Controlling

1. SALALE UNIVERSITY COLLEGAE OF HEALTH SCIENCE
DEPARTMENT OF ADULT HEALTH NURSING
Seminar Presentation on ; Controlling
Presented To: Mr. Ayele T {BSc, MSc, Asst.proff}
Nov . 2023
Salale , Fitche
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2. 1 Sufa Mengiste…………….AHN /191/15
2 Tolosa Nugussie…………..AHN/192/15
3 Mulugeta Alemu………….PCH/084/15
4 Chaltu Tsehay……………. PCH/
GROUP MEMBERS
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3. Roles of nurse manager
Introduction to control
Purpose, scope , principles of control, control process
Quality assurance
Quality control in nursing
Standard development
Nursing audit
Totality quality management
Controlling and managing employees
Labor relation and labor laws
Principles of control applicable to nursing service and
education
summary
Reference
CONTENT
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4. To describe control
To explain quality assurance
To explain quality control in nursing
To describe of development of standard
To explain nursing audit
To explain labor relation and labor laws
OBJECTIVES
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5. ROLE OF NURSE MANAGER
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Creation of vision
Implementation of the
vision
Facilitation of changes
Mentoring
Information collection
Evaluation of information
Communication
Decision making
Relationship development
Control work environment

6. STEPS OF MANAGEMENT
 planning,
 organizing,
 staffing,
 leading and
 controlling.
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7. Control is a fundamental managerial function of
a manager which is concerned with securing
good individual performance at a desirable level.
INTRODUCTION CONTROLLING
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8. CHARACTERISTICS OF
CONTROLLING
Control is a continuous process.
• Control is a management process.
• Control is forward looking.
• Control is closely linked with planning.
• Control is a tool for achieving orgsnizational activities.
• Control is a tool for achiving organization activities.
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9. According to:-Henry fayol : control consists in
everything occurs in conformity with the plan
adopted , the instruction issued and the principles
established..
 According to mordan concepts :-control is a
foreseeing action whereas earlier concept of
control was used only when errors were detected.
DEFINITION
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10. Purpose of control includes :Open opportunities for
employees,Compare performance against set
standard and Provides information about how well
processes and people function.
PURPOSE OF CONTROL
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Control Policies: – The success of any business organization
depends to a large extent on how far its policies are
implemented.
Control over Organization: – Control over the organization is
accomplished through the development of organization charts
and organization manuals. The organization manual attempts to
resolve organization problems and conflicts to enable
rationalization of the organization structure to help in the proper
design of the organization and department.
Control over Personnel: – The statement that the Management is
getting the job done through the people adequately underlines
the importance of personnel control.
Control over Wages and Salary: – Such control is done by a
program of job evaluation and salary and wage analysis.
SCOPE OF CONTROL

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Control Over Costs: – Cost control is used by the cost accountant
by setting cost standards for materials, labor, and heads, and
comparing actual cost data with standard costs. Cost control is
complemented by budgetary control systems.
Control Over Method: – Control of methods is accomplished by
periodically analyzing the activities of each department. The tasks
performed, the methods and time adopted by each employee are
dedicated, studied to eliminate non-essential motions, tasks and
methods.
Overall Control: – It is effected through budgetary control. The
master plan should be designed for overall control in the
organization and all departments should be included in this
process.
SCOPE OF CONTROL

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Principle of Reflection of Plans:
The more clear and complete the plans of the organisation and
the more contr61s are designed to reflect these plans, the more
effectively will controls serve its needs.
2. Principle of Prevention:
The truth of the saying ‘Prevention is better than cure’ is well-
established. In control more attention should be directed to
prevention of shortfalls than, remedying them after they occur.
Peed forward control is very helpful in this respect.
3. Principle of Responsibility:
Responsibility for control particular measurement of deviations
taking corrective action should be given to specific individuals at
each stage of the operation.
APPLICABLE PRINCIPLES OF CONTROL

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4. Exception Principle:
The managers should concern themselves with exceptional cases i.e., those
where the deviations from standards are very significant. Deviations of a minor
mature may be left to subordinates for necessary action.
5. Principle of Critical Points:
All operations have got’ certain vulnerable or critical points. It is these which
cause most of the troubles – give rise to major deviations. The managers should
pay more attention to the guarding of these points.:
6. Principle of Pyramid:
Feedback data should first be communicated to the bottom of the pyramid i.e.,
those supervisors and even operating staff who is at the lowest levels. This will
give the employees opportunity to control their own situations, apart from
quickening remedial action.
APPLICABLE PRINCIPLES OF CONTROL

15. CONTROL PROCESS
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16. 1) Feed forward -Feedforward Control. This is management
communication from the top and provides information on
any problem that may occur.
2) Concurrent -direct supervision:Concurrent control is also
known as real-time or steering control. It is the type of
controlling the activities in the process of functioning.
3) Feedback -most popular:It is also known as post-action
or feedback control. It takes place after the activity is over.
TYPES OF CONTROL
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• 1. Physical resources:- inventory management, quality
control, and
equipment control.
• 2 Human resources:- selection and placement,
training and development,
performance appraisal, and compensation.
• 3. Information resources:- sales and marketing
forecasts, environmental
analysis, public relations, production scheduling and
economic forecasting.
4 Financial resources:- managing capital funds and cash
flow, collection in
paymen
AREAS OF CONTROL

18. QUALITY
It is degree to which health services for individuals
& population increase the likelihood of desired
health outcomes & are consistent with current
professional knowledge.
Joint Commission on
Accreditation of health care organization ,2002
(JCAHO)
QUALITY ASSURANCE
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19.  Quality assurance is an on-going, systematic,comprehensive
evaluation of health care services& impact of those services on health
care
services-Kozier
 Quality assurance is defined as all activities undertaken to predate &
prevent poor quality.
-Neetve
The unique function of nurse is to assist in individual sick or well in
performance of those activities .contributing to health or its recovery or
to a peaceful death that he would perform unaided if he had necessary
strength will or knowledge & to do this in such a way as to help him to
gain independence as rapidly as possible.”
-Virginia Henderson
QUALITY ASSURANCE…
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20. OBJECTIVES
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To ensure the delivery of quality client care.
• To demonstrate efforts of health care providers
to provide good results.
• To formulate plan of care.
• To evaluate achievement of nursing care

21. PRINCIPLES
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Customer focus- It focuses on patient’s care with
standard & recent medical knowledge.
2. Leadership – It helps to inculcate qualities of
leadership in staff.
3. Involvement of People- It should involve
maximum nursing staff so that standards can be
maintained.
4) Process approach- There should be a systematic &
planned approach to provide quality care.
5) Factual approach to decision making- There should be fact or
appropriate reason in taking certain decision for quality assurance
of patient.

22.  Quality control is a specific type of controlling, which refers to
activities that evaluate, monitor or regulate services rendered to
consumers .
 Quality Control (QC) may be defined as a system that is used to
maintain a desired level of quality in a product or service. It is a
systematic control of various factors that affect the quality of the
product.
QUALITY CONTROL IN NURSING
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23. three basic steps:
1) Criterion or standard is determined
2) Information is collected to determine if the
standard has been met.
3) Educational or corrective action is taken if the
criterion has not been met.
QUALITY CONTROL IN NURSING…
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A1. Establishment of Standards
In order or a quality control system to be fully effective, it must have detailed information on what to monitor
and an understanding of the set standards. This aids in the establishment of a scoring system to accurately
measure whether the level of quality improvement efforts is reached.
The establishment of standards begins with a clear vision of what the ideal service should look like. Standards
are then set to correspond with the areas of focus, and the set standards are used to monitor compliance.
2. Ensuring Monitoring Compliance
In the medical field, the purpose of quality control procedures is to monitor services by performing audits.
Audits are performed on documents like patients' medical files and the quality of processes involved in serving
the patients, like how long it takes them to receive appointments when referred.
Audits are performed through a quantitative approach to capture data that is then compiled into statistics.
Auditing tools used may be primary or comprehensive, depending on the level of detail to be reviewed. The
areas being reviewed receive a score used to depict whether the audited variable has met the required
standards or not.
3. Process Improvement
When certain areas of a medical field don't reach the targeted standards, process improvement projects are
initiated. The role of process improvement projects is to allow departments in healthcare to improve their
efficiency and effectiveness.

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SIX DOMAINS OF QUALITY IN HEALTH CARE
Safe: Avoiding harm to patients from the care that is intended to help them.
Effective: Providing services based on scientific knowledge to all who could
benefit and refraining from providing services to those not likely to benefit
(avoiding underuse and misuse, respectively).
Patient-centered: Providing care that is respectful of and responsive to
individual patient preferences, needs, and values and ensuring that patient
values guide all clinical decisions.
Timely: Reducing waits and sometimes harmful delays for both those who
receive and those who give care.
Efficient: Avoiding waste, including waste of equipment, supplies, ideas, and
energy.
Equitable: Providing care that does not vary in quality because of personal
characteristics such as gender, ethnicity, geographic location, and
socioeconomic status.

27. Nursing Standard ;
is descriptive statement that effect the nature of current
nursing practice, knowledge and quality of nursing care.
It is means of establishing accountability of nursing care
rendered by professional nurse.
Purposes of standards;
 it improves quality of nursing education programs.
Provides professional accountability
Helps to achieve objectives, aims and goal of program.
Give direction and provide guidelines for performance of
nursing
DEVELOPMENT OF STANDARD
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28. Professional organization
Universities and nursing institutions
Government units at national , state and local
government unit
individual
SOURCES OF STANDARDS
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Standards for nursing care are set by
several organizations, including the
American Nurses Association (ANA), your
state's Nurse Practice Act, agency policies
and procedures, federal regulators, and
other professional nursing organizations.

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TYPES OF STANDARD

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TYPES OF STANDARD…
NORMATIVE STANDARDS describe practices considered good or ideal by some
authoritative group.ideal sides set by authoritative group. EMPIRICAL
STANDARDS describe practices actually observed in a large number of patient
care setting.Here ,the norm active standards describe a higher quality of
performance than empirical standards .generally,professional organizations
(ANA/TNAI) promulgate normative standards where as law enforcement and
regulatory bodies (INC/MCI)promulgate empirical standards.
19. THE ENDS STANDARD are patient oriented .They describe the change as
desired in a patients physical status or behavior. THE MEANS STANDARD are
nursing oriented ,they describe the activities and behavior designed to achieve
the ends standard .ends or patient outcomes standards require information
about the patient .A means standard call for information about the nurses
performance.

32. Nursing audit;
 Is the assessment of the quality of nursing care and uses records as an
aid in evaluating the quality of patient care. It is an evaluation of the
nursing service.
Methods of nursing audit
 :The goal of a prospective audit is to catch any billing or coding errors
before the claim is submitted.
 Retrospective audits involve reviewing claims that have already been
submitted – and preferably adjudicated – as either paid, denied, or
pending. The goal of a retrospective audit is to do a ‘deep dive’ on the
internal claims process, and identify underlying problems or high-risk
areas based on the adjudication results.
NURSING AUDIT
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33. A nursing audit consists of collecting information from
nursing reports, medical notes and other patient care records
to help assess the quality of care. Therefore, a nurse auditor is
responsible for managing medical records in healthcare
settings and insurance companies, Evaluating nursing care
given,achieves deserved and feasible quality of nursing
care,Stimulant to better records,Focuses on care provided
and not on care provider and Contributes to research.
PURPOSES OF NURSING AUDIT
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34. This is a philosophy developed by Dr. Edward Deming(TQM) is a
management strategy aimed at embedding awareness of quality in all
organizational processes. TQM has been widely used in manufacturing,
education, government, and service industries, as well as NASA space
and science programs. Total Quality provides an umbrella under
which everyone in the organization can strive and create customer
satisfaction at continually lower real costs.
15. Total Quality Management (TQM ) TQM is composed of three
paradigms: Total: Involving the entire organization, supply chain,
and/or product life cycle Quality: With its usual Definitions, with all its
complexities Management: The system of managing with steps like
Plan, Organize, Control, Lead, Staff,
TOTAL QUALITY MANAGEMENT
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35. Principles
Improve constantly every process of planning, producting
and service.
Institute job training and retraining.
Develop leadership in the organization.
Foster inter-departmental cooperation, and
breakdown barriers between departments
Drive out fear by encouraging employees to
participate actively in the process.
Focus on quality and not just quantity.
Promote team work rather than individual
Principles…
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36. MANAGING EMPLOYEES
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. Hire the right people
Great staff management begins with finding the right person for the role, but it goes far beyond
that. Your baseline is a candidate who fits the job description and has the right qualifications.
2. Implement training and development
Regular staff training helps you identify growth areas and provides a chance to plug any skill gaps.
Employees who receive training feel valued. This helps to increase productivity and hence to grow
your business.
3. Use employee management software
Good employee management software lets you roster staff, set permissions, schedule time off and
keep track of hours all in one place. It streamlines the process of managing staff expectations
around shifts and holiday bookingheps.
4. Promote open communication
Do your staff look forward to seeing you or do they cower in your wake? Don’t be the manager
everyone avoids; instead try to foster great communication..
5.Regularly monitor staff performance
Performance management is important for both you and for your team. It allows you to check
people are hitting targets and meeting company standards. It can also flag up areas which need
attention. For your employees it sets clear expectations.

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Cont....
6. Implement a rewards system
People love to be recognised for things they do well, so make it an intrinsic part of your
employee management. Whether it’s verbal recognition, a small gift or an employee of
the month award, it makes them feel valued. It also demonstrates to the rest of your
staff that hard work is rewarded. This means it can also motivate staff and create a more
positive workplace culture.
7. Set clear, recognisable goals
Part of being a good manager involves setting goals your employees can understand.
Work out your business needs in terms of sales, for example, and what you need to do to
get there. Use the SMART acronym to make sure your goals are:
S – Specific
M – Measurable
A – Attainable
R – Relevant
T – Time-based

38. Is when managers of an employees track and use
an employees action during work, which includes
work activities such as software, internet and
phone usage.
Controlling ensures efficient and effective use of
the resource of the organization in order to achieve
the organizational objectives
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CONTROLLING EMPLOYEES

39. Labor relation; Is relationship between an employer and unionized
employees.Also referred to as union management relation or industrial
relation.or the relationship between employers and employees in industry,
and the political decisions and laws that affect it.
 Labour laws, labour code or employment laws are those that mediate the
relationship between workers, employing entities, trade unions, and the government.
Collective labour law relates to the tripartite relationship between employee,
employer, and union.
 Poor labor law causes ;Declining performance,Heightened interpersonal
conflict,Absenteeism,Excessive turnover
LABOR RELATION AND LABOR LAWS
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40. Focus on collaboration:To start improving
collaboration within your organization, focus on
these three areas: team orientation, networking and
building common purpose
Interdependence:the extent to which team members
rely on each other for the functioning of their teams
SYSTEM APPROACH TO LABOR RELATION
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Synergy:Synergy is the working together of two or
more parts, where the combined effort is greater than
the effectiveness of the individual parts alone.
 Contingency theory:situational factors can affect the
relationships between dependent and independent
variables in the work environment, which in turn will
affect employee behavior, motivation, and
effectiveness.

42. LABOR LAW Minimize labor unrest,Helps workers
in getting fair wages,Ensures job security of
workers,Provides compensation for workers, who
are victims of accident and Reduce conflicts.
IMPORTANCE OF LABOR LAW
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43. freedom of association and the effective recognition
of the right to collective bargaining;the elimination of
all forms of forced or compulsory labour;the effective
abolition of child labour;the elimination of
discrimination in respect of employment and
occupation; and a safe and healthy working
environment.
PRINCIPLES OF LABOR LAW
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44. Nurse managers responsible for; managing human and
financial resource; ensuring patient and staff
satisfaction; maintaining safe environment for staff ,
patients and visitors; ensuring standard and quality of
care are maintained; and aligning the units goal with
the hospitals strategic goal.
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SUMMARY

45. 1. Vati Jogindra; Principles & Practice Of Nursing Management &
Administration For B.Sc. & M.Sc. Nursing; Edition 2018; Page
no. 72-79.
2. Clement Nisha; Essentials of Management of Nursing Service &
Education; Edition 2016; Page
no. 43-51.
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Reference

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