This exhaustive and vibrant PowerPoint has around 90 slides and explains in detail all the must know concepts of Management in Healthcare. These slides have enough information to use it for 3 hour seminar (2 sessions) on Modern Management Techniques and its application in Healthcare. The session can be further extended if the concepts are explained with appropriate examples.
Measuring Health and Disease I: Introduction to Epidemiology Module GuideSaide OER Africa
Ā
This module was developed at the School of Public Health, University for the Western Cape for the Postgraduate Certificate in Public Health which was offered as a distance learning module between 2001 and 2008. It was designed to meet the growing need for an applied course in the measurement of a variety of health indicators and outcomes. Whether you manage a health programme, a health facility, or simply have to interpret health data in the course of your work, this module sets out to increase your capacity to deal with health and disease information. It aims to assist you in applying epidemiological knowledge and skills to a variety of Public Health problems such as:
Is your DOTS programme succeeding?
What does it mean if a TB prevalence is 850/100 000?
Is this a Public Health problem or not?
What is the āburden of diseaseā in different communities?
Measuring Health and Disease I: Introduction to Epidemiology Module GuideSaide OER Africa
Ā
This module was developed at the School of Public Health, University for the Western Cape for the Postgraduate Certificate in Public Health which was offered as a distance learning module between 2001 and 2008. It was designed to meet the growing need for an applied course in the measurement of a variety of health indicators and outcomes. Whether you manage a health programme, a health facility, or simply have to interpret health data in the course of your work, this module sets out to increase your capacity to deal with health and disease information. It aims to assist you in applying epidemiological knowledge and skills to a variety of Public Health problems such as:
Is your DOTS programme succeeding?
What does it mean if a TB prevalence is 850/100 000?
Is this a Public Health problem or not?
What is the āburden of diseaseā in different communities?
The Role and Responsibilities of Statisticians in Clinical Trials Presentation to MedicReS 5th World Congress on October 19-25,2015 in New York by Shing Lee, PhD
Planning is defined as an organized conscious and continual attempt to select the best available alternative to achieve specific goals
Management is the act of securing maximum results with minimum efforts to achieve maximum prosperity&happiness and give public the best service
Operations Management A CEO Checklist for High-Value H.docxvannagoforth
Ā
Operations Management
A CEO Checklist for High-Value Health Care:
Ten Elements
Foundational elements
ā¢ Governance priorityāvisible and determined
leadership by CEO and board.
ā¢ Culture of continuous improvementācommitment
to ongoing, real-time learning.
Infrastructure fundamentals
ā¢ IT best practicesāautomated, reliable information to
and from the point of care.
ā¢ Evidence protocolsāeffective, efficient, and
consistent care.
ā¢ Resource utilizationāoptimized use of personnel,
physical space, and other resources.
Care delivery priorities
ā¢ Integrated careāright care, right setting, right
providers, right teamwork.
ā¢ Shared decision-makingāpatient-clinician
collaboration on care plans.
ā¢ Targeted servicesātailored community and clinic
interventions for resource-intensive patients.
Reliability and feedback
ā¢ Embedded safeguardsāsupports and prompts to
reduce injury and infection.
ā¢ Internal transparencyāvisible progress in
performance, outcomes, and costs.
What is Operations Management?
ā¢ The design, operation, and improvement of
the processes that create and deliver the
organizationās services.
ā¢ The goal is to more effectively and efficiently
produce and deliver the organizationās
services.
Healthcare Management
ā¢ The management of processes or health systems
that provide care to patients.
ā¢ The use of decision tools to manage and
improve processes.
ā¢ Functional roles:
ā CEO
ā COO
ā CXO
ā Mid-level manager
ā Department or function manager
Health Care Operations Management
ā Process improvement.
ā Quality control and outcomes .
ā Patient satisfaction.
ā Financial operations ā cost, reimbursement.
ā Supply chain management ā procurement, medical supplies.
ā Human resources management ā productivity, motivating
employees.
ā Information systems management.
ā Population health.
ā Physician alignment.
ā Governance.
ā Strategy and operations.
System Decisions
System Design
ļCapacity.
ļLocation.
ļProximity.
ļService planning.
ļAcquisition and placement of
equipment.
System Operations
ļPersonnel.
ļ Inventory.
ļScheduling.
ļProduct management.
ļQuality measurement
and assurance.
There are two groups of decisions:
Applicability to Health Care
ā¢ Patient is a participant in the process.
ā¢ Production and consumption occur
simultaneously.
ā¢ Uncontrollable capacity.
ā¢ Site selection is dictated by patient location.
ā¢ Labor intensive.
INTRODUCTION TO PROCESS IMROVEMENT
Process or Performance Improvement
ā¢ Scientific management
ā Mass production
ā¢ TQM, CQI, Six Sigma
ā¢ ISO 9000
ā¢ Lean
ā¢ Six Sigma
Background
ā¢ Scientific Management Techniques (1910s) ā Frederic W. Taylor
ā¢ Standardization ā Frank & Gillian Gilberth
ā¢ Psychological Effects of Work Conditions ā Henry Gannt
ā¢ Quantitative Inventory Management (1915) ā F.W. Harris
ā¢ Quality Control & Sampling (1930s) ā W. Shewhart
ā¢ Operations ...
Certified Specialist Business Intelligence (.docxdurantheseldine
Ā
Certified Specialist Business
Intelligence (CSBI) Reflection
Part 5 of 6
CSBI Course 5: Business Intelligence and Analytical and Quantitative Skills
ā Thinking about the Basics
ā The Basic Elements of Experimental Design
ā Sampling
ā Common Mistakes in Analysis
ā Opportunities and Problems to Solve
ā The Low Severity Level ED (SL5P) Case Setup as an Example of BI Work
ā Meaningful Analytic Structures
Analysis and Statistics
A key aspect of the work of the BI/Analytics consultant is analysis. Analysis can be defined as
how the data is turned into information. Information is the outcome when the data is analyzed
correctly.
Rigorous analysis is having the best chance of creating the sharpest picture of what the data
might reveal and is the product of proper application of statistics and experimental design.
Statistics encompasses a complex and detailed series of disciplines. Statistical concepts are
foundational to all descriptive, predictive and prescriptive analytic applications. However, the
application of simple descriptive statistical calculations yields a great deal of usable information
for transformational decision-making. The value of the information is amplified when using these
same simple statistics within the context of a well-designed experiment.
This module is not designed to teach one statistic. It is designed to place statistical work within
the appropriate context so that it can be leveraged most effectively in driving organizational
performance..
An important review of the basic knowledge for work with descriptive and inferential statistics.
The Basic Elements of Experimental Design
Analytic tools also can provide an enhanced ability to conduct experiments. More than just
allowing analysis of output of activities or processes, experiments can be performed on
processes and the output of processes. Experimenting on processes is a movement beyond
the traditional r.
Many resources discuss machine learning and data analytics from a technology deployment perspective. From the business standpoint, however, the real value of analytics is in the methodology for solving some systemic holistic problems, rather than a specific technology or platform.
In this presentation, the focus is shifted from the technology deployment to the analytics methodology for solving some holistic business problems. Two examples will be covered in detail:
(i) Analysis of the performance and the optimal staffing of a team of doctors, nurses, and technicians for a large local hospital unit using discrete event simulation with a live demonstration. This simulation methodology is not included in most Machine Learning algorithms libraries.
(ii) Identifying a few factors (or variables) that contribute most to the financial outcome of a local hospital using principal component decomposition (PCD) of the large observational dataset of population demographic and disease prevalence.
How To Drive Clinical Improvement Programs That Get Results - HAS Session 20Health Catalyst
Ā
Getting accurate data does not improve care unless empowered teams are created with knowledge of how to apply the data. This was the highest-rated breakout session, and the second-highest rated session overall. This was a very hands-on session, using four different āah haā experiences to demonstrate key principles for getting clinical improvement results. These experiences included a deal or no deal re-enactment, a popsicle bomb exercise, a water stopping contest, and Paul Revere exercise. Key principles included how to prioritize your clinical improvement programs and cohorts, defining and selecting the most impactful AIM statements, fixing data quality, and defining and rolling out interventions throughout the system.
š„HOT TOPICš„
Sharing my PowerPoint slides on šµ MONKEYPOXšµ
(a potential/sure shot question for MD exam)
This can be used for a 2 hour session of PG seminar since all the aspects of the disease are covered.
It includes a compilation of;
1. Infectious history (in detail)
2. Epidemiology (Global, local)
3. Case definitions
4. Clinical features
5. Differential diagnosis (including comparison with common DDs)
6. Complications
7. Investigations
8. Management
9. Vaccines
10. Other specific preventive measures
Share among Community Medicine residents for maximum reach and benefits...š
TOTAL QUALITY MANAGEMENT (TQM) and it's relevance in healthcare
(A potential question under health care management topic)
CONTENTS:
1. Definitions
2. Milestones of TQM
3. Rationale for quality in healthcare
4. Five attributes of quality
5. Dimensions of quality
6. Quality measurement
7. Quality management and it's principles
8. TQM view in areas of conflict
9. Deming's 14 points
10. PDCA/ Deming's cycle
11. Quality in health care organization
12. Implementation of quality improvement.
13. Quality assurance process
14. Clinical applications of TQM
15. Success story (chokpot PHC)
Happy learning!!
This presentation is for observing World Breastfeeding Week-2022. It covers themes over years, statistics, recommendations, benefits to child and mother, 10 steps to successful breastfeeding, breastmilk substitutes, marketing tactics and its regulation, Breastfeeding support system, Breastfeeding and COVID and innovations in breastfeeding.
Link for video (Covid and breastfeeding): https://www.youtube.com/watch?v=OFGiy6t7k5E
RABIES-A fatal but preventable viral disease is explained in detail (with exclusive pictures) in this PowerPoint presentation.
It also includes the "updates on prevention and control strategy" and "Zero by 2030-Rabies Elimination Strategy"
This was presented at seminar hall, Department of Community Medicine, IMS, Banaras Hindu University as a part of PG seminar.
(The video by Lancet included in this may not be played in this slideshare platform...one can access youtube for the same)
This PowerPoint was prepared and presented in IAPSMCON-2022 as a part of Journal Club competition...
It was judged by eminent stalwarts Dr.Anand Krishnan sir, Dr. Sanjay Zodpey sir and Dr. Amarjeet Singh sir and bagged the first prize as well...!!!
It critically appraises a Mixed Method Research study...Dive in to explore...!!!
This presentation explains in detail the World's Deadliest animal...THE MOSQUITO...!!!!
(Public health aspects of this arthropod is discussed in detail)
Objectives:
To morphologically Identify mosquito species (In India)
To elaborate the Life Cycle of mosquito
To know the unique features (Habits) of each mosquito
To understand their role in disease transmission and the Diseases transmitted
To identify and differentiate eggs of various mosquito
To learn about mosquito control measures
These slides were presented on the occasion of WORLD HEALTH DAY-2021 for a National level PPT competition conducted by IAPSM and was one among the Top-10
This slide presentation historically, statistically and attractively explains various vaccines for covid19 available in India. (Please update the statistical data to current values)
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Ā
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Health Education on prevention of hypertensionRadhika kulvi
Ā
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Ā
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patientās body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
1. MODERN MANAGEMENT TECHNIQUES
APPLICATION OF MMT IN HEALTHCARE
Dr. Immanuel Joshua. E
Junior Resident (PGT-3)
Dept. of Community Medicine
Banaras Hindu University
1
2. CONTENTS
Definition Relevance in healthcare Traditional vs Modern techniques
Description of each technique Classification
Challenges
References
"The first rule of management is delegation. Don't try and do everything yourself because you can't." ā
Anthea Turner
Estimated time: 90-120 minutes
2
3. āManagement is getting the right things done
ļ§ in right way,
ļ§ in right time,
ļ§ by right persons,
ļ§ with right amount of resources and
effective use of resources.ā
MANAGEMENT
It is the efficient use of resources and to get people to work harmoniously
together in order to achieve objective 3
4. Applications of management techniques
Marketing
Operations
Finance Human Resource
Information Technology
Management Science
4
6. "Management is the opportunity to help people become better people. Practiced that way, it's a
magnificent profession" ā Clayton Christenson
RELEVANCE IN HEALTHCARE
ā¢ Overlapping, conflicting and competing organizations within Health system
ā¢ Widely scattered funding mechanism with little control over costs
ā¢ Decisions on the mixture of facilities and services without reference to population
need and with no information about those who do not use the services
ā¢ It has been proved that these techniques are useful in increasing the efficiency
by cost reduction as well as ensuring better health care
6
7. Traditional vs Modern Management Techniques
Based on behavioral sciences
(Personnel selection, training & retraining,
motivational methods, leadership
development, supervision etc..)
TRADITIONAL MODERN
Based on sociology, psychology, educational
technology, economics and statistics
Needed for larger and complicated organizations
with their own unique organizational and
structural issues
The conventional methods of management
are no longer adequate to meet the
demand of todayās projects
7
9. Miscellaneous
Financial techniques
Statistical techniques
Activity analysis
Mathematical techniques
1) Time trends and forecasting
2) Decision theory and tree
1) Time and Motion study
2) Work sampling and activity analysis
3) Queuing theory
4) Gantt chart and work schedule
1) Simulation study/ model
2) System analysis
3) Linear programming
4) Inventory control
5) Network analysis
6) PERT
7) CPM
9
10. Miscellaneous
Financial techniques
1) Cost accounting and analysis
2) Cost Benefit Analysis
3) Cost Effective Analysis
4) Zero base budgeting
5) Input output analysis
1) Management by exception
2) Situation analysis
3) SWOT Analysis
4) Log frame Analysis
10
12. TIME TRENDS AND FORECASTING
(Eg: Seasonal trend, Cyclical trend, Secular trend)
Based on past experience, predictions can be made about
the expected occurrence, by using mathematical methods
(Eg: Demographers made projections about population,
epidemiologists anticipation of epidemic)
Based on information on occurrence of certain events, certain patterns can be recognized
12
13. DECISION TREE A decision tree is a flowchart that starts with
one main idea and then branches out based on
the consequences of your decisions
Itās called a ādecision treeā because the model
typically looks like a tree with branches
It enables people to decompose a large complex
decision problem into several smaller problems
13
14. Types of environment:
1. Decision making under certainty
2. Decision making under uncertainty
3. Decision making under risk
Decision tree
A method for determining the optimal course of action when a number of alternatives
are available and their consequences cannot be forecast with certainty
14
15. DECISION TREE SYMBOLS
ā¢Decision nodes: Squares that represent a decision being made on tree.
Every decision tree starts with a decision node.
ā¢Alternative branches: Lines that branch out from decision node. These
branches show two outcomes that stem from the initial decision.
ā¢Chance nodes: Circles that show multiple possible outcomes.
ā¢End nodes: Triangles that show a final outcome.
15
17. Surgery
Drug
Disease absent
Disease present
Disease present
Disease absent
Survive
Operative death
Cure
No cure
Curative
Palliative
Survive
Operative death
Cure
No cure
Survive
Operative death
Cure
No cure
17
18. Surgery
Drug
Disease absent
Disease present
Disease present
Disease absent
Survive
Operative death
Cure
No cure
Curative
Palliative
Survive
Operative death
Cure
No cure
Survive
Operative death
Cure
No cure
Each path through the tree defines a unique potential result
18
19. Surgery
Drug
Disease absent
Disease present
Disease present
Disease absent
Survive
Operative death
Cure
No cure
Curative
Palliative
Survive
Operative death
Cure
No cure
Survive
Operative death
Cure
No cure
10%
10%
90%
90%
90%
90%
90%
90%
99%
98%
10%
1%
10%
2%
10%
10%
Insert probabilities at each chance node based on data
from literature, modeling, expert judgment, etc.
19
20. Surgery
Drug
Disease absent
Disease present
Disease present
Disease absent
Survive
Operative death
Cure
No cure
Curative
Palliative
Survive
Operative death
Cure
No cure
Survive
Operative death
Cure
No cure
10%
10%
90%
90%
90%
90%
90%
90%
99%
98%
10%
1%
10%
2%
10%
10%
Assign a value to the outcome at each end points
20 LY
0 LY
20 LY
20 LY
2 LY
0 LY
0 LY
20 LY
20 LY
2 LY
2 LY
Average outcome:
Operative death = 0 LY
Death from progression of disease = 2 LY
Cure = 20 LY
20
21. Surgery
Drug
Disease absent
Disease present
Disease present
Disease absent
Survive
Operative death
Cure
No cure
Curative
Palliative
Survive
Operative death
Cure
No cure
Survive
Operative death
Cure
No cure
10%
10%
90%
90%
90%
90%
90%
90%
99%
98%
10%
1%
10%
2%
10%
10%
20 LY
0 LY
20 LY
20 LY
2 LY
0 LY
0 LY
20 LY
20 LY
2 LY
2 LY
Compute average results, working from right to left
Average LY
= 10% (20) + 90% (2)
= 3.8 LY
21
22. Surgery
Drug
The outcome for each decision is more apparent now
19.46 LY
18.38 LY
Surgery (intending cure) produces average of 19.46 LY
Medical management yields an average of 18.38 LY
The incremental benefit of surgery versus medical
management is 19.46 ā 18.38 = 1.08 LY
22
23. ā¢ Simple to understand and interpret
ā¢ Useful to analyze the possible outcomes of complex decisions
ā¢ Possible scenarios can be added
ā¢ Most rational decision is taken in terms of resource and effectiveness
ā¢ Worst, best and expected values can be determined for different scenarios
ADVANTAGES OF DECISION TREES
23
24. Miscellaneous
Financial techniques
Statistical techniques
Activity analysis
Mathematical techniques
1) Time trends and forecasting
2) Decision theory and tree
1) Time and Motion study
2) Work sampling and activity analysis
3) Queuing theory
4) Gantt chart and work schedule
1) Simulation study/ model
2) System analysis
3) Linear programming
4) Inventory control
5) Network analysis
6) PERT
7) CPM
24
26. BASIS TIME STUDY MOTION STUDY
Meaning
Time study is conducted to find
out the standard time for
performing a task
Motion study is conducted to find out
total movements of workers while they
are performing the task
Purpose
To find out standard time to fix
dayās work for the workers
To eliminate wasteful and unproductive
movements of workers to increase their
efficiency level
Method of
conducting
It is conducted with the help of a
stopwatch
It is conducted with the help of a moving
camera which keep eyes on movements
āTime is what we want most but what we use worstā ā William Penn
TIME AND MOTION STUDY
26
27. Modification: One servant from the central lab goes to different ward with trolley
at predetermined time. Reports delivered in same way
Example: From each ward, lab samples are sent with a servant to central
laboratory. Servants take excessive time to return
ADVANTAGES
ā¢ Reduction of physical effort
ā¢ Time saving
ā¢ Increase productivity
27
28. Work sampling is a method of finding the percentage occurrence of a certain activity
by statistical sampling and random observations
WORK SAMPLING
Technique in which a large number of instantaneous observations are made at random intervals over
a specified period of time on a group of workers machines and processes
Each observation records what is happening at that instant (Working/ Not working)
The percentage of observations recorded for a particular activity is the measure of
percentage of time during which that activity occurs
28
29. STEPS
ā¢ Determine the main objective of the study
ā¢ Define each activity to be measured
ā¢ Obtain the approval of the supervisor of the department where work sampling is to be
performed
ā¢ State the desired accuracy limits for the ultimate RESULTS
ā¢ Conduct a pilot study to
i. Estimate the approximate percentage occurrence of the activity (p)
ii. Estimate the required number of observations for the desired accuracy set
iii. Ensure that the workers have become habitual to the visits of work study engineer
ā¢ Design the actual study
ā¢ Calculate the number of observations (N) to be made by using the following formula N = 4pq/L2
29
30. ADVANTAGES
ā¢ Work sampling is a low cost alternative to continuous monitoring, just as sampling
in the audit context is a low cost alternative to 100% evaluation of an account
ā¢ A simultaneous work sampling of several operators or machines can be made by a
single observer
Ex: There is complain that nursing officers are working only 70% of their duty time in wards
Number of observations required for work sampling (N) = 4 (0.7) (0.3)/ (0.05)2 = 336
Results: Nursing officers were seen working on 252 observations (=75% of the time)
Out of the total working time, 35% were spent on bedside and 65% on clerical ward work
30
33. ā¢ Queuing theory was first introduced in the early 20th century
by Danish mathematician and engineer Agner Krarup Erlang.
ā¢ Erlang worked for the Copenhagen Telephone Exchange and
wanted to analyze and optimize its operations.
ā¢ He sought to determine how many circuits were needed to
provide an acceptable level of telephone service, for people
not to be āon holdā (or in a telephone queue) for too long.
ā¢ Also to find out how many telephone operators were needed
to process a given volume of calls.
ā¢"Start with the end in mind." ā Stephen Covey 33
34. His mathematical analysis
culminated in his 1920 paper
āTelephone Waiting Timesā, which
served as the foundation of applied
queuing theory. The international
unit of telephone traffic is called the
Erlang in his honor.
34
35. Queuing theory is a mathematical approach applied to the analysis of waiting lines
At its core, a queuing situation involves two parts
Someone who requests a service Someone who delivers the service
Customer Server
Doctor
35
36. Cost associated with patients having to wait for service
ā¢ Loss of business to HCO.
ā¢ Costs incurred by society.
ā¢ Decreased patient satisfaction and quality of care.
Cost of providing the services (capacity cost)
ā¢ Salaries paid to employees.
ā¢ Salaries paid to employees or servers while they wait for service from other
server, for eg: waiting for the pathology report, radiology report, labs, etc.
ā¢ Fixed costs ā cost of waiting space, facilities, equipment, and supplies.
COSTS OF WAITING IN LINES OR QUEUE
36
37. ā¢"It's easy to solve a problem that everyone sees, but it's hard to solve a problem that almost no one sees."
ā Tony Fadell
Arrival rate
Customers
Queue discipline Service rate
Queue Service facility Served customers
Queuing theory scrutinizes the entire system of waiting in line, including elements like
customer arrival rate, number of servers, number of customers, capacity of the waiting area,
average service completion time, and queuing discipline.
37
38. The Gantt chart can also include the start and end dates of
tasks, milestones, dependencies between tasks, and
assignees.
GANTT CHART
Devised by Henry Gantt, an
American engineer and
project management
consultant
A project management tool that illustrates work completed over
a period of time in relation to the time planned for the work
It typically includes two sections:
ā¢ Left side outlines a list of tasks
ā¢ Right side has a timeline with schedule bars that visualize work
38
39. CHARACTERISTICS
39
ā¢ The bar in each row identifies the corresponding task
ā¢ The horizontal position of the bar identifies start and end times of the task
ā¢ Bar length represents the duration of the task
ā¢ Task durations can be compared easily
ā¢ Good for allocating resources and re-scheduling
ā¢ Precedence relationships can be represented using arrows
ā¢ Critical activities are usually highlighted
ā¢ Slack times are represented using bars with doted lines
ā¢ The bar of each activity begins at the activity earliest start time (ES)
ā¢ The bar of each activity ends at the activity latest finish time (LF).
40. Choose research area
Preliminary research
Decide research topic
Decide methodology
Submit/present proposal
Finalize methodology
Conduct research
Analyze data
Write up
Submit assignment
10 11 12 13 14 15 16 17 18 19 20
9
8
7
6
5
4
DURATION (in weeks)
40
41. Miscellaneous
Financial techniques
Statistical techniques
Activity analysis
Mathematical techniques
1) Time trends and forecasting
2) Decision theory and tree
1) Time and Motion study
2) Work sampling and activity analysis
3) Queuing theory
4) Gantt chart and work schedule
1) Simulation study/ model
2) System analysis
3) Linear programming
4) Inventory control
5) Network analysis
6) PERT
7) CPM
41
43. SYSTEM ANALYSIS
ā¢ Set of objectives to be achieved is defined and alternatives to
achieve these are formulated
ā¢ Alternatives are evaluated in terms of cost-effectiveness
ā¢ Mathematical models may be used
43
Study of inter relationships operating in the various components
within a system and also between a system and other systems
System: An arrangement and set of relationships among multiple parts functioning as a whole
44. LINEAR PROGRAMMING
44
It is a useful tool for deciding the course of action for a problem in which there are
competing alternatives uses for limited resources
Mathematical tool where components of a system and its constraints are depicted in a
linear equation and the desirable combination of activities with regard to certain given
set of objectives and constraints is arrived
Linear Programming (LP) problems are optimization problems in which the objective
function and the constraints are all linear
45. A Company manufacturers two types of drugs A and B. Each product uses Machine X and
Machine Y. The process time per unit of drug a on Machine X is 10 hours and on the
Machine Y is 8 hours. The processing time per unit of drug B on Machine X is 15 hours and
on the Machine Y is 10 hours. The maximum number of hours available per week on
Machine X and Machine Y are 80 hours and 60 hours respectively. Also the profit per unit of
selling Drug A and Drug B are Rs 25 and Rs 35 respectively. Formulate a LP model to
determine the production volume of each of the drugs such that total profit is maximized.
45
46. 46
Machine
Machine hours/ unit Limit on
machine
hours
Drug A Drug B
Machine X 10 15 80
Machine Y 8 10 60
Profit/ unit (Rs) 25 35
Maximize Z = 25(A) + 35 (B)
10 (A) + 15 (B) ā¤ 80
8 (A) + 10 (B) ā¤ 60
A and B ļ³ 0
48. ABC METHOD
ITEM % COST %
A 10% 70%
B 20% 20%
C 70% 10%
A items: Less quantity; more resources
ā¢ Tight control
ā¢ Rigid estimate of requirement
ā¢ Strict & closer watch
ā¢ Low safety stock
ā¢ Managed by top management
Also known as āProportional Part Valueā method
C items: More quantity; less resources
ā¢ Ordinary control measures
ā¢ Purchase based on usage estimates
ā¢ High safety stocks
Different items categorized into three
groups based on annual expenditure
incurred on these items
48
49. V = Vital life saving drugs
(Absence of which cannot be tolerated)
E = Essential items
(Absence can be tolerated for a short time period)
D = Desirable
(Non availability can be tolerated for a longer period)
VED Analysis
Based on criticality in patient care
49
50. A
B
C CV CE CD
BV
AV
V E D
AD
BD
BE
AE Category I
Category II
Category III
Close monitoring & control
Combination of ABC & VED
Analysis
Moderate control
No control needed
CV CE CD
BV
AV AD
BD
BE
AE
50
51. It looks at quantity, consumption rate and how often the item is issued and used
F = Fast moving (needs constant monitoring)
N = Normal moving (consumed on regular basis; purchased once or twice a year)
S = Slow moving (periodically reviewed to prevent expiry & obsolescence)
D = Dead stock (Items which is no longer required)
FNSD Analysis
Inventories are classified on the basis of productās unit price
H = High value of inventories (High cost)
M = Medium value of inventories (Medium cost)
L = Low value of inventories (Low cost)
HML Analysis
51
52. Materials are categorized based on the nature of supply
Seasonal and Off-Seasonal materials
Helps to manage purchases and storage of materials which are seasonal in nature
SOS Analysis
Classification is based on the scarcity of supply
This technique handles problem faced in lead time analysis and purchasing strategies
S ā Scarce (imported; longer time to arrive; supply irregular)
D ā Difficult to procure
E ā Easy to procure
SDE Classification
52
53. Materials are categorized according to variability of their demand or forecasted consumption
X ā Very little variation (future demand can be reliably forecasted)
Y ā Some variation (demand can be predicted to some extent)
Z ā Most variation (demand forecasting is impossible)
XYZ Analysis
53
54. The activities are interrelated in a logical sequence which is known as
āPrecedence relationshipā
Project is represented in the form of network for the purpose of analysis to get
solutions for scheduling and controlling its activities
PROJECT MANAGEMENT (NETWORK ANALYSIS)
A project consists of interrelated activities which are to be executed in a certain
order before the entire task is completed
54
55. PHASES OF PROJECT MANAGEMENT
PLANNING
ā¢ Dividing the project into distinct activities
ā¢ Estimating time requirement for each
activity
ā¢ Establishing precedence relationships
among the activities
ā¢ Construction of arrow diagram (Network)
SCHEDULING
CONTROLLING
ā¢ Determines the start and end time of each and
every activity
ā¢ Uses the arrow diagram and time chart for
continuous monitoring and progress reporting
55
56. GUIDELINES FOR NETWORK CONSTRUCTION
ā¢ The starting event and ending event of an activity are called tail event and
head event respectively
ā¢ The network should have a unique starting node (tail event)
ā¢ The network should have a unique completion node (head event)
ā¢ No activity should be represented by more than one arc in the network
ā¢ No two activities should have the same starting node and same ending node
56
57. ACTIVITY
PREDECESS
OR
DURATION
A - 1
B - 2
C - 3
D A 4
E B 5
F B 4
G C 6
H D, E 6
I G 2
J F, H, I 3
ļ¶ Construct the CPM network
ļ¶ Determine Critical path and Project completion time
57
58. 1
5
2
7
4
3 6 8
A = 1 day
C = 3 days
B = 2 days
D = 4 days
E = 5 days
F = 4 days
G = 6 days
H = 6 days
I = 2 days
J = 3 days
58
60. 1
5
2
7
4
3 6 8
A = 1 day
C = 3 days
B = 2 days
D = 4 days
E = 5 days
F = 4 days
G = 6 days
H = 6 days
I = 2 days
J = 3 days
1
5
2
6 8
7
4
3
1
5
2
6 8
7
4
3
7
4
60
CRITICAL PATH
62. Under PERT, three time-estimates are made
1. Most Likely Time: Time taken most frequently in completing a particular activity.
2. Optimistic Time: Time in which an activity can be completed, if all goes as per the
predetermined plan.
3. Pessimistic Time: Time taken to complete an activity under most adverse
conditions. This is thus the longest possible time taken to complete a project.
Activity Time= [Optimistic time + 4 x (Likely expected time) + Pessimistic time] /6
62
63. Consider the following table summarizing the details of a project:
ACTIVITY PREDECESSOR
DURATION (WEEKS)
OPTIMISTIC MOST LIKELY PESSIMISTIC
A - 5 6 7
B - 1 3 5
C - 1 4 7
D A 1 2 3
E B 1 2 9
F C 1 5 9
G C 2 2 8
H E, F 4 4 10
I D 2 5 8
J H, G 2 2 8
ā¢ Construct the project network
ā¢ Find the expected duration of
each activity
ā¢ Find the critical path and the
project completion time
63
65. ACTIVITY PREDECESSOR
DURATION (WEEKS) EXPECTED
TIME
OPTIMISTIC MOST LIKELY PESSIMISTIC
A - 5 6 7 6
B - 1 3 5 3
C - 1 4 7 4
D A 1 2 3 2
E B 1 2 9 3
F C 1 5 9 5
G C 2 2 8 3
H E, F 4 4 10 5
I D 2 5 8 5
J H, G 2 2 8 3
Expected time =
[O + (4 x M) + P] / 6
65
66. 1
5
2
6 8
7
4
3
A = 6
H = 5
G = 3
F = 5
I = 5
D = 2
E = 3
B = 3
C = 4
J = 3
Critical path = C-F-H-J Project completion time = 17 weeks
1
5
2
6 8
7
4
3
66
67. Plan service
Equipment ordered Equipment installed
Start providing service
Staff recruited Staff trained
2 months
10 months
1 month
4 months
2 months
1 month
67
68. Miscellaneous
Financial techniques
Statistical techniques
Activity analysis
Mathematical techniques
1) Time trends and forecasting
2) Decision theory and tree
1) Time and Motion study
2) Work sampling and activity analysis
3) Queuing theory
4) Gantt chart and work schedule
1) Simulation study /model
2) System analysis
3) Linear programming
4) Inventory control
5) Network analysis
6) PERT
7) CPM
68
69. Miscellaneous
Financial techniques
1) Cost accounting and analysis
2) Cost Benefit Analysis
3) Cost Effective Analysis
4) Zero base budgeting
5) Input output analysis
1) Management by exception
2) Situation analysis
3) SWOT Analysis
4) Log frame Analysis
69
71. Is there a good evidence of effectiveness of interventions being compared
Are the effectiveness of interventions equal?
Can the outcome be valued in monetary terms
Can outcomes be measured in terms of QALY/ DALY
Costing study
Cost minimization analysis
Cost-benefit analysis
Cost effectiveness
Cost Utility analysis
YES NO
YES
NO
YES NO
NO
YES
71
72. ZERO-BASED BUDGETING
Method of budgeting in which all expenses must be justified for each new year
(current need, cost, alternate options) rather than based on previous years
Setting objectives Developing decision unit Developing decision packages
Ranking decision packages
Resource allocation
Controlling and Monitoring
PROCESS
72
73. BENEFITS
ā¢ Efficient allocation of resources, as it is based on needs and benefits rather than history
ā¢ Drives managers to find cost effective ways to improve operations
ā¢ Detects inflated budgets
ā¢ Increases staff motivation by providing greater initiative and responsibility in decision-making
ā¢ Identifies and eliminates wasteful and obsolete operations
ā¢ Flexible technique
ā¢ Useful for government department
73
74. DRAWBACKS
ā¢ More time-consuming than incremental budgeting
ā¢ Justifying every line item can be problematic for departments with intangible outputs
ā¢ Requires specific training, due to increased complexity
ā¢ High administrative cost
ā¢ Increased paper work and man-power
74
75. INPUT-OUTPUT ANALYSIS
Input-output analysis seeks to explain how one industry sector affects others in the same nation
There is a circular relationship between inputs and output of an economy
Wassily Leontief, a Soviet-American economist developed the input-output analysis
method, earning him the Nobel Prize in economics in 1973
Output of A Input of B, C, D
75
76. X1 X2 FD
X1 X11 X12 F1
X2 X21 X22 F2
Balancing equation: X1 = X11 + X12 + F1
Purchasing sector
Selling
sector
An input-output table shows how much of each input is needed to produce
unit amount of each output
76
77. Miscellaneous
Financial techniques
1) Cost accounting and analysis
2) Cost Benefit Analysis
3) Cost Effective Analysis
4) Zero base budgeting
5) Input output analysis
1) Management by exception
2) Situation analysis
3) SWOT Analysis
4) Log frame Analysis
77
79. MANAGEMENT BY EXCEPTION
Management by exception is the practice of examining the financial
and operational results of a business, and only bringing issues to the
attention of management if results represent substantial differences
from the budgeted or expected amount.
79
80. Efficient practices
Managers can lead their company efficiently by delegating tasks. They focus on achieving the
company's vision while other employees work on daily tasks to keep the company operational.
Sets clear priorities
For example, if an employee knows they should notify a manager if they sign a high-profile
client, the employee also understands how important that activity is.
Motivates employees
Because management by exception allows employees to work independently, it can motivate
employees to take more responsibility at work.
Quickly addresses problems
ADVANTAGES
80
81. DISADVANTAGES
Less focus on preventive measures
Because management by exception relies on reacting to a problem, it can neglect to
put preventative measures in place.
Requires close monitoring
Companies need to establish close monitoring practices ensuring professionals alert
the managers when a problem arises.
Requires advanced problem-solving skills
All leaders within a company are required to have exceptional problem-solving skills.
This helps them quickly address issues and find creative solutions.
81
82. SITUATIONAL ANALYSIS
It is an integral component of the management process to find out what the existing situation
is, analyze the same, identify, which aspects needs changing, and then plan accordingly
This method described as āwhere are we nowā, is the means by which a company can identify
its own strengths and weaknesses as they relate to external opportunities and threats
82
For example, studies regarding drug prescription and consumption in different types of health
facilities. The result of these studies reveal the prescribing habits of Doctors, and the need
and ways for improving drug management to make them safer and economical
83. OBJECTIVE INTERVENTION OUTPUTS INDICATORS
To increase deliveries
by SBA from 20% in
2012 to 80% in 2017
ā¢ SBAs are posted at PHC
on 8 hours duty
ā¢ One MO available at PHC
on 8 hours shift basis
ā¢ Referral transport
available
ā¢ Number of deliveries
by SBA
ā¢ Expected outcome:
80% deliveries by SBA
ā¢ % of deliveries by SBA
out of total deliveries
ā¢ Verify from HMIS
LOGICAL FRAMEWORK
A logical framework or āLog Frameā is a management tool for Planning, Progress
Monitoring and Evaluation of the program
This tool ensures that planning is result-oriented and outcomes are evidence-based
A Logical Framework for safe deliveries 83
85. It involves identifying the internal and external
factors that are favorable and unfavorable to
achieve a objective
SWOT ANALYSIS
SWOT analysis is a strategic planning
method used to evaluate the Strengths,
Weaknesses, Opportunities, and Threats
involved in a project/ program
85
86. HELPFUL HARMFUL
ā¢ Political will
ā¢ Commitment of key research institutes
ā¢ Framework in form of NCD programs
ā¢ Integration of all chronic diseases
ā¢ Dedicated resources
ā¢ Poor monitoring and evaluation
ā¢ Limited implementation capacity
ā¢ Low levels of community awareness
ā¢ Low utilization rates
ā¢ Low expenditure rates
ā¢ Best buys
ā¢ PEN Intervention Package
ā¢ Health system strengthening
ā¢ NCD surveillance
ā¢ Digitization
ā¢ Adherence monitoring
ā¢ Rising burden of NCDs
ā¢ Low budget allocation for NCD programs
ā¢ Diversity in sub-populations
ā¢ Absence of regulatory mechanism
SWOT Analysis of NCD program
INTERNAL
EXTERNAL
S
O T
W
86
87. Miscellaneous
Financial techniques
1) Cost accounting and analysis
2) Cost Benefit Analysis
3) Cost Effective Analysis
4) Zero base budgeting
5) Input output analysis
1) Management by exception
2) Situation analysis
3) SWOT Analysis
4) Log frame Analysis
87
89. REFERENCES
ā¢ https://www.gantt.com/
ā¢ https://queue-it.com/blog/queuing-theory/
ā¢ WHO Modern management methods and the organization of health services
ā¢ https://www.youtube.com/watch?v=WrAf6zdteXI
ā¢ Park textbook of community medicine
ā¢ Public Health Management by Sunderlal
ā¢ Treatise on Health Management by SC Mohapatra
ā¢ Handbook of Health Planning and Management by Sukamal Bisoi
ā¢ Pdf on MMT by Dr. Sharon (shared in telegram group)
ā¢ YouTube videos (link will be provided on request)
89