CONTROLLING

CONTROLLING

Use of formal authority to assure the achievement of goals and objectives.

CONTROLLING

Performance is measured and corrective action is taken to ensure the accomplishment of organizational goals.

CONTROLLING

Is an on-going function of management which occurs during planning, organizing, and directing activities.

A Critical Few

A Defined Point of Control

Self-Control / Discipline

Principles of Controlling

A Critical Few

The fewer people involved in control brings about the best results.

A defined Point of Control

Centralization or decentralization of authority.

Self-control or Discipline

Which translates to personal acceptance of responsibility and accountability

Pre-action Control

Post-action Control

Kinds of Formal Control

Pre-action Control

Controlling by means of personal supervisión and utilizing control checks consisting of procedures for any given task or function.

Post-action Control

Controlling as the task or function is being performed or may have been performed and correcting deviations from standards or plans.

Feedforward Control

Concurrent Control

Feedback Control

Types of Control (by Timing)

Feedforward Control

BEFORE the process begins

Concurrent Control

DURING the process

Feedback Control

AFTER it ceases

Feedforward Controls

Focus on operations before they begin; goal is to PREVENT anticipated problems.

Concurrent Controls

Applied to processes AS they are happening.

Feedback Control

Focus on RESULTS of operations; guides future planning, inputs, and process design.

Step 1 — Establish and Specify Criteria and Performance Standards

Step 2 — Monitor and Measure Performance

Step 3 — Compare Performance with Standards/Models/Criteria

Step 4 — Enact Remedial Measures to Correct Deviations or Errors

Steps in the Control Process

Standards

Created when objectives are set during the planning process.

Time controls

relate to deadlines and time constraints.

Material controls

relate to inventory and material-yield controls.

Equipment controls

are built into the machinery, imposed on the operator to protect the equipment or the process.

Employee performance controls

focus on actions and behaviors of individuals and group of employees

Time Controls

Material Controls

Equipment Controls

Employee Performance Controls

Resource Controls

Financial Controls

Facilitate achieving the organization’s profit motive

Operations Control

Assess how efficiently and effectively an organization’s transformation processes create goods and services.

Statistical Process Control

Use of statistical or mathematical methods and procedures to determine whether production operations are being performed correctly, to detect any deviations, and to find and eliminate their causes.

The Just-in-Time (JIT) System

The timely application of medication for the illness of a patient, and purchased materials just in time to be transforemd into parts

Nursing Rounds

Quality Assurance

Nursing Audit

Techniques for Monitoring and Measuring Services

Nursing Rounds

Pay particular attention to patient care and nursing practice issues; satisfies needs/problems met or unmet.

Quality Assurance

Monitors compliance with established standards.

Nursing Audit

Documentation of the quality of nursing care in relation to standards set by the nursing department.

Step 1 — Establish and Specify Criteria and Performance Standards

These serve as the criteria against which performance is measured.

Step 2 — Monitor and Measure Performance

Evaluated against standards through records, reports, and observations.

Step 3 — Compare Performance with Standards/Models/Criteria

Evaluation ensures tasks are carried out as planned. Actual accomplishment is matched with the accepted standard to check for delays or deviations

PERT (Program Evaluation and Review Technique)

Benchmarking

Techniques for Correction and Improvement Based on Feedback

PERT (Program Evaluation and Review Technique)

Provides a visual picture depicting the sequence of tasks needed to complete a project.

Benchmarking

Seeks out the best so as to improve its performance. It provides a standard or point of reference in measuring or judging such factors as quality, values and cost.

Market Control

Bureaucratic Control

Clan Control

Self-Control / Adhocracy Control

Management Control Strategies

Quality Improvement / Quality Management

•    Systematic process to improve outcomes based on customers' needs.

•    Emphasis: “Doing the right thing.”

•    More of an overall management approach rather than a single program.

1. Plan-Do-Check-Act Cycle (PDCA)

2. FOCUS Methodology

Methods for Quality Improvement

Plan-Do-Check-Act Cycle (PDCA)

Starting questions: (1) What are we trying to accomplish? (2) How will we know a change is an improvement? (3) What changes can we make that will result in improvement?

Plan

Plan a change, test, or activity aimed at improvement.

Do

Carry it out (preferably on a small scale).

Check

Study the results — what did you learn? What can you predict?

Act

Adopt the change, abandon it, or run through the cycle again under different conditions.

F Focus on an important idea.

O Organize a team that knows the process.

C Clarify what is happening in the current process.

U Understand the degree of change needed.

S Solve the problem.

FOCUS Methodology

Benchmarking

Process of identifying best practices and comparing them with the agency's practices to improve performance. Identifies gaps in performance and provides options for improvement.

Regulatory Requirements

Standards developed to guide critical activities performed by health care organizations.

Sentinel Event Review

Review of an UNEXPECTED occurrence involving death or serious physical/psychological injury to a patient.

Balanced Scorecard

Measures progress across 4 domains: functional outcome, satisfaction, costs, clinical status (McLaughlin & Houston, 2003). A change in one domain must be evaluated for its effect on the others.

Story Board

takes the major steps in the improvement methodology and visually outlines the progress in each step.

Patient Satisfaction Data

Feedback from patients via questionnaire, focus group, or postcare interview.

Accreditation

• A voluntary program in which trained EXTERNAL peer reviewers evaluate a health care organization's compliance and compare it with pre-established performance standards.

Performance Appraisal

•    The MOST VALUABLE tool in controlling human resources and productivity.

•    A control process in which an employee's performance is evaluated against standards.

•    A method of acquiring and processing information needed to improve the individual's performance and accomplishments.

•    The periodic, FORMAL evaluation of how well personnel performed their duties during a specific period.

Anecdotal Records

Describes the nurse’s experience with a group or a person , or in validating technical skills and interpersonal relationship

Checklist

It is composed of behavioral statements that represent desirable behavior

Ranking

Descending order from highest to lowest even if they do not think there is a difference.

Trait Rating Scale

Method of rating a person against a set standard which may be the job description, desired behavior and personal trait

Job Dimension Scales

It focuses on job requirements and the quality work performance.

Behaviorally Anchored Rating Scales (BARS) Behavioral Expectation Scales.

Focuses on desired behaviors to improve performance.

Essays

The appraiser writes a paragraph or more about the worker’s strengths, weaknesses, and potentials.

Self-appraisal

Employees are asked to submit written summaries or portfolios of their work-related accomplishments and productivity.

Peer Review

Provides employees with an opportunity to receive better feedback that can promote growth and learning opportunities for the peer reviewers.

Management By Objectives

An excellent method to appraise the performance of the registered nurse in a manner that promotes individual growth and excellence in nursing.

Management By Objectives

Emphasizes the achievement of objectives instead of personality characteristics.

Halo Effect

A tendency to over rate staff based on the rater’s first impression of the ratee. The evaluation is based on the good traits or the good things one sees in a person.

Horn Effect

Occurs when rating an employee very low because of an error committed

Logical Error

Based on the first impressions of the rater to the ratee.

Rating a nurse high on one characteristics because the nurse possesses another characteristics that is logically related.

Contrast Error

Produced by the tendency of managers to rate the nurse opposite from the way they perceive themselves.

Leniency Error

There is propensity to overlook the weaknesses and mistakes of the person being evaluated leading to an inaccurate picture of the job performance.

Hawthorne Effect

Behavior of the ratee changes simply because he/she is observed by the rater.

Central Tendencies (median, mode, mean)

It rates the staff as average.

Used by the rater when feedback tools are inadequate.

Game playing

Control is something to be beaten, a game between the “boss and me and I want to win.”

Resisting control

A passive aggression or negative reaction to too much control

Providing inaccurate information

A lack of understanding of why the information is needed and important leading to “you want numbers, we will give you numbers.”

Following rules to the letter

People following dumb and unprofitable rules in reaction to “do as I say.”

Sabotaging

Stealing, discrediting other workers, chasing customers away, gossiping about the firm to people in the community.

Playing one manager off against another

Exploiting lack communication among managers, asking a second manager if don’t like the answer from the first manager.

NURSING AUDITS AND ROUNDS

Systematic and oficial examination of records, process, structure environment or accounts to evaluate performance.

Structure Audit

Process Audit

Outcome Audit

Basic Forms of Nursing Audit

Structure Audit

Monitors the STRUCTURE or SETTING in which patient care occurs.

Process Audit

Measures the PROCESS of care and HOW care was carried out.

Assumes a relationship between the nursing process used and quality of care.

Outcome Audit

Examines the END RESULT of care — how the patient's health status changed as a result of specific nursing interventions.

Retrospective

Performed after the client received the service

Concurrent

Performed while the client is receiving the service

Prospective

Attempts to identify how future performance will be affected by current interventions

Net Expense Worksheet

Variance Report per Cost Center

Budget Dashboard

Variance Reports

Net Espense Worksheet

Shows the actual expenses of the unit.

Variance report per cost center

A tool used to identify when categories are out of line, to identify the need for corrective action.

Budget dashboard

Shows the overall activity of the unit in terms of volumen/Access, patient satisfaction, human resources, expenses, capital budget and comments.

1. Finances

2. Customer satisfaction and services

3. Internal operating efficiency

4. Learning and growth

Dashboard identifies 4 perspective about organization

ACCREDITATION

➢ the action or process of officially recognizing someone as having a particular status or being qualified to perform a particular activity.

➢ an acknowledgment of a person's responsibility for or achievement of something.

➢ a big fancy word that simply means a quality check.

Accreditation

is usually a voluntary program in which trained external peer reviewers evaluate a healthcare organization's compliance and compare it with pre-established performance standards

EMPLOYEE DISCIPLINE

is the process of generating employee compliance to institutional rules and regulation.

Coaching

s a day-to-day process of helping employees improve their performance. This is done through interaction which encompasses need analysis, staff development, interviewing, decision making, problem solving, analytical thinking active listening, motivation, mentoring, and communication skills. The goal is to eliminate or improve performance problems such as excessive absenteeism or frequent personal phone calls.

Confrontation

is a communication technique used to address specific issues such as violation of a policy or procedure.

Disciplinary Conference

uses a combination of directive and non-directive

technique, in order to minimize stress during the interview

Progressive discipline

means the adherence to the principle of due process, and fair treatment of subordinates. The measures taken should be graduated according to the frequency (1st time, 2nd time, etc.) and severity of the offense.