the chief executives at the top with lines of authority flowing down
the hierarchy. This the most effective when managers desire better coordination and effective
communication. Furthermore, this structure clearly defines the relationships between among the different
levels in the organization. More attention is given to messages which come from top managers than those
from lower managers. Members, however, are given more opportunities to participate in decision making
activities because of limited or small span of control.
2. Horizontal Chart or Flat Structure – depicts the manager at the top with a wide span of control. The levels of
management are not shown in a flat chart. Employees are not shown in a flat chart. Employees in this
structure report to one manager. They have more function. Head nurses o frontline managers are given
more authority. Communication in this structure is direct, simple, and fast with minimal distortions of
messages since the distance between top and lower levels is shorter.
3. Circular or Concentric Chart -depicts top management in the center represented by the Board of Trustees or
Directors, Chief of the Hospital and the Chief Nurse. Those in the middle and lower levels of management
such as the nurse supervisor, charge nurse and staff nurse are in concentric circles. This chart shows the
outward flow of formal authority which is from the center moving outward. This type of structure minimizes or
reduces the implications of status or positions. It represents conceptual, rather than a functional views of the
organization.

LINE AND STAFF RELATIONSHIP

Line Authority – is a chain of command, a manger-staff associate or leader-follower relationship. In this relationship,
the manager delegates authority to an associate who in turn delegates authority to the staff.

Staff Authority – refers to a form of influence used by specialized individuals who hold unique roles in the
organization and who while not directly responsible for employees, are involved with the outcome of employees’
work.

Staff support line-authority relationship by serving as consultants or advisers. They are responsible for
locating data, providing details and offering counsel on managerial problems.
 MODULE V ( February 23, 2022)

STAFFING

Staffing – is defined as filling, and keeping filled, positions in the organization structure through identifying work-force
requirements, inventorying the people available , recruiting, selecting ,placing, promoting, appraising, planning the
careers, compensating, and training otherwise developing both candidates and current job holders to accomplish
their tasks effectively and efficiently.

- Is the process of determining and providing the acceptable number and mixture of personnel to
produce a desired level of care and to meet the patient’s demand for care.

Three Parts of Staffing

1. Planning – it involves forecasting of the needed human resources or people over a period of time. It also
means an analysis must be done of the job to be done or task required. The way the job description can be
matched against suitable applicants. It is also the basis for formulating policies and programs on staffing.
2. Execution or Implementation – this involves various steps such as recruitment, selection, placement,
training, and post-training development.
3. Evaluation or Maintenance – this involves performance appraisal, information, and evaluation of the
program. All this information in turn is feedback to planning so that planning can improve its forecasting, job
analysis and policies. The cycle the, repeats itself as shown in this figure.

Planning

- human resource forecasting

- Job Analysis
- Policies and programs formulation

Execution/Implementation

- Recruitment
- Selection
- Placement
- Training
- Development

Evaluation/ Maintenance

- Human Resource accounting

 - Performance Appraisal
- Human resource Information
- Program Activities

Factors Affecting Staffing

1. Type, philosophy and objectives of the hospital and the nursing service.
2. Population served- kind of patients served whether pay or charity
3. Number of patients and acuity of their illness- knowledge and ability of nursing personnel
are matched to the actual care needs of patients.
4. Availability and characteristics of the nursing staff- Education, level of preparation, mixture
of personnel, number and position.
5. Administrative policies
6. Standards of care desired.
7. Lay-out of the various nursing units and resources available within the department
8. Budget- amount allotted for salaries, fringe benefits, supplies, materials and equipment.
9. Professional activities and priorities in non-patient activities-involvement professional
organizations, formal educational development, participation in research and staff
development
10. Teaching program-extent of staff involvement to teaching activities.
11. Expected hours of work per annum of each employee.
12. Patterns of work schedule.

Selection of Personnel

1. Recruitment and selection

Recruitment – is the development of a pool of applicants for a job. The first step in the
selection of personnel recruitment. The aquation of qualified people in any agency is
critical for the establishment maintenance, and growth of the organization. Therefore,
active recruitment is important. Modes of recruitment include the following.

a. Advertising – This is the most common method of informing the public of vacant
positions. Advertisement in the local newspapers, professional publications,
bulletins, newsletters, radio, or television offer the employer a broader field for
selecting personnel.
b. Word of mouth employment requirements.– This can be a very effective method of
recruitment, but it can also lead to hiring of friends and relatives of the current
workforce, this practice may foster nepotism and violate equal opportunity
employment requirements.
c. Employee recommendation – referrals from employees should be sought in-house
applicants encouraged; however, favoritism should not be shown. Radiologic
 Technologist may recommend fellow radiologic/xray technologist whom they have
previously worked within the past and who are competent and reliable.

2. Screening the Staff

Following the recruitment process is the screening of the staff.

It is best to keep in mind the three underlying philosophies during the screening process
and these are;

a. Screen out applicants who do not fit the agency’s age.

b. Try to fit the job to a promising applicant.
c. Try to fit the applicant to the job.

During the screening process, the applicants submit their biographical data that include
information on personal history, educational background, and work experience. The
recruiter can use the data to determine whether the applicant is qualified and meets the
minimum requirements.

3. Interview – as soon the recruiter screens the most qualified applicants, a pre-employment
interview is conducted. The purposes of the interview are to obtain information, to give
information, and to determine if the applicant meets the requirements for the position.

During the interview process, the interviewer judges the applicant’s dependability,
willingness to assume responsibility for the job, willingness and ability to work with
others., interest in the job, adaptability, consistency of goals with available
opportunities, and conformance of managers and appearance to job requirements.

Some institutions may require the applicant to take a series of tests to assess
their general intelligence, personality, mental, perceptual and psychomotor abilities.

4. Orientation – After choosing from among the qualified applicants, you should take the
responsibility to assist and introduce the nurse to her new job. Orientation is a process of
becoming familiar with a new environment and adapting well to it. Orientation is a part of staff
development and one of your important functions. When policies, regulations, and job
descriptions are diminished, anxiety is reduced and misunderstandings are prevented.

All new employees are entitled to be oriented during the first few days of employment.

A well-designed program would include the following:

1. Information of the philosophy, goals, policies, and standards of the institution.

2. Description of the organizational structure of the institution.
3. Job description/ responsibilities
4. Introduction to co-workers
 5. A tour of the physical facilities

In- service education training program may also be conducted to prepare the beginning
nurse practitioner to assume bigger responsibilities.

5. Staff Development – it is a continuing liberal education of the whole person to develop this
potentials to the fullest. The employee should engage in professional education activities such
as attending seminars, workshop, conferences, in service training program, reading professional
publications, and engaging in other activities that will enhance his competencies as an employee
and develop his aesthetic sense and personality.

MODULE VI

DIRECTING/LEADING

Directing – it is the issuance of assignments, orders and instructions that permit the worker to
understand what is expected of him and the guidance and overseeing of the worker so that he can
contribute effectively to the attainment of organizational objectives.
Elements of Directing

A. Delegation- it is defined as sharing responsibility and authority with subordinates and holding
them accountable for their performance.

-it is the process that facilitates complex organizations to accomplish work through
the coordinated and differentiated efforts of others.

- it is a tool that the manager uses to build morale among the staff. It involves giving
assignments to subordinates and motivating them to perform their job efficiently and
effectively.

Purpose of Delegation

Delegating is a means for promoting internalized motivation and job enrichment by

giving employees a sense of being their own boss through the opportunity to exercise control
over their work.

Reasons for Delegation

1. It saves time and can help develop others

2. It maximizes the use of the talents of staff associates.
3. It uses latent abilities in personnel that contribute to their growth and development

Three {3} Aspects of Delegation

1. Responsibility – refers to what must be done to complete a task and the obligation created
by the assignment. It denotes obligation.

Both the manager and subordinates understand what activities the latter is responsible
for the expected results and how the performance will be evaluated.

2. Authority – it is the power to make final decisions and give commands. It is inherent in the
position. Authority like responsibility can be shared with subordinates. Although authority is
delegated, the manager still maintains control and may recall the authority.
3. Accountability – it is defined as the fulfillment of the formal obligation t disclose to referent
others the purposes, principles, procedures, relationships, results, income and expenditures
 for which one has authority. When the subordinates accept delegated responsibility, they
are under obligation to complete the task and use authority appropriately.

Guidelines for Effective Delegation

1. Give a clear description of what is you want the employee to do. Describe the overall scope
and background of the current task.
2. Share with the employee the outcome you expect and by when.
3. Discuss the degree of responsibilities and authority that the employee will have.
4. Ask the employee to summarize the main points of the task that has been delegated.

Areas to consider for Delegation

1. Routine tasks
2. Task for which you don’t have time
3. Problem-solving
4. Change in your job emphasis
5. Capability building

Areas not to be delegated

1. The power to discipline

2. Responsibility for maintaining morale
3. Overall control
4. The ” Hot Potato”
5. Authority to sign your name is never delegated
6. The opportunity to say few words to your subordinates is not delegated.

Barriers to Delegation

1. Lack the ability to direct

2. Absence of controls that warns impending difficulties
3. Aversion to taking a risk

DELEGATION DO’S AND DON’TS

 DO’S of Delegation

1. Delegate as simply and directly as possible. Give precise instructions.

2. Illustrate how each delegation applies to organizational goals
3. Mutually develop standards of performance
4. Clarify expected results
5. Anticipate the questions your employees may have, and answer them in order.
6. Discuss recurring problems
7. Seek employee ideas about how to do the job.
8. Accentuate the positive rather than the negative. Be supportive. Exhibit trust.
9. Recognize superior performance
10. Keep your promises.

DON’TS of Delegation

1. Do not threaten your staff. Effective delegation depends more on leadership skills than on
position power.
2. Do not assume condescending attitude.
3. Do not merely give answers. Show an employee how to do something and why it is done
that way.
4. Do not overreact to problems.
5. Refrain from criticizing an employee in front of others
6. Avoid excessive checks on progress.

B. Motivation – it is defined as a leadership function aimed to arouse, excite or influence another

person to behave in some role or perform some actions the person would not ordinarily do. It
also refers to some inner drive, impulse, or intentions that causes one to act or believe in a
certain way, or to seek a particular goal.

One of the most important tasks of managers in directing is motivating subordinates

in work setting. It is commonly assumed that an employee’s motivation is related to
individual’s productivity, job satisfaction and job turnover.