III.

ROLES AND FUNCTIONS IN PLANNING

1. STRATEGIC AND OPERATIONAL PLANNING

Strategic Planning is concentrated towards attaining the long-term objectives of business, but if we talk
about Operation Planning, it is done to achieve short-term objectives of the company.

Definition of Strategic Planning

Strategic Planning is a planning process undertaken by the top level management, to decide where the
organization wants to reach in future. And what should be done to pursue the organizational vision, mission, and
objectives. It is an analytical process which examines the micro and macro environment of business. The process
is used to define the companys vision, ambitions, and set priorities to make a route that will lead the company
towards its ultimate goal.

The planning is not made for a particular department or unit, but it covers the entire organization. The
strategic planning is done to determine the factors of the internal and external environment which directly
influences the organization. The plan focuses on the enduring development of the organization. The tools used in
this process are:
SWOT Analysis (Strength, Weakness, Opportunities, Threats)
Portfolio Analysis
PEST Analysis (Political, Economic, Social, Technological Environment)
Porters 5 forces Analysis (New Entrants, Rival Sellers, Substitute Products, Buyer Bargaining Power,
Supplier Bargaining Power)
BCG Matrix (Boston Consulting Group)
These tools help the management to design a strategy considering various elements that will lead the
organization towards its vision.

Definition of Operational Planning

The process which predetermines the day to day activities of the business is known as Operational
Planning. The planning is done to support the strategic planning to accomplish the organizational goals. In this
process, short run objectives of the company are determined as well as a means to achieve those objectives are
also discovered.

Middle-level management performs the function of the operational planning process. It includes planning of
regular business activities and operations for a short period. Under this process, the organization is classified into
the various department, division, unit, and center for which planning is performed individually, which is aligned
with the strategic planning to reach the organizations vision.

The following are the features of Operational Planning:

Objectives need to be clearly defined.
Achievement of the desired result.
The activities are to be performed as decided.
Maintenance of quality standards.
Measuring performance.

Key Differences between Strategic Planning and Operational Planning

The following are the differences between strategic planning and operational planning:
 1. The planning to pursue the organizations vision is known as Strategic Planning. The planning to achieve the
tactical objectives of the organization is known as Operational Planning.
2. Strategic Planning is long lasting as compared Operational Planning.
3. Operational Planning is done to support Strategic Planning.
4. Strategic Planning takes into account the internal as well as the external environment of business. Conversely,
Operational Planning is concerned with the internal environment of business.
5. Strategic Planning is done by top level management, whereas the Operational Planning is a function of middle-
level management.
6. Strategic Planning covers the whole organization, but Operational Planning is done in a particular unit or
department of the organization.

COMPARISON CHART

BASIS FOR COMPARISON STRATEGIC PLANNING OPERATIONAL PLANNING

Operational Planning is a process of deciding in

The planning for achieving the vision of the
Meaning advance of what is to be done to achieve the
organization is Strategic Planning.
tactical objectives of business.

Time Horizon Long term planning Short term planning

Approach Extroverted Introverted

Modifications Generally, the plan lasts longer. The plan changes every year.

Performed by Top level management Middle level management

Scope Wide Narrow

Emphasis on Planning of vision, mission and objectives Planning the routine activities of the company.

2. PLANNED CHANGE
Every change should have a planned way. Planned change may help the person people to adapt with the
change environment, planned change is pre-determined. It is decided in advance what is to be done in future. It
is a deliberate process.

DEFINITION. Any kind of alternation or modification which is done in advance and differently for the
improvement of present position into brighter one is called planned change.

Forces for planned change is an Organization

An organizations planned change may take place-having demand for two sources. These forces are classified into
internal sources and external sources. These two forces demanding for planned change are shown in the
following diagram:
Internal Forces External forces
Obsolescence of production and service Regulators
New market opportunities Competitors
New strategic direction Market force
Increasing divers work force Customers
Shift in socio cultural values Technology

Models of Planned Change in Organizations

Model is a structure of organizational activities to be performed in future. A few models, however, are available in
the following list:
 Name of the model Designer
Three Stage Model Kurt Lewin
Seven Stage Model Ronald Lippitt and Associates
Burk Litwin Model Warner Burk and Litwin
Porras Robertson Model Jerry Porrars and Peter Robertson

Three Stage Model by Kurt Lewin

This model of change has been division by Kurt Lewin in the 1940s. In this model three stages are
suggested to follow:
Stage 1: Unfreezing: creating of confirmation and readiness to change through
Dis confirmation or lack of confirmation
Creation of guilt or anxiety
Psychological safety
Stage 2: Changing through cognitive restructuring: Helping the client to see things,
judge things, feel things and react to things differently based on a new points of view obtained
through
Identifying with a new role model mentor etc.
Scanning environment for new relevant information.
Stage 3: Refreezing: Helping the client to integrate the new point of view into
The total personality and self-concept
Significant relationship.
If these three stages are followed one by one, we hope that change process will be completed
successfully.

Seven Stage Models of planned change by Ronald Lippitt and Associates

This model has been proposed by Ronald Lippit, Jeanne, Watson and Bruce Westley, This model is the
expanded version of-3 stage model of K.Lewin, and these seven stages are given below.
Phase-1: Developing need: At this stage planner should develop a need for change.
Phase-2: Change relationship: In this phase a working relationship between the client and
outside agent needs to be established.
Phase-3: Clarification: Then clarification or diagnosis of client systems is to be made properly.
Phase-4: Alternative routes: Some alternative routes and goals are to be selected and then
necessary actions are to be taken.
Phase-5: Transformation: At this stage intention are to be transformed into actual change.
Phase-6: Generalizing: AT this stage of this model change is supposed to be generalized and
stabilized.
Phase-7: Terminal Relationship: In the last stage of this model; relationship between client
and consultant is terminated.
According to the above scholars, with the completing of all sever phases, change can take place effectively.

Models of planned change by Warner Burk and Litwin

These two scholars have designed two order changes, first order change and second order change. In
first order change model, eight transaction factors have been identified. These factors are:
1. Management practice
2. Structure
3. Systems
4. Work unit climate
5. Motivation
6. Individual needs and values
7. Task requirements and individuals skills
8. Individual and organizational performance
According to this model, if all eight factors help each other, a successful change may be made in the
organization. Lack of cooperation from any factor can destroy the change efforts. Management factor is
one of the most important factors in this regard.
 Not only that, work unit climate cannot be ignored. At the same time motivation of employees as well as
change agents is supposed to consider. Of course, individual needs and aspirations can intensify the level
of motivation.
In second order change, Burker-Kitwin have given five transformational factors.
External environment
Leadership
Organizational culture
Mission and strategy
Individual and organizational performance.
In the following figure, transformational factors are shown with interrelationships between
structure, management practices, work unit climate, task requirements, individual needs and values.
These interrelated factors can contribute for better individual and organizational performance.
According to this model, if the first four factors act with interrelationships, then the last objective,
i.e. individual and organizational performance may be achieved.
By combining these two order change models, Burke-Litwinhas again designed a very complex
model. This model incorporates thirteen stages along with one new step feedback. The models shown in
the following diagram.
It is directly linked with external environment. According to this model, a complex relationship
has been established. If organization can maintain this relationship and manage everything properly,
change program may be implemented.

Models of planned change according to Jerry Porrars and Peter Robertson

Jerry Porras and Peter Robertson have proposed another models of planned change. This model has six
basic steps. These are:
1. Environment,
2. Vision of the organization,
3. Organizing arrangements,
4. Social factors,
5. Physical setting
6. Technology.
The favorable environment encourages management to set its vision. IN compliance with the vision
management then select these components for further action. The last four components have again been
divided into a few sub factors which are shown in the following diagram.
According to this model, organizing arrangements incorporate seven factors, social factors
include five aspects, physical setting involves four elements and technology covers seven items. If all
these factors behave positively, we hope planed change may be implemented successfully.

Importance of planned change

1. Increased productivity: Planned change help increase productivity and service ability. On the other
hand, change without plan might not help that much to increase productivity.
2. Enhancement of quality: Enhancement of quality deserves planned change in an organization. Quality
of the goods is the condition of success of the organization.
3. Facing completion: If change process starts in a planned way that can help face competition
successfully. Otherwise it may be difficult.
4. Technological change: Planned change can also help in technological change, which type of
technology is to be installed, that decision is supposed to take through a proper plan.
5. Customer satisfaction: Customer satisfaction is one of the prime objectives of the organizations. That
satisfaction can also be increased and retained in a planned way.
6. Expansion of market: Every organization wants to expand its business. This expansion program should
be taken with effective plan.
7. Satisfaction of owners: Owners and managers satisfaction is one of the prime implied objectives of
establishing organization. This objective may be achieved, if it is tried in a planned way.
8. Complying with laws: Some changes take place in compliance with law provisions. In honor of law
provisions, change is initiated.
 9. Development of manpower: Manpower training and development is a continuous process. If this
process is undertaken in a planned way that can help the organization to gain long term benefits.

The planned change process is typically made up of the following steps:

Recognize the need for change
Develop change goals
Appoint a change agent
Assess the current climate
Develop a change plan method for implementation
Implement the plan
Evaluate the success of the plan at reaching the change goals

Types of resistance to change in organizations

1. Logical and rational,
2. Psychological and emotional, and
3. Sociological resistance.

All these types of resistance to change are discussed below in detail:

Logical and Rational Resistance
These resistances are the outcomes of disagreement with rational facts, rational reasoning, logic
and science. These arise from the actual time and effort required to adjust to change including
new job duties that must be learned.
These are too costly which might be borne by the common employees and managers. Even
though change may be beneficial for the employees in the long run. But the short run costs for
change must be paid first. Logical resistance to change include the following:
1. Time required to adjust
2. Extra efforts to relearn
3. Possibility of less desirable condition
4. Economic costs of change
5. Questionable technical feasibility of change

Psychological Resistance
These types of resistances are typically based on emotion and attitude. It is internally logical
from the perspective of the employee attitude and feelings about change. Employees may fear
the unknown, mistrust management, or feel that their security and ego needs are threatened.
Even though management may believe that there is no justification for these feelings they are
very rational to employees, and as such mangers must deal with them. Psychological or
emotional resistance may take place in the following manner:
1. Fear of unknown
2. Low tolerance of change
3. Dislike of management/change agent
4. Lack of trust in other
5. Need for security
6. Desire for status quo

Sociological Resistance
Sociological resistance may sometimes be logical. This happens when it is seen as a product of
challenge to group interests, norms, and values. Since social values are powerful force in the
environment, they must be carefully considered.
On a small group level, there is work friendship and relationships that may disrupt buy change.
Then resistance occurs. However, sociological resistance includes the following:
1. Political coalitions
2. Opposing group values
3. Parochial/narrow outlook
4. Vested interest
5. Desire to retain existing friendships
 Whatever may be the types of resistance, mangers should be very careful and tolerant. Tolerance
sometimes helps the employees to realize about the need for change and employees accept that.

3. TIME MANAGEMENT

DEFINITIION. Time management is the process of organizing and planning how to divide your time
between specific activities. Good time management enables you to work smarter not harder so that you get
more done in less time, even when time is tight and pressures are high. Failing to manage your time damages
your effectiveness and causes stress.

It may seem counter-intuitive to dedicate precious time to learning about time management, instead of
using it to get on with your work, but the benefits are enormous:
Greater productivity and efficiency.
A better professional reputation.
Less stress.
Increased opportunities for advancement.
Greater opportunities to achieve important life and career goals.

Failing to manage your time effectively can have some very undesirable consequences:
Missed deadlines.
Inefficient work flow.
Poor work quality.
A poor professional reputation and a stalled career.
Higher stress levels.
Spending a little time learning about time-management techniques will have huge benefits now and throughout
your career.

Practice the following techniques to become the master of your own time:

1. Carry a schedule and record all your thoughts, conversations and activities for a week. This
will help you understand how much you can get done during the course of a day and where youre
precious moments are going. You'll see how much time is actually spent producing results and how
much time is wasted on unproductive thoughts, conversations and actions.
2. Any activity or conversation that's important to your success should have a time assigned to
Time is the most it. To-do lists get longer and longer to the point where they're unworkable. Appointment books
valuable coin in your life. work. Schedule appointments with yourself and create time blocks for high-priority thoughts,
conversations, and actions. Schedule when they will begin and end. Have the discipline to keep
You and you alone will
these appointments.
determine how that coin
3. Plan to spend at least 50 percent of your time engaged in the thoughts, activities and
will be spent. Be careful conversations that produce most of your results.
that you do not let other 4. Schedule time for interruptions. Plan time to be pulled away from what you're doing. Take,
people spend it for you. for instance, the concept of having "office hours." Isn't "office hours" another way of saying
Carl Sandburg "planned interruptions?"
5. Take the first 30 minutes of every day to plan your day. Don't start your day until you
complete your time plan. The most important time of your day is the time you schedule to schedule
time.
6. Take five minutes before every call and task to decide what result you want to attain. This
will help you know what success looks like before you start. And it will also slow time down. Take
five minutes after each call and activity to determine whether your desired result was achieved. If
not, what was missing? How do you put what's missing in your next call or activity?
7. Put up a "Do not disturb" sign when you absolutely have to get work done.
8. Practice not answering the phone just because it's ringing and e-mails just because they
show up. Disconnect instant messaging. Don't instantly give people your attention unless it's
4. FISCAL PLANNING absolutely crucial in your business to offer an immediate human response. Instead, schedule a time
DEFINITION. to answer email and return phone calls.
Approximation of the cost 9. Block out other distractions like Facebook and other forms of social media unless you use
of an activity, job, these tools to generate business.
program or project, 10. Remember that it's impossible to get everything done. Also remember that odds are good
prepared for budgeting that 20 percent of your thoughts, conversations and activities produce 80 percent of your results.
and planning purposes only. Not accurate enough to provide a basis for a firm commitment, it represents only the
budget maker's understanding of the scope and expense of what needs to be done. Fiscal planning is not
intuitive; it is a learned skill that improves with practice. Fiscal planning requires vision, creativity, and a thorough
knowledge of the political, social, and economic forces that shape health care.
Role of the Nurse Manager in Fiscal Planning
To see that adequate resources are available to provide nursing services.
Nursing managers at all levels must become proficient in the budgeting process.
Good nurse manager who is in the best position to predict trends in census and acuity, supplies
and equipment needs.

Steps in Budgetary Process

1) Determine the requirements of the budgets:
-personnel, equipment, and operating expenses are needed to determine the organizational
budget.
2) Develop a plan:
- Reviewing the established goals and objectives of the nursing unit, department, and the
organization.
- A fiscal year budget is a budget cycle for 12 months.
May be subdivided into monthly, quarterly, or semiannual periods.
3) Analyze and control the operation:
- To avoid inadequate or excess funds at the end of the fiscal year.
- Each unit manager is accountable for budget.
- Large deviations must be examined.
 Variance: the difference between budget and actual performance
Example: Anything under 4% or 500$ is acceptable thus only variances over that
percentage would be examined.
4) Review the plan:
- The budget is reviewed periodically and modified as needed throughout the fiscal year.

Types of Budget
Personnel Budget
The Operating Budget or Revenue-And-Expense Budgets
Capital Budget

- The largest of budget expenditures is the workforce health care is labor intensive.
Includes: salaries, compensation for vacation time, sick leave, holidays, overtime,
etc.
- Personnel budget monitored closely to prevent under- or overstaffing, (be alert for
numbers and types of clients).

- Manager must be aware: the most economical level of nursing care- that will cover
patient needs can provided. A manager must monitor the personnel budget closely to
prevent understaffing or overstaffing. The manager must be aware of the patient acuity.

- The number of client's visits, or cases per day never remain constants, so manager
must be ready to alter staffing.
- The personnel budget includes actual worked time ( productive time or salary expense)
and time the organization pays the employee for not working ( nonproductive or benefit
time).
The operating budget or revenue-and-expense budgets
- Includes: daily expenses as the cost of electricity, repairs and maintenance, and
medical, surgical supplies, office supplies, laundry, etc.
- Supplies are the second most significant component in the hospital budget next to
personnel costs.
- Formulation of the operating budget should begin several months before the beginning
of the next fiscal year to provide sufficient data and time for planning.
Capital Budget
- Budget plan for buildings and or major equipment that has a long life (usually greater
than five years).
- Cost effectiveness is the desired result of careful fiscal planning (unit managers goal)
- Cost effective does not mean cheap, it means using the money for getting the most
products.
Takes into account factors regard Cost effectiveness:
1- Anticipated length of service.
2- Need for such a service.
3- Availability of other alternatives.
- In addition to the original price cost, examine the costs of implementation, installation,
upkeep, and technological updates.

Prerequisites to Budgeting
1. There is need for sound or organization structure with clear lines of authority and
responsibility.
Employees know their responsibilities and accountabilities about their actions.
Organization charts, job descriptions, Goals and objectives are available.
Then budgets developed to conform to the pattern of authority and responsibility
2. Statistical data
 e.g. No. of admissions, average length of stay, and percentage of occupancy, etc. are
used for planning and control of the budgetary process.
3. Revenues and expenses are reported for planning and evaluation.
4. Managerial support: essential for a budgetary program, done at the department level and
valued by top administration.
5. Formal budgeting policies and procedures are available in a budget manual.
Objectives, Instructions, Procedures for reviews of the budgetary program are defined &
discussed in detail.

5. CAREER DEVELOPMENT
DEFINITION. Career Development is the lifelong process of managing learning, work, leisure, and
transitions in order to move toward a personally determined and evolving preferred future. In educational
development, career development provides a person, often a student, and focus for selecting a career or subject
to undertake in the future. Often educational institutions provide career counsellors to assist students with their
educational development.

The International Council of Nurses (ICN) firmly believes that career development is a major contributing
factor in the advancement of health systems and the nursing profession worldwide, and is directly linked to the
maintenance of high quality care delivery. Career development must therefore be supported and sustained by
means of an articulated educational system, recognized career structures (including clinical ladders) flexible
enough to provide career mobility, and access. (International Council of Nurses)

ICN supports research demonstrating that career mobility provides incentives for professional
development and fosters higher levels of job satisfaction thus ensuring a more consistent coverage of health
facilities. Appropriate reward mechanisms need to be promoted, introduced and maintained so that achievement
is rewarded by recognition, advancement and/or remuneration.

Individual nurses have a responsibility to plan and develop their careers through continuous self-
assessment and goal setting. As health care providers, they must also participate in determining collective and
social development goals.

The Council believes that access to continuing education and professional development is critical and a
fundamental workers right. Continuing education should be available to all nursing personnel, using suitable
means to reach those working in isolated areas.

References

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