NCM 119 LEC by Pauline Siasoco

SEPT 1, 2021 Prof. Margarita Santiago CHARACTERISTICS OF LEADERS

1. Do not have delegated authority but obtain their
DIFFERENCE BETWEEN
power through influence
LEADERSHIP AND MANAGEMENT
2. With wider variety of roles than do managers
3. May or may not be part of the formal organization
DEFINITION OF TERMS 4. FOCUS: Group process, information gathering,
feedback & empowering others
● Organization - structured group of people brought
5. EMPHASIS: Interpersonal relationships
together to achieve certain goals that the same
6. Direct willing followers
individuals could not reach alone Bryman (1999) found 3 elements in most definitions of
● Management leadership: Influence, Groups & Goal
➢ Working with & through others to effectively achieve
organizational objectives by efficiently using limited DIFFERENCE BETWEEN A LEADER & MANAGER
resources in a changing environment
➢ Tasks or activities involved in managing an
organization
➢ Planning organizing, directing, controlling
➢ Science & art of guiding human & physical
resources of an organization toward satisfying the
health related needs & expectations (healthcare
organizations
● Nursing Management Process - active participation
by managers in 4 basic interrelated usually
simultaneous & managerial functions: PODC to
achieve organizational goals
● PODC - planning, organizing, directing & controlling
● Nurse Manager - head of nursing unit for smooth
functioning of the unit both administratively &
technically (patient care)
CHARACTERISTICS OF A MANAGER
1. Have an assigned position within the formal
organization
2. Have a legitimate source of power due to the
delegated authority that accompanies their position
3. Carry out specific functions, duties & responsibilities
4. Emphasize control, decision making, decision,
analysis & results ● Management emphasizes control such as hours,
5. Manipulate people, environment, money, time & costs, salaries, overtime, use of sick leave, inventory &
other resources to achieve organizational goals supplies
6. Greater formal responsibility & accountability for ● Leadership increases productivity by maximizing
rationality & control than leaders workforce effectiveness
7. Direct willing & unwilling subordinates ● Effectiveness - performing in the best possible
manner w/ the least waste of time & effort
● Leadership
➢ Ability to lead people towards the appropriate MANAGEMENT COMPETENCIES
direction to attain the goal set ● Competency - quality of being competent; adequacy;
➢ Influencing other people to do things you want to do possession of required skill, knowledge, qualification or
➢ Persuading others to understand & agree about capacity
what needs to be done & how to do it ● Managerial Competencies - skills, motives attitudes
➢ Facilitating individual & collective efforts to achieve necessary to a job
common goals & objectives

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 - Characteristics like communication skills, problem
(3) LEVELS OF MANAGEMENT
solving, customer service and build a team

LEADERS: MANAGEMENT COMPETENCIES

Supervision Conflict Emotional Communicatio
Resolution Intelligence n competency

Manage Interviewing Team Building Delegation

Performance Skills

Change Agent Coaching Motivating Problem

Others Solving Levels of Management
1. Emotional Intelligence - Line that separates b/w various managerial
- Manage & control emotions & possess or influence positions
- Control emotions of others as well - Chain of command, amount of authority & status
Five Main Elements: enjoyed by a managerial position
1) Self-awareness 1. TOP-LEVEL MANAGERS
2) Self-regulation - In charge of major departments, formulation of
3) Motivation rules, regulations & protocols & guidelines for their
4) Empathy departments
5) Social Skills - Ensure smooth functioning of the department
2. MID-LEVEL MANAGERS
MANAGERIAL SKILLS - Proper functioning of the department, quality of
● Accdg to Robert Katz, management attributes that an service or products
executive should possess in order to fulfill specific - Supervise the first-line managers of the department
tasks - Carry out goals set by the management
● Developed through learning & practical experience as 3. FIRST-LEVEL MANAGERS
a manager - Supervise frontline workers; possess expertise of
TYPES frontline work
*By Katz (1955) & Hersey & Blanchard (1977) - Timely completion of work
● Technical Skills - use knowledge, methods,
TYPES OF MANAGERS
techniques & equipment for specific tasks acquired
from experience, education & training 1. FUNCTIONAL MANAGER - 1 organizational activity
● Interpersonal/ Human Skill - ability & judgement in such as finance or HR management
working with & through people, including understanding 2. GENERAL MANAGER - All functional activities:
of motivation & application of effective leadership production, sales, marketing & finance such as a company
● Conceptual Skill - understand complexities & where
one’s operation fits in the org
EXAMPLES
1. Planning - organize activities inline with guidelines &
budget
2. Communication - how well information is shared
throughout a team to ensure that the group acts as one
unified workers
3. Decision-making - clear & right decisions to succeed;
making choices by identifying a decision, gather information
& assess alternative resolutions MANAGEMENT FUNCTIONS
4. Delegation - hand over tasks to subordinates
*By Koontz & O’donnel: Planning, Organizing, Staffing,
5. Problem-solving - recognized problem & find best
Directing, Controlling
solution
1. PLANNING
6. Motivating - encourage to bring desired behavior from
- Accdg to Henry Fayol, “to manage is to forecast &
subordinates
plan, to organize, to command & to control”
● To forecast & plan - examining the future & draw
plans for action

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 ● To organize - build up structures ● Managers performs tasks such as training employees
● To direct (command/ coordinate) - to harness/ as necessary & managing deadlines during this stage
enhance on both activities ● Performance appraisals, fiscal accountability, quality
● To control - sees that everything occurs in control, legal & ethical control & professional & collegial
conformity with the plan control
5 M’s of Organization
- Functions are performed Man, Method, Machine, Materials, Money
continuously PROCESS OF MANAGEMENT
- Interrelated &
simultaneous
- Not done step by step or
one after another

PLANNING
1. Determine the goals, philosophy, objectives, policies
2. Carrying out long & short range projections
3. Determining a fiscal course of action
4. Managing planned change
ORGANIZING MANAGER
● Bringing together physical, financial & human
● Directing the efforts aimed at helping orgs
resources for achievement of goals
● Achieving organizational goals through efficient &
● Purpose: Allocate resources & delegate tasks
effective use of resources
● Determine what tasks to be done, who will do them,
MANAGERIAL ROLES (Mintzberg)
how tasks are grouped, who reports to whom & where
decisions are to be made ROLE DESCRIPTION IDENTIFIABLE
ACTIVITIES
● Working within the structure of the organization, use of
power & authority appropriately A. Interpersonal
● Authority - legitimate right to give commands to act in
1. Figurehead Symbolic head; obliged Ceremonies, status
the interest of the org; an officially sanctioned activity to perform a number of requests, solicitations
● Power - organized human, informational & material routine duties of a legal
resources to accomplish a task, demonstrated ability to or social nature

get results 2. Leader Motivation & activation Virtually all managerial

STAFFING of subordinates, activities involving
staffing, training & subordinates
DIRECTING associated duties
● Put into action the organizational systems; focus on
directing one’s performance leading in the most 3. Liaison Maintains self Interdepartmental
development network of relations & other
effective manner outside contacts & activities involving
● Supervising, motivating, guiding & influencing people to informers who provide outsiders
favors & information
work efficiently
Elements of Directing: B. Informational
a. Supervision - overseeing the work of subordinates
1. Monitor Scans the environment Handling all contacts
by their superior. Acts of watching & directing work
for new information to categorized as
& workers collect: Seeking info concerned primarily w/
b. Motivation - inspiring, stimulating, or encouraging regarding issues that receiving info
affect org
the subordinated w/ zeal to work. Use of positive,
negative, monetary, non-monetary incentives 2. Disseminator Transmits info received Forwarding mail into org
c. Leadership - manager guides & influences the from outsiders or from for information
other subordinates to purposes, verbal
work in desired direction. Use interpersonal skills to members of orgs; some contacts involving
encourage, inspire, motivate information factual; information flow to
some interpretation & subordinates (review
d. Communication - passing information, experience, integration of diverse sessions, instant
opinions. Bridge of understanding value positions of communication flows)
CONTROLLING organizational
influences
● Assessing the accomplishment of the plan & making
adjustments 3. Spokesman Transmits information to Department meetings;

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 outsiders on handling contacts
8. INITIATIVE - eagerness to initiate actions w/o being
organization’s plans, involving transmission asked to do so. Fayol advised that management should
policies, actions, of info of info to provide opportunity to its employees to suggest ideas,
results, etc.; serves as outsiders
expert on org industry experiences & new method of work.
9. FAIR REMUNERATION - wages should be determined
C. Decisional on the basis of cost of living, work assigned, financial
1. Entrepreneur Searches organization Strategy & review
& its environment for sessions involving position of the business, prevailing wage rate
opportunities and initiation or design of - Fair compensation
initiates “improvement improvement
projects” to bring about
10. STABILITY OF TENURE - employees should not be
change; supervises moved frequently from one job position to another
design of certain - Fayol: “Time is required for an employee to get
projects as well
used to new work & succeed in doing it well but if
2. Disturbance Responsible for Strategy & review he is removed before that he will not be able to
handler corrective action when sessions involving
render worthwhile services”.
an organization faces disturbances & crises
important, unexpected 11. SCALAR CHAIN - “The chain of superiors ranging from
disturbances. the ultimate authority to the lowest”. All orders, instructions,
3. Resource Allocation of Scheduling; requests for
messages, requests, explanation has to pass through line of
allocator organizational authorization; any authority from top to lowest level of management
resources of all things in involving budgeting & 12. SUB-ORDINATION OF INDIVIDUAL INTEREST TO
effect making or the programming of
approval of all subordinates’ work GENERAL INTEREST - organization is much bigger than
significant the individual it constitutes therefore interest of the
organizational decisions
undertaking should prevail in all circumstances.
4. Negotiator Representing the Negotiation Reconciliation should be achieved b/w individual & group
organization at major interests
negotiations
13. ESPIRIT DE’ CORPS (can be achieved through unity of
command) - team spirit; harmony in the work groups &
14 PRINCIPLES OF MANAGEMENT
mutual understanding among the members; inspires
by Henri Fayol
workers to work harder
1. DIVISION OF LABOR - Specialization of jobs 14. CENTRALIZATION & DECENTRALIZATION
- Work of all kinds must be divided & subdivided & ● Centralization - concentration of authority at the top
allotted to various persons according to their level. Anything which increases the role of subordinate
expertise in a particular area ● Decentralization - disposal of decision making
2. AUTHORITY & RESPONSIBILITY - co-existing & there authority to all the levels of the organization. Authority
should be balance b/w the 2 is shared downwards to the lowest level of
● Authority - right of superiors to get exactness from management. Increases role of subordinated
their subordinates * Fayol: “Degree of centralization or decentralization
● Responsibility - obligation for the performance of the depends on # of factors like size of business, experience of
job assigned superiors, dependability & ability of subordinates
3. PRINCIPLE OF ONE BOSS - subordinate should receive
orders and be accountable to one & only one boss at a time INTEGRATING LEADERSHIP ROLES &
4. UNITY OF DIRECTION - related activities should be MANAGEMENT FUNCTIONS
grouped together. One plan of action & should be under the ● Gardner (199) asserted that integrated leader
charge of a particular manager managers possess (6) distinguishing traits:
5. EQUITY - combination of fairness, kindness & justice in 1. They think longer term.
dealing w/ subordinated if we would want them to be 2. They look outwards, toward the larger organization
dedicated/ committed in their work 3. They influence others beyond their own group
6. ORDER - proper & systematic arrangement of things & 4. They emphasize vision, values & motivation
people; People should be placed in the position there are 5. They are politically astute
most suitable 6. They think in terms of change & renewal
● Material Order - arrangement of things
● Social Order - placement of people
7. DISCIPLINE - sincerity, obedience, respect of authority &
observance of rules & regulations of the enterprise

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📖 LECTURE 💡 REMEMBER 5 of 29
SEPT 8, 2021 Prof. Margarita Santiago ➢ FOCUS: organization applicable in any
setting
MANAGEMENT THEORIES &
➢ POSDCORB: Planning, Organization -
LEADERSHIP STYLES
Staffing (organization), Directing -
Coordination, Reporting, Budgeting
MANAGEMENT THEORIES
(planning)
● Concepts surrounding recommended management ➢ Main concern: optimal approach...
strategies such as frameworks & guidelines B. Human Relation (1930-today)
THEORY ● FOCUS: Empowerment of worker as a source of
● Coherent group of assumptions put forth to explain the control, motivation & productivity
relationship b/w 2 or more observable facts & sound ● Major Belief: organization would proper if its workers
basis for predicting future events prospered as well
WHY STUDY MANAGEMENT THEORY ● Main Determinants of Efficiency: Human relations b/w
● Theories provide stable focus for understanding workers & managers & among the workers
people’s experience ● Emphasis: Training of the employees to improve work
- Communicate efficiently about what they consider ● FOCUS: Changing working conditions, changes that
to be relevant aspects of management & result to paying attention to the employees & making
organizations them feel valued
- Challenge people to keep learning about the world C. Contemporary Theory of Management
EVOLUTION OF MANAGEMENT THEORIES
A. Classical or Scientific Management (1900-1930)
● Oldest theory - traditional management theory
1. Bureaucratic - relies on rules, set hierarchy. Clear
vision of labor & detailed rules & procedures
➢ FOCUS: superior-subordinate
communication transmitted from top to
bottom via a clear chain of command,
1. Contingency Approach - when managers make
hierarchy of authority & division of labor
decisions:
chain
a. Take into account all aspects of the current
➢ Structure the organizations in a hierarchy -
situation
clear rules of governance
b. Act on those aspects that are key to the
➢ Establishing standards & procedures that
situation at hand
are at the core of most organizations today
➢ Approach: “It depends”; Continued effort to
2. Scientific - individual worker - machine
identify the best leadership or management
relationships in manufacturing plants focus on the
style, conclude that the best style depends
management of work and workers
on the situation
➢ Best methods for performing any task &
➢ Fred Fiedler’s Theory - set of leadership
selecting training & motivating workers
traits handy for every kind of situation, a
➢ Frederick Taylor
leader must be flexible enough to adapt to
○ Focus: Goals & productivity
the changing environment
○ Simplifying tasks so as to increase
➢ Primary Focus: No one management
productivity
approach works for every organization
○ Father of Scientific Management
2. Systems Approach - org as unified, directed
Theory
system of interrelated parts
➢ Have proper tools & equipment
➢ Gives managers a way of looking at the org
➢ Focus on training the workers to work more
as a whole & as a part of a larger, external
efficiently
environment
➢ Use: performance incentives
➢ System - collection of parts unified to
➢ Time & motion studies: determine how to
accomplish an overall goal. If one part of
do & organize the work in the most efficient
the system is removed, nature of the
manner
system is changed
3. Administrative - manager & basic managerial
functions

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 -
Brought a new perspective for Principles of Scientific Management
managers to interpret patterns & 1. Traditional “rule of thumb” means of organizing work
events in the workplace must be replaced w/ scientific methods
- Have inputs, processes, outputs & 2. A scientific personnel system must be established so that
outcomes. Share feedbacks among workers can be hired, trained & promoted based on their
each of these four aspects of the technical competence & abilities
systems 3. Workers should be able to view how they “fit” into the
a. Open & Closed System in Systems Theory organization & how they contribute to overall organizational
i. Closed System - insensitive to productivity
environmental deviations, self contained & 4. Relationship b/w managers & workers should be
isolated cooperative & interdependent & the work should be shared
ii. Open Systems - responsive to changes in equally
environment
1. Open Organizations - exchange Henry L. Gantt
info, energy or resources w/ their ● Wage system that rewarded workers who reached the
environments, whereas closed do daily standard & supervisors for every worker who
not reached the standard
● Workers’ progress rated publicly & recorded on
individual bar charts
● Method of scheduling & recording work
Frank B. & Lillian M Gilbreth
● Fatigue & motion studies - upgrade performance,
reduce fatigue, raise worker morale
● Management concern for workers
➢ Key Concepts of Systems Theory ● Aim of scientific management: to help workers reach
○ Flow - info, material & energy that enter & full potential as human beings
leave a system Bureaucratic Management Theory (1930-1950(
○ Feedback - results are returned to the
Proponent Title of Theory Advocacy
individual, allowing work procedures to be
analyzed & corrected Max Weber Bureaucratic German sociologist, study
(1864-1920) Functions/ The large-scale organizations
➢ Organization’s Success: Synergy/ collaboration,
Theory of to determine what made
interdependent & interrelations b/w subsystems Bureaucracy some workers more
➢ Employees are the most important component efficient than others
- Need for legalized,
formal authority &
consistent rules &
regulations

WEBER’S IDEAL BUREAUCRACY

Job specialization - Authority hierarchy - Formal selection -
Formal rules & regulations - Impersonality - Career
orientation
● Stressed need for strictly defined hierarchy
● Bureaucracy = ideal organization
● Theory became design prototype for large orgs
Proponent Title of The Advocacy ● Orgs develop comprehensive & detailed standard
Theory
operating procedures for all routinized tasks
Frederick Winslow Scientific Midvale & Bethlehem Steel ● Weber focused on dividing orgs into hierarchies
Taylor (1900-1930) Management Plants experiments in establishing strong lines of authority & control
Pennsylvania late 1800
Incentive wage plans
(differential rate system) Proponent Title of Advocacy
- Used scientific method to Theory
define the “one best way”
for a job
Henri Fayol (1925) Management Identified principles that
- Father of Scientific
Functions constitute good
Management
management practice

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 5 Management Functions: Managerial domination
Plan, Organize, Command, causes workers to become
Coordinate & Control discouraged & passive

Contested the belief that If self-esteem &

managers are born not independence needs are
made & management was a not met, employees will
skill one that could be become discouraged &
taught once underlying troublesome
principles are understood;
common to all human Open communication within
undertaking an organization, can block
learning & hinder progress
Luther Gulick (1937) Seven POSDCORB if it’s based on
Activities of defensiveness, denial of
Management real problems

SYNTHESIS
HUMAN RELATIONS MANAGEMENT (1930 - 1970)
● HR era developed concepts of participatory & ● Management - integrating functions that includes
humanistic management, emphasizing people rather planning, organizing, leading & controlling of an
than machines organization
● Brought about a great interest in the study of workers ● 3 Levels of Management: Top, middle & first line
● Attempted to correct what was perceived as the major ● Theories pertaining to management:
shortcoming of the bureaucratic system 1. Scientific
2. Administrative
Proponent Title of Theory Advocacy
3. Behavioral
Mary Parker Follet Participative 1st to suggest participative
(1926) Management decision making or
participative management HISTORICAL DEVELOPMENT OF LEADERSHIP
Human beings grew
through their relationships LEADERSHIP
w/ others
● Influencing & supporting others
Manager’s job: harmoniza ● Work enthusiastically
& coordinate group efforts
LEADERSHIP ROLES
Group ethic rather than
individualism

Elton Mayo (1927 & Hawthorne Hawthorne experiments

1932) effect Human
Behavior in Testes the assumption of
Work Situation Scientific Management
Theory Relationship b/w
light illumination in the
factory & productivity
CHARACTERISTICS OF LEADERS
Conclusion: Employees ● Uphold goals
would work harder if they
believed management was
● Lead willing followers
concerned about their ● Obtain their power through other means: influence &
welfare & supervisors paid often do not have delegated authority
special attention to them
● Broader variety of roles than managers
Conclusion: Informal work ● May or may not be part of formal org
groups have a positive
influence on productivity
● Focus on group process, information gathering,
feedback & empowering others
Douglas McGregor Theory X & Theory Y - worker enjoy ● Emphasize interpersonal relationships
(1960) Theory Y their work , motivated &
willing to work hard THEORIES OF LEADERSHIP
Theory X - employees need
constant supervision & 1. “GREAT MAN” THEORIES
direction & are indifferent to
organizational needs
● People are born to lead, others are born to be led
● Leaders: born with necessary internal characteristics:
Chris Argyris (1964) Employee Supported Mcgregor & charisma, confidence, intelligence & social
Participation Mayo

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● People cannot really learn how to become strong ● Both leaders & followers have the ability to raise each
leaders other to higher level of motivation & morality
● Inherent - capacity for leadership ● Leader is able to transform the follower into one like
2. TRAIT THEORIES her/him
● People have certain characteristics or personality traits ● Able to cascade his leadership to the followers
that make them better leaders than others ● Focus: Process
● “Leaders are born not made” ● Motivate & inspire leaders are focused on the
● Personality, social, physical or intellectual traits performance of the group, want every person to fulfill
differentiated leaders from non-leaders their potential
3. BEHAVIORAL THEORIES ● Have high ethical & moral standards
● Specific behaviors differ from leaders & non-leaders
● Emphasis - shifts from traits or qualities of leaders to
TRANSACTIONAL TRANSFORMATIONAL
their behaviors & actions
● Individuals can learn to become a good leader because 1. Focus: Management task 1. Identifies common values
effective leadership is the result of many … 2. Caretaker 2. Is committed
3. Trade-off to meet goals 3. Inspired other with vision
● Belief: Great leaders are made, not born 4. Share values not identifies 4. Has long-term vision
● Focus: actions of leaders or what the leader does, not 5. Examines causes 5. Looks at effects
on mental qualities or internal states 6. Use contingency reward
● Can learn to become leaders through teaching &
observation 1. Primary Leadership Styles (Lewin 1951)
● Lewin 1951) & White & Lippit (1960) - common a. Autocratic (Authoritarian)
leadership styles: b. Democratic (Participative)
1. Authoritarian Leader c. Laissez-Faire
2. Democratic Leader 2. Situational Leadership
3. Laissez-faire Leader 3. Contingency Leadership
4. SITUATIONAL & CONTINGENCY LEADERSHIP
THEORIES (1950 - 1980) LEADERSHIP STYLE
● Leadership style - accdg to situation & individuals ● Leader’s characteristic behaviors when directing,
● Management technique that best contributes to the motivating, guiding & managing groups of people
attainment vary ● Inspire political movements & social change
● Manager’s task - identify which technique to attain ● Motivate others to perform, create & innovate
management goals ● Help you lead your team members as well as to
● Best course of action based upon situational variables develop leaders yourself
● No single leadership style is best KURT LEWIN DIFFERENT STYLES OF LEADERSHIP
● Most appropriate leadership style depends: 1. Authoritarian - clear expectations for what needs to be
a. Level of maturity & readiness of the followers done, when it should be done, & how it should be done
b. Demands of the situation - Leader makes decisions
4. CONTINGENCY THEORIES - Task centered “leadership for those who advocate
● Focus on how specific situations affect a leader’s the situational form of leadership where the leader’s
effectiveness & how a leader’s ability to adapt can be concern is on production”
their most important tool - Less concern for people who perform the task
● Success depends on a number of variables including - Effective in crisis situation when highly specialized
the leadership style, qualities of the followers & aspects skills are required
of the situation - Focus: control & chain of command to achieve
● No one leadership style is ideal for every situation results
● “It depends” - Make decisions independently, with little or no input
● Best leadership or management style depends on the from the rest of the group
situation - Effective: followers need a great deal of direction &
5. TRANSACTIONAL THEORIES where rules & standards must be followed; situation
● Focus on the role of supervision, org & group calls for rapid decisions & decisive actions
performance - Benefit: ability to maintain a sense of order
● Base leadership on a system of rewards & 2. Democratic or Participative - contribute along with their
punishments group
6. TRANSFORMATIONAL THEORIES ● Aka Consensus leadership

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● Discusses options, consults & draws supervised before
making decisions
● “People centered” leadership, for those who advocate
the situational form of leadership where the leader’s
concern is on “people”
● Interaction b/w leader & subordinates, is open, friendly
& trusting; with collaboration & governance
● Most effective leadership style
3. Laissez-Faire Leader - let the group manage itself
● Little or no guidance to group members & leave the
decision-making up to the group members
● Useful on situations w/ high qualified experts, but could
often leads to poorly defined roles & lack of motivation
● Information center & exercises minimum control,
depending on the employee’s sense of responsibility &
good judgement to get things done
● “Let alone” style
● Leader abdicates leadership responsibility & leaves the
workers w/o direction, supervision or coordination
● Lacks focus or time management, resulting in high job
satisfaction w/ risk of low productivity
● Leads to poorly defined roles made less progress &
produced less work

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SEPT 15, 2021 Prof. Margarita Santiago
CHARACTERISTICS OF A GOOD PLAN
PLANNING
1. Have precise clearly stated objective; including desired
PLAN results & methods of evaluation
● Blueprint specifying the resource allocations, 2. Be guided by policies & or procedure affecting the
scheduled & actions to attaining goals planned action indicate priorities
● Man, Money, Materials, Methods, Machinerys 3. Planning in all areas of the organization must follow the
PLANNING FOR THE NURSING SERVICE mission, philosophy & goals of the organization
● Pre-determining a course of action in order to arrive at 4. Develop actions that are flexible & realistic in terms of
desired result (Venzon, 2006) available personnel, equipment, facilities & time
● Continuous process of assessing, establishing goals & 5. Develop a logical sequence of activities
objectives, implementing & evaluating & subjecting 6. Include the most practical methods for achieving each
these to change as new facts are known (Douglas, objective
1986 in Venzon) 7. Pervades the whole organization
TO A MANAGER WHY DO MANAGERS PLAN?
● Thinking about what is to be done, who is going to do it ● Provides direction
& how & when it will be done ● Reduces certainty
● Process of selecting a future course of action, where ● Minimizes waste & redundancy
there’s decision-making (means selecting a course of ● Sets standards for controlling
action) REASONS WHY MANAGERS FAIL TO PLAN
EFFECTIVELY
● Bridge the gap b/w where you are & where you want to ● Lack of knowledge of the philosophy, goals & objective
go or lack of understanding of the significance of the
● Determine the rate, effectiveness & quality of the planning process
program ● May not know how to manage their time to devote for
● Specific aim & purpose & map out program planning
● Making commitment ● Lack of confidence in formulating plans or may fear
● Establish tools to measure outcome that planning may bring about unwanted changes that
BASIC COMPONENTS OF PLANNING they are unwilling to undertake or are unable to cope
1. GOALS - represent an end state the targets & results with
that managers hope to achieve
LEVEL OF MANAGEMENT & SCOPE OF
Ex. GOAL: The nursing Service Organization will be
PLANNING
a center of excellence using innovative research & activities
based on a caring science frameworks 1. Top Management - responsibility plan covering the
2. ACTION STATEMENTS - how an organization goes overall management of the organization’s Nursing Service
ahead to attain its goals 2. Middle Management - direct activities to actually
Ex. implement the broad operating policies of the organization
A. Relate principle of caring science to such as staffing & delivery of services to the units
evidence-based practice or research initiatives 3. Lower Management or the First - do the daily & weekly
B. Provide an increase RN research activities for plans for the administration of direct patient care in their
nurses 1yr in service & above respective units
PURPOSE OF PLANNING ELEMENTS or COMPONENTS OF PLANNING
1. Leads to the achievement of goals & objectives ● Forecasting helps managers loon into the future &
2. Gives meaning to work decide in advance where to go
3. Provides for effective use of available personnel & ● Tell where agency would like to be & what is to be done
facilities in order to get there
● Setting the Vision, Mission, Philosophy, Goals & Objectives
4. Helps in coping w/ crisis
- Plans at the top influencing all the
5. Cost effective plans that follow
6. Base on the past & the future helps reduce the element - Hierarchy broadens at lower
of change levels, representing an increase in
7. Through planning, one can discover the need for change the # of planning components
- Top of the hierarchy more general,
8. Provides a basis for control
& lower components are more
9. Necessary for effective control specific

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 ● Areas that requires policy statement
ORGANIZATIONAL FOUNDATION OF PLANNING
- Focus of responsibility
1. VISION - Area of patient focus on safety, privacy, patient
● Vision Statement - outline the organization’s future
rights & quality care
role & function. It gives the agency something to strive
- Area for personnel concerns & welfare
for
GOOD POLICIES MUST BE:
● What & where the organization wants at a certain
● Clearly written & known to all
period of time
● Comprehensive w/ certain flexibility
○ Ex. Preparing for Life through God
● Consistent & free from biases
Centered Education & Practice
● With stated limitations
○ Ex. Filipinas Hospital will be leading center
7. PROCEDURES
for trauma care in the region by 2025
● Plans that establish customary or acceptable ways of
2. MISSION
accomplishing a specific task & describe a sequence of
● Mission Statement - agency’s reason for existence
steps of required action
● Who: the target clients are & what services will be
● Reflect the policies of the company
provided
● Support the organization’s long-term goals
● What the organization wants to do. Ex. Develop a
● Specific instructions of how to perform activities in line
faculty of highly competent & wholly committed
w/ the policies
Christian Nursing Education
● Areas of coverage:
3. PHILOSOPHY
a. Job relative to patient care
● Statement of beliefs & values. Direct one’s life or one’s
b. Related to personnel management
practice
particularly along disciplinary measures
● Sense of purpose of the organization & reason behind
c. How to use certain medical equipment
its structure & goals
d. Tools to use & responsible person
● How to achieve the Vision, Mission & Objective
e. Materials
4. VALUES - beliefs that guide behavior
f. Precautionary measures to take
5. GOALS
g. Documentation
● What would like to attain or achieve
h. Specified time of doing it
● Goals are general & cover a broad area
8. RULES
● Desired result toward which effort is directed (aim of
● Rules are the least flexible type of planning
philosophy)
● Plans that define specific action or nonaction
● Importance:
● Part of policy or procedure statements
a. Provide a sense of direction
● Describe situations that allow only one choice of action
b. Focus our efforts
● “Do” and “don’t” statements to promote the safety of
c. Guide plans
employees & the uniform treatment & behavior of
● Goals in Nursing Service:
employees
a. Good patient relationship-customer
9. STANDARDS
satisfaction
● Yardstick against which the performance of the org &
b. Fall prevention
or people in the org will be measured
c. Fast & efficient patient discharge
● Nursing standards - desired & achievable level of
d. Staff training & development
performance against which actual performance can be
6. OBJECTIVES
compared
● Specific short statement on how the mission & goals
● Ex. 1. What is the qualification of VP Nursing?
will be attained
2. How must patients be taken care of?
● Result oriented & it should be SMART
*Because a plan is a guide to reach goal, it must be flexible
● Include a specific time frame for completion
& allow for readjustment as unexpected events occur
● Be stated in behavioral terms
● Be objectively evaluated STEPS OF PLANNING
● Identify positive rather than negative outcomes 1. Establishing objectives
6. POLICIES ● Should clearly define & measurable
● Statements of expectations that set boundaries for ● Indicate what is to be achieved, where action should
action taking & decision making take place, who is to perform it, how it is to be
● Guidelines for managerial decisions in planning, undertaken & when it is to be accomplished
operating their respective departments

📖 LECTURE 💡 REMEMBER 12 of 29
2. Determining planning premises 3. TACTICAL PLANNING
● Premises - actual forecast data, policies & plans 4. CONTINGENCY PLANS
● Involves looking into the future which necessitates the 5. PROJECT PLANS
org to know, how future conditions will affects its PLANNING HIERARCHY
activities
● Forecasting of general economic conditions & market
conditions for a specific product or service
3. Determining alternative courses
● Study all the alternatives, consider the strong & weak
points & select the most promising ones
4. Evaluating alternative courses
● Evaluate/ study of performance of various actions/
factors alternatives which should be weighed against
each other HIERARCHY OF PLANS
● Alternative should be closely studied to determine its ● Mission Statement - broad organizational goal, based
sustainability on planning premises which justifies & organization’s
5. Identifying alternatives existence
● Most suitable alternative is selected from various ● Strategic Plans - plans designed to meet an
alternatives organization’s broad goals
6. Evaluating alternatives ● Operational Plans - plans that contain details for
● Best course is selected carrying out, or implementing, those strategic plans in
● Make the planning process more effective, it should day-to-day activities
provide feedback mechanism
7. Choosing a plan of action 1. STRATEGIC PLANNING (long-term)
● Best & most suitable alternative is selected ● Long-term plan - crucial to the success
8. Drawing up the budget establishing deadlines ● Strategic Planning - long range (5-10years)
- Directional guidelines given by top management
IMPLEMENTATION OF THE PLAN - High-level company goals
● Put the plans into action to achieve objectives
2. OPERATIONAL PLAN (short-term)
● Establishment of policies,
● Procedures, standards, budgets ● Short-Term Plans - allocate resources for a year or
● Use of strategy less
● Final step in the process - Monitored & updated
KEY STEPS IN THE PLANNING PROCESS - Done by the middle & first-level management
● Programming & implementation ● Operational plans concerned w/ daily activities
● Followed proposed course of action. Review goals functional & operational
● Provide feedback - Detailed activities, schedule, responsible persons &
● Modify action plans resources required
● Do evaluation - what has been done what has been ● Ongoing plans - include rules & regulations,
planned to do procedures & the day to day running of the company
● Any deviation & gaps - explained & action has to be ● Operating plans (detailed plans for a specific
initiated department) made by frontline or low-level managers
MANAGEMENT PLAN ● FOCUS: specific procedures & processes occurring
● Kron - developed a planning formula which is used for within the lowest levels of the org
daily duties or for short & long range projects ● Describes the specific goals & objectives & milestones
● Program are determined, developed & targeted within set by an organization during a specific period
a time frame to reach the set goals & objectives ● Allocate the tangible resources (labor, equipment,
DEVELOPING & SCHEDULING A PROGRAM space)
The Planning Formula ● Authorize the financing necessary to meet the
● What, When, Can, Where, How, Who, objectives of the plan
● Can be ongoing or single use
KINDS OF PLAN
1. STRATEGIC PLANNING
2. OPERATIONAL PLANNING

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TYPES OF OPERATIONAL PLAN
4. CONTINGENCY PLAN
1. SINGLE USE PLAN - detailed course of action used
● Identifying alternative courses of action that can be
once or only occasionally to solve a problem that does not
implemented if & when the original plan proves
occur repeatedly
inadequate because of changing circumstances
● Types:
● Applied on possibility of unforeseen anticipated
a. Program - large set of org activities & specifies
changes; created for when the unexpected occurs or a
major steps, their order & timing & unit responsible
major change needs to be made in order to continue
for each step
towards the goal
b. Project - smaller & separate portions of the
programs 5. PROJECT PLAN
c. Budgets - formal quantitative statements of the
● Plans to implement projects such as launching new
resources allocated to specific programs or projects
products or building a new plant
for a given period
2. STANDING PLANS - established set of decisions used STRATEGIC MANAGEMENT
by managers to deal w/ recurring or org activities
● Involves an org engaging in strategic planning & then
● Types:
acting on those plans
a. Policy - general guidelines for decision making
● Strategy - comprehensive plan that sets directions
b. Rules - specific actions to be taken in a given
- Broad program for defining & achieving an orgs
situation
objectives; the orgs response to its environment
c. Procedure - contains detailed guidelines for
over time
handling organizational actions that occur regularly
- Comes from greek strategia which means the art or
STRATEGIC VS. OPERATIONAL PLAN
science of being a general

● STRATEGIC PLANNING
● Examines an orgs purpose, mission, philosophy &
goals in the context of its external environment
● Foundation of an organization
● Dictate the important decisions made within a business
● Scopes: ranges 3 years to 10 years
● Top level managers will design & execute strategic
plans paint a picture of the desired future & long-term
goals of the org
● Begins w/ an orgs mission
3. TACTICAL PLAN ● Serves as the framework for lower-level planning
● Require multi level involvement so that each level of
● Support strategic plans by translating them into specific
the org plays a significant role in achieving the goals
plans relevant to a distinct area of the organization
being strategically planned for
● Responsibility & functionality of lower level units within
each departments of a division to fulfill their parts of the SWOT ANALYSIS
strategic plan
● SWOT (identification of strengths, weaknesses,
● What they must do, how they must do it & who is in
opportunities, threats) analysis - management
charge at each level
technique to assess the strengths & weaknesses of an
● Short range/ short-term, specific plans to work toward
organization
goals
○ Strengths - internal attributes that help an
● Steps or tactics needed to achieve the goals defined in
org achieve its objectives
a strategic plan

📖 LECTURE 💡 REMEMBER 14 of 29
 ○Weaknesses - internal attributes that
challenge an org in achieving its objectives
○ Opportunities - external conditions that
promote achievement of org objectives
○ Threats - external conditions that challenge
the achievement of org objectives
STRATEGIC PLANNING TOOL-SWOT
● Forecasting estimates of the future in terms of:
1. External (Environmental Scanning Climate outside
the Organization) looks at Opportunities & Threats
- Socio-economic environment
- Prevailing lifestyle of the people & values
- Changes in government policies (Drug
abuse, devolution)
2. Internal Scanning (looking inward to see what you
have & what you need from the org) checks for
Strength & Weaknesses
- What services to offer
- What kind of cases to be served
- How will quality service be provided
- What is the financial capability of the org
- Human resources availability
- Managerial capability of those who will
manage
SWOT ANALYSIS

📖 LECTURE 💡 REMEMBER 15 of 29
SEPT 22, 2021 Prof. Margarita Santiago ● Plan for utilization of manpower, material * other
resources to cover capital projects in the operating
PLANNING IN THE NURSING SERVICE
programs
FISCAL MANAGEMENT
● Concrete, precise, picture of the total operation of
TIME MANAGEMENT
organization in monetary term
FISCAL PLANNING PURPOSE OF BUDGETING
● Mechanism for translating fiscal objective into projected
● Important but often neglected dimension of planning
monthly spending pattern
● Should reflect the philosophy, goals & objectives of the
● Enhances fiscal planning & decision making
org
● Clearly recognizes controllable & uncontrollable cost
● Skill increasingly critical to nursing managers because
areas
of increased emphasis on finance & big business of
● Offers a useful format for communicating fiscal
healthcare
objectives
FISCAL MANAGEMENT
● Allows feedback of utilization of budget
● Process of planning, organizing, controlling & ● Provides means for measuring & recording financial
monitoring financial resources to achieve org goals & success w/ the objective of the organization
objectives FEATURES OF BUDGETING
● Associated w/ management responsibilities for
● Flexible
expenditures
● Combination of past, present & future
● Working together w/ accounting team under the Chief
● Product of joint venture + co-operation of executives or
Financial Officer
department heads at different levels of management
IMPORTANCE OF FISCAL PLANNING
● In the form of statistical standard laid down in specific
1. Determine the resource needs numerical terms
2. Guide visioning of justification for resources, negotiate for ● Have support of top management throughout the
needed resources period of its planning
3. Analyze expenses IMPORTANCE OF BUDGETING
4. Anticipate, recognize & creativity deal w/ budgetary
● Needed for planning for the future course of action to
problems
have a control over all organizational activities
5. Involvement of group members in fiscal planning
● Facilitates coordinating operation of various
6. Find innovative ways to be more cost effective
department & sections for realizing organizational
BASICS OF FISCAL or FINANCIAL MANAGEMENT
objectives
BUDGETING ● Serves as a guide for action
● Concrete precise picture of the total operation of an ● Helps one to weigh the values & make decision = of a
enterprise in monetary terms greater value in the program than the other
● Device for controlling BUDGETING BASICS
● Major part of the planning process
Nursing Budget - plan for allocation of resources based on
● Powerful tool of coordination
preconceived needs for series of programs to deliver patient
● Effective device of eliminating duplicating & wastage
care during one fiscal year
COST CONTAINMENT
BUDGET PREPARATION
● Effective & efficient delivery of services while
● Estimated cost of nursing activities relative to patient
generating needed revenues
care & includes:
● Measures that keep expenses in check
1. Personnel needed
RESPONSIBILITY
2. Supplies
● Each of an organization’s revenues, expenses, assets
3. Instruments
& liabilities is someone’s responsibility
4. Medical equipment
BUDGET 5. Personnel training
● Must jive w/ the hospital financial plans in terms of the
● Plan that uses numerical data to predict the activities of
volume of operations that the hospital will undertake
an org over a period of time
TYPES OF BUDGETS
● The annual operating plan
● Financial “road map” & plan 1. OPERATING or REVENUE & EXPENSE BUDGET
● An estimate of future costs ● Planning the operation budget requires projections for
volume, revenue & expenses

📖 LECTURE 💡 REMEMBER 16 of 29
● Associated w/ major activities over coming years, ● Represents the planned cash receipts & disbursements
including wages, salaries & compensations ● Money available for immediate use
● Cost of supplies, minor equipment, repair & overhead Project Budgets - associated w/ major projects
expenses STEPS IN BUDGET PLANNING
The Operating Budget - expenses that change in response 1. Assess what needs to be covered in the budget; reflect
to the volume of service input from all levels of the organizational hierarchy
● Ex. cost of electricity, repairs & maintenance & supplies - Review the budget appropriation & actual
Revenue Budget = estimated income expenditure for the current year
Expense Budget = estimated expenses - Manpower, capital & operating expenses are
2. PERSONNEL or MANPOWER computed for each program old & new
● Work-force or personnel budget is the largest of the 2. Analyze the goal or what needs to be accomplished
budget expenditures because healthcare is labor which is to create a cost-effective budget that maximizes
intensive the use of available resources
● Handle fluctuating patient census & acuity managers 3. Develop the plan. A budgeting cycle set for 12 months
need to use historical data about unit census called a fiscal year budget or develop a 1 year period
fluctuation in forecasting short & long term personnel budget broken into monthly periods
needs 4. Implement the planned budget. In this step, ongoing
● Manager must monitor the personnel budget closely to monitoring & analysis occur to avoid inadequate or excess
prevent understaffing or overstaffing funds at the end of the fiscal year.
The Personnel Budget - Top level managers must watch for & correct
● Manpower budget/ Personnel - includes wages & other unrealistic budget projections before they are
benefits provided for regular & temporary workers implemented
● Manager must be aware of patient acuity & staffing mix 5. Budget must be reviewed periodically & modifies as
so that the most economical level of nursing care that needed throughout the fiscal year
will meet patient needs can be provided RESPONSIBILITY OF NURSING ADMINISTRATOR IN
○ Staffing Mix - mis of licensed RN & BUDGET
unlicensed assistive personnel staff ● Participation in planning budget.
working at a given time ● Consult & take assistance of his/her subordinates in
Supplies determining the needs of the unit for the ensuing year
● Personnel costs, supplies are the 2nd most significant on the basis of info received.
component in the hospital budget ● Request sufficient funds to suggest a sound program
● Includes the types & quantities of supplies provision, expansion of program to attract & hold
● Managers must understand b/w supply use & patient qualified staff to provide for expansion of physical
mix, occupancy rate, technology requirement & types facilities.
of procedure being perform in the unit ● To support the budget.
3. CAPITAL BUDGET ● Responsible for budget & should cover the routine
● Consist of accumulated data of fixed assets that are budget control.
expected to be acquired during the budgeted period
● For intensive facilities ex. Building, improvements, TIME MANAGEMENT
replacements & addition to fixed assets etc. ● Making optimal use of available time
● Proposal for capital assets must be accompanied by ● Technique for allocating one’s time through the setting
complete descriptions of the item, reason for purchase of goals, assigning priorities, identifying & eliminating
& classification (a priority or not) wasted time & using managerial techniques to reach
● Plan for the purchase of building or major equipment, goals efficiently
which include equipment that has a long life (usually > ● “Work smarter, not harder”
5 to 7 years) ● Develop a better understanding of ones use of time
● Not used in daily operations, more expensive than would help reduce stress
operating supplies ● Learning to use time & resources wisely requires both
● Includes purchase of land, of considerable expenses & leadership skills & management functions
long life ● If managers are to direct employees effectively &
4. CASH BUDGET maximize other resources, they must first be able to
● Expected cash receipt & disbursements of day to day find the time to do so
operation of the institution KEYS IN OPTIMIZING TIME MANAGEMENT (Homisak,
● Amount of money received 2021)

📖 LECTURE 💡 REMEMBER 17 of 29
1. Prioritizing duties 3. With the use of calendars, executive planners, logs or
2. Managing & controlling crises journals write what you expect to accomplish yearly,
3. Reducing stress monthly, weekly or daily-organized.
4. Balancing work & personal time 4. Breakdown large projects to smaller parts- set priorities.
3 BASIC STEPS IN TIME MANAGEMENT 5. Devote a few minutes at the beginning of each day for
1. Allow time for planning & establish priorities planning - make a list.
2. Complete the highest priority task whenever possible & 6. Close your door when you need to concentrate.
finish one task before beginning another 7. Learn to delegate- technical work can be delegated to
3. Reprioritize based on the remaining tasks & on new info subordinates.
that may have been received 8. Organize your work space so its functional- sort
9. In a meeting, define the purpose clearly before
The truth about time: it is irreversible & irreplaceable.
➢ We can’t save it & use it later starting.-agenda, time schedule
➢ We can’t elect not to spend it 10. Take or return phone calls during specified time.
➢ We can’t borrow it
➢ We can’t leave it or retrieve it
11. Develop effective decision-making skills.
12. Take rest breaks and make good use of your spare time.
*Without adequate planning, the manager finds getting
Reward yourself periodically.
started difficult & begins to manage by crisis
● To prioritize, what needs to be accomplished is to
divide all requests for our time into 3 categories: “don’t
do”, “do later” & “do now”
● 2 mistakes:
1) Underestimating the importance of a daily
plan
2) Not allowing adequate time for
planningTime management should be
proactive, not crisis driven
CRISIS MANAGEMENT
● Allowing time at the beginning of the day to plan will
help reduce the need for crisis management
PERSONAL ORGANIZATION
● Knowing & understanding how & why you use time or
set priorities as you do
● How you waste time
● What types of work you avoid
● What is the best time of day for you to work
● How long you can work before becoming
non-productive
MAKING LISTS
● Remember that lists are planning tools & thus must be
flexible
● Re-examine items that remain on the list day after day.
Perhaps they don’t need to be done or they need to be
broken down into smaller tasks
● Only put as many items on the daily list as can
reasonably be accomplished in a day
● Taking regularly scheduled breaks is important to allow
the worker to refresh both physically and mentally
TIME SAVING TECHNIQUES, DEVICES & METHODS TO
BETTER USE OF TIME
1. Conduct an inventory of your activities. Logging your
activities for one day to know how much time is spent in
each activity.
2. Set goals & objectives & write them down.

📖 LECTURE 💡 REMEMBER 18 of 29
SEPT 22, 2021 Prof. Margarita Santiago 2. DEPARTMENTALIZATION - grouping into
ORGANIZING departments of work activities that are similar &
logically connected
● 2nd step in the management process
3. HIERARCHY - a pattern of multiple levels of an
● Includes formal & informal structure of the organization
● Formal Structure - relationships are defined, organizational structure
procedures are outlines, equipment is readied & tasks 4. DIVISION OF WORK - breakdown of complex task
are assigned into components
● Informal Structure - unplanned & covert, with informal ELEMENTS OF ORGANIZATION STRUCTURE
authority & lines of communication Organizational Design
● 2 or more people who work together in a structured - Determination of the organizational structure
way to achieve a goal that is most appropriate for the strategy,
● Group of people sharing common purpose
people, technology & tasks of the organization
● Body of persons, methods, policies & procedures
6 ELEMENTS:
arranged in a systematic process through delegations
of functions & responsibilities for the accomplishment 1. WORK SPECIALIZATION
of purpose - Tasks are subdivided into separate jobs;
● Includes development of job descriptions by defining division of labor
the qualifications and functions of personnel - Involves having each discrete step of a job
● Building block of an organization done by a different individual rather than
● Arranging of component parts into functioning wholes having one individual do the whole job
ORGANIZATIONS & THEIR GOALS 2. DEPARTMENTALIZATION
ORGANIZATION PURPOSE/ GOAL - Basis by which jobs are grouped together
Business organizations To earn profit
3. CHAIN OF COMMAND
- Unbroken line of authority that extends from
Entity that aims to satisfy people’s
needs for goods, services, ideas &
the top of the organization to the lowest
facilities for optimum profit echelon and clarifies who reports to whom
Government agencies To provide public service
4. SPAN OF CONTROL
- # of subordinates a manager can efficiently &
Religious groups To propagate the faith; To spread effectively direct
the word of God
- # of workers who report directly to a manager
Professional organizations To upgrade the practice of the 5. CENTRALIZATION & DECENTRALIZATION
profession
- Centralization is the degree to which decision
Non-government organizations Various goals depending on making is concentrated at a single point in the
group’s advocacy
organization
International organizations To foster international cooperation - Decentralization is the discretion is pushed
in various fields
down to lower-level employees
Crim syndicates To earn ‘big buck’ through illegal - Centralized Decision making
means
➢ Keeps the power & authority
COMPONENTS OF AN ORGANIZATION concentrated at the top level; there’s
● Goal assembly line/ Division of labor
● Structure ➢ If something happens to a step in the
● Human
task the whole assembly is affected &
● Technology
has to stop
● Physical resources
● Process ➢ Top down communication & decision
● Finance making - there is a poor upward
● Six M’s: Man, Money, Materials, Mission, Methods, communication process
Machines - Decentralization/ Proper Delegation of
4 BUILDING BLOCKS OF ORGANIZATION Authority
1. COORDINATION - integration of the activities of the
separate parts of an organization

📖 LECTURE 💡 REMEMBER 19 of 29
 ➢ Process of conferring specified ● Starts w/ clarifying the chain of command. A clear &
decisions making to the lower levels of distinct line of authority among the position
organization - Need a clear reporting relationship & unbroken line
of authority that extends from the lowest to the
➢ Power & authority as well as
highest position
communication is diffuse throughout the
● Span of management partially dictates whether the
org & problem are solved by the lowest organization is relatively tall or flat
managerial level. Usually, this means - Trend toward flatter organizations
that problems can be solved at the level 4. DISTRIBUTING AUTHORITY - starts w/ delegation
at which they occur ● Authority - power that has been legitimized (approved)
6. FORMALIZATION by the org
- Degree to which jobs within the organization ● Delegation - manager assigns a portion of his/her total
are standardized workload to others
ORGANIZATION PROCESS ● Systematic delegation throughout the og is
decentralization
1. Review the output of the planning process
5. COORDINATING ACTIVITIES
● Vision, Mission ● Linking the activities of the various depts of the orgs
● Goals & objectives ● Depend on each other for information & resources to
● Key Results Area perform their respective activities
● Specific Objectives OTHER ELEMENTS OF ORGANIZING
2. Divide the task into activities that can be performed 1. Setting the organizational structure
by one persons or group 2. Staffing
- Each person or group has a set of activities to 3. Scheduling
perform 4. Developing job descriptions
- Manager to come up w/ a label for each job TYPES OF ORGANIZATION CLASSIFIED BY NATURE
position to describe its main activity OF AUTHORITY
3. Formulate the job description & job specification 1. LINE ORGANIZATION - simplest & most direct
● Job objective - purpose of the job which each position has general authority over the
● Job summary - main functions lower positions in the hierarchy
- Work relationship (to whom the position is 2. INFORMAL ORGANIZATION - horizontal
reporting to); # of subordinates; position being relationship rather than vertical. Composed of small
supervised; coordinating function groups of workers w/ similar interests
4. Group related jobs together in a logical & efficient 3. STAFF ORGANIZATION - purely advisory to the
manner line structure w/ no authority to put recommendations
- Create specialized depts section into actions
5. Establish the relationship b/w the various jobs & 4. FUNCTIONAL ORGANIZATION - each unit is
groupings responsible for a given part of the organization’s
ORGANIZATION PROCESS INCLUDES: workload
1. Identifying & defining basic tasks 3 FORMS OF AUTHORITY
2. Delegation of authority & assigning responsibility 1. LINE AUTHORITY
3. Establishing relationships ● Directs supervisory authority from supervisor to
BASIC ELEMENTS OF ORGANIZING subordinates
1. DESIGNING JOBS ● Chain of Command - unbroken line of reporting
● Job Design - determination of an individual’s relationships that extends through the entire org
work-related responsibilities. The most common form is - Line defines the chain of command & formal
job specialization of division of labor decision making structure
2. GROUPING JOBS ● Unity of Command - each person in the org should
● After jobs are designed, they are grouped into take orders & reports only to one person
departments according to function, product, customer ● Span of Control - # of employees that should be
& location placed under the direction of one leader-manager
3. ESTABLISHING REPORTING RELATIONSHIPS 2. STAFF AUTHORITY

📖 LECTURE 💡 REMEMBER 20 of 29
● Based on the expertise & which involves advising the - Right to act or make decisions w/o approval
line managers of higher administrators
3. TEAM AUTHORITY
● Granted to committees or work teams involved in an ORGANIZATION STRUCTURE TERMINOLOGY
organization’s daily operations ● Hierarchy - body of persons or organized or classified
● Work teams are group of operating employees who in a pyramidal fashion accdg to rank, authority
shared a common vision, goals & objectives assigned to vertical levels w/ offices ranked in grades,
orders or class, one above the other
ORGANIZATIONAL STRUCTURE
● Line Authority - simplest & most direct type in which
● How jobs are formally divided, grouped & coordinated each positions has general authority over the lower
(Robbins, 1998) positions in the hierarchy in the accomplishment of the
● Pattern & groups of jobs in an org main operations of the organization
● Set of building block that can be used to configure an ● Staff personnel - provides advise, counsel or technical
org support that maybe accepted, altered or rejected by the
● Way in which a group is formed, its lines of line officer
communication & means for channeling authority & ● Power - influence another to behave in accordance w/
making decisions one's wishes
● Depicts & identifies role & expectations, arrangement ● Status - rank a group bestows on a person in accord
of positions & working relationships, way a group is w/ the group’s estimations of value & significance
formed, channels of authority, span of control & lines of ● Communication - transmission of info b/w persons
communication ● Centrality - location of a position on an organization
PURPOSE OF ORGANIZATIONAL STRUCTURE chart where frequent & various types of communication
1. Informs members of their responsibilities so they may occur
carry them out ● The middle manager generally has the largest degree
2. Allows the manager & individual workers to concentrate of centrality because information is relayed upward,
on his/ her specific role & responsibilities downward, horizontally & diagonally
3. Coordinates all organizational activities so there is Level Scope of Responsibility Examples
minimal duplication of effort or conflict
4. Reduces the chances of doubt & confusion concerning
Top Level Generally make CEO, President,
assignments Managers decisions with the help V-President, Chief
5. Avoids overlapping of ►few guidelines or Nursing Officer
structure.
6. Shows to whom & for whom they are responsible
7. Improve lines of communication Coordinates internal
8. Create a visual employee directory and external influences

ORGANIZATION STRUCTURE TERMINOLOGY

Middle Level They conduct day-day Head Nurse,
● Span of control - # of people directly reporting to any Managers operations with some Department Head, Unit
one manager & determines the number of interactions involvement, long term Supervisor/Manager
planning and policy
expected of him or her making.
● Line of authority
● Staff authority First Level Concerned with Charge Nurse, Team
Managers specific unit workflows. Leader, Primary Nurse,
● One man, one bass Staff Nurse
● Unity of command Deals with immediate
● Scalar chain day-day problems.

● Accountability - moral responsibility that accompanies

a position
- Taking full responsibility for the quality of ORGANIZATIONAL CHART
work & behavior while engaged in the ● Drawing shows how the parts of the orgs are link
practice of the profession ● Depicts the formal organizational relationship, areas of
● Responsibility - job assignment & must be responsibility & accountability & channel of
accomplished communication
- Obligation to perform the assigned task ● Depicts an organization’s structure
● Authority - official power to act & direct the work of ● Depicts & identifies role & expectations, arrangement
others of positions & working relationships

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● Vertical Charts - most common; CEO at the top w/ DIVISIONAL ORGANIZATIONAL CHART
formal lines of authority down the hierarchy ● Reflects company organized along a product line or
● Left or Horizontal Charts - CEO at left w/ lower level specific geography
managers/ ranks at the right ● Use a divisional set up like this when one division is
● Concentric or Circular Chart - CEO in the center w/ sufficiently independent from another, however this
successive ranks in concentric circles depicts outward kind of structure can also add some accounting & other
flow of formal authority from the top executive & overhead
supposedly reduce status implication FLAT ORGANIZATIONAL CHART
ADVANTAGES OF THE ORGANIZATION CHART ● Remove hierarchical layers by flattening the scalar
1. Maps line of decision-making authority chain & decentralizing the org
2. Helps people understand their assignments & those of ● Continue to have line authority, but because the org
their coworkers structure is flattened, more authority & decision making
3. Reveals to managers & new personnel how they fit into can occur where the work is being carried out
the organization ● Despite being very flat, often retain many
4. Contributes to sound organizational structure characteristics of a bureaucracy
5. Shows formal lines of communication PRINCIPLES OF ORGANIZING
DISADVANTAGES OF THE ORGANIZATION CHART 1. Unity of Command - accountable to only one superior
1. Does not show the informal structure of the organization 2. Scalar Principle or Hierarchy - chain of command,
2. Does not indicate the degree of authority held by each authority should flow in clear unbroken lines form the
line position highest to the lowest
3. May show things as they are supposed to be or used to 3. Departmentation or Homogenous assignment -
be rather than as they are workers doing similar assignments are grouped together for
4. Possibility exists of confusing authority with status a common purpose
5 MAJOR CHARACTERISTICS OF AN 4. Span of Control - # of people directly reporting to any
ORGANIZATIONAL CHART one manager & determines the number of interactions
1. DIVISION OF WORK - each box represents the expected of him or her
individual or sub-unit responsible for a given task - Span of managerial responsibility & the number
2. CHAIN OF COMMAND - lines indicate who reports which on superior can assist, teach & help to reach
whom & by what authority objectives of their own jobs
3. TYPE OF WORKED TO BE PERFORMED - labels or 5. Exception Principle - recurring decisions should be
description for the boxes handled in a routine manner by lower managers whereas
4. GROUPING OF WORK SEGMENTS - shown by the problems involving unusual matters should be referred to
clusters of work groups (department or single units) higher levels
5. LEVELS OF MANAGEMENT - individual & entire 6. Decentralization or Proper delegation of authority -
management hierarchy conferring specified decision making to lower levels
ORGANIZATION CHARTS DEFINES FORMAL ELEMENTS OF ORGANIZATION STRUCTURE
RELATIONSHIPS Organizational Design - determination of the
1. Formal relationships, lines of communication & authority organizational structure that is most appropriate for the
are depicted on a chart by unbroken (solid) lines strategy, people, technology & tasks of the organization
a. Line positions as horizontal or vertical lines ORGANIZATIONAL DESIGN DECISIONS
i. Solid Horizontal Lines - communication 1. Managers decide how to divide the overall task into
b/w people w/ similar spheres of successively smaller jobs
responsibility & power but different 2. Managers decide the bases which to group the job
functions 3. Managers decide the appropriate size of the group
ii. Solid Vertical Lines reporting to each superior
b. Dotted or broken lines 4. Managers distribute authority among the jobs
MATRIX ORGANIZATIONS Job Description
● Focus on both product & info Organizing is developing job description
● Have formal vertical & horizontal chain of command ● Job Description - general tasks or other related duties
● Fewer formal rules & fewer levels of the hierarchy & responsibilities of a position
● Can cause slow decision making due to info sharing ● Content:
● Can produce confusion & frustration for workers a. Specify to whom the position reports
because of dual-authority hierarchical

📖 LECTURE 💡 REMEMBER 22 of 29
 b. Specifications such as the qualifications or skills
needed by the person in the job
c. Information about the equipment, tools & work aids
used
d. Working conditions
e. Physical demands
ORGANIZATIONAL CULTURE
● System of symbols & interactions
● It’s their way of life in that org
● Sum total of values, language, past history of “sacred
cow,” formal & informal communication networks &
ritual of an organization
● Differs from organizational climate (how individuals
perceive the organization)
● Basic mission of an org is part of its culture:
employment, service, learning & research
● There is a technical or operating arm for getting the
work done
● Administrative arm that covers wages & salaries,
hiring, firing & promoting, report making & quality
control, fringe benefits & budgeting
● Dress, personal appearance, social decorum &
physical environment
● Culture is created by such rites & rituals as casual
days, where workers wear jeans & sport shirts to
create an atmosphere of creativity & friendship
● Often confused w/ organizational climate - how
employees perceive an org
- Perception may be accurate or inaccurate
& people in the same organization may
have different perceptions about the same
org
ORGANIZATIONAL CLIMATE
● Emotional state shared by members of the system
● Can be formal or relaxed, defensive, cautious,
accepting, trusting etc.
● It is employee subjective impression or perception of
their organization
● Nurses wants a climate that will give them job
satisfaction, their achievement recognize & appreciated
by the managers
ORGANIZATIONAL DEVELOPMENT
● Changing the work environment to make it more
conducive to worker satisfaction & productivity
● Allows managers to attend to the psychological as well
as physical aspects of org
● Emphasizes personal growth & interpersonal
competence

📖 LECTURE 💡 REMEMBER 23 of 29
OCT 06, 2021 Prof. Margarita Santiago 2. Forecasting - ….
3. Job analysis - job description & job specification
STAFFING
- Study of a position to determine what
● Primary goal when organizing patient care: delivering knowledge, skills, aptitude & personal
safe & quality nursing care using available resources characteristics are needed to perform
effectively certain responsibilities = basis of job
... evaluation
PRINCIPLES OF STAFFING - 2 Phases of Analysis:
● Patient needs should determine clinical competencies 1) Job description - position
● Nurses need management support description
● Nurses need representation at both operational & 2) Job specification - who should
executive levels qualify for the job
● Less experienced registered nurses need clinical 4. Policy & program plan
support from experienced nurses ● Total # of nursing personnel in the institution & each
● Organizational policy reflects valuing of employees unit by job category
● Documented competencies should be available for ● Percentage of personnel in each job category w/ BSN,
staff Master’s degree, Doctoral & specialist Certification
● Organizational policies should recognize both patients ● Percentage of personnel in each job category in 20-35;
& staff 35-50 & 50-65 years age group
FACTORS AFFECTING STAFFING ● Number of personnel in all job categories who are
1. Type, philosophy & objectives currently enrolled in college courses & who attended
2. Population served whether pay or charity continuing education or staff dev’t courses during the
3. Number of patients & severity of their illness; knowledge previous year
& ability of nursing personnel are matched w/ the actual ● Annual percentage of personnel turnover by job
care needs of patients category for the total nursing dept & each nursing unit
4. Availability & characteristics of the nursing staff ● Average length of employment for personnel in each
(education, level of preparation, mix of personnel, number & job category, for the total nursing dept & each nursing
position) unit
5. Administrative policies such as rotation, weekends & ● Average rate of absenteeism, by job category, for the
holiday off-duties total nursing department & each nursing unit
6. Standards of care desired which should be available & ● Percentage of nursing staff who live within the agency’s
clearly spelled out. Institutions may utilize the ANSAP’s immediate vicinity
Standard of Nursing Practice; PRC-ANSAP’s Standard of B. EXECUTION
Safe Nursing Practice &/or the hospitals themselves may 1. Recruitment - seeking ….
formulate/ develop their own standards 2. Selection - selecting an applicant & placing him/her in a
7. Layout of the various nursing units & resources available specific job….
within the department such as adequest equipment, 3. Replacement - selecting & putting the right person to the
supplies & materials right job
8. … 4. Training - using guided experience to change
9. Professional activities & priorities in non patient activities employee’s behavior & attitudes
like environment in professional organizations, formal 4. Staff Development - in-service training & education
educational dev’t, participation in research & staff dev’t among personnel (orientation, documentation, etc)
10. Teaching programs or the extent of staff involvement in - Includes all training …
teaching activities - Goal: ….
11. Expected hours of work per annum of each employee. Development Activities - influence a worker’s through all
This is influence by the 40-hour week law stages of adult dev’t
12. Pattern of work schedule 1. Induction Training - brief indoctrination to agency policy
a. Traditional 5 days per week; 8 hours per day purpose, mission/ vision during first 2 to 3 days of
b. 4 days a week, ten hours per day employment
c. 3 days off or 3 ½ days of 12 hours per day & 3 ½ 2. Orientation - assimilate to the workforce
days off per week Objectives:
PARTS OF STAFFING a. Acquaint with existing work environment to relate
A. PLAN effectively to his new environment
1. Human Resources - manpower needed for the job

📖 LECTURE 💡 REMEMBER 24 of 29
 b. To feel wanted & accepted by co-workers & ● FOr job placement, transfer & dismissal
supervisors ● Aid in evaluating the performance of an employee
c. Enable to cultivate an attitude that will provide ● For budgeting purposes - salaries are equated w/ the
optimum satisfaction in his relationship w/ other levels of responsibilities & skills as defined in the JD
personnel ● For classifying levels of nursing functions according to
d. Develop an understanding of her role in the unit & skill level requirement
in the accomplishment of the institutional goal ● Identify training needs
Sample Checklist: ● As a basis for staffing
● Information or Activity ● Serve as channels of communication
- History of org
- Vision, purpose NURSING CARE DELIVERY SYSTEM
- Structure of organization ● Modes of Nursing Care Delivery - organizes the work
- Payroll information of caring for the patient
- Tour of facilities - Manner in which nursing is organized & provided
- Introduction to unit heads & purposes of - Depends on:
departments - Philosophy….
- Employee & organizational responsibilities, rules of ● Choosing the most appropriate org mode to deliver
conduct patient care for each unit or org depends on the:
- Fire & safety videos 1. Skill & expertise of the staff
- Personnel policies 2. Availability of registered nurses
- Tour of unit 3. Economic resources of the organization
- Introductions to unit personnel 4. Acuity of the patients & the complexity of the tasks
- Work schedules, staffing , scheduling policies to be completed
- Cardiopulmonary resuscitation recertification ● Nursing care delivery models describes:
- Universal precautions update 1. Which health care worker is going to perform what
- Workload assignments tasks
3. Internship 2. Who is responsible
● Provide to nurses who are hired immediately after 3. Who has the authority to make decisions
graduation to prevent “reality shock” experienced by 5 Primary Means of Organizing Patient Care Delivery
them 1. TOTAL PATIENT CARE or CASE METHOD NURSING
● Provided the nurses with emotional support…. ● Assignment of 1 nurse to 1 patient for total care
● Kramer (1974) - reality shock as the conflict b/w a ● Patient care is more efficient & there is less confusion
new graduate’s expectations of the nursing role & the about responsibilities
reality of the actual role in the work setting ● Oldest mode
● Preceptors - Preceptory System - Buddy System ● Nurse assume total responsibility for meeting the
➢ Newly hired staff is paired w/ an experienced nurse needs of all assigned patients during their time on duty
in the same level ● One nurse attends to all patient’s need during the shift;
➢ Based on adult education principle that a role model there is consistency of q nursing caring for the entire
shapes a learner’s behaviour shift
➢ Active …. ● More time to observe & monitor progress of patient
4. In-service Education - all job instruction that is… ● Common ICU/ PICU/ PACU
5. Continuing Education - planned learning activities
beyond the basic nursing education program that are
designed to provide knowledge & skills….
6. Management Training - program to augment the
management skills for the individual to make accurate
analysis, produce sound decision & take effective action
when confronted by orgs problems
7. Organization Development - improving the process by
Advantages
which employees interact to achieve organizational goals…
● Consistency in carrying out the NCP
● Patient’s needs are quickly met as high number of
Uses of Job Description
nurse hours are spent on the patient
● Recruitment & selection of qualified personnel
● Orient new employees to their job

📖 LECTURE 💡 REMEMBER 25 of 29
● Relationship based on trust is developed b/w the nurse
& the patient’s family
● More opportunity to observe & monitor progress of the
patient
Disadvantages:
● Very costly
● May look at the patient on a shift-by-shift basis rather
than on a continuum of care
2. FUNCTIONAL NURSING Advantages:
● Evolved as a result of WWII ● Each member’s capabilities are maximized so job
● 1950’s emphasis on an assembly line style of satisfaction…
management that focuses on division of labor specifics
& tasks that need to be completed 4. MODULAR NURSING
● Uses relatively unskilled workers who have been ● Modification of team & primary nursing
trained to complete certain tasks ● Geographic assignment of patients that encourages
● Care is assigned by task or assignment by function continuity of care by organizing a group of staff to work
rather than by patient w/ a work of patients in the same locale
● Task oriented system ● Clients are grouped by a floor plan, happens a lot in
● Function under a autocratic system w/ concentration of ED’s
workers & cost ● Uses smaller group of staff providing care for a smaller
● Responsibility rests w/ the nurse manager for group of patients
coordinating & supervising all activities & responsible ● Pairs professional nurse w/ ancillary staff to deliver
for making work assignments care to group of patients
● Roles such as those of medication nurse & treatment ● Focuses on the patient’s geographic location for staff
nurse are part of the functional delivery approach assignments
● Used during 1980s and 1990s
5. PRIMARY CARE NURSING
● Requires an all RN nursing staff
● RN primary nurse assumes 24 hour responsibility for
planning the care of one or more patients from the start
of treatment to discharge
● During work hours, the primary nurse provides direct
care for those patients
● Continuous & coordinated in which RN provides initial
Advantages: patient care assessment & assumes accountability for
● No role confusions because one knew what he is doing planning & comprehensive 24 hour care for the length
● Method that is efficient & cheap of hospitalization or the duration of care needed
Disadvantages: ● May not be applicable in the Philippine setting, This
● Lack of continuity of care need a nurse clinician who will be giving nursing orders
● Patient client does not get much individual attention
● Care of patients become fragmented & depersonalized
● Patients do not have one identifiable nurse
● Very narrow scope of practice for nurses
● Leads to patient & nurse dissatisfaction
3. TEAM NURSING
● Professional, technical, ancillary are grouped together
& work within certain number of patients Advantages:
● Plan of care in which group of nursing personnel are ● Patient & families are able to develop a trusting
lead by a qualified nurse to plan, direct & evaluate the relationship w/ the nurse
delivery of care to a group of patient ● Defined accountability & responsibility for the nurse to
● System focuses on total patient care develop a plan of care w/ patient & family
● Includes the patient in the planning process ● Holistic approach of care
● Adapt & recognizes & uses members talents, abilities & ● Increased satisfaction for patients & nurses
interest to the fullest extent ● More professionals system

📖 LECTURE 💡 REMEMBER 26 of 29
Disadvantages:
● High cost
● Only confines a nurses’ talents to a limited number…

CASE MANAGEMENT NURSING

● Collaborative process that assess, plans, implements,
coordinates, monitors & evaluates options & services
to meet an individual’s health needs through
communication & available resources to promote
quality, cost-effective outcomes
● Coordinates care throughout an episode of illness
● Focus is on individual clients, not populations of clients

Care Managers
● Handle each case individually
● Identifying the most cost-effective providers, treatments
& care settings for insured individuals
● In planning patient care, they do critical pathways &
multidisciplinary action plans
● Multidisciplinary Action Plans - combination of a
critical pathway & NCP
- Indicates times when nursing interventions
should occur

📖 LECTURE 💡 REMEMBER 27 of 29
OCT 13, 2021 ● Family complaints
● Injuries to patients
SCHEDULING ● Long length of stay
GUIDELINES ● Patient complaints
1. Ensure equal distribution of manpower base on patient ● Patient falls
care needs ● Postoperative infections
2. Fair distribution of off-days NURSE-SENSITIVE INDICATORS
3. Personnel should maintain a record of their schedule ● Should be considered in determining staff adequacy:
4. When conflict arise, patient care is the priority ❖ Nursing hours per patient-day
5. Adherence to established rotation ❖ Use of on-call or per diem personnel
6. Establish written policies on “request” for offs, vacation ❖ Overtime
leave & others ❖ Sick time
7. Schedule should be posted at least one week before ❖ Staff satisfaction
8. Schedule should conform w/ all the Labor Laws & ❖ Staff turnover rate
hospital policies ❖ Staff vacancy rate
9. Provide good staffing mix ❖ Failure to achieve the levels in the institution’s
10. Ensure teamwork among the staff staffing plan
TYPES OF SCHEDULING STAFFING FORMULAS
1. Centralized ● Determine the number of staff to hire, one must
2. Decentralized consider:
3. Cyclical - covers a designated period of time (2 months ❖ Hours for which coverage is required
or monthly) w/ a certain length & sequence of duties ❖ Vacations
● Advantages: ❖ Holidays
➢ Fair to all ❖ Absenteeism
➢ Saves time ❖ Staff development time
➢ Enables employees to planned ahead for their STAFFING FOR PATIENT SAFETY
personal needs ● Appropriate staffing is a match of RN expertise w/ the
➢ Leave is more stable needs of the recipient of nursing care services in the
➢ Productivity is improved context of the practice setting & situation (ANA, 2012)
4. Block System - staff are grouped together. Whole team ● Appropriate # & mix of nursing staff at all times
rotates in the staffing process
Safe staffing result in:
SAMPLE STAFFING & SCHEDULING OPTIONS
○ 10 or 12 hour shifts Fewer hospital-acquired infections Reduces hospital costs
○ 8-hour shifts
Reduces nurse fatigue Improves patient satisfaction
○ Job sharing
○ Flex time Decreases nurse turnover Increases nurse productivity
○ Self-scheduling DEFINITION OF TERMS:
○ Part time
● Staffing pattern - written plan that specifies the # of
○ Per diem
classification type of staff personnel who are needed to
○ Premium pay for weekend only
implement a care delivery model for each unit
○ External registry or agency staffing
- Number & mix of personnel that should be on duty
○ Travel nursing
per each unit per shift per day
● Flex Time - allows employees to select the time
● Staffing plan - how many persons of what job
schedules that best meet their personal needs while
classification should be on duty per each unit per shift
still meeting work responsibilities
- # of nursing personnel must be hired to deliver
EXAMPLES OF STAFFING STANDARDS
nursing care on the nursing units
● Inpatient units: NCH/PPD - To provide adequate numbers of the right mixture of
● Surgery: minutes per case nursing personnel to give proper care to patients
● Emergency departments: total visits housed in the unit at a particular time.
● Labor & delivery: # of births ● Average Daily Census - average total # of patients ….
● Home health agencies: visits per month ● Skill Mix
NEED FOR BETTER STAFFING ● Patient Acuity - how patients are categorized accdg to
● Adverse drugs reactions an assessment of their nursing care needs

📖 LECTURE 💡 REMEMBER 28 of 29
 - Critical factor in determining safe staffing ● Nursing Care Hours:
- Patient classification system are tools used to ○ Needed per PT per Day: 4.5
determine staffing ○ Ratio of Prof to Non-Prof: 65:35
4. Level 4: Highly Specialized Critical Care
PATIENT CARE SYSTEM ● Patients need continuous treatment & observation.
PURPOSE OF PCS Vital signs every 15-30 mins
● Staffing - system will establish a unit of measure of ● …
nursing: TIME ● Nursing Care Hours:
● Budgeting- unit of time will be used to determine the ○ Needed per PT per Day: 6-7 or higher
cost of nursing services... ○ Ratio of Prof to Non-Prof: 70:30; 80:20
COMPONENT

PATIENT CARE NEEDS:

a.
b. Indirect or administrative care
c. Health teaching

Patient Classification Categories:

1. Level I: Self Care or Minimal Care
● ADL = Patient can take a bath on his own, fed himself
& perform his daily activities of daily living
● General health
- Patients about to be discharged, those on
non-emergency, newly admitted, do not exhibit
unusual symptoms & requires none or simple
medication, little treatment/ observation and/ or
instruction
- Teaching-routine for simple procedures or
discharge teaching
● Nursing Care Hours:
○ Needed per PT per day: 1.5
○ Ratio of Prof to Non-Prof: 55:45
2. Level II: Moderate Care or Intermediate Care
● Patient who need some assistance in bathing, feeding
or ambulating for short periods of time
● Patient may have slight emotional need, w/ vital signs
3x per shift, require monitoring q 1hr for continuous
monitoring
● Extreme symptoms of illness must have subsided or
have not appear or impending
● Needs 10-30 mins. A shift for teaching or emotional
support
● Tx & medication requires 30-60 min a shift, requires
observation q 1h for mental status
● Nursing Care Hours:
○ Needed per PT per Day: 3
○ Ratio of Prof to Non-Prof: 60:40
2. Level III: Total Complete or Intensive Care
● Patients are completely dependent upon the nursing
personnel. They are provided a complete bath, are fed,
may or may not be unconscious. Vital signs more than
3x/shift
● Require close observation at least 30 mins for
impending hemorrhage w/ hypo or hypertension

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