Controlling Flashcards
Includes assessing and regulating performance in accordance with the plans that have been adopted, the instructions issued and the principles established
Controlling
It provides information about how well processes & people function so they can be motivated to perform better in future
Controlling
During the controlling phase of the management process:
-Performance is measured against predetermined standards
- And action is taken to correct discrepancies between these standards and actual performance
Functions in controlling are:
- the periodic evaluation of unit philosophy, mission, goals and objectives
- The measurement of individual and group performance against preestablished standards
- and the auditing of patient goals and outcomes
A specific type of controlling refers to activities that are used to evaluate, monitor, or regulate services rendered to consumers
Quality Control
The Hallmarks of Effective Quality Control Programs
- Support from top level administration
- Commitment by the organization in terms of fiscal and human resources
- Quality goals reflect search for excellence rather than minimums
- Process is ongoing (continuous)
Reasons for Conducting Evaluation
- Ensures that quality nursing care is provided
- Allows for the setting of sensible objectives and ensures compliance with them
- Provides standards for establishing comparisons
- Promotes visibility and a means for employees to monitor their own performance
- Highlights problems related to quality care and determines the areas that require priority attention
- Provides an indication of the costs of poor quality
- Justifies the use of resources
- Provides feedback for improvement
Tool is free from bias
Objectivity
Tool is accurate
Reliability
Tool is relevant
Validity
Tool can measure fine lines of differences among the criteria being measured
Sensitivity
Characteristics of an Evaluation Tool
- Objectivity
- Reliability
- Validity
- Sensitivity
Focus on the structure or management system used by the agency to deliver care
Structure Standards
Ensure safe and effective environment, but they do not address the actual care provided
Structure Standards
Staffing ratios, staffing mix, emergency department wait times, and the availability of fire extinguishers in patient care areas are examples of what type of performance standards?
Structure standards
Action of the nurse relative to the nursing process
Process standards
Measure how nursing care is provided
Process standards
Tends to be task oriented and focus on whether practice standards are being fulfilled
Process audits
May be documented in patient care plans, procedure manuals, or nursing protocol statements
Process standards
Designed to measure the results of care provided
Outcome standards
End result of care
Outcome standards
Determine what results, if any, occurred as a result of specific nursing interventions for patients
Outcome standards
Reflect the end result of care or how the patient’s health status changed as a result of an intervention
Outcome
She was advocating the evaluation of patient outcomes when she used mortality and morbidity statistics to publicize the poor quality of care during the crimean war
Florence Nightingale
Creates accountability for nurses as professionals and is important in developing nursing as a profession
Nursing sensitive
An ongoing, repetitive process with the actual frequency dependent on the type of activity being measured
Measuring actual performance
Maybe scheduled in advance/maybe done at periodic but announced intervals
Measuring Actual Performance
Performance should match with standards & objectives
Comparing results of performance with standards & objectives
Corrective actions are applied to improve performance
Reinforcing Strengths & Taking Corrective Action
Employee’s performance is evaluated against standards
Performance Appraisal
Reflects how well the nursing personnel have performed during a specific period of time
Performance Appraisal
Generate information for salary adjustments, promotions, transfers, disciplinary actions, and terminations
Performance Appraisal
Occurs when the appraiser lets one or two positive aspects of the assessment or behavior of the employee excessively influence all other aspects of the employee’s performance
Halo effect
Occurs when the appraiser allows some negative aspects of the employee’s performance to influence the assessment to such an extent that other levels of job performance are not accurately recorded
Horns Effect
Is hesitant to risk true assessment and therefore rates all employees as average
The central tendency trap
Is a pattern in which those who begin with advantage accumulate more advantage over time and those who begin with disadvantage become more disadvantaged over time.
Matthew effect
May consist of “incidental observation” of performance while the worker is engaged in performing nursing care
Informal appraisal
The appraiser describes in narrative form an employee’s strengths & areas where improvement is needed
Essay
Performed as the free-form review
Essay
Accomplished regularly and methodically by collecting objective facts that can demonstrate the difference between what was expected and what was done
Formal Appraisal
It is time consuming, and some appraisers simply write better than others
Essay
The appraiser ranks the employees according to how he fared with co-workers with respect to qualifications
Ranking
Composed of many behavioral statements that represent desirable job behaviors
The weighted scale
A complication of all nursing performances expected of a worker
Checklists
Requires the supervisor to select an undesirable and a desirable behavior for each employee
The forced checklist
Composed of numerous words or phrases describing various employee behaviors or traits
The simple checklist
These descriptors are often clustered to represent different aspects of one dimension of behavior, such as assertiveness or interpersonal skills
The simple checklist
Includes a series of items representing the different tasks or activities in the nurse’s job description or the absence or presence of desired behaviors and the extent to which these are possessed
Rating Scale
The evaluator will choose the statement that best/least describes the nurse being evaluated
Forced-Choice Comparison
Describes the nurse’s experience with a group or a person, or in validating technical skills and interpersonal relationships
Anecdotal Recording
May be done by peers (employees of the same profession, rank and setting evaluating another’s job performance against accepted standards
Peer Review
Process of evaluation that is applied to the health care system and the supplying of health care services by health workers
Quality assurance
A continuous ongoing measurement and evaluation process that includes structure, process, and outome
Quality Improvement Program
Process of measuring products and services against those of best-performing organizations
Benchmarking
The degree to which health services for individuals & population increase the likelihood of desired health outcomes
Quality of Care
Documentation of the quality of nursing care in relation to the standards established by the nursing department
Nursing audit
Patient care is observed and evaluated
Concurrent
Patient care is evaluated thru review of discharged patient’s chart & questionnaires sent to or interviews on discharged patients
Retrospective
A collegial evaluation of the performance done to promote excellence in practice
Peer Review
Attempt to identify how future performance will be affected by current interventions
Prospective
Group of workers doing similar work who meet regularly, voluntarily on normal working time under the leadership of their supervisor
Peer Review
Measure how nursing care is provided or how the care was carried out
Process audit
Monitors the structure or setting in which patient care occurs such as the finances, nursing service structure, medical records, and environmental structure
Structure Audit
Used to provide a tool to assess deviations from accepted best practice process standards
Process audit
Determines what results if any, occurred as a result of specific nursing intervention for patients
Outcome Audit
Considered to be the most valid indicators of quality care
Outcome Audit
A sound disciplinary program must be tailored to the objectives of the institution
Disciplinary Approach
A constructive and effective means by which employees take personal responsibility for their own performance and behavior
Discipline
A sound disciplinary program must be tailored to the objectives of the
institution.
Disciplinary Approach
The employee is counseled regarding expectations of improved
performance, ways of correcting the problem and a warning that a
repetition of the same offense may warrant further disciplinary action.
Counselling and Oral Warning/Informal Reprimand
This reprimand includes an informal meeting between the employee and the
manager to discuss the broken rule or performance deficiency.
Counselling and Oral Warning/Informal Reprimand
This includes the statement of the problem, identification of the rule which
was violated, consequences of continued deviant behavior, and the
employee’s commitment to take corrective action, and any follow-up
action to be taken.
Written warning/formal admonishment
This is very specific about what rules or policies have been
violated, the potential consequences if behavior is not altered to meet
organizational expectations, and the plan of action that the employee is
expected to take to achieve expected change.
Written warning/Formal admonishment
gives the employee the opportunity to reflect on the behavior and to plan how he or she might modify the behavior in the future.
Suspencion
is given after an evidence of oral and written warnings
Suspension over a minor violation
Is applied when management feels that the employee can still be rehabilitated.
Suspension rather than dismissal
Invoked only when all disciplinary efforts have failed
Dismissal
should always be the last resort when dealing with poor performance
Termination
