HA410 Unit 8 Director Delegation Analysis Example

Nineteen Hours a Fortnight on Work Others Could Hold: A Delegation Analysis of a Composite 24-Chair Outpatient Infusion Center Director's Own Time Log, Sorting Each Task by What Can Be Handed Over, Shared or Kept

[Student Name]

Purdue University Global

HA410: Health Care Leadership

Unit 8 Delegation Analysis

[Instructor Name]

[Date]

The infusion center, the director and every logged hour are composite and bracketed; the analysis shows the form of a delegation review and does not describe a real person.

Background

[Dana], a composite registered nurse, was promoted from charge nurse to director of the infusion center [fourteen] months ago. The center treats about [110] patients a day with chemotherapy, biologics and supportive infusions, with [16] nurses, [two] charge nurses, [three] schedulers and a pharmacy team. She still builds the nurse staffing schedule, answers every complaint about chair wait times, writes the monthly quality report and approves supply orders line by line. She works about [55] hours a week and has not started the strategic projects her vice president assigned.

The Log

For two weeks she recorded every task in fifteen-minute blocks. Of [110] logged hours, [19] went to tasks below her level, [31] to clinical and operational problem solving, [22] to meetings, [24] to administrative work and [14] to her direct reports. What she expected: that meetings were the problem. What the log showed: meetings were necessary; the hours she could free sat in tasks she had carried over from her charge nurse role. The tasks she could not let go of were the ones she had been best at before her promotion.

The Continuum

Tannenbaum and Schmidt (1973) describe a continuum of leadership behavior, from the manager deciding and announcing, through consulting before deciding, to letting the team decide within limits the manager sets. Delegation is not all or nothing; each task can sit at a different point.

Task by Task

1. Nurse staffing schedule, [six] hours: move toward the team end. Charge nurses build the schedule within limits she sets, such as minimum staffing by chair count; she approves it.

2. Chair wait complaints, [four] hours: share. Charge nurses handle first contact and resolve most; she handles complaints involving a safety issue or a repeat complainant.

3. Supply orders, [three] hours: hand over. A scheduler orders within par levels she sets; she reviews a monthly variance report.

4. Monthly quality report, [four] hours: share. The quality analyst drafts the data; she writes the interpretation.

5. Daily chair assignment changes, [two] hours: hand over to charge nurses entirely.

6. Decisions to close chairs during a nurse shortage: keep. This affects patient access and safety, and she is accountable to the vice president and medical director for it.

7. Performance reviews and discipline for nurses: keep. Accountability for personnel decisions belongs to the manager.

8. Clinical judgments, such as whether a patient with a reaction can continue treatment: these belong to licensed nurses and physicians at the chair, not to the director, and must not be delegated to unlicensed staff. National nursing guidelines describe delegation of clinical tasks as bounded by each person's legal scope of practice, with the delegating nurse remaining accountable (National Council of State Boards of Nursing & American Nurses Association, 2016).

Why She Held On

Managers delegate more when subordinates are seen as competent and share the manager's goals, and less when tasks are important to the manager or the manager doubts the outcome (Yukl & Fu, 1999). Dana trusts her charge nurses clinically but doubts they will build a schedule as carefully as she does, because she did it for six years. Her doubt is partly fair: the charge nurses have never been taught.

Transfer Plan

Weeks 1 to 2: she builds the next schedule with the charge nurses beside her, explaining each choice. Weeks 3 to 4: the charge nurses build it; she reviews and explains changes. Weeks 5 to 8: the charge nurses build it; she approves without changes unless a limit is broken. Supply orders and chair assignments move in week 1, with par levels written down. Complaint handling moves in week 2, with a short guide on which complaints come to her.

What She Will Do With the Time

[Twelve] of the [19] hours go to the two strategic projects: a new scheduling template to reduce chair idle time and a plan for a second infusion site. The rest go to her direct reports, who receive about [one] hour each a month now.

Measures

Her logged hours on delegated tasks after [two] months; schedule errors; complaint resolution time; progress on the strategic projects.

Telling the Team

She will explain the changes at a staff meeting, including why she is making them and which decisions stay with her, so nurses know whom to ask about a schedule or a complaint.

Risks

Charge nurses may feel the work is dumped on them. The plan answers this by teaching first, giving them authority within clear limits and recognizing the work in their reviews.

Conclusion

The log showed that the director's overload came from her past, not her present role. Sorting tasks by the continuum, keeping what licensure and accountability require, and teaching before transferring frees time for the work only she can do.

References

National Council of State Boards of Nursing & American Nurses Association. (2016). National guidelines for nursing delegation. Journal of Nursing Regulation, 7(1), 5-14. https://doi.org/10.1016/S2155-8256(16)31035-3

Tannenbaum, R., & Schmidt, W. H. (1973). How to choose a leadership pattern. Harvard Business Review, 51(3), 162-180.

Yukl, G., & Fu, P. P. (1999). Determinants of delegation and consultation by managers. Journal of Organizational Behavior, 20(2), 219-232. https://doi.org/10.1002/(SICI)1099-1379(199903)20:2<219::AID-JOB922>3.0.CO;2-8