CONTROLLINGLEADERSHIP AND MANAGEMENT PROCESS

CONTROLLING

An on going function of management which occurs during planning, organizing and directing activities

Process wherein the performance is measured and corrective action is taken to ensure the accomplishment of organizational goal

PURPOSES OF CONTROLLING

Open opportunities for improvement

Compare performance against set standard

Provides information about how well processes and people function

Steps in Control Process

Establish standards and criteria

Measure performance

Compare results with standards

Match with standards? YES - do nothing to improve NO - take corrective action

REASONS FOR CONDUCTING EVALUATION

Ensures that quality services is provided

Allow for setting of sensible objectives and ensures compliance

Provides standards for establishing comparisons

Promotes visibility and means for employees to monitor own performance

Highlights problem related to quality care and determines areas that require priority attention

REASONS FOR CONDUCTING EVALUATION

Provides an indication of the cost of poor quality

Justifies the use of resources

Provides feedback for improvement

EVALUATION PRINCIPLES

1. Must be based on behavioral standards of performance with the position requirement

2. There should be enough time to observe employee’s behavior

3. Employee should be given a copy of the ff. Before scheduled evaluation

Job descriptionPerformance standardsEvaluation forms

EVALUTAION PRINCIPLES

4. Performance appraisal should include both satisfactory and unsatisfactory results

5. Areas needing improvement must be prioritized

6. Should be scheduled and conducted at a convenient time for both evaluator and employee

7. Should be structured in such a way that it is perceived and accepted positively as a means of improving job performance

CHARACTERISTICS OF EVALUATION TOOL

OBJECTIVE Free from bias

RELIABLE Accurate and precise that it will produce the same

results if administered twice

SENSITIVE Instrument can measure fine lines of differences

among criteria being measured

VALID

TYPES OF PERFORMANCE STANDARDS

1. STRUCTURE Focus on the management system or

structure used by the agency in the delivery of care

Includes: Number and categories of nursing personnel Education Personal and professional qualities Function Physical facilities Equipments

TYPES OF PERFORMANCE STANDARDS

2. PROCESS STANDARDS Decision and actions of the nurse relative

to the nursing process

INCLUDES : Assessment Plan of care Nursing intervention

TYPES OF PERFORMANCE STANDARDS

3. OUTCOME STANDARDS Designed to measure the results og care

provided in terms of: Changes in health status of client served

Changes in level of their knowledge, skills and attitude

Satisfaction of those served

PERFORMANCE APPRAISAL

A control process in which employee's performance is evaluated against standards

The most valuable tool in controlling human resources and productivity

Reflects how well a personnel have performed during a specific period of time

PURPOSE OF PERFORMANCE APPRAISAL

1. Determine salary and merit increases

2. Select qualified individual for promotion or transfer

3. Identify unsatisfactory employees for demotion or termination

4. Make inventories of talents within an institution

5. Determine training and developmental needs of employees

PURPOSE OF PERFORMANCE APPRAISAL

6. Improve performance of work group

7. Improve communication between supervisors and employees

8. Establish standards of supervisory performance

9. Provide recognition of employee for accomplishments

10. Inform employees “where they stand’

METHODS OF MEASURING PERFORMANCE

ESSAY The appraiser writes a paragraph about the

workers strength, weaknesses and potentials

CHECKLIST A compilation of performances expected of a

worker

RANKING Evaluator ranks according to how

Employee fared with co-workers

METHODS OF MEASURING PERFORMANCE

RATING SCALE Includes a series of items representing the

different tasks or activities in job description or the absence or presence of desired behaviors

FORCED-CHOICE COMPARISON The evaluator is asked to choose the statement

that best describes the employee being evaluated

The evaluator is forced to choose from favorable as well as unfavorable statement

METHODS OF MEASURING PERFORMANCE

ANECDOTAL RECORDING Describe experience with a group or a person,

or in validating technical skills and interpersonal relationship

Anecdotal report should include:1. Description of the particular occasion2. Delineation of the behavior noted including:

WHO, WHAT, WHY, WHEN, WHERE AND HOE

3. The evaluator’s opinion or assessment of the incident or behavior

QUALITY ASSURANCE

Assurance achieving sense of accomplishment and implies a guarantee of excellence

Quality the degree of excellence QUALITY ASSURANCE:

A process of evaluation that is applied to the health care services b health workers

Focuses on the care and services the patient receives than on how well the professionals performs the duties that the position required

PRINCIPLES UPON WHICH QUALITY ASSURANCE PROGRAM ARE BASED

1. All health professionals should collaborate in the effort to measure and improve care

2. Coordination is essential in planning a comprehensive QAP

3. Resource expenditure for QA activities is appropriate

4. There should be focus on critical factors5. Quality patient care is accurately evaluated through

adequate documentation6. The ability to achieve nursing objectives depends

upon the optimal functioning of the entire nursing process and its effective monitoring

PRINCIPLES UPON WHICH QUALITY ASSURANCE PROGRAM ARE BASED

7. Feedback to practitioners is essential to improve practice.

8. Peer pressure provides the impetus to effect prescribed changes based on the result of assessment and needed improvements on the quality of care

9. Reorganization in the formal organizational structure may be required if assessment reveals the need for a different pattern of health care

10. Collection and analysis of data should be utilized to motivate remedial action

QUALITY IMPROVEMENT PROGRAM The umbrella program that extends the

many areas for the purpose of accountability to the consumer

A continuous, on-going measurement & evaluation process that includes structure, process and outcome

TOTAL QUALITY MANAGEMENT (TQM)

A way to ensure customer satisfaction by involving all employees in the improvement of the quality of every product or service

Aims to reduce waste and cost of poor quality

It is a structured system for involving entire organization in a continuous quality improvement process targeted to meet and exceed customer expectations

CONTINIOUS QUALITY IMPROVEMENT (CQI)

A process of continuously improving a system by : gathering data or performance Using Multi-disciplinary team to analyze the

system Collect measurements Propose changes

PRINCIPLES OF CONTINOUS QUALITY IMPROVEMENT (CQI)

1. Customer focus2. Identification of key processes to

improve quality3. Use of quality tools and statistics4. Involvement of all people in problem

solving

QUALITY ASSURANCE

Focuses on the care and service the patient receives than on how well the professional performs the duties that the position requires

METHODS USED Patient care audit Patient care profile analysis Peer review Quality circles

NURSING AUDIT COMMITTEE Composed of a representative from all

levels of the nursing staff The audit team designate a day within

the week to be the audit day The nurses do not know which unit will

be audited

PATIENT CARE AUDIT

CONCURRENT PATIENT CARE AUDIT One in which patient care is observed and

evaluated Done during rounds or patient interview Given through:1. Review of patient chart while the patients are

still confined in the hospital2. Observation of the staff as patient care is given3. Inspection of patient or observation and/or

observation of the effects of patient care where the focus is on the patient

PATIENT CARE AUDIT

RETROSPECTIVE PATIENT CARE AUDIT ONE IN WHICH PATIENT CARE IS

EVALUATED THROUGH:1. A REVIEW OF DISCHARGED PATIENTS’

CHART2. QUESTIONAIRES SENT TO OR INTERVIEW

CONDUCTED ON DISCHARGED PATIENTS

QUALITY CIRCLES

One of the most publicized approaches to quality control introduced by the Japanese

A group of workers doing similar works who: Meet regularly Voluntarily On normal working time Under the leadership of the supervisor

QUALITY CIRCLES

TO: Identify, analyze, and solve work related

problem

Recommend solution to management quality circle members should implement the solution themselves

CONTROL OF RESOURCES

Consumption of supplies and materials should be proportionate to the number of patients served

Requisition or stock of large numbers of supplies and materials should be avoided to prevent misuse or spoilage

A high turnover inventory is desired A low turnover is:

the result of poor purchasing policies Overstock or decreased demand for the item

CONTROL OF RESOURCES

Equipment utilization report should be made including frequency of breakdown help to evaluate the:

quality of equipment purchased The way it was handled

Preventive maintenance requires the regular inspection of equipment to prevent breakdown or detect needed repairs Breakdown results in more expenses and non

productivity of personnel

CONTROL OF RESOURCES

Human Resource: Absences due to leaves, whether

scheduled or not, should be analyzed Provision for relievers should be included

in the staffing pattern to maintain quality service

Unusual number of unscheduled absences should be investigated this may necessitate disciplinary action

DISCIPLINE

Rigid obedience to rules and regulations

SELF DISCIPLINE: A constructive and effective means by which employees take personal responsibility for their own performance and behavior

FACTORS THAT INFLUENCE SELF DISCIPLINE

1. Strong commitment to the vision, philosophy, goals and objectives of the institution

2. Laws that govern the practice of all professionals and the respective Codes of Conducts

3. Understanding of the rules and regulation of the agency

4. Atmosphere of mutual trust and confidence5. Pressure from peers and organization

DISCIPLINARY ACTION

Any employee charge with breach of the rules and regulation, policies, norms of conducts should be given due process

There must be existing rules of conduct governing his behavior and a documentation of actual violation

The charged employee must be notified in writing about the violation and be given the right counsel

Principles of disciplinary action

1. investigate carefully 2. be prompt 3. protect privacy 4. focus on the act 5. enforces rules consistently Be flexible

Components of disciplinary action program

Code of conduct Employees must be informed of the nature and

meaning of codes of conduct Must understand that the rules are reasonable and

directly related to efficient, effective operation of the agency

Authorized penalties

Records of offenses

Right of appeal

DISCIPLINARY ACTION

Should be progressive in nature

CONSELLING AND ORAL WARNING Best given in private and in an informal

atmosphere Employee is given fair chance to air his

side Relevant facts are analyzed and

evaluated against past performance

DISCIPLINARY ACTION

COUNSELLING Employee is counseled regarding:

Expectations of improved behavior/performance Ways of correcting the problem Warning that a repetition of the same offense

may warrant disciplinary action The employee must commit to correct the

behavior He should be informed of any follow-up

action that may be taken

DISCIPLINARY ACTION

WRITTEN WARNING The second step in disciplinary action Preceded by an interview similar to oral warning Employee is told after the interview that he will

be given a written warning WRITTEN WARNING: includes

Statement of the problem Identification of the rule that was violated Consequence of the continued deviant behavior Employees commitment to take corrective action Any follow-up action to be taken

DISCIPLINARY ACTION

SUSPENSION DISMISSAL

Invoked only when all other disciplinary efforts have failed

Disciplinary Committee should be very sure that the cause for dismissal conforms with the criteria of a major discipline violations as contained in the policy manual

Review is done by higher management