CONTROLLING PROCESS

The Control Process

· Explain the basic control process.

· Differentiate between feedback, proactive, and concurrent controls.

The proper performance of the management control function is critical to the success of an organization. After plans are set in place, management must execute a series of steps to ensure that the plans are carried out. The steps in the basic control process can be followed for almost any application, such as improving product quality, reducing waste, and increasing sales. The basic control process includes the following steps:

1. Setting performance standards: Managers must translate plans into performance standards. These performance standards can be in the form of goals, such as revenue from sales over a period of time. The standards should be attainable, measurable, and clear.

2. Measuring actual performance: If performance is not measured, it cannot be ascertained whether standards have been met.

3. Comparing actual performance with standards or goals: Accept or reject the product or outcome.

4. Analyzing deviations: Managers must determine why standards were not met. This step also involves determining whether more control is necessary or if the standard should be changed.

5. Taking corrective action: After the reasons for deviations have been determined, managers can then develop solutions for issues with meeting the standards and make changes to processes or behaviors.

Consider a situation in which a fictional company, The XYZ Group, has suffered a decrease in the profits from its high-end sunglasses due to employee theft. Senior executives establish a plan to eliminate the occurrence of employee theft. It has been determined that the items are being stolen from the company warehouse. The executives establish a goal of zero thefts ($0) within a three-month period (Step 1). The company currently loses an average of $1,000 per month due to employee theft.

To discourage the undesired behavior, XYZ installed cameras in the warehouse and placed locks on the cabinets where the most expensive sunglasses are stored. Only the warehouse managers have keys to these cabinets.

After three months, XYZ managers contact the bookkeeper to get the sales and inventory figures for the past three-month period (Step 2). The managers then compare the figures with the previous period, taking into account orders for deliveries, returns, and defective merchandise (Step 3). It has been determined that the company lost $200 the first month, $300 the second month, and $200 the third month due to theft, which is an improvement but short of the goal. Managers then come up with suggestions for making adjustments to the control system (Step 4).

XYZ senior executives approve of the suggestion to institute a zero-tolerance policy for employee theft. Now, if there is evidence that an employee has stolen a pair of sunglasses, that employee’s job will be terminated. The employee handbook is updated to include the change, and XYZ executives hold a meeting with all warehouse employees to communicate the policy change (Step 5).

Timing of Controls

Controls can be categorized according to the time in which a process or activity occurs. The controls related to time include feedback, proactive, and concurrent controls. Feedback control concerns the past. Proactive control anticipates future implications. Concurrent control concerns the present.

Feedback

Feedback occurs after an activity or process is completed. It is reactive. For example, feedback control would involve evaluating a team’s progress by comparing the production standard to the actual production output. If the standard or goal is met, production continues. If not, adjustments can be made to the process or to the standard.

An example of feedback control is when a sales goal is set, the sales team works to reach that goal for three months, and at the end of the three-month period, managers review the results and determine whether the sales goal was achieved. As part of the process, managers may also implement changes if the goal is not achieved. Three months after the changes are implemented, managers will review the new results to see whether the goal was achieved.

The disadvantage of feedback control is that modifications can be made only after a process has already been completed or an action has taken place. A situation may have ended before managers are aware of any issues. Therefore, feedback control is more suited for processes, behaviors, or events that are repeated over time, rather than those that are not repeated.

Proactive control

Proactive control, also known as preliminary, preventive, or feed-forward control, involves anticipating trouble, rather than waiting for a poor outcome and reacting afterward. It is about prevention or intervention. An example of proactive control is when an engineer performs tests on the braking system of a prototype vehicle before the vehicle design is moved on to be mass produced.

Proactive control looks forward to problems that could reasonably occur and devises methods to prevent the problems. It cannot control unforeseen and unlikely incidents, such as “acts of God.”

Concurrent control

With concurrent control, monitoring takes place during the process or activity. Concurrent control may be based on standards, rules, codes, and policies.

One example of concurrent control is fleet tracking. Fleet tracking by GPS allows managers to monitor company vehicles. Managers can determine when vehicles reach their destinations and the speed in which they move between destinations. Managers are able to plan more efficient routes and alert drivers to change routes to avoid heavy traffic. It also discourages employees from running personal errands during work hours.

In another example, Keen Media tries to reduce employee inefficiency by monitoring Internet activity. In accordance with company policy, employees keep a digital record of their activities during the workday. IT staff can also access employee computers to determine how much time is being spent on the Internet to conduct personal business and “surf the Web.” The following diagram shows the control process. Note that the production process is central, and the control process surrounds it.

Controlling in Leadership & Management for Nurses

1. Definition of Controlling

Controlling is the fourth key function of management (after planning, organizing, and directing) that involves:

Monitoring performance (e.g., patient care, staff efficiency, resource use).
Comparing actual results with set standards (e.g., infection control compliance, patient satisfaction scores).
Taking corrective actions when deviations occur.

2. Importance of Controlling in Nursing

Ensures high-quality patient care and safety.
Helps in efficient resource allocation (medicines, staff, equipment).
Reduces errors (medication mistakes, procedural lapses).
Improves staff accountability and adherence to protocols.
Supports regulatory compliance (hospital policies, government healthcare standards).

3. Steps in the Controlling Process

Establishing Standards
- Setting measurable benchmarks (e.g., hand hygiene compliance ≥90%).
- Examples:
  - Clinical standards (Nursing Care Plans, WHO safety protocols).
  - Administrative standards (shift schedules, budget limits).
Measuring Performance
- Using tools like:
  - Checklists (e.g., pre-surgery verification).
  - Audits (e.g., medication administration records).
  - Patient feedback surveys.
  - Digital tracking (Electronic Health Records).
Comparing Performance with Standards
- Identifying gaps (e.g., nurse response time slower than expected).
Taking Corrective Action
- Solutions may include:
  - Retraining staff (e.g., updated CPR techniques).
  - Revising workflows (e.g., better triage systems).
  - Reallocating resources (e.g., more nurses during peak hours).

4. Types of Control in Nursing

Preventive (Feedforward) Control → Prevents errors before they occur (e.g., mandatory hand hygiene training).
Concurrent (Real-time) Control → Monitoring during care delivery (e.g., supervising a nurse during IV insertion).
Feedback (Post-action) Control → Evaluating after care is given (e.g., reviewing patient fall incidents).

5. Tools for Controlling in Nursing

Clinical Audits (e.g., infection control audits).
Key Performance Indicators (KPIs) (e.g., patient recovery rates).
Incident Reports (e.g., medication errors, patient falls).
Staff Performance Appraisals.
Budget Variance Reports (tracking expenses vs. allocations).

6. Challenges in Controlling for Nurse Leaders

Staff resistance to monitoring.
Time constraints in busy healthcare settings.
Balancing strict control with staff morale.
Keeping up with changing healthcare regulations.

7. Case Study Example

Problem: High hospital-acquired infection rates.
Control Measures:

Set standard: Reduce infections by 50% in 6 months.
Monitor: Daily hygiene audits.
Corrective action: Retrain staff, install more hand-sanitizing stations.

Conclusion

Effective controlling ensures safe, efficient, and patient-centered care. Nurse leaders must balance oversight with empowerment to maintain team motivation while upholding standards.

Key Takeaway: Controlling is not about micromanagement but about continuous improvement in nursing care.

Introduction to Levels and Types of Control

What you’ll learn to do: describe the different levels and types of control

In management, there are varying levels of control: strategic (highest level), operational (mid-level), and tactical (low level). Imagine the president of a company decides to build a new company headquarters. He enlists the help of the company’s officers to decide on the location, style of architecture, size, etc. (strategic control). The project manager helps develop the project schedule and budget (operational control). The general contractor directs workers, orders materials and equipment for delivery, and establishes rules to ensure site safety (tactical control).

Control can be objective or normative. Objective control involves elements of the company that can be objectively measured, such as call volume, profitability, and inventory efficiency. Normative control means employees learn the values and beliefs of a company and know what’s right from observing other employees.

1. Definition & Purpose

Controlling is the process of monitoring performance, comparing it against defined standards, and implementing corrective actions to ensure organizational goals are met In nursing, the primary purpose is to ensure high-quality patient care, enforce compliance, and support continuous improvement .

2. Core Control Process

A cyclical, five-step control model:

Set standards – Define quantitative and qualitative benchmarks (e.g., nurse-to-patient ratios, treatment protocols) .
Measure performance – Through audits, observations, documented reports, or scheduled appraisals
Compare results – Identify deviations between actual and expected performance
Analyze causes – Determine why deviations occurred and whether standards need updating
Take corrective action – Reinforce effective practices; address issues with interventions, training, or process changes

3. Performance Standards in Nursing

Structure – Resources and infrastructure: staffing levels, facility readiness .
Process – Care delivery methods (e.g., assessment, medication, hygiene)
Outcome – Patient outcomes: recovery rates, satisfaction, clinical indicators

4. Monitoring Tools & Techniques

Nursing audits, spot-checks, observational rounds, feedback surveys, performance appraisals .
Appraisal types: Formal (biannual reviews) and informal (ongoing observations) .

5. Corrective & Reinforcement Actions

Positive reinforcement – Recognize good performance to boost morale and consistency
Corrective actions – Modify procedures, provide staff training, or shift resources to address deficits

6. Advanced Control Types

Strategic control – Ensuring large-scale goals are on track
Tactical control – Monitoring department-level initiatives
Operational control – Overseeing day-to-day clinical activities

Includes input feedforward, concurrent (ongoing), and feedback controls

7. Human-Side Control in Nursing

Control within Nursing Management isn't just mechanical—it's also sociological: involves honesty, trust, ethical practice, and respectful confrontation when necessary
Sociological focus: promotes professional self-regulation and ethical value systems

8. Continuous Quality Improvement Tools

Popular methodologies include PDCA (Plan–Do–Check–Act) cycles, FOCUS, benchmarking, sentinel event monitoring, and balanced scorecards

Integration within Nursing Management

“Controlling” fits within the 5-function nursing management framework: Planning → Organizing → Staffing → Directing → Controlling
It's an ongoing feedback loop, refining planning, organization, and staffing based on review outcomes .

9. Effective Nurse Manager Role in Control

Implements regular audits and data-driven evaluations to ensure procedural compliance .
Balances corrective measures and recognition, using transactional and transformational strategies
Adapts control depending on team acuity—more structure with novice staff, more autonomy with experienced teams

Summary Table

Stage	Nursing Example
Set Standards	Nurse-to-patient ratios; clinical protocols
Measure	Rounds, audits, incident logs
Compare	Benchmark vs. actual care indicators
Analyze	Investigate deviations—e.g., medication errors
Act	Training sessions, schedule adjustments

Conclusion

The controlling function is vital for maintaining patient safety, enforcing standards, and promoting continuous improvement. Effective nurse managers utilize both technical tools and interpersonal strategies to guide teams toward excellence.

Stage Nursing Example

Set Standards Nurse-to-patient ratios; clinical protocols

Measure Rounds, audits, incident logs

Compare Benchmark vs. actual care indicators

Analyze Investigate deviations—e.g., medication errors

Act Training sessions, schedule adjustments