MANAGEMENT

NCM 105
2010
MANAGEMENT
 Comes from old French term “MENAGEMENT”
 “the directing”
 From Latin word “mau agere”  “ to lead by the
hand”
 The process of leading and directing all or part of
an organization through the manipulation of
resources
 One role of leadership
 Emphasize control
MANAGEMENT
 PROCESS of:
 working with and through others to achieve organizational objective in a
changing environment
 Obtaining and organizing resources and of achieving objectives through other
people
 Getting work through others
 Planning, directing, coordinating and controlling, including:
 Leadership
 Giving direction
 Developing staff
 Monitoring operations
 Giving rewards
 Representing both staff and administration as needed
MANAGEMENT
 The process of:
 Coordinating action
 Directing action
 Assigning resources
 Purpose: to perform the tasks in order to achieve
the objectives/desired outcomes of an organization
NURSING MANAGEMENT
The process of working through
nursing staff members to provide
care, cure and comfort to patients
MANAGERS
 HAVE:
 Assigned position within the formal organization
 Legitimate source of power due to delegated authority that accompanies
their position
 Greater formal responsibility and accountability for rationality and control

 Are expected to carry out specific functions, duties and

responsibilities
 Emphasize control, decision making and analysis, and results
 Manipulate people, the environment, money, time and other
resources to achieve organizational goals
 Direct willing and unwilling subordinates
MANAGEMENT THEORIES
SCIENTIFIC MANAGEMENT
(1900 – 1930)

 Frederick W. Taylor – father of scientific management

 “if workers could be taught the “one best way to accomplish a task “
productivity would increase
 Principles:
 Traditional “rule of thumb” means of organizing work must be replaced
with scientific method
 Scientific personnel system must be established so that workers can be
hired , trained, and promoted based on their technical competence and
abilities
 Workers should be able to view how they “fit” into the organization and
how they can contribute to overall organizational productivity
 The relationship between managers and workers should be cooperative
and interdependent, and work should be shared equally
MANAGEMENT FUNCTION
 HENRI FAYOL (1925)
 Identified management function of:
 Planning
 Organizing
 Command
 Coordination
 Control
MANAGEMENT FUNCTION
 Luther Gulick (1937)
 “seven activities of management”
 POSDCRB
 Planning
 organizing
 Staffing
 Directing
 Coordinating
 Reporting
 Budgeting
HUMAN RELATIONS MANAGEMENT
(1930-1970)

 Mary Parker Follett: Participative Management

 Participative decision making
 Managers should have the authority with, rather than over,
employees
 Elton Mayo (1953): Hawthorne effect
 Indicated that people respond to the fact that they are being
studied, attempting to increase whatever behavior they feel will
continue to warrant the attention
 Informal work group and socially informal work environment
were factors in determining productivity
 Recommended more employee participation in decision making
THEORY X AND THEORY Y
 DOUGLAS McGREGOR
 Theory X: managers believe that their employees are:
 Basically lazy
 Needs constant supervision and direction
 Indifferent to organizational needs
 Theory Y: managers believe that their workers:
 Enjoy their work
 Are self-motivated
 Are willing to work hard to meet personal and
organizational goals
EMPLOYEE PARTICIPATION
 CHRIS ARGYRIS (1964)
 Stress the need for flexibility within the
organization and employee participation in decision
making
MANAGEMENT THEORY
THEORIST THEORY
Taylor Scientific management If person can be taught the one best
way to accomplish a task, productivity
will increase
Weber Bureaucratic organizations Need for legalized, formal authority,
and consistent rules and regulation for
personnel in different position
Fayol Management functions Planning, organizing, command,
coordination, control
Gulick Activities' of management Planning, organizing, staffing,
directing, coordinating, reporting,
budgeting
Follet Participative management Managers should have the authority
with rather than over employees
MANAGEMENT THEORY
THEORIST THEORY
Mayo Hawthorne effect People respond to the fact that they are
being studied, attempting to increase
what ever behavior they feel would
warrant attention
Mc Gregor Theory X and theory Y Employees are basically lazy, needs
constant supervision and direction
indifferent to organizational needs
Employees enjoy their work, self
motivated and willing to work hard to
meet personal and organizational goals
Argyris Employee participation Employees participation in decision
making
 LEVELS OF MANAGERS
LEVEL RESPONSIBILITY
TOP MANAGERS Responsible for the overall operations of nursing services,
establish objectives, policies, and strategies
Represents the organization in community affairs, business
arrangement and negotiations
Typical titles: director of nursing service, chairman,, executive
vice president

MIDDLE Coordinate the nursing activities of several units;

MANAGERS Receives broad, overall strategies and policies from top
manager and translate them into specific objectives and
programs, typical titles; supervisor, coordinator, clinical nurse
managers and case managers are included at this level as they
use collaborative management to move patient’s through the
system

FIRST-LINE Directly responsible for the actual production of nursing

MANAGERS service; act as links between higher level managers and non-
managers
Typical titles: nurse manager, team leader, primary care nurse
ROLE OF MANAGERS
ROLE DESCRIPTION
INTERPERSONAL The manager :
1. As a symbol because of the position he/she occupies
2. As a leader who hires, trains, encourages, fires,
remunerates and judges
3. As a liaison between outside contact such as community,
supplier and organization
INFORMATIONAL The manager
1. As one who monitors information
2. Disseminate information from both external and internal
sources
3. As spokesperson of the organization
DECISIONAL 1. An entrepreneur or innovator, problem discoverer, designer
to improve projects that direct and control change in the
organization
2. Trouble shooter
3. Negotiator when conflict arise
SIMILARITIES & DIFFERENCES BETWEEN
LEADERS AND MANAGERS
LEADERS MANAGERS
 May or may not have official  Appointed officially to the
appointment to the position position
 Have power and authority to
enforce decisions only as  Have power and authority to
long as followers are willing enforce decision
to be led
 Influence others towards  Carry out pre-determined
goal setting policies, rules, and regulations
 Interested in risk taking and  Maintain an orderly,
exploring new ideas controlled, rational, and
equitable structure
SIMILARITIES & DIFFERENCES BETWEEN
LEADERS AND MANAGERS

LEADER MANAGER
 Relate to people  Relate to people
personally in an according to their roles
intuitive and empathic by enabling others to
manner act
 Feel rewarded by  Feel rewarded when
personal achievements fulfilling
organizational mission
or goals by fostering
collaboration
SIMILARITIES & DIFFERENCES BETWEEN
LEADERS AND MANAGERS

LEADER MANAGERS
 May or may not be  Are managers as long
successful as as the appointment
managers holds
EFFECTIVE LEADERSHIP & MANAGEMENT

Understanding of individual strengths, weaknesses, and

potential
+
Knowledge of basic ingredients for leadership and
management
+
Learning from other people and experiences
+
Systematic use of self to get the right things done at the right
time
DECISION MAKING
DECISION MAKING
 The process of establishing criteria by which a leader can
develop and select course of action from a group of
alternatives
 One of the criteria on which management expertise is judged
 The innermost leadership activity and the core of management
 Choosing a particular course of action
 Triggered by a problem, but is handled in a manner that does
not focus on eliminating the underlying problem
 May or may not be the result of a problem
 Considered as a critical thinking process just like problem
solving
Characteristics of Decision Making
 Not linear or totally logical process, may involve
intuition
 Often the result of many incremental steps rather
than one large steps
 Smaller choices may be impacted by many factors
other than rationality and analytical thought
(Sullivan & Decker, 1992; Little-Stoetzel, 2003)
Characteristics of Successful Decision Makers

 Learn to emphasize the tools and techniques that

help make decision-making effective and efficient
 Minimize the technique or events that can sidetrack
the critical thinking/decision making process
 Ability to engage in critical thinking
CRITICAL THINKING
 Analyzing the way one thinks
 Must be incorporated into all steps of problem solving and decision making
 EFFECTIVE CRITICAL THINKERS
 Constantly generate new ideas and alternatives
 Do not rely on “we’ve always done it this way”
 Able to step back from issues and analyze its component
 Often ask:
 What are the underlying assumptions of this point of view?
 Where does the evidence come from and how is it being interpreted?
 How does the logic and argument hold together?
 Can discern the quality of information that underlies ideas, whether it is:
 Precise, accurate, relevant, consistent, logical, complete, and unbiased
 Able to assume another person’s perspective or point of view in order to see all
sides of an issue
Strategic Steps in Decision Making
 Identify need for decision
 Consider:
 What needs to be determined
 Why a decision is needed
 All information available
 State issues in broader term rather than narrower term

 Determine desired goal or outcome

 Goal should be:
 Clear and specific
 Stated in a sentence or two
Strategic Steps in Decision Making
 Identify any other actions that exist.
 For each alternative action, identify:
 Possible consequences
 Possible benefits

 Decide which action to implement, based on each action’s

benefits and consequences

 Evaluate the action by asking:

 Was the goal achieved completely or partially
 Was the goal not achieved
Steps in Managerial Decision Making Models

 Determine the importance and context of the decision

 Consider possible consequences of the decision
 Determine the objective for the decision
 List all options
 Explore promising options
 Establish decision making criteria
 Evaluate the options against criteria
 Select option to pursue
 Analyze the risk
IDEALS MODEL
 Identify the problem
 Define the context
 Enumerate the choices
 Analyze options
 List reasons explicitly
 Self correct
Critical Elements in Decision Making

 Define objective clearly

 Decisions with out clear objective, poor quality lesion
is likely
 Gather data carefully
 Generate many alternatives
 Think logically
 Choose and act decisively
Decision Making Tools
 Decision Grids
 Allows one to visually examine the alternatives and
compare each against the same criteria

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Decision Making Tools
 Decision Tree
 Consequence Tables
 List the objectives for solving a problem down one
side of a table and rates how each alternatives would
meet the desired objective
 Payoff Tables
 Have a cost-profit-volume relationship
 One must determine probabilities and historical data
such as:
 Hospitalcensus
 Report on numbers of operating procedures performed
Decision Making Tools
 Logic Models
 Schematics or pictures of how program are intended to operate
 Includes:
 resources
 Processes
 Desired outcomes
 Depicts exactly what the relationship are between the 3 components
 PERT – Program Evaluation and Review Technique
 A popular tool to determine the timing of decisions
 Developed by Booz-Allen Hamilton organization and the US navy in
connection with the Polaris missile program
 A flow chart that predicts when events and activities must take place if a
final event is to occur
Conditions that may Affect
Decision Making
 Conditions of CERTAINTY
 Alternatives and existing conditions are well known
 Decisions can be made with full knowledge of what the outcome will be

 Conditions of RISK
 Alternative and conditions are not very well known
 Decision outcomes can only be expressed as probability rather than
certainty
 Different levels of probability
 Objective probability = like hood that an event will or will not occur based on
the facts and reliable information
 Subjective probability = like hood that an event will or will not occur based on a
leader’s personal judegement or belief
Conditions that may Affect
Decision Making
 Conditions of UNCERTAINTY
 Alternatives and conditions are complex and variable
 Person making the decision may not be even aware of all possibilities
 Decision making may be occurring in a rapidly changing environment
 Decision outcome cannot be expressed even as probability

 3 approaches for dealing with UNCERTAINTY

 Maximax approach –most optimistic
 Select alternative with best possible outcome for all alternatives
 Maximin approach – most pessimistic
 Choose the worst possible outcome for each possible alternative then choose the least
objectionable worst outcome
 Minimax approach /Risk averting approach
 Select the alternative that has the fewest variable among its possible outcomes
 Considered as highly effective
DECISION MAKING WITHIN
GROUPS
 Group decisions must include the stakeholders  persons
who will be affected by the decision

 Advantages of group decision making:

 More people involved
 More input and feedback
 More stake holders who can “buy in” to decisions and outcome and
support group’s decision
 Disadvantages:
 Time consuming
 Can lead to increased conflict and sabotage of the group’s decision
Methods of Group Decision
Making
 CONSENSUS building
 All group members can live with and fully support the decision
 Consensus does not mean that everyone agrees, it just mean that they can live with it
 Advantage – greater support for decision made
 Disadvantage s:
 Time needed for decisions
 People wanting to block a decision can use consensus to delay decisions

 NOMINAL group technique

 Nonverbal technique in which group members write out their ideas
 Ideas and their pros and cons are presented on a flip chart or board
 Group discusses ideas and puts them into a private vote; highest rating wins
 DELPHI group technique
 Group members receive questionnaires
 Results are summarized and redistributed
 Process of questions followed by summary continues until group reaches concensus
Do’s and Don'ts of Decision
Making
DO DON’T
 Make only decision that are yours to  Make snap decision
make  Waste your time making decisions
 Write notes and keep ideas visible that do not have to be made
about decisions to utilize all relevant  Consider decision a choice between
information
right and wrong but a choice between
 Write down pros and cons of an issue alternatives
to help clarify our thinking  Prolong deliberation about decisions
 Makes decision as you go along rather
than letting them accumulate
 Regret a decision
 Consider those affected by the decision
 Always base decision made on the
“way things have always been done”
 Trust your self
Group Work
 Situation:
 A visiting policy may allow only one family member
to be with a patient at a time. However, the patient is
15 years old and his single mother is with his 10 year
old brother because she did not have anyone else to
stay with the younger boy

What would be the desired goal

What are the things to be taken into considerations
DECISION MAKING
 Goal:
 To decide if making an exception to hospital policy is in this
patient’s best interest
 Determine if the hospital’s goal concerning patient care and
privacy can be met if an exception to the policy is allowed
 Pros and cons
 Benefit :
 allowing the brother is additional support for the patient since he and the
brother are close
 Not having a 10 year old boy by himself in a waiting area
 Consequence:
 Possible loss of privacy and inconsistency with other patient’s visitors
DECISION MAKING
 Actions to implement based on pros and cons
 Depending on liability and other issues nursing staff may:
 Rank issues of consistency with all other visitors and privacy for other
patient in the room higher or
 Staff may decide that patient comfort and keeping the family together
higher

 Evaluate
 If the decision was to allow the visitor
 Did having the brother’s presence make the patient less anxious
 Did it not seem to make a difference
 Did having the brother makes the patient more anxious