resource

1. Unit Seven:
Managing Resources for Health
1

2. 7.1. Human Resource Management
2

3. Human Resource Management
Session objectives
 Define human resource management
 Identify components of HRM activities/functions
 Describe different stages of disciplinary actions
 Discuss on performance appraisal types
3

4. Human Resource Management
• The process of attracting, developing and maintaining a
talented and energetic workforce to support
organisational mission, objectives and strategies.
• HRM is supplying organizations with the right people in
the right position, when they are needed.
• HRM is the integrated use of procedures, policies and
practices to recruit, maintain and develop employees to
meet the desired goals of the organization.
4

5. HRM…
HRM includes seven basic activities
1. Human resource planning
2. Recruitment
3. Selection
4. Socialization (Orientation)
5. Training and Development
6. Performance Appraisal
7. Promotions, Transfers, Demotions, and Separations
5

6. 1. Human Resource Planning
• Planning for the future personnel needs of an organization
taking into account analysis of both internal and external
factors.
• Human Resource Planning includes the estimation of
numbers and categories of personnel required both in the
immediate and long-term and the allocation of resources
to train and pay these staff.
6

7. Approaches used in calculating health personnel
requirements
• Health needs approach
• Human resource to population ratios
• Service targets
7

8. 2. Recruitment
• Recruitment: Process of searching /attracting
potential candidates to fill the vacant position in
accordance with HRP
• Recruitment includes:
1. Job description: is a written document that
shows the nature and characteristics of the
task to be performed.
2. Job specification: a written description of the
education, experience, and skills needed to perform
perform a job or fill a position effectively
– Note: Every employee should be provided with a
job description. 8

9. HRM…
Methods of recruitment
• Peer recruiter (advantage: well informed person
is identified)
• Within the organization (advantage: familiar,
inspiring, less expensive)
• Outside the organization (e.g. colleges, graduate
schools, other organizations)
• Formal announcement (mass media)
9

10. Legal considerations
1. Prohibiting discrimination by: Race, Sex, Age,
Colour, National origin
2. Equal employment opportunity, which should
apply to both public and private sectors.
3. Affirmative action for like job for women, disable
persons
4. Comparable worth /equivalent/: Different jobs that
require comparable skills and knowledge deserve
comparable pay ( like pay for like job) 10

11. 3. Selection
• It is the process of choosing individuals who can
successfully perform a job from available candidates
• It is a crucial process in management and requires constant
attention, interest and concern of management.
• The three sources of information used in selection are
application forms, pre-employment interviews and
testing
11

12. 4. Introduction (Socialization) and
Orientation
• When the candidate is selected and offered a job, it is
necessary to introduce the new employee to the rules and
polices, etc of the organization.
• Thus, before the employee begins his/her work, he/she
should be assimilated /full understand/ to job and
organizational environment.
 Introduce employee peers, superiors & subordinates.
• Orienting him/her to the new working environment.
12

13. Socialization…
Employee’s concerns:
• Anxious (new environment)
• Perception of the tasks and performance
• Experience in relation to job & organization
• How to go along with other employee
• Personal and family problems
13

14. 5. Training and development
Training begins at the first day, which is designed to
improve the person’s skills and knowledge to do the current
job at high level.
Designed to provide learners with the knowledge and skills
needed for their present jobs – formal and informal.
 Development refers to the organizations efforts to help
employee’s acquire knowledge, skills and behavior that
improve their ability to meet changes in job requirements
and customer needs. Involves learning that goes beyond
today's job – more long-term focus.
14

15. Training and Development…
Approaches to training
On-the-job training
 Job rotation: Employees move from one job to another to
broaden experience.
 Helps new employees understand variety of jobs
 Internship: Combined classroom teaching, that offer students the
opportunity to gain real-life experience while allowing them to
find out how they will perform in work organizations.
 Apprenticeship: training under guidance of skilled co-worker
15

16. Training and Development…
Off- the-job training
• Vestibule training: training on realistic job setting or equipment.
• Behaviorally experienced training: simulation exercises, cases,
games, role-playing (done outside the organization).
16

17. Training and Development
Procedures to determine training needs of individuals:
1. Performance appraisal
2. Analysis of job requirements
3. Organizational analysis
4. Employee survey
17

18. 6. Performance Appraisal
18

19. Performance Appraisal
 The process by which an employee’s contribution to the
organization during a specified period of time is assessed.
 It is the process through which a manager measures employees’
activities and output against organizations objectives.
 It involves measuring actual performance of an employee and
providing information about his/her strengths and weakness.
 It is systematic, periodic review and analysis of employees’
performance.
19

20. Performance Appraisal…
Purpose:
• To give feedback,
• To recognize outstanding performance,
• To locate the need for additional training
• To identify candidates for promotion
20

21. Performance appraisal …
Types: informal appraisal and formal systematic appraisal
• Formal appraisals
– An appraisal conducted at a set time during the year and
based on performance dimensions that were specified in
advance(usually semi-annually or annually)
• Informal appraisals
– An unscheduled appraisal of ongoing progress and areas for
improvement
21

22. Who Appraises Performance?
• Self
– Self appraisals can supplement manager view.
• Peer appraisal
– Coworkers provide appraisal; common in team settings.
• 360 Degree
– A performance appraisal by peers, subordinates, superiors,
and clients who are in a position to evaluate a manager’s
performance
22

23. Why Performance Appraisal Fails?
Insufficient
Rewards
Manager
not
prepared
No on-
going
feedback
Mgr not
honest
or
sincere
Ineffecti
ve
discussi
on
Lack
appraisal
skills
Mgr
Lacks
Inform
ation
Fear of
Hurt
Feelings
Ineffective
Application
of
Standards
23

24. Poorly Implemented PM Systems
• False and misleading information
• Increased turnover
• Wasted time and money
• Damaged relationships
• Decreased motivation
• Job dissatisfaction
• Risk of litigation
• Unfair standards
24

25. 7. Promotion, Transfer, Demotion and Separation
Promotion
• Moving to a higher position and responsibility
• Recognize outstanding performance
Transfer
Shift to other positions without change in status or pay.
• For experience
• To fill gap
• To keep promotion ladders open
• To keep individuals interest in the job sometimes, for
those with inadequate performance
25

26. Discipline, Demotion and Separation
When the organization’s policy is violated.
Steps:
• Warning
• Admonishment-Counseling/Advising
• Probation Testing
• Suspension
• Disciplinary transfer
• Demotion
• Discharge/separation
“For poor performance, separation is better than letting the
employee stay on the job”.
26

27. 7.2. MANAGEMENT OF FINANCE
27

28. Objectives
 Define Finance, Budget and Budgeting.
 Describe the different types of budgeting
 Mention the different models and codes of line
item budgeting
28

30. Financial Management
 one of the useful resources for running Health
Sector Organizations is finance.
 It needs to be handled and managed properly.
30

31. Why FM is Important?
• Could not implement our plans with out finance.
• To be more accountable to donors
• Gain the respect and confidence of funding
agencies, partners, beneficiaries
• Give the HSO a competitive advantage for
increasingly scarce resources
• For financial sustainability
31

32. Financial Management…
Who Is Responsible For Financial Management?
• Managers are more responsible to use it more
effectively and efficiently.
• Given in the form of budget.
32

33. Budget
 An estimate of income and expenditure for a
specified period of time.
• Budget is a plan for the allocation of resources
and a control for ensuring that the results
comply with the plans.
The results are expressed in quantitative
terms.
Budgeting – is the process of planning and
controlling future operations by comparing
actual results with planned expectations.
33

34. Types of Budget
1. Revenue Budget: It is the organization’s
of expected revenues for the coming year. e.g. taxes,
surpluses, etc.
2. Expenditure Budget
A. Recurrent expenditures: activities that are
recurring and continuous in nature (like
salaries of civil servants)
B. Capital expenditures: Short-term activities
that are project in nature are included in
capital budget (e.g. construction of roads,
buildings or other infrastructures) 34

35. BUDGET Cont…
Other types
1. Line-Item Budgeting:
• Fixed amount of money is allocated to a given item &
expenditure.
 Has a number of advantages: First, it promotes control since the budget is
detailed down to particulate expenditure items.
• The use of the budget of one line item for another may require the
verification of both the finance and health office.
2. Program Budgeting.
• Budget is allocated for the program/project rather than for
specific items.
• used by large organizations
• flexible decisions
• usually obtained from aids and funds
35

36. Line-item budgeting in Ethiopia
The Ethiopian government prepares its
revenue and expenditure budgets using
Line item budgeting.
In line-item budgeting a fixed amount of
money is allocated to a given item.
Expenditures above the allocation or
transfer of allocation, whole or in part,
from item to another is impossible without
prior request and authorization from
government.
36

37. Budgeting Techniques
1. Incremental budgeting
• This approach bases any year’s budget on the
previous year’s actual, or budgeted, figures with
an allowance for inflation and known changes in
activity levels
• Most useful for organisations where activity and
resource levels change little from year to year
37

38. Budgeting Techniques
2. Zero-based budgeting
• Start with a clean sheet – a zero base.
• Zero-base budgeting (ZBB) ignores previous
experience and starts with next year’s targets
and activities
• May suit organizations going through a period
of rapid change
38

39. BUDGET…
• Budget Cycle
- Budget preparation
- Budget compiling and approval
- Budget execution
- Budget audit
Fiscal Year: A specified 12-month period during which
operational and financial performance is measured.
 Budget allocated has to be used within this time.
39

40. Budget Cycle:
1. Budget
preparation
2. Budget
compiling
&
approval
3. Budget execution
(implementing)
4. Budget audit
(evaluation)
40

41. AUDIT
WHAT IS AN AUDIT?
 An independent examination of records, procedures and
activities of an organization resulting in a report on the
findings.
Why do we need audit?
• Accountability
• Credibility
• Transparency
• Legal requirement.
41

42. Coding the line item budget
There are three major line of item Coding
• 1000: Revenue items
• 6000: Items for recurrent budget:
e.g. 6101, 6102, 6201, 6202, 6301
• 8000: Item for capital budget
42

43. Line Item Budgeting
Once approved-money can not be transferred from one category
of item to another
61: Item for salaries
6101: Salary for civil servants
62: Line item for diff, services (Budget)
6201: Item for postage, water, telephone and electric bill
6202: Transport and per diem
6203: Information advertisement and publication
6204: Equipment, building and fence repair and maintenance
6205: Repair and maintenance of vehicles
6206: For rent
63: Line item for expendable items
6301: For food
43

44. Line Item Budgeting...
6302: Drugs and equipment
6304: For clothing
6305: Fuel for cars
6306: For stationers
6307: Contingency fund for which item not set for
64: Item for supportive fund
6401: For individual support
6402: For organization support
6403: For international organization support
65: Line item for non-expendable items
6501:For parches of cars
44

45. Line Item Budgeting...
There are six major items or recurrent budget
6000: Recurrent Budget
6100: Expenditure for social service
6200: Non-social contract based service
6300: Expendable (consumable) goods and
equipment
6400: Support and contribution
6500: Purchase of vehicles and machines
6600: Military construction works and equipment
45

46. Line Item Budgeting...
8000: Capital Budget
8100: Surveying, surveillance, Design and Engineering works
8101: Preliminary studies and surveillance
8102: Engineering works and technical designs
8200: Building construction and related works:
8201: Residential Buildings
8205: Transport equipment (vehicles. etc)
8300: Labour and running expenses:
8301: Management and Control
8304: Financial expenses:
8400: Capital Transfer:
46

47. Models dealing with property and finance
• Model 20:Model for requesting items/drugs
• Model 21:Model for approving item delivery by
person in authority
• Model 22:Model for issuing items/drugs
• Model 19: Model for confirming delivery of items
• Model 33: (Pay roll) – payment of salary
• Model 85: to deposit money
• Model 86 : to release deposited money
47

48. 7.3. Managing Time
48

49. Session objectives
• Understand the concept of time management
• Explain benefits of time management
• Describe strategies of effective Time management
• Understand time management matrix
• Obstacles to effective time management
49

50. Time management
50

51. Time
• It is a non-renewable resource
• No event can take place unless there is time for it.
• Using time efficiently requires managerial skills.
• Time can not be stored
• Time is equally shared to people
NB- Our ability to manage our time is the ONE to
make difference in life
51

52. What is time management?
 It is the ability to decide what is important in life, both at
work, in our home and personal life.
 Simply, it is devoting most of time and energy for the
bold goal.
• It is not a way to make you work harder and longer, but a
means to help you work smarter to accomplish your
work more easily and rapidly.
• Spending time on important, not just urgent matters
52

53. 53

54. Time Management…
 Efficient time use
• Plan the time daily
• Prioritize activities
• Time for important one
• Set recording system
• Resources before start
• Do one activity at a time
• Decide time limit for
every activity
• Take rest whenever
necessary
 Inefficient time use
• Disorganized desk and
cluttered files
• Wrong appointments,
• Lack of delegation,
• Stress/ tiredness ,
• Counting saying no as
guilty,
• Getting early or staying
late at work,
54

55. The Benefits of Time Management
Yes!
 Increases productivity,
 Reduces stress,
 Improve self-esteem,
 Avoids meltdowns,
 Develops confidence,
 Reach goals.
Achieve Balance in your life.
55

56. Time Management…
Strategies to Effective Time Management
1. Set Goals
2. Set priorities
3. Plan your time
4. Avoid Procrastination
5. Delegation
56

57.  Start with big, then set smaller
goals.
 Make your goals specific and
concrete.
 Set both long and short-term
goals support one other.
 Integrate your goals: school,
personal and career.
 Set a deadline for your goals.
Go for
the goal!
Where to start?
1. Set Goals!
57

58. 2. Set priorities
• Select what’s important and what is not?
• What order do things need to be done?
• Based on your priorities, plan out a schedule for
the time period
• Planning may seem hard at first, but the more
you do it, the easier and more natural it gets.
Time Management…
58

59. Time Management…
3. Plan your time
 Begin with blocking/portion/ all activities.
 Consider: office work, field work, social
work, religious worships, meetings, so on.
 Highlight all project due dates.
 Identify routine work days.
 Avoid temptation to socialize when
you’ve scheduled work.
No! I have a
study group
tonight. Are
you free on
Thursday?
59

60. Time Management…
3. Plan your time…
 common ways of time plan arrangement:
 Time table:- used for daily/weekly recurring and
regular events, e.g. staff meeting, classes, etc.
 Schedule:- for intermittent, irregular or variable
events, e.g. visit to peripheral health centers.
 Program: - Long term arrangements of events e.g.
TTP, apprentice, semester break, etc.
60

61. Time Management…
4. Avoid Procrastination
• “Procrastination is the theft of time” – it is a time
waster.
• It is the act of postponing tasks that could have been
done now.
 Note: Deadlines are really important, doing things at
the last minute is much more expensive than just
before the last minute
61

62. Time Management…
4. Avoid Procrastination…
Forms of procrastination:
 Ignoring the task, hoping it will go away.
 Underestimating how long it will take.
 Overestimating your abilities and resources.
 Telling yourself: poor performance is okay.
 Doing something else that isn’t very important
 Believing that repeated delays not hurt you
62

63. Time Management…
4. Avoid Procrastination…
How to Overcome Procrastination:
 Win mental battle to being on time.
 Organize, schedule & plan
 Set and keep deadlines.
 Divide a big job into smaller ones.
 Make game of your work or make it fun.
 Reward yourself when you have done it.
 Tell your friends to remind deadlines.
 Use memo
 Learn to say “no” to time wasters.
63

64. Time Management…
5. Delegation
“Delegation: is granting authority with responsibility”
 No one is an island
 Delegation is not dumping/discarding tasks.
 Treat your people well by delegating for tasks
 We can accomplish a lot more with help
 Graduate students, subordinates, secretaries, families,
colleagues etc. can be delegated.
64

65. Time management Matrix
Urgent Not Urgent
I
M
P
O
R
T
A
N
T
I
 Crisis
 Pressing problems
Deadline-driven projects,
meetings, preparations
 vital programs/schedules
II
Preparation
. Prevention
. Values clarification
. Planning
. Relationship building
. True recreation
Not
I
M
P
O
R
T
A
N
T
III
• Interruptions, some phone
calls
• Some mail, some reports
.Some meetings
. Many popular activities-
breaking news
IV
 Irrelevant talks
 Some Time wasters
 Irrelevant e-mail, chat
 Excessive TV
 Long fictions/novels
65

66. Quadrant of Necessity
Important, Urgent
Quadrant of Quality
& Personal
Leadership
Important, Not Urgent
Quadrant of Deception
Not Important, Urgent
Quadrant of Waste
Not Important, Not Urgent
Managing Your
Time Effectively
Manage the
best you can
Focus here
Avoid as much as
possible
Be careful here
66

67. Obstacles to effective Time Management
Unclear objectives
Inability to say “no”
67

68. Obstacles to Effective Time Management…
Too many things at once
Stress and fatigue- always
work, no play
68

69. Don’t let this be you!
70

70. manage your time Manage
your self!
71

71. “Never do tomorrow what you can do
today”
“Prioritize, and do the most
important things first”
72

72. 7. 4: Logistics and Pharmaceutical Management

73. Pharmaceutical Logistics Mgt.
It is a system of:
 Selecting
 Quantifying
 Supply-planning
 Ordering/procuring
 Distributing products from one level to
another

74.  Allocation or “Push” System: the higher-level decides
what, when and how much of each pharmaceuticals
move down through the system
 Requisition or “Pull” system: the lower level orders
what, when and how much of each pharmaceuticals,
thus pulling or receiving through the system
Types of Logistics Systems

75.  In the integrated pharmaceutical logistics system,
pharmaceuticals are handled and managed in an
integrated manner.
 There are three pipeline levels namely;
 Central PFSA,
 PFSA Hubs/branches and
 Health Facilities (health centers and hospitals).
Integrated Pharmaceutical Logistics System (IPLS)

76.  This level is the central medical store where pharmaceutical
products are procured, received and stored.
 Major activities done at this level are:
• Perform forecasting and quantification and procure
pharmaceutical products necessary for the country
• Perform supply planning, follow shipment status of procured
supplies
• Receive, store, manage and distribute them to PFSA Hubs
(branches)
I. Central Level (Central PFSA)

77.  Major responsibilities of branch PFSAs are:
 Plan, quantify and request pharmaceutical
requirement from central level for health facilities
under their area, periodically.
 Receive, store, and manage supplies coming from
central level
 Receive and check requests coming from facilities
 Distribute products to facilities appropriately
II. PFSA Branch or PFSA Hub Level

78.  Prepare and submit their reports and requests on time
 Receive, store and manage supplies at their facility
 Receive periodic reports from different units (for health
centers this includes from health posts) and issue
supplies to them
III. Facility Level

79. Flow of pharmaceuticals and information in the IPLS

80. An inventory management is a system that informs the
store manager:
 How much stock is available
 When to order more stock
 When to issue
 How much to order or issue and
 How to maintain an appropriate stock
Inventory Management (Inventory Control) System

81. 7.5. Health Mgt Information
System(HMIS)

82. Learning objectives
 Understand the Organization of the health systems of Ethiopia
and healthcare reform
 Identify the flow of data in the health sector
 Define Health management information system
 Name the main information sources
 Describe the main strengths and weaknesses of different data
sources
 Discuss the main data quality issues that need to be considered
 Discuss the different health indicators

83. Types of health care facilities
• Hospitals, 3 in number
• Health center
• Health post
• Specialty Centers, 10 in number
• Specialty clinic, 19 in number
• Stand alone Medical Laboratories, 2 in number
• Medium clinic
• Primary clinic
• Nursing Home

84. Health care facilities . . .
• There will not be a Nomenclature for
Zonal hospital
District hospital
Medium or small hospital
higher clinic
Small clinic

85. MANAGEMENT OF INFORMATION
DATA
- collection of raw facts and figures
INFORMATION
- is the end processed product of
data/facts, by adding order, context & purpose.
• Knowledge: the product of adding meaning to information by
making connections and comparisons and by exploring causes
and consequences
• System :- A collection of components that work together to
achieve a common objective

86. INFORMATION SYSTEM
 is a combination of people, equipment, & procedures,
organized to provide certain
information to make informed decisions.
 A system that provides information support to
the decision making process at each level of an
organization

87. Flow of Information
Collection of
Data
Reporting Processing
Analysis
Action
Feedback

88. Management Information System (MIS)
Management Information System (MIS)
- An information system that utilizes information for
management purposes.
- Is a system to convert data from internal &
external sources into information,
- To make timely & effectively decisions for
planning, directing & controlling the activities.

89. Health Information System
• A system that provides specific information support to
the decision making process at each level of an
organization.
• A set of interrelated components working together; to
gather, retrieve, process, store and disseminate
information to support the activities of health system
planning, control, coordination, and decision-making
both in management and service delivery.

90. Health Management Information System
HMIS
- A combination of instruments, norms
(procedures) & activities which together
produce information for health workers to
take decisions in the area of health care
services.

91. HMIS
• Instruments: e.g. formats, registration books, etc.
• Norms/procedures:
- who should carry out the various activities?
- frequency?
- flow of information, etc.
• Activities: Registration (data collection), Copying in
the weekly forms, Processing into information,
Presenting (tables/graphs), Interpreting, Utilization
(decision to action), Communication, Reception
(within a specified time), Feedback.

92. HMIS. . .
Sources of information
• Health institutions
• Vital registrations
• Laboratories and pharmaceuticals
• Community – census and survey
• Investigation of outbreaks – surveillances
• Routine reports
• Information is collected, analyzed, presented and
communicated.

93. Routine Data Collection & HMIS Data flow
Facility Based Data
Service delivery/disease report
WorHO/
ZHD
Compiled
and used /
reported
RHB
FMOH
Compiled
and used /
reported
Compiled
and
used
Community
Based Data
Compiled
and used /
reported

94. 7.6 Management of change,
Introduction
• Change is a phenomenon faced by all organizations. Global and
local events affect how organizations are structured and conduct
their activities and the health sector is no exception. Changes in
the political, socio-economic, technological and physical
environment profoundly affect the program and activities of the
health sector.
• The human resource management system is one of the areas
constantly affected by change. There are many new changes in
managerial processes related to human resource management,
and, as a human resource manager, you must be aware of these.

95. 2. Types of Organizational Change
• There are various ways of categorizing types of
change which include:
– routine versus non-routine change
– strategic versus operational change
– change in structure, technology and people.

96. A. Routine versus non-routine change
• Routine changes are frequent changes that are expected by
employees. Examples include changes in HR guidelines and
procedures, reshuffling of staff or changes in ways of providing
services. People accept that when some staff are away on holiday
or at a training course they may be expected to cover some of their
activities for instance.
• Non-routine changes are unique changes that are unexpected by
employees, for instance, public announcements about projected
redundancies (dismissal). The unique and radical nature of non-
routine changes make them more difficult to manage. For example,
major structural change in the organization may cause anxiety
about job security among employees. In such cases, employees will
resist efforts for change.

97. B. Strategic VS Operational Change
• Strategic change involves a major readjustment in the
organization's overall activities. Commonly, such
changes occur in order to respond to the changing
environment in which the organization is operating.
Strategic changes may involve a change of mission or
engaging in a new purpose, a change of clients, a
change of values or changes in technology.
• Unlike strategic change, which addresses long term
goals, operational change focuses on changes that have
an immediate effect. Adopting new financial or drug
procurement procedures are examples of operational
change.

98. C. Change in Technology, Structure and People
• Structural change involves adjustment or modifications to the
organizational structure, such as a change in hierarchal
relationships among employees, a change in the span of
management, a change in the levels of organizational structure
such as a move from pyramidal structures to teams and
redesigning jobs.
• Usually, organizations engage in structural change in response to
changes in the external environment or when they adopt a new
strategy. Because the organizational structure is the decision
making framework, a change in strategy is likely to be
accompanied by a change or an adjustment in how work gets
done and who does it. For instance, structural changes can
include combining responsibilities, decreasing management
levels, introducing new rules and procedures or enriching
employees’ jobs by increasing their role in decision making.

99. Cont…
• Technological change occurs when organizations
change their approach and methods of how the work is
done or change the equipment they use to perform
work.
• That means technological changes usually involve
computerization of work, introducing new relevant
methods or equipment. Changing technology is a very
important focus of managers, in order to increase
efficiency and effectiveness and human resource
managers (HRMs) have to embrace technological
changes. For example, computerization is necessary for
establishing a strong human resource management
information system.

100. Cont…d
• Changing people refers to changes in the attitudes,
expectations, perceptions, and behavior of individuals
or groups. Organizational development (OD) is the
term used to describe change methods that focus on
people and the nature and quality of interpersonal
work relationships.
• Managers use different OD techniques while engaging
in strategic change including team building, survey
feedback and intergroup development. The degree of
acceptance by employees is an indicator of how well
these techniques worked in getting people to change.

101. 3. Organizational Environment and Change
• Change is not a one off activity. It is a process. When
initiating change, you must have a clear picture about
the type of change you want to occur and the
environment in which your organization is operating.
The concern of change management is not on individual
activities alone, but relates to the organization as a
whole.
• One of the common methods managers use widely in
change processes is the PEST analysis. A PEST analysis
gives you a picture of your operating environment and
allows you to positively relate the factors to your change
process to produce a realistic change plan.

102. Political Factors
• Government type and stability
• Health policy
• Levels of bureaucracy
• Regulation trends
• Social and employment
• legislation
• Tax policy
• Environmental policy

103. Economic Factor
• State of economic growth, inflation
• Unemployment
• Labor supply
• Labor costs.
• Levels of income and income
• distribution
• Impact of globalization
• Impact of technological change on the economy
• Likely changes in the economic environment

104. Social Factor
• Population growth rate and age profile
• Population health, education and social
mobility
• Population employment patterns
• Social attitudes and social taboos
• Lifestyle choices and attitudes to these
• Socio-cultural changes

105. Technological Factor
• Impact of emerging technologies
• Impact of internet
• Research and development activity
• Impact of technology transfer

106. 4. Change Management Process
• An important skill for managers is to be able to change poorly
functioning areas of their organization. Even if employees know
that change is necessary, they may resist it, and for others change
can be taken as disruptive. Thus, the change process has to be
managed effectively in order for individuals to be fully engaged in
the process. The manager needs to help them adjust to do their
work in new ways.
• In all organizations an effective change management process has
to be based on addressing the following basic issues:
– Where are we now?
– Where do we want to be?
– How are we going to get there?

107. Steps of an Effective Change Management
• An effective change management process has to follow these six
steps regardless of its size or impact:
– 1. establish a clear direction – a compelling case and a
sense of urgency
– 2. clear ownership and leadership of the change
process
– 3. communicate the case for change early and often
– 4. create and maintain a workable change plan
– 5. empower broad-based action – maintain and
measure progress
– 6. anchor new approaches to achieve organizational
goals.

108. 5. Resistance to Change
• Some of the most common reasons employees
resist change include:
– suspicions that the change will mean that
established routines, methods of working or
conditions of employment that they are comfortable
with will be affected adversely
– economic fears such as loss of financial benefits and
fear of the possibility of upcoming threats to job
security
– inconvenience, change could make the workplace
environment unpleasant and difficult

109. Cont…
– uncertainty about the impact of the change can feel
threatening
– concerns that change may cause loss of personal
status or benefits such as a separate office
– concerns that change will disrupt established social
relationships and standards of the group
– change is perceived as reducing the status of
individuals if it means their skill is being displaced
– fear of coping with new tasks or worry about the
potential to learn the skill required for the tasks can
undermine confidence.

110. 7.7 Space management
• Managing space efficiently improves both
productivity and safety.
• Moreover there is considerable evidence that
thoughtful design of an environment that is
both a workplace and a temporary home for
patients has psychological and social benefits
that contribute to reducing stress and
enabling healing to take place.
111

111. Activity
• Take ten minutes to look around your office or
workspace and note down where your use of
space could be improved.
112

112. Office Management
• For good office management, you need to be
sure that all the things in the office are arranged
for maximum efficiency and maximum safety.
– Is it possible to maintain privacy when it is needed?
Can confidential materials be securely stored?
– Are there enough electric sockets for the equipment
and can the electricity supply support these safely?
– Is there sufficient ventilation and light?
– How feasible is access for someone on crutches or in a
wheelchair?
113

113. Care Setting
• Where care settings work well they are said to
be enabling.
– An enabling environment is one that facilitates key
aspects of everyday living, allowing people to
make choices.
– A disabling environment, on the other hand, is
one that prevents people from controlling their
situation.
• Care setting will be evaluated based on Physical, Social and
Psychological Environment
114

114. Work flows
• Workflow is an arrangement in which a series of
work functions are co-ordinated in space and
time so that delays are minimal.
• The sitting of wards and laboratory facilities can
facilitate this.
• Advances in technology means expensive
equipment must be shared and their use
managed.
• This also affects the spaces in which they are
used.
• patients are often accompanied by family when
they come to hospitals
115

115. Thank you very much!
.