MBA - Lecture 1 - M E of Hospital Services - Overview.pdf

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1. Monitoring and Evaluation of Hospital Services
Dr.Ahmed EL Damati
Lecturer of General Surgery –Alexandria University
PhD General Surgery / MRCS / JMHPE / MQM

2. EXPECTATIONS
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3. Day 1 Day 2 Day 3 Day 4 Day 5
Lecture 1
Controlling
Lecture 3
KPIs
Lecture 6
Essentials of PE
Lecture 8
Combining
indicators to
assess hospital
performance
Teams
Presentations
Lecture 2
SPC & Control
Chart
Lecture 4
BSC
Feedback &
Reflections
Lecture 5
Staff Competence
Lecture 7
Guidelines for
hospitals M&E
Lecture 9
M&E of National
Health Policies
Revision 1 Mid-Term Exam Revision 2 Final Exam
3MBA –Lecture 1 -M&E Overview -AD

4. ▪To Realize & Master Principles of Monitoring & Evaluation of
Hospital Services including coding & documentation
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5. ▪Differentiate Control, Monitoring& Evaluation
▪Appreciate foundational knowledge of Statistical Process Control & Identify various types of
Control Charts
▪Interpret concepts of competence& performance and identify their roles in hospital services
▪Analyze workers tasksinto sub-competenciesamenable to monitoring
▪Identify various methods & uses of workers competence assessment
▪Describe different methods of performance assessment & their utility
▪Distinguish successive levels of competence evolution
▪Define & differentiate methods of monitoring & evaluation of hospital services
▪Design a plan for establishing Hospital Monitoring System
▪Use acquired knowledge & skills to formulate proposal on monitoring activity based upon
candidate’ specific workplace
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6. ▪Use acquired knowledge & skills to formulate a
proposal on a monitoring activity based upon
candidate’ specific workplace
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7. LECTURE 1
CONTROLLING FROM A MANAGERIAL PERSPECTIVE –AN OVERVIEW
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9. Do illustrate foundational knowledge regarding controlling, monitoring& evaluation
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11. MANAGEMENT
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English verb "manage"
comes from Italian
maneggiare (to handle,
especially tools or a
horse)
Derives from the 2 Latin
words manus (hand) &
agere (to act)

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PLANNING ORGANIZING LEADING CONTROLLING

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16. CONTROLLING
▪Managers at all levels
engage in managerial
function of controlling to
some degree
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3 steps:
Establishing performance
standards
Comparing actual
performance against standards
±Taking corrective action
Involves ensuring that Performancedoes not deviate from
Standards

18. PERFORMANCE
STANDARDS
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•Revenue
•Costs
•Profits
Often stated in monetary terms
•Units produced
•Number of defective products
•Customer satisfaction
May also stated as

19. PERFORMANCE
MEASUREMENT
▪Done in several ways, depending on
performance standards:
▪Financial statements
▪Sales reports
▪Production results
▪Customer satisfaction
▪Formal performance appraisals
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≠ Control in behavioral or manipulative sense
≠ Managersshould attempt to control or to manipulate
personalities, values, attitudes, or emotions of subordinates

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= Manager role in taking necessary actions to ensure that work-
related activities of subordinates are consistent with & contributing
toward accomplishment of organizational & departmental objectives

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Existing plans
Planning provides
necessary performance
standards or objectives
01
Clear understanding of
where responsibility for
deviationsfrom
standards lies
02

26. ▪If you can't describe what you are doing
as a process →you don't know what
you're doing
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28. ▪Anything that can go wrong will go
wrong
Edward Murphy
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29. ▪If everything seems to be going well, you
obviously don’t know what’s going on
Edward Murphy
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30. ▪Essential functions to ensure that priority
health actions are implemented as
planned against stated objectives &
desired results
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31. ▪Examination & verification of records & supporting
documents
▪Controlling is often thought of in terms of financial criteria, but
managers must also control production & operations
processes, procedures for delivery of services, compliance
with company policies & many other activities within
organization
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32. ▪Physician & founder of study of quality in HC & medical
outcomes research
▪Creator of Donabedian Model of care
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AvedisDonabedian

33. DONABEDIAN
MODEL OF
CARE
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Output Intermediate Outcome Outcome
Products, goods &
services that result
from the process
•Short & medium-term effects of
investment’ outputs
•Steps along way to end-of-project
outcomes
•Short term: changes in KSAs
•Medium term: changes in
behavior, practice & decisions
•‘End state’ = outcome achieved
•Who or what is expected to change
•Type of change expected to occur
including:
•Knowledge (awareness of new
ideas, techniques, or strategies)
•Action/ practice (behavior
change based upon new
information/ideas)
•Condition (organisationalor
societal changes due to
stakeholder’ actions)

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Audit Monitoring Evaluation
قيقدتلا ةبقارملا قيقدتلا
Financial Process Outcome
Examination & verification of
company' financial records
Ensure that financial statements
are prepared in accordance
with relevant accounting
standards
Continuous assessment
of programs based on
early detailed
information on progress
or delay of ongoing
assessed activities
Examination
concerning relevance,
effectiveness,
efficiency & impact of
activities considering
specified objective

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Budget auditprovides information about
where organization is with respect to what
was planned or budgeted for
Performance audit might try to determine
whether figures reported reflect actual
performance

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Audit Monitoring of
process
Evaluation of results

40. ▪Collecting, tracking & analyzing data to
determine what is happening, where,
and to whom
▪Uses set of core indicators & targets to
provide timely & accurate information to
inform progress & performance reviews
and decision-making processes
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41. One of broadest & most controversial issues in
management
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42. ▪Formal & regulated determination of effectiveness, efficiency& acceptabilityof
a planned action to fulfill certain goals
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43. ▪The measurement
system should be able
to compare
performance within
organization, as well
as performance
among similar
organizations
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44. ▪Builds upon monitoring data but
analysis goes much deeper
▪Additional data are often needed to
consider contextual changes &
determine if change is attributable to
services
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47. ▪Existence & application of a suitable
model to evaluate performance of
hospitals can lead to ↑responsiveness,
patients’ satisfaction & improvement
of service quality
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Means through which power is used responsibly
Process of taking account of & being held
accountable by, different stakeholders, primarily
those who are affected by the exercise of power

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Can affect multiple levels of stakeholders in a project (donors, target
populations, government)
Concerned with how needs of different groups are balanced & considered in
decision making & activity implementation
1ry focus = ensuring that men, women, boys & girls affected by a crisis, and that
the project aims to assist, are involved in planning, implementing & judging
interventions

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Set out commitments that it will ensure accountability on & how
these will be delivered
Ensure that staff have competencies that enable them to meet
organization’ commitments
Ensure that people it aims to assist & relevant stakeholders
have access to timely, relevant & clear information about
organization & its activities
Listen to people it aims to assist, incorporating their views &
analysis in program planning & decisions
Facilitate ways for people it aims to assist & relevant
stakeholders to raise complaints & receive a response through
effective, accessible & safe process
Learn from experience to continually improve its program
performance

51. ▪Establishing feedback
mechanism(s) = key step towards
meeting IN standards &
strengthening projects
accountability
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POLC SIPOC
Measure
than Control
Audit /
Monitoring /
Evaluation
Accountable
>
Responsible

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