health management basics

1. Health Management:
Basic Concepts
Dr Khem R. Sharma
SPH&CM

2. Introduction
• Management: The purposeful and effective use of resources–
manpower, materials, finances and time for fulfilling pre determined
objectives.
• It is the efficient use of resources, getting people to work
harmoniously together in order to achieve set objectives. ( WHO)
• The health care system today is based on science and the skill of
preventing disease, prolonging life and promoting health through
organized efforts of society.
• A strategic approach to managing the health care system is necessary
to achieve these goals and improve the health of the population.

3. Management is getting the right things done
 In the right way
 In the right time
 By the right persons
With the right amount and effective use of resources
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5. Introduction
The term management can be used in 3 alternative ways: a discipline,
a group of people and a process.
The importance of management for an individual or organization is
reflected from the following:
• Management helps to achieve the goals of the team,
• Management increases efficiency,
• Management creates a dynamic organization,
• Management helps to achieve personal goals and
• Management helps in the development of society.

6. Scope of health management

7. Introduction
• An efficient manager’s main responsibility is to facilitate the
attainment of organizational objectives, delegating authority and
follow up with effective supervision and monitoring.
• Unless people in the team know what is expected of them, they are
unlikely to achieve it.
• Management activities are those that direct, guide and decide on the
use of available resources in the interest of achieving defined goals
• Healthcare management is centred around three main concepts:
effectiveness, efficiency, and equity.

8. Health Care Management
• Based on the type of responsibility each individual has in
management, managers of health care institutions can be divided into
three levels, as follows:
1) First line/level managers (operational management)
2) Middle/tactical level management.
3) General managers/top-level managers (strategic management)

9. 1) First line/level managers
(operational management)
• They are responsible only for the work of their associates, make short-term
decisions and work at the lowest level of the health institution where
individuals can be responsible for the work of others. They must:
1) be adapted to the team and change the way they use their energy and
free time;
2) recognize the values and success of others;
3) listen to the needs of their employees and give feedback on their work
and results achieved;
4) build a strategy that would extend the process of communication from
the patient/user to the external environment (community, government
and private sector);

10. 2) Middle/tactical level management
• Managers at this level manage and are responsible for the work of
lower-level managers, and sometimes for the activities of work staff,
including heads of departments and services.
• Responsibility of the manager of this level extends for a longer period
of time during which team members plan and anticipate activities, (ie
be a visionary who will recognize the strategic context in which the
activity develops), recognize activity trends and find connections and
development opportunities.

11. 3) General/top-level managers
(strategic management)
• Relatively small group in charge and responsible for the overall functioning
of the health institution and for making long-term, strategic decisions.
Their functions include:
1) create and implement work plans, organize and implement the everyday
functioning of the institution and conduct programs,
2) develop adequate working relationships to communicate and resolve
conflicts and establish control mechanisms to implement activities.
3) have a high degree of personal motivation and the ability to lead people,
4) establish mutual relations with other organizations, provide support for
the participation of the community and people,
5) make appropriate real/timely decisions based on evidence, to achieve
the set goals of the institution, in the most efficient and effective way.

12. Health Care Management
• consists of four basic activities :
I. planning: determining what is to be done.
II. organizing: setting up the framework or apparatus, making it
possible for groups to do the work.
III. communicating: motivating people to do the work.
IV. monitoring (controlling): checking to make sure the work is
progressing satisfactorily.
• The current emphasis by WHO and many governments is on
improving the efficiency of the health care delivery systems through
the application of modern management methods and techniques.

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14. Health Care Management Steps

15. 1. PREPARATION FOR PLANNING

16. 2. SITUATIONAL ANALYSIS (WHERE ARE WE NOW?)

17. 3. IDENTIFY COMMUNITY NEEDS/PROBLEMS
ACCORDING TO SITUATIONAL ANALYSIS

18. 4. PLANNING
(HOW CAN WE REACH THE OBJECTIVES?)

19. 4. PLANNING
(HOW CAN WE REACH THE OBJECTIVES?)……..

23. 5. ACTION PLAN
(OPERATIONAL/IMPLEMENTATION PLAN)

24. 6. EVALUATION
(DO WE REACH OUR OBJECTIVES?)

26. 7. COMMUNICATION AND REPORTING PLAN

27. 8. RE-PLANNING AND DECISION MAKING:

28. Health Care Management Steps (summary)

29. Management Methods and Techniques
• Many methods of management exist based either on the principles of
behavioural sciences or quantitative methods.
1. Statistical techniques
2. Activity analysis techniques
3. Mathematical techniques
4. Financial techniques
5. Miscellaneous

30. 1)Time trends and forecasting
Certain patterns can be recognized from
information on occurrence of certain events
(Eg: Seasonal trend, Cyclical trend, Secular
trend) or from past experience
2) Decision theory and tree
Rationale choice among different
alternatives
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31. 1)Time and Motion study
2)Work sampling and activity analysis
3)Queuing theory
4)Gantt chart and work schedule
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32. 1)Simulation study
2) System analysis
3) Linear programming
4) Inventory control
5) Network analysis
-PERT
-CPM
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33. 33
1. Cost accounting and analysis.
2. Cost benefits analysis.
3. Cost effectiveness analysis.
4. Zero base budgeting.
5. Input output analysis.

34. 1. Management by objectives and
appraisal by results
2. Management by exception
3. Situational analysis
5. SWOT analysis
6. Log Frame Analysis
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