Chapter 7 Organizational Planning

Inactive planning

- seek the status quo, and they spend their energy preventing change and maintaining conformity. - When changes do occur, they occur slowly and incrementally.

Balanced scorecard

- Kaplan and Norton - Another highly assistive tool in strategic planning - Strategic planners use a balanced scorecard develop metrics (performance measurement indicators), collect data, and analyze that data from four organizational perspectives: financial, customers, internal business processes (or simply processes), and learning and growth. - Because all the measures are considered to be related and because all of the measures are assumed to eventually lead to outcomes, an overemphasis on financial measures is avoided. The scorecard then is "balanced" in that outcomes are in balance.

Mission statement / purpose

- a brief statement (2-4 sentences) identifying the reason that an organization exists - highest priority in the planning hierarchy because it influences the development of an organization's philosophy, goals, objectives, policies, procedures, and rules. - an organization must truly believe and act on its mission statement; otherwise, the statement has no value.

Planning

- defined as deciding in advance what to do; who is to do it; and how, when, and where it is to be done. Therefore, all planning involves choosing among alternatives. - proactive and deliberate process that reduces risk and uncertainty, required of all managers - must be flexible and allow for readjustment as unexpected events occur - critically important to and precedes all other management functions - without adequate planning, the management process fails and organizations needs/objectives cannot be med

Forecasting

- involves trying to estimate how a condition will be in the future. - forecasting takes advantage of input from others, gives sequence in activity, and protects an organization against undesirable changes.

Proactive (interactive) planning

- is dynamic, and adaptation is considered to be a key requirement because the environment changes so frequently. - consider the past, present, and future and attempt to plan the future of their organization rather than react to it. - adaptability is a key requirement - occurs in anticipation of changing needs or to promote growth. - a proactive planning style is always the goal.

Reactive planning

- occurs after a problem exists - there is dissatisfaction with the current situation, so planning efforts are directed at returning the organization to a previous, more comfortable state. - problems are dealt with separately without integration with the whole organization. - because it is done in response to a crisis, this type of planning can lead to hasty decisions and mistakes.

Organizational philosophy

- the philosophy flows from the purpose or mission statement and delineates the set of values and beliefs that guide all actions of the organization. It is the foundation that directs all further planning toward that mission. - provides the basis for developing nursing philosophies at the unit level and for nursing service as a whole. - the nursing service philosophy should address fundamental beliefs about nursing and nursing care; the quality, quantity, and scope of nursing services; and how nursing specifically will meet organizational goals. - the unit philosophy, adapted from the nursing service philosophy, specifies how nursing care provided on the unit will correspond with nursing service and organizational goals. - A working philosophy is evident in a department's decisions, in its priorities, and in its accomplishments.

The planning hierarchy

- the plans at the top (e.g., mission, philosophy) influence all the plans that follow. - the hierarchy broadens at lower levels, representing an increase in the number of planning components. - planning components at the top of the hierarchy are more general, and lower components are more specific. - a person should be able to identify exactly how the organization is implementing its philosophy by observing members of the nursing staff, reviewing the budgetary priorities, and talking to patients.

Strategic planning

- typically examines an organization's purpose, mission, philosophy, and goals in the context of its external environment. - generally, complex organizational plans that involve a long period (usually 3 to 7 years) are referred to as long-range or strategic plans. - unlike the 20-year strategic plans of the 1960s and 1970s, most long-term planners today find it difficult to look even 5 years in the future - must consider short- and long-term goals and needs of the organization as to forecast the future success of the organization - includes the delineation of the agency's strategic goals and objectives, typically in a 3- to 5-year plan, and the development of strategies to achieve the goals - contemporary strategies suggest the need to seek input from subordinates from all organizational levels (not just top-level executives and boards of directors) to give the strategic plan meaning and increase likelihood of successful implementation - there are many effective tools that assist organizations in strategic planning. One of the most commonly used in health-care organizations is SWOT analysis (identification of strengths, weaknesses, opportunities, and threats)

Vision statements

- used to describe the future goals or aims of an organization - big picture of what all group members want to accomplish together - an organization will never be greater than the vision that guides it

Preactive planning

- utilize technology to accelerate change and are future oriented. - unsatisfied with the past or present, preactivists do not value experience and believe that the future is always preferable to the present.

Why plans fail

-sound strategies not used -inadequate delegation of authority -not recognizing organizational goals and needs -planning too narrow in scope—not recognizing community, legal, and licensing requirements -false assumptions -not knowing overall goal -not enough alternatives -inadequate time or other resources -low motivation levels

Steps of strategic planning as a management process

1. Clearly define the purpose of the organization. 2. Establish realistic goals and objectives consistent with the mission of the organization. 3. Identify the organization's external constituencies or stakeholders and then determine their assessment of the organization's purposes and operations. 4. Clearly communicate the goals and objectives to the organization's constituents. 5. Develop a sense of ownership of the plan. 6. Develop strategies to achieve the goals. 7. Ensure that the most effective use is made of the organization's resources. 8. Provide a base from which progress can be measured. 9. Provide a mechanism for informed change as needed. 10. Build a consensus about where the organization is going

11. Which statement is true regarding individual values? A) They are often modified by parents, peers, and role models throughout life B) They seldom change as a result of lifes experiences C) They have little influence on decision making once employed because organizational values eliminate personal values D) They show little variation between nursing managers once they have achieved some level of authority

Ans: A Feedback: Personal values are shaped by the socialization processes experienced by that person, and values change with time. The remaining statements are not true regarding individual values.

24. Which statement regarding rules is true? Select all that apply. A) Rules should be flexible B) There should be as few rules as possible C) Rules should be changed on a regular basis D) Enforcement of the rules supports staff morale

Ans: A, B, D Feedback: Rules are fairly inflexible, so the fewer rules, the better. Existing rules, however, should be enforced to keep morale from breaking down and to allow organizational structure. It is neither reasonable nor necessary for all involved parties to agree with the rules but all must follow them. Rules require regular evaluation but change may not be warranted.

19. One of the most commonly used tools in health-care organizations is SWOT analysis. What is the definition for S? A) Internal attributes that help an organization achieve its objectives B) Internal attributes that challenge an organization in achieving its objectives C) External conditions that promote achievement of organizational objectives D) External conditions that challenge or threaten the achievement of organizational objectives

Ans: A Feedback: Strengths are internal attributes that help an organization achieve its objectives. Weaknesses are internal attributes that challenge an organization in achieving its objectives. Opportunities are external conditions that promote achievement of organizational objectives. Threats are external conditions that challenge or threaten the achievement of organizational objectives.

7. What is required in a health-care organization philosophy statement? A) Should be evident in a nursing departments decisions, priorities, and behavior B) Has value, even if not implemented, because it provides a picture of what the organization would like to accomplish C) Should reflect the values and priorities of each specific unit manager D) Should be consistent with that of other health care agencies in the area to avoid competition

Ans: A Feedback: The unit philosophy will be congruent with the organizational philosophy. A philosophy delineates the set of values and beliefs that guide all actions. The other options do not accurately describe requirements of a health-care organization philosophy statement

8. Which term is used for strategies that are neither written nor stated verbally and that have developed over time called? A) Implied policies B) Expressed policies C) Understood precedents D) The organizational culture

Ans: A Feedback: Implied policies are neither written nor stated verbally and have developed over time. The other options fail to meet this description.

5. Which statement identifies a characteristic of a planning objective? A) It has a specific time frame for completion B) It is subjectively evaluated on a periodic basis C) It has a100% compliance as a minimum criterion D) It is broad and inclusive in its nature

Ans: A Feedback: Multiple planning objectives, each with a target completion date, make up a goal. The remaining options are not characteristics of this objective.

1. What determines the functions and priorities of an organization? A) The organizations mission statement B) The organizations budget C) Consumer satisfaction surveys D) The organizations policy and procedure statements

Ans: A Feedback: The mission statement is a brief statement identifying the reason the organization exists and its future aim or function. This is not the function of the other options.

16. Benefits of effective planning include timely accomplishment of higher quality work and the best possible use of capital and human resources. Because planning is essential, managers must be able to overcome barriers that impede planning. What is an important point for successful organizational planning? A) The organization can be more effective if movement within it is directed at specified goals and objectives B) Plans to reach a goal must be rigid and not be distracted by current events C) The manager should include in the planning process the leadership people of units that could be affected by the plan D) A global plan and outline is sufficient to encourage and motivate employees

Ans: A Feedback: The organization can be more effective if movement within it is directed at specified goals and objectives. Because a plan is a guide to reach a goal, it must be flexible and allow for readjustment as unexpected events occur. The manager should include in the planning process all people and units that could be affected by a plan. A plan that is too global or unrealistic discourages rather than motivates employees.

25. Which statement concerning the role of the leader-manager in organizational planning is true? Select all that apply. A) They need to be future oriented B) They must be willing to take risks C) They must possess human resource management skills D) They need to be prepared to appraise the social climate that affects the organization

Ans: A, B, C, D Feedback: Planning requires managerial expertise in health-care economics, human resource management, political and legislative issues affecting health care, and planning theory. Planning also requires the leadership skills of being sensitive to the environment, being able to appraise accurately the social and political climate, and being willing to take risks. Managers then must draw on the philosophy and goals established at the organizational and nursing service levels in implementing planning at the unit level. The manager then draws on his or her leadership skills in creativity, innovation, and futuristic thinking to problem solve.

21. Which factor contributes to the difficulty health-care organizations are having in planning for identified long-term needs? Select all that apply. A) Government regulations B) Rapidly changing technologies C) Decreased provider autonomy D) Changing population demographics

Ans: A, B, C, D Feedback: Because of the rapidly changing technology, increasing government regulatory involvement in health care, changing population demographics, and reduced provider autonomy, health-care organizations are finding it increasingly difficult to appropriately identify long-term needs and plan accordingly. Consumer distrust is not a current factor contributing to the difficulty health-care organizations are experiencing with long-term planning.

12. What is a characteristic of strategic planning? Select all that apply. A) Requires managerial expertise in health-care economics B) Should reflect political issues related to health care C) Human resource expertise is required D) Should be based on a planning theory

Ans: A, B, C, D Feedback: Strategic planning generally forecasts 3 to 10 years into the future and requires managerial expertise in health-care economics, human resource management, and political and legislative issues affecting health care, as well as planning theory.

4. During the process of acquiring values, criteria should be used to assist in clarifying the chosen value. Which is a criterion for a true value? Select all that apply. A) It is freely chosen from among alternatives B) It is prized and cherished C) It is positively affirmed D) It is acted upon

Ans: A, B, C, D Feedback: A value is prized and cherished, positively affirmed and acted upon, and chosen freely from among alternative. Because our values change with time, periodic clarification is necessary to determine how our values may have changed.

14. Which element influences the nurse executive most heavily when assessing the organizations philosophy for nursing services for possible revision? A) Consumer surveys B) Financial resources C) Mission statement D) Policy statements

Ans: C Feedback: The philosophy flows from the mission statement, the highest priority in the planning hierarchy. The other options are not as influential.

17. A good plan incorporates which characteristic? A) A midterm evaluation B) Built-in evaluation checkpoints C) The rejection of plans that originally failed D) Over-planning to arrange required details

Ans: B Feedback: Good plans have built-in evaluation checkpoints so that there can be a midcourse correction if unexpected events occur. A final evaluation should always occur at the end of the plan. If goals were not met, the plan should be examined to determine why it failed. This evaluation process assists the manager in future planning. One who over plans may devote excessive time to arranging details that might be better left to those who will carry out the plan.

22. What makes an organizational philosophy useless? A) Being expensive to implement B) Viewed as being impossible to implement C) Not having the support of all the involved parties D) Involving a change in the organizational point of view

Ans: B Feedback: An organizational philosophy that is not or cannot be implemented is useless. While challenging, the other options are surmountable.

15. How are preactive planners described? A) They consider and value the past, the present, and future B) They use evolving technologies to accelerate change C) They consider the status quo as a stable environment D) They direct planning in response to a crisis

Ans: B Feedback: Dissatisfied with the past and present, preactive planners do not value experience and believe the future is always preferable. Their focus is not necessarily crisis response.

23. Which statement regarding nursing policies and procedures is most important to their successful role in achieving goals? A) The policies and procedures are created by staff representatives B) All policies and practices are based on current evidence related to practice C) Policy or procedure adoption is dependent upon effective utilization of resources D) 100% of the staff adheres to established policies and procedures 100% of the time

Ans: B Feedback: Policies and procedures should be evidence based. While the other options are influential to success, they are the most important aspect of policies and procedures.

20. One of the most commonly used tools in health-care organizations is SWOT analysis. What is the definition for opportunities? A) Internal attributes that help an organization achieve its objectives B) Internal attributes that challenge an organization in achieving its objectives C) External conditions that promote achievement of organizational objectives D) External conditions that challenge or threaten the achievement of organizational objectives

Ans: C Feedback: Opportunities are external conditions that promote achievement of organizational objectives. Strengths are internal attributes that help an organization achieve its objectives. Weaknesses are internal attributes that challenge an organization in achieving its objectives. Threats are external conditions that challenge or threaten the achievement of organizational objectives.

What is the best definition for the process of planning? A) Problem oriented B) Short-term goal setting C) Continuous with cyclic evaluation checkpoints D) A long-range needs assessment

Ans: C Feedback: Planning can be short term or long term, but should always include built-in evaluation checkpoints so there can be a midcourse correction if unexpected events occur.

18. At the unit level, what time frame may be considered long-range planning? A) 3 months B) 4 months C) 5 months D) 6 months

Ans: D Feedback: At the unit level, any planning that is at least 6 months in the future may be considered long-range planning.

3. Which is a true statement about planning? A) All plans should be defined well so that changes arent necessary B) Long- and short-range plans should be kept separate so priorities do not become confused C) Objectives and goals must be established before the philosophy is written D) All plans should include reasonable time limits

Ans: D Feedback: Every plan should have a reasonable time span for completion. The other statements are not true regarding the process of planning.

10. What is represented in a document entitled Fourteen Specific Steps to Successful Intravenous Catheterization at Hospital XYZ? A) Philosophy B) Mission statement C) Policy D) Procedure

Ans: D Feedback: Procedures delineate a series of specific steps of required action. None of the other options is the focus of this document.

6. How is the leadership role and management function associated with operational and strategic planning? A) Articulating the unit philosophy in writing B) Assessing unit resources available for planning C) Developing unit policies and procedures that operationalized unit objectives D) Encouraging subordinates to be involved in policy formation

Ans: D Feedback: Encouraging subordinates is a leadership function; the others are management functions. The other options do not achieve this goal.

13. Which statement describes an emerging paradigm that is likely to influence strategic planning for health care in the twenty-first century? A) Reduced emphasis on cost containment B) Reduced regulatory oversight of health-care organizations C) A shift from interdependence of health-care professionals to greater autonomy D) A movement from client-as-customer to population-as-customer

Ans: D Feedback: Health services are increasingly being provided to large groups of people, usually defined by employers, through managed care or capitated contracts. The other options do not describe an influential twenty-first-century paradigm.

Goals, Objectives, Policies, Procedures, and Rules

Goal—the desired result toward which effort is directed Objective—how the goal will specifically be achieved (includes time frame and is measurable) Policies—plans reduced to statements Procedures—step-by-step process of accomplishing a specific task Rules—plans that specifically define acceptable choices of action - Because rules are the least flexible type of planning, there should be as few rules as possible in the organization. - Existing rules, however, should be enforced to keep morale from breaking down and to promote organizational structure.

9. Place the planning hierarchy in its proper order from top (being 1) to bottom (being 7) represent. A) Philosophy B) Goals C) Mission statement D) Objectives E) Policies F) Procedures G) Rules

The planning hierarchy follows this order: begins with organizations mission statement, philosophy, goals, objectives, policies, procedures, and ends with rules.

SWOT analysis

first step is to defined the desired end state or objective, then the SWOTs are discovered and listed Strengths are those internal attributes that help an organization to achieve its objectives. Weaknesses are those internal attributes that pose barriers to an organization achieving its objectives. Opportunities are external conditions that promote achievement of organizational objectives. Threats are external conditions that challenge or threaten the achievement of organizational objectives. -Performed correctly, SWOT analysis allows strategic planners to identify those issues most likely to impact a particular organization or situation in the future and then to develop an appropriate plan for action.