1. Concepts of Management
    1. Definitions
      1. Case management - process that involves comprehensive coordination of activities and services provided to the client throughout the continuum of care or episode. Activities include case finding, screening, intake, assessment, problem identification, prioritization of client’s problems and needs, planning, reassessment, evaluation, documentation, designing and monitoring critical pathways, and identification of variances.
      2. Continuous quality improvement - process used to make improvements in client care; indicators of excellence are identified and process involves actively including input from and collaboration with the client (whose needs are at the center of the process), the family, and all health-care team members.
      3. Incidents/variance reports - part of quality improvement, where occurrences take place in a health-care agency that are not typical according to medical orders, may be an accident, or may be a violation of policy and procedures (e.g., wrong medication dose, a client or visitor falls, needle stick by nurse). These are considered unexpected incidents, exceptions that happen during client care.
      4. Quality assurance - activities that evaluate the quality of care provided to clients to ensure that it meets predetermined standards of excellence.
      5. Resource management - providing appropriate number and type of resources needed by clients to achieve desired outcomes.
      6. Supervision - process of guiding, encouraging, and assessing the work of others to whom tasks were delegated.
    2. Management theories
      1. Microlevel theories: clarify and predict behavior (e.g., motivation) of the individual, with input on the group/organization (e.g., group dynamics).
      2. Macrolevel theories: focus on best ways to make changes within an organization, organizing projects, obtaining resources, attaining goals.
      3. Intrapersonal/interpersonal theories:
        1. Cognitive: belief - a person’s motivation is based on expectations about what will happen as a result of own behavior; involves goal setting, with regular feedback to increase motivation to achieve.
        2. Scientific management: belief - repetition of task will result in expertise.
        3. Neoclassical management: based on Maslow (i.e., person continuously strives to meet higher level needs); ERG (Existence, Relatedness, Growth); job redesign (i.e., ensures that task has validity, significance, autonomy, and feedback).
        4. Social/reinforcement: belief - motivation comes from learning from those with whom a person identifies; conditioned by reinforcement.
    3. Management behaviors
      1. Decision maker
        1. Initiator of new projects.
        2. Crisis handler (e.g., interpersonal conflicts among staff).
        3. Resource allocator (people, physical, financial).
        4. Negotiator.
      2. Communicator
        1. Monitor of data collection and processing.
        2. Dissemination of collected information.
        3. Speaker on behalf of agency.
      3. Representative
        1. Institutional figurehead.
        2. Group leader.
        3. Liaison between agency and community.

  2. Disaster Planning
    1. Definition: any man-made (e.g., toxic material spill, riot, explosion, structural collapse) or naturally occurring (e.g., communicable disease epidemic, flood, hurricane, earthquake) event that results in destruction or devastation that causes suffering, creates human needs, and cannot be alleviated without support
    2. Goal: reduce vulnerability to prevent recurrence.
    3. Benefits of a disaster plan
      1. Decrease in costs of damage control.
      2. Decreased extent and duration of injury.
      3. Decreased loss of life.
      4. Increased ability to respond to unforeseen disasters.
    4. Health-care components
      1. Early warning signals, with realistic expectations.
      2. Brief and succinct assessment of those at risk.
      3. Simple, flexible rescue chains that unfold in organized stages/steps.
    5. Nursing responsibilities
      1. Nurses at the scene: assisting with rescue, evacuation, and first aid.
      2. Nurses at the hospital: triaging victims and providing acute care.
      3. Nurses at community shelters or health clinics: assessing, planning, implementing, and evaluating ongoing health care needs of victims.
    6. Level of prevention
      1. Primary prevention: prevention of disaster and limiting consequences when cannot be prevented.
        1. Nursing activities: identification of factors that pose actual or potential problem.
      2. Secondary prevention: responding to the disaster, halting it, and resolving problems caused by it.
        1. Nursing activities: assessment of extent of injuries; tagging victims for treatments and evaluation; Drovidine first aid; identifying complications; coordinating activities of shelter workers.
      3. Tertiary prevention: recovery and prevention of recurrence.
        1. Nursing activities: implementing community’s disaster plan; providing continuous assessment, planning, implementation, and evaluation; providing counseling as needed to victims and co-workers; educating the public about disaster preparedness.