CONTROLLING
Controlling
-Measuring performance against pre determined
standards and taking action to correct the
discrepancies between those standards and the
actual performance.
Quality control – specific type of controlling which
involves activities used to evaluate, monitor, or
regulate services rendered to consumers
Hallmarks of Effective Quality Control
1. Support from top level administrators
2. Commitment by the organization in terms of
fiscal and human resources
3. Quality goals reflect search for excellence
rather than minimums
4. Process is continuous
Quality Control Process
1. Criterion or standard is determined
2. Information is collected to determine if the
standard has been met
3. Educational or corrective action is taken if
criterion has not been met
Standards
Predetermined level of excellence that serves as a guide
for practice
1. Standards for Practice
- provides the means to determine the quality of
nursing service that a patient receives
Ex. Competency Standards for Nursing Practice in the
Philippines (BON [Link]. 112 s. 2005) and Intravenous
Nursing Standards of Practice by the ANSAP
Evaluation
-Evaluation is a systematic determination of a
subject's merit, worth and significance, using
criteria governed by a set of standards.
Reasons for Conducting Evaluation
1. It ensures that quality nursing care is provided
2. It allows for the setting of sensible objectives and
ensures compliance with them.
3. It provides standards for establishing comparisons.
4. It promotes visibility and means for employees to
monitor their own performance.
5. It highlights problems related to quality care and
determines the areas that require priority attention.
6. It provides an indication of the costs of poor quality.
7. It justifies the use of resources.
8. It provides feedback for improvement.
Evaluation Principles
[Link] evaluation must be based on the behavioral standards of
performance which the position requires.
2. In evaluating performance, there should be enough time to observe
employees behavior.
3. The employee should be given a copy of the job description,
performance standards, and evaluation form before the scheduled
evaluation conference.
4. The employees performance appraisal should include both
satisfactory and unsatisfactory results with specific behavior .
5. Areas needing improvement must be prioritized to help the worker
upgrade his performance.
6. The evaluation conference should be scheduled and conducted at a
convenient time.
7. The evaluation report and conference should be perceived and
accepted as a means of improving job performance.
Characteristics of an Evaluation Tool
[Link]- objectivity means that the evaluation tool is
free from bias.
2. Reliable- refers to the accuracy or precision of the tool
3. validity- refers to the relevance of the measurement to
the performance of the employee
4. Sensitivity- means that the instrument can measure
fine lines of differences among the criteria being
measured.
Basic Components of the Control Process
[Link] of standards, objectives, and methods
for measuring performance.
2. Measurement of actual performance
3. Comparison of results of performance using standards
and objectives and identifying strenghts and areas for
correction and or improvement.
4. Action to reinforce strenghts or successes
5. Implementation of corrective action as necessary
Establishment of Standards for Measuring Performance
- to ensure the quality of nursing care services.
3 Types of Performance Standards
1. Structure- focus on the structure or management
system used by the agency to deliver care.
2. Process- refer to decisions and actions of the nurse
relative to the nursing process which are necessary to
provide good nursing care.
3. Outcome- designed to measure the results of care
provided in terms of changes in the health status of
clients served.
Performance Appraisal
- is a control process in which
employee’s performance is evaluated
against standards.
- it is the most valuable tool in
controlling human resources and
productivity.
Factors Contributing to an Effective Performance Appraisal
1. Compatibility between criteria for individual evaluation
and organization goals.
2. Direct application of the rated performance standards
and objectives expected of the worker.
3. Development of behavioral expectation which mutually
agreed upon by both the rater and the worker.
4. Understanding the process and effective utilizationof
procedure by the rater.
5. Rating of each individual by the immediate supervisor.
6. Concentration on the strenghts and weaknesses to
improve individual performance.
7. Encouragement of feedback from the rated employees
about their performance needs and interests.
8. Provision for initiating preventive and corrective action
and making adjustment to improve performance.
Methods of Measuring Performance
[Link]- carry significant weight on the presumption that
an honest statement from someone who knows the
person well is valid.
2. Checklist- compilation of all nursing performances
expected of a worker.
3. Ranking- the evaluator ranks the employees according
to how he fared with co-workers with respect to certain
aspects of performance or qualification.
4. Rating Scale- includes a series of items
representing the different tasks or activities in the
nurses job description.
5. Forced-choice Comparison- the evaluator is
asked to choose the statement that best describes
the nurse being evaluated.
6. Anecdotal Recording- describes the nurse’s
experience with a group or a person or in validating
technical skills and interpersonal relationships.
Audits
-A systematic and official examination of a record,
process, structure, environment or accounts
Types of Audit according to when the audit is done:
1. Retrospective – done after the service is received
2. Concurrent- done while the patient is receiving
service
3. Prospective – identify how future performance
can be affected by current interventions
Types of audit according to what is audited
1. Outcome audit – determine results
2. Process Audit – determine process or how care
was carried out
3. Structure audit – determine environment in
which health care was delivered
Total Quality Management (TQM)
- Also referred to as continuous
quality improvement
-The quest for quality is an ongoing
process and there is always room for
improvement
Discipline
Training or moulding of the mind or character to bring
about the desired behaviors
1. Punishment
2. Constructive discipline
3. Progressive discipline
* informal or verbal reprimand
* formal or written reprimand
* suspension from work
* Involuntary termination or dismissal
Rules for Fair and Effective Discipline
1. Forewarning-advance warning
2. Immediate consequences
3. Consistency
4. Impartiality-equal treatment
Disciplinary Strategies
[Link] thoroughly
[Link] behavior that occurred and attempts to
counsel erring employee
[Link] with a superior or the personnel department
[Link] not discuss reasons for discharging another
employee or make negative comments about other
employees
[Link] deficiency coaching
[Link] conference
Grievance Procedures
-Statement of wrongdoings or a procedure to
follow when one believes a wrong has been
committed
-Not limited to discipline discrepancies but to
any case an employee feels he or she has not
been treated fairly.
End of the Semester and
WELCOME to CA2!!!!!!