modern management technique tells us about the management techniques and its implication in health field. From Statistical methods to SWOT analysis is explained with example. It also tells about log frame and cost benefit and cost effective analysis

1. 1

2. 2

3. ACTIVITIES OF A MANAGER
Planning Organizing Communicating Monitoring
3

4. 4

5. 1.
2.
3.
4.
5.
5

6. STATISTICAL TECHNIQUE
1. TIME TRENDS AND FORECASTING
2.DECISION THEORY AND TREE
3.SIX SIGMA
6

7. TIME TRENDS AND FORECASTING
•
•
•
7

8. 8

9. DECISION THEORY AND DECISION TREE
•
•
9

10. Determine all possible alternatives and associated risks
Estimate the cost of each alternatives
Determine the uncertainties associated with each alternatives
Draw a diagram based on these steps
Determine the best alternative and all consequences 10

11. DECISION TREE ANALYSIS
Breast cancer
Screening
test
No Cancer
Cancer
Low Cost +
Life Saving
No screening
test
Cancer
High cost +
Life Lost
No cancer
10,000
- 10,000
- 100,000
+ Life
-200,000
- Life
0
11

12. disease
Surgery
Death
Survive
Cured
Not cured
Drugs
Cured
Not cured
Counsel
Drug 2
Cured
Not Cured
0
15
0.5
13
1.5
10
1
12

13. SIX SIGMA APPROACH
•
•
•
13

14. Define
Measure
Analyze
Improve
Control
SIX SIGMA APPROACH
Define
Measure
Analyze
Improve
Control 14

15. •
•
•
• 15

16. • TIME STUDY IS A DIRECT AND CONTINUOUS OBSERVATION OF A TASK, USING A
TIMEKEEPING DEVICE (EG: STOPWATCH) TO RECORD THE TIME TAKEN TO
ACCOMPLISH A TASK AND IT IS OFTEN USED WHEN:
1. THERE ARE REPETITIVE WORK CYCLES OF SHORT TO LONG DURATION,
2. WIDE VARIETY OF DISSIMILAR WORK IS PERFORMED, OR
3. PROCESS CONTROL ELEMENTS CONSTITUTE A PART OF THE CYCLE. 16

17. Other
work
suffer
Other
work
Scene 1 Scene 2 17

18. WORK SAMPLING AND ACTIVITY ANALYSIS
• The technique of time motion study which examines a
single activity of a worker at a time can be extended to
study the total activities carried out during a work day
• The method makes use of sampling to estimate the time
spent on different categories of activities by a worker
during working
18

19. 21 % Bedside Nursing
30 % clerical work
Rest in other works
19

20. QUEUING THEORY
A queue is a line that persons or products have to wait in, before
being serviced
Each person servicing an individual in the queue is called a channel.
In a factory when a series of processes is to be carried out sequentially
the job has to move from one place to another.
The time required for the processes to be carried out at different
places may vary.
The job thus may join the queue waiting their turn to be processed at
different rates at different places.
20

21. Reception time
(10 min)
Consultation time
(20 min)
Medical Store time
(20 min)
21

22. • GANTT CHART IS AN ADAPTABLE TECHNIQUE DEVELOPED BY
FRENCHMAN HENRY L GANTT WHO WAS PIONEER OF SCIENTIFIC
MANAGEMENT.
• IT WAS A USEFUL TECHNIQUE ESPECIALLY WHERE PRODUCTION
DEADLINES ARE TO BE MET AND A WATCH IS TO BE KEPT ON
ATTAINMENT OF TASKS IN TIME. 22

23. • IT IS USED TO ASSIST CONTROLLING THE QUANTITY OF
WORK IN RELATION TO TIME.
• IT IS A DEPICTION OF WORK PLANNED AND WORK CARRIED
OUT IN RELATION TO EACH OTHER AND IN RELATION TO
PASSAGE OF TIME FROM A STARTING POINT. 23

24. Activity April – Sept 16 Oct – March 17 April – Sept 17 Oct – March 18
Q1 Q2 Q3 Q4 Q5 Q6 Q7 Q8
Performa
Formation
X
Questionnaire X X X
Field Work:
prevalence
X X
Randomized
Control Trial
X X X
Data Analysis X X
Final thesis X
24

25. MATHEMATICAL MODELS
Simulation study
Systems analysis
Linear programming
Inventory control
Precedence and arrow diagramming method
Network analysis
Program evaluation review technique / Critical Path method 25

26. • THIS METHOD MAKES USE OF MATHEMATICAL MODELS WHICH ENABLE
COMPUTATION OF RESULTS OF VARIABLE VALUES OF DIFFERENT
MATERIAL FACTORS
• REAL SITUATIONS ARE INVARIABLY SO COMPLEX THAT IT IS ESSENTIAL TO
SIMPLIFY, TO SELECT AND ISOLATE CERTAIN FEATURES OF REALITY TO
DEVELOP A MORE OR LESS IDEALIZED SITUATION.
• THIS MODEL IS A SYMBOLIC REPRESENTATION OF AN IDEALIZED SYSTEM.
26

27. • THE IMPACT OF THE CHANGES ON THE TOTAL OUTPUT CAN THUS BE
ESTIMATED.
• THE METHOD HAS FOUND APPLICATION IN HEALTH FIELD, FOR
PLANNING AND EVALUATION OF IMMUNIZATION AND SANITATION
PROGRAM FOR CONTROL OF TYPHOID FEVER AND OTHER BACTERIAL
DISEASES
27

28. • NUMERICAL VALUES ON KNOWN
EVIDENCE WERE ASSIGNED TO
PARAMETERS TO PROVIDE REALISTIC
SIMULATION OF STABLE ENDEMICITY
• CHANGES WERE INTRODUCED IN
SOME PARAMETERS TO STUDY THE
RELATIVE EFFECT OF MASS
VACCINATION AND SANITATION
IMPROVEMENT ON INCIDENCE OF
TYPHOID FEVER.
28

29. • An institution, activity or organization can be viewed at with
the systems approach.
• It is accepted that the functioning of the whole organization
is dependent upon a harmonious, balanced and integrated
functioning of the various constituent components.
29

30. USES
Defense problems
Public administration
Health sector reforms
Area development projects
30

31. • LINEAR PROGRAMMING IS A SPECIAL CASE OF MATHEMATICAL PROGRAMMING IN
WHICH THE RELEVANT COMPONENTS OF THE SYSTEM ARE SHOWN BY LINEAR
FUNCTIONS
• THE MEASURE OF PERFORMANCE IS A LINEAR EQUATION AND RESTRICTIONS ON
RESOURCES ARE ALSO EXPRESSED AS LINEAR EQUATION.
• IT IS A USEFUL TOOL FOR DECIDING THE COURSE OF ACTION FOR A PROBLEM IN
WHICH THERE ARE COMPETING ALTERNATIVE USES FOR LIMITED RESOURCES.
31

32. • IF LINEAR RELATIONSHIP IS ASSUMED THEN MATHEMATICAL TREATMENT
AS USED IN THE TECHNIQUE CAN GIVE AN OPTIMAL SOLUTION.
• THIS METHOD IS A PERSPECTIVE METHOD I.E AN OPTIMAL SOLUTION IS
SUGGESTED SUBJECT TO VARIOUS FINANCIAL, HUMAN OR BIOLOGICAL
CONSTRAINTS.
• USE; THIS TECHNIQUE HAS BEEN USED FOR CHOICE OF STRATEGIES FOR
CONTROL OF TUBERCULOSIS
32

33. INVENTORY CONTROL
The application of quantitative methods for reduction of expenditure
on maintaining a stock of different items and supplies required in a
health institute or a hospital proves useful.
Various types of items are required for providing services.
The right item must be available in right quantity when
needed.
A large stock can prevent the condition of out of stock but
the cost of maintaining the inventory will be high.
33

34. PRECEDENCE AND ARROW DIAGRAMMING
METHOD
The Precedence diagramming Method (PDM) consists of constructing a project
network diagram, using boxes or rectangles called nodes to represent the
activities.
These are connected with arrows which show the
dependencies.
This is also known as activity on node 34

35. PRECEDENCE AND ARROW DIAGRAM
Start
1 2 3
4 5 6
Finish
Nodes
Depends on 2 : Activity
on node
35

36. DEPENDENCIES ARE OF VARIOUS TYPES
Finish to start
Finish to finish
Start to start
Start to finish 36

37. NETWORK ANALYSIS
• COORDINATION IS A BASIC REQUIREMENT OF MANAGEMENT.
• PLANNING AND MONITORING THE PROGRESS OF A LARGE
NUMBER OF DIFFERENT INTERRELATED ACTIVITIES NECESSARY
FOR THE COMPLETION OF A PROJECT WITH TIME AND
MINIMUM COST IS DESIRABLE.
37

38. NETWORK ANALYSIS
THE BASIC PRINCIPLE OF NETWORK ANALYSIS IS A SIMPLE
ONE. IT IS TO SHOW DIAGRAMMATICALLY THE LOGICAL
SEQUENCE IN WHICH DIFFERENT EVENTS NECESSARY BETWEEN
THE START AND THE END OF A PROJECT NEED TO TAKE PLACE.
38

39. NETWORK ANALYSIS
• THE TIME REQUIRED FOR ACCOMPLISHMENT OF DIFFERENT TASKS CAN
ALSO BE CONSIDERED IN NETWORK ANALYSIS
• WHEN THE ELEMENT OF TIME IS INTRODUCED, THIS MANAGEMENT
TECHNIQUE BECOMES MORE POWERFUL
39

40. Decision to start Measles
Vaccination
Availability
of Fund
Establishment of
cold chain
Knowledge of Public
Perception
Local
epidemiological
information
Development of health
education material
Development of
training material
Identification of
Staff
Establishment of
Surveillance
Availability of
Vaccine
Public
Acceptance
Trained Staff
Monitoring evaluation
and Feedback System
Vaccination
Program
40

41. PROGRAM EVALUATION REVIEW TECHNIQUE (PERT)
AND PROGRAM EVALUATION PROCEDURE (PEP)
• PERT AND PEP TECHNIQUES WERE THE INNOVATIONS AFTER WORLD
WAR II
• THE CONSTRUCTION OF EXPENSIVE, LARGE SIZED POLARIS SUB
MARINE PROJECT OF USA WITHOUT PRECEDENCE IN THE SHORTEST
POSSIBLE TIME NECESSITATED THE DEVELOPMENT OF THIS TECHNIQUE.
ITS USE REDUCED THE TIME BY 2 YEARS.
41

42. PERT
It consists of identification of various events necessary in the final achievement of an
objective
A directed network of flow diagram consisting of events is shown by circles or square in
their logistic sequence is drawn.
Activities which are time consuming elements of the project are shown as arrows to
connect these events
Some events depend upon achievement of one single prior event while some others
require the completion at two or more prior events.
An estimate is made using a special method, which gives a 50 % probability of correct
estimate of time. 42

43. The critical path method was developed for establishment of chemical
plants most economically by coordination and control of different
activities
It had the reduction of cost as primary objective.
The periods required for accomplishment of tasks are expected to be
known from prior experience 43

44. The points in CPM network represent activities rather than events as done in
PERT.
The critical path method is made up of activities that can not be delayed
without delaying the completion of the project
Another way to describe a float is that it is the maximum amount of time an
activity can slip without pushing out the completion date of the project. 44

45. PERT CRITICAL PATH METHOD
NETWORK DESIGN IS BASED ON
EVENTS
NETWORK DESIGN IS BASED ON
ACTIVITIES
TIME REQUIREMENTS ARE ESTIMATED TIME REQUIREMENTS ARE EXPECTED
TO BE KNOWN FROM PAST
EXPERIENCES
THE SHORTEST POSSIBLE TIME AT ANY
COST IS OBJECTIVE OF PERT
OPTIMUM MIX OF TIME AND COST IS
VITAL IN CPM TO ACHIEVE ECONOMIC
RETURN
45

46. FINANCIAL TECHNIQUES
BUDGETING
MONITORING EXPENDITURE
COST ACCOUNTING AND ANALYSIS
COST BENEFIT ANALYSIS
COST EFFECTIVE ANALYSIS
PERFORMANCE BUDGET
PPBS
ZERO BASE BUDGETING
INPUT – OUTPUT ANALYSIS
OUTCOME BUDGET
46

47. BUDGETING
• A BUDGET IS A FINANCIAL DOCUMENT USED TO ESTIMATE FUTURE
INCOME AND EXPENSES FOR A SPECIFIED PERIOD WHICH IS USUALLY A
YEAR.
• THE 2 BASIC ELEMENTS OF ANY BUDGET ARE THE REVENUES /
RECEIPTS AND EXPENSES
47

48. Principle of annuality
Principle of comprehensiveness
Principle of specification and clarity
Principle of presentation of budget demands in gross terms
Principle of accuracy and actuality
48

49. Principle of non diversion of funds
Principle of periodic review and corrective actions
49

50. This is a management techniques which has attracted the
widest attention for application in the health field.
The economic benefits of any program are compared with
the cost of that program
The benefits are expressed in monetary terms to determine weather a
given program is economically sound or not and to select the best
alternative program 50

51. DISEASE MORBIDITY
MORTALITY
LAB INVESTIGATIONS
DRUGS
RUPEES
51

52. INTENSIFIED SMALL POX CAMPAIGN
(1973 – 1975)
REDUCED COST BY
Rs 1058 MILLION
ELIMINATION REDUCED COST BY
Rs 728/- MILLION
COST BENEFIT ANALYSIS OF SMALL POX
52

53. COST BENEFIT ANALYSIS
•
53

54. COST EFFECTIVE ANALYSIS
• THIS IS A MORE PROMISING TOOL FOR APPLICATION IN THE HEALTH
FIELD THAN COST BENEFIT ANALYSIS.
• IT IS SIMILAR TO COST BENEFIT ANALYSIS EXCEPT THAT BENEFIT,
INSTEAD OF BEING EXPRESSED IN MONETARY TERMS IS EXPRESSED IN
TERMS OF RESULTS ACHIEVED.
54

55. COST EFFECT
DDT
REDUCED MORTALITY AND
MORBIDITY DUE TO
MALARIA
VACCINATION REDUCED MORTALITY AND
MORBIDITY DUE TO VPDs
55

56. •
•
56

57. •
•
•
57

58. COST ACCOUNTING
ANALYSIS OF 35
DISEASES
COST OF
TREATMENT OF
EACH DISEASE
IT WAS A FRACTION OF
THE CLAIM FROM
INSURANCE COMPANIES BY
PATIENTS
58

59. INPUT OUTPUT
ANALYSIS
•
•
•
•
59

60. MANPOWER
DOCTORS
NURSES
PARAMEDICAL STAFF
MATERIAL
INFRASTRUCTURE
VACCINES / DRUGS
MONEY
MORTALITY
MORBIDITY
OOP
60

61. ZERO BUDGET APPROACH
•
61

62. Planning Programming budgeting System
(PPBS)
The Planning Programming budgeting System (PPBS) is
primarily a system to help decision makers to allocate
resources so that the available resources of an organization
are used in the most effective way in achieving its objectives.
62

63. Management by objectives and appraisal by results
Management by exception
Situational analysis
Current state assessment
SWOT / SWOC analysis 63

64. • For bringing about an improvement of the performance of
an organization, Strategic Planning has to be carried out.
• SWOT analysis helps in this process
64

65. • GAPS BETWEEN CURRENT SITUATION AND IDEAL
SITUATION BECOMES CLEAR
• HELPS TO DEVELOP ACTION POINTS TO BRIDGE THE GAPS
• COMPARE TWO OR MORE ORGANIZATION
65

66. S W
T
Strengths
Opportunities Threats
O
Weaknesses
66

67. S
WIDE NETWORK
OF ASHA
WORKERS
IMPROVED
PROGRAM
MANAGEMENT
FLEXIBLE
FINANCING
DECENTRALIZED
MANAGEMENT OF
HEALTH FACILITIES
IPHS STANDARDS
FOR SUB
CENTERS, PHC
AND CHC
INNOVATIONS IN
HUMAN
RESOURCE
MANAGEMENT
SWOT ANALYSIS :
NATIONAL HEALTH MISSION
67

68. W
LACK OF INTEGRATION
WITH OTHER
DEPARTMENTS
CHC NOT DEVELOPED
TO THE LEVEL OF FRU’S
DUE TO LACK OF
SPECIALISTS
INADEQUATE
COMMUNITY
PARTICIPATION
WEAK COMMUNITY
MONITORING SYSTEM
WEAK LOGISTIC
AND SUPPLY CHAIN
MANAGEMENT
INADEQUATE CAPACITY AT
DISTRICT, CHC, PHC AND
SUB CENTER TO PREPARE
HEALTH ACTION PLANS AT
LOCAL LEVEL
Weaknesses
SWOT ANALYSIS
68

69. O
REFORMS IN
HEALTH
SECTOR
BETTER HEALTH
FINANCING
SYSTEM
STRENGTHENING
SUB CENTERS,
PHC, CHC
RESRTUCTURING
HEALTH CARE
DELIVERY SYSTEM
Opportunities
SWOT ANALYSIS
69

70. T
LACK OF WORKFORCE
MANAGEMENT POLICIES
LEADS TO HIGH ATTRITION
RATE
STAGNATION OF TRAINING
PROGRAMS DUE TO LACK
OF INSTITUTIONAL
CAPACITY
LOSS OF BUREAUCRATIC
CONTROL OVER THE SC,
PHC & CHC AS PRI’S
TAKEOVER
MANAGEMENT
Threats
SWOT ANALYSIS
70

71. SWOT ANALYSIS HELPS TO IDENTIFY THE WEAKNESS IN
THE PROGRAM AND HELPS TO FILL THE GAPS SO
DISCOVERED IN THE ANALYSIS TO IMPROVE THE
SYSTEM OF HEALTH CARE DELIVERY
71

72. LOGICAL FRAMEWORK
• LOGICAL FRAME WORK SIMPLY CALLED LOG FRAME IS A METHOD
USEFUL FOR BRINGING ABOUT CLARITY IN THE PROCESS OF PLANNING
AND EVALUATION.
• IT COMPRESSES THE ENTIRE PROGRAM BEING PROPOSED IN A SUMMARY
FORMAT.
• IT HAS BEEN USED BY UNDP, UNFPA, PRIVATE ORGANIZATIONS AND
FUNDING AGENCIES.
• IT IS A MATRIX WITH 16 CELLS.
72

73. 73

74. Project Description Indicators Source of
Verification
Assumptions
Overall objective :
Impact of a capacity building package
on malnutrition status among children
of 1-2 years of age.
1. Weight for age
2. Height for age
3. BMI for age
WHO Growth
charts
Purpose:
To reduce child mortality and
morbidity
1. Infant Mortality in
Control and
Intervention Group
Number of
infant deaths
Reduction in child
mortality
Results:
Reduction in Malnutrition in children
aged 1-2 years
1. Nutrition Status of
children after 1
year of
intervention
Number of
malnourished
children
Reduction in the
malnutrition
Activities:
A randomized control trial using
capacity building package for mothers
Increase in the
adoption of good
maternal and infant
practices
74

75. THOUGH THE APPLICATION OF MANY OF THESE MODERN TECHNIQUES
REQUIRES THE SERVICES OF A SPECIALIST, IT IS AN ADVANTAGE IF HEALTH AND
HOSPITAL ADMINISTRATORS HAVE SOME ELEMENTARY KNOWLEDGE AND
APPRECIATION OF THE PURPOSE, METHODOLOGY, USEFULNESS AND
LIMITATIONS OF COMMONLY USED TECHNIQUES.
75

76. 76