NCM 105

LEADERSHIP AND
MANAGEMENT
PLANNING
The first element of
management is
PLANNING
 PLANNING is simply deciding
in advance what will and will not
be done in the next minutes,
hours, days, months, or years
 Fayol defined it
as “making a
plan of action for
a foreseeable
future”
 Douglas stated that
“planning is having specific aim
or purpose and mapping out a
program or method beforehand
for accomplishment of the goal”
Alexander defined planning as
“deciding in advance what to
do, how to do it, when to do it,
and who is to do it”
PRINCIPLES OF PLANNING
Planning is always based and
focused on the vision, mission,
philosophy, and clearly defined
objectives of the organization
Planning is a continuous process.
PRINCIPLES OF PLANNING
Planning should be pervasive within
the entire organization covering the
various departments, services, and the
various levels of management to
provide maximal cooperation and
harmony
Planning utilizes all available
resources
 PRINCIPLES OF PLANNING
Planning must be precise in its scope
and nature. It should be realistic and
focused on its expected outcomes
Planning should be time-bound
Projected plans must be documented
for proper dissemination to all
concerned for implementation and
evaluation
 REASONS FOR PLANNING
It leads to success in achieving goals
and objectives
It gives meaning to work
It provides for effective use of
available personnel and facilities
It helps in coping with crisis situations
REASONS FOR PLANNING
It is cost-effective
It is based on past and future, thus
helping reduce the element of change
It can be used to discover the need
for change
It is needed for effective control
 BENEFITS OF PLANNING
(Donovan)

Satisfactory outcomes of decisions

Improved functions in emergencies
Assurance of economy of time,
space, and materials
The highest of personnel
WHY MANAGERS FAIL TO
PLAN EFFECTIVELY?
They lack
knowledge of the
philosophy, goals,
and objectives of the
agency
 WHY MANAGERS FAIL TO
PLAN EFFECTIVELY?

They do not know

how to manage their
time
Lack of confidence
in formulating plans
FACTORS TO CONSIDER TO
HAVE AN EFFECTIVE PLAN
Characteristics of planning
Elements of the planning process
Strategic or long-range planning
process
Tactical or short-range planning
process-functional versus operational
FACTORS TO CONSIDER TO
HAVE AN EFFECTIVE PLAN
Planning standards
Application of the planning processes
and standards to the work situation
 CHARACTERISTICS OF
PLANNING
Tappen describes planning as the
component of effective management
that is hardest to do and easiest to
ignore
It deals primarily with the future and can
easily be postponed
 CHARACTERISTICS OF
PLANNING
Planning is based on objectives
Simplification and standardization
characterize it. In other words, first and
foremost good plans are based on objectives,
they must be simple, they must have
standards, must be flexible, must be balanced
and must use available resources
 CHARACTERISTICS OF
PLANNING
Planning requires decision making
That is choosing future courses of action from
among alternatives
 SCOPE AND LEVEL OF
PLANNING
SCOPE – defined as the BREADTH
of or OPPORTUNITY to function
In Management SCOPE means how
far can the manager can go in
developing plans for self and others
 3 LEVELS OF PLANNING IN
NURSING
1. TOP-LEVEL MANAGERS
- comprise a small group of
executives who covers the over-all
management of the organization’s
nursing service
- Top managers are typically titled
CEO
 3 LEVELS OF PLANNING IN
NURSING
1. TOP-LEVEL MANAGERS
Top-level nurse executives are
continuously named vice-president,
associate administrator, or director
of nursing service
 STRATEGIC PLANNING – is a
systematic process of determining
how to pursue the organization’s
long term goals with the available
resources
 It has been said that:
“any organization that doesn’t
have a plan for its future isn’t
likely to have one”
STRATEGIC goals directly
supports the organization’s
mission statement
 3 LEVELS OF PLANNING IN
NURSING
2. MIDDLE-LEVEL MANAGERS
Middle Level managers direct the
activities of other managers, usually
of units or departments, both inside
and outside of the hospital
 3 LEVELS OF PLANNING IN
NURSING
2. MIDDLE-LEVEL MANAGERS
Common titles for middle managers
in nursing include Supervisor,
coordinator, case manager and clinical
specialist
 3 LEVELS OF PLANNING IN
NURSING
3. LOWER-LEVEL MANAGERS
-constitute the lowest level at which
individuals are responsible for the
work of others; they often
participate in the work itself
 3 LEVELS OF PLANNING IN
NURSING
3. LOWER-LEVEL MANAGERS
- example: dept or unit manager,
case manager, team leader or primary
nurse
- responsible for the management of
all nursing care on the nursing unit or
for administering direct nursing care
to one or more patients
 ELEMENTS OF PLANNING

FORECASTING – helps managers look

into the future and decide in advance
where the agency would like to be and
what is to be done in order to get there

FORECASTS and estimates provide

the bases for planning
 SETTING THE VISION,
MISSION, PHILOSOPHY,
GOALS AND
OBJECTIVES
 VISION
- OUTLINES the organization’s future
role and function
EXAMPLE:
VISION
“To be the premier teaching medical
institution in the southern part of Manila;
and as the 1st Air Reserve Hospital
delivering compassionate and holistic
quality health care services”
 MISSION
- Outlines the agency’s reason for
existing (whether hospital or health
care), who the target clients are, and
what services will be provided
EXAMPLE:
MISSION
1. Committed to providing:
a. Quality services through competent
healthcare professionals
b. Accredited training programs
c. Dedicated community service
2. Capable of rendering patient-directed
health services.
3. Generating sustainable, self-sufficient
and viable health service units
 PHILOSOPHY
-Describes the vision.
-It is a statement of beliefs and values
that direct one’s life or one’s practice
-In an organization, the philosophy is
the sense of purpose of the
organization and the reason behind its
structure and goals
 GOALS AND OBJECTIVES
-Differ in that goals are more general.
Objectives tend to be more specific.
Objectives are concrete
 TYPES OF PLANNING

STRATEGIC OR LONG-
RANGED PLANNING
OPERATIONAL OR SHORT-
RANGED PLANNING
STRATEGIC OR LONG-RANGED
PLANNING
-Determines where an organization is
going over the next year or more
-How it is going to get there and how it
will know if it got there or not
 MAJOR ACTIVITIES IN
STRATEGIC PLANNING
1. STRATEGIC ANALYSIS – this
activity includes the conduct of some
sort of scan, or review, of the
organization’s environment
 EXAMPLE: political, social,
economic, and technical environment
Planners carefully consider various
driving forces in the environment,
example, increasing competition,
changing demographics
Planners also consider the various
STRENGTHS,
WEAKNESSES,
OPPORTUNITIES, and
THREATS
regarding the organization

SWOT is the acronym of this activity

 S
SE S
ES IE
IT
ORGANIZATION

UN
KN
RT
EA
W O
PP
O
S
TH

S
NG

A T
RE

E
R
ST

TH
 A SWOT analysis is a tool that is
frequently used to conduct these
environmental assessments.

A SWOT analysis identifies the

STRENGHTS and WEAKNESSES in
the INTERNAL ENVIRONMENT and
OPPORTUNITIES AND THREATS in
the EXTERNAL ENVIRONMENT
 MAJOR ACTIVITIES IN
STRATEGIC PLANNING
2.SETTING STRATEGIC DIRECTION
–Planners carefully come to
conclusions about what the
organization must do as a result of the
major issues and opportunities facing
the organization
During the strategic planning process –
sometimes in the activity of setting the
strategic direction – planners usually
identify or update what might be called
the strategic “philosophy”
This includes identification and update
of the mission, vision and/or values of
the statements of the organization
 MAJOR ACTIVITIES IN
STRATEGIC PLANNING
3. ACTION PLANNING – The process
of laying out how the strategic goals
will be accomplished carefully

OBJECTIVES or specified results

are often included in action planning
 THINGS TO BE CONSIDERED IN
DEVELOPING OBJECTIVES

-TACTIC
-RESPONSIBILITIES and TIMELINES
(who, what, where and when)
-ANNUAL PLAN
-OPERATIONAL PLAN
 STRATEGIC PLANNING BENEFITS
1.Clearly defines the purpose of the
organization and establishes realistic
goals and objectives
2.Communicates those goals and
objectives to the organization’s
constituents
3.Develops a sense of ownership of the
plan
 STRATEGIC PLANNING BENEFITS
4.Ensures the most effective use is
made of the organization’s resources
by focusing the resources on key
priorities
5.Provides a base from which progress
can be measured and establishes a
mechanism for informed change when
needed
 STRATEGIC PLANNING BENEFITS
6.Brings together of everyone’s best
and most reasoned efforts have
important value in building a
consensus about where an
organization is going
7.Provides clearer focus of
organization, producing more
efficiency and effectiveness
 STRATEGIC PLANNING BENEFITS
8.Bridges staff and board of directors
(in the case of corporations)
9.Builds strong teams in the board and
the staff (in the case of corporations)
10.Provides the glue that keeps the
board together
 STRATEGIC PLANNING BENEFITS
11.Produces great satisfaction among
planners around a common vision
12.Increases productivity from
increased efficiency and effectiveness
13.Solves major problems
 THE PLANNING FORMULA
1.WHAT
What has been done?
What should be done?
What equipment and supplies
have been used or are needed?
What steps are necessary in the
procedure?
 THE PLANNING FORMULA
1.WHAT
What sequence of activities was
previously used?
What other efficient methods may
be used?
 THE PLANNING FORMULA
2. WHEN
When should the job be done?
When was it formerly done?
When could it be done?
 THE PLANNING FORMULA
3. WHERE
Where is the job to be done?
Where does an activity occur in
relation to those activities
immediately preceding and
following it?
Where could supplies be stored,
cleaned, and so forth?
 THE PLANNING FORMULA
3. HOW
How will the job be done?
What re the steps to be followed in
doing the procedure?
How will the time and energy of
personnel be used?
How much will it cost?
 THE PLANNING FORMULA
4. HOW
How much time will it require?
5.WHO
Who has been doing the job?
Who else could do it?
Is more than one person involved?
 THE PLANNING FORMULA
6. WHY
To teach of the questions, ask
why.
Why is this job, this procedure,
this step necessary?
Why is this done in this way, in this
place, at this time, by this person?
 THE PLANNING FORMULA
7. CAN

Can some steps or equipment be

eliminated?
Can this activity be efficiently
combined with other operations?
Can somebody else do it better?
Can we get a machine to help?
Can we get enough money?
TIME MANAGEMENT
is a technique for allocating one’s
time through the setting of goals,
assigning priorities, identifying and
eliminating wasted time, and using
managerial techniques to reach
goals efficiently
 TIME MANAGEMENT
LIST OVERALL RESPONSIBILITIES
 REDUCE OVERALL TASKS TO
SPECIFICS
 MUST IMPORTANT NICE TO DO
DO TO DO BUT NOT
VITALLY
IMPORTANT
Plan or Oversee daily Meet with
oversee daily activities representative of
schedules for volunteer services
Visit patients/
staff
clients/ families Call a staff who is
Attend unit on leave
Conduct
manager’s
performance Have lunch break
meeting
evaluations with staff
 MUST IMPORTANT NICE TO DO
DO TO DO BUT NOT
VITALLY
IMPORTANT
Receive Supervise team Assist physician
assignment
members on routine rounds
Count
narcotics
Make self Teach staff about
available for new medications/
Review assistance as procedures
patients’ possible
records Clean the
Talk with family medication room
Make patient
members
rounds
Complete a “TO-DO” list for tomorrow.
Focus on an activity for a class, RLE, or
group assignment, or work experience,
case presentation

MUST IMPORTANT NICE TO DO

DO TO DO BUT NOT
VITALLY
IMPORTANT
 PHASES OF PLANNING
According to Tappen, planning is
divided into three phases:
Developing the plan
Presenting the plan
Implementing and monitoring the plan
 DEVELOPING THE PLAN
PHASE 1
1.Establish its purpose – it is important
to be clear about the purpose of
planning to avoid confusion.
2.Generating alternative solutions – a
climate of open-mindedness and
positive thinking is important
 DEVELOPING THE PLAN
PHASE 2
1. Presenting the Plan – the plan must
be presented in an organized manner
 DEVELOPING THE PLAN
PHASE 3
1.Implementation and Monitoring
a. Organizing the implementation
includes:
- identifying and arranging activities
according to sequence
 DEVELOPING THE PLAN

- setting target dates for completing

each activity
- assignment of responsibilities to
particular individuals, and
- the allocation of resources
 Techniques in organizing the
implementation of the plan:
- Schedule
- Gantt Chart
- PERT (Program Evaluation and
Review Technique
- CPM (Critical Path Method)
 SCHEDULE
-schedules organize work on the basis
of time and assigned staff members,
leaving out details of staff to be done
-Schedules are easy to make and use,
and they form the basis for the more
complex methods
 GANTT CHART
-which is actually a highly developed
schedule, specifies in detail the tasks
to be performed and the time they are
expected to be completed
Example:

Nursing Seminar to be held on Sep. 14, 2009

Task: A. Title conceptualization

B. Statement of objectives
C. Speaker seeking or inquiring
D. Committee formation
E. Committee task
conceptualization
F. Committee presentation of
concepts.
 Example of a
GANTT CHART

A
B
TASK

Nov. Nov. Nov. Nov. Dec. Dec. Dec. 15

3 10 17 24 1 8
TASK ASSIGNED JAN FEB MAR APR MAY
PERSON

HIRE CMR

TRAIN RAA

EVALUATE CRA
 PERT CHART
-graphically illustrates the sequence of
events and their interrelationships,
using circles for events and arrows for
activities
-one can see how the work must flow
from one event to the next and how
one activity depends on another
 CRITICAL PATH METHOD
-is very similar to PERT except that it
also identifies the critical path, that is,
the path that takes the longest time to
complete and the most likely to cause
a delay
 DEVELOPING THE PLAN
PHASE 3
2.After organizing the project, implement
3. Monitoring the implementation
4.Evaluating outcomes
5.Revising and updating the plan
 BUDGETS
-a budget is the annual operating
plan, a financial “ROAD MAP” and
plan which serves as an estimate of
future costs and a plan for utilization
of manpower, material and other
resources to cover capital projects in
the operating program
 BUDGETS
-specify money needed for the
resources that are necessary to
implement the annual plan
-also indicate how the money will
be spent, example: for human
resources, equipment, materials
BUDGETING can be defined as
the allocation of scarce resources
or assets on the basis of
forecasted needs, for proposed
programs or activities, over a
specified period of time
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
HOSPITAL BUDGET is a
financial plan to meet future
service expectations.
 PREPARING THE BUDGET
TYPES OF BUDGET
1.OPERATING BUDGETS
2.PROJECT BUDGETS
3.CASH BUDGETS
4.CAPITAL BUDGETS
TYPES OF BUDGET
1.OPERATING BUDGETS – compose of
the revenue and the expense budget.
Deals primarily with salaries, supplies,
contractual services, employee benefits,
laundry service, drugs and
pharmaceuticals, in-service education,
travels to professional meetings, books,
periodicals, professional magazines, and
repairs, maintenance
TYPES OF BUDGET
2. PROJECT BUDGETS – these budgets
are associated with major projects, for
example, constructing a building,
developing a new program or product
line
TYPES OF BUDGET
3. CASH BUDGETS – these budgets
depict where cash will be spent over
some near term, for example, over the
next three months (this is very useful in
order to know if an organization can
afford bills that must be paid soon
TYPES OF BUDGET
4. CAPITAL BUDGETS – these budgets
are associated with operating some
major asset, for example, a building,
automobiles, furniture, computers, etc
TWO DIFFERENT APPROACHES
IN PREPARING THE BUDGET
1.INCREMENTAL
2.ZERO-BASE BUDGETING
INCREMENTAL – or historical, is the
traditional process in which budgets,
are prepared every year on the basis of
what was spent the year before
TWO BASIC COMPONENTS OF
BUDGET:
INCOME
 EXPENSES
ZERO-BASE BUDGETING – an
approach that is based on the idea that
no expense should be assumed to be
absolutely necessary

The result is that every cost must be

analyzed and justified as essential to the
function of organization
The ZERO-BASED budget begins with
a blank slate every year, that is, no
expense from last year can simply be
repeated for the next year without giving
reasons why it is necessary
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