2. Definitions
• Controlling and evaluating refer to
the process by which managers
attempt to see the actual activities
conform to planned activities.
• These are management functions by
which performance is measured and
corrective action is taken to ensure
the accomplishment of organizational
goals.
3. Basic Components
• Establishing standards, objectives and
methods for measuring performance.
• Measuring actual performance.
• Comparing results of performance with
standards and objectives and identifying
strengths and areas for correction.
• Acting to reinforce strengths or successes
and taking corrective action as necessary.
4. Nature and Purposes
• To establish trust and
commitment to the system by all
personnel through the use of an
effective communication system.
• To clarify organization and
individual objectives.
• To present uniform and fair
standards with precise
definitions of each standard,
goal and objective.
5. Nature and Purposes
• To compare expectancy with
performance.
• To improve organization
development by providing
information for decision making
on staffing, system for delivery
of care and quality of care.
• To promote growth and
development of personnel.
7. Standards of Care
• Yardsticks for gauging the quality and
quantity of services.
• Established criteria of performance,
planning goals, strategic plans, physical or
quantitative measurement of products,
units of service, labour hours, speed, cost,
capital, revenue, program and intangible
standards.
• An acknowledged measure of comparison
for quantitative value, criterion or norm, a
standard rule or test on which a judgement
or decision can be based.
8. Total Quality Management (TQM)
refers a work ethic involving everyone
in the organization. The client is the
focus.
9. a. Elements
• Decentralization
• Participatory management: making
decisions at lower levels in the
organizational hierarchy
• Matrix management: free-form
organizational structure
• by Objectives (MBO): every person or
group in a work setting has specific,
attainable and measurable objectives
that are in a harmony with those of
the organization.
10. Cont… a. Elements
• Statistical analyses
• Team building
• Quality circles: participatory
management technique that uses
statistical analysis of activities to
maintain quality products.
• Theory Z (consensual decision-making):
the leadership style is a democratic one
which includes decentralization,
participatory management, employee
involvement and an emphasis on quality
of life.
11. b. Quality assurance defines performance
measures and compares actual processes and
outcomes to clinical satisfaction indicators.
c. Quality control involves performance
management and maintenance and includes
systematic methods of ensuring conformity
to a desired standard or norm.
d. Quality improvement concerned with
performance development and is ongoing,
involved with fixing now, preventing future
costly mistakes and fostering breakthroughs
12. e. Quality improvement
methods
• Standards of care: descriptions of minimum
acceptable performance during client care
from health acre provider who has specific
knowledge and skill; developed by
professional organizations, legal sources,
regulatory agencies and healthcare
agencies.
• Credentialing and licensure: review process
used by an insurance carrier or healthcare
professional may practice or provide care to
clients.
• Utilization review/management: process of
evaluating healthcare services to specific
client populations for necessity,
appropriateness, and efficiency.
13. Cont…
e. Quality improvement
methods
• Clinical guidelines: produced most notably by
the Agency for Healthcare Research and
Quality (AHRQ) and also by professional
organization. They help improve care by
identifying outcomes and supporting best
practices.
• Clinical pathways: tools for use with specific
client diagnoses to focus on client outcomes
and appropriate use of resources in a timely
manner. They promote cost effectiveness as an
added benefit.
• Benchmarking: tool that identifies best
practices and allows the healthcare
organization to compare its performance with
other units or areas within the organization
and also with other organizations.
14. Cont…
e. Quality improvement
methods
• Methodologies for quality
improvement start with the following
three
• questions:
• What are we trying to accomplish?
• How will we know that a change is an
improvement?
• What changes can we make that will
result in improvement?
15. Cont…
e. Quality improvement
methods
Plan – Plan a change, test or activity
aimed at improvement
Do – Carry it out (preferably on a small
scale).
Study – Study the results. What did you
learn? What can you predict?
Act – Adopt the change or abandon it
or run through cycle again (preferably
under different conditions).
16. Cont…
e. Quality improvement
methods
The FOCUS Methodology
Focus on an Opportunity for
Improvement
Organize a Team
Clarify the Current Process
Understand the Degree of Change
Needed
Select a Solution for Improvement
17. Cont…
e. Quality improvement
methodsOther Improvement Strategies
a. Benchmarking is a continual and
collaborative discipline of measuring and
comparing the results of key work processes
with those of the best performers. It
fosters learning to adopt best practices to
achieve breakthrough process improvement
and build healthier communities.
b. Regulatory requirements refers to developed
standards to guide critical activities
performed by a healthcare organization.
Example: Joint Commission on
Accreditation of Hospital Organization
(JCAHO), International Standards
Organization (ISO)
18. Nursing Audit involves an
examination, a verification or an
accounting of predetermined
indicators.
20. Structure audit focuses on the setting
in which care takes place, i.e.,
physical facilities, equipment,
caregivers, organization, policies,
procedures and medical records.
These are measured by means of
checklists.
21. Process audit implements indicators for
measuring nursing care to determine
whether nursing standards are met.
It is generally task-oriented.
22. Outcome audit evaluates nursing
performance in terms of establishing
client outcome criteria. It may either
be concurrent or retrospective.
23. Control Techniques
– Nursing rounds cover issues like patient
care, nursing practice and unit management.
– Nursing operating instructions include
policies which become standards for
evaluation as well as controlling techniques.
– Gantt charts depict a series of events
essential to the completion of a project or
program.
– Critical control points and milestones use
specific points in a master evaluation plan at
which the nurse judges whether the
objectives are being met, qualitatively and
quantitatively.
24. – Program Evaluation and Review Technique
(PERT) uses a network of activities, each of
which is represented as a step on a chart. It
includes time measurement, an estimated
budget and calculation of the critical path (the
sequence of events that would take the longest
time to finish).
– Benchmarking is a technique whereby an
organization seeks out the best practices in its
industry so as to improve its performance. It is a
standard, or point of reference, in measuring or
judging quality, values and costs.
