ORGANIZING

Process of establishing formal authority

Involves :
Setting up the organizational structure
Determining the staff needed
Developing job description
ORGANIZATION
An organization is defined as a system of interrelated resources, including environment,
materials, supplies and behavior of people, that performs a task which has been differentiated
into several distinct subsystem.
Planned groupings of people to accomplish a specific purpose
Is an organized body, system or society where members harmoniously work together to achieve
organization goals.

ELEMENTS OF ORGANIZING
I. SETTING UP ORGANIZATIONAL STRUCTURE
1. FORMAL
Highly planned and visible
Provides framework for defining managerial:
Authority
Responsibility
Accountability
Roles and functions are defined and arrange systematically
Different people have different roles
Rank and hierarchy is evident
2. INFORMAL
Unplanned often hidden
Generally social
With shifting lines of authority and accountability
Had horizontal relationships
Composed of small groups of workers with similar interest

PURPOSE OF ORGANIZATIONAL STRUCTURE

1. Inform members of their responsibilities
2. Allows manager and individual workers to concentrate on specific roles & responsibilities
3. Coordinates all organizational activities
4. Reduces the chances of doubt and confusion concerning assignments
5. Avoids overlapping of functions
6. Shows to whom and for whom they are responsible

Types of Organization Classified by Nature of Authority.

1. Line Organization/ Bureaucratic/ Pyramidal
- shows that each position has general authority over the lower position of the hierarchy.
- Power are concentrated at the top.
2. Flat Organization
- refers to an organizational structure with few or no levels of intervention between
management and staff.
3. Staff Organization
- purely advisory to the line structure with no authority to place recommendations into action.
4. Functional Organization
- permits a specialist to aid line position within a limited and clearly defined scope authority.

Five Major Characteristic of Organization Chart.

1. DIVISION OF WORK
Box represents the individual or sub-unit responsible for a given task of the
organizations work load
2. CHAIN OF COMMAND
Lines indicate who reports to whom and by what authority
3. TYPE OF WORK TO BE PERFORMED
Indicated by labels or description for the boxes
4. GROUPING OF WORK SEGMENTS
Shows the cluster of work group
5. LEVELS OF MANAGEMENT
Indicate individual and entire management hierarchy

DEFFINITION OF TERMS
Authority is the right to act or make decision without the approval of the higher administrator.
Accountability mean taking full responsibility for the quality of work and behavior while
engaged in the practice of the profession
Responsibility is the obligation to perform the assigned task
Power is the ability to influence another to behave in accordance with one's wishe
Status is the rank bestows on a person in accord with the groups estimation of the person value,
significance to the group
Communication is the transmission of information between persons.

PRINCIPLES OF ORGANIZING
UNITY OF COMMAND
Responsible to only one superior
One person/one boss employee have one manager to whom they report and to
whom they are responsible
Indicated by vertical line between position on the organizational chart
SCALAR HIERARCHY/CHAIN OF COMMAND
Authority and responsibility flow in clear unbroken lines from highest to lowest position
Those having the greatest decision making responsibility are located at top , those with
least responsibility at he bottom
HOMOGENEOUS ASSIGNMENT/DEPARTMENTATION
Workers performing similar assignment are group together for a common purpose
SPAN OF CONTROL
Number of workers that a supervisor can effectively damage
Top level 1:6 of supervisor
Base 1:10
EXCEPTION PRINCIPLE
Recurring decisions handled in a lower level managers
Problems involving unusual matters referred to higher level
 DECENTRALIZATION/PROPER DELEGATION OF AUTHORITY
Process of conferring specified decision making to the lower level of organization

II. STAFFING
Process of determining and providing the acceptable number and mix of nursing personnel to
produce a desired level of care to meet the patients demand.

Purpose: to provide nursing unit with appropriate and acceptable numbers of workers to perform the
nursing task required.

Factors Affecting Staffing

Type, philosophy and objective of hospital & nursing service
Population served
Number and severity of illnesses of patient
Availability and characteristics of nursing staff
Administrative policies- rotation, weekends & holiday duty
Standards of care desired
Layout of various nursing units and resources available within the department
Budget
Professional activities and priorities in non patient activities
Teaching program expected hours of work/annum of employee
Pattern of work schedule
Types of Staffing
1. Centralized
done by the nursing director who develops a master plan for nursing personnel; an
impersonal approach
2. Decentralized
the managers of individual nursing units have more control over the budget, resources, and
process.
NOTE:
It should be noted that the personnel computed are only for those in patients. Therefore,
additional personal should be hired for those in supervisory and administrative position and for those in
the special units.
o Head Nurse should be provided for every nursing unit.
o Nursing Supervisors is provided .
o Roomed in babies should be provided with additional staff.

PATIENT CARE CLASSIFICATION SYSTEM

A method of grouping patient according to the amount and complexity of the nursing care
requirement and nursing skill and time required.
CLASSIFICATION:
LEVEL I: Minimal Care or Self care
Can take a bath on his own
Perform ADL on his own
Patient about to be discharge
Non=emergency cases
Do not exhibit unusual symptoms
Requires little treatment
 LEVEL II: Intermediate or Moderate Care
Needs assistance in bathing, feeding or ambulating for short periods of time
Extreme symptoms have subsided or yet to appear
Have slight emotional needs
With IVF or BT
Semi-conscious
Have some psychosocial or social problem
Periodic treatment, observation
LEVEL III: Intensive, Total, Complete Care
Completely dependent on nursing personnel
On continuous O2 therapy
With chest or abdominal tubes
Requires close observations
LEVEL IV: Highly Specialized Critical Care
Needs continuous treatment & observations
VS q 15 minutes
Hourly I & O
Significant changes in Doctors order

PATIENT CARE CLASSIFICATION SYSTEM

PERCENTAGE OF PATIENT AT VARIOUS LEVEL OF CARE/TYPE OF HOSPITAL

COMPUTING FOR NUMBER OF NURSING PERSONNEL NEEDED
Ensure that there is sufficient staff to:
Cover all shifts
Off duties
Holidays
Leaves
Absences
Time for staff development

RA 5901: Forty-Hour Week Law

Employees working in 100 bed capacity and up will work only 40 hours a week
Applied also to employees working in agencies with at least 1 million population
Employees working on less than 100 bed capacity or in agencies located in the community with
less than 1 million population will work 48 hours a week

STAFFING FORMULA
1.Categorize the number of patients according to the levels of care needed.
Multiply total number of patient by % of patient at each Level of Care
250 patients x .30 = 75 patients needing minimal care
250 patients x .45 = 112.5 patient needing moderate care
250 patients x .15 = 37.5 patients need intensive care
250 patients x .01 = 25 patients needed highly specialized nursing care
2.Find the number of NCH needed by patients at each level of care per day
A. find the number of patients at each level by the average number of NCH
needed/day
B. get the sum of NCH needed at various level
75 patients x 1.5 NCH needed at Level I = 112.5
112.5 patients x 3 NCH needed at Level II = 337.5
37.5 patients x 4.5 NCH needed at level III= 168.75
25 patients x 6 NCH needed at Level IV = 150
_______
total 768.75 NCH/day

3. Find the total NCH needed by 250 patients per year

total NCH needed/day x total number of days in a year
768.75 x 365 days/year = 280,593.75 NCH/year
4. Find the actual working hours rendered by each nursing personnel per year
8 hours x 213 working day/year = 1,704 working hours/year
5. Find the total number of nursing personnel needed
A. total NCH per year = 280,593.75 = 165 TNP
working hrs/year 1,704

Find the number of reliever

B. total Nsg. Personnel x 0.15 (For those working 40 hours a week) = 165 x 0.15 = 25
total Nsg. Personnel x 0.12 (For those working 48 hours a week)
Add no. of relievers to no. of nursing personnel needed
165 + 25 = 190 nursing care personnel needed
6.Categorize as to professional and non-professional personnel
Ratio of professional to non-professional in tertiary hospital is 65:35
190 x .65 = 124 professional nurses
190 x .35 = 66 nursing attendants
7. Distribute by shift
124 nurses x .45 = 56 nurses on AM shift
124 nurses x .37 = 46 nurses on PM shift
124 nurses x .18 = 22 nurses on night shift
8. Distribute nursing attendants/ shift
66 nursing attendant x .45 = 30 nsg. Attendant AM shift
66 nursing attendant x .37 = 24 nsg. Attendant PM shift
66 nursing attendant x .18 = 12 nsg. Attendant

II.SCHEDULING
SCHEDULE
Timetable showing planned workdays and shift of nursing personnel.
OBJECTIVE OF SCHEDULING
To assign working days and off days to nursing personnel so that adequate patient care
is assured.
FACTORS TO CONSIDER IN MAKING A SCHEDULE
The different levels of Nursing Staff
Adequate coverage for 24 hours, seven days a week.
Staggered vacation and holidays
Weekends
Long stretches of consecutive working days
Evening and Night shift
Floaters
ASSESSING SCHEDULE SYSTEM
Ability to cover the needs of the unit
Quality to enhance the nursing personnels knowledge, training and experience.
Fairness to staff
Stability
Flexibility

TYPES OF SCHEDULING
CENTRALIZED SCHEDULE
1 Person, Usually Chief Nurse or her designated assigns the nursing personnel.
DECENTRALIZED SCHEDULE
The shift and off duties are arranged by supervising nurse or head or senior of a
particular unit.
CYCLICAL SCHEDULE
Covers a number of weeks and is repeated thereon.
IV. DEVELOPING JOB DESCRIPTION
JOB DESCRIPTION
STATEMENT THAT SETS THE DUTIES AND RESPONSIBILITIES OF A SPECIFIC JOB
INCLUDES:
Characteristic or Qualification of individuals to perform job responsibilities.
CONTENTS OF JOB DESCRIPTION
IDENTIFYING DATA
Position
Department
JOB SUMMARY
QUALIFICATION REQUIREMENTS
JOB RELATIONSHIP source of worker
SPECIFIC AND ACTUAL FUNCTIONS AND ACTIVITIES

USES OF JOB DESCRIPTION

For recruitment and selection of qualified personnel
For orientation of new personnel
For job placement, transfers or dismissal
Aid in evaluating performance of employee
For budgetary purposes
For determining departmental function and relationship to help define the organizational
structure
For classifying levels of nursing functions according to skill
To identify training needs
As basis for staffing
To serve as channel of communication