Hospital management17

Hospital management17

1. Hospital Management Prof. Kyawt Sann Lwin Professor/Head Health Policy and Management 1

2. Sakharkar BM (2009) Principles of Hospital Administration and Planning , 2 nd Edit, Chapter 7 . Jaypee brother Publishing. Joshi DC and Joshi Mamta (2009) Hospital Administration , Chapter 2, Jaypee brother Publishing. Robbins SP, Coulter M (2005) Management , 8 th Edit., Pearson Education Limited. Laurie JM (2010) Management and Organizational Behavior , 9 th edit., Pearson Education Limited. References: 2

3. “Making things happen through people” Coordinating work activities so that they are completed efficiently and effectively with and through other people Efficiency – getting the most output from the least amount of inputs – (low waste) Effectiveness – completing activities so that organizational goals are attained – (high attainment) Management 3

4. Dictionary definitions tend to see the two words as synonymous Mgt. as “administration of business concerns” Admin. As “Management of public affairs” Administration – taken place in accordance with some form of rules or procedure , part of management process Mgt. implies a greater degree of discretion Management and Administration 4

5. 5 Central focus of management Organizational performance and effectiveness Achieving the goals and objectives of the organization Satisfying the needs and expectations of people at work Creating an organisational climate in which people work willingly and effectively The focus of management Improving the people-organization relationship Welding a coherent pattern of work activities System of motivation, job satisfaction and rewards Harnessing the efforts of staff Organizational process and the execution of work

6. Someone who works with and through other people by coordinating their work activities in order to accomplish organizational goals Helping others do their work and achieve May have other work duties not related to coordinating and integrating the work of others Classification – first-line, middle, top manager 6 Manager

7. 7 Managerial levels

8. First-line managers – mangers at the lowest level of the organization who manage the work of non-managerial employees who are directly involved with the production – often called supervisors Middle managers – managers between the first level and the top level of organization who manage the work of first-line managers Top managers – managers at or near the top level of organization who are responsible for making organization-wide decisions and establishing the goals and plans that affect the entire organization 8 Managerial levels

9. Three specific categorization schemes to describe what managers do Functions, roles and skills Management functions: Planning, organizing, leading/directing and controlling Roles : Interpersonal, informational, and decisional Skills : conceptual, human, and technical skills 9 What do managers do?

10. Planning – involves defining goals, establishing strategies for achieving those goals, and developing plans to integrate and coordinate activities Organizing – involves for arranging work to accomplish the organization’s goals - involves determining what tasks are to be done, who is to do them, how the tasks are to be grouped, who report to whom, and where decisions are to be made 10 Management functions

11. Leading /Directing – involves motivating subordinates, influencing individuals or teams as they work, selecting the most effective communication channels, or dealing in any way with employee behaviour issues Controlling – involves monitoring actual performance, comparing actual to standard, and taking action, if necessary 11 Management functions

12. Role Organized set of behavior associated with a position Managers have formal authority over the unit they command and this leads to a special position of status in the organization Interpersonal roles Informational roles Decisional roles (Henry Mintzberg ) General roles of managers /Hospital administrators 12

13. Figurehead role Most basic and simple role, as a symbolic head, obliged to perform certain duties, like attending ceremonies, etc. Leader Responsible for motivating employees, responsible for staffing and training Liaison Maintain contacts ( horizontal relationship ) with outside organizations and develop rapport with other organizations Interpersonal roles 13

14. Recipient/monitor Seeks and receives information (formal or informal) from inside the hospital or outside organizations, govt. / private hospitals, National /State Govt. Disseminator Transmits the information, after processing it to the people who need it, inside or outside the organization Spokesperson Represents the hospital and calls press conferences, conduct board meetings Informational roles 14

15. Entrepreneur Searches for, is visionary and can arrange resources for improvement Disturbance handler Responsible for corrective action and crisis mgt. during disaster, strikes etc. Resource allocator Responsible for allocation of resource to various areas of hospital, budgeting and scheduling activities opportunities Decisional roles 15

16. Negotiator Responsible for representing the hospital for negotiation, in respect of public private partnership, merger or joint ventures etc. Decision role 16

17. 17 Roles and Functions of Hospital Administrators Working with people Has no direct clinical responsibility Balance the goals of the hospital by working with patient care teams understand workers, their motivations and aspirations, and knit them together as a team Enabling role Ensure the provision of necessary physical facilities, supportive services are available in the right amount, of right quality, and at right time at right place

18. 18 Roles and Functions of Hospital Administrators Hospital administration and staff There are many types of staff who are specialist in their own sphere and department which function more or less as autonomous unit Need to understand the staff and understand the variations in the style of administration

19. 19 Roles and Functions of Hospital Administrators Staff motivation Develop measures to keep up motivation of all categories of staff Facilitating decision making Provide appropriate inputs to decision making at clinical departmental level, and coordinate decision making at interdepartmental level Management of resources To decide between competing claims for manpower and financial resources

20. 20 Roles and Functions of Hospital Administrators Negotiating With agencies outside the hospital and staff members within, especially regarding working arrangement and conflict resolution Containing costs To make medical staff cost-conscious, to reduce expenditure without jeopardizing patient care Understanding efficiency and effectiveness To secure maximum output from minimum input To achieve goals of hospital i.e., to meet customer needs and delivering service quality Dealing with new technology

21. 21 Roles and Functions of Hospital Administrators Establishing managerial climate Administrative personnel must be compatible with each other and with the organization Management development Plan leadership development at different levels Evaluation The ability to evaluate people, programs and overall effectiveness of the hospital Fact-finding and investigation Social commitment Serve the society through the hospital

22. Technical skill – understanding of and proficiency in specific type of activities involving methods, process or techniques without this skill – will find it difficult to supervise and train juniors Human skill – skill in dealing with people, as mgt. is science as well as art of getting things done through people it involves effective team work, the direction and leadership of staff to achieve coordinated effort Skills of effective managers 22

23. Conceptual skill ability to understand complexity of the whole organization and how changes in any one part of organization affect others, to see the big picture, to look into the future of the organization (strategic planning) Also involve decision making skills Skills of effective managers 23

24. Level of mgt. Skills Higher level mgt. Middle level mgt. Lower level mgt. Management skills Human Conceptual Technical 24

25. Technical skill Analytical skill Decision making skill Computer skill Human relation skill Communication skill Conceptual skill Skills of Hospital Administrator 25

26. Ability to diagnose and evaluate Required to understand the problem and develop an action plan Is used in scientific approach and techniques for problem solving 2. Analytical skill 26

27. To choose from among the alternatives, and ability to choose most appropriate alternative for effectiveness and efficiency This ability differentiate one administrator to other Administrators are paid to make decisions 3. Decision making skill 27

28. Using computer significantly increase administrator’s productivity Important for handling information and management of Hospital Information System (HIS) Conceptual understanding of computers and how particular software performs various tasks 4. Computer skill 28

29. Effective communication is a key to success : what you speak and how you speak is important – the contents, the tone, the pitch, body language, the medium etc. Ability to communicate in a way that other people understand and seek and use feedback from hospital staff to ensure they understood 6. Communication skill 29

30. Facilitating different groups in an organization and orchestrate their effort to achieve the common goal Central problem: Human – diverse groups of people - forced to achieve a cohesive goal Active activity , deliberately planned and executed Easier to coordinate in organization characterized by clear lines of authority, well-understood allocation of functions and delegation of authority Cooperation – passive activity , may arise spontaneously Co-ordination 30

31. One of the general administrative the ories of what managers do and what constitute good management practice Fundamental rules of management that could be applied in all organizational situations – flexible and adaptable to changing circumstances Principles of Mgt. ( Fayol ) 31

32. Division of work Authority and responsibility Discipline Unity of command Unity of direction Centralization of Authority Scalar chain Order Principles of Mgt. ( Fayol’s ) 32

33. Remuneration Stability of tenure Esprit de corps Initiative Subordination of individual interest to organizational interest Equity Principles of Mgt. 33

34. The work assigned to each worker – should be clearly defined Activities of organization – precisely clarified Thus work performed efficiently with gradual development of competence and skills – the advantage of specialization 1. Division of work 34

35. Managers must be able to give orders and authority should be commensurate with responsibility without authority one cannot discharge responsibility Responsibility – is assumed and arises out of assignment of activity Authority – official / personal authority Official authority – by virtue of official position Personal authority – as a result of personal qualities like competence, intelligence, experience, moral worth and past service 2. Authority and responsibility 35

36. Essential for efficient operation of the organization Respect/obey the rules that govern the organization Require good supervisors at all levels Managers must decide on the most appropriate form of sanction in case of offences against discipline Manager should set the good example through their actions and behavior 3. Discipline 36

37. In any action an employees should receive orders from one supervisor only Must know who is his “immediate boss” and be responsible to him for his work Dural command is a perpetual source of conflicts 4. Unity of command 37

38. Each group of activities with the same objective must have one head and one plan Relate to “ organization ” as a whole – should have team work and unity – without this there will be wastage of organizational resources 5. Unity of direction 38

39. The degree to which subordinates are involved in decision making The extent to which authority is concentrated or dispersed – depend upon type of organization, size of organization and manager’s ability to control should be clear in the organization – who is to issue orders and the areas of authority Conflicting orders – will create confusion 6. Centralization of authority 39

40. The line of authority or chain of supervisors from the top management to the lowest ranks in the organization Could be short-circuited in crisis situation or emergency 7. Scalar chain 40

41. People and materials should be in the right place at the right time There should be appointed place for every thing/each employee, and each thing/employee in its appointed place Will result in optimization of the resources 8. Order 41

42. Equal pay for equal work Each person should be paid according to his contribution Payment method can influence organizational performance and should be fair and afford maximum possible satisfaction to employees and employer 9. Remuneration 42

43. Unnecessary turnover of employees is both the cause and the effect of bad management Permanent nature of the job, resulting in a feeling of security and involvement in work Management should provide orderly personnel planning and ensure that replacements are available to fill vacancies 10. Stability of tenure 43

44. Harmony and unity among members of the organization is a greatest strength To avoid the dangers of divide and rule of one’s own team, and whenever possible verbal contacts should be used 11. Esprit de corps 44

45. Employees who are allowed to originate and carry out plans will exert high level of effort Employee should be given opportunities for use of creative ideas in their work It is a means to job involvement and commitment to organizational goals 12. Initiative 45

46. Organization is set up to meet the needs of society Individual / group must sacrifice some selfish interests in the overall interest of the organization and society 13. Subordination of individual interest to organizational interest 46

47. Subordinate must be treated without any bias for race, religion, sex, and class Manager should be Impartial, kind, and fair to their subordinates 14. Equity 47

48. Determination of goals and objectives Facility and program planning Financial management Personal management Co- ordinating departmental operation Program review and evaluation Public and community activities Health industry activities Government related activities Educational development Managerial activities of a Hospital 48

49. A body of persons statutorily responsible for running the hospital can make and guide policy but cannot “run” a hospital’s day to day affairs Also called board of directors/ trustees, governing body, management board Governing board 49

50. Job of the administrator is to plan, to organise , to direct and to control Represents the organization to higher authorities and to outside world Responsible for policies and procedures, the overall administrative structure, financial mgt., personnel mgt., reporting to the board, relations with medical staff, overseeing medical care, maintaining the physical facilities, legal matters and maintaining good public relations Hospital administrator 50

51. Leadership in the hospital lack of funds for hospital services Adaptation to external pressures – government policies, trade unions, other political bodies Lack of dedicated professional staff - Due to ineffective manpower planning, recruitment, compensation and development system Stringent financial and managerial controls on administrative staff Ineffective organization and allocation of work Problems of motivation and job satisfaction of employees Problems faced by hospital 51

52. Heterogeneous groups of workers Specialization Complex interrelationship Group work: individual merit is not noted Crisis orientation Round the clock functioning Objective is not clear, results not quentifiable Exhibit both authoritative and participative pattern of leadership Patients cannot express their needs Characteristics of work of the hospital 52

53. Horizontal contact Vertical contact Motivation Participation Communication How is coordination facilitated 53

54. Thank You 54