1. What is time management?

Time management has been defined as a set pf related common sense skills that helps you
use your time in the most effective and productive way possible.
Time management is the act or process of planning and exercising conscious control over
the amount of time spent on specific activities, especially to increase effectiveness, efficiency or
productivity.
Time management is a set of principles, practices, skills, tools and system that work
together to help to get more value out of your time.

IMPORTANCE OF TIME MANAGEMENT IN NURSING:

The nursing profession is very busy, and the more productive a nurse can be, the more effective
they are in their job.
Nursing is a demanding career and requires you to practice a lot of patience as well as learn and
apply a highly effective time management system to truly stay on top of the game.
Time is care and time is money.
Inadequate nursing time contributes to poor quality care and excess nursing time contributes to
the high cost of care.
Time management in nursing also is important so nurses feel less stressed.
Nurses who feel less stress are better able to take care of themselves and their patients.
Most of the nursing services are time consuming and demanding. The time of the hours of the
day cant be increase but the proper time planning and management can yield positive results.
Working smarter, not harder and longer is the key for the nurses of all levels.

2. What is pareto principle?

The Pareto Principle (80/20 Rule, Law of the Vital Few) is a valuable quality management tool
because its application encourages a focus on the most crucial issues.
The Pareto Principle is the filter that can protect us from ourselves and our natural response to
having too many things on our plate.
The Pareto principle separates the vital few from the many less fruitful activities. It is named
after the highly influential Vilfredo Pareto, an Italian economist of the late 19th early 20th
century, who observed that 80% of the wealth was owned by 20% of Italians and whose
thinking has underpinned much of micro economic thinking.

APPLYING THE PARETO PRINCIPLE IN HEALTHCARE QUALITY

IMPROVEMENT:
A well-known business tool, the Pareto principle can help you channel your resources to the
most important items (the vital few) and give you the best bang for buck.
For example, if long waits and billing issues in an Emergency Room are causing 70% of
complaints by ER patients, then these two problems should be given priority (over the host of
other issues) when selecting quality improvement initiaztives. Some hospitals make the
mistake of trying to tackle every problem simultaneously because they all seem important.
And they might be; in an ideal world you would address all the problems. However,
realistically, you are more likely to have limited resources (staff, money, time) in which case
paying attention to the items that matter the most would be a more effective management
strategy.

3. How should a nurse prioritize the use of time?

 Nurse Thorson believes time management is all about critical thinking and how to prioritize
your time and efforts as a nurse. To get to that point in comfort in prioritizing, she says that
nurses need to ask these four questions that can help put everything in its place in your mind
and in your schedule:
1. What am I going to do first and why?
2. Which is more important to do, and why is it the most important?
3. What is the worst thing that could happen if I dont do it now?
4. What is most important to the patient?
Thats how they teach time management in many nursing schools; but nurses have to
remember that they cant do everything they set out to do that day unless, of course, its giving
medicine to a patient she says. There are certain duties that must be accomplished. But
there just might be a few things that can be left off until the next day or next shift, such as
some administrative duties that arent so critical.

4. How to establish priorities when you are the nurse?

PRIORITY RANKING OF PATIENTS:
First level patient problems- these are threats to a patients immediate survival or safety and
demand immediate nursing intervention.
Second level- concerns such things as mental status change, acute pain, acute urinary
elimination, untreated medical problems, etc.
Third level- those that do not fit into the above two categories such as medication side effects,
lack of patient knowledge, longer-term problems with living activities, etc.
When no life-threatening problems exist, the nurse used both professional judgment and the
patient to set priorities and determine planning.

ADDITIONAL PRINCIPLES:
Know needs and priorities of each patient
Consider all factors
Always remain flexible
Use of creativity

PRIORITY SETTING TRAPS:

Whatever hits first- this trap occurs when an individual simply responds to things as they
happen rather than thinking first and then acting. This is common to new nurses.
Path of least resistance- the individual makes the assumption that it is easier to do a task by
himself or herself and fails to delegate properly.
Squeaky wheel- the individual falls prey to those who are most vocal about their requests
and then feels a need to respond to the time frame imposed by the squeaky wheel rather than
his or her own.
Default- the individual feels obligated to take on tasks that no one else has come forward to
do.
Inspiration- individual wait until they become inspired to accomplish a task. Some tasks
will never be inspiring, and the wise time manager recognizes that the only thing that will
complete these tasks is hard work and appropriate attention to the matter.

5. What are the priorities to enhance personal productivity?

Cost supervising activities in progress to ensure they are on-course and on-schedule in
meeting the objectives and performance targets.
6. What are the strategies for avoiding time destruction?
1) Know how you spend your time. Keeping a time log is a helpful way to determine how
you are using your time. Start by recording what you are doing for 15-minute intervals for a
week or two. Evaluate the results. Ask if you did everything that was needed; determine which
tasks require the most time; determine the time of day when you are most productive; and
analyze where most of your time is devoted job, family, personal, recreation, etc. identifying
your most time-consuming tasks and determining whether you are investing your time in the
most important activities can help you to determine a course of action. In addition, having a
good sense of the amount of time required for routine tasks can help you be more realistic in
planning and estimating how much time is available for other activities.
2) Set Priorities. Managing your time effectively requires a distinction between what is
important and what is urgent. Experts agree that the most important tasks usually arent the
most urgent tasks. However, we tend to let the urgent dominant our lives. Covey, Merrill, and
Merrill categorize our activities into four quadrants in their Time Management Matrix: urgent,
not urgent, important, and not important. While activities that are both urgent and important
must be done, they suggest that we spend less time on activities that are not important
(regardless of their urgency) in order to gain time to focus on activities that are not urgent but
important.
3) Use a planning tool. Time management experts recommend using a personal planning tool
to improve your productivity. Examples of personal planning tools include electronic
planners, pocket diaries, calendars, computer programs, wall charts, index cards, and
notebooks. Writing down your tasks, schedules, and memory joggers can free your mind to
focus on your priorities. The key is to find one planning tool that works for you and use that
tool consistently.
4) Get Organized. Most people find that disorganization results in poor time management.
Professional organizers recommend that you first get rid of the clutter. A frequently used
method is to set up three boxes (or corners of a room) labeled Keep Give away Toss.
Separate the clutter by sorting items into these boxes.
5) Schedule Your Time Appropriately. Even the busiest people find time for what they want
to do and feel is important. Scheduling is not just recording what you have to do, it is also
making a time commitment to the things you want to do. Good scheduling requires that you
know yourself.
6) Delegate: Get Help from Others. Delegation means assigning responsibility for a task to
someone else, freeing up some of your time for tasks that require your expertise. Delegation
begins by identifying tasks that others can do and then selecting the appropriate person(s) to
do them. You need to select someone with the appropriate skills, experience, interest, and
authority needed to accomplish the task. Be as specific as possible in defining the task and
your expectations, but allow the person some freedom to personalize the task.
7) Stop Procrastinating. You may be putting off tasks for a variety of reasons. Perhaps the task
seems overwhelming or unpleasant. Try breaking down the task into smaller segments that
required less time commitment and result in specific, realistic deadlines.
8) Manage External Time Wasters. Your time may be impacted by external factors imposed
by other people and things. You can decrease or eliminate time spent in these activities.

7. What are the symptoms of time mismanagement?

Poor time management affects every part of your life. Many people convince themselves
that they are effective time managers because their diary is full. They are constantly rushing from
one place to another, and they feel that they are incredible busy. This is the most fundamental
principle of time management, and one which is constantly misunderstood i.e. effectiveness if far
 more important than efficiency. Efficiency and effectiveness are often used interchangeably but
they are not the same thing.
Efficiency is getting a lot of tasks done.
Effectiveness is getting the right tasks done.
SYMPTOMS:
a. Poor punctuality. Your punctuality is a sign of your respect for others. If you are consistently
late for meetings with somebody, you are telling them that you do not respect them enough to
turn up on time. Poor time management damages relationships.
b. Rushing is often a sign that you are struggling with overwhelm and overload. You need to
focus on getting more work off your plate by saying No, delegating, automating, outsourcing,
etc.
c. Impatience is often the first sign that you have poor time management skills. You are taking
your failings out on others. If you are becoming more impatient, it is time to examine your
workload and work practices.
d. Poorly defined goals. Goals are an essential way to reduce your workload and reduce your
poor time management. Not only do you want to become clearer about what you want; you
become more certain about the tasks and projects which are not a good use of your time.
e. Procrastination. When tackling procrastination, you must first be sure that the task/project
you are putting off actually needs to be done. There is no benefit to making time for
tasks/projects which add no value to your work or life.
f. Poor performance. The most important step in arresting poor performance and eliminating
poor time management is to get more focused and eliminate the things you should not be
doing. This allows you to focus on improving your performance in the areas which matter.
g. Lack of energy
h. Perfectionism. Even a job done to an average standard is better than a perfect job which never
gets done.
i. Indecisiveness. Most decisions are not very important and; you can always change course
further down the road if necessary.
j. Saying YES to everything. The biggest difference between highly successful people and
the average person is that highly successful people say NO far more often.
k. Doing everything yourself

8. What are the time saving techniques that manager can adapt?
Tip #1: Focus on the Critical Few. 85% of the things that you do account for only 15% of your
results. And vice versa. Therefore, only work on the critical things and youll get there faster and
with less effort.
Tip #2: Take more free time. Relaxing is absolutely essential to your success. Just make sure your
take time off at the right time, that is after you tackle your 15% top activities.
Tip #3: Re-think your to do list. Create an 85/15 list. Write the top priority items at the top. Write
the low priority items at the bottom. Throw a line between them. Only work on the top of your list.
Tip #4: Reward yourself for doing the right things. The things that get rewarded get done. If you
reward yourself for your best actions, you will get more of these done almost effortlessly.
Tip #5: Do your feared things first.
Tip #6: Dont multitask.
9. What is budget?
A forecast of the resources required to deliver the services offered by the organization.
A budget is a financial plan that includes estimated expenses as well as income for a period of
time.
 A nursing budget is a systematic plan that is informed best estimate by nurse administrators of
nursing revenues and expenses. It projects how revenues will meet expenses and projects a
return on equity or profit.

PRINCIPLES OF BUDGETING:
Flexible
Synthesis of past, present & future
Product of joint venture or participation of executive at different levels
It should be clearly defined
Form of statistical standard laid down in specific numerical form
Represent expected revenue as compare with anticipated expense
Facilitate goal achievement

IMPORTANCE OF BUDGET:
An essential management tool
Budget tells you how much money you need to carry out your activities
Budget enables to monitor income and expenditure
The budget is basis for financial accountability and transparency

TYPES OF BUDGET:
a. Workforce or personnel budget- largest of the budget expenditures because health care is labor
intensive
b. Operating budget- reflects expenses that change in response to the volume of service, such as
the cost of electricity, repairs and maintenance, and supplies.
c. Capital budgets- plan for the purchase of buildings or major equipment, which include
equipment that has a long life (usually greater than 5 to 7 years).

10. How to formulate budget preparation?

Step one: Review past performance
o Prior financial records
o Present activities of the nursing division
o Activities that the division plans to institute during the projected financial period
o Activities the division plans to delete during the projected period

Step two: Review the organizations goals and projections

o Items in the major budgetary report that affect the nursing department should be determined
Step three: Review of the variances with higher levels
o Consider:
Proposed departmental goalds
Variances, their causes,
Proposed corrective actions
o Then:
The new budgeting process can begin

11. What are the examples of indirect and direct expenses?

 Direct expense is an expense incurred that varies directly with changes in the volume of a
cost object. A cost object is any item for which you are measuring expenses, such as products,
product lines, services, sales regions, employees, and customers.
Here are several examples of direct expenses:
The materials used to construct a product for sale
The cost of the freight needed to transport goods to and from a manufacturing facility
The labor incurred to produce hours billable to a client
Labor and payroll taxes paid based on the number of units produced
Production materials consumed during the manufacture of goods
The commission and payroll taxes related to the sale of goods or services
Indirect expenses do not vary with changes in the volume of a cost object.
Examples of indirect expenses are:
Facility rent
Facility insurance
Salaried compensation
Secretarial wages
Depreciation and amortization
Research and development

12. What is fixed cost and variable cost?

Fixed costs are costs that are independent of output. These remain constant throughout the
relevant range and are usually considered sunk for the relevant range (not relevant to output
decisions). Fixed costs often include rent, buildings, machinery, etc.
Variable costs are costs that vary with output. Generally, variable costs increase at a constant
rate relative to labor and capital. Variable costs may include wages, utilities, materials used in
production, etc.
Mixed costs are simply costs that are part fixed and part variable. An example could be
electricity electricity usage may increase with production but if nothing is produced a factory
still may require a certain amount of power just to maintain itself.

13. What is cost containment?

Cost-containment strategies are the business practice of maintaining expense levels to prevent
unnecessary spending or thoughtfully reducing expenses to improve profitability without
long-term damage to the company.
Driving engagement is the key to generating actual value for the employer and employees in
new cost-containment strategies.
The process of controlling the expenses required to operate an organization or perform a
project within pre-planned budgetary constraints. The cost containment process is an
important management function that helps keep costs down to only necessary and intended
expenses in order to satisfy financial targets.
Cost containment is the business practice of maintaining expense levels to prevent
unnecessary spending or thoughtfully reducing expenses to improve profitability without
long-term damage to the company. Cutting expenses in ways that decrease quality or reduce
marketing efforts to bring in new business can lead to a company's demise and are not
examples of a cost-containment strategy.

3 HEALTHCARE COST-CONTAINMENT STRATEGIES TRENDING IN THE

BENEFITS INDUSTRY:
1. Price Transparency
 2. Telemedicine
3. Population Health Management

14. What is cost monitoring?

Monitoring costs are incurred when the principals attempt to monitor or restrict the actions of
agents.
For example, the board of directors at a company acts on behalf of shareholders to monitor
and restrict the activities of management to ensure behavior that maximizers shareholder
value. The cost of having a board of directors is therefore, at least to some extent, considered
an agency monitoring cost. Costs associated with issuing financial statements and employee
stock options are also monitoring costs.

< REFERENCES >

o www.coachingpositiveperformance.com/11-symptoms-poor-time-
management/
o www.tehandassociates.com/2010/06/pareto-principle-dont-sweat-
the-small-stuff/
o www.mytimemanagement.com
o www.economics.fundamentalfinance.com/micro_costs.php
o www.fshealth.com/blog/what-are-cost-containment-stratregies-
plus-3-solutions- for-your-clients
o www.strategiccfo.com/agency-costs
o www.accountingtools.com/articles/what-is-direct-expense.html