CONTROLLING
LEADERSHIP AND MANAGEMENT PROCESS
CONTROLLING
An on going function of management which occurs
during planning, organizing and directing activities
Process wherein the performance is measured and
corrective action is taken to ensure the
accomplishment of organizational goal
PURPOSES OF CONTROLLING
Open opportunities for improvement
Compare performance against set standard
Provides information about how well processes and
people function
Steps in Control Process
Establish standards and criteria
Measure performance
Compare results with standards
Match with standards?
YES - do nothing to improve
NO - take corrective action
REASONS FOR CONDUCTING EVALUATION
Ensures that quality services is provided
Allow for setting of sensible objectives and ensures compliance
Provides standards for establishing comparisons
Promotes visibility and means for employees to monitor own
performance
Highlights problem related to quality care and determines areas
that require priority attention
REASONS FOR CONDUCTING EVALUATION
Provides an indication of the cost of poor quality
Justifies the use of resources
Provides feedback for improvement
EVALUATION PRINCIPLES
1. Must be based on behavioral standards of performance with the
position requirement
2. There should be enough time to observe employee’s behavior
3. Employee should be given a copy of the ff. Before scheduled
evaluation
Job description
Performance standards
Evaluation forms
EVALUTAION PRINCIPLES
4. Performance appraisal should include both satisfactory and
unsatisfactory results
5. Areas needing improvement must be prioritized
6. Should be scheduled and conducted at a convenient time for
both evaluator and employee
7. Should be structured in such a way that it is perceived and
accepted positively as a means of improving job performance
CHARACTERISTICS OF EVALUATION TOOL
OBJECTIVE
Free from bias
RELIABLE
Accurate and precise that it will produce the same results if administered
twice
SENSITIVE
Instrument can measure fine lines of differences among criteria being
measured
VALID
TYPES OF PERFORMANCE STANDARDS
1. STRUCTURE
Focus on the management system or structure used by
the agency in the delivery of care
Includes:
Number and categories of nursing personnel
Education
Personal and professional qualities
Function
Physical facilities
Equipments
TYPES OF PERFORMANCE STANDARDS
2. PROCESS STANDARDS
Decision and actions of the nurse relative to the
nursing process
INCLUDES :
Assessment
Plan of care
Nursing intervention
TYPES OF PERFORMANCE STANDARDS
3. OUTCOME STANDARDS
Designed to measure the results og care provided in
terms of:
Changes in health status of client served
Changes in level of their knowledge, skills and attitude
Satisfaction of those served
PERFORMANCE APPRAISAL
A control process in which employee's performance
is evaluated against standards
The most valuable tool in controlling human
resources and productivity
Reflects how well a personnel have performed
during a specific period of time
PURPOSE OF PERFORMANCE APPRAISAL
1. Determine salary and merit increases
2. Select qualified individual for promotion or transfer
3. Identify unsatisfactory employees for demotion or
termination
4. Make inventories of talents within an institution
5. Determine training and developmental needs of employees
PURPOSE OF PERFORMANCE APPRAISAL
6. Improve performance of work group
7. Improve communication between supervisors and
employees
8. Establish standards of supervisory performance
9. Provide recognition of employee for accomplishments
10. Inform employees “where they stand’
METHODS OF MEASURING PERFORMANCE
ESSAY
The appraiser writes a paragraph about the workers
strength, weaknesses and potentials
CHECKLIST
A compilation of performances expected of a worker
RANKING
Evaluator ranks according to how
Employee fared with co-workers
METHODS OF MEASURING PERFORMANCE
RATING SCALE
Includes a series of items representing the different tasks
or activities in job description or the absence or presence
of desired behaviors
FORCED-CHOICE COMPARISON
The evaluator is asked to choose the statement that best
describes the employee being evaluated
The evaluator is forced to choose from favorable as well
as unfavorable statement
METHODS OF MEASURING PERFORMANCE
ANECDOTAL RECORDING
Describe experience with a group or a person, or in
validating technical skills and interpersonal relationship
Anecdotal report should include:
1. Description of the particular occasion
2. Delineation of the behavior noted including:
WHO, WHAT, WHY, WHEN, WHERE AND HOE
3. The evaluator’s opinion or assessment of the incident or
behavior
QUALITY ASSURANCE
Assurance achieving sense of accomplishment
and implies a guarantee of excellence
Quality the degree of excellence
QUALITY ASSURANCE:
A process of evaluation that is applied to the health
care services b health workers
Focuses on the care and services the patient receives
than on how well the professionals performs the
duties that the position required
PRINCIPLES UPON WHICH QUALITY
ASSURANCE PROGRAM ARE BASED
1. All health professionals should collaborate in the effort to
measure and improve care
2. Coordination is essential in planning a comprehensive QAP
3. Resource expenditure for QA activities is appropriate
4. There should be focus on critical factors
5. Quality patient care is accurately evaluated through
adequate documentation
6. The ability to achieve nursing objectives depends upon the
optimal functioning of the entire nursing process and its
effective monitoring
PRINCIPLES UPON WHICH QUALITY
ASSURANCE PROGRAM ARE BASED
7. Feedback to practitioners is essential to improve practice.
8. Peer pressure provides the impetus to effect prescribed changes
based on the result of assessment and needed improvements on the
quality of care
9. Reorganization in the formal organizational structure may be
required if assessment reveals the need for a different pattern of
health care
10. Collection and analysis of data should be utilized to motivate
remedial action
QUALITY IMPROVEMENT
PROGRAM
The umbrella program that extends the many areas
for the purpose of accountability to the consumer
A continuous, on-going measurement & evaluation
process that includes structure, process and
outcome
TOTAL QUALITY MANAGEMENT (TQM)
A way to ensure customer satisfaction by involving all
employees in the improvement of the quality of every
product or service
Aims to reduce waste and cost of poor quality
It is a structured system for involving entire
organization in a continuous quality improvement
process targeted to meet and exceed customer
expectations
CONTINIOUS QUALITY IMPROVEMENT (CQI)
A process of continuously improving a system by :
gathering data or performance
Using Multi-disciplinary team to analyze the system
Collect measurements
Propose changes
PRINCIPLES OF CONTINOUS QUALITY
IMPROVEMENT (CQI)
1. Customer focus
2. Identification of key processes to improve
quality
3. Use of quality tools and statistics
4. Involvement of all people in problem solving
QUALITY ASSURANCE
Focuses on the care and service the patient receives
than on how well the professional performs the
duties that the position requires
METHODS USED
Patient care audit
Patient care profile analysis
Peer review
Quality circles
NURSING AUDIT COMMITTEE
Composed of a representative from all levels of the
nursing staff
The audit team designate a day within the week to
be the audit day
The nurses do not know which unit will be audited
PATIENT CARE AUDIT
CONCURRENT PATIENT CARE AUDIT
One in which patient care is observed and evaluated
Done during rounds or patient interview
Given through:
1. Review of patient chart while the patients are still
confined in the hospital
2. Observation of the staff as patient care is given
3. Inspection of patient or observation and/or observation
of the effects of patient care where the focus is on the
patient
PATIENT CARE AUDIT
RETROSPECTIVE PATIENT CARE AUDIT
ONE IN WHICH PATIENT CARE IS
EVALUATED THROUGH:
1. A REVIEW OF DISCHARGED PATIENTS’
CHART
2. QUESTIONAIRES SENT TO OR INTERVIEW
CONDUCTED ON DISCHARGED PATIENTS
QUALITY CIRCLES
One of the most publicized approaches to quality
control introduced by the Japanese
A group of workers doing similar works who:
Meet regularly
Voluntarily
On normal working time
Under the leadership of the supervisor
QUALITY CIRCLES
TO:
Identify, analyze, and solve work related problem
Recommend solution to management quality circle
members should implement the solution themselves
CONTROL OF RESOURCES
Consumption of supplies and materials should be
proportionate to the number of patients served
Requisition or stock of large numbers of supplies
and materials should be avoided to prevent misuse
or spoilage
A high turnover inventory is desired
A low turnover is:
the result of poor purchasing policies
Overstock or decreased demand for the item
CONTROL OF RESOURCES
Equipment utilization report should be made
including frequency of breakdown
help to evaluate the:
quality of equipment purchased
The way it was handled
Preventive maintenance requires the regular
inspection of equipment to prevent breakdown or
detect needed repairs
Breakdown results in more expenses and non
productivity of personnel
CONTROL OF RESOURCES
Human Resource:
Absences due to leaves, whether scheduled or not,
should be analyzed
Provision for relievers should be included in the
staffing pattern to maintain quality service
Unusual number of unscheduled absences should
be investigated this may necessitate disciplinary
action
DISCIPLINE
Rigid obedience to rules and regulations
SELF DISCIPLINE: A constructive and effective
means by which employees take personal
responsibility for their own performance and
behavior
FACTORS THAT INFLUENCE SELF
DISCIPLINE
1. Strong commitment to the vision, philosophy,
goals and objectives of the institution
2. Laws that govern the practice of all professionals
and the respective Codes of Conducts
3. Understanding of the rules and regulation of the
agency
4. Atmosphere of mutual trust and confidence
5. Pressure from peers and organization
DISCIPLINARY ACTION
Any employee charge with breach of the rules and
regulation, policies, norms of conducts should be
given due process
There must be existing rules of conduct governing
his behavior and a documentation of actual violation
The charged employee must be notified in writing
about the violation and be given the right counsel
Principles of disciplinary action
1. investigate carefully
2. be prompt
3. protect privacy
4. focus on the act
5. enforces rules consistently
Be flexible
Components of disciplinary action program
Code of conduct
Employees must be informed of the nature and meaning of codes
of conduct
Must understand that the rules are reasonable and directly related
to efficient, effective operation of the agency
Authorized penalties
Records of offenses
Right of appeal
DISCIPLINARY ACTION
Should be progressive in nature
CONSELLING AND ORAL WARNING
Best given in private and in an informal
atmosphere
Employee is given fair chance to air his side
Relevant facts are analyzed and evaluated against
past performance
DISCIPLINARY ACTION
COUNSELLING
Employee is counseled regarding:
Expectations of improved behavior/performance
Ways of correcting the problem
Warning that a repetition of the same offense may
warrant disciplinary action
The employee must commit to correct the behavior
He should be informed of any follow-up action
that may be taken
DISCIPLINARY ACTION
WRITTEN WARNING
The second step in disciplinary action
Preceded by an interview similar to oral warning
Employee is told after the interview that he will be given a
written warning
WRITTEN WARNING: includes
Statement of the problem
Identification of the rule that was violated
Consequence of the continued deviant behavior
Employees commitment to take corrective action
Any follow-up action to be taken
DISCIPLINARY ACTION
SUSPENSION
DISMISSAL
Invoked only when all other disciplinary efforts have
failed
Disciplinary Committee should be very sure that the
cause for dismissal conforms with the criteria of a
major discipline violations as contained in the policy
manual
Review is done by higher management
