What would be examples of an internal and an external control the manager could set up to improve any problems with charting?

In an effort to establish controls, a new manager decides to spend one afternoon each week double-checking every chart his nursing care staff has completed for the previous week.

(a) In what ways is this attempt at control ineffective?

(b) What would be examples of an internal and an external control the manager could set up to improve any problems with charting?

Requirement:  One original post (200 word minimum) and two additional posts.

APA Format, please include references and in citations.

Chapter 7

Keeping Things in Check

[These slides are intended to be used in conjunction with Health Care Management by Donald J. Lombardi and John R. Schermerhorn, Jr. with Brian Kramer (the Text).    Please refer  to the Text for a more complete explanation of the materials covered herein and for all source material references.]

Copyright by John Wiley and Sons, 2006

*

  • Controlling: the process of measuring performance and taking action to ensure desired results – is a basic function for health care managers, on par with organizing, planning, and leading.
  • The control process involves four steps: establishing objectives and standards, measuring actual performance, comparing results with objectives and standards, and taking corrective action as needed.

Understanding the Control Process

*

Four Steps in Management Control

*

Steps in Control Process

  • Step 1: Establishing Objectives and Standards: performance objectives and standards are set through planning. The objectives provide the performance targets, and the standards provide the yardstick for assessing actual accomplishments.
  • Two types of standards can be used for this purpose:
  • Output standards measure results in terms of performance quantity, quality, cost, or time.
  • Input standards, by contrast, measure effort in terms of the amount of work expended in task performance.
  • Step 2: Measuring Actual Performance: the measurement must be accurate enough to spot significant differences between what is really taking place and what was originally planned.

*

Steps in Control Process (con’t)

  • Step 3: Comparing Results with Objectives and Standards: establishes whether or not any corrective actions are needed.
  • The control equation summarizes this step:
  • Need for Action = Desired Performance – Actual Performance
  • Types of comparisons include
  • historical comparison
  • relative comparison
  • engineering comparison
  • Step 4: Taking Corrective Action: to correct or improve future performance. Allows for a judicious use of management by exception – the practice of giving priority attention to situations that show the greatest need for action. Two types of exceptions are:
  • problem situation
  • opportunity situation

*

Setting up Effective Controls

  • The best managers are proactive and positive in applying the control process to full advantage. Rather than simply assuming things are going right, they make sure that everything works out as intended.
  • Effective controls in organizations share the following characteristics:
  • controls are strategic and results-oriented
  • controls are understandable
  • controls encourage self-control
  • controls are timely and exception-oriented
  • controls are positive in nature
  • controls are fair and objective
  • controls are flexible

*

Types of Controls

  • Health care managers utilize three major types of managerial controls: feedforward, concurrent, and feedback controls.

*

Types of Controls (con’t)

  • Feedforward Controls or preliminary controls are accomplished before a work activity begins.
  • What needs to be done before we begin?
  • Concurrent Controls or steering controls focus on what actually happens during the work process.
  • Now that we’ve started, what can we do to improve things before we finish?
  • Feedback Controls or post action controls take place after work is completed.
  • Now that we are finished, how well did we do?

*

Control Strategies

  • Two broad options with respect to control are:
  • Internal control: allowing motivated individuals and groups to exercise self-discipline in fulfilling job expectations.
  • External control: attempting to control the behavior of others through personal supervision or formal administrative systems.
  • Health care organizations with effective controls typically use both strategies to good advantage, but more progressive workplaces seem to have a renewed emphasis on internal and self-controls.

*

Management Process Controls

Each of the other functions of the management process facilitates control.

  • Planning
  • control via strategy and objectives
  • control via policies and procedures
  • control via learning organizing
  • Organizing
  • Control by selection and training
  • Control via performance appraisal
  • Control via job design and work structures
  • Leadership
  • Control by performance norms
  • Control via organization culture

*

Employee Discipline Systems

  • Discipline is the act of influencing behavior through reprimand.
  • Progressive discipline ties reprimands to the severity and frequency of misbehavior.

*

Information and Financial Controls

For control purposes, health care managers need to generally understand the following important financial aspects of organizational performance:

  • Liquidity: The ability to generate cash to pay bills.
  • Leverage: The ability to earn more in returns than the cost of debt.
  • Asset management: The ability to use resources efficiently and operate at minimum cost.
  • Profitability: The ability to earn revenues greater than costs.

*

  • Control is an essential part of operations management.
  • Operations management is the portion of management duties that emphasizes utilizing people, resources, and technology to the best advantage.
  • Important aspects of operations management today include:
  • purchasing control
  • Inventory control
  • quality control

Managing and Controlling Operations

*

  • Purchasing Control: controlling the rising costs of materials through efficient purchasing management. Organizations use methods including:
  • centralized purchasing to allow buying in volume
  • commit to only a small number of suppliers with whom they can negotiate special contracts, gain quality assurances, and get preferred service
  • Inventory Control: because inventories represent costs, they must be well managed. Organizations use methods including:
  • economic order quantity (EOQ) is a quantitative method of inventory control that involves ordering a fixed number of items every time an inventory level falls to a predetermined point.
  • just-in-time scheduling (JIT) systems try to reduce costs and improve workflow by scheduling items to arrive just in time to be used.
  • Quality Control: involves checking processes, materials, products, and services to ensure that they meet high standards.

Operations Control

*

  • When planning is done well, control gets better – and vice versa. Without good planning, control lacks a framework for performance measurement. Without good control, planning lacks the follow-through needed to ensure results.
  • Six Sigma is a collection of rigorous, systematic control tools that use information and statistical analysis to measure and improve an organization’s performance, practices and systems. Six Sigma strives to identify and prevent “defects.”
  • Management by objectives, or MBO, is a structured process of regular communication in which a supervisor and subordinate jointly set performance objectives for the subordinate and review results accomplished. (footnote 6)

Integrated Planning and Controlling

*

An MBO framework for integrated planning and controlling in a work team.

Management by Objective

*

  • Following certain steps can help managers make MBO as successful as possible.
  • Performance objectives are essential to the MBO process, and the ways objectives are specified and established influences how well MBO works. In many organizations, the MBO process emphasizes both:
  • improvement objectives – which document intentions for improving performance in a specific way and with respect to a specific factor
  • personal development objectives – which pertain to personal growth activities, often those resulting in expanded job knowledge or skills
  • Effective MBO objectives are
  • specific: targeting a key result to be accomplished;
  • time-defined: identifying a specific date for achieving results;
  • challenging: offering a realistic and attainable challenge;
  • measurable: stating goals in quantitative terms, whenever possible.

Management by Objective (con’t)

*

  • Internal control, simply defined, is self-control.
  • People motivated to take charge of their own behavior on the job are exercising internal control.
  • People are more likely to do this when they participate in setting performance objectives and the standards of measurement. This, of course, is what the notion of management by objectives is all about.
  • Although they may describe how they manage using differing language, many of the best managers utilize MBO concepts.

Internal Control
and Self-Management

*

© 2007 John Wiley & Sons, Inc. All rights reserved. Reproduction or translation of this work beyond that permitted in section 117 of the 1976 United States Copyright Act without express permission of the copyright owner is unlawful. Request for further information should be addressed to the Permissions Department, John Wiley & Sons, Inc. The purchaser may make back-up copies for his/her use only and not for distribution or resale. The Publisher assumes no responsibility for errors, omissions, or damages caused by the use of these programs or from the use of the information herein.

Copyright Notice

Copyright by John Wiley and Sons, 2006

Copyright by John Wiley and Sons, 2006

“Get 15% discount on your first 3 orders with us”
Use the following coupon
FIRST15

Order Now