CONTROLLING

CONTROLLING
y

Controling or evaluating is an on-going function of management which occurs during planning,organizing and directive activities. Process wherein the performance is measured and corrective action is taken to ensure the accomplishment of organizational goal.

Purposes of Controlling
y y

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

Reasons for Conducting Evaluation

y y y y y y y y

Ensures that quality services is provided Allow for setting of sensible objectives and ensures compliance Provides standards for establishing comparisons Promotes visibility and means for employees to monitor own performance Highlights problem related to quality care and determines areas that require priority attention Provides an indication of the cost of poor quality Justifies the use of resources Provides feedback for improvement

Evaluation Principles
1.

Must be based on behavioral standards of performance with the position requirement There should be enough time to observe employees behavior Employee should be given a copy of the following before scheduled evaluation Job description Performance standards Evaluation forms

2.

3.

Evaluation Principles
4.

Performance appraisal should include both satisfactory and unsatisfactory results Areas needing improvement must be prioritized Should be scheduled and conducted at a convenient time for both evaluator and employee Should be structured in such a way that it is perceived and accepted positively as a means of improving job performance

5. 6.

7.

Characteristics of Evaluation Tool

 

OBJECTIVE
Free from bias

RELIABLE
Accurate and precise that it will produce the same results if administered twice

SENSITIVE
Instrument can measure fine lines of differences among criteria being measured

VALID
Refers to the relevance of the measurement to the performance of the employee

Tools for Controlling Organizational Performance

o Feed-forward Feed-

Control - A control that prevents anticipated problems before actual occurrence of the problem o Concurrent Control -A control that takes place while the monitored activity is in process. o Feedback Control - A control that takes place after an activity is being done.

Steps in Control Process

1. 2. 3.

Establish standards and criteria Measure performance Compare performance with standards, criteria to determine deviations

4.

Enact Remedial measures or steps to correct deviations

1. Establishment of Standards for Measuring Performance

Standards are desirable sets of condition and performance necessary to ensure the quality of nursing care services which are acceptable to those instrumental to or responsible for setting and maintaining them.

Types of Performance Standards

1)

Standards on STRUCTURE
Focus on the management system or structure used by the agency in the delivery of care Includes:
      Number and categories of nursing personnel Education Personal and professional qualities Function Physical facilities Equipments

Types of Performance Standards

2)

PROCESS Standards
x Decision and actions of the nurse relative to the nursing process Includes :  Assessment  Plan of care  Nursing intervention

Types of Performance Standards

3)

OUTCOME Standards
Designed to measure the results of care provided in terms of:  Changes in health status of client served  Changes in level of their knowledge, skills and attitude  Satisfaction of those served

2. Measure Performance
y y

Nursing Rounds Quality Management

Quality Control Quality Assurance Quality Improvement

Nursing Audit

Quality Management
It ensure that an organization or product is consistent. y Quality management is focused not only on product/service quality, but also the means to achieve it. Quality management therefore uses quality assurance and control of processes as well as products to achieve more consistent quality.
y

Quality Control (QC)

y

A specific type of controlling that includes activities that evaluate, monitor or regulate services rendered to consumers.
Total Quality Management (TQM)

Quality Improvement (QI)

It is a systematic approach in reducing or eliminating waste and losses in production process. y As applied in nursing, QI, is a method of evaluating and improving processes of patient care which emphasizes a multidisciplinary approach and focuses not on individuals but systems of patient care.
y

Continuous Quality Management (CQM)

y

A management approach to improving and maintaining quality that emphasizes continuous assessment of potential causes of quality defects, followed by actions aimed either at avoiding decrease in quality or correcting it in early stages.

Quality Assurance (QA)

y

The process of verifying or determining whether products or services meet or exceed customer expectations. It is a process-driven approach with specific steps to help define and attain goals. This process considers design, development, production and service.

Quality Assurance (QA)

Shewhart Cycle

Quality Assurance

TQM + CQM

PATIENT SATISFACTION

Quality Assurance and Performance Evaluation

Performance Evaluation -focuses on the worker. It asks questions about how well the worker satisfies the requirements of his or her job within the organization. Quality Assurance -focuses on the care and service the patient receives than on how well the professional performs the duties the that the position requires.

AUDIT
y

A systematic and official examination of record, process, structure, environment, or account to evaluate performance

Categories of Audit
y

Retrospective Audits
- performed after the client receive the service.

Concurrent Audits
- performed while the client is receiving the service.

Prospective Audits
- attempt to identify how future performance will be affected by current interventions.

Categories of Audit
y

Outcome Audits
- determine what results occurred as a result of specific nursing interventions to clients

Process Audits
- used to measure the process of care and how the care was carried out

Structure Audits
- monitors the structure or setting in which patient care occurs

Accreditation
A voluntary process of being certified as meeting the minimum requirements as designated by accrediting agency. y It engages the organization in meeting high quality standards, implementing a continuous improvement process, and engaging in quality assurance through internal and external review.
y

Accreditation
JCI (Joint Commission International) y ISO (International Organization for Standardization) y PACUCOA (Philippine Association of Colleges and Universities Commission on Accreditation) y PAASCU (Philippine Accrediting Association of Schools, Colleges, and Universities)
y

3. Compare performance with standards, criteria to determine deviations

Benchmarking y PERT
y

4. Enact Remedial measures or steps to correct deviations

y

Maybe done by changing the number of personnel, training subordinates, minimizing resources or increasing quality care.

Performance Appraisal
y

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. 2. 3. 4. 5.

Determine salary and merit increases Select qualified individual for promotion or transfer Identify unsatisfactory employees for demotion or termination Make inventories of talents within an institution Determine training and developmental needs of employees

Purpose of Performance Appraisal

6. 7. 8. 9. 10.

Improve performance of work group Improve communication between supervisors and employees Establish standards of supervisory performance Provide recognition of employee for accomplishments Inform employees where they stand

Methods in Measuring Performance

Essay y Checklist y Ranking y Rating Scale y Forced Choice Comparison y Anecdotal Recording y Management by Objectives (MBO)
y

Pitfalls to avoid in Appraisal

Halo Effect y Horn Effect y Central Tendency y First Impression Error y Stereotyping Error y Leniency error
y

Discipline
y

Discipline means rigid obedience to rules and regulations, the violation of which resulted in punitive actions in the past. Today, discipline is regarded as constructive and effective means employees take personal responsibility for their own performance and behavior.

Factors that influence self discipline

1. 2.

3. 4. 5.

A strong commitment to the vision, philosophy, goals and objectives of the institution Laws that govern the practice of all professionals and their respective codes of conduct. Understanding the rules and regulation of the agency. An atmosphere of mutual trust and confidence Pressure from peers and organization.

Disciplinary Action
Counseling and Verbal warning y Written Warning y Suspension without Pay y Dismissal
y

END