Controlling in nursing.pptx presentation

INTRODUCTION TO CONTROLLING
 Controlling or Evaluating is an on-going function of management
which occurs during planning, organizing and directing activities
 It is a process wherein the performance is measured and corrective
action is taken to ensure the accomplishment of organizational goal
 Controlling or evaluating is a fundamental managerial function of a
manager which is concerned with securing good individual
performance at a desirable level.
 Controlling has the features of unity, continuity, flexibility and
pervasiveness.

Definition
 Controlling consists in everything that occurs in
conformity with the plan adopted, instruction is
used and the principles establishes
- Henry Fayol
 According to modern concepts “Controlling is a
foreseeing action whereas earlier concept of
control was used only when errors were detected”

CHARACTERISTICS OF CONTROLLING
1. Control is a continuous process.
2. Control is a management process.
3. Control is forward looking.
4. Control is closely linked with planning.
5. Control is a tool for achieving organizational
activities.
6. Control is a tool for achieving organization
activities.

Reasons for conducting Evaluation/Controlling
 Evaluation ensures that quality nursing care is provided.
 It allows for the setting of sensible objectives and ensures
compliance with them.
 It provides standards for establishing comparisons.
 It promotes visibility and a means for employees to monitor
their own performance.
 It highlights problems related to quality care and determines
the areas that require priority attention.
 It provides an indication of the costs of poor quality.
 It justifies the use resources.
 It provides feedback for improvement.

PURPOSES OF CONTROLLING
 Open opportunities for improvement
 Compare performance against set standard
 Provides information about how well processes
and people function

AREAS OF CONTROL
1. Physical resources
2. Human resources
3. Information resources
4. Financial resources

AREAS OF CONTROL (Conti)
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 payment.

CLASSIFICATION OF CONTROL
1. MAN & MACHINE CONTROL:-
 Machine system can be complex because of the sophisticated.
 Technology where as control of people is complex because
the elements of control are difficult to determine.
2. ORGANIZATIONAL AND OPERATIONAL CONTROL:-
 The direction for organizational control comes from the goals
and strategic plans of the organization.
 General plans are translated into specific performance
measures such as share of the market, earnings, return on
investment, and budgets.

Principles of Evaluation or Controlling
 The evaluation must be based on the behavioral
standards of performance which the position requires.
 The evaluation should have enough time to observe
employee’s behavior.
 The employee should be given a copy of the job
description, performance standards, and evaluation
conference.
 The employee’s performance appraisal should include
both satisfactory and unsatisfactory results with specific
behavioral instances to exemplify these evaluative
comments.

Principles of Evaluation or Controlling (Conti)
 Areas needing improvement must be prioritized to
help the worker upgrade his/her performance.
 The evaluation conference should be scheduled
and conducted at a convenient time for the rater
and the employee.
 The evaluation report and conference should be
structured in such a way that is perceived and
accepted positively as a means of improving job
description.

BASIC PROCEDURES IN CONTROLLING
PROCESS
1. Setting Standards provide the established criteria of the
performance for evaluating both personnel or organizational
performance.
2. Evaluating Performance Actual results or performances are
evaluated against the desired results and standards. It is done
by comparing planned and actual performance.
3. Taking Corrective Actions Measurement and evaluation of
performance, detection of deficiencies and preparation of the
control reports. Corrective actions are taken to overcome the
deficiency during the work progress..

ADVANTAGES OF CONTROL
1. Insurance value of control
2. Basis for future actions
3. Acts as indicators for managerial
weakness
4. Facility of co-ordination

LIMITATIONS OF CONTROL
1. Lack of satisfactory standards
2. Imperfection in measurements
3. Limitations of corrective actions
4. Human reaction to control

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 (Conti)
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 (Conti)
 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 (Conti)
 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

QUALITY ASSURANCE
• It focuses on the care and service the patient
receives than on how well the professional
performs the duties that the position requires
• It is a process of evaluation that is applied to the
health care system and the provision of
healthcare services by health workers
• It contains both TQM & CQI (continuous quality
improvement)
• It is important for customer satisfaction

Purpose of Quality Assurance program
 The primary purpose of QA programs in nursing is
to measure and improve the quality of nursing
delivery in the agency.
 The patient is the best and sometimes the only
judge of the interpersonal aspects of care, like
empathy, communication, room & food services.
 Patient satisfaction is an essential goal of care.
 Patients attitude influence the degree of
compliance to the medical regimen

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 (Conti)
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

How to develop QA criteria
1. Structure Approach Includes physical setting, instrumentalities
and conditions through which nursing care is given such as the
philosophy and objectives, the building, organizational
structure, financial resources, and equipment.
2. Process Approach Includes the steps in the nursing process in
compliance with established standards of nursing practice.
3. Outcome Approach Identifies desirable changes in the
patient’s health status such as modification of symptoms, signs,
knowledge, attitudes, satisfaction, skill level, and compliance
with the treatment regimen

METHODS USED FOR QUALITY ASSURANCE
1. Patient care audit
2. Patient care profile analysis
3. Peer review
4. Quality circles

TOTAL QUALITY
MANAGEMENT
(TQM)

TOTAL QUALITY MANAGEMENT (TQM)
 It is a way to ensure customer satisfaction by
involving all employees in the improvement of the
quality of every product or service
 It 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)
It is 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

Program (Project) Evaluation and Review Technique
• PERT is a project management tool used to
schedule, organize, and coordinate tasks
within a project
• It is basically a method to analyze the tasks
involved in completing a given project,
especially the time needed to complete
each task, and to identify the minimum time
needed to complete the total project.

OBJECTIVES OF PERT
 To facilitate decision making
 To reduce both the time and cost required
to complete a project.

Requirements of PERT
Personnel should already have a good understanding
of formal project management terminology, tools, and
techniques
 PERT form template of equivalent tool (e.g.
software)
 Create of project plan
 Choose the most appropriate scheduling method
 Select and organize a team to perform project
tasks.

STEPS IN PERT
1. Identify the specific activities and milestones.
2. Determine the proper sequence of the activities.
3. Construct a network diagram Estimate the time
required for each activity.
4. Determine the critical path.
5. Update the PERT chart as the project progresses

STEPS IN PERT (Conti)
1. IDENTIFY THE SPECIFIC ACTIVITIES AND MILESTONES
• The activities are the tasks required to complete a project.
• The milestones are the events marking the beginning and the end of
one or more activities.
• It is helpful to list the tasks in a table that in later steps can be
expanded to include information on sequence and duration.
2. DETERMINE THE PROPER SEQUENCE OF THE ACTIVITIES
• This step may be combined with the activity identification step since
the activity sequence is evident for some tasks.
• Other tasks may require more analysis to determine the exact order
in which they must be performed.

3. CONSTRUCT A NETWORK DIAGRAM
 Using the activity sequence information, a network diagram can be
drawn showing the sequence of the serial and parallel activities.
 Each activity represents a node in the network, and the arrows
represent the relation between activities.
 Software packages simplify this step by automatically converting
tabular activity information into a network diagram.
4. ESTIMATE THE TIME REQUIRED FOR EACH ACTIVITY
 Weeks are a commonly used unit of time for activity completion, but
any consistent unit of time can be used.
 A distinguishing feature of PERT is its ability to deal with uncertainty in
activity completion time.

5. DETERMINE THE CRITICAL PATH
• The critical path is determined by adding the times for the activities in
each sequence and determining the longest path in the project.
• The critical path determines the total calendar time required for the
project.
6. UPDATE THE PERT CHART AS THE PROJECT PROGRESSES
• Make adjustments in the PERT chart as the project progresses.
• As the project unfolds, the estimated times can be replaced with
actual times.
• In cases where there are delays, additional resources may be needed
to stay on schedule and the PERT chart may be modified to reflect the
new situation.

BENEFITS OF PERT
PERT is useful because it provides the following
information:
 Expected project completion time;
 Probability of completion before a specified date;
 The critical path activities that directly impact the
completion time;
 The activities that have slack time and that can be
lend resources to critical path activities;
 Activity start and end date.

INTRODUCTION TO BENCHMARKING
Benchmarking is a process of finding what best practices are
and then proposing what performance should be in the future.
The main emphasis of benchmarking is not on “best
performance” but on improving a given business operation
or a process by exploiting “best practices”
The three principles of benchmarking are
 Maintaining quality,
 Customer satisfaction and
 Continuous improvement

DEFINITION OF BENCHMARKING
It can be defined as a process for improving performance by constantly
identifying, understanding and adapting best practices and process followed
inside and outside the company and implementing the results.
“Benchmarking is an ongoing outreach activity; the goal of the outreach is
identification of the best operating practices that, when implemented, produce
superior performance”
- Bogan and English, Benchmarking for best practices
 Benchmark refers to a measure of best practice performance.
 Benchmarking is the systematic search for best practices, innovative ideas and
highly effective operating procedures.
 It measures performance against that of the “ best-in-the-class” organization.

TYPES OF BENCHMARKING
1. Strategic Benchmarking
2. Performance Benchmarking
3. Process Benchmarking
4. Functional Benchmarking
5. Internal Benchmarking
6. External Benchmarking
7. International Benchmarking

Strategic Benchmarking
 It is used where businesses need to improve
overall performance by examining the long-term
strategies and general approaches that have
enabled high performers to succeed.
 It involves considering high level aspects such as
core competencies.
 This type of benchmarking is suitable when the
company has to realign business strategies that
have become inappropriate.

Performance Benchmarking
 It is also known as Competitive Benchmarking
 It is used when organizations consider their
positions in relation to performance characteristics
of key products and services.
 This type of benchmarking is suitable for
assessing relative levels of performance in key
areas or activities in comparison with others in the
same sector to find ways of closing gaps in
performance.

Process Benchmarking
 It is used by the organization when the focus is on
improving specific critical processes and
operations
 Benchmarking partners are sought from best
practice organization and are drawn from the
same sector.
achieving improvements in key processes to obtain
quick and short-term benefits.

Functional Benchmarking
 It is also known as Generic Benchmarking
 It can lead the organization to innovation &
dramatic improvements.
 It is used when organizations look to benchmark
with partners drawn from different business
sectors or areas of activity.
improving activities or services for which
counterparts do not exist.

Internal Benchmarking
 It involves seeking partners from within the same
organization & from business units located in different
regions.
 The main advantages are access to sensitive data &
information, availability of standardized.
 This type of benchmarking is suitable when several
business units within the same organization exemplify
good practice and management and want to spread
this expertise quickly throughout the organization.

External Benchmarking
 It involves analyzing outside organizations that
are known to be the best in the class.
 It provides opportunities of learning from those
who are at the “learning edge”.
 This type of benchmarking is suitable where
examples of good practices can be found in
other organization and there is a lack of good
practices within internal business units.

International Benchmarking
 This is used when the best practitioners are located
in other countries. This is due to globalization and
advances in information technology.
 There is a need for careful analysis &
interpretation due to national differences.
 This type of benchmarking is suitable where the
aim is to achieve world class status or simply
because there are insufficient “national” businesses
against which to benchmark.

Guidelines for successful Benchmarking
 Thorough understanding of one’s own processes.
 Emphasis on industry best practices.
 Selection of appropriate benchmarking partners and techniques.
 The benchmarking partner’s willingness to share information
 Maintaining confidentiality of critical information
 Involvement of management and employees in the analysis of best practices,
 Emphasis on practices and processes not on end results.
 Benchmarking should be a continuous process as the competition is always changing.
 Commitment towards the adoption and implementation of best practices.
 Selection and empowerment of benchmarking teams.
 Willingness to change as per the findings of the benchmarking study.
 The adaptability of the practices should be tested and the implementation results
should be verified.
 Strict adherence to the benchmarking.

GANTT CHART
 A Gantt chart is a type of bar chart that
illustrates a project schedule, named after its
inventor
 Henry Gantt designed such a chart around the
years 1910–1915.
 Modern Gantt charts also show the dependency
relationships between activities and current
schedule status.

GANTT CHART (Conti)
• A Gantt chart is a type of bar chart that
illustrates a project schedule.
• This chart lists the tasks to be performed on the
vertical axis, and time intervals on the horizontal
axis.
• The width of the horizontal bars in the graph
shows the duration of each activity.
• Gantt charts illustrate the start and finish dates of
the terminal elements and summary elements of a
project

Elements of GANTT CHART
 Task list: Runs vertically down the left of the Gantt
chart to describe project work and may be organized
into groups and subgroups
 Timeline: Runs horizontally across the top of the Gantt
chart and shows months, weeks, days, and years
 Dateline: A vertical line that highlights the current date
on the Gantt chart
 Bars: Horizontal markers on the right side of the Gantt
chart that represent tasks and show progress, duration,
and start and end dates

Elements of GANTT CHART (Conti)
 Milestones: The diamonds that call out major
events, dates, decisions, and deliverables
 Dependencies: The lines that connect tasks that
need to happen in a certain order
 Progress: Shows how far along work is and
may be indicated by % Complete and/or bar
shading
 Resource assigned: Indicates the person or
team responsible for completing a task

Uses of GANTT CHART
 To show the current schedule status
 To measure task duration in the project
 To represent cost, time and scope of the project
 A useful tool for planning and scheduling projects
 To plan how long a project should take
 Lays out the order in which the tasks need to be carried out
 Modern Gantt chart software provides dependencies between tasks
 To monitor a project’s progress
 To visualize immediately what should have been achieved at any point
in time
 To assist in taking remedial action to bring the project back on course,
if required

Limitations to Benchmarking
 Benchmarking is a tough process that
needs a lot of commitment to succeed.
 It is a time consuming and expensive.
 More often they are sensitive that
prevents the free flow of necessary
information.

Control Techniques
Control techniques may be broadly classified into
two categories
1. Traditional control techniques.
2. Advance / Modern control techniques.

Control Techniques (Conti)
Traditional Control Techniques
• Personal observation.
• Statistical reports and analysis. .
• Break-even analysis.
• Budgetary control.
Advance control techniques
• Self Control
• Management Audit.
• Programme Evaluation and Review Techniques (PERT).
• Critical Path Method (CPM).
• Management Information Systems (MIS).

Critical Path Analysis (CPA)
 Critical path analysis (CPA) is a project management
technique used in nursing management to identify the
sequence of activities that determine a project's minimum
completion time, helping to standardize and optimize patient
care pathways.
 By breaking down complex projects into tasks, CPA highlights
the longest chain of interdependent activities (the critical
path) that, if delayed, will delay the entire project.
 This allows nursing managers to focus on critical tasks, allocate
resources efficiently, mitigate risks, and improve overall
efficiency, leading to better patient outcomes and increased
satisfaction.

How does Critical Path Analysis Work in Nursing?
1. Identify Activities:
Break down a nursing project, such as implementing a new care protocol or managing a
patient's treatment, into individual tasks.
2. Determine Dependencies:
Map out the relationships between tasks, showing which activities must be completed before
others can begin.
3. Estimate Task Durations:
Assign estimated timeframes for the completion of each activity.
4. Create a Network Diagram:
Visualize the project's flow using a network diagram, where tasks are nodes and arrows
represent dependencies.
5. Find the Critical Path:
Calculate the longest path through the network diagram, representing the sequence of tasks
that, if delayed, would extend the project's total duration.
6. Monitor and Adjust:
Track progress and identify tasks with "slack time," which are activities that can be delayed
without affecting the project's overall timeline, allowing for resource reallocation.

Benefits of Using CPA in Nursing Management
• Improved Efficiency: Optimizes resource use and streamlines the
delivery of patient care.
• Standardized Care: Establishes structured plans and guides for
multidisciplinary care, promoting consistency among providers.
• Enhanced Communication: Facilitates better coordination and
communication among healthcare teams.
• Better Patient Outcomes: Reduces delays in care, which can lead
to improved patient outcomes.
• Cost-Effectiveness: Helps to control costs by improving the
efficiency of the care process.
• Risk Mitigation: Proactively identifies potential delays in critical
tasks, allowing for timely intervention and risk management.

Controlling in nursing.pptx presentation

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