Nursing Management Organizing Flashcards
involves establishing a formal structure that provides the coordination of resources to accomplish objectives, establish policies and procedures, and determine procedures and descriptions. It is the process of establishing formal authority.
Refers to a body of persons, method, policies, and procedures arranged in a systematic process through delegation of functions and responsibilities for the accomplishment of purpose.
Organizing
It is a line drawing that shows how the parts of an organization are linked. It depicts the formal organizational relationships, areas of responsibility, persons to whom, one is accountable, and channels of communication.
Organizational chart
individual or sub-unit responsible for a given task.
Division of work
lines indicating who reports to whom, and by what authority.
Chain of command
clusters of work groups differentiated from one another.
Types of work segments
indicating hierarchical relationships.
Levels of management
one nurse performs all services for the patient.
- common for PDNs, special care units, ISOLATION
Case method
task-oriented in which a particular nursing function is assigned to each worker
Functional method
decentralized system of care - Patient-centered care
- Team conference/planning
Every team member should have some knowledge of the patient’s condition, including problems and suggestions
Team method
RN is responsible for the total care of a small group of patients from admission to discharge.
The 24-hour responsibility of evaluating patient care is placed on the registered nurse. The secondary or the associate nurse execute the nursing care plan during the afternoon and night shifts and during the days when the primary nurse is off-duty.
Primary nursing
Assigned with a relatively small case load (4-8 patient)
d. The one-on-one relationship of “my patient my nurse from admission to discharge”
e. Care is based on patient’s needs and patient’s problem
Accountable for 24/7
Primary nursing
the creation of an organization system compatible with the philosophy, conceptual framework, goals of the organization provides the means for accomplishment of purpose.
Setting-up the Organizational Structure
- Comprises personal and social relationship that do not appear on the organizational chart
- it has its own channel of communication, which may disseminate information more broadly and rapidly than the formal communication system.
The best way to correct an invalid rumor is for the manager to provide accurate information.
Informal Organizational structure
- It is the official arrangement of position or working relationship that will coordinate efforts of workers of diverse interests and abilities.
- It describe position, task, responsibilities, and relationships among people in their positions in the different department in the organization and presented in diagrammatic form called organizational chart.
Formal Organizational Structure
– oldest simplest and most direct type
- each position has general authority over lower positions in the hierarchy
- connects position and task of each level (above or below level) or
(Superior-subordinate relationship)
- related to direct achievement of organizational objectives.
Line Organization / Bureaucratic/ Pyramidal
purely advisory to the line structure with no authority to place recommendations into action.
- provides advisory functions to line supervisors and executives, offers suggestion to aid and not to criticize.
- they function through influence for they do not have authority to accept, use, modify, or reject plans
- they make the line more effective but organization can function without staff authority, staff assistant, administrative assistant.
Staff Organization
permits a specialist to aid line positions within a limited and clearly defined scope authority.
- It decreases the line manager’s problem because it permits orders to flow directly to lower levels without attention to routine technical problems by the line positions.
Functional Organization
Major Forms of Organizational Structure ( Patterns )
- Centralized/Pyramidal or tall structure
- Decentralized/Participatory or Flat Structure
- Matrix System
- control emanates from top to down.
- most common in hospital
- emphasis is concentrated on traditional nursing
ADVANTAGES:
can be highly cost-effective.
It makes management easier.
DISADVANTAGES:
- As the organization becomes large and more complex, the hierarchal arrangement can prove cumbersome. (slow moving)
The arrangement does not readily adapt to change. And decisions to be made by higher managers.
Centralized
- This is a system whereby the large structure is broken down into smaller units and authority is delegated to those closer to the majority of workers.
The top management still retains ultimate responsibility for the operations of the various hospital departments but planning and implementation for each department is carried out by the department head who functions autonomously
ADVANTAGES:
Reflect their interest and have a voice in decision making.
Improve quality of care through 24 hours continuity.
Increase communication departmentally and interdepartmentally.
Problem solved with greater imagination and creativity.
DISADVANTAGES:
The initial cost in developing managers and staff training
Communication breakdown
Effective communication cannot occur with the face exchange of information among all of the concerned parties.
Problem with the role clarification can also occur.
Decentralized
the benefits of centralized and decentralized control are used.
It provides for both hierarchal
coordination in a separate department as well as lateral coordination across department.
Design to focus on both products & function
It has both vertical & horizontal chain of command.
ADVANTAGES:
The management can apply specialized skills to solve a problem.
Interdisciplinary cooperation is encouraged.
DISADVANTAGES:
All members must possess good interpersonal skills to receive orders from two different bosses.
Matrix
It is the graphic representative of the organizing process.
It shows reporting relationships and communication channels
are sometimes referred to as schemas.
Organizational chart
major characteristics of organizational charts
with task/workload per boxes
Division of work
Major characteristics of organization line indicates authority
Chain of command
Major characteristics of organization indicated as per labels or description
Type of worked performed
Major characteristics of organization clustered as per work groups, departments or units
Grouping of work segment
Major characteristics of organization indicates individual and entire management hierarchy
Levels of management
although employees may interact with many different employees in the performance of their duties, they should be responsible to only one superior.
This is to avoid confusion, overlapping of duties, and misunderstanding.
Unity of command
authority and responsibility should flow in clear unbroken lines from the highest executive to the lowest.
Proper definition and delegation of authority and responsibility facilitates the accomplishment of work
Scalar principle
workers performing similar assignments are grouped together for a common purpose.
Departmentation specializes activities, simplifies the administrator’s work and maintains effective control.
Homogeneous Assignment or Departmentation
the number of workers that a supervisor can effectively manage should be limited, depending upon the pace and pattern of the working area. If the workers are highly skilled, and working near each other, the number of workers may be increased.
At the top level of the structure a 1:6 ratio of the supervisor-workers is common,
while at the base of the organization a 1:10 ratio is common.
Span of control
recurring decisions should be handled in a routine manner by lower-level managers whereas problems involving unusual matters should be referred to higher levels.
This will enable subordinates to learn how to make decision at their own level.
Exception Principle
- It is the sum total of an organization’s beliefs, norms, values, philosophies, traditions, and ‘sacred cows’. It is a social system that is a subsystem of the total organization.
It has artifacts, perspectives, values, assumptions, symbols, language, and behaviors that have been effective.
Organizational culture
are those happening outside the organization that influence the organization as a whole or the top administrators.
Ex. 1. Population explosion – additional maternity ward
2. Economic force – training and education
External force
– are those that originate primarily from inside operations or are the result of external force
Ex. 1 . Decrease no. of RN and increase no. of Nursing Aide
2. Productivity need- 1:4 ~ 1:6 N ~ P ratio
Internal force
- It is the process of determining and providing the acceptable number and mix of nursing personnel to produce a desired level of care to meet the patient’s demand of care.
- It’s purpose is to provide each nursing unit with appropriate and acceptable number of each category of workers.
Staffing
STEPS IN STAFFING
- Determine the number and types of personnel needed
- Recruit personnel
- Interview
- Induct or orient personnel
- Job Offer
Expected hours of work per annum of each employee. This is influenced by the 40Hrs Week
(Employees working in 100 bed capacity & above will work only 40 hrs./week).
Law- RA 5901
Patient classification system
Self-care or Minimal care patients
Intermediate or moderate care patients
Total care patients
Intensive care patients
Types of formal organizational structure
Line Organization /Bureaucratic/Pyramidal
Staff organization
Functional organization
