CONTROLLING, BUDGETING AND TEAMWORK


Abstract

This paper will cover adequate control mechanisms, the employee-retention committee meeting and concepts of total quality management. It is critical that managers search for ways to provide quality care. Managers must search for excellence. The search for excellence, striving for perfection, creating a climate of continuous improvement; these and similar mottoes reflect the overall theme of performance improvement initiatives associated with the management functions of quality improvement and controlling. Managers can use different features to ensure there is a control process in place for the organization.

Controlling, Budgeting and Teamwork

Display the status of the accomplishment of routine scheduled preventative maintenance activities by the plant engineering department.

The characteristics of adequate control that is appropriate for this task would be understandability. Understandability has been chosen because it provides control devices, such as charts and graphs that will be used to display the progress that the department has made towards a specified task. It is critical that maintenance managers keep employees informed on the progress they are achieving on task that have been assigned. Healthcare organizations are involved in different task or projects. These projects need to be accomplished in a specific time frame in order to improve the quality of care being provided by the organization.

Once the project is underway regular (usually weekly) project status reviews should be conducted. Employees can brief managers on the status of a maintenance project around the facility. Managers will then inform superiors of the accomplishment of routine scheduled preventative maintenance activities. These reviews are not simply to produce general status information as much as they are intended to identify variances from the preventative maintenance schedule. Having project status metrics will make this easier than simply reviewing the maintenance schedule (Taylor, 2009).

Managers can use a Gantt charts to track the progress of the preventative maintenance schedule. A Gantt chart is a visual control device; the Gantt chart was developed by Henry l. Gantt (1861-1919), one of the pioneers in scientific management. The gantt-chart (or the bar chart) is a mean of displaying simple activities or events plotted against time (Liebler & McConnell, 2008). This chart will be an invaluable tool for maintenance managers to use. It will aide them in monitoring the progress of task that have been assigned. An activity represents the amount of work required to proceed from one point to another.

Events are described as either the starting or ending point for either one or several activities. Gantt charts are most commonly used for exhibiting program progress or defining specific work required to accomplish an objective. They often include such items as listing of activities, activity duration, schedule dates, and progress-to-date. Maintenance managers that work in healthcare organization can use this chart to brief hospital directors on how long a specific area is going to be down for maintenance (Taylor, 2009). Gantt-charts are advantageous in that they are simple to understand and easy to change. They are the least complex means of portraying progress (or lack of it) and can easily be expanded to identify specific elements that may be either behind or ahead of schedule. This chart also aides in improving scheduling for routine maintenance operations and cutting cost due to schedules being shortened.


Track the number of repeat patient chart request fulfilled beyond a stated two-hour response time limit.

The characteristics of adequate control that is appropriate for this task would be timeliness. Timeliness has been chosen because it is a control device that should reflect deviations from the standard promptly, at an early stage, so there is only a small time lag between detection and the beginning of corrective action (Liebler & McConnell, 2008). A histogram can be used to track the number of repeat patient chart request fulfilled beyond a stated two-hour response time. There are many other charts that can be used to obtain a graphical representation of the data. It is critical that managers have a way to track the number of times a patient chart has been requested or accessed. The Department of Veteran Affairs uses software called Computerized Patient Record System to track a veteran's medical care. Managers can export data into graphs that will help with management briefings. CPRS enables clinicians to enter, review, and continuously update all order-related information connected with any patient.

The response time in which patient records are being retrieved is critical if manager are looking to improve the quality of care being provided. Faster response time will ensure patient are being seen and or responded to in a timely manner. Faster response time will help improve customer satisfaction and organizational goals. With CPRS, you can order track repeat patient chart request, lab tests, medications, diets, radiology tests and procedures, record a patient's allergies or adverse reactions to medications, request and track consults, and enter progress notes, diagnoses, and treatments for each encounter, and enter discharge summaries. Close integration with the clinical reminders and text integration packages allows better record keeping and compliance with Clinical Guidelines and medical record requirements (Healthimaging, 2010).


Follow the processing of a letter of complaint from its initial receipt to the disposition of the problem.

The characteristics of adequate control that is appropriate for this task is responsibility. Responsibility controls should reflect the authority-responsibility pattern. It should involve monitoring and correcting any deficiencies that may have occurred. Patient complaints happen every day in healthcare organizations. Managers must have a way of tracking patient complaints from start to finish. Software developers have developed specific software that can track the progress of a patient complaint. In most of the healthcare facilities the patient advocate will be the individual that will have access to this software. This software will help them create reports for management, so that management can track the number of complaints the facility has received over a given period of time.

Patient satisfaction is one of most important issues within the healthcare environment. It is critical that managers have a way of tracking patient satisfaction. Measurement of patient satisfaction stands poised to play an increasingly important role in the growing push toward accountability among health care providers. Patient's complaints can hinder the process of quality care being provided; therefore these complaints will need to be reviewed in a timely manner. Overshadowed by measures of clinical processes and outcomes in the quality of care equation, patient satisfaction measurement has traditionally been delegated to service improvement efforts by hospitals and larger physician practices, and to fulfilling accreditation requirements of health plans, while some plans tie satisfaction scores to financial incentives as a portion of their calculation of payment bonus to primary care physicians with capitation contracts (Guadagnino, 2003).


Track the timeliness of the clinical laboratory's responses to STAT test request.

The characteristics of adequate control that is appropriate for this task would be timeliness. Timeliness has been chosen because it is a control device that should reflect deviations from the standard promptly, at an early stage, so there is only a small time lag between detection and the beginning of corrective action (Liebler & McConnell, 2008). It is critical that healthcare managers have a way to track the timeliness of clinical responses to STAT test. Providers look at these tests to improve the quality of care they are providing to the patient. When providers are diagnosing patients they will need test back in a timely manner so that they can prescribe the necessary medication or rehabilitation to improve the patient's health.

Health care organizations have been trying for years to improve the turnaround time (TAT) for test results. Unhappiness with TAT remains a problem today. A 2006 report of a CAP Q-Probes study of nursing satisfaction with hospital clinical laboratory services in 162 hospitals showed most satisfaction with result accuracy, phlebotomy courtesy toward patients and nursing staff, and notification of abnormal results (Hawkins, 2007).

29 Respondents were least satisfied with urgent test TAT, laboratory management responsiveness and accessibility, phlebotomy responsiveness to service requests, and routine test TAT. The most important aspect of laboratory service reported by nursing personnel was urgent test TAT (Hawkins, 2007). It is critical that managers develop policies and purchase software systems that will improve TAT. Once this is done the organization will see an increase in employee and patient satisfaction.


Track the departments financial operating results as compared with the departmental budget.

The characteristics of adequate control that is appropriate for this task would be specificity and appropriateness. Healthcare managers must submit a budget to their fiscal department for the items or services where funds will be obligated and committed. Managers can use the balance scorecard to track the department's financial operating results as compared with the departmental budget. The balanced scorecard is a strategic planning and management system that is used extensively in business and industry, government, and nonprofit organizations worldwide to align business activities to the vision and strategy of the organization, improve internal and external communications, and monitor organization performance against strategic goals. It was originated by Drs. Robert Kaplan (Harvard Business School) and David Norton as a performance measurement framework that added strategic non-financial performance measures to traditional financial metrics to give managers and executives a more 'balanced' view of organizational performance (Balance scorecard, 2010).


Report on employment turnover throughout the organization by quarter and by year.

The characteristics of adequate control that is appropriate for this task would be understandability. Understandability has been chosen because it provides control devices, such as charts and graphs that will be used to display detailed reports on employment turnover rates throughout the organization by quarter and by year. Healthcare managers should research the reason as to why their employees are leaving. Tracking these rates will allow managers to develop a strategy that can be used to retain employees longer. This strategy can provide benefit packages to employees that may be leaving or entering the organization.

High turnover is a tell-tale sign of low morale and dissatisfied employees. Employees who are satisfied with their jobs generally don't give them up, so high turnover usually indicates a problem. There are many reasons as to why employees may leave a job. It is critical that managers are aware of these reasons. That's not to say that every employee who leaves your company is dissatisfied--after all, some will retire, leave town, quit because of family circumstances, desire to change professions, or even start a business of their own (Handelsman, 2010). But if you have high turnover and you're losing good employees, you may want to give some thought to the possibility that there is a morale problem. Managers are responsible for ensuring that employees are provided with intrinsic and extrinsic awards so that morale remains high.

The causes of turnover are related to the same factors that contribute to absenteeism and low morale. If workers aren't interested in their jobs, they will either stay away or leave. But being unhappy in a job isn't the only reason people leave one employer for another. If the skills that they possess are in demand, they may be lured away by higher pay, better benefits, or better job growth potential (Handelsman, 2010). In many cases most employees are looking for a way to advance their careers. Advancement can be either going to school full time to obtain a higher level of education or switching career fields. An example would be that in the Department of Veteran Affairs there is a high turnover rate in the field of prosthetics. Purchasing agents that work in prosthetics can be hired as low as a GS-4 but cannot exceed a GS-7. Therefore if they find a job that is a GS-8 or GS-9 they will most likely apply to the position if they are able to meet the minimum qualifications.


1. Perform a detailed critique of the employee retention committee meeting. List the occurrences or omissions that you believe indicate faulty committee practice, and state why you believe so and what should have been done differently.

The employee retention committee meeting was very much unorganized. Dave Andrews the chairman of the meeting had called the meeting 10 days before it was scheduled. Dave did not call the group members to remind them the day before, so there were group members that forgot about the meeting. On the day of the meeting, group members were complaining as to why Dave was conducting the meeting in his office. Group members stated that the office was small, uncomfortable and hot. The meeting was scheduled to start at 1:00 p.m. and did not get underway until 1:32 p.m., by then group members had informed Dave that they had other meetings the needed to attend by 2:00 p.m., by the conclusion of the meeting nothing that was relevant was actually discussed.

Below there is a recommended scheduled that Dave should have followed.

a. Schedule the meeting five days in advance

b. Send out a meeting reminder through email so that members can mark on their calendar.

c. Confirm that all members will be at the meeting. Here is where the chairperson can adjust the dates of the meeting if members are not unable to attend.

d. Establish a location for the meeting that will ensure group members are comfortable.

e. Develop an agenda for the meeting and provide copies to members.

f. Delegate a committee member to be a recorder, so that they can record notes of the meeting.

g. On the day before the meeting send out a reminder to ensure that all members will be in attendance.

h. On the day of the meeting ensure that the meeting starts at the recommended time and that the agenda is followed.

i. At the end of the meeting allow committee members to provide feedback on the topics that was discussed. A follow up meeting can be determined at this time, if there is further information that needs to be discussed.

             If an effective meeting is desired, then a great agenda will insure success. Create a meeting agenda using the 3 T's rule of Time, Topic, and Talker. The first T is time, there needs to be a start and end time for the meeting. Committee members must be aware of this factor as it will ensure that the meeting is conducted in a timely manner. The second T is Topic, the chairperson must ensure that members have come to an agreement on the topics that will be discussed or the chairperson can ask if members of they would like to discuss a topic related to the agenda. Then at the start of the meeting, be sure to get everyone's agreement to the agenda before continuing the meeting. Meeting management tends to be a set of skills often overlooked by leaders and managers. The following information is a rather "Cadillac" version of meeting management suggestions (Mcnamara, 2010). The reader might pick which suggestions best fits the particular culture of their own organization. Keep in mind that meetings are very expensive activities when one considers the cost of labor for the meeting and how much can or cannot get done in them. So take meeting management very seriously (Mcnamara, 2010).


2. Comment on the composition and membership of the employee retention committee, and indicate how you would structure and position such a committee and how you would thoroughly describe its, mission, purpose, or charge.

Membrship:

Chairperson - this position can be filled by the chief of human resources because this individual may have more expertise in how to manage retention.

Recorder - this position can be filled by the administrative assistant for the human resources chief.

Member - this position can be filled by the Chief of staff

Member - this position can be filled by the chief of nursing

Member - this position can be filled by the chief of surgery

Member - this position can be filled by the chief of logistics

             It is critical that members of this committee have the expertise and decision making skills to recommend retention plan of action to the medical center director. The committee will fail its objective if it is composed of member that have very little knowledge in the organization and how to effective manage retention rates.

Mission

             The mission of the retention committee is to provide leadership in the study of how to effectively manage retention rates.

Purpose

              The purpose of the General hospital retention committee is to organize a system-wide nursing recruitment and retention committee, consisting of 6 member's from different department within the organization. The goals and objectives of the recruitment and retention committee were to "create an awareness of national position shortage issues, promote involvement of staff, managers and human resources staff to lessen shortage effects through workforce education for staff, management and physicians, improving work environment and nursing image, prioritizing ideas by value and cost and planning, implementing and evaluating strategies (Pinkerton, 2003)." It is the main responsibility of General Hospital to ensure that all patients with our geographical area are provided with quality care.

              In conclusion healthcare managers are constantly searching for excellence in healthcare. Organizational committees will need to collaborate with one another to ensure that the facility is meeting or exceeding the demands of the patient population. Daily meetings can be conducted to ensure that employees and managers are aware of the changes that the organization is undergoing. It is important the management decides on what adequate control measures they are going to use, so that they can track the organization performance. Tracking performance is critical towards the organizations success in providing quality patient care. It is the ultimate goal of management to look after the wellbeing of employees and staff so that the highest standards of healthcare are achieved.


References

Balancescorecard (2010) What is the balance scorecard? Retrieved March 31, 2010 from http://www.balancedscorecard.org/BSCResources/AbouttheBalancedScorecard/tabid/55/Default.aspx

Handelsman (2010) Understanding and Remedying Employee Turnover. Retrieved from March 31, 2010 from http://www.toolkit.com/news/newsDetail.aspx?nid=138turnover

Hawkins (2007) Laboratory turnaround time. Retrieved March 31, 2010 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2282400/

Healthimaging (2010) VA seeks to update patient record tracking system. Retrieved March 30, 2010 from http://www.healthimaging.com/index.php?option=com_articles&view=article&id=20694:va-seeks-to-update-patient-record-tracking-system

Liebler, J, & McConnell, C. (2008). Management principles for health professionals. Sudbury, MA: Jones & Bartlett Publishers.

Mcnamara, C. (2010) Basic Guide to Conducting Effective Meetings. Retrieved March 31, 2010 from http://www.managementhelp.org/misc/mtgmgmnt.htm#anchor639767

Pinkerton, S (2003) A System Approach to Retention and Recruitment. Retrieved March 31, 2010 from http://www.medscape.com/viewarticle/446159

Taylor, M. (2009) How to monitor a project. Retrieved March 30, 2010 from http://www.projectmgt.com/Files/Article-How%20to%20Monitor%20a%20Project

Source: ChinaStones - http://china-stones.info/free-essays/business/controlling-budgeting-and-teamwork.php



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