Planning

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Planning

• NUR 4606

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Nursing Management Planning

• Two major types of Planning
• Strategic Planning
• Tactical Planning (operational)

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Benefits of Planning

• Goal oriented
• Through reasoning process, managers minimize
  risks and maximize opportunities
• Top down process
• Eliminates guess work
• Self explanatory
• If plan for emergencies, can handle them is a
  calm, efficient manner

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Benefits Continued

• Employees know what is expected of them and can
  be evaluated effectively
• Interactive planning creates a feeling of
  ownership
• Cost Effective

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Scopes of Planning for Nurse Managers

• Top Level- DON-organizational activities broad in
  scope, phrased in general terms Strategic
  Planning!
• Middle Level- Nurse Supervisor/Case Mgr.-
  Formulation of policies, rules/regulations,
  methods, procedures for personnel and practice

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Scope of Planning for Nurse Managers Continued

• Lower level managers- Head Nurse/Charge
  Nurse/Team Leader-schedules daily and weekly plan
  for administration of direct patient care Day to
  day operations at the unit level
• With health care today,nurse leaders are being
  asked to make decisions that benefit both the
  patient and the health care agency

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Decision Making

• The process of selecting one course of action
  from a list of alternatives.
• Pervades all of the basic management
  functionsplanning, organizing, directing, and
  controlling.
• According to Lee Iacocca, If I had to sum up in
  1 word the qualities that make a good manager,
  Id say that it all comes down to decisions.

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Variables That Affect Nursing Decisions

• Complexity-how complex is the decision?
• Multiple criteria involved in a decision
• Consider intangibles
• Risk and Uncertainty-there are varying degrees of
  uncertainty in all our lives Will the nurses at
  St Vincent strike? How will that strike impact
  nursing in Little Rock? In Arkansas?

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Variables Continued

• Long-term Implications
• Interdisciplinary input
• Value judgments
• Need to use different information processing
  systemspeople perceive things differently there
  are also differences in ones ability to process
  data, remember facts and explore alternativesbe
  aware of these factors

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Approaches to Decision Making

• Intuitive Approach
• Scientific Approach
• Pragmatic Approachhow is this similar to the
  Nursing Process??

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Pragmatic Approach to Decision Making

• 1. Identify the problem
• Eliminate myths from fact
• What are the s/s?
• What is the desirable situation?What is cause?
• Who is involved
• 2. Generate Alternative Solutions
• Experience often helps one to generate
  alternatives yet with changing trends in health
  care, what worked yesterday may not work today!

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Pragmatic Approach

• 3. Select a Solution
• Consider risks/benefits, consider patient safety,
  staff acceptance, public acceptance, cost
• 4. Implement the Solution
• Communication is key
• 5. Evaluate the results of the solution

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Pragmatic Approach/Nursing Process

• Identify the Problem
• Generate Alternative Solutions
• Select a Solution
• Implement
• Evaluate

• Assessment
• Nursing Diagnosis
• Planning
• Implementation
• Evaluation
• Often nursing considers diagnoses a part of
  planning

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Decision Making Strategies

• Trial Error- shooting from the hip
  ineffective
• Pilot projects-experimentation with limited
  trials
• Problem Critique-dialogue about a problem
• Decision Tree- graphic model that shows options,
  outcomes, and risks to be anticipated
  algorhythms critical paths

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Decision Making Strategies

• Fish Bone-cause and effect
• Cost-Benefit Analysis-formal balancing of
  positive and negative factors
• Worst Case Scenario-outlining worst case for each
  alternative
• Group Decision Making
• brainstorming, brainwriting, Delphi technique

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Group-aided Decision Making

• Advantages
• Greater pool of knowledge
• Different perspectives
• Greater comprehension
• Increased acceptance
• Training ground

• Disadvantages
• Social pressures
• Minority domination
• Logrolling
• Goal displacement
• Group think

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Financial Management

• A series of activities designed to allocate
  resources and plan for the efficient operation of
  an organization
• 4 phases
• Budgeting
• Recording
• Reporting
• Evaluating

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Budget

• A projected plan for income and expenses
• Functions both as a planning instrument and
  evaluation tool
• Types of Budgets (p. 277)
• Operating budget
• Long-range budget
• Program budget
• Capital budget

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Budget

• Types (p. 277)
• Product-line budgets
• Cash budget
• Special purpose budget
• The primary budgets r/t directly to the delivery
  of nursing services are the capital budget and
  the operating budget
• Nursing is primarily concerned with direct,
  indirect, and supply costs