Effective Hospital Management

Definition of management
 Henry Fayol (considered father of
management) defined management as
“To manage is to forecast and plan, to
organise, to command, to coordinate and
to control”
 Task of management:
 Determining the goal and objectives of the
enterprise,
 Acquisition and utilisation of resources
 Instituting communication systems,
 Determining control procedures, and
 Evaluating the performance of the
enterprise
 Principles of management(14
principles by Henry Fayol)
1. Division of work: The work assigned to each worker should be clearly
defined. All work thus gets performed efficiently with gradual
development of competence and skills called specialisation

2. Authority & Responsibility: Authority and responsibility are

inseparable, with the latter arising from the former. Without authority
one cannot discharge responsibility.

3. Discipline: Discipline should be observed at all levels. Managers and

administrators should set the good example through their actions and
behaviour.

4. Unity of Command: This means that employees should receive orders

from one superior only. (normally his immediate boss)

4. Unity of Direction: The ultimate objective and goal of the an

organisation should be same and known to all. All employees
irrespective of department should head towards that goal.
6. Centralisation of authority: This refers to the extent
to which authority is concentrated or dispersed. It
should be clear in the organisation as to who is to
issue orders and the areas of authority.
7. Scalar chain: The chain of supervisors from the
highest to the lowest ranks in the organisation.
8. Order: This is “a place for everything and everything
in its place.
9. Remuneration: Equal pay for equal work. Each
person should be paid according to his contribution.
10. Stability of tenure: The employee requires assurance
about permanent nature of the job, resulting in a feeling
of security and involvement in work.
11. Delegation of authority: Because mangers manage
through work of others, there should be delegation of
authority.
12. Initiative: Employees should be given opportunities for
use of creative ideas in work.
13. Subordination of individual interest to organisational
interest
14. Equity: Subordinates must be treated equal without
any bias of race, religion or gender.
 Managerial Activities of a Hospital
 Determination of goals and objectives: concerns
with policy making.
 Facility and programme planning: Deals with
remodelling existing services, organising new
facilities, services and programmes.
 Financial management: Relates to financial
affairs like budgeting and costing
 Personnel management: This category relates to
selection, motivation and guidance of
employees. Includes wage and salary
administration.
 Coordinating departmental operation: deals with
internal functioning of all hospital departments.
 Programme review and evaluation: relates to the
clinical services and programmes, and is a
continuous process.
 Health industry activities: This classification
refers to activities that are external to the
hospital. Includes participation in hospital
associations, third party players (insurance co.s)
 Govt. related activities: concerned with the legal
problems of the hospitals and dealing with local,
state and central government agencies.
 Planning
 Planning, the foremost of management
functions which enables the organisation
to deal with the present and anticipate the
future.
 Through this process the management
decides where it is at present, and where
it wants to be at some time in future
 Involves six questions:
 What we expect to do?
 Why will it be done?
 Where will it be done?
 When we expect to do it?
 How will it be done?
 The purpose of planning
 To assure the most efficient utilisation of
resources.
 It involves choice of objectives along with
policies, strategies, programmes, procedures
and rules that are necessary for its
accomplishment.
 Forecasting of demand
 Types of Planning
 Strategic Planning: Concerned with developing
the main mission of the organisation. Done at
top level. Has wider perspective.e.g. Where
would the hospital like to be in ten years? What
speaciality programmes it would like to start.
 Operational Planning: It focusses on programme
formulation and implementation. Concerns with
implementing the strategic plan.
 Step by step approach to planning
1. Analysis of the situation
2. Identifying priority problem
3. Formulating objectives
4. Setting goals
5. Reviewing constraints
6. Laying down operational policy &
systems
7. Writing down the plan
 Planning Cycle
 Planning is best thought of as a cycle, not a straight-
through process.
 Once a plan has been devised it should be evaluated.
This evaluation may be cost or number based, or may
use other analytical tools.
 This analysis may show that the plan specified may
cause unwanted consequences, may cost too much, or
may simply not work.
 In this case the planning process will have to cycle back
to an earlier stage, or the plan may have to be
abandoned altogether - the outcome of your planning
may simply be that it is best to do nothing!
Planning Cycle