NCM 205

Concept of
Management
 Definition
 Management in all business and human
organization activity is simply the act of getting
people together to accomplish desired goals and
objectives. Management comprises planning,
organizing, staffing, leading, or directing, and
controlling, an organization(a group of one or
more people or entities) or effort for the purpose of
accomplishing a goal. Resourcing encompasses
the deployment and manipulation of human
resources, financial, resources, technological
resources, and natural resources.
• is the organizational process that includes
strategic planning, setting; objectives,
managing resources, deploying the human
and financial assets needed to achieve
objectives, and measuring results.
Management also includes recording and
storing facts and information for later use
or for others within the organization.
Management functions are not limited to
managers and supervisors. Every member
of the organization has some management
and reporting functions as part of their job
• The process of planning, leading,
organizing and controlling people
within a group in order to achieve
goals; also used to mean the group
of people who do this.
• a process of coordinating actions
and allocating resources to achieve
organizational goals.
 Management Theories
• Management theories, evolve from governance of
ancient Samaria & Egypt ( 3000 BC)
• Classical Theories of Management in (1800)
Industrial Age , rise of factories also known as
Traditional Management Theory
– Three Subfields
• Scientific Management
• Bureaucratic Management
• Administrative Management
• Scientific Management
• Frederick Taylor ( an engineer), the father of scientific
management for his use of the scientific method &
the author of Principles of Scientific Management.
• Frank & Lillian Gilbreth also contributed to scientific
management.
– Focus is on goals & productivity
– The organization is viewed as a machine to be run efficiently
to increase production.
– Managers must closely supervise the work to assure
maximum efficiency
– Workers must have proper tools & equipment.
– There is focus in training the worker to work most efficiently &
performance incentives are used.
– Time & motion studies are the vehicle for determining how to
do and organize the work in the most efficient manner
• Frederick Winslow Taylor
• American Mechanical
Engineer
• Born= 20 March 1856
• Died= 21 March 1915
• Occupation= Efficiency
Expert
• Known for = Father of
Scientific Management
• Scientific management
• Taylor believed that the industrial
management of his day was amateurish,
that management could be formulated
as an academic discipline, and that the
best results would come from the
partnership between a trained and
qualified management and a cooperative
and innovative workforce. Each side
needed the other, and there was no need
for trade unions.
 The Principles of Scientific Management, published in
1911. The Eastern Rate Case propelled Taylor's ideas to
the forefront of the management agenda. Taylor wrote to
Brandeis "I have rarely seen a new movement started with
such great momentum as you have given this one."
Taylor's approach is also often referred to, as Taylor's
Principles, or frequently disparagingly, as Taylorism.
Taylor's scientific management consisted of four
principles:
1.Replace rule-of-thumb work methods with methods based
on a scientific study of the tasks.
2.Scientifically select, train, and develop each employee
rather than passively leaving them to train themselves.
3.Provide "Detailed instruction and supervision of each
worker in the performance of that worker's discrete task"
(Montgomery 1997: 250).
4.Divide work nearly equally between managers and
workers, so that the managers apply scientific
management principles to planning the work and the
workers actually perform the tasks.
 Bureaucratic Management
Maximilian Carl Emil
Weber
German Lawyer , political
economist & sociologist
Born: 21 April 1864
 Erfurt, Prussian, Saxony,
Germany
Died: 14 June 1920
Munich, Bavaria
 Bureaucratic Management
Max Weber, a German theorist for the organizational
theory of bureaucracy.
◦ Focus is on superior-subordinate communication from the top
down via a clear chain of command, a hierarchy of authority,
and a division of labor chain. Uses rational, impersonal
management process.
◦ Uses explicit rules & regulations for governing activities
focuses on exacting work processes & technical competence.
◦ Uses merit & skill on basis for promotion / reward.
◦ Emphasizes lifetime career service & salaried managers.
Administrative Management
– Focus is on the science of management & principles
of an organization applicable in any setting.
– Identifies need for Planning, Organizing, Supervising,
Directing, Controlling, Organizing, reviewing &
Budgeting ( POSDCORB)
– Commonly referred to as the management process
that involves planning, organizing, coordinating, &
controlling.
– Concern with the optimal approach for
administrators to achieve economic efficiency.
 Human Relations
– Focuses on empowerment of the individual
worker as the source of control, motivation, &
productivity in organizations.
– Hawthorne studies at Western Electric plant in
Chicago led to belief that human relations
between workers and managers and among
workers were the main determinants of
efficiency.
– The hawthorne effect refers to the phenomena of
how being observed or studied results in a
change of behavior.
– Emphasizes that participatory decision making
increases worker autonomy.
– Provides training to improve work
 Basic Management Roles &
•
Functions
Mintsberg groups of basic roles performed by
managers
– Interpersonal
• The Figurehead
• The Leader
• The liaison
– Informational
• As a monitor
• The disseminator
• As a spokesperson
– Decisional
• The Entrepreneur
• The Disturbance handler
• As resource allocator
• Interpersonal Role
– As a symbol because of the position he/she
occupies & consists of such duties as signing of
papers/ documents required by the organization.
• Informational Role
– Monitors information, disseminates information
from both external/internal sources, as
spokesperson or representative of the
organization
• Decisional Role
– Entrepreneuer or innovator, problem discoverer,
a designer to improve projects that direct &
control change in the organization. A trouble-
shooter who handles, firing of subordinates, &
losses clients & negotiator when conflicts arise.
 Major Functions of Management
Process
 Henri Fayol- 1916,French Industrialist, he
1st described the Four functions of
Management:
1.PLANNING
2.ORGANIZING
3.DIRECTING
4.CONTROLLING
Henri Fayol
1916
French Industrialist
He identified the Four
Functions Management
◦ Planning
◦ Organizing
◦ Directing
◦ Controlling
He developed the 14
principles of
Management
 The 14 Principles of
Management
1.DIVISION OF WORK: Work should be divided among individuals and
groups to ensure  that effort and attention are focused on special portions
of the task. Fayol presented work specialization as the best way to use the
human resources of the organization.                                                            
                                                      
2.AUTHORITY: The concepts of Authority and responsibility are closely
related. Authority was defined by Fayol as the right to give orders and the
power to exact obedience. Responsibility involves being accountable, and is
therefore naturally associated with authority. Whoever assumes authority
also assumes responsibility.                                                              
3.DISCIPLINE: A successful organization requires the common effort of
workers. Penalties should be applied judiciously to encourage this common
effort.                                                                              
4.UNITY OF COMMAND: Workers should receive orders from only one
manager.                                                                                              
5.UNITY OF DIRECTION: The entire organization should be moving towards
a common objective in a common direction.                                                  
                           
6.SUBORDINATION OF INDIVIDUAL INTERESTS TO THE GENERAL
INTERESTS: The interests of one person should not take priority over the
interests of the organization as a whole
7. REMUNERATION: Many variables, such as cost of living, supply of qualified personnel, general
business conditions, and success of the business, should be considered in determining a worker’s
rate of pay.                                                                                                  
8. CENTRALIZATION: Fayol defined centralization as lowering the importance of the subordinate role.
Decentralization is increasing the importance. The degree to which centralization or decentralization
should be adopted depends on the specific organization in which the manager is working.                  
                                                
9. SCALAR CHAIN: Managers in hierarchies are part of a chain like authority scale. Each manager,
from the first line supervisor to the president, possess certain amounts of authority. The President
possesses the most authority; the first line supervisor the least. Lower level managers should always
keep upper level managers informed of their work activities. The existence of a scalar chain and
adherence to it are necessary if the organization is to be successful.                                                    
                        
10. ORDER: For the sake of efficiency and coordination, all materials and people related to a
specific kind of work should be treated as equally as possible.                                                              
      
11. EQUITY: All employees should be treated as equally as possible.                                                
                                                                
12. STABILITY OF TENURE OF PERSONNEL: Retaining productive employees should always be
a high priority of management. Recruitment and Selection Costs, as well as increased product-reject
rates are usually associated with hiring new workers.                                                                          
                      
13. INITIATIVE: Management should take steps to encourage worker initiative, which is defined as
new or additional work activity undertaken through self direction.                                                    
14. ESPIRIT DE CORPS: Management should encourage harmony and general good feelings
among employees.
 Four Major Functions Management
Process
by: Henri Fayol
1. Planning
2. Organizing
3. Delegating
4. Controlling
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 Planning
A. Establish policies procedures,
definite course of action &
methods
B. Prepare budget , allocate
resources
C. Develop & Schedule Programs
D. Define Activities needed & set
time frame
E. Set objectives
 Directing
1. Delegate Nursing Care Assignments
2. Utilize update policies & procedures
3. Supervise harmonize goals thru guidance
4. Coordinate unite personnel & services
5. Communicate, ensure common
understanding via various routes
6. Develop people, provide staff
development programs
7. Decide/ make judgement
 Planning
 Is defined as pre-determining a course of action in
order to arrive at a desired result.
 Means to decide in advance what is to be done.
 It aims to achieve a coordinated & consistent set
of operations aimed at desired objectives.
 Main activities are the formulation of strategies
and setting the objectives.
 Strategy- is the set of decisions that determine the character
( size, scope, & mix of services ) of a health services
organization & give direction in the market place.
 It is a continuous process of assessing, establishing goals
& objectives, implementing and evaluating them, and
subjecting these to change as new facts are known.
 Thinking Ahead, Making Future Projections
 • A .Planning
– Is the first function of the management process.
– By forecasting one can estimate the future; by
setting objectives the results to be achieved can
be determined.
– Developing & scheduling programs, the activities
needed within a set time frame can be defined;
by preparing the budget, tools & resources can
be allocated while establishing policies &
procedures that will define the course of action &
standards.
 Principles of Planning
1. Planning is always based & focused on the
vision, mission, philosophy, & clearly defined
objectives of the organizations.
2. Planning is a continuous process
3. Planning should be pervasive w/in the entire
organization covering the various departments,
services, & the various levels of management to
provide maximal cooperation & harmony.
4. Planning utilizes all available resources
5. Planning must be precise in its scope & nature.
6. Planning should be time-bounded.
7. Projected plans must be documented &
evaluation as to the extent of its achievement.
 Importance of Planning
• It leads to the achievement of goals &
objectives.
• It gives meaning to work
• It provides for effective use of available
resources & facilities.
• It helps in coping with crises
• Planning is cost effective
• Planning based on past & future activities
• Planning leads to the realization of the
need for change.
• Planning provides the basis for control.
• Planning is necessary for effective control.
 Scope of Planning
» Top Management
» Nursing Director/ Chief Nurse
» Asst. Nursing Director/ Asst. Chief Nurse
• Set the over –all goals & policies of an organization.
• Covers the over-all management of the organization’
Nursing Service
» Middle Management
» Nursing Supervisors
• Implements the broad operating policies of the
organization such as:
– Staffing
– Delivery of services to the units
» Lower or First Level Management
» Head Nurses or Senior Nurses/ Charge Nurses
• Do the daily /weekly plans for the administration of direct
patient care in their respective units.
 Characteristics of a Good Plan
• Be precise w/ clearly-worded objectives,
including desired results & methods for
evaluation.
• Be guided by policies & / or procedures
affecting the planned action.
• Develop actions that are flexible & realistic
in terms of available personnel,
equipment, facilities , & time.
• Include the most practical methods for
achieving each objective &
• Pervade the whole organization.
 Setting the Vision, Mission,
Philosophy, Goals & Objectives
• A vision statement- outlines the organization’s
future role and function. It gives the agency
something to strive for.
• A mission statement – outlines the agency’s
reason for existing, who are the target clients,
and what services will be will be provided.
• A philosophy – describes the vision. It is a
statement of belief and values that direct one’s
life or one’s practice.
• Goals & objectives – differ in that goals are more
general and cover a broad area.
• Objectives- are concrete, they are action
commitments through w/c an organization’s
mission and purpose will be achieved and the
philosophy or belief sustatined.
 Establishing Nursing Standards, Policies &
Procedures
• Nursing Standards
– Structure, Criteria, and Standards
– Guidelines- The Nursing Service Administrator:
• Nursing Service Policies
– Characteristics of Good Policies
– The Nursing Service Policy Manual
• Accidents- care reporting, precaution to prevent occurrence
• Admissions- receiving consent, notifying doctor, care of
patients.
• Autopsies- obtaining informed consent
• Breakage- classification, responsibility, reporting
• Bulletin Boards- location, posting of information
• Committees- types, memberships, functions
• Complaints- how handled, action taken
• Consent – informed consent taken by whom, from whom
shared decision- making w/ patient & family & or significant
others together w/ members of the health team
• Death- notification, care & identification,
care of personnel belonging, death
certificate.
• Discharge- time, clearances, discharge
planning accompaniment of patient.
• Doctor’s orders- written, verbal, by
telephone.
• Equipment & supplies- list of
expendable and non expendable items,
care, lending, requesting, repairing.
• Fire regulations- drills, prevention
• Nursing Care
– Administration & preparation of oral meds, IV infusions,
blood transfusion
– Charting- Forms used, use of various colors of ink,
format considering legal implications
– Daily assignment – by whom, where, when
– Emergency Drug Supply- contents, responsibility,
location
– Kardex- use, sample form
– Medications- card system, responsibility, checking,
dosages, errors, reporting, correction.
– Property of Patients- responsibility, placement
– Private Duty Nurses- engaging, obligations to hospital,
supervision, evaluation, remuneration.
– Reasonable & Due Care- definition, explanation, legal
implication
– Referrals- w/in & outside of agency.
– Safety Devices- siderails, restraints
• Reports – forms, responsibility
• Reporting On or Off- Duty- Information given when
leaving unit.
• Meeting- frequency, purpose, types, membership,
minutes.

• Interdepartmental Policies:
– Ensuring unity & harmonious relationships among
departments.
– The nursing unit will endeavor to make god use of the
professional & technical services to render help to the
patient.
– Coordinating of all activities in obtaining the same final
goal may be made through the use of written policies:
• Examples:
– Admissions- type of patients, time, reservation, identification of
patients, signing consents.
– Transfers - requests, departments to be notified.
– Discharges – notification, against medical discharge,
conduction, clearances.
– Blood Bank- how obtained, checking information ( type ,
x-match) , reactions, replacement.
– Cashier – safekeeping of valuables, clearances.
– Dietary – requisition ( diet list, new diets, therapeutic),
discharge planning w/ nutritionist.
– Laboratory – requests ( routine, emergency), record-
keeping.
– Personnel Department – request for additional
personnel, interview ( pre-employment, exit), record
keeping, counseling, grievances, health & welfare,
training, personnel policies, general orientation, record
keeping.
– Pharmacy – ordering of drugs, narcotic & barbiturate
regulations, inspection of stock drugs, & solutions in the
units, safety procedures.
– Social Service- referrals from various departments.
– X-ray – requests, preparation of patient ( details of the
procedure) , transporting of patient.
 Nursing Procedures
• Procedures are specific directions for
implementing written policies;
• Nursing Procedure manuals should be available
in each unit to familiarize nurses w/ the common
nursing procedures utilize in that unit.
– Examples of Contents in a Procedure Manual
• Admission of Patients
• A.M. Care
• Bath: Bed bath, TSB
• Bed Making- Occupied or unoccupied
• Bladder, Catheterization of
• Bladder, Insertion of Foley catheter,
• Etc.
 Decision Making
• Is considering & selecting
interventions from a repertiore of
actions that facilitate the
achievement of a desired outcome.
• Five Steps
– Identify the need for a decision
– Determine the goal or outcome
– Identify alternatives or actions along
with the benefits and consequences of
each action.
– Decide which action to implement
– Evaluate the decision.
 Decision- Making Process for
Nurse Managers
• Managerial Decision • Nursing Process
Making Process
• Set Objectives – Assess
• Search for – Problem
Identification
alternatives
– Nursing Diagnosis
• Evaluate alternatives
– Plan
• Choose – Implement
• Implement – Evaluate
• Follow-up
 Tools for Decision Making

• Decision Tree
• Decision Grid
• Numerical Scoring
• Program evaluation & review technique
(PERT)
 Budgeting
• Budget
– is the annual operating plan, a financial “road
map” & plan which serves as an estimate of
future costs & a plan for utilization of manpower,
material, & other resources to cover capital
projects in the operating programs.

• Nursing Budget
– Is a plan for allocation of resources based
on preconceived needs for a proposed
series of programs to deliver patient care
during one fiscal year.
 Four Components:
1. Revenue Budget – summarizes the income
w/c management expects to generate
during the planning period.

2. Expense Budget – describes the expected

activity in operational & financial terms for a
given period of time.
3. Capital Budget- outlines the programmed
acquisitions, disposals & improvements in
an institution’s physical capacity.

4. Cash Budget – represents the planned cash

receipts & disbursements as well as the
cash balances expected during the planning
period.
 Types of Budget
• Capital Expenditure- Long range budget ( usually three
years)
• Operating – Short term budget ( per fiscal year or
annually), that allocate funds for day to day activities of
the organization.
– Expenses / Costs – small equipment, medical & non medical
supplies, building & equipment maintenance, personnel
expenses.
– Projected revenues - come from payment sources ( Medicare,
Insurance, etc.)
• Cash – accounts for the monthly expenditures & receipts
to the dept/ organization. Cash flow is an important
element.
• Personnel- allocates expenses related to personnel
( salary, vacation, holidays, education, & other benefits.)
 Budgetary Process
• Four major Phases
• Planning – gathering information related to goals &
objectives, setting priorities, conducting an
environmental assessment, identifying financial
objectives.
• Development of the budget – collecting & analyzing
data from past budgets, allocating amounts based on
priority, & approving the operational and capital
budgets.
• Implementation & monitoring – analyzing variances &
adjustments during the fiscal period, negotiating &
revising the budget as necessary, allocating
departmental & cash budgets.
• Evaluation- obtaining performance reports & analyzing
efficiency.
 Budget Preparation
• Begins with preparation & planning
• Budget are generally developed for a 12- month
period.
• To prepare a budget, organization gather
fundamental information about a variety of
elements that influence the organization,
including demographic & marketing information,
competitive analysis, regulatory influences, &
strategic plans. Additionally, it is helpful to
review the dapartment’s scope of service, goals,
& history.
 Management Process
Setting
• Setting shall be confined to hospitals.
• The Expert Committee on Organization of
Medical Care of the WHO define Hospital
as:
– An Integral part of a social and medical
organization
• Function:
– To provide for the population it serves
» Complete health care both curative & preventive
» Reach out to the family in its home environment
– Center for the training of health workers and for bio-
social research.
• Republic Act 4226,
– defines Hospital as a Place devoted primarily to
the maintenance & operation of facilities for the
diagnosis, treatment and care of individuals
suffering from illness, disease or deformity, or in
need of obstetrical or other medical & nursing
care.
– Also be construed as any institution, building or
place where there are beds, cribs or bassinets for
use by patients for twenty four hours or longer, in
the treatment of diseases, diseased conditions,
injuries, deformities, and all institutions such as
those for convalescence, sanitorial care,
infirmaries, nurseries, despensaries, & such other
names by which they may be designated.
Classification of Hospitals & Other
Health Facilities
• Administrative Order No. 2005- 0029
dated December 12, 2005 amended
Administrative Order No 70A series re:
Revised Rules & Regulation Governing
the Registration, Licensure, & Operation of
Hospitals & other Health Facilities in the
Philippines.
 A. General / Special
• General
– Provides services for all types of deformity,
disease, illness or injury.
• Example: PGH, De Los Santos- STI Medical Center.
• Special
– Primarily engaged in the provision of specific
clinical care & management. It must have
ancillary support services appropriate for a
given service capability.
• Example: NKI, Lung Center of the Phils, Phil. Heart
Center, San Lazaro Hospital
 B. Service Capability
• A. Hospital
1. Level 1
• An emergency hosp. that provides initial
care & management to patients requiring
immediate treatment, as well as primary
care on prevalent diseases in the locality.
• Clinical services include general medicine,
pediatrics, obstetrics, & non- surgical
gynecology & minor surgery.
• General administrative services ( primary
clinical laboratory, first level radiology, &
pharmacy).
• Provide nursing care for patients who
require minimal category or supervised
care for 24 hours or longer.
• 2. Level 2
– Non- departmentalized hospital that
provides clinical care & management on
the prevalent diseases in the locality.
– Clinical services include general
medicine, pediatrics, obstetrics, &
gynecolgy, surgery & anesthesia.
– Appropriate administrative and ancillary
services ( secondary clinical laboratory,
first level radiology & pharmacy).
– Nursing care provided in lvel 1 Hospital
as well as intermediate, moderate, &
partial category of supervised care for
24 hours or longer.
• 3. Level 3
– Departmentalized Hospital that provides
clinical care & management on the
prevalent diseases in the locality, as
well as particular forms of treatment,
surgical procedures & intensive care.
– Clinical services provided in Level 2
Hospital as well as specialty clinical
care.
– Appropriate administrative and services
( tertiary clinical laboratory, second
level radiology & pharmacy).
– Nursing Care provided in Level 3
hospitals as well as continuous and
highly specialized critical care.
 Other Health Facilities
• Birthing Home- a health facility that
provides maternity service on pre-natal &
postnatal care, normal spontaneous
delivery, & care of the newborn babies.
• Psychiatric Care Facility- a health facility
engaged in the care of mentally ill
patients.
– Acute- Chronic- provides medical service,
nursing care, pharmacological interventions for
mentally ill patients.
– Custodial- provides long- term care, inclusing
basic human services such as food & shelter,
to chronic mentally ill patients.
 According to:Ownership &
Control
• 1. Government Hospitals- are operated &
controlled either partially or wholly by the
national, provincial, municipal, or city
government, or other political subdivision,
board or other agency thereof.
– Example
• National- directly under the Office of the President:
– PGH, POC, NCMH,
• Regional – Baliwag District Hospital
• Provincial- Bulacan Integrated Provincial Hosp.
• City- QCGH
• Municipal- Don Formilleza Mem. Hosp.
• 2. Private/ Non- Government Hospitals.

• Privately owned, established & operated w/ funds,

raised capital or other means by private
individuals, associates, corporations, religious
organization, firms, companies, or joint stock
corporations.

– Examples:
• Missionary- MJH
• Civic Organization- Q.I.
• Community- Romero Community Hosp.
• Private- De Los Santos- STI Medical Center
 Training & Non- Training
Hospitals
• A training Hospital- is a departmentalized
hospital with accredited Residency Training
Program in one or more specified specialty or
discipline.
– Example, POC, DLS-STI Medical Center

• A Non- Training Hospital – may be

departmentalized but without an accredited
Residency Training Program in or more specialty
disciplines.
– Example, CGH