managerial effectiveness - case study situational

MANAGERIAL EFFECTIVENESS

Human Behaviour in Organizations

Hanna Grace G. Olvido, RN

MAN III

Presentor

MANAGERIAL EFFECTIVENESS

• Delegation

• Control

• Decision Making

IMPORTANCE OF DELEGATIONManagerial effectiveness


CASE STUDY:

• A Nurse Manager hires a nurse to work part-time

evenings and every other weekend on a 42 bed

medical/surgical unit. The Nurse has been out of school

for two years and this is her first job as a staff nurse in a

hospital setting, prior to this she worked in a physician's

office. Shortly after completing orientation the nurse was

assigned as the "charge nurse" for the next several

weekends. After the nurse's first weekend as "charge

nurse", the Nurse Manager receives the following

complaints:


From other licensed staff:

• "It seems like she just picked out rooms to make the

assignments. She didn't listen to report first or check the

charge nurse report sheet. She didn't state any concerns

at that time and seemed more concerned about her own

patients and getting her medications out on time."


From the Unlicensed Staff:

• "She asked me to do things I have never done before!

When she told me to hang the tube feeding, I said I can't

do that and she said JUST DO AS YOU ARE TOLD."


From the Nurse:

• "I don't understand what the concern is? The tube

feeding is just putting fluid into a bag. In the doctor's

office, the assistants do all kinds of stuff, and besides I

had my own patients…what is the big deal?"


Questions for Discussion:

• List 3 principles of delegation and supervision that were

violated in this situation?

• If you were working with this charge nurse what would

you have done?

IMPORTANCE OF CONTROLManagerial effectiveness


CASE STUDY:

• Who?

• A large, acute-care, academic hospital with more than

600 beds, 1,000 physicians, and 2,000 nurses,

therapists, technologists, and support personnel, serving

more than 300,000 people from its surrounding urban

area, the United States, and the world.


• What?

• The hospital implemented a successful quality

improvement (QI) intervention to improve the emotional

support offered by its registered nurses, nursing

assistants, and other nursing staff to adult medical and

surgical inpatients.


• Why?

• Data indicated that the hospital’s nurses were not

offering optimal emotional support to patients and thus

were missing an opportunity to provide the best care,

boost the patient experience, and ensure the hospital’s

competitiveness with similar hospitals. The data came

from the Picker Hospital Survey (PHS), the hospital’s

own QI survey, hospital records of patient complaints,

and the “U.S. News and World Report” annual hospital

rankings.


• When?

• A QI initiative began early in 2004 and developed into an

action plan with a full set of targeted activities by the end

of 2004. The first performance goals were reached in

late 2005, and QI was ongoing. Sustained improvements

were reached by the middle of 2006.


• How?

• A hospital QI team used a six-step Plan-Do-Study-Act

process to identify the areas that needed improvement

and implement a multi-faceted strategy for improving the

emotional support offered to patients. This strategy

included actions for each of three sets of interventions:

strengthen focus on patient service, improve

communication with patients, and provide support to

staff.


• So What?

• The emotional support offered to patients improved

steadily, and the hospital reached its goal of improving

the patient experience of care. As a result, the hospital’s

reputation in the community improved, market share was

maintained, nursing staff morale improved, and nursing

turnover and absenteeism declined.


• This QI process yielded valuable lessons applicable to

QI efforts more broadly: use all available data to identify

specific problems, trends, causes, and actions for

improvement; align action plans with problem areas and

improvement goals; think system-wide; be open to

potential need for changes in organization, staffing and

processes; maintain leadership support, accountability,

and presence; communicate with and train management

and staff; monitor and refine the intervention during

implementation; continuously monitor indicators such as

CAHPS and other data to make sure improvements

stick; and celebrate successes.

DECISION MAKING FOR MANAGERSManagerial effectiveness

THANK YOU!

managerial effectiveness - case study situational

Health & Medicine

staff nurse

nurse manager

charge nurse report

hospitals nurses

academic hospital

hospital setting

nursing staff

qi survey