Principles of

Management
Neeraj Lal Vice President (Quality &
Strategic Alliances)
Shalby Hospitals

What is Hospital
Management???
Definition:
Management is the active
organ of leadership,
direction and decision
which faces the same
task in every organization
in every country.
Basic issues in
MANAGEMENT:
EIdentification of responsibility by
defining the goals and objectives of
the institution
EIdentification, acquisition and proper
use of the resources
EEstablishing control procedures
EExperimenting innovations
EEvaluation of performance
Impact of management
techniques:
Satisfactory (Input = Output)
Input Output
Inefficient (Input > Output)
Input
Output
Efficient and Effective
(Output > Input)
Input
Output
-Satisfactory ( average):
When output is equal to
input

-Inefficient: When output is
less than to input

-Efficient and Effective: When
output is more that to input
Appropriate Management
techniques:
Planning
Budgeting
Coordinating
Controlling
Motivating

Innovating
Experimenting
Supervising
Revolutionizing

Basic Functions:
CClinical
CAdministrative
CEducation
CResearch & Innovation
Clinical Functions:
EPatient care services for Indoor and
outdoor patients.
EThese services include clinical
examinations, investigative
procedures and also therapeutic
interventions.
EThe above services can be of
routine nature, emergency nature
and mass casualties.
Administrative Functions:
=These services also known as ancillary
services or support services.
=It includes equipment installations,
pharmacy, laboratories, Radiology,
laundry, house keeping, dietary
services security and others.
=These services are very important for
giving high quality of patient care.
Cont
=If there is disruption of any of
these services it will result in
delays, complaints, bottle
necks, higher morbidity,
higher rate of complications,
increased death rate and
patient dissatisfaction.
Education:
OIf the hospital is attached to the
medical college or affiliated to
the local university, there will be
formal training activities for under
graduates and post graduates
students of medicine, nursing,
pharmacy, occupation therapy,
physiotherapy etc.
Cont..
OUnder such circumstances
hospital needs to follow the
guidelines decided by the
medical council and fulfill certain
minimum requirements as
regards bed strength, distribution
of beds for different specialists,
staffing pattern etc.
Cont..
OEven of the hospital is not
formally designated as
teaching hospital, it is
imparting training and
learning opportunities all the
time to almost all the
category of staff members.
Research & Innovation:
Usually research is imagined as an
expensive and complicated
activity in a sophisticated
laboratory.
We need to study and implement
newer and need based
methods based on our vast
clinical experience.

About Management:
+The Hospital Management is not
confined only to profit making
organizations.
+In health care sector
management acquires slightly
different and more complicated
role as compared to profit
oriented production industry.
Aspects of Hospital Management:
Giving quality services to maintain good health.
Ensuring uninterrupted supply of (a)
consumables (b) non consumable items
Personnel Management
Maintenance of (a) Structure (b) Installation ( c)
equipment
Crisis Management, that is disaster
preparedness for (a) natural calamities (b)
accidental mishaps (c ) man made disasters.
Understand and identify scope and
limitations of given methods and act
or withhold actions to avoid wastage.
It is desirable to have a concept of
hospital without walls. This attitude
will not restrict the services for only
those who come to hospital, but
would define a specific catchments
area and would assist the occupants
to maintain good health.
Types of the Management:
EDepending upon the decision
making powers and interaction with
employees management can be
divided into 3 types:
OAutocratic
OBureaucratic
OParticipative
Autocratic Management:
Governance by one individual who
spells out details using dictatorship.
a) This management type is
b) Top heavy
c) Boss centered
d) Less concerned about employees
e) Believes in do at any cost
principle

Bureaucratic Management:
Governing person is selected and
guided by central administration.
In this type rules are given too much
importance and are followed rigidly.
In this method
a) There are lengthy procedures
b) Poor mutual trust
c) More weightage to the procedures
rather than outcome.
Participative Management:
+ Employees participate in decision
making, thus collective wisdom is
generated.
+ This type of management centered
a) Employee centered
b) Result oriented
c) Believes in mutual trust
d) Behavior is resilient.
Planning Decisions
&
Decision Making
EThe decision making process and the
working style were based on
experience, common sense and at
times informal training.

Management Tools:
-There are specific management
tools to monitor and control
programme implantation.
-In human service programmes,
management control mainly needs
to consider few aspects while
monitoring and controlling any
activity or project.

o These are:
Who dose
What
For whom
When
Where
How
At what cost
Monitoring Standards:
For the monitoring process, it is necessary
to have appropriate performance criteria
which will form the standard.
If there are well defined, preexisting
standards for comparison the same can
be used.
If standard have not been developed, it
becomes to first develop standards and
then carry out comparison.
Principles for developing
standards:
EStandard must be easy to
understand.
EThey should be easy to measure
EStandard should refer to the
(a) Important
(b) Critical
(c) Relevant activities
EStandard must be accepted or agreed
upon by all personnel concerned. i.e. (a)
Performer (b) Supervisor
EFor preparing standards, involving staff
members of both senior and junior levels is
useful because
(A) Standards become appropriate
(B) Difficulties of junior level are taken into
consideration
(C) Participatory decision creates a sense
of ownership or responsibility.

Types of Standards:
E Norms
E Criteria
Norms:
Norms are based upon earlier
experience while providing the
service.
E.g. If during duty period of 8 hours,
radiology technician can take 40 x-
ray pictures on most of the days, 40
x-rays will become a NORM.
Criteria:
wCriteria are specific performance
expectations associated with the
satisfactory method of the activity.
wE.g. Each resident doctor should be
able to give intravenous injections,
Each clerk should be able to type
out 30 x-ray reports every day.
OWhen the criteria are fixed on
specific number or target, it is not
possible to maintain arithmetical
accuracy.
OSlight variation on either side of
the target is accepted.
OThis limit of tolerance must be set
up depending on the variables.
Variables like:
Activity
Circumstances e.g. festivals,
holidays
Geographical location
Availability of Materials, expertise
etc.
Unforeseen circumstances like
Strike etc.
Effects and Advantages
of Monitoring:
+ Monitoring determines efficiency of
the ongoing activities.
+ It establishes level and standards of
performances
+ It helps in having the accountability
+ If there are discrepancies between
anticipated and actual performance
it can be detected well on time by
monitoring.
+ Monitoring helps in resource
allocation on realistic basis.
+ It identifies strong and weak areas of
programme implementation.
+ The information is useful in suggesting
modification in objectives,
procedures and operations.
+ It indicates and detects possible
undesirable effects or fringe benefits
for other activities.
Methods of Monitoring:
w Rounds (a) Planned (b) surprise
w Periodic feed back (a)
interaction with sectional head
(b) meeting to discuss the
performance (c) management
information system (d) periodic
reports
THANK YOU