MAHARSHI KARVE STREE SHIKSHAN SAMSTHA’S

SMT. BAKUL TAMBAT INSTITUTE OF NURSING EDUCATION,

KARVENAGAR, PUNE-52

(NURSING MANAGEMENT)
SEMINAR
ON
PLANNING

Submitted to:
Mrs. Nupoor Bhambid
Lecturer, MKSSS, BTINE, Pune
Submitted by:
Ms. Vaishali S Patil
1st Year M.Sc. Nursing
MKSSS, BTINE, Pune
Submitted on:
14/08/2023

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GENERAL OBJECTIVES(S):
At the end of the seminar, the students will acquire in-depth knowledge about planning and
educating students to implement knowledge during their clinical posting.

SPECIFIC OBJECTIVES(S):

At the end of the seminar, the students will be able to:

• Introduce the planning

• Describe the concept
• Define planning
• Enlist the nature/characteristics of planning
• Enumerate elements and objectives of planning
• Explain the principles, principles of planning
• Describe the process of planning
• Describe types of planning
• Explain program evaluation and review technique
• Explain the Gantt chart
• Explain management by objectives
• Explain planning new venture
• Describe the plan for change
• Explain the plan for the change process
• Enumerate the advantages of planning
• Enumerate limitations of planning
• Describe the role of the nurse
• Explain the application of planning to nursing service and education

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INTRODUCTION:

Planning is a deliberative, systematic phase of the nursing process that involves decision-
making and problem-solving. In planning the nurse refers to the client's assessment data and
diagnostic statements for direction and formulating client goals and designing the nursing
strategies required to prevent, reduce or eliminate the client's health problems.
Planning is the systematic thinking about the ways s and means for the accomplishment of
predetermined objectives. Planning produces fundamental decisions and actions that shape and
guide what an organization is, what it does, and why it does it. Planning to build the bridge
between where we are and where we want to go.

MEANING:
A plan is forecast for accomplishment. It is a predetermined course of action. It is today's
projection for tomorrow's activity.
Based on Futurity: Planning is a trap laid down to capture the future"-Allen
Planning is informed anticipation of future-Haimmann
Planning is important for socioeconomic development. It helps to conceive and achieve results
in an atmosphere and spirit of a truly democratic situation, wherein different agencies at various
levels are involved in the policies of the Government for the welfare of its people.
Planning is essentially a process of making choice between available alternatives at all levels
of decision-making. It is the exercise of intelligence to deal with. facts and solutions as they
find a way to solve problems. So, planning is an essence, an organized, conscious, and continual
attempt to select the best available alternative to achieve specific goods.
Planning is one of the major fundamental elements of administration. In the planning stage,
decisions are made about what needs to be done, how and when it has to be done, by whom,
and with what resources. Planning is an intellectual process of making decisions and it aims to
achieve a co-ordinate and consistent set of operations aimed at desired objectives.

DEFINITIONS OF PLANNING:
Planning is deciding in advance and looking ahead. According to the Oxford Dictionary,
planning is the act or process of making plans for something.

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“Planning is done by a manager, which involves the selection of alternatives for the
organization in common and each department within it.”
-Koontz and O'Donnell

“Planning means the determination of what to do, how and where to do it, who and how
results to evaluate.”
-James Lundy
“It is an organized attempt to anticipate and make rational arrangements for dealing with
the future problem by projecting trends.”
-Dimock and Dimock
“Planning is an intellectual thinking process. It makes possible the actions to be done to
accomplish objectives and requires a nurse administrator to think critically about the
implications of taking a particular decision.”

NATURE/CHARACTERISTICS OF PLANNING:
The following list details the nature/characteristics of planning:
1. Planning is goal oriented: Planning, being goal-oriented, focuses on setting
organizational goals and suggests ways to achieve them. It provides a blueprint for the
entire organization to operate. The planning process includes sub-activities and
determines the future course of actions-all activities in planning focus on achieving
organizational objectives. Without plans, action and monitoring may not be systematic.
2. Planning is a continuous process basic to all managerial functions: Planning is the
foremost function of management and includes various activities A manager has to plan
before doing any activity. It is an ongoing process of making modifications and re-
examining and readjustment to changing situations, which is important in directing and
controlling as well. Planning logically precedes the performance of all other managerial
activities. It is the first function of a planner and follows all other managerial functions
as depicted. Formulating objectives, policies, procedures, programs, and rules is basic
to planning. The output of all managerial activities when matched with a plan in the
controlling process, acts as a basis for replanning or future planning to achieve the
desired objectives. It assists in workforce planning and designing training programs for
the nursing staff. It lays down the standards or benchmarks of performance for the staff
to control their activities.
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3. Planning is futuristic or forward-looking: Planning requires forecasting of future
situations in which an organization has to function. It also includes decision-making for
the future. Planners develop strategies and action plans by keeping in mind all probable
threats and opportunities and trying to control them.
4. Planning aims at efficiency: Planning is a conscious process to decide in advance
about the future course of action to achieve predetermined goals and objectives.
Efficiency is measured by looking at the output or the best result produced with lesser
input regarding resources such as human resources, money, material, methods, and
machinery used for a particular activity.
5. Planning is a thinking process: Planning is an intellectual process of creative thinking.
It involves vision and foresightedness to decide actions to be done in the future and
involves mental faculties by the managers. A manager uses facts, reasonable premises,
and constraints, and from these, he or she visualizes and formulates what necessary
activities, such as generating key issue formulation of proposals, making choices,
preparing a budget, implementing, and monitoring, are required to achieve the desired
results. One requires a thinking process to carry out all these steps. Hence planning is
an intellectual process.
6. Planning is a pervasive function: Planning being pervasive extends throughout the
organization. All levels of managers are involved in planning. Nurse manager at every
level has a planning function to perform. The higher level of management is responsible
for formulating the overall objectives and actions of the nursing organization. They
need to formulate organizational objectives, develop policies and action plans, and draw
procedures and programs for the nursing service. Similarly, the block-level nurse
managers need to formulate objectives of their block within organizational objectives
and also methods of achieving those objectives; ward/nursing unit supervisors
formulate objectives of respective units and ways to attain those objectives. At the
operational level, nurses frame objectives and develop nursing care plans based on the
need of the individual patient-client under their charge. Thus each level of nurse
manager contributes toward organizational goals, i.e. to ensure the best possible patient
care.
7. Planning is a dynamic function: Planning has a scope of flexibility by the needs of
customers and changing situations in the internal environment of the organization.
Hence it is called a dynamic function. Successful organizations are always ready to
cope up with the current situations and plan for the future. The planning process must
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 allow flexibility to meet new challenges. The targets need to revise and require
introducing new steps to achieve the said targets.
8. Planning is a social process: Planning requires consultation and participation. All the
employees of the organization should be informed about the planning and coordinated
with all concerned involved in planning.
9. Planning has a rational approach: The concept of rationality denotes the choice of
appropriate means for achieving stated objectives. It is a rational process to select the
best course of action from various alternative courses of action. It tries to identify and
bridge the gap between the actual status and the desired performance status of various
courses of action. There is a need for utilizing various sources to carry out actions. The
most appropriate use of these resources is the focus of the rational approach to planning.
10. Planning is a form of a bridge: Planning is a form of a bridge that fills the gap between
the present and the future. It indicates an open-system approach to planning. Open-
system approach to planning indicates the identification of the gap between the current
status and the desired status in the future actions required to bridge the gap influenced
by external environmental factors such as political, legal, technical, and social.
Managers have to take into account all the external and internal environmental factors.
11. Planning is a realistic approach to problems: Planning starts with the formulation of
objectives. and action plans are developed to achieve those objectives. The objectives
are defined in meaningful and technical terms so that managerial actions could be
possible. Various alternatives of action plans are drafted keeping in mind strengths,
weaknesses, encountered threats, and opportunities. It selects the most realistic and
possible alternative action plan so that the organization can pursue and achieve its
objectives successfully.
12. Planning aims at ensuring coordination: Planning is pervasive and required at all
levels of management. Organizational objectives, policies, procedures, and programs
are drawn to bind all departments to work in pursuit of attaining the main goals. They
all perform their roles and move in the same direction. Planning coordinates what, who,
how, why, and where action plans are done. If planning is appropriate, the coordination
of all activities will be better. Hence planning aims at ensuring coordination.

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ELEMENTS OF PLANNING:

There are six Ps required for planning. The elements of planning are as follows:

1. Purpose: While planning, the purpose or the aim of the organization must be stated
clearly and should be specific.
2. Philosophy: It provides a statement of belief and values that are basic to all operations
of the organization and to achieve the organization's purpose. It should be inconsistent
with the organization or mission.
3. Promise: It is a process of assessing the strengths and weaknesses of an organization
based on knowledge and assumptions of internal and external environmental factors.
The management can deal with changing environment by knowing the capability of the
organization in comparison to opportunities and threats that are likely to prevail in the
organization through strength, weaknesses, opportunities, and threats (SWOT) analysis,
4. Policies: They are designated plans or courses of action in a specific situation. These
provide guidelines and constraints for decision-making and preparing action plans.
Policies are framed by the top management usually by the Board of Directors.
5. Plans: Action plans are written documents reflecting objectives and detailed courses of
action to achieve objectives. Organizational plans are guides for the actions to be taken
and for monitoring and evaluating progress at different stages.
6. Priorities: Priorities of organizational goals are set according to the purpose and
philosophy of the organization as well as external environmental factors such as
political, social, and economic factors. A time frame is fixed to attain each goal and
allocates resources per set priorities.

OBJECTIVES OF PLANNING:

The objectives of planning are given below:

1. To set objectives: Planning starts with formulating objectives. Specific, clear, and
measurable objectives are formulated. Objectives by purpose and philosophy of the
organization are developed. The objectives in meaningful terms to develop managerial
actions are stated.
2. To focus on meaningful activities: Effective planning lays down various courses of
action, which are useful to accomplish the objectives. The chance of unproductive

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 activities reduces to a great extent. Planning makes it clear for working at different
levels how their operations can contribute to the organizational objectives that are
inconsistent with the objectives of the organization.
3. To economize time, effort, and other resources: Planning at all levels keeps the whole
process in order It helps to ensure proper utilization of resources and also helps to
minimize wastage, time, and efforts of the staff.
4. To maintain coordination: Planning is the basis of coordination. With the help of
plans, the departments work in harmony and achieve their respective goals without any
failure.
5. To reduce risk and uncertainty: Proper planning is made considering various
environmental factors such as human and other factors since there is diversity in these
factors. There is always a scope for flexibility or alternatives in good planning that
reduces the risk and uncertainty arising out of them.
6. To aid in taking decisions: A planner thinks of various plans of action and selects the
best among alternative courses of action according to the priority of the organization.
7. To ensure proper control: Planning ensures proper control by laying down
performance evaluation methods and measuring the performance of people. The
performance and standards are compared, which provides a gap between the actual and
the expected performance. It will help to take appropriate measures.
8. To achieve organizational effectiveness: During the implementation of plans, it is
easy to monitor the effective utilization of resources per plan or not. Proper monitoring
improves organizational performance and has scope to explore and take appropriate
corrective measures to improve the effectiveness of the organization.
9. To promote creativity: Planning is basically concerned with critical thinking of
exploring, selecting, and applying the best alternative to achieve the goal. Thus,
planning promotes creativity and innovation.
10. To improve efficiency: Planning determines as to when and how various tasks are to
be performed by different nursing units. It brings efficiency, reduces wastage, and
avoids needless efforts in various units.

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PRINCIPLES OF PLANNING:
The following list shows the principles of planning:
1. The principle of meaningful objectives: Planning should be done with clearly defined
objectives. It is a means of achieving objectives. Hence objectives should be explicit,
specific, and measurable. These should be formulated in light of the strengths and
weaknesses of the organization and also keeping in mind other internal and external
environmental variables that may influence in achieving those objectives.
2. The principle of primacy: All managerial activities after planning are executed. It
provides the basis for organizing, staffing, directing, coordinating, and controlling and
flows through all of them. It is the lifeblood of all functions of management.
3. The principle of planning premises: Planning premises are the anticipated
environment in which the plans are expected to operate. These are also known as
conditions that will affect an organization. The planner must keep in mind the premises
of the organization while formulating objectives and planning the future course of
action. Premises include assumptions and frameworks that are to work on in the future.
4. The principle of alternatives: The principle of alternative means developing many
alternatives and then selecting the best one that would help in achieving predetermined
goals. It is also known as the principle of rational process. The planner needs sound
judgment and objective thinking while planning. He or she needs to have knowledge
and ability to analyse alternatives. Various alternatives are developed, and the pros and
cons of each alternative in light of objectives, cost, and output are considered.
5. The principle of timing and continuity: Planning should be done quite ahead, and
the action plans on time before execution are developed. It should be an ongoing
process of making modifications and re-examining new situations.
6. The principle of flexibility: Planning should be flexible. It should provide a way to
reduce the risk involved in the future due to uncertainties. There should be scope for
readjustment to modify the plan according to the new situations.
7. The principle of communication: The principle of communication means that all
people working in the organization must know the expectation and work from them.
People of all levels must be aware of objectives comp and goals, policies, programs,
and rules they are going follow to achieve the said goals.
8. The principle of adequate control techniques: The principle of adequate control
techniques states that there should be the provision of sufficient performance standards
with time dimensions. Evaluation should be done for people who are working at all
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 levels for their performance according to laid down standards. Planning must
incorporate control techniques and a code of conduct for corrective measures to achieve
the goals of the organization successfully.
9. The principle of participation: There should be reasonable participation in planning
and making managerial decisions. It is a bottom-to-top approach in management. It is
the best technique to ensure cooperation and gain confidence and maximum
contribution from employees toward various action plans.
10. The principle of competitive action plans: The principle of competitive action plans
or strategies states that all plans must develop keeping in mind the actions and plans
framed by competitors in similar situations. To strive to make the number one
organization, one must know who the competitors are and what are their strategies and
one should try to plan one step.
11. The principle of the economy: According to this principle, the planner must do a cost-
and-benefit analysis of every planning process. The total cost of planning must be less
than the added advantage of planning regarding money and another cost. The most
economical plan was selected as possible with the maximum output.

IMPORTANCE OF PLANNING:
The list below shows the importance of planning:
• It provides a blueprint to guide and support the management of the organization
• All staff working in the organization must be aware of its vision, mission, and objectives
It focuses on organizational goals
• It facilitates the quality of services and a means to monitor and evaluate services given
• It promotes creativity and innovation
• It secures the economy in operations through the proper allocation of resources to
various operations It sets priorities according to the resources available
• It facilitates decision-making
• It establishes benchmarks for the appraisal of actual performance
• It reduces uncertainty and overcomes threats
• It achieves coordination among all departments
• It helps to manage the crisis.

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PLANNING PROCESS:
The planning process varies from organization to organization because of its different sizes and
complexities. The process of planning comprises the following steps (Fig.)
1. Perception of opportunities and gathering information: Before carrying out the
actual planning, one needs to explore and gather relevant and related information
regarding threats and possible opportunities, strengths, and weaknesses of the
organization. Information gathered should be accurate, precise, and up to date based on
estimation. Evaluate all the pros and cons of possible new opportunities. It is the
preliminary step before the formulation of objectives.
2. Establishing objectives: Frame objectives by the availability of opportunities and
resources. Objectives form the core of the planning process. It aids the staff to
understand the expectation of the organization. Objectives are the endpoints of any
organization translated into the departmental objective. These departmental objectives
then serve as the means of accomplishing the overall objective of the organization.
3. Developing premises (forecast future): Premises are the expected environmental or
external and internal conditions to undertake planning activities. These are an asset of
forecasts regarding these conditions or factors, and the success of planning depends on
the accuracy of these forecasts.
4. Identification of alternatives: After determining the various planning assumptions,
the next step is to work to find out the maximum alternatives based on empirical
evidence or experiences, or intuitions. Then a short listing of the alternatives is done
for a detailed analysis.
5. Evaluation of alternatives: In this step, an attempt has been made to evaluate the
selected alternatives per the criteria required for achieving particular objectives. All the
merits and demerits of the alternatives are listed and compared with the criteria laid
down,
6. Selection of the best possible alternatives: After evaluating all the short-listed
alternatives, the most appropriate alternative is taken up. It is the actual stage of
decision-making in the process of planning.
7. Developing subsidiary plans: After selecting the best plan, various derivative plans
such as policies, procedures, schedules, methods, and budgets are put into practice.
These supportive plans are the subsidiary plans formulated for various units, sections,
and activities in the light of the master plan to help the organization to achieve its
objectives in a unified manner.
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 8. Defining various activities and preparation of action plans: Related activities
according to plans are developed and defined. Time plans using various managerial
techniques such as Programme Evaluation and Review Techniques are developed.
These planning and control techniques are important to minimize time and cost and for
ensuring the completion of projects.
9. Communication of plans and securing cooperation: Supportive plans properly to the
lower levels of the organization are communicated. All staff should be aware of the
plans, their scope, and benefits. The participation of the staff at this stage helps them to
boost their morale to implement the plans effectively to the best of their
skills and abilities.
10. Follow-up and review: After implementation of the plan, it is essential to follow it up
to remove difficulties at every step of implementation. If needed, plans may even be
modified or revised to achieve the indented goal.

TYPES OF PLANNING:
Planning must be done at several levels and each has its own particular problems and
configuration of the planners and methods. Planning may be classified as directional
planning, administrative planning, and operational planning.
1. Directional Planning: It is often called policy planning, and it is concerned with the broad
general direction of the program i.e., setting the framework of intent and philosophy within
which the program will proceed., and relating the program to the broad planning of the
community in which the program will function. For Example, State level planning at
Directorate or Secretariat of State or Union (Centre).

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2. Administrative planning: It is concerned with the overall implementation of the policies
developed and with the mobilization and coordination of the personnel and material
available in the administrative unit for the effectuation of the service. For example, the
Medical Superintendent of major hospitals, or district Surgeon of district hospitals, or the
Medical Superintendent of the primary health center are responsible for administrative
planning.
Planning may be classified as long-range and short-range and also strategic and
operational. There are similar activities involved and long-range and short-range
planning and also strategic and operation planning.
I. Strategic planning: usually strategic and long-range planning is undertaken by the top
level which involves the following activities.
• Detailed analysis of strengths, weakness, opportunities, and threats (SWOT) of the
organization both internal and external environment.
• Developing philosophy and formulation of policies and objectives on the basis of
analysis of the organization.
• Allocation of resources on the basis of priority.
• Evaluation of activities to increase efficiency. Providing proper direction to avoid
duplication of services.

Meaning:
• The process to establish priorities on what you will accomplish in the future
• Forces you to make choices on what you will do and what you will not do
• Pulls the entire organization together around a single game plan for execution
• Broad outline of where resources will get allocated

Nature of strategy planning:

• A strategy is an overall approach and plan. Facilitates the good management of a process.
• It takes you outside the day-to-day activities of your organization or project.
• It provides you with the big picture of what you are doing and where you are going.
• It gives you clarity about what you actually want to achieve and how to go about
achieving it, rather than a plan of action for day-to-day operations.
• It refers to a firm's overall planning and dealing with something that exists
in the environment.

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 • It is a tool for organizing the present on the basis of the projections of the desired future.
It is a road map to lead an organization from where it is now to where it would like to
be in five or ten years.

Need for strategy planning:

• If you fail to plan, then you plan to fail - be proactive about the future
• Strategic planning improves performance
• Counter excessive inward and short-term thinking Solve major issues at a macro level
• Communicate to everyone what is most important

Characteristics of strategy planning:

• Address critical performance issues
• Create the right balance between what the organization is capable of doing vs. what the
organization would like to do
• Cover a sufficient time period to close the performance gap
• Visionary-convey a desired future end state
• Flexible - allow and accommodate change Guide decision-making at lower levels-
operational, tactical, individual

Quality of strategy planning:

• Simple
• Written
• Clear
• Based on the real current situation
• Have enough time allowed to give it time to settle. It should not be rushed. Rushing the
plan will cause problems.

Benefits of Strategic planning:

• It serves as the road map to the work It utilizes the resources in the best manner
• It responds to the environmental changes
• Decreases the chances of mistake
• Provides a framework for the communication
• Good behavior

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 • Basics for individual responsibilities
• Helps in encouraging good tools for cooperation and thinking
• Guide
• Gives a picture of employees in an organization

Elements of the strategic plan:

• Analysis
• Choice
• Implementation
• Evaluation

Planning at various levels of management:

II. Operational planning: Usually this operational and short-range planning is

undertaken by middle or supervisory-level personnel. This involves.
• Planning for a few months to a financial year.

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 • Planning for details budgeting, provision for short range goods and it should be achieved
within a given period
• Extensional aspect of the long-range plan.

The planning cycle may be considered in eight steps as follows:

1. Assessing the planning environment, which means none of the environmental and socio-
economic cultural peculiarities?
2. Data collection, using rapid rural appraisal technique where necessary, and data analysis
for bringing out the problems and potentials of the area.
3. Strategy formulation and setting realistic targets for the plan.
4. Participatory plan formulation.
5. Pan authentication and linking the plan with the plan at a near higher level.
6. Task adoption and plan implementation.
7. Midterm appraisal and making corrections.
8. Evaluation and re-planning
Characteristics of Operational Planning:
• Operational planning is a subset of the strategic work plan.
• It describes short-term ways of achieving milestones and explains how, or what portion
of, a strategic plan will be put into operation during a given operational period.
• An operational plan is the basis for, and justification of an annual operating budget
request. Therefore, a five-year strategic plan would need five operational plans funded
by five operating budgets.
• Operational plans should establish the activities and budgets for each part of the
organization for the next 1-3 years.
• They link the strategic plan with the activities the organization will deliver and the
resources required to deliver them.
• An operational plan draws directly from agency and program strategic plans to
describe agency and program missions and goals, program objectives, and program
activities.
Operational plans should contain:
• Clear objective
• Activities to be delivered
• Quality standards

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 • Desired outcome
• Staffing and resource requirements
• Implementation timetables
• A process for monitoring progress.

III. Management plans:

This plan will be done at the managerial level
Top-level managers → Strategic or long-term planning
Middle-level managers → Functional planning
Low-level managers → Operational planning
The Management Plan is the main tool to guide the development and management of an
organization. It helps to
• Improve the use of human and financial resources, by setting priorities
• Provide continuity in case of staff changes;
• Increase accountability
• Improve communication with stakeholders, the public, and potential donors

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 • Ensure that management decisions are based on a clear understanding of the
organization's objectives.
Management Plans have tended to be 'issue-driven", or focused on issues that were important
when they were prepared. A more useful approach is for a Plan to answer the question 'what is
needed for the objectives of the institution to be met?" Objective-oriented management is
proactive rather than reactive, emphasizes outcomes, and makes progress easier to measure
Some Management Plans have the status of legal documents, in which case failure to manage
an organization in accordance with it may constitute an offense. Although this may seem
stringent, legally binding Plans are advantageous as they have greater force and help to back
up management decisions and actions.
Once the plan and any supporting documents are produced, they should be used to guide the
implementation of the plan in the organization, and monitoring programs should be designed
to assess their effectiveness. Plans are often not used or are difficult to implement, particularly
if they were prepared without the participation of all those involved in implementation, and if
they were poorly structured and written. Management Plans should be revised and adjusted at
intervals to reflect new issues, lessons learned, or changes in management objectives, adapting
the contents according to new information gained from monitoring. The review process for this
is usually laid out in the legislation or in the Plan itself.

MANAGEMENT PLAN PREPARATION:

The Plan can be prepared before or after the MPA is set up, and will usually take at least a year
to ensure adequate consultation. MPA agencies often lack the financial resources for the work
involved but donors may be willing to fund such activities. Management Plan preparation
generally involves the following steps:
1. Pre-planning: establish the planning team, define the process to be used, find funding,
and train the planning team and key stakeholders if required.
2. Review existing information: (e.g. physical, biological, social, economic, policies,
legislation)
3. Identify stakeholders and establish a transparent consultation process, which may
involve meetings or workshops, with individual interest groups and for all stakeholders
together.
4. Analyse constraints, opportunities, threats, issues, problems, and needs, and identify
solutions.

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 5. Formulate vision, objectives, and, where appropriate, targets. 6. Design management
actions and interventions,
6. Determine financing mechanisms, bearing in mind the need for benefit and revenue
sharing with stakeholders.
7. Establish monitoring and evaluation protocols including a process for periodic
review and revision.
8. Prepare the draft Plan, and submit it for public consultation and review.
9. Incorporate comments and publish final Plan (preferably both as a hard copy and
electronically)
10. Submit the plan for approval and disseminate it.

PROGRAM EVALUATION AND REVIEW TECHNIQUE:

DEFINITION:
The program evaluation and review technique is a refined version of the original Gantt chart.
It is the most advanced and recent technique for logistics (planning, scheduling, and
controlling) of program/project-type activities. This technique has replaced the traditional
flowchart method for budgeting activities about time.
PERT is a model to analyze and represent the tasks/ events involved in the completion of a
given program. Booz Allen Hamilton, Inc. developed PERT in 1958. PERT is a refined
milestone budgeting. Milestones are identifiable and controllable pieces of a task and form. A
PERT/time-event network is a network of many signs and time showing to complete each sign.

PURPOSES OF PERT:
• To minimize the time and cost of completing a program
• To minimize idle resources
• To improve communication and coordination among different management levels
• To identify issues and obstacles
• To monitor the work progress
• To complete the project so as to minimize time.

FEATURES OF PERT:
• PERT is a task-oriented technique. It may contain hundreds or thousands of events.
• It identifies events (tasks/activities).

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 • The graph shows the relationship between events. It identifies critical activities.
• It specifies the time required to complete each identified event/task/activity.
• It calculates the minimum time for project completion. • It allows uncertainty in the
duration of tasks/activities.
• It includes uncertainty in scheduling time estimates measured by three parameters:
i. Time estimation based on the assumption that everything will go per plan (optimistic
time)
ii. An estimate of time based on whether the time manager thinks that it is necessary to
complete the task (most likely time)
iii. An estimate of time based on the assumption that some may occur (pessimistic time).
Operational Definitions:
Program: A program comprises many tasks/events.
Activity: An activity designates a task or a subproject of the total project. It is an action that
goes on between the event with which an operation begins and the event with which it
concludes.
Event: An event is "to start," "to finish," "to order," and "to receive." Usually, it terminates
one activity and simultaneously represents the beginning of another event.
A PERT event: A PERT event represents the beginning or completion of a task or more tasks.
A predecessor event: An event that comes immediately before another event. A successor
event: An event that occurs quickly after another event.
A PERT activity: It refers to a task that requires a fixed schedule and resources to carry out.
Critical path: A complete path to finish a program from the start to reach the final point. It is
the total scheduled time to carry out all activities.
Critical activity: An activity that has no slack time.
Slack: A time is taken to complete an event either on schedule (zero slack), ahead of schedule
(positive slack), or behind schedule (negative slack).
Expected time of activity (T): A predicted time required to complete a given task, based on
the assumption that everything will go to plan.
Expected time: It is the average time needed for a task if repeated.

Steps Involved in PERT:

1. Define the objectives of the program/project.
2. Identify and list down both critical and noncritical activities of the project.

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 3. Arrange all activities in a technological sequence.
4. Locate both predecessor and successor events in sequential order. 5. Estimate the time
to complete each activity. It includes elapsed time (days, weeks, and months),
"optimistic" time (0) showing the least time of activity, "pessimistic" time (P) indicating
the maximum time of activity, and "most likely" time (M) that lies between the two.
5. Calculate T, (expected time of activity) Expected time of activity (T) = (O+4M+P) +6
where denotes "optimistic" time (time estimation based on the assumption that
everything will go to plan) P denotes "pessimistic" time (an estimate of time-based on
the assumption that some problem may encounter, excluding major catastrophes) M
denotes the "most likely" time (an estimate of time based on whether manager thinks
that it is necessary to complete the task).
6. Estimate the shape of the probability distribution for the expected time for each activity.
This distribution is described as variance (o't). Calculate variance using the following
formula:
o't= (b-a/o) SD = √ost
7. Prepare or draw a draft of the network diagram that should show the relationship
between the activities and the events (Fig. 16.1) using the arrow diagram, which
represents the logical sequence in which the vents must take place. The numbers on the
arrow depict the elapsed time estimate.
8. Identify the critical path and amount and location of float by subjecting this network to
mathematical analysis. Revise the relationship and make changes, if required. Perform
another accurate analysis. Steps 1-6 are the line manager's functions, and steps 7-9 are
the staff functions for which one needs to have experts in this field.
9. Determine critical path: A complete path to finish a program from start to reach a final
point. It is the total scheduled time without any or the least slack time to perform all
activities. The events and the time of each event determine the critical path. In Figure
16.1, the critical path denotes from A to G with a scheduled time of 12 months.
Advantages:
• It is simple, comprehensive, and the most accessible tool for organizational planning
and management development, acquisition and installation of a system, and
development of projects and programs.
• It is an essential means to improve communication among different management levels.
It is a helpful technique to identify various issues and problems during the process.

21
 • It provides grounds for monitoring the continuous and timely progress of the project. It
provides a base for evaluation and control systems.

Limitations:
• There is a chance to omit the necessary step at the time of project planning.
• Uncertainty is attached to the time estimate.
• Number of resources available is a significant restriction.
• All activities may not be progressing on schedule.
• Lack of trained staff to adopt PERT/CPM techniques.

ACTIVITY PLAN (GANTT CHART)

What is an Activity Plan (Gantt Chart)?
An activity plan (Gantt chart) is a traditional method of planning that depicts the
sequence of tasks to be completed within the set time frame. It is a simple graphical
representation of various activities performed in the stipulated time framework or against the
progression of time in the form of a bar diagram. It was developed by Henry Gantt, a
mechanical engineer, in 1910. It shows time relationships between the "events" of a program;
these events are goal oriented.
The Gantt chart is a tool to assess the progress of the program. It shows the relationship between
tasks and time duration in the bar diagram to accomplish a plan. Gantt charts can be used in
many software tools for project management planning and other activities, for example, one
can prepare Gantt charts in an Excel program.

Purposes of Gantt Chart:

• To plan and provide a visual graphical illustration of scheduled tasks/activities.
• To track specific critical activity to observe carefully.
• To monitor and control program activities.
• For logistics of a project or program.

Features of Gantt Chart:

• It gives a graphical illustration of a schedule. It is a time-oriented activity plan depicted
in the
• graphical chart.

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 • It visualizes all activities of the project and the total time of the project.
• It represents each event in a bar. Each bar represents the time duration of that activity.
• Length of the bar also depicts its starting time and ending time.
• Each event in a bar corresponds to another activity.

Construction of Gantt Chart:

• A Gantt chart (Fig. 16.2) has the following A horizontal line (X-axis) is the time scale
over which to complete a program. The length of each task/event bar corresponds to the
duration of the task/event. Specify the period in days, weeks or months, years, etc.
• A vertical axis/line depicts different activities of the project, e.g. A, B, C, D. List the
tasks sequentially/ chronologically.
• The event/taskbar depicts the starting time and finishing time of that event/task.
• One event/taskbar describes its relationship with other event/taskbars for its starting
and ending time, e.g. Task "D" will begin after completing Task "C"; Task "B" will start
after 2 weeks of Task "A"; and "C" will start after 4 weeks of Task "A" and after 2
weeks of Task "A" and so on. Some tasks are independent, e.g. Task "A" will start at
the beginning of a project.

Uses of Gantt Chart:

• To represent the time and type of task of the project
• To plan and schedule projects
• To depict a sequence of the functions
• To monitor the functioning of the project
• To take immediate remedial action if delays.

Advantages:
The merits of the Gantt chart are as follows:
1. It is simple and easy to use.
2. It represents activities on a scale.
3. It expresses the time of each event explicitly.
4. It is easy to understand the starting and completion times of each operation.
5. It makes it easy to calculate the total time of the program.
6. It assists in planning, monitoring, and controlling program activities.

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 7. It depicts a deadline for each action.

MANAGEMENT BY OBJECTIVES:
Management by Objectives (MBO) is a boon for healthcare administration and has implications
in nursing. Peter Drucker was the pioneer in introducing the concept of MBO in 1954. George
Odiorne, Dale D, McCaskey, and others also contributed to MBO.
Definition Of MBO:
“MBO is a process whereby the top and subordinate managers of an organization jointly
identify its common goals, determine each significant area of responsibilities regarding
the results expected of an individual.”
-Odiorne
“MBO is a management system that has many management-related activities organized
systematically and collaboratively to achieve organizational objectives efficiently and
effectively. “
-Weihrichs and Heinz Hernold Koontz
“MBO is a collective endeavor to create an environment to provide each one with the
optimum opportunity to realize his or her full potential. It makes each employee a
manager of his or her particular work.”
-George Terry
Objectives of MBO:
The main aim of MBO is to help managers and supervisors to make the most effective use of
human resources such that each member, as a part of a team, creates a maximum contribution
to the organizational performance and profitability. The objectives are as follows:
• To identify and define goals and objectives
• To develop strategic and operational plans
• To assign roles, tasks, and responsibilities from managers to employees’ level
• To ensure proper communication and coordination among employees
• To empower employees to participate in decision- making at the individual level during
the whole process
• To direct employees for their actions and guide them to give their level best to achieve
goals and objectives
• To set objective-based standards to measure performance
• To facilitate work efficiency in the organization.

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Features of MBO:
• The MBO is result oriented, focused on objectives and transparency at all levels.
• It leads to a well-defined organizational structure with hierarchy and lines of authority.
• It emphasizes all significant priority areas, appropriate systems, and procedures.
• Managers and employees anticipate in setting objectives and reviewing performance.
• It provides an opportunity for subordinates to participate in planning and implementing
the program. 6. It believes in role clarity and accountability at different levels.

Steps in the MBO Process:

MBO is essentially a philosophy of management, based on identifying the purpose, objectives,
strategy, desired results, and evaluating performance in achieving goals. It is a continuous
process and has a series of activities (Fig.).
1. Defining organizational goals and objectives: The first step in MBO is to define
organizational goals based on the mission and purpose of the organization and develop
aims and objectives for both short- and long-term organizational, departmental, and unit
objectives under given appropriate planning premises by analysis and judgment.
2. Identifying key result areas: Key result areas (KRAS) indicate the priority areas for
organizational performance. It also shows current strengths, weaknesses, opportunities,
and threats of the organization and the perspective for the future.
3. Clarifying organizational roles: According to goals and subgoals, it defines the role
and responsibility of each department/unit manager. Hence, each coordinating
manager's contribution is to achieve the organizational goal.
4. Setting subordinate's objectives: After setting the goals and objectives, identifying
KRAS, and clarifying each manager's role in KRAS, the top-level managers work with
employees to set and define employees' objectives at par with organizational goals
within the specified period and available resources. They along with subordinates
develop a strategic and operational plan for each department.
5. Measuring and monitoring progress: During this stage of MBO, each departmental
manager implements operational plans in their respective departments, and the
employees perform their defined roles and responsibility accordingly. The managers
monitor the actual performance and achievement of each employee against set
objectives using the management information system. The senior managers conduct

25
 periodic meetings with subordinate managers to discuss the work progress and
implementation of the plans.
6. Continuous tracking and providing feedback: Providing feedback is a constant
process. Managers give ongoing feedback to employees about their performance
against set objectives. It is a way of monitoring the employees' performance and guiding
them to correct their actions.
7. Performance evaluation: Review the performance of employees within the
organization regularly and the organization as a whole at the end of an operating cycle.
8. Reevaluating the process: Reevaluate the whole process, replan it, and develop an
improvement plan if required (Fig.).

Advantages of MBO:
• It is a goal- and result-oriented process.
• It identifies structure, strategies, and practice-related problems.
• It can manage decentralized operations.
• It emphasizes in development and utilization of human resources.
• It exercises participatory management for organizational development.
• All the superiors and subordinates work together with a team spirit.
• It coordinates the activities of different units and departments.

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 Limitations of MBO:
• Developing objectives is a difficult task.
• The process of MBO is time-consuming.
• There is a lack of cooperation between management and employees.
• It needs competent and trained managers.
• It lacks flexibility in the revision of objectives.
• It focuses on goal setting and results rather than implementation.
• There is no room for considering external factors.

Implications of MBO in Nursing:

MBO is not only essential and useful for business managers but is equally important to
nursing administrators to improve the efficiency of nursing personnel. MBO based on
Taylorist principles applies in the nursing managerial process. The implementations of
MBO are as follows:
• It measures performance.
• It correlates individual performance to organizational goals.
• It clarifies the job responsibilities expected from employees.
• It fosters the increasing competence and growth of the subordinates.
• It provides data to estimate remuneration and promotion.
• It stimulates the subordinate's motivation.
• It helps in organizational work control and integrating the activities.

PLANNING NEW VENTURE:

Concept of a New Venture
A new venture is a new activity or business that involves risks and uncertainties in
operationalizing. It is a plan of action that needs strategic and business planning. It provides an
opportunity to set up a venture/business with innovative business and management ideas. It is
a sort of competition that offers an excellent chance to formulate a creative plan to start a new
venture. It may be a joint or business venture.
A Venture-Building Process
The main focus of the venture-building process is on delivering the annual operating plan.
Management of a new high-growth business is centered on a client-driven idea or a technology.
The venture-building process has four phases: startup, initial growth, rapid growth, and

27
continuous growth. At the time of startup, it is necessary to create a business model and a
business plan, build a management team, and develop a product/strategy that be different from
the competitive world. Raise venture capital. During initial and rapid growth, one has to
continuously monitor the implementation of operative and strategic plans and the progress of
the new venture to achieve its goals. Continuous growth is essential for the survival of a
business/venture.

Factors Determining the Need for a New Venture:

According to Gartner (1985), four factors determine the need for creating a new venture
(Fig.):
1. Personal characteristics of a person including motive, attitude, desire, and capability of
a person to carry out the decision to start a new venture.
2. Environmental factors including external surroundings and socioeconomic factors.
3. A business policy framework that can affect decisions before, during, and after starting
a new venture.
4. Type of venture, the entrepreneurship process, leadership qualities and skills, and risk-
taking behavior.

Steps for Planning a New Venture:

A. Preplanning stage:

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 • Assess motivation and attitude for planning a new venture and taking the risk of
uncertainty and failure of a new venture
• Plan the investment based on experience, expertise, and interest Plan work
schedule legally and systematically
• Find the sources of finance and conditions Plan the requirements and formalities
to start a venture/business
• Plan market, and financial model for the venture.
B. Identify the demand of the decided venture
• Assess the value of the new business and the requirements of clients for the
product/service Define clear goals and assess strengths and weaknesses
• Define the objective of starting a new venture.
C. Evaluate the feasibility of the new venture
To begin a new venture, assess the feasibility and potentials with regard to its
demand, productivity, availability, a better competitor, market value, financial
risk, backup monetary, profit margin, management skills, and capability instead
of taking a chance and dealing with the worst. Seek expert advice from team
members, marketing experts, lawyers, and financial advisors.
D. List down the requirements
• Legal formalities, filing the name of the business, address of office and attorney
in case of a partnership project
• Consider legal, accounting and tax, insurance, and professional banking needs
Permissions, licenses, rules, and regulations applicable to the new venture
• Types of records for tax purposes, management, and control, and plan
documentation systems
• Registration, select mailing address, and telephone number
• Finalize the location of the business office and its design layout and furnishing.
E. Develop a business and budget plan
• Develop a strategic and operational plan
• Ensure that the program fulfilled all the requirements
• Mention the venture, its clients, methods of promotion and planned cost for the
initial stage
• Outline the framework of venture.
F. Plan the financial request/loan

29
 • Find the sources of finance apart from the personal investment that has to be at least
25-30%. Open a separate business account.
G. Make a final check of the requirements
• Check for the completion of all the formalities, plans, finance, permission, contract,
fees, etc. to start a new venture. Prepare a checklist.

PLANNING FOR CHANGE

Concept of Change Management
Change
The word "change" in the Sanskrit language is "Vishwa." Etymologically it comes from the
root word "Vish" meaning spreading, especially that which is never the same at two different
points in time. It is not an occurrence but a way of survival. To change means to alter, to become
changed, or to transform. Change refers to an alteration in the physical, biological, or social
system of an individual or the organization to cope with internal and external environmental
factors.

Change Management
Change management is a structured approach to modify/ transition individuals, teams, and
organizations as a whole from their current status to the desired future status. It also tries to
improve the ability of the organization to adjust to the changes. It focuses on values, cost,
quality, and schedule. There is a shift in behaviours and attitudes of people to adapt and adjust
to future changes. An organization needs a planned transition, not merely in response to some
event or problem. In project management, change management usually concerns technical or
specification point of view.

Planned Change
Planned change is a systematic and organized evidence-based change. It involves deliberate
designing and implementing of a new policy based on changed operating philosophy, climate,
and style, which are all done in a systematic and organized way. Planned change always
prepares the organization for new goals or directions, enabling it to face challenges for its
betterment and to facilitate the process in a better manner. It consists of planning and
diagnosing the organization's problems and solving revising the philosophy, goals, policies,

30
and strategies per the gathered information. Planned change uses a humanistic approach and
applies principles of behavioral science and open-system theory to solve the problems

Areas of Planned Change

Planned change attempts to cover all areas of the organization when viewed as a
multivariate system. It includes changes in technology, task, structure, and people. The
difference in one area affects the other areas (Fig.).

1. Change in management technology: To improve efficiency, coordination,

communication, and relationship, the shift in management technology is a must. For
example, by using modern technology data processing, decision-making, and problem-
solving can improve efficiency, flowchart analysis can be used for better coordination, and
democratic and participative types of supervisors can be replaced by supervisors with
different leadership styles to improve the relationship.
2. Change in tasks: Technical tasks can be improved by designing and simplifying the
procedures, using high-tech equipment, and enhancing their competencies and skills.
Various motivational techniques such as assigning additional responsibilities, recognition
for good work, advancement, etc., can enhance motivation.
3. Change in structure: The difference in the structure area can improve relationships, formal
communication and interaction, work assignment, and authority structure, which can be
achieved by replacing the key personnel, modifying the cadre for a better career, and
providing better administrative guidance.
4. People-related changes: The changes among employees in their behavior, attitude, skill,
and knowledge can bring a drastic change in organizational performance, leading to the
achievement of goals. Sociopsychological factors such as motivation, positive attitude, and
high morale do matter in the performance of the employees, which in turn is made possible
by formal and informal training and other development methods. The most challenging task
in planning a move in the organization is to bring the desired changes in behavior, attitude,
belief, and values among employees. Changes must take place at the individual and
organizational levels.

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At the individual level, subjective changes include behavior regarding attitude, beliefs, and
values, which are necessary to bring changes in work culture. At the organizational level,
technological and operation management and financial consultations are essential to
improve the economic, financial, and technical aspects of the organization. At the micro
level, the improvement involves leadership development, group dynamics, and work
design. The macro-level changes are strategic, organizational design, and international
relations. The changes at the organizational systems and processes are a more holistic
approach involving individuals and cultural transformation.

Aims and Objectives of Planned Change:

The main objective of the planned change is to modify and reinforce strategies, structure,
and processes (interventions), which lead to organizational effectiveness.
• To bring the overall development of the organization both at the micro and macro level
• To bring stability and certainty in the organization
• To improve work culture by applying behavioral theories
• To adapt to changes in the environment for its existence
• To improve the capability of the organization to solve problems
• To cope with external environment threats
• To increase the effectiveness of the organization through planned intervention
• To develop self-renewing capability through a collaborative approach

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 • To bring useful changes in the organizational structure, technology, task, and among
people to adopt
• To compete with other similar organizations nationally and internationally.

Factors Affecting Change:

I. At the Management Level
1. Vision: A clear vision to accomplish the first essential element for implementing
change, at the micro or macro level.
2. Values and beliefs: Values and beliefs determine one's ability to accomplish the vision.
3. Mission: A mission statement determines the existence of a group.
4. Goals and objectives: Goals can be achieved through objectives. An aim is a short-
term, practical target related to a goal. Objectives are specific, measurable, attainable,
realistic, and time-bound goals.
5. Organizational structure and work culture: Organization may choose any
combination of the models: team model, whole-group model, or hierarchical model.
6. External and internal environment: It is to highlight the internal and external factors
that can support or harm an organization.
7. Strategic plans: Outlines that need to be met to achieve the objectives.
8. Financial plan: It is established by the goals and objectives of the group.
9. Communications plan: It is a strategy or plan to establish a better communication
system at different levels for the organization.
10. Evaluation plan: It includes outcomes, indicators, and measures.

II. At Individual Level

1. Competency and skill
2. Positive attitude
3. Highly motivated to work
4. High morale.

Principles of Change Management:

1. Understanding the current situation of the organization and diagnosing the problems.
2. Planning out a target, time, and the reason for the change and also the methodology for
change.

33
 3. Planning development in appropriate achievable and measurable stages.
4. Communicating, involving people and facilitating the changes openly.
5. Seeking support from people to change environment, processes, culture, relationships,
and behaviors, whether personal or organizational.

Change Management Model/Approaches:

Various models and approaches are available in the literature for effective management and
leading change. Lewin's change model based on its theory is the most preferred in planning for
a change in the organization.
I. Lewin's Change Model: Lewin's field theory is a basis for the process of planned change.
Planned change occurs in a planned manner, not spontaneously. Lewin's theory has field
and force concepts. A field is viewed as a system. If a change occurs in one part of the
system, it affects the whole system. Force gives direction and strength to move. According
to Lewin, due to internal and external factors, a disruption occurs in the balance of forces;
and planned change would stabilize and bring those forces to the desired equilibrium.
Lewin proposes a "force field analysis" diagram to identify and analyse resisting
(restraining forces) and promoting (driving forces) change (Fig.1). Based on the theory,
Kurt Lewin developed a change model consisting of three phases with a "top-down"
perspective (Fig.2)

34
 1. Unfreezing phase: It is the first stage in the process of planned change. The old ideas
and methods including internal and external factors are to be identified in the
organization so that rooms are made for newer purposes and transformation.
Information is collected to diagnose the problems. Finally, the individuals involved are
informed of the need for change, and they should also agree that change is needed.
2. Changing phase: During this phase, define, learn, and implement new ideas and
processes. The role of a change agent is to convince the people to adopt the change and
overcome their frustrations. The change agent should anticipate and expect the
difference and recognize that change takes place gradually. The change agent must
identify the driving and restraining forces to determine the best plan for implementing
change. Therefore, it is necessary to carefully plan to make changes in an organized
way before implementation. It is imperative to apply many behavioral science
approaches to bring about the desired change.
3. Refreezing phase: This phase comprises standardized and accepted changes. It is also
referred to as a stabilization phase. After successful stabilization, the replacement must
integrate into the system. Evaluate the new behavior after applying the planned change
and reinforce, if required.

II. An Iceberg Approach

The following are the steps involved in the iceberg approach:
1. Identify the need
2. Communicate objectives and processes
3. Engage each person to participate
4. Build change in communities: Informal, cohorts, and support groups.
5. Evaluate the measure success
6. Reinforce positive change behaviors
7. Grow and develop during the change.

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Strategies for Change:
The three main strategies involved in planned change management are as follows:
1. Power-coercive strategy: A power-coercive approach by a nurse who wishes to be a
change agent would need official authority to bring in change. Regulations and rules
originate from this strategy. It may be used to force a replacement for the common good
but may become very costly and fail due to the resistance.
2. Empirical-rational strategy: The empirical-rational strategy is based on the facts and
rationales and used for technological changes. When this approach is used for a person,
group, or organization, desirable changes are accepted.
3. Normative educative strategy: The normative educative strategy is all about
achieving the changes in attitudes, beliefs, values, skills, and norms of those who are
affected by the change. The change agent must include those who are most involved in
working out the plans for achieving the transformation.

36
Process of Planning Change:
The figure given below depicts various steps in planning change:
1. Identify the need for change: Identify the need for change by analyzing the gap
between the existing state and the desired future state. It should be a continuous process.
The difference in any aspect requires a change in other aspects of the organization.
Gather information from existing feedback and control data. Assess the internal and
external factors of an organization that needs to be replaced.
2. Formulate goals and objectives: After getting information and diagnosing the
problems, formulate the goals of change. Evaluate opportunities and identify areas for
change. Usually, organizational structure, technology, and people need change. The
nature and size of the area depending on the type and severity of the problem identified
any difference in the evident gap.
3. Select a change agent: Assign responsibility to a change agent, that is, person who has
the leadership capabilities, communication abilities, creative and decision-making
skills to solve problems. The change must be open-minded, willing to take risks,
flexible, and supportive of initiating changes. The agent should be trustworthy,
unbiased, and have a positive attitude and also welcome resistance toward the change.
4. Diagnose the current situation: Gather information to assess the situation. Consider
both external and internal factors for the organization as a whole, that is, both for
organizational development and for individuals with a commitment for action through
planned change. Evaluate existing practices, processes, cultural norms, and
performance matrices; the behavior of managers and employees; and communication
process that may need modification. Identify both restraining and driving forces.
Driving forces influence organizational change. Hence, it is necessary to find strategies
to convert restringing forces into driving forces, so that the employees accept the
change.
5. Selection of interventions and development of the action plan: Change is a complex,
continuous, and challenging process. Change can be brought about only through proper
planning and anticipating problems. Adequate preparation can overcome many
challenges associated with change management.

37
a. Plan for a change in organizational structure:
• The design solution, the period of the change
• Resources and support
• Develop new processes, systems, and organizational structure
• Implementation solution in the organization.
b. Plan for managing change in general:
• Define and implement new values, attitudes, norms, and behaviors within an
organization and overcome resistance to change
• Build consensus among employees on specific reforms designed to meet their
needs better
• Plan, test, implement, and evaluate all aspects of change
c. Anticipate reaction and resistance to change:
• Both managers and employees react to any change.
• Attitudes are necessary to determine the response to change.

38
 • The three types of alternative reactions to change are resistance, indifference,
and acceptance.
• Resistance to change is average but has to be handled carefully. Resistance to
change includes both individual and organizational factors. The individual's-
related factors include problems of adjustment, insecurity, fear of the unknown,
defensiveness, group norms, lack of trust, comfort with the contemporary style
of doing things, lack of information, or understanding about change. The
organizational and administrative factors include organizational structure itself
and resource constraints, poor timings of the change, a poorly planned proposal
for the change, and improper pacing of the change.
d. Prepare for people to change and minimize resistance:
• Create awareness among people regarding the need for change and provide
change details
• Develop a trusting relationship through open communication
• Listen to their viewpoints, fears, and the losses they perceive
• Prepare to participate and support the change
• Allow questions and suggestions Demonstrate commitment to the change
• Reinforce to keep the change in place.
6. Implementation: The implementation of planned change involves carrying out and
monitoring activities per plans by utilizing resources.
7. Monitoring and evaluation: During this stage, monitor and evaluate the situation for
its by using an evaluation and monitoring checklist. Ensure that the change is achieving
the goals within the allocated time and resources. Is the anticipated change occurring?
Are the participants showing hope and satisfaction with the change?
8. Feedback and follow-up: Get inputs and do a follow-up to ensure that the change
program is progressing in the right direction or requires modifications. In case of any
problem, replan and make necessary modifications and reframe strategies immediately
to achieve the goal. Prepare a process report that will provide a reference for the future.

ADVANTAGES OF PLANNING:
The advantages of planning are as follows:
1. Clarity of objectives: It must be clear, comprehensive, measurable, and defined
qualitatively and quantitatively.

39
2. Better utilization of resources: Planning ensures better utilization of resources and
thus increases efficiency.
3. Helps in coordination: Planning is regarded as a prime function of management as it
covers all other functions of management. Since it is a step-to-step systematic approach,
it helps in coordination to carry out all activities in harmony.
4. Reduces uncertainties: Planning is always done considering various threats and
opportunities available from the external environment, strengths, and weaknesses of the
organization. It helps to reduce many uncertainties.
5. Encourages creative thinking: Planning is a thinking process. Management tries to
develop realistic plans. It requires creative thinking and
foresightedness while planning.
6. Provides reasonable flexibility: There is always a scope of flexibility in planning to
make the required modification and adjustment in between without affecting its main
objectives.
7. Facilitates decision-making: Decision-making is the core of planning. During the
planning process, the best course of action among various courses of action was
selected. Planning provides guidelines for decision-making and prevents ambiguity.
8. Promotes efficiency: Planning is a process of selecting the best alternative based on
cost-benefit analysis, finance, and rational reasoning. Thus, planning helps to minimize
the cost regarding time and other resources and promotes efficiency in the organization.
9. Facilitates control: Planning helps in controlling performance by setting performance
standards. It involves designing various control and corrective measures. Thus,
planning facilitates effective control to achieve desired results.
10. Facilitates delegation: According to the predetermined goals, each department and
individual are made accountable for their work to achieve desired goals. This delegation
of authority facilitates the planning process.

40
LIMITATIONS OF PLANNING:
The following list explains the limitations of planning:
1. Restricts creativity: Planning involves deciding in advance and planning all activities.
Thus, there is very little scope or no scope for making the major modification. This
nature of planning discourages individuals to take initiative and freedom.
2. Rigidity: Planning is a predetermined development to achieve the desired objectives.
Hence these should have stability. It may leave no room for individuals to use their
experiences and ability, resulting in rigidity in planning
3. Uncertainty: There are certain unforeseen internal and external factors such as
economic, social, political, legal, and international climate that may act as a limitation
on the planning process.
4. Lack of reliable facts: It is always not possible to get authentic information and facts
relating to the future, and sometimes the planner may not supply accurate Information.
Then it becomes very difficult for management to draw accurate premises and predict
the plan of action.
5. Time-consuming and expensive process: Planning is time-consuming. It takes a series
of steps and actions on various operations. The collection of data itself is time-
consuming and expensive. Many operations are delayed due to poor planning, and
sometimes urgent actions carry out without planning
6. Resistance to change: It is very difficult to change the mindset of people, they do not
want to adopt a change. This type of attitude of people becomes a limitation to
planning.
7. Fast-changing conditions: Planning is done keeping in mind unforeseen conditions.
Therefore, strategic plans are flexible and require modifications per need.
8. Government policies: There are no fixed policies of the government. These are revised
from time to time per requirement. Revisions in health policies change from time to
time and reflect on planning.
9. Advancement in technology: In the modern technology world, technology changes
occur so fast that may upset planning.

Role of a Nurse Manager in Change Management:

As a change agent, the role of a nurse manager is very challenging to establish new routines by
replacing old ones to bring change. A nurse manager is expected to perform various roles
including the following:
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 1. Making staff understand the need for the change
2. Encouraging them to identify the areas for changes
3. Motivating them to take part in the change process
4. Inviting suggestions for planning and implementing change
5. Respecting the staff's ideas and opinions
6. Counselling staff who resist the change.
7. Restoring accountability in the change process
8. Being flexible and robust to take a risk in change management
9. Being a catalyst and seeking support from the staff during the implementation
10. Rewarding the team for bringing successful changes.

APPLICATION OF PLANNING TO NURSING SERVICE AND EDUCATION:

The planning phase of the nursing process helps nurses set priorities, outline patient-centered
goals and expected outcomes, and tailor nursing interventions to align with the aligned care
plan. Through the planning phase, the nurse applies critical thinking skills to align and develop
interventions according to the patient's needs. It provides continuity of care allowing patients
to receive the maximum benefit from treatment. It serves as a pilot plan for allocating individual
staff to a particular patient.

The planning phase begins once the medical and nursing team confirms the patient's diagnosis
and includes developing short and long-term goals. The focused planning phase should be
distinct from comprehensive care planning, which starts from the patient's admission and
continues after discharge.
The care plan involves three stages: initial, ongoing, and discharge planning. Initial planning
is executed by the nurse who performs the admission assessment. It includes addressing all
problems identified during the initial assessment and setting goals accordingly. A nurse updates
the care plan to enhance communication, documentation, and continuity of care; failure to do
so leads to a lack of efficiency and effectiveness in the plan. The nurses carry out ongoing
planning before their shift. The on-going planning determines any changes in health status and
decides which issue to focus on during their shift. Discharge planning includes anticipation of
needs after discharge.

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 Planning to
Nursing Service

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Planning is essential in the field of education entitled as “Educational Planning” which is a

major requirement in the contemporary society. The complexities of the present scientifically

developed and technologically advanced society have given special position to the need for

planning in education.

Like planning in any field, educational planning has to explore the best possible means of

making the greatest use of available resources leading to the maximum realization of the

educational aims and objectives, both individual and social.

So educational planning may be defined as a systematic design of action for realization of

educational aims and objectives for individual and social development through maximum

utilization of available resources. In practical perspective, educational planning is defined as a

process utilized by an administrator while performing the role of a leader, decision-maker,

change agent and so on.

Significance of Educational Planning:

1. To make every program of an educational institution or organization grand success.

2. Proper educational planning saves time, effort and money as planning in every field is

a time-saving, an effort-saving and a money-saving activity.

3. Educational planning is a sound method of solving educational problems by avoiding

the trial-and-error method of doing things.

4. Educational planning is essential for the best utilization of available resources.

5. Educational planning checks wastage and failure and contributes to the smoothness,

ease and efficiency of the administrative process in the field of education.

6. Through proper planning in education, education can be the best means by which

society will preserve and develop its future value system, way of life of an individual,

knowledge, skills, and applications, and culture of the country.

7. Through proper educational planning, the means and ends of society can be properly
interacted with through educational system.

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8. It implies that the educational system utilizes a large proportion of the country’s

educated talents and a major part of public expenditure.

9. Educational planning is highly essential for preparing a blueprint or plan of action for

every program of an educational institution or organization.

10. Planning in education is necessary for making one’s educational journey goal-oriented

and purposeful. It is essential to maintain, sustain and enhance the thinking process of

an individual, institution, or organization.

11. Planning in education is necessary to highlight the universal aims of education required

for every nation for its development in every respect.

12. To bring total development of a nation in time, in which educational development is

one among its various aspects.

13. To reflect the modern developments like an explosion of knowledge, advancement of

science and technology, and development of research and innovation while

reformulating the aims and objectives of education in the light of the particular situation

a country is facing.

14. It explores and provides the best possible means of making the wide use of available

resources leading to the maximum realization of the educational goals.

15. Educational planning facilitates the gathering of educational experts, teachers,

supervisors, and administrators to taking the decision in relation to the realization of

the purposes of the educational program.

16. Educational planning gives equal importance to the purposes of different classes of
experts such as sociologists, economists, scientists, politicians, educationists, etc.

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CONCLUSION:
The planning process of any organization is essential to the overall success of the company. All
levels of planning must do their part to incorporate situational analysis, alternative goals and
plans, goals and plan evaluation, goal and plan selection, implementation, and monitoring and
control into their organization to achieve the desired results. In addition to these steps,
managers must also consider the various impacts such as legal issues, ethics, and corporate
social responsibility as well as internal and external factors when devising plans for their
organization. As proven by the ongoing success of the Boeing Company, these steps and
considerations in the hands of the right managers ensure a promising future. In conclusion,
strategic planning is very important for any organization to achieve its short- and long-term
goals. Especially, with the boom and busts of the global economies in the last few decades, it
has become even more important for companies to execute their strategies carefully. Avery
important part of the strategy is to get ready for any future changes and to be well placed to
face the challenges brought by these changes. This is why; strategy should be capable of
minimizing the threats and maximizing the opportunities which are brought by the change.

REFERENCES:
1. Jogindra Vati, “Principles & Practice of Nursing Management & Administration for
BSc & MSc Nursing”, 2nd Edition, JAYPEE, Page no. 123-159
2. Deepal K, “A Comprehensive Textbook on Nursing Management”, 2nd Edition,
EMMESS, Page no. 69-100
3. Tsiakkiros A, Pashiardis P. Strategic planning and education: the case of Cyprus.
International Journal of Educational Management. 2002 Feb 1;16(1):6-17.
4. Fusarelli BC, Fusarelli LD, Riddick F. Planning for the future: Leadership development
and succession planning in education. Journal of Research on Leadership Education.
2018 Sep;13(3):286-313.
5. Wedell M. Planning for educational change. Planning for Educational Change. 2009:1-
94.

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