Nursing Management

UNIT –II
MANAGEMENT PROCESS
INTRODUCTION
 Management Process
  Some regard management process as

getting things done through people;

  Some consider it as the process of reaching

organizational goals by working with and

through people.
DEFINITION
 Management process is defined as the process, composed of
interrelated social and technical functions and activities
(including roles), occurring in a formal organizational setting
for the purpose of accomplishing predetermined objectives
through the utilization of human and other resources.
  According to D. E. McFarland, "Management process is the
distinct process by which the managers create, direct,
maintain and operate purposive organisation through
systematic, co-coordinated and cooperative human efforts”.
  According to Gemp R. Terry, "Management process is a
distinct process consisting of planning, organising, actuating
and controlling, performed to determine and accomplish
objectives by the use of people and other resources".
 Elements/Components of Management
Process The essential elements/components
of Management Process are four which are
actually basic functions of management: 
Planning  Organising  Directing and 
Controlling. We may add some more elements
in the management process as follows: 
Motivating  Co-coordinating  Staffing and
 Communicating.
  Luther Gullic gave a new formula to suggest
the elements of Management Process i.e. basic
functions of management.  According to him,
management process may be indicated by the
word "PODSCORB”.  Here, ‘P' states for
'planning'. "O" for 'organising', "D" for
'directing', "S" for 'Staffing', "CO" for
'Coordinating, "R" for 'Reporting' and "B" for
'Budgeting'.  Gullic coined the word
"PODSCORB" to suggest seven functions of
management.
INTRODUCTION
  Planning is necessary in Health care system because it is in stage
of restructuring:
  Patient empowerment
  Efficient and effective use of sources (MMMTT).
  Emphasis on health promotion and prevention.
  Establishment of professional training centers.
 Planning is the primary function of management.  It involves
determination of a course of action to achieve desired
results/objectives.  Planning is the starting point of management
process and all other functions of management are related to and
dependent on planning function.  Planning is the key to success,
stability and prosperity in business.  It acts as a tool for solving
the problems of a business unit.  It helps to visualize the future
problems and keeps management ready with possible solutions.
  Planning  Deciding in advance (what, who,
when, where and how ) about something is to
be done.
DEFINITION
 Planning
 A continuous process, beginning with the setting
of goals and objectives and then laying out a plan
of action to accomplish them, put them into play,
review the process and the outcomes, provide
feedback to personnel and modify as needed.
  The process of coping with uncertainty by

formulating courses of action to achieve specified

results.
  The determination of what is to be

accomplished. (Bernard and walsh)

 A Plan  A specific documented intention
consisting of an objective and an action
statement.  Written document, which serves
as a blue print as a for the future action.
 Planning in Nursing Management  A basic

function of nursing management.  This plan

of action must have unity, continuity,
flexibility and precision”. (Fayol)
 Purpose for planning in nursing 1. To
increase the chance of success 2. Best use of
resources- Cost effective 3. To forces
analytical thinking and improves decisions 4.
To orients people to action 5. To avoid crisis
in nursing management 6. To increases
employee involvement and improves
communication
 PRINCIPLES OF PLANNING • a. Principles of
contribution to objectives • b. Principles of
Pervasiveness • d. Principles of continuity
and Flexibility • f. planning is hierarchial in
nature. • g. planning should always be
documented.
 Area of Planning in Nursing  Budgets and
fund raising  Recruitment, rotation and
staffing  Workshop/ conference/CNE
organizing planning  Examination  Day to
day patient care planning  Community
services planning  Curriculum planning,
students rotation  Planning for
establishment of hospital nursing services
/SON/ CON
 Planning modes 1. Reactive planning – • Done in
response to crisis, no integration in whole organization.
• Can lead to hasty decisions and mistakes. 1.
Inactivism – • Spend a great energy to prevent change
and conformity. • When changes occur, slowly and
incrementally. 1. Preactivism – • Use technology to
accelerate change and future oriented. • Unsatisfied
with past & present, do not value experience 1.
Interactive or proactive planning- • Present, past and
future is considered, key element is adaptation, •
minimize risk and uncertainty, encourage the best use
of resources. • provides the leaders with means of
control, dynamic
 Types of Planning  Strategic planning:
determining how to pursue long-term goals
with available resources. 
Intermediate/functional planning:
determining subunits’ contribution with
allocated resources.  Operational planning:
determining how to accomplish specific tasks
with available resources.
 Strategic planning  “An ongoing, future-
oriented, values-based process that
empowers an organization and its members
to identify action strategically necessary to
accomplish its mission in an ever-changing
and diverse environment. (Safrit, 1998)
 Mission or purpose  It describes the
purpose for which that organization exists 
1st step in strategic planning process  It
moves, guides and delivers the organization
to its perceived goal and provide vision
 18. Vision  It is an image of the future the

organization seeks to create

 Values  These are concepts of perceived worth or importance 
Eg. creativity, honesty, courtesy, caring  These are morale
rationale for business/work.  Value statements make employees
feel proud and managers feel committed  Values bond people
and set behavioral standards
 20. Philosophy  The philosophy flows from the mission

statement and delineates the set of values and beliefs that guides
all actions of the organization  It is the basic foundation that
directs all further planning toward achievement of mission. 
Philosophy which cannot be implemented is useless
 21. Philosophy.. example  “We believe that our hospital is

dedicated to excellence in the fields of patient care, teaching and

research and  We are dedicated to providing most effective and
efficient patient care”
 Goals  Goals setting is the process of developing, negotiating and
formalizing the objectives that an employee is responsible accomplishment.
 Help nurse administrator to focus attention on what is relevant and
important.  Help to develop strategies and action to achieve the goals.
 23. Objectives  Concrete and specific statements of the goals that nurse

managers seek to accomplish.  They are action commitments through

which the key elements of the mission will be achieved and the philosophy
sustained.  Objectives are usually "milestones" along the way when
implementing the strategies.
 24. Procedures  These are plans that have been reduced to a sequence of

steps of required action  They identify steps needed to implement a policy

 Generally found in manuals at unit level  They establish an acceptable
way of accomplishing a task with rationales for each activities
 25. Tasks  Particularly in small organizations, people are assigned various

tasks required to implement the plan.  If the scope of the plan is very
small, tasks and activities are often essentially the same.
 Rules and Regulation  These are plans that
define specific action or non action  They
describe situations that allow only one choice
of action  Least flexible, so there should be
few rules in the organization.
 Action Strategies  Specific work plans

leading the organization toward positive and

desired future
 Stakeholders  A person who is involved in
particular organization/project. Because he has
invested money.  Current users of the
organization  Potential users of the
organization  People affected by the work of the
organization
 29. Resources and Budgets  Resources include

the man, materials, technologies, money, etc.,

required to implement the strategies or
processes.  The costs of these resources are
often depicted in the form of a budget.
 Responsibilities for Planning 1. Planning Staff-
gather information, coordinate planning activities,
and take a broader view than individual managers. 2.
Planning Task Force- Created when the organization
wants a special circumstance addressed. 3. Board of
Directors- Establishes corporate mission and
strategy. 4. President & CEO- Completes and
implements strategy. 5. Executive Committee- Top
executives that meet regularly for input and review.
 Line Managers- Help to formulate strategy by

providing information. Responsible for executing

plans.
 Barriers to planning in nursing  Lack of knowledge
regarding philosophy, goals.  Lack of skill about how to
plan  Focus on day to day operations rather than short
term and long term plans  Consistent use of reactive
rather than proactive planning  Lack of understanding
about the external environment’s impact on planning 
Inadequate intra organizational support  Inappropriate
use of plans
 32. Barriers to planning in nursing contd…  No Time 
Staff resistance to change.  Board members or
stakeholders  Planning is non-productive use of time 
Previous bad planning experience  Poor management 
Plans used to control rather than inspire or lead.
STEPS IN PLANNING PROCESS
 Determination of the objectives
 Collection and forecasting of information
 Development of planning premises
 Discovering alternatives courses of action
 Formulation of derivative plans
 Communicating the plan
 Follow up measures
 Phases in Planning Process 1. Mission 2. Data
collection and analysis 3. Assess strength and
weakness. 4. Goals and objectives 5.
Establish Strategies to Reach Goals 6.
Timetable 7. Write and Communicate a Plan
Document 8. Implementation 9. Evaluation
Assessment Planning Implementation
Evaluation
 . Mission  During planning, planners have in mind (consciously or
unconsciously) some overall purpose or result that the plan is to achieve.
 For example, during strategic planning, it's critical to reference the
mission, or overall purpose, of the organization.
 35. Phases In Planning contd… 2. Data collection and analysis  About
health care industry and nursing  An environmental scan  considering
various internal or external forces that might effect the organization.
 Assessment of external environment  Markets  Competition  Health
care trends  Economic factors  Technology  Social factors 
Educational factors Assessment of internal environment  Patient care 
Financial resources  Human resources  Information system 
Research and development capabilities  Educational system
 37. Phases In Planning contd… 3. Assess strength and weakness. For
exa. During strategic planning, planners often conduct a "SWOT
analysis".  Define the current position and strength of the unit
 SWOT profile of a nursing organization Strengths 1. 2. 3. Opportunities 1. 2. 3.
Weaknesses 1. 2. 3. Threats 1. 2. 3.
 39. Phases In Planning contd… 4. Goals and objectives  Based on the analysis and
alignment to the overall mission of the system, planners establish a set of goals that build
on strengths to take advantage of opportunities, while binding up weaknesses and
warding off threats.  Goals are broken to objectives to be accomplished in next 1-5
years
 40. Phases In Planning contd… 5. Establish strategies to reach goals  The particular
strategies (or methods to reach the goals) chosen depend on matters of affordability,
practicality and efficiency.
 41. Phases In Planning contd… 6. Timetable  Attach responsibilities and time lines with
each objective  Responsibilities are assigned for implementation of the plan, and for
achieving various goals and objectives.  Deadlines are set for meeting each
responsibility.
 42. Phases In Planning contd… 7. Write and Communicate a Plan Document  Operational
and functional plans  The information is organized and written in a document which is
distributed around the system.  Plan includes detailed action, policies, practices,
communication and feedback, controlling and evaluation plans, budgets and persons to
be held accountable
 Operational plan  These are everyday
working management plans developed from
both long range objectives and the strategic
planning process and short range or tactical
plans  It is the written blueprint for achieving
objectives  It specifies the activities and
procedures that will be used  Sets timetables
for achieving objectives  It tells who is
responsible for what activity or procedure  It
specifies the records to be kept and policies
needed
 Objective Actions Target Dates
Accomplishments Operational plan contd…
 45. Functional plan contd…  Functional

plan- nursing planning performed at a

service or departmental level  It relates to a
specialty service within a nursing division
 8. Implementation  Put plan to work 9.
Evaluation  Formative and summative
evaluation  Feedback is provided to modify
and update the plan
 Guidelines for Successful Organizational Planning  The
movement within organization should be directed at
specified goals and objectives  Plan must be flexible 
Involve people that could be affected by the course of
action  Plan should be simple, specific and realistic 
Know when to plan and when not to plan
 48. Guidelines for Successful Planning and
Implementation  Must be written and communicated
widely  Goals and objectives should be SMARTER  Build
in accountability (Regularly Review Who's Doing What and
By When?)  Note deviations from the plan and re-plan
accordingly  Evaluate the plan and planning process
 ADVANTAGES OF PLANNING • 1. Planning
facilitates management by objectives • 2.
Planning minimizes uncertainties • 3. Planning
facilitates coordination • 4. Planning improves
employee’s morale • 5. Planning helps in
achieving economies • 6. Planning facilitates
controlling
 LIMITATIONS OF PLANNING • 1. Rigidity • 2.
Misdirect planning • 3. Time consuming • 4.
Probability in planning • 5. False sense of
security • 6. Expensive
 Summary  Planning is primary and essential
element of management.  Strategic planning
sets objectives for 1-10 years.  Intermediate
planning is short range planning. 
Operational planning is daily, weekly and
monthly planning and provide data for
strategic and tactical planning to keep in
motion.
 50. Plan Today for a Successful Tomorrow