NLM - Organizing and Staffing
NLM - Organizing and Staffing
NLM - Organizing and Staffing
Exception Principle
• Routine situations or recurring decisions
Principles of Organizing
should be handled in a routine manner by
1. The Principle of Chain of Command the lower-level managers while situations
• States that organization shall be established that involve unusual matters should be
with hierarchical relationships within which properly referred to the higher level of
the authority flows from top to bottom. managers.
• Communication flows through the chain of • This allows the lower-level managers to build
command and tends to be one-way confidence in doing decisions and at the
downward. same time give more time for the top-
• Supports mechanistic structure with managers to perform other important tasks
centralized authority and responsibility at their level.
Organizational Charts
5. Functionalized Line and Staff Structure
The drawing that shows how the parts of the
• Staff have some authority over line
organization are linked.
executives; the staff experts responsible for
a specific management function such as Components
staffing, staff development, or quality
1. Division of Work: Each box represents the
improvement, has authority to command
individual or sub-unit responsible for a given task
line executives to implement staff plans.
of the organization’s workload.
• ADVANTAGE: Increase staff morale.
2. Chain of Command: Lines indicates who reports
• DISADVANTAGE: When chain of command is
to whom and by what authority.
broken, conflict, confusion and poor
3. Type of Work to be Performed: Indicated by
communications can result.
labels or description for the boxes.
4. Grouping of Work Segments: Shown by clusters
6. Adhocracy Organizational Structure
of work groups (departments or single units).
• Also known as organic models; newer
5. Levels of Management: Indicates individual and
organizational models that are free form,
entire management hierarchy.
Types Advantages Disadvantages
• Increase morale, • Organization may not
1. Structural
promotes be large enough to
• Reflects basic organizational components – interpersonal merit decentralization.
simplicity, clarity, symmetry, and unity. relationship • Top administrators
• Examples: FLAT VS. TALL STRUCTURE • Promotes informality may not desire
• Vertical Chart, left-to-right chart, circular and democracy, brings decentralization.
chart. decision making closer • Conflicts between
to the action. divisions.
a. Flat Structure • Determines • Increased cost – more
• Develop along horizontal dimensions accountability. managers and larger
according to the number of staff.
organizational functions that are • Problem with control
and uniform policies.
identified separately.
• Work duplication.
• Few levels of management
• ADVANTAGE: minimize distortion
through shorten line of communication; 2. Centralized Organization
large group has greater variety of skills • Concentrate power, authority and decision
and capacity to solve greater problems- making at one-point within the
high employee morale and confidence- organization.
Democratic and Personal.
Advantages Disadvantages
• DISADVANTAGE: impractical for large
• Uniformity of • Static and highly
organization- overburdened managers.
command, predictable regulated
internal environment. environment, reduce
b. Tall Structure people morale.
• Developed along vertical dimensions by
use of the scalar process to define 3. Matrix Organization
relationship between levels of • Try to combine the advantages of project
organization – Authoritarianism. and functional structures; functional line
• Most effective in situation that require organization provides support for project
rapid changes and precise coordination. line organization.
• ADVANTAGES: Narrow range of
management allows staff to evaluate Advantages Disadvantages
decision frequently - allow group • Manage dual • Dual Authority – 1 line
cohesiveness. demands. 1 project.
• DISADVANTAGES: Expensive, more • Good for complex • Complicated
levels of communication leading to works. • Maybe viewed as
• Good for uncertain confusing.
distortion, increases impersonality.
environment. • Complex structure.
• Need well-educated
2. Functional • Good for non-routine
personnel.
• Same as the structural chart but shown also technologies.
• Complex
major function of each component. • High interdependence communication.
• Position Chart (Billet Assignment Chart) between functions. • Advanced
o Show assignment of personnel by • Collaborative interpersonal
name, title, rank or grade in an management. relationship skills
existing organization or planned • Flexible efficient used needed.
organization. of scarce resources. • Role conflicts and
• Adaptive and ambiguity.
Forms of Organization • Requires frequent
innovative.
1. Decentralized Organization • Decision close to meetings.
• Time consuming.
• Degree to which decision is diffused operations.
• Improved • Special learning
throughout the organization.
required in conflict
• Factors to consider: interpersonal skills and
management and
o Top management positive attitude conflict management
interpersonal
towards decentralization. leading to relationships.
o Competent personnel achievement and job
o Larger organization satisfaction.
o Organization growth through
acquisition- geographical.
Staffing 3. The type and number of care procedures that
will be needed by a typical patient in each
Is a process of determining and providing the acceptable
category.
and necessary number and mix of nursing personnel to
4. The time needed to perform these procedures
produce a desired level of care to meet the patient’s
that will be requires by a typical patient in each
demand.
category.
Factors Affecting Staffing
Classification Categories
• The type, philosophy, and objectives of the
• Classifying patient care according to the acuity of
hospital and the nursing services
their patient’s illnesses
• The population served or the kind of patient
• Various units can develop their own ways of
being served whether pay or charity
classifying patient care
• The number of patients and severity of their
illness-knowledge and ability of nursing NCH Ratio
needed of Pro
personnel are matched with the actual care Level of Care
Patient under the
per to
needs of patients Category
patient Non-
• Availability and characteristics of the nursing per day Prof
Level I: Self- Patient about to be
staff, including education, level of preparation,
care of discharged; requires little
mix of personnel number and position 1.5 55:45
Minimal treatment/ observation
• Administrative policies such as rotation, Care and or instruction.
Patients need some
weekends, and holiday off-duties
assistance in bathing,
• Standards of care desired which should be Level II: feeding, or ambulating
available and clearly spelled out. Hospital may Moderate or for a short period of
3.0 60:40
Intermediate time; with vital signs
utilize Standard of Nursing Practice formulated
Care needed to be monitored
by government agency or the hospitals 3x per shift; semi-
themselves may formulate/ develop their own conscious
standards Level III:
Total, Patients are completely
• Layout of the various nursing units and resources Complete or dependent upon nursing 4.5 65:35
available within the department such as Intensive personnel.
adequacy of equipment, supplies, and materials Care
Level IV: Patient needs maximum
• Budget including the amount allotted to salaries, Highly level of nursing care, 6.0 to 7
70:30 or
fringe benefit, supplies, materials and Specialized doctors’ orders and care or
80:20
equipment or Critical changes per patient per higher
Care hour/day.
• Professional activities and priorities in
nonpatient activities like involvement in
professional organizations, formal educational The Hospital Nursing Services Administration Manual of
development, participation in research and staff DOH recommendation for Nursing Care Hours for
development patients in Various Units of Hospital
• Teaching program or the extent of staff Prof to Non-Prof
involvement in teaching activities Units/Cases/Patients NCH/patient/day
ratio
• Expected hours of work per annum of each General Medicine 3.5 60:40
Medical 3.4 60:40
employee. This is influenced by the 40-hour
Surgical 3.4 60:40
week law Obstetrics 3.0 60:40
• Patterns of work schedule- traditional 5 days per Pediatrics 4.6 70:30
week, 8hours per day; 4 days a week, ten hours Pathologic Nursery 2.8 55:45
ER,ICU.RR 6.0 70:30
per day and three days off; or 3 ½ days of 12 CCU 6.0 80:20
hours per day and 3 ½ days off per week
Principles of Evaluation