CONTROLLING

LEADERSHIP AND MANAGEMENT PROCESS

CONTROLLING
 An on going function of management which occurs
during planning, organizing and directing activities

 Process wherein the performance is measured and

corrective action is taken to ensure the
accomplishment of organizational goal
PURPOSES OF CONTROLLING
 Open opportunities for improvement

 Compare performance against set standard

 Provides information about how well processes and

people function
Steps in Control Process
 Establish standards and criteria

 Measure performance

 Compare results with standards

 Match with standards?

 YES - do nothing to improve
 NO - take corrective action
REASONS FOR CONDUCTING EVALUATION

 Ensures that quality services is provided

 Allow for setting of sensible objectives and ensures compliance

 Provides standards for establishing comparisons

 Promotes visibility and means for employees to monitor own

performance

 Highlights problem related to quality care and determines areas

that require priority attention
REASONS FOR CONDUCTING EVALUATION

 Provides an indication of the cost of poor quality

 Justifies the use of resources

 Provides feedback for improvement

EVALUATION PRINCIPLES
1. Must be based on behavioral standards of performance with the
position requirement

2. There should be enough time to observe employee’s behavior

3. Employee should be given a copy of the ff. Before scheduled

evaluation

Job description
Performance standards
Evaluation forms
EVALUTAION PRINCIPLES
4. Performance appraisal should include both satisfactory and
unsatisfactory results

5. Areas needing improvement must be prioritized

6. Should be scheduled and conducted at a convenient time for

both evaluator and employee

7. Should be structured in such a way that it is perceived and

accepted positively as a means of improving job performance
CHARACTERISTICS OF EVALUATION TOOL

 OBJECTIVE
 Free from bias

 RELIABLE
 Accurate and precise that it will produce the same results if administered
twice

 SENSITIVE
 Instrument can measure fine lines of differences among criteria being
measured

 VALID
TYPES OF PERFORMANCE STANDARDS

1. STRUCTURE
 Focus on the management system or structure used by
the agency in the delivery of care
 Includes:
 Number and categories of nursing personnel
 Education
 Personal and professional qualities
 Function
 Physical facilities
 Equipments
TYPES OF PERFORMANCE STANDARDS

2. PROCESS STANDARDS
 Decision and actions of the nurse relative to the
nursing process

 INCLUDES :
 Assessment
 Plan of care
 Nursing intervention
TYPES OF PERFORMANCE STANDARDS

3. OUTCOME STANDARDS
 Designed to measure the results og care provided in
terms of:
 Changes in health status of client served

 Changes in level of their knowledge, skills and attitude

 Satisfaction of those served

PERFORMANCE APPRAISAL
 A control process in which employee's performance
is evaluated against standards

 The most valuable tool in controlling human

resources and productivity

 Reflects how well a personnel have performed

during a specific period of time
PURPOSE OF PERFORMANCE APPRAISAL

1. Determine salary and merit increases

2. Select qualified individual for promotion or transfer

3. Identify unsatisfactory employees for demotion or

termination

4. Make inventories of talents within an institution

5. Determine training and developmental needs of employees

PURPOSE OF PERFORMANCE APPRAISAL

6. Improve performance of work group

7. Improve communication between supervisors and

employees

8. Establish standards of supervisory performance

9. Provide recognition of employee for accomplishments

10. Inform employees “where they stand’

METHODS OF MEASURING PERFORMANCE

 ESSAY
 The appraiser writes a paragraph about the workers
strength, weaknesses and potentials

 CHECKLIST
 A compilation of performances expected of a worker

 RANKING
 Evaluator ranks according to how
Employee fared with co-workers
METHODS OF MEASURING PERFORMANCE

 RATING SCALE
 Includes a series of items representing the different tasks
or activities in job description or the absence or presence
of desired behaviors

 FORCED-CHOICE COMPARISON
 The evaluator is asked to choose the statement that best
describes the employee being evaluated

 The evaluator is forced to choose from favorable as well

as unfavorable statement
METHODS OF MEASURING PERFORMANCE

 ANECDOTAL RECORDING
 Describe experience with a group or a person, or in
validating technical skills and interpersonal relationship
 Anecdotal report should include:
1. Description of the particular occasion
2. Delineation of the behavior noted including:
 WHO, WHAT, WHY, WHEN, WHERE AND HOE
3. The evaluator’s opinion or assessment of the incident or
behavior


QUALITY ASSURANCE
 Assurance  achieving sense of accomplishment
and implies a guarantee of excellence
 Quality  the degree of excellence
 QUALITY ASSURANCE:
 A process of evaluation that is applied to the health
care services b health workers
 Focuses on the care and services the patient receives
than on how well the professionals performs the
duties that the position required
PRINCIPLES UPON WHICH QUALITY
ASSURANCE PROGRAM ARE BASED

1. All health professionals should collaborate in the effort to

measure and improve care
2. Coordination is essential in planning a comprehensive QAP
3. Resource expenditure for QA activities is appropriate
4. There should be focus on critical factors
5. Quality patient care is accurately evaluated through
adequate documentation
6. The ability to achieve nursing objectives depends upon the
optimal functioning of the entire nursing process and its
effective monitoring
PRINCIPLES UPON WHICH QUALITY
ASSURANCE PROGRAM ARE BASED

7. Feedback to practitioners is essential to improve practice.

8. Peer pressure provides the impetus to effect prescribed changes

based on the result of assessment and needed improvements on the
quality of care

9. Reorganization in the formal organizational structure may be

required if assessment reveals the need for a different pattern of
health care

10. Collection and analysis of data should be utilized to motivate

remedial action
QUALITY IMPROVEMENT
PROGRAM
 The umbrella program that extends the many areas
for the purpose of accountability to the consumer

 A continuous, on-going measurement & evaluation

process that includes structure, process and
outcome
TOTAL QUALITY MANAGEMENT (TQM)

 A way to ensure customer satisfaction by involving all

employees in the improvement of the quality of every
product or service

 Aims to reduce waste and cost of poor quality

 It is a structured system for involving entire

organization in a continuous quality improvement
process targeted to meet and exceed customer
expectations
CONTINIOUS QUALITY IMPROVEMENT (CQI)

 A process of continuously improving a system by :

 gathering data or performance
 Using Multi-disciplinary team to analyze the system
 Collect measurements
 Propose changes
PRINCIPLES OF CONTINOUS QUALITY
IMPROVEMENT (CQI)

1. Customer focus
2. Identification of key processes to improve
quality
3. Use of quality tools and statistics
4. Involvement of all people in problem solving
QUALITY ASSURANCE
 Focuses on the care and service the patient receives
than on how well the professional performs the
duties that the position requires

 METHODS USED
 Patient care audit
 Patient care profile analysis
 Peer review
 Quality circles
NURSING AUDIT COMMITTEE
 Composed of a representative from all levels of the
nursing staff
 The audit team designate a day within the week to
be the audit day
 The nurses do not know which unit will be audited
PATIENT CARE AUDIT
 CONCURRENT PATIENT CARE AUDIT
 One in which patient care is observed and evaluated
 Done during rounds or patient interview
 Given through:
1. Review of patient chart while the patients are still
confined in the hospital
2. Observation of the staff as patient care is given
3. Inspection of patient or observation and/or observation
of the effects of patient care where the focus is on the
patient
PATIENT CARE AUDIT
 RETROSPECTIVE PATIENT CARE AUDIT
 ONE IN WHICH PATIENT CARE IS
EVALUATED THROUGH:
1. A REVIEW OF DISCHARGED PATIENTS’
CHART
2. QUESTIONAIRES SENT TO OR INTERVIEW
CONDUCTED ON DISCHARGED PATIENTS
QUALITY CIRCLES
 One of the most publicized approaches to quality
control introduced by the Japanese

 A group of workers doing similar works who:

 Meet regularly
 Voluntarily
 On normal working time
 Under the leadership of the supervisor
QUALITY CIRCLES
 TO:
 Identify, analyze, and solve work related problem

 Recommend solution to management  quality circle

members should implement the solution themselves
CONTROL OF RESOURCES
 Consumption of supplies and materials should be
proportionate to the number of patients served
 Requisition or stock of large numbers of supplies
and materials should be avoided to prevent misuse
or spoilage
 A high turnover inventory is desired
 A low turnover is:
 the result of poor purchasing policies
 Overstock or decreased demand for the item
CONTROL OF RESOURCES
 Equipment utilization report should be made
including frequency of breakdown
 help to evaluate the:
 quality of equipment purchased
 The way it was handled
 Preventive maintenance  requires the regular
inspection of equipment to prevent breakdown or
detect needed repairs
 Breakdown results in more expenses and non
productivity of personnel
CONTROL OF RESOURCES
 Human Resource:
 Absences due to leaves, whether scheduled or not,
should be analyzed
 Provision for relievers should be included in the
staffing pattern to maintain quality service
 Unusual number of unscheduled absences should
be investigated  this may necessitate disciplinary
action
DISCIPLINE
 Rigid obedience to rules and regulations

 SELF DISCIPLINE: A constructive and effective

means by which employees take personal
responsibility for their own performance and
behavior
FACTORS THAT INFLUENCE SELF
DISCIPLINE

1. Strong commitment to the vision, philosophy,

goals and objectives of the institution
2. Laws that govern the practice of all professionals
and the respective Codes of Conducts
3. Understanding of the rules and regulation of the
agency
4. Atmosphere of mutual trust and confidence
5. Pressure from peers and organization
DISCIPLINARY ACTION
 Any employee charge with breach of the rules and
regulation, policies, norms of conducts should be
given due process

 There must be existing rules of conduct governing

his behavior and a documentation of actual violation

 The charged employee must be notified in writing

about the violation and be given the right counsel
Principles of disciplinary action

 1. investigate carefully
 2. be prompt
 3. protect privacy
 4. focus on the act
 5. enforces rules consistently
 Be flexible
Components of disciplinary action program

 Code of conduct
 Employees must be informed of the nature and meaning of codes
of conduct
 Must understand that the rules are reasonable and directly related
to efficient, effective operation of the agency

 Authorized penalties

 Records of offenses

 Right of appeal
DISCIPLINARY ACTION
 Should be progressive in nature

 CONSELLING AND ORAL WARNING

 Best given in private and in an informal
atmosphere
 Employee is given fair chance to air his side
 Relevant facts are analyzed and evaluated against
past performance
DISCIPLINARY ACTION
 COUNSELLING
 Employee is counseled regarding:
 Expectations of improved behavior/performance
 Ways of correcting the problem
 Warning that a repetition of the same offense may
warrant disciplinary action
 The employee must commit to correct the behavior
 He should be informed of any follow-up action
that may be taken
DISCIPLINARY ACTION
 WRITTEN WARNING
 The second step in disciplinary action
 Preceded by an interview similar to oral warning
 Employee is told after the interview that he will be given a
written warning
 WRITTEN WARNING: includes
 Statement of the problem
 Identification of the rule that was violated
 Consequence of the continued deviant behavior
 Employees commitment to take corrective action
 Any follow-up action to be taken
DISCIPLINARY ACTION
 SUSPENSION
 DISMISSAL
 Invoked only when all other disciplinary efforts have
failed
 Disciplinary Committee should be very sure that the
cause for dismissal conforms with the criteria of a
major discipline violations as contained in the policy
manual
 Review is done by higher management