DIRECTING 5.

coordinate to prevent duplication of effort

6. solve problem and develop new ideas
Directing – link bet. ORGANIZING WORK and getting WORK DONE 7. accept delegation as desirable
- Issuance of assignments, orders, instructions for understanding, 8. specify goals and objectives
guidance and overseeing for effective and efficient attainment of job. 9. know subordinates capabilities and match task to employee
- FUNCTION: implement plans to meet objectives of the org. 10. agree on performance standards
11. take an interest
MANAGEMENT DIRECTION – geared towards: 12. assess results
1. REGULATORY responsibilities – unit is functioning well 13. give appropriate rewards
2. CORRECTIVE responsibilities – manager corrects the wrong 14. do not take back delegated tasks
3. PREVENTIVE responsibilities – prevents something untoward situations to
happen. DON’T DELEGATE
4. PROMOTIVE responsibilities – managers sees to it that KAS of employees 1. responsibility for disciplining an immediate subordinate
is updated (ex. Seminars) 2. responsibility for handling morale problem within the unit
3. anything for which he has legal responsibility – “HOT POTATO”
Accdg. To ZALEZNICK (3 EXECUTIVE FUNCTION) 4. jobs that are too technical
1. HOMEOSTATIC – balance 5. duties involving trust and confidence
2. MEDIATIVE – mediator
3. PRO-ACTIVE – actor; initiate things; make things happen GUIDELINES FOR EFFECTIVE DELEGATION
1. give clear description
CONCEPT OF DIRECTING 2. share with the employee the outcome you expect
1. DELEGATING – assigning responsibility or authority 3. discuss the degree of responsibility and authority that the employee
- giving directions –Clean will have
- Concise 4. ask the employee to minimize the main points of the task that has been
- Consistent delegated
- Conform to req. to situation
2. LEADING – inspire and influence others BARRIERS IN THE DELEGATOR
3. MOTIVATING – stimulate the behavior of employees to identify needs to 1. preference for operating by oneself
attain goals 2. demand that everyone “know all details”
4. SUPERVISING – overseeing work of others 3. “I can do it better myself”
- concerned with training and discipline of the workforce 4. lack of experience in delegating
5. COORDINATING – synchronizing people / activities 5. insecurity
6. COMMUNICATING – What? Why? How? By whom of directives? 6. fear of being disliked
7. COLLABORATION – working together 7. refusal to allow mistakes
8. lack of confidence in subordinates
DELEGATION – assigning parts or all responsibilities to another person 9. perfectionist; leading to excessive control
- use of personnel to accomplish a desired objective
- sharing responsibility & authority to subordinates & holding the BARRIERS IN THE DELAGATEE
accountability for the performance 1. lack of experience
PURPOSE: promote internalized motivation and job enrichment 2. lack of competence
– cost saving 3. avoidance of responsibility
- time saving (do 2 works at a time) 4. overdependence on boss
- growth of employee 5. disorganization
- growth of manager 6. overload of work
WAYS TO SUCCESSFULLY DELEGATE: 7. fear of criticism
1. train and develop subordinates
2. plan ahead
3. control and coordinate work of subordinates
4. visit subordinates frequently
 FACTORS CONTRIBUTING TO AN EFFECTIVE PERFORMANCE
CONTROLLING APPRAISAL SYSTEM
-or evaluating is an on-going function of management which occurs during planning,
organizing, and directing activities. 1. Compatibility bet. the criteria for individual evaluation & organization
goals.
PURPOSE OF CONTROLLING 2. Direct application of rated performance to performance standards and
1. taking necessary preventive or corrective actions to ensure organization’s objectives expected of the worker
objectives are accomplished effectively and efficiently. 3. Development of behavioral expectations which have been mutually agreed upon
2. guide behavior and set into motion plans for the future. by both the rater and the worker
4. Understanding the process and effective utilization of procedure by the rater
METHODS OF CONTROLLING 5. Rating of each individual by the immediate supervisor
1. NURSING ROUNDS- an effective technique for nursing managers is planned 6. Concentration on the strengths and weaknesses to improve individual
nursing rounds, which can be placed on a schedule and can include all nursing performance
personnel. 7. Encouragement of feedback from the rated employees about their
2. GANTT CHARTS- Henry L. Gantt developed the Gantt chart as a means of performance needs and interests
controlling production. usually used for production activities, depicted as series 8. Provision for initiating preventive and corrective action and making
of events essential to the completion of a project or program. adjustments to improve performance
3. NURSING OPERATING INSTRUCTIONS- Nursing Operating instructions CRITERIA/ COMPONENTS TO BE EVALUATED
policies become standards for evaluation as well as controlling techniques.

PERFORMANCE APPRAISALS 1. TRAITS AND PERSONAL CHARACTERISTICS- may include stability,

- A control process in which an employee’s performance is evaluated against ability to handle stress, etc.
standards 2. RESULTS- the “bottom line” of the organization
- Consist of: 3. BEHAVIORAL CRITERIA- focuses on what the employee actually does; gives
a. dad-to-day manager-employee interactions the employees a more specific way of behaving
b. written documentations
c. the formal appraisal interview METHODS OF PERFORMANCE APPRAISAL
d. follow-up sessions that may involve coaching and/or discipline when needed
1. TRADITIONAL RATING SCALES
PURPOSES OF PERFORMANCE APPRAISALS 2. ESSAY EVALUATION- describing employee’s performance over the entire
1. Give constructive feedback evaluation period by writing a narrative about the strengths and weaknesses of
2. Serve as a basis for administrative decisions such as: the said employee
a. Size of a salary increase 3. FORCED-CHOICE COMPARISON – in this method, the evaluator is asked to
b. Who gets promoted, transferred, demoted or terminated choose the statement that best describes the nurse being evaluated.
3. Make inventories of talents within the institution
4. Determine training and developmental needs of employees
4. CHECKLISTS
5. Improve the performance of work groups by examining, improving, correcting 5. RANKING
interrelationships between members 6. ANECDOTAL RECORDING – the anecdotal record describes the nurse’s
6. Improve communication between supervisors and employees and reach an experience with a group or a person, or in validating technical skills and
understanding on the objectives of the job interpersonal relationships.
7. Establish standards of supervisory performance
8. Discover the aspirations of employees and reconcile these with the goals of the The anecdotal record should include:
institution 1. description of the particular occasion
9. Provide “employee recognition” for accomplishments 2. delineation of the behavior noted including answers to the
10. Inform employees “where they stand” questions who, what, why, when, where and how
3. the evaluator’s assessment of the incident or behavior
 - MBO allows people to control their own performance, measure
themselves and exercise self- control.
PROCEDURES AND PROCESS
1. TRAINING – should begin with the nurse managers of the enterprise, after
POTENTIAL APPRAISAL PROBLEMS which, the nurse manager is ready to simulate the procedures to be used. All
nursing employees are given similar training,
1. LENIENCY ERROR- overrate staff performance 2. FIRST MEETING – should be held in a quiet surrounding, with sufficient time
2. RECENCY ERROR- evaluators tend to recall recent performance and forget for discussion. Nurse manager and clinical nurse set goals that are SMART.\
more distant events 3. SECOND MEETING – employee is encouraged to spell out gratifying
3. HALO ERROR- raters tend to focus on the few outstanding activities experiences, do self-exam and relate thoughts about work. At the end, both
4. HORN EFFECT – raters tend to focus on the few negative actions manager and employee should exit the meeting with a sense of accomplishment.
5. AMBIGUOUS EVALUATION STANDARDS- confusion towards the use of PROBLEMS WITH MBO
rating scales among evaluators 1. top management not supportive
6. WRITTEN COMMENTS PROBLEM- the space for the comments may be 2. inconsistency among managers
misused by the evaluator 3. goals too easy or unattainable
7. SIMILAR-TO-ME-ERROR – the rater rated according to how she views herself 4. conflict of goals and policies
8. CENTRAL TENDENCY ERROR – all ratings are at the middle of the scale. 5. accountability beyond control of subordinates
9. FIRST-IMPRESSION ERROR - the rater views early behavior that may be 6. lack of commitment of subordinates
good or bad and rates all subsequent behaviors similarly.
SOCIALIZATION
- means that nurses internalize professional values and standard codes of
TIPS TO AVOID ERRORS IN PERFORMANCE APPRAISAL (APPRAISERS) behavior
1. Proper Documentation STAGES IN SOCIALIZATION PROCESS
a. Taking notes 1. Anticipatory socialization– ind. Acquire what they believe to be the attitude,
b. Review of Critical Incidents values and beliefs of the grp. To which they hope to belong
2. Familiarize the Appraisal Forms 2. Learning in s presocializing institution.
3. Be Future Oriented 3. Recruitment
4. Focus on Employee Behavior- rather than personal trains or characteristics 4. Institutional socialization
5. Spend Enough Time Observing the Employee 5. rite of passage

MANAGERIAL SURVEILLANCE
PEER REVIEW- a process by which registered nurses assess and judge the performance - using records
of their peers against predetermined standards. The steps for peer review follow: - DIRECT OBSERVATION of subordinate behavior
- INDIRECT – through record.
1. the employee selects peers to conduct the evaluation - NARROW SPAN OF CONTROL – few members of directly supervised
2. the employee submits a self-evaluation portfolio. staff; higher degree of direct observation
3. the peer evaluates the employee. - WIDER SPAN OF CONTROL – many members; lower degree of direct
4. manager and employee meet to discuss the evaluation. observation.

MANAGEMENT BY OBJECTIVES BENCHMARKING

- organization seeks out the best practice in its industry to improve its
Accdg to PETER DRUCKER “a process whereby the superior and subordinate managers performance.
of an org. jointly identify its common goals, define each individual’s major areas of
responsibility in terms of the results expected of him…” TQM (Total quality management) [philosophy]
- MBO spells out the results expected of the clinical nursing unit and of - to improve product value
the unit in relation to other units.\ - management philosophy that emphasizes a commitment to excellence
- It emphasizes teamwork and team results. throughout the org.
TQM CHARACTERISTICS
 1. Customer/Client Focus conflict avoids Uses
-INTERNAL – employees and dept. w/n org. direction Existing roads New roads
-EXTERNAL- patients/visitors Truth establishes Seeks
2. Total org. improvement – the phrase “that’s not my job is eliminated” Answers Whom? What? Where? Why?
3. Use of quality tools and statistics for measurement When? How?
4. Identification of key processes for improvement Time frame Past - present Present – future
Effectivity & efficiency Master routine Vision &judgment
CQI (Continuous quality improvement) [process] SIMILARITIES:
- all team members are continuously involved in peer reviews, so that - Primary purpose- learn how to work with people not only as individuals
they can identify ways to improve process or programs and constanly but also as members of the group.
enhance quality of care.
LEVELS OF MANAGEMENT
CORE CONCEPTS OF CQI 1. FIRST LEVEL – (charge nurse/staff nurse)
1. quality – meeting and exceeding costumers expectations - first line manager
2. success is achieved through meeting needs of clients - resp. for supervising work of non-managerial personnel and day to day
acts.
CQI (how it works) - 24-hour accountability for the management of the unit
1. Nursing audits – RETROSPECTIVE – when pt. is discharged 2. MIDDLE LEVEL – (supervisor)
- CONCURRENT – PT. IS STILL ADMITTED - supervise first level
2. Peer review - 24-hour accountability
3. utilization review – allocation of resources 3. UPPER LEVEL – (director)
4. outcome management – cost & quality - executive level management
- where middle managers reports
P -lan - planning - responsible for establishing org. goals and strategic plans for entire
D -o - doing; collecting data division
S -tudy / C –heck – studying what they have collected
A –ct - acting; doing management 4 A’s

FOCUS Methodology ADVOCACY – influence others on what you believe

ACCOUNTABILITY – reliable of acknowledgement of responsibility
F ocus on an opportunity for improvement ADAPTABILITY – flexible
O rganize the team AWARENESS – awareness of self, others and env’t to provide needs of pt.
C larify the current process
U ndestand degree of change needed CHARACTERISTICS OF A NURSE-LEADER &MANAGER
S elect a solution for improvement
Nurse as LEADER – guiding vision
LEADERSHIP AND MANAGEMENT - passion
- integrity
MANAGER LEADER
Acting Doing things right Doing right things Nurse as MANAGER – leadership
Essence Stability Change - clinical expertise
focus Managing work Leading people - business sense
seeks objectives Vision
decision makes Facilitates
power Formal authority Personal charisma
Appeal to Head Heart
energy Control Passion
likes action Striving
wants results Achievement