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Management Techniques and Health – 1

Lecture available here:

  • Management techniques were initially developed for organizations’ managers for ensuring efficient functioning of these organizations
  • These were found useful in health sector too, some more than others
  • Management techniques are based on:
  1. Organizational behavior and
  2. Quantitative methods

The quality and performance of health services are difficult to quantify.
Management Techniques Useful in Health Sector

Those based on organizational behavior (behavioral sciences)

  1. Organizational design
  2. Personnel management
  3. Communication
  4. Information systems
  5. Management by objectives

Those based on quantitative methods

  1. Cost benefit analysis
  2. Cost effective analysis
  3. Cost accounting
  4. Input – output analysis
  5. Model
  6. System analysis
  7. Network analysis- PERT and CPM
  8. Planning programming budgeting system
  9. Work sampling
  10. Decision taking

Organizational Design

  • ‘Organizational design’ refers to the
  • – number of departments, each concentrating on one aspect of the organization’s operations,
    – their hierarchy and
    – how do these co-operate to achieve the goal of the organization

  • An organization may be small, consisting of a few individuals or large, comprising of thousands of individuals
  • Some organizations (e.g. Govt. organizations) are ‘tall’, i.e. containing a large number of levels and a long chain of command.
  • Others are ‘flat’, i.e. limited number of levels
  • As companies grow and the challenges in the external environment become more complex, businesses processes, structures and systems that once worked become barriers to
  • – efficiency,
    – patient service,
    – employee morale and
    – Financial profitability (if any).

  • Therefore the organizational design should be:
  • – Suited to its current situation and the needs to be serviced
    – Reviewed every few years because of changing concepts, needs and technology

Personnel Management
Personnel management refers to the process of hiring and developing employees so that they become more valuable to the organization i.e. skillful use of human resources
It includes:
– Job analysis and assessing need for personnel
– Recruitment
– Selecting the right people for the job (elimination of square pegs in round holes)
– Orientation and training
– Determining and managing salaries
– Providing incentives (e.g. promotion) and motivation
– Resolving disputes and
– Communicating with all employees at all levels


  • ‘Communication’ refers to a two- way process of reaching mutual understanding, in which the participants not only exchange information, news, ideas and feelings by means of:
  1. Speech
  2. Writing or
  3. Signs
  • It’s a means of connecting people in an organization
  • It is a key function of management
  • An organization cannot operate without communication between levels, departments, employees and other sectors
  • Lack of communication can lead to medical errors which can compromise patient satisfaction and safety. Hence communication between
    1. doctor and patient
    2. Doctor and nurse
    3. Nurse and patient
    4. Communication between senior officer and junior officials
    • Instructions
    • Orders
    • Monthly reports etc.
    • Communication between directorate and health ministry
    • Compilation of disease statistics
    • Release of medical supplies and salaries
    • Communication between health ministry and rest of the government
    • For inter-sectoral coordination e.g. disaster management

    Removing communication roadblocks at all these levels helps health organization

    • functioning as a team
    • Improving efficiency and
    • Keeps motivation levels high among workers

    In fact communication delays is one of the major weaknesses in health ministries
    Information Systems
    “a system which provides the required information
    – to each level of management
    – at the right time,
    – in the right form,
    – of the desired quality and quantity
    – so as to form the basis of decision making”

    Functions of an Information System
    Collection, e.g. registering each case presenting at all OPD’s
    Classification: e.g., tabulating the above cases into categories like respiratory system cases, allergies, skin infections, dental caries etc.
    Transmission: to the appropriate level, both above and below
    Storage: filing the data
    Retrieval: e.g. for comparison of current scenario with previous years, or for research etc.
    Transformation and
    – Display of information in a form that the intended audience can understand
    – Basically making data useful for interpretation and decision making

    A good Information system can form the basis of
    – monitoring and
    – Evaluation of the health programs and
    – Give feedback at all levels so as to assist in decision making
    – Use of Computers has played a big role in in all the 7 functions of Information system listed previously
    Management by Objectives
    • Short term objectives are set for each unit and subunit comprising the organization
    • Each unit then chalks out its own plan of action for achieving these objectives in the allotted time
    • Efficient achievement of the objectives by the units and subunits contributes to achievement of the broad objective of the organization
    • Objectives are JOINTLY set i.e. in consultation with the top management and the employees
    • The objectives should be feasible and clear
    • Top management should provide support to the subunits for achieving the objectives
    MBO- Advantages
    • Measurement of performance of each unit is automatically set – the % age of the objective achieved
    • Offers motivation to the workers and sets accountability

    MBO – Disadvantages
    • Highest priority may be given to attainment of the objectives without considering even if it is detrimental to the overall goals of the organization
    • Objectives may have been set at the top level and may actually be unattainable. This would lead to frustration among the workers.
    – Hence objectives should be participatory

    MBO – an example
    • Distribution of family planning targets to each district
    – The overall target for the stage in the year was considered and then distributed among various districts
    – Setting up of targets was in actuality, not participative and the target were handed down by the top management
    – This led to under-performance as false reporting was resorted to, for achieving the overambitious targets
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