Pamantasan ng Lungsod ng MaynilaPamantasan ng Lungsod ng Maynila(University of the City of Manila)(University of the City of Manila)

Intramuros, ManilaIntramuros, Manila

College of NursingCollege of Nursing

NURSING MANAGEMENTNURSING MANAGEMENTWritten Report onWritten Report on

Planning

1. Definition—Mission, Philosophy, Goal and Objective2. Purpose3. Steps/ Process

3.1. Forecasting or Estimating the future3.2. Defining the philosophy and objectives3.3. Identifying Strategies3.4. Setting time frame3.5. Preparing the budget

4. Types5. Resistancy to planning

Submitted to Professor Nemia VerameSubmitted to Professor Nemia Verame

Submitted by:Submitted by: Amisola, Jovic

Capindit, Ma. Rosalyn Cordero, Arlene

Hollero, Fermin RomuloLumanta, HoneylettePascual, Lea Pamela

Villa- Real, Ana Cristina

BSN III-4BSN III-4

17 November 2010

PLANNING

1. Definition—Mission, Philosophy, Goal and Objective

2. Purpose

By: Lumanta, Honeylette

WHAT IS PLANNING?

• Is deciding in advance what to do, how to do a particular task, when to do it,

and who is to do it.

• Is predetermining a course of action in order to arrive at desired results.

• It is the continuous process of assessing, establishing goals and objectives and

implementing and evaluating them, which is subject to change as new facts are

known

COMPONENTS OF PLANNING

PRINCIPLES OF PLANNING

1. Planning is always based and focused on the vision, mission, philosophy, and

clearly defined objectives of the organization.

2. Planning is a continuous process. Provision for proper analysis would indicate

a revision or flexibility to be done to make it more effective.

3. Planning should be pervasive within the entire organization covering the

various departments, services, and the various level of management to

provide maximal cooperation and harmony.

4. Planning utilizes all available resources.

5. Planning must be precise in its scope and nature. It should be realistic and

focused on its expected outcomes.

6. Planning should be time bounded with short and long range plans. .

7. Projected plans must be documented for proper dissemination to all

concerned for implementation and evaluation to the extent of its

achievement.

IMPORTANCE OF PLANNING

It leads to success in the achievements of goals and objectives. Workers

relate what they do to meaningful results since plans are focused on

objectives.

It provides meaning to work. Employee or workers experience greater

satisfaction if what they do becomes meaningful to them.

It provides for the effective use of available personnel and facilities. The best

use of personnel and materials resources prevents wastage.

It helps in coping with crises. Hospital should provide for disaster plan. This

allows the worker to function more clearly and efficiently when actual

emergencies occur such as fire, typhoons, and earthquakes or during New

Year celebrations and/or other occasions when more people are likely to get

hurt.

It is cost effective. Cost can be controlled through planning for efficient

operation.

It is based on past and future activities. Evaluation of programs, schedules

and activities whether successful or not, prevents and/or reduces the

recurrence of problems and provides better ideas in modifying or avoiding

them.

It leads to the realization of the need for change. It becomes the basis for

evaluating the accomplishments of the set programs/ activities.

It provide the basis of control

It is necessary for effective control. Nurse-managers evaluate the

environment or setting in which they work or where the patients are

confined and make necessary recommendations to make hospital conditions

more therapeutic not only for the patients but for workers as well.

CHARACTERISTICS OF A GOOD PLAN

1. Be precise with clearly-worded objectives.

2. Be guided by policies and/or procedures affecting the planned action.

3. Indicate priorities.

4. Develop actions that are flexible and realistic.

5. Develop a logical sequence of activities.

6. Include the most practical method for achieving each objective

7. Pervade the whole organization.

MISSION

• It is a statement that outlines the agency’s reason for existing, which the target

clients are and what services will be provided.

VISION

• It is a statement that outlines the organization’s future role and function.

• It gives the agency something to strive for.

PHILOSOPHY

• It is a statement of beliefs and values that directs one’s life or one’s practice.

• It is the sense of purpose of the organization and the reason behind its

structure and goal.

GOALS

• It is more general and covers a broad area than objectives.

OBJECTIVES

• More specific. It is concrete.

• It is actions commitments through which an organization’s mission and

purpose will be achieved and the philosophy or belief sustained.

3. Steps/ Process

3.1 Forecasting or Estimating the future

By: Capindit, Ma. Rosalyn

Forecasting or Estimating the Future

Forecasting helps the 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.

FACTORS TO BE CONSIDERED:

The environment in which the plan will be executed.

Who the client will be:

Their customers and beliefs

Language/ dialects barriers

Public attitudes and behavior

The severity of their conditions and illnesses

The kind of care they will receive

The number and kind of personnel required

The necessary resources:

Equipments

Facilities

Supplies

Forecasts and estimates provide the basis for planning.

3. Steps/ Process

3.2Defining the philosophy and objectives

By: Amisola, Jovic

DEFINING THE PHILOSOPHY AND OBJECTIVES

Philosophy refers to a statement of values and beliefs that directs behavior.

Goal refers to the end or outcome to be accomplished.

Objective refers to something aimed at or striven for; things done to achieve the goal.

Philosophy

The philosophy articulates a vision and provides a statement of beliefs and

values that direct one’s practice. It should be written, included in appropriate

documents such as the staff handbook and annual reports, and reviewed periodically. If

the philosophy stated is vague, abstract terms that are not easily understood, it is

useless. Conflicting philosophies between overlapping units cause confusion and should

be avoided. Workers are most likely to interpret the philosophy from the

pronouncements and actions of the leaders in the institution. Therefore conformity of

action to belief is important.

The philosophy of an organization is derived from its mission and incorporates

the organizational values that direct the behavior of the organization. The information

provided in the philosophy—the values and principles of the organization—provides the

framework for the decision-making process of the organization and shapes the social

and professional development of the organization. The philosophy serves to allow

employees to achieve common goals (Wendenhof & Strahley, 1995). The philosophy

underlies the goals and objectives of the organization, so it is imperative that nurses

understand and know their organization’s philosophy.

When developing or reevaluating a philosophy, the manager should consider the

following:

Theory

Education

Practice

Research

Nursing’s role in the organization.

Approaches that can be used to incorporate nursing theory into the philosophy

include an eclectic approach that selects ideas from various nursing theories and

incorporates them into the philosophy statements or a theory might be adopted and

integrated into the philosophy. Attaching an explanation of the theory to the philosophy

would also be useful. Secondary sources give an overview of various nursing theorist’s

work, reference the theorists’ extensive publications, and address work related to the

theorists’ work.

Levine and Orem focus on nursing therapeutics. Wholism, holism, integrity, and

conservation are major concepts in Levine’s conservation principles. Orem’s theories of

self-care and self-care deficits are particularly useful in community health and

promotion of health situations.

Johnson and Roy emphasize the client. Johnson used a behavioral model and

identified six subsystems as (1) attachment-affiliation, (2) achievement, (3) sexual, (4)

ingestive-eliminative, (5) aggressive, and (6) dependency. Sister Callista Roy’s adaptation

model is particularly useful in acute care settings.

King, Newman, Orlando, Patterson, Zderad, Travelbee,and Wiedebach discuss

interaction. King’s conceptual framework specifies personal, interpersonal, and social

system interactions. Her theory of foal attainment is particularly useful for nursing care

and nursing administration. Newman stressed purposeful interventions and a total

person approach. Orlando addressed deliberative nursing actions that purposefully

identify and meet the patient’s needs. She maintained that automatic actions may not

meet the patient’s needs. Patterson and Zderad developed a humanistic nursing theory

and indicated that the defining event in nursing is the interaction between the patient

and the nurse. Wiedebach developed a philosophy of nursing and a flow chart that

indentifies a need for help.

Rogers focused on the environment and interactions of human beings. Her

conceptual model of unitary human beings is very abstract and thought provoking.

Middle-range theories that are specific to a particular aspect of nursing practice may be

useful for agency units. Middle-range theories of nursing are proliferating.

It is appropriate to comment on:

Skill levels needed

Advanced preparation for certain positions

Need for continuing education

Provision of educational opportunities for students, and

Specific practice modalities

The value of applying research findings to practice, supporting research efforts,

and acknowledging nursing’s role in the overall organization could also be clarified in the

philosophy.

Goals and Objectives

Goals and objectives state actions for achieving the mission and philosophy. In

fact, if the mission or purpose and philosophy are to be more than good intentions, they

must be translated into explicit goals. The more quantitative the goal, the more likely its

achievement is to receive attention and the less likely it is to be distorted.

Goals are central to the whole management process – planning, organizing,

staffing, directing, and controlling/evaluating. Planning defines the goals; the institution

is organized and staffed to accomplish goals. Direction stimulates personnel toward

accomplishment of the objectives and control compares the results with objectives to

evaluate accomplishments.

Goals and objectives may address services rendered, economics, use of

resources – people, funds, facilities – innovations, and social responsibilities. Objectives

are selective rather than global, are multiple, and cover a wide range of activities. The

immediate, short-term, and long-term goals should be balanced, interdependent and

ranked in order of importance. It is common to have more short-term than long-term

goals.

Because goals are dynamic, they change over time. They should be reviewed

periodically so that they can be changed in an evolutionary rather than a radical

manner. Goals should be specific rather than vague, and challenging yet reachable.

Necessary support available should be available.

Goals help focus attention on what is more important and are broader

statements than objectives. Objectives are more specific ways to reach the goal. It is

recommended that objectives be achievable, specific, measurable, and outcome

oriented, starting with “to” followed by a verb. Each objective should be about a single

result with a target date. Strategies identify how an organization will attain the vision.

The development of long and short-term objectives is appropriate. A form with four

columns (one for goals/objectives, one for strategies/actions, one for target dates and

person or persons responsible, one for accomplishments) can be a helpful planning tool.

Sample Philosophy, Goal and Objective

Philosophy of General Hospital

General Hospital is committed to assessing and meeting the physical, emotional,

spiritual, environmental, social, and rehabilitative needs of the citizens in the region.

The worth, dignity, and autonomy of individuals (customers, employees, and others) are

recognized, as is each individual’s right to self-direction and responsibility for one’s own

life. Individual uniqueness will be considered when assessing needs and delivering

quality care. Educational pursuits, research, and public service programs will be used

toward innovations and improvement of health care in the region. General Hospital

Personnel will work in collaboration with customers and in partnership with other

organizations to provide cost-effective services.

Goal

Develop and implement staff development programs to meet the need for increased

knowledge

Objective

Develop and implement at least 12 staff development programs by the end of the fiscal

year

***References:

Jones, Rebecca. Nursing Leadership and Management: Theories, Processes and Practice.

USA: F.A. Davis Company, 2007.

Tomey, Ann Marriner. Guide to Nursing Management and Leadership. Singapore:

Elsevier Pte Ltd, 2009.

Venzon, Lydia and Nagtalon, Jennifer. Nursing Management towards Quality Care.

Quezon City: C&E Publishing Inc., 2006.

3. Steps/ Process

3.3Identifying Strategies

3.4Setting time frame

By: Pascual, Lea Pamela

Identifying Strategies

Strategy is the techniques, methods, or procedure by which the overall plan of

the higher management achieves desired objectives.

Programs are activities put together to facilitate attainment of some desired

goals.

Time Management is a technique for allocation of one’s time through the setting

of goals, assigning priorities, identifying and eliminating time wastes and use of

managerial techniques to reach goals efficiently.

Principles of Time Management

1) Planning for contingencies-planning anticipates the problem that will arise from

actions without thought.

2) Listing of task-task to be accomplished should be done in sequence which is

prioritized according to importance.

3) Inventory

4) Sequencing

5) Setting and keeping deadlines- and adhering to deadline is an excellent exercise

in self discipline.

6) Deciding on how time will be spent.

Setting the Time Frame

1. Conduct an inventory of your activities.

2. Set goals and objectives and write them down.

3. With the use of calendars, executive planners, logs or journals, write what you

expect to accomplish yearly, monthly, weekly or daily.

4. Break down large projects into smaller parts.

5. Devote a few minutes at the beginning of each day for planning.

6. Organize your work space so it is functional.

7. Close your door when you need to concentrate.

8. Learn to delegate.

9. In a meeting, define the purpose clearly before starting.

10. Take or return phone calls during specified time.

11. Develop effective decision-making skills.

12. Take rest breaks and make good use of your spare time.

3. Steps/ Process

3.5 Preparing the budget

By: Villa- Real, Ana Cristina

PREPARING THE BUDGET

1. A budget is the annual operating plan, a financial “road map” and plan which

serves as an estimate for future costs and a plan for utilization of manpower,

material and other resources to cover capital projects in the operating programs.

2. A 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.

3. A hospital budget is a financial plan to meet future service expectations.

4. A budget is simply a plan for future activities expressed in operational as well as

financial or monetary terms. In health care institution, budget consists of four

components:

a. Revenue Budget- summarizes the income which the management

expects to generate during planning period

b. Expense budget- describes the operational and financial terms for a given

period of time.

c. Capital budget- outlines the programmed acquisitions disposals and

improvements in an institution’s physical capacity.

d. Cash budget- represents the planned cash receipts disbursements as well

as the cash balances expected during the planning period.

BEBEFITS DERIVED FROM THE BUDGETARY PROCESS

The major benefits of budgetary process can be categorized under the major

functions of planning, coordination and control.

1. Planning

a. Stimulates thinking in advance; anticipates future opportunities or

problems and prepares for them.

b. Leads to specific planning—volume and types of services to be

rendered and revenue to be delivered there from; number and type

of personnel required; cost, volume and type of supplies needed; cost

of fix asses when needed; cost and source of funds, cash collections

and disbursements.

c. Budget preparation stimulates action and interaction. Mechanical

budgeting process gives empirical information, additional benefits

result from the organizational thinking process that is generated and

the worthwhile interrelationships that develop.

2. Coordination

a. Balancing effect on the total organization—quantity and quality of

service to be given a patient should be closely equal to the expected

revenue; hospital departments are interrelated, future plans of one

department must complement the plans of other affected

departments.

b. Encourages exchange of information

c. Stimulates team play or team approach—enabling team member to

contribute to organizational planning as well as to see the results of

good team play, the budget becomes a stimulant to employee

commitment and efficiency, and as effective guide to proper

utilization of resources.

3. Comprehensive Control

a. Gives the administration an opportunity to evaluate thinking of the

budget contributor. Is the budget planning realistic? Are standards

too high or to low?

b. Comparisons between the actual expenditures and budgeted

standards can be made with no or little effort.

c. Cost consciousness.

FACTORS IN BUDGET PLANNING

1. Type of patient, length of stay in the hospital and acuteness of illness

2. Size of hospital and bed occupancy

3. Physical lay out of the hospital, size and plan of the wards, units, nurse’s

station, treatment rooms, etc

4. Personnel policies

a. Salaries paid to various type of nursing personnel including OT pay or

shift differential

b. Extent of VL, SL, holidays

c. Provision for staff development programs

5. Grouping of patients such as those in specialized areas

6. Standards of nursing care: kind and amount of care to be given as it affects

the number of hours of bedside care

7. The method of performing nursing care whether simple or complex;

8. the method of documentation

9. Proportion of nursing care provided by the professional nurses and those

given by non-professionals

10. Amount and quality of supervision available and provided;

11. the efficiency of job description and job classification

12. Method of patient assignment whether functional, case, team or primary

13. Amount and kind of labor-saving devices and equipments

14. Amount of centralized service provided: sterile supply , central o2 supply,

linen supply

15. Nursing service requirements of the ancillary departments: clinics, admitting

office, ER

16. Reports required by administration whether simple or complex

17. Affiliation of nursing students or medical students

Budgetary process

Budget committee

Assures orderly and timely development of the budget.

Assists the budget officer in budget preparation and in monitoring the

budget.

Chief Nurse or his/ her assistant

Usually a member of the budget committee.

Works with the supervisors and head nurses in preparing the budget for

the nursing service.

Compiles and completes the final draft of the budget and presents this to

the Budget Officer or Hospital Administrator

Nursing personnel

Their participation can lead to cost consciousness, awareness of

activities, and increased cost- effectiveness.

Past operations must be analyzed and the overall master staffing plan must be

reviewed—supervising nurse works with the head nurses to determine the staff

requirements for each unit.

Factors to be considered in budget preparation:

o Assurance of standards (philosophy and objectives of the hospital and the

division of nursing

o Past experiences in the unit

o Anticipated needs of the unit

o Percentage of the unit occupancy

Estimation of staff for each unit should be based on the following:

o number of patients

o the number of nursing care hours needed

o provision of vacation

o sick and other leaves

o holidays

o Average number of absences per staff member per year.

o Privileges—attendance in continuing education programs

New activities/ program should also be considered-- new patient services, staff

development programs or changes hospital services that affect the required

nursing services.

Ascertain the amount and kind of supplies needed for the operation of each

nursing unit.

o Review of past expenses and consumption provides data for planning

o Requests fort the replacement of capital equipment must be

supported with documented justification

Components of Budget

o Three major budgets of budgetary control program:

a. Cash Budget

o Forecast the amount of money received

o Consists of beginning cash balance, estimates of the receipts and

disbursement, and estimates balance for a given period

corresponding to that of the operating and capital budgets.

o Prepared by estimating the amount of money to be collected from

patients and allocating it to cash disbursement required to meet

obligations promptly as they come.

b. Operating Budget

o Deals primarily with salaries, supplies, contractual services,

employee benefits, laundry service, drug and pharmaceuticals, in

service education, travels to professional meetings, books,

periodicals, professional magazines and repair and maintenance

o Composed of the revenue and the revenue and expense budget.

c. Capital Expenditure budget

o Consist of accumulated data for fixed assets that are expected to

be acquired during the budgeted period.

o Includes estimated costs and sources of funds for expected

replacements, improvements and additions to fixed assets

o (cost of estimated requirements + anticipated dates of acquisition)

Individual report

=information about anticipated procurements, priorities and

timing as well as feasibility of acquisition

o Proposal for capital equipment must be accompanied by

complete description of the item—statement as to the reason of

purchase (addition, improvement or replacement), classification

(prioritized as urgent, essential, economically desirable, or just

desirable) and probable outcome of the purchase (improvement

of patient care, increase or decrease department revenue,

whether there will be charge for its use and if so, how much,

including a probability of the frequency of its use

4. Types

By: Cordero, Arlene

Types of Planning

1. Long range/ strategic :

It is usually a type of planning good for 3-5 years in the future. It is an in depth

analysis of the internal environments strength and weaknesses and the external

opportunities and threats so that realistic goals can be set for the preferred future. It

determines the direction of the organization, allocates resources assigns responsibilities

and determines time frames.

History: As the year goes by, the health care setting goes with the trend of form

curative to preventive, from individual based treatments to population based

treatments. From content mastery to process mastery, from being governed

professionally to being governed managerially, from paper health records to

computerized health records.

Purpose: Gives direction to the organization, improves efficiency, weeds out

poor underused programs. Eliminates duplication efforts, concentrates resources on

important services, improves communications and coordination activities, provides a

mind expanding opportunity, allows adaptation to the changing environment, sets

realistic and attainable yet challenging goals, and helps ensure goal achievement.

Goals: generic

2. Short range/Operational:

Nurse managers are more likely to be involved in this. It is done in conjunction

with budgeting, usually a few months before the new fiscal year. It develops

departmental maintenance and improvement goals for the coming year.

Purpose: It is more on developing and monitoring tactics, plans, and evaluation

plansfor a short term planning.

Goals: specific

Top level manages such as chief executive officers, presidents and division heads

do strategic planning for 3-5 years. Middle level managers such as supervisors and

clinical specialists do intermediate planning for 6 mos. to 2 years. Lower level managers

such as managers of nursing units, team leaders, case managers and primary care nurse

do operational planning 1 week to 1 year.

5. Resistancy to planning

By: Fermin, Hollero

Why manager fail to plan effectively?

Many nurse- managers fail to plan effectively for different reasons. They may

lack knowledge of the philosophy, goals and objectives of the agency or lack

understanding of the significance of the planning process. They may not know how to

manage their time to devote for planning. They may lack confidence in formulating

plans of may fear that planning may bring out unwanted changes that they are unwilling

to undertake or are unable to cope up with. Knowing these factors will help nurse-

managers to overcome their weaknesses and utilize planning as the key to success in

their work.