MANAGEMENTNCM 105

2010

MANAGEMENT

Comes from old French term “MENAGEMENT” “the directing”

From Latin word “mau agere” “ to lead by the hand”

The process of leading and directing all or part of an organization through the manipulation of resources

One role of leadership Emphasize control

MANAGEMENT

PROCESS of: working with and through others to achieve organizational

objective in a changing environment Obtaining and organizing resources and of achieving

objectives through other people Getting work through others

Planning, directing, coordinating and controlling, including: Leadership Giving direction Developing staff Monitoring operations Giving rewards Representing both staff and administration as needed

MANAGEMENT

The process of: Coordinating action Directing action Assigning resources

Purpose: to perform the tasks in order to achieve the objectives/desired outcomes of an organization

NURSING MANAGEMENTThe process of working through nursing staff members to provide care, cure and comfort to patients

MANAGERS

HAVE: Assigned position within the formal organization Legitimate source of power due to delegated authority that

accompanies their position Greater formal responsibility and accountability for rationality

and control Are expected to carry out specific functions, duties

and responsibilities Emphasize control, decision making and analysis, and

results Manipulate people, the environment, money, time and

other resources to achieve organizational goals Direct willing and unwilling subordinates

MANAGEMENT THEORIES

SCIENTIFIC MANAGEMENT (1900 – 1930)

Frederick W. Taylor – father of scientific management “if workers could be taught the “one best way to accomplish a

task “ productivity would increase Principles:

Traditional “rule of thumb” means of organizing work must be replaced with scientific method

Scientific personnel system must be established so that workers can be hired , trained, and promoted based on their technical competence and abilities

Workers should be able to view how they “fit” into the organization and how they can contribute to overall organizational productivity

The relationship between managers and workers should be cooperative and interdependent, and work should be shared equally

MANAGEMENT FUNCTION

HENRI FAYOL (1925) Identified management function of:

Planning Organizing Command Coordination Control

MANAGEMENT FUNCTION

Luther Gulick (1937) “seven activities of management” POSDCRB

Planning organizing Staffing Directing Coordinating Reporting Budgeting

HUMAN RELATIONS MANAGEMENT(1930-1970)

Mary Parker Follett: Participative Management Participative decision making Managers should have the authority with, rather than

over, employees Elton Mayo (1953): Hawthorne effect

Indicated that people respond to the fact that they are being studied, attempting to increase whatever behavior they feel will continue to warrant the attention

Informal work group and socially informal work environment were factors in determining productivity

Recommended more employee participation in decision making

THEORY X AND THEORY Y

DOUGLAS McGREGOR Theory X: managers believe that their

employees are: Basically lazy Needs constant supervision and direction Indifferent to organizational needs

Theory Y: managers believe that their workers: Enjoy their work Are self-motivated Are willing to work hard to meet personal and

organizational goals

EMPLOYEE PARTICIPATION

CHRIS ARGYRIS (1964) Stress the need for flexibility within the

organization and employee participation in decision making

MANAGEMENT THEORY

THEORIST THEORY

Taylor Scientific management

If person can be taught the one best way to accomplish a task, productivity will increase

Weber Bureaucratic organizations

Need for legalized, formal authority, and consistent rules and regulation for personnel in different position

Fayol Management functions

Planning, organizing, command, coordination, control

Gulick Activities' of management

Planning, organizing, staffing, directing, coordinating, reporting, budgeting

Follet Participative management

Managers should have the authority with rather than over employees

MANAGEMENT THEORY

THEORIST THEORY

Mayo Hawthorne effect People respond to the fact that they are being studied, attempting to increase what ever behavior they feel would warrant attention

Mc Gregor Theory X and theory Y

Employees are basically lazy, needs constant supervision and direction indifferent to organizational needsEmployees enjoy their work, self motivated and willing to work hard to meet personal and organizational goals

Argyris Employee participation

Employees participation in decision making

LEVELS OF MANAGERSLEVEL RESPONSIBILITY

TOP MANAGERS Responsible for the overall operations of nursing services, establish objectives, policies, and strategiesRepresents the organization in community affairs, business arrangement and negotiationsTypical titles: director of nursing service, chairman,, executive vice president

MIDDLE MANAGERS

Coordinate the nursing activities of several units;Receives broad, overall strategies and policies from top manager and translate them into specific objectives and programs, typical titles; supervisor, coordinator, clinical nurse managers and case managers are included at this level as they use collaborative management to move patient’s through the system

FIRST-LINE MANAGERS

Directly responsible for the actual production of nursing service; act as links between higher level managers and non-managersTypical titles: nurse manager, team leader, primary care nurse

ROLE OF MANAGERS

ROLE DESCRIPTION

INTERPERSONAL The manager :1. As a symbol because of the position he/she

occupies2. As a leader who hires, trains, encourages,

fires, remunerates and judges3. As a liaison between outside contact such as

community, supplier and organization

INFORMATIONAL

DECISIONAL

The manager1. As one who monitors information2. Disseminate information from both external

and internal sources3. As spokesperson of the organization1. An entrepreneur or innovator, problem

discoverer, designer to improve projects that direct and control change in the organization

2. Trouble shooter3. Negotiator when conflict arise

SIMILARITIES & DIFFERENCES BETWEEN LEADERS AND MANAGERS

LEADERS May or may not have

official appointment to the position

Have power and authority to enforce decisions only as long as followers are willing to be led

Influence others towards goal setting

Interested in risk taking and exploring new ideas

MANAGERS Appointed officially to the

position

Have power and authority to enforce decision

Carry out pre-determined policies, rules, and regulations

Maintain an orderly, controlled, rational, and equitable structure

SIMILARITIES & DIFFERENCES BETWEEN LEADERS AND MANAGERS

LEADER Relate to people

personally in an intuitive and empathic manner

Feel rewarded by personal achievements

MANAGER Relate to people

according to their roles by enabling others to act

Feel rewarded when fulfilling organizational mission or goals by fostering collaboration

SIMILARITIES & DIFFERENCES BETWEEN LEADERS AND MANAGERS

LEADER May or may not

be successful as managers

MANAGERS Are managers as

long as the appointment holds

EFFECTIVE LEADERSHIP & MANAGEMENT

Understanding of individual strengths, weaknesses, and potential

+Knowledge of basic ingredients for leadership

and management+

Learning from other people and experiences+

Systematic use of self to get the right things done at the right time

DECISION MAKING

DECISION MAKING

The process of establishing criteria by which a leader can develop and select course of action from a group of alternatives One of the criteria on which management expertise is

judged The innermost leadership activity and the core of

management Choosing a particular course of action Triggered by a problem, but is handled in a manner that

does not focus on eliminating the underlying problem May or may not be the result of a problem Considered as a critical thinking process just like problem

solving

Characteristics of Decision Making Not linear or totally logical process, may

involve intuition Often the result of many incremental

steps rather than one large steps Smaller choices may be impacted by

many factors other than rationality and analytical thought (Sullivan & Decker, 1992; Little-Stoetzel, 2003)

Characteristics of Successful Decision Makers

Learn to emphasize the tools and techniques that help make decision-making effective and efficient

Minimize the technique or events that can sidetrack the critical thinking/decision making process

Ability to engage in critical thinking

CRITICAL THINKING

Analyzing the way one thinks Must be incorporated into all steps of problem solving and

decision making EFFECTIVE CRITICAL THINKERS

Constantly generate new ideas and alternatives Do not rely on “we’ve always done it this way” Able to step back from issues and analyze its component

Often ask: What are the underlying assumptions of this point of view? Where does the evidence come from and how is it being interpreted? How does the logic and argument hold together?

Can discern the quality of information that underlies ideas, whether it is: Precise, accurate, relevant, consistent, logical, complete, and unbiased

Able to assume another person’s perspective or point of view in order to see all sides of an issue

Strategic Steps in Decision Making Identify need for decision

Consider: What needs to be determined Why a decision is needed All information available State issues in broader term rather than

narrower term

Determine desired goal or outcome Goal should be:

Clear and specific Stated in a sentence or two

Strategic Steps in Decision Making Identify any other actions that exist.

For each alternative action, identify: Possible consequences Possible benefits

Decide which action to implement, based on each action’s benefits and consequences

Evaluate the action by asking: Was the goal achieved completely or partially Was the goal not achieved

Steps in Managerial Decision Making Models

Determine the importance and context of the decision Consider possible consequences of the decision

Determine the objective for the decision List all options Explore promising options Establish decision making criteria Evaluate the options against criteria Select option to pursue Analyze the risk

IDEALS MODEL

Identify the problem Define the context Enumerate the choices Analyze options List reasons explicitly Self correct

Critical Elements in Decision Making

Define objective clearly Decisions with out clear objective, poor

quality lesion is likely Gather data carefully Generate many alternatives Think logically Choose and act decisively

Decision Making Tools

Decision Grids Allows one to visually examine the

alternatives and compare each against the same criteria

Alterantives

Financial effect

Political effect

Departmental effect

Organizational effect

time

1

2

3

Decision Making Tools

Decision Tree Consequence Tables

List the objectives for solving a problem down one side of a table and rates how each alternatives would meet the desired objective

Payoff Tables Have a cost-profit-volume relationship One must determine probabilities and

historical data such as: Hospital census Report on numbers of operating procedures

performed

Decision Making Tools

Logic Models Schematics or pictures of how program are intended to operate Includes:

resources Processes Desired outcomes

Depicts exactly what the relationship are between the 3 components

PERT – Program Evaluation and Review Technique A popular tool to determine the timing of decisions Developed by Booz-Allen Hamilton organization and the US

navy in connection with the Polaris missile program A flow chart that predicts when events and activities must take

place if a final event is to occur

Conditions that may Affect Decision Making Conditions of CERTAINTY

Alternatives and existing conditions are well known Decisions can be made with full knowledge of what the

outcome will be

Conditions of RISK Alternative and conditions are not very well known Decision outcomes can only be expressed as probability

rather than certainty Different levels of probability

Objective probability = like hood that an event will or will not occur based on the facts and reliable information

Subjective probability = like hood that an event will or will not occur based on a leader’s personal judegement or belief

Conditions that may Affect Decision Making Conditions of UNCERTAINTY

Alternatives and conditions are complex and variable Person making the decision may not be even aware of all possibilities Decision making may be occurring in a rapidly changing environment Decision outcome cannot be expressed even as probability

3 approaches for dealing with UNCERTAINTY Maximax approach –most optimistic

Select alternative with best possible outcome for all alternatives Maximin approach – most pessimistic

Choose the worst possible outcome for each possible alternative then choose the least objectionable worst outcome

Minimax approach /Risk averting approach Select the alternative that has the fewest variable among its possible

outcomes Considered as highly effective

DECISION MAKING WITHIN GROUPS Group decisions must include the stakeholders

persons who will be affected by the decision

Advantages of group decision making: More people involved More input and feedback More stake holders who can “buy in” to decisions and

outcome and support group’s decision Disadvantages:

Time consuming Can lead to increased conflict and sabotage of the

group’s decision

Methods of Group Decision Making CONSENSUS building

All group members can live with and fully support the decision Consensus does not mean that everyone agrees, it just mean that they can live

with it Advantage – greater support for decision made Disadvantage s:

Time needed for decisions People wanting to block a decision can use consensus to delay decisions

NOMINAL group technique Nonverbal technique in which group members write out their ideas Ideas and their pros and cons are presented on a flip chart or board Group discusses ideas and puts them into a private vote; highest rating wins

DELPHI group technique Group members receive questionnaires Results are summarized and redistributed Process of questions followed by summary continues until group reaches

concensus

Do’s and Don'ts of Decision Making

Make only decision that are yours to make

Write notes and keep ideas visible about decisions to utilize all relevant information

Write down pros and cons of an issue to help clarify our thinking

Makes decision as you go along rather than letting them accumulate

Consider those affected by the decision

Trust your self

Make snap decision Waste your time making

decisions that do not have to be made

Consider decision a choice between right and wrong but a choice between alternatives

Prolong deliberation about decisions

Regret a decision Always base decision made on

the “way things have always been done”

DO DON’T

Group Work

Situation: A visiting policy may allow only one family

member to be with a patient at a time. However, the patient is 15 years old and his single mother is with his 10 year old brother because she did not have anyone else to stay with the younger boy

What would be the desired goal What are the things to be taken into

considerations

DECISION MAKING

Goal: To decide if making an exception to hospital policy is in

this patient’s best interest Determine if the hospital’s goal concerning patient care

and privacy can be met if an exception to the policy is allowed

Pros and cons Benefit :

allowing the brother is additional support for the patient since he and the brother are close

Not having a 10 year old boy by himself in a waiting area Consequence:

Possible loss of privacy and inconsistency with other patient’s visitors

DECISION MAKING

Actions to implement based on pros and cons Depending on liability and other issues nursing staff may:

Rank issues of consistency with all other visitors and privacy for other patient in the room higher or

Staff may decide that patient comfort and keeping the family together higher

Evaluate If the decision was to allow the visitor

Did having the brother’s presence make the patient less anxious

Did it not seem to make a difference Did having the brother makes the patient more anxious