1. ORGANIZING
(NCM 107 Nursing Leadership &
Management
Nelia B. Perez RN MSN
PCU – MJCN
BSN 2013

2. ORGANIZING
• Organization consists of the structure
and process which allow the agency to
enact its philosophy and utilize its
conceptual framework to achieve its
goals.
• Also refers to a body of persons,
methods, policies and procedures
arranged in a systematic process
through the delegation of functions and
responsibilities for the accomplishment
of purpose.

3. Elements of Organizing
• Setting up the organizational
structure
… refers to the process to which
an organization/group is formed,
its channels of authority, span of
control and lines of
communication.

4. Purposes
• Informs members of their
responsibilities so that they may carry
them out.
• Allows the manager and the individual
workers to concentrate on his / specific
role and responsibilities.
• Coordinates all organization activities so
there is minimal duplication of effort or
conflict.

5. • Reduces the chances of
doubt and confusion
concerning assignments.
• Avoids overlapping of
function because it
pinpoints responsibilities.
• Shows to whom and for
whom they are responsible.

6. Types of organization
classified by Nature of
Authority.
• Line organization
…simplest and most direct type of
organization in which each position
has general authority over the
lower position in the hierarchy.
ex. Clinical and Administration

7. • Informal Organization
… refers to horizontal
relationships rather than
vertical.
… composed of small
groups of workers with
similar interests.

8. • Staff Organization
… purely advisory to the line
structure with no authority to
put recommendations in
action.
… Ex. Training and
Research

9. • Functional Organization
… one where each unit is responsible for the
given part of the organization’s workload.
… there is a clear delineation of roles and
responsibilities which are actually interrelated.
Ex. All Standing and Ad Hoc Committees

10. Five Major Characteristics of
an Organizational Chart
• Division of Work
• Chain of Command
• Type of Work
• Grouping of Work Segments
• Levels of Management

11. Definition of Terms
• Authority – right to act or make decisions
without approval of higher administration.
• Line and Staff Relationships
Line authority is the simplest and most direct type in which
each position has general authority over the lower positions in
the hierarchy in the accomplishment of main operations of the
organization.
Staff personnel provides advice, counsel or technical support
that may be accepted, altered or rejected by the line officer.

12. • Accountability - taking full responsibility
for the quality of work and behavior
while engaged in the practice of the
profession.
• Responsibility – the obligation to
perform the assigned task.
• Power – ability to influence another to
behave in accordance with one’s
wishes.
• Status – rank a group bestows on a
person in accord with the group’s
estimation of the person’s value and
significance to group goals.
• Communication - the transmission of
information between persons.

13. Organizing Principles
• Unity of Command
• Scalar Principle or Hierarchy
• Homogenous assignment or
departmentation
• Span of Control
• Exception Principle
• Decentralization or Proper
Delegation of Authority

14. Kinds of Organization
Structure
• Traditional Hierarchical Structure
• Organization Structure for
Devolved Hospitals

15. Staffing
• Process of determining and
providing the acceptable number
and mix of nursing personnel to
produce a desired level of care to
meet the patient's demand.

16. Factors Affecting Staffing
• The type, philosophy, and objectives of
the hospital and the nursing service;
• The population served and the kind of
patient served, whether pay or charity;
• The number of patients and severity of
their illness – knowledge and ability of
nursing personnel are matched with the
actual needs of patients;
• Availability and characteristics of the
nursing staff, including education, level
of preparation, mix of personnel,
number and positions.

17. • Administrative policies such as
rotation, weekends and holiday-off-
duties.
• Standards of care desired which
should be available and clearly
spelled out.
• Layout of the various nursing units
and resources available within the
department such as adequate
equipment, supplies, and
materials;
• Budget including the amount
allotted to salaries, fringe benefits,
supplies, materials and equipment.

18. • Professional activities and priorities in
non-patient activities like involvement in
professional organizations, formal
educational development, participation
in research and staff development.
• Teaching program or the extent of staff
involvement in teaching activities.
• Expected hours of work per annum of
each employee. This is influenced by
the 40=hour week law; and
• Patterns of work schedule – traditional 5
days per week, 8 hours per day; 4 days
a week, ten hours per day and three
days off; or 3 ½ days of 12 hours per
day and 3 ½ days-off per week.

19. PATIENT CARE
CLASSIFICATION SYSTEM
• A method of grouping patients
according to the amount of
complexity of their nursing care
requirements and the nursing time
and skill they require.

20. Requirements
• The number of categories into
which the patients should be
divided;
• The characteristics of patients in
each category;
• The type and number of care
procedures that will be needed by
a typical patient in each category;
and
• The time needed to perform these
procedures that will be required by
a typical patient in each category.

21. Classification Categories
• Level I – Self Care or Minimal Care
Average amt of NCH/pt/day = 1.5
Ratio of Prof to NonProf = 55:45

22. • Level II – Moderate Care or
Intermediate Care
Average NCH/pt/day = 3
Ration or Prof to NonProf = 60:$0

23. • Level III – Total, Complete or
Intensive Care
Average NCH/pt/day = 6
Ratio of Prof to NonProf = 65:35

24. • Level IV – Highly Specialized
Critical Care
Average NCH/pt/day = 6-9 hours
Ratio of Prof to NonProf = 70:30 or
80:30

25. Percentage of Nursing Care
Hours
Type of Minimal Moderate Intensive Highly
Care Care Care Spcl Care
Hospital
Primary Hosp 70 25 5 -
Secondary 65 30 5 -
Hosp
Tertiary Hosp 30 45 15 10
Spcl tertiary 10 25 45 20
Hosp

26. Computing for the number of
Nursing Personnel Needed
• Consider sufficient staff to cover all
shifts, off-duties, holidays, leaves,
absences and time for staff
development programs.
• R.A. 5901 – Forty-Hour Week Law

27. Relievers Needed

28. Distribution by Shifts
• 45% AM shift, 37 % PM and 18 %
night

29. Staffing Formula
• Categorize the patients according
to the level of care needed.
Multiply the total number of
patients by the percentage of
patients at each level of care.
• Find the total number of nursing
care hours needed by patients at
each category level.

30. • Find the number of patients at
each level by the average number
of nursing care hours needed per
day.
• Get the sum of the nursing care
hours needed at the various levels

31. • Find the actual number of nursing
care hours needed by the given
number of patients. Multiply the
total nursing care hours needed
per day by the total number of
days in a year.
• Find the actual number of working
hours rendered by each nursing
personnel per year. Multiply the
number of hours on duty per day
by the actual working days per
year.

32. • Find the total number of nursing
personnel needed.
a. Divide the total number of nursing
care needed per year by the actual
number of working hours rendered by
an employee per year.
b. Find the number of relievers.
Multiply the number of nursing
personnel needed by 0.15 (for those
working 40 hours per week) or by 0.12
(for hose working 48 hours per week).
c. Add the number of relievers to the
number of nursing personnel needed.

33. • Categorize the nursing personnel
into professionals and non-
professionals. Multiply the number
of nursing personnel according to
the ratio of professionals to non-
professionals.
• Distribute by shift.

34. Placement
• Advantages
– Fosters personal growth
– Provides motivating climate for
the employee
– Maximizes productivity
– Organizational goals have better
chances of being met.

35. • Results of Inappropriate
placement
– Frustration
– Poor quality of work
– Reduced organizational
efficiency
– Rapid turn-over
– Poor image of the agency

36. Factors to consider
• Inherent in the employee
• Past experience and training
• Culture of the clientele
• Decision-making skills
• Communication skills

37. Advantages of proper
placement
• Adapt faster
• Feet are lighter
• A lot happier
• Felt confident when supervised

38. Scheduling
• A timetable showing planned
work days and shifts for
nursing personnel.

39. Factors considered in Making
Schedules
• Different levels of the nursing staff;
• Adequate coverage for 24 hours,
seven days a week;
• Staggered vacations and holidays;
• Weekends and long stretches of
consecutive working days;
• Evening and night shifts; and
• Floating.

40. Assessing a scheduling
system
• Ability to cover the needs of the
unit.
• Quality to enhance the nursing
personnel’s knowledge, training
and experience.
• Fairness to the staff
• Stability
• Flexibility

41. Types of Scheduling
• Centralized Schedule
• Decentralized Schedule
• Cyclical Schedule

42. Advantages of Cyclical
Schedule
• It is fair to all
• It saves time
• Enables the employee to plan
ahead for their personal needs
• Scheduled leave are more stable
• Productivity is improved.

43. Rotating Work Shifts
• Common in most hospitals.

44. Developing Job descriptions
• Contents
– Identifying data
– Job summary
– Qualification requirements
– Job relationships
– Specific and actual functions and
activities

45. Uses of Job Description
• For recruitment and selection of
qualified applicants
• To orient new employees to their
jobs
• For job placement, transfer or
dismissal
• As an aid in evaluating the
performance of an employee

46. • For budgetary purposes;
• For determining departmental
functions and relationships to
help define the organizational
structure;
• For classifying levels of nursing
functions according to skill levels
required;
• To identify training needs;
• As basis for staffing; and
• To serve as channel of
communication.