This document discusses various modern management techniques used in healthcare. It begins by defining management and its importance in healthcare, specifically regarding human resources, time, materials, and financial management. It then contrasts traditional behavioral management approaches with modern quantitative and semi-quantitative techniques emerging after World War II using mathematics, statistics, and other concepts. Several specific modern techniques are described in detail, including statistical techniques like decision trees, activity analysis methods like time motion studies and work sampling, queuing theory, and mathematical techniques like simulation, systems analysis, and various inventory control analyses. The document provides examples of how these techniques can increase efficiency and ensure better healthcare.
The document provides an outline for critiquing a research paper, describing key elements that should be evaluated such as the title, abstract, introduction, methods, results, and discussion sections. Specifically, it lists questions researchers should consider for each section, such as whether the problem statement specifies the nature of the population and variables, if the literature review identifies gaps in knowledge, and how the randomization process, blinding, and statistical analysis were described. A thorough critique of a research paper requires carefully evaluating each of these components using the outlined criteria.
This document discusses issues related to treatment switching in clinical trials and potential methods for adjusting overall survival results when treatment switching occurs. It defines treatment switching as when a patient randomized to one treatment arm changes to the alternative treatment during a study. Several challenges and potential solutions are outlined, including determining whether adjustment is necessary, which adjustment method is appropriate, and assumptions of different adjustment methods. The document emphasizes transparently reporting assumptions, considering multiple adjustment methods, and using simulation to assess the impact of assumptions.
Presentation by David Wonderling, Head of Health Economics at National Guideline Centre, Royal College of Physicians and Lauren Ramjee, Senior Health Economist, Royal College of Physicians.
This workshop outlines the principles of health economic evaluation for the NHS.
This document discusses key concepts of quality in healthcare. It begins by providing definitions of quality from various experts and emphasizes that quality is the result of intention, effort, direction and execution. It then discusses 11 dimensions of quality care including appropriateness, availability, competency, continuity, effectiveness, efficiency, prevention, respect, safety and timeliness. The document outlines principles of quality management including a focus on processes, customer relationships, variability reduction, and employee involvement. It concludes by discussing the Joint Commission's standards for assessing an organization's commitment to quality.
D1 design and analysis approaches to evaluate cardiovascular risk - 2012 eugmtherealreverendbayes
This document summarizes a presentation on approaches to evaluate cardiovascular risk in diabetes drug development. It discusses using meta-analysis and group sequential designs to integrate cardiovascular evaluation into clinical trials and potentially reduce patient exposure. It also compares options like conducting a single large outcome study, two separate cardiovascular outcome trials, or incorporating sub-studies into cardiovascular outcome trials. The presentation emphasizes planning for both non-inferiority and superiority assessments and considering operational aspects like maintaining trial blinding for interim analyses.
This document discusses adaptive clinical trials. Adaptive trials allow changes to the trial design based on interim data analysis in order to make the trial more efficient. Key aspects that can be adapted include sample size, treatments, endpoints, and eligibility criteria. Adaptive designs are well-suited for exploratory trials aimed at learning, but confirmatory trials require more prior data and safeguards to ensure the trial's integrity and the validity of its conclusions. The FDA has provided guidance on adaptive designs to ensure patient safety and that adaptive trials meet evidentiary standards for approval.
This document discusses a methodological framework for conducting economic analyses to inform the selection of medicines for China's Essential Medicines List. It outlines steps such as developing a focused research question, systematically reviewing existing economic evidence, assessing methodological quality and transferability, and conducting primary economic studies if needed. The framework provides guidance on key aspects of economic analyses including study design, measurement of health outcomes and resource use, discounting, and dealing with uncertainty. The goal is to establish practical tools for preparing and critically appraising economic evidence to support medicines selection in China.
1. Operational research began in the 1930s to help optimize resource allocation for problems in defense, industry, education, and health services.
2. It uses scientific techniques to help policymakers and program managers review, redirect, and restructure programs to improve efficiency, effectiveness, and evidence-based decision making.
3. Some examples of operational research include optimizing tuberculosis screening and treatment, improving adherence to HIV/AIDS treatment, and evaluating new interventions through implementation research before scaling up programs.
The document provides an outline for critiquing a research paper, describing key elements that should be evaluated such as the title, abstract, introduction, methods, results, and discussion sections. Specifically, it lists questions researchers should consider for each section, such as whether the problem statement specifies the nature of the population and variables, if the literature review identifies gaps in knowledge, and how the randomization process, blinding, and statistical analysis were described. A thorough critique of a research paper requires carefully evaluating each of these components using the outlined criteria.
This document discusses issues related to treatment switching in clinical trials and potential methods for adjusting overall survival results when treatment switching occurs. It defines treatment switching as when a patient randomized to one treatment arm changes to the alternative treatment during a study. Several challenges and potential solutions are outlined, including determining whether adjustment is necessary, which adjustment method is appropriate, and assumptions of different adjustment methods. The document emphasizes transparently reporting assumptions, considering multiple adjustment methods, and using simulation to assess the impact of assumptions.
Presentation by David Wonderling, Head of Health Economics at National Guideline Centre, Royal College of Physicians and Lauren Ramjee, Senior Health Economist, Royal College of Physicians.
This workshop outlines the principles of health economic evaluation for the NHS.
This document discusses key concepts of quality in healthcare. It begins by providing definitions of quality from various experts and emphasizes that quality is the result of intention, effort, direction and execution. It then discusses 11 dimensions of quality care including appropriateness, availability, competency, continuity, effectiveness, efficiency, prevention, respect, safety and timeliness. The document outlines principles of quality management including a focus on processes, customer relationships, variability reduction, and employee involvement. It concludes by discussing the Joint Commission's standards for assessing an organization's commitment to quality.
D1 design and analysis approaches to evaluate cardiovascular risk - 2012 eugmtherealreverendbayes
This document summarizes a presentation on approaches to evaluate cardiovascular risk in diabetes drug development. It discusses using meta-analysis and group sequential designs to integrate cardiovascular evaluation into clinical trials and potentially reduce patient exposure. It also compares options like conducting a single large outcome study, two separate cardiovascular outcome trials, or incorporating sub-studies into cardiovascular outcome trials. The presentation emphasizes planning for both non-inferiority and superiority assessments and considering operational aspects like maintaining trial blinding for interim analyses.
This document discusses adaptive clinical trials. Adaptive trials allow changes to the trial design based on interim data analysis in order to make the trial more efficient. Key aspects that can be adapted include sample size, treatments, endpoints, and eligibility criteria. Adaptive designs are well-suited for exploratory trials aimed at learning, but confirmatory trials require more prior data and safeguards to ensure the trial's integrity and the validity of its conclusions. The FDA has provided guidance on adaptive designs to ensure patient safety and that adaptive trials meet evidentiary standards for approval.
This document discusses a methodological framework for conducting economic analyses to inform the selection of medicines for China's Essential Medicines List. It outlines steps such as developing a focused research question, systematically reviewing existing economic evidence, assessing methodological quality and transferability, and conducting primary economic studies if needed. The framework provides guidance on key aspects of economic analyses including study design, measurement of health outcomes and resource use, discounting, and dealing with uncertainty. The goal is to establish practical tools for preparing and critically appraising economic evidence to support medicines selection in China.
1. Operational research began in the 1930s to help optimize resource allocation for problems in defense, industry, education, and health services.
2. It uses scientific techniques to help policymakers and program managers review, redirect, and restructure programs to improve efficiency, effectiveness, and evidence-based decision making.
3. Some examples of operational research include optimizing tuberculosis screening and treatment, improving adherence to HIV/AIDS treatment, and evaluating new interventions through implementation research before scaling up programs.
The randomised control trial (RCT) is a trial in which subjects are randomly assigned to one of two groups: one (the experimental group) receiving the intervention that is being tested, and the other (the comparison group or control) receiving an alternative (conventional) treatment
The background, key features and main steps of the concise analysis method are described, discussed and applied in this module together with the main tools used during a concise analysis (timeline, guiding questions, constellation diagram, and statements of findings).
1. The document discusses the nursing process and its key steps: assessment, nursing diagnosis, planning, implementation, and evaluation. It emphasizes that critical thinking is essential for each step.
2. Key aspects of critical thinking discussed include reflection, intuition, problem-solving, decision-making, and developing critical thinking skills and attitudes.
3. The nursing process provides a systematic framework for nurses to gather data, analyze it, identify issues, design goals and interventions, take action, and evaluate outcomes. It requires ongoing assessment, modification of the care plan as needed, and reevaluation until goals are met.
Health technology assessment- Dr. Saraswathy MD, PGIMERYogesh Arora
This document provides an overview of health technology assessment (HTA), including its need, scope, and current status. It discusses:
1. The growing need for priority setting and efficient resource allocation in health systems has led to the rise of HTA globally and in India.
2. HTA involves systematically evaluating medical, economic, social, and ethical aspects of health technologies to inform policy decisions. It aims to maximize health benefits within limited budgets.
3. India has established the Health Technology Assessment Board to conduct HTAs and provide recommendations to guide public health programs and policies. However, developing local evidence and building capacity remains an ongoing challenge.
This document discusses nursing quality management. It provides an overview of quality assurance and total quality management approaches in healthcare. It also outlines some common quality management tools used in nursing like check sheets, control charts, Pareto charts, scatter plots, Ishikawa diagrams, histograms. Finally, it lists some other related topics to nursing quality management.
1. The document discusses decision making, outlining key principles, types, strategies, and processes involved.
2. Decision making involves defining problems, gathering alternatives, evaluating options, selecting a solution, and following up on outcomes.
3. Decisions can be programmed, for routine issues, or non-programmed, for unique problems, and involve varying levels of risk and uncertainty.
Operational research is becoming important in real world setting of health care as it always tried to find out challenges or gaps in any health related issues or in program. For health program improvement, OR should be conducting frequently. Program manager and doctors should be involve in OR and encourage to do so.
This document discusses patient-reported outcomes (PROs) and their importance in clinical research. It covers:
1) Why PROs that measure how patients feel and function are increasingly important primary outcomes, as they better reflect the impacts of chronic diseases than physiological tests alone.
2) The different types of PRO instruments and their properties, such as discriminating between patient groups or measuring changes over time.
3) Key concepts in interpreting PRO results, including the minimal important difference (MID) - the smallest difference perceived as important by patients - and using it to determine meaningful treatment benefits.
This document discusses reference intervals, which provide the range of normal test results for clinical decision making. It outlines the process for establishing and verifying reference intervals, including selecting a healthy reference population and statistically analyzing the results. Both nonparametric and parametric statistical methods can be used to determine the reference interval that spans the central 95% of reference values. Clinical laboratories often rely on published reference intervals from assay manufacturers or literature to avoid the cost and effort of establishing their own.
This document discusses the place of surgical research within the North East AAAScreening Programme and is presented by Gerry Stansby, the Clinical Lead. It covers several key points:
1) Evidence-based medicine is important for improving patient care and relies on systematically reviewing clinical research findings.
2) Randomized controlled trials are considered the highest level of evidence but are difficult to conduct in surgery due to challenges like accounting for learning curves.
3) The AAA screening research committee should be notified of any research involving patient data or audits/service evaluations related to the screening program so they can provide input and ensure ethical standards are met.
4) Obtaining more evidence through high-quality research is
This document discusses the importance of effective trial management for clinical trials. It notes that many trials fail due to a lack of structured management approaches. The key elements of effective trial management include:
1) Developing a robust project management plan that outlines the trial processes and responsibilities.
2) Establishing an efficient trial management team with clear roles.
3) Carefully planning recruitment strategies and ensuring minimal workload for investigators and participants.
4) Implementing standardized, transparent systems for data management and quality control.
Effective trial management requires considering clinical trials from a business management perspective and applying project management principles.
This document provides an overview of quality risk management guidelines from ICH Q9. It discusses risk assessment, which involves defining risks, assessing likelihood and consequences, and providing quantitative or qualitative estimates. Risk control aims to reduce risks to acceptable levels through measures like benefit-cost analysis. Risks should be regularly reviewed as part of quality management. Tools for risk assessment include FMEA, FMECA, HACCP, and risk ranking/filtering. HACCP in particular is useful for identifying and controlling physical, chemical and biological hazards through critical control points.
Journal Club Presentation on The Importance of Leadership in Preventing Healt...Sonali Shah
Leadership plays a key role in preventing healthcare-associated infections. Through interviews at multiple hospitals, the study found that effective leaders in infection prevention displayed behaviors like vision, knowledge, and strong communication skills. While senior executives can be leaders, the study observed that roles like epidemiologists, nurses, and quality managers also demonstrated transformational leadership through inspiring staff and cultivating a culture of clinical excellence. The findings suggest leadership broadly defined and at different levels contributes significantly to hospitals' ability to implement infection control practices.
The document discusses using the scientific method (TSM) as an operational tool to reduce laboratory errors. It describes TSM as a knowledge acquisition tool that imposes rigorous standards to establish facts before taking action. TSM provides a structured process and feedback loops to integrate elements critical for successful laboratory practice, including validating instruments and investigating errors. Implementing TSM principles through an integrated validation system would allow flexible configuration of verification steps to ensure all information is evaluated and necessary actions are taken.
Sample size calculation in medical researchKannan Iyanar
A short description on estimation of sample size in health care research. It describes the basic concepts in sample size estimation and various important formulae used for it.
Strategies for Analgesic Development and the FDA Guidance for Analgesic Indic...Brook White, PMP
This presentation provides a high-level review of FDA’s guidance, offers strategies for analgesic product development and shares experiences with PROs and paper vs. tablet collection.
The document discusses quality risk management (ICH Q9) and provides guidance on its goals, expectations, principles, tools, and methodology. The key goals of quality risk management are to prioritize risks based on their potential impact to patient safety, conduct scientific risk assessments, and ensure appropriate quality systems. The level of risk management should be commensurate with the level of risk and have a strong focus on protecting public health. It also outlines various risk management tools that can be used including FMEA, FMECA, HACCP, and provides guidance on how to initiate, conduct, and review a quality risk management process.
Different techniques of costing in strategic management accounting discussed.
Marginal costing,budgetary control, standard costing,Activity based costing,responsibility costing.
Cost and management accounting techniques are essential tools for effective decision making. Some key techniques discussed are:
1) Make or buy analysis which helps decide whether to produce an item internally or purchase it based on relevant costs like variable production costs and supplier prices.
2) Inventory management techniques like just-in-time and economic order quantity which aim to reduce inventory costs.
3) Budgeting allows defining goals, coordinating activities, and allocating resources.
4) Variance analysis identifies reasons for deviations from budgets.
5) Cost-volume-profit analysis uses graphs and equations to understand break-even points and profit/loss areas.
6) Activity based costing allocates overhead costs based on
The document discusses different types of audits:
- Statutory audits are legally required reviews of a company's or government's financial records to determine if they provide an accurate representation of their financial position.
- Non-statutory audits are voluntary and terms are agreed upon between the auditor and proprietor.
- Internal audits are independent reviews conducted within an organization to evaluate risk management, controls, and governance processes.
- Special audits are specifically requested to detect potential errors, irregularities, or fraud.
The randomised control trial (RCT) is a trial in which subjects are randomly assigned to one of two groups: one (the experimental group) receiving the intervention that is being tested, and the other (the comparison group or control) receiving an alternative (conventional) treatment
The background, key features and main steps of the concise analysis method are described, discussed and applied in this module together with the main tools used during a concise analysis (timeline, guiding questions, constellation diagram, and statements of findings).
1. The document discusses the nursing process and its key steps: assessment, nursing diagnosis, planning, implementation, and evaluation. It emphasizes that critical thinking is essential for each step.
2. Key aspects of critical thinking discussed include reflection, intuition, problem-solving, decision-making, and developing critical thinking skills and attitudes.
3. The nursing process provides a systematic framework for nurses to gather data, analyze it, identify issues, design goals and interventions, take action, and evaluate outcomes. It requires ongoing assessment, modification of the care plan as needed, and reevaluation until goals are met.
Health technology assessment- Dr. Saraswathy MD, PGIMERYogesh Arora
This document provides an overview of health technology assessment (HTA), including its need, scope, and current status. It discusses:
1. The growing need for priority setting and efficient resource allocation in health systems has led to the rise of HTA globally and in India.
2. HTA involves systematically evaluating medical, economic, social, and ethical aspects of health technologies to inform policy decisions. It aims to maximize health benefits within limited budgets.
3. India has established the Health Technology Assessment Board to conduct HTAs and provide recommendations to guide public health programs and policies. However, developing local evidence and building capacity remains an ongoing challenge.
This document discusses nursing quality management. It provides an overview of quality assurance and total quality management approaches in healthcare. It also outlines some common quality management tools used in nursing like check sheets, control charts, Pareto charts, scatter plots, Ishikawa diagrams, histograms. Finally, it lists some other related topics to nursing quality management.
1. The document discusses decision making, outlining key principles, types, strategies, and processes involved.
2. Decision making involves defining problems, gathering alternatives, evaluating options, selecting a solution, and following up on outcomes.
3. Decisions can be programmed, for routine issues, or non-programmed, for unique problems, and involve varying levels of risk and uncertainty.
Operational research is becoming important in real world setting of health care as it always tried to find out challenges or gaps in any health related issues or in program. For health program improvement, OR should be conducting frequently. Program manager and doctors should be involve in OR and encourage to do so.
This document discusses patient-reported outcomes (PROs) and their importance in clinical research. It covers:
1) Why PROs that measure how patients feel and function are increasingly important primary outcomes, as they better reflect the impacts of chronic diseases than physiological tests alone.
2) The different types of PRO instruments and their properties, such as discriminating between patient groups or measuring changes over time.
3) Key concepts in interpreting PRO results, including the minimal important difference (MID) - the smallest difference perceived as important by patients - and using it to determine meaningful treatment benefits.
This document discusses reference intervals, which provide the range of normal test results for clinical decision making. It outlines the process for establishing and verifying reference intervals, including selecting a healthy reference population and statistically analyzing the results. Both nonparametric and parametric statistical methods can be used to determine the reference interval that spans the central 95% of reference values. Clinical laboratories often rely on published reference intervals from assay manufacturers or literature to avoid the cost and effort of establishing their own.
This document discusses the place of surgical research within the North East AAAScreening Programme and is presented by Gerry Stansby, the Clinical Lead. It covers several key points:
1) Evidence-based medicine is important for improving patient care and relies on systematically reviewing clinical research findings.
2) Randomized controlled trials are considered the highest level of evidence but are difficult to conduct in surgery due to challenges like accounting for learning curves.
3) The AAA screening research committee should be notified of any research involving patient data or audits/service evaluations related to the screening program so they can provide input and ensure ethical standards are met.
4) Obtaining more evidence through high-quality research is
This document discusses the importance of effective trial management for clinical trials. It notes that many trials fail due to a lack of structured management approaches. The key elements of effective trial management include:
1) Developing a robust project management plan that outlines the trial processes and responsibilities.
2) Establishing an efficient trial management team with clear roles.
3) Carefully planning recruitment strategies and ensuring minimal workload for investigators and participants.
4) Implementing standardized, transparent systems for data management and quality control.
Effective trial management requires considering clinical trials from a business management perspective and applying project management principles.
This document provides an overview of quality risk management guidelines from ICH Q9. It discusses risk assessment, which involves defining risks, assessing likelihood and consequences, and providing quantitative or qualitative estimates. Risk control aims to reduce risks to acceptable levels through measures like benefit-cost analysis. Risks should be regularly reviewed as part of quality management. Tools for risk assessment include FMEA, FMECA, HACCP, and risk ranking/filtering. HACCP in particular is useful for identifying and controlling physical, chemical and biological hazards through critical control points.
Journal Club Presentation on The Importance of Leadership in Preventing Healt...Sonali Shah
Leadership plays a key role in preventing healthcare-associated infections. Through interviews at multiple hospitals, the study found that effective leaders in infection prevention displayed behaviors like vision, knowledge, and strong communication skills. While senior executives can be leaders, the study observed that roles like epidemiologists, nurses, and quality managers also demonstrated transformational leadership through inspiring staff and cultivating a culture of clinical excellence. The findings suggest leadership broadly defined and at different levels contributes significantly to hospitals' ability to implement infection control practices.
The document discusses using the scientific method (TSM) as an operational tool to reduce laboratory errors. It describes TSM as a knowledge acquisition tool that imposes rigorous standards to establish facts before taking action. TSM provides a structured process and feedback loops to integrate elements critical for successful laboratory practice, including validating instruments and investigating errors. Implementing TSM principles through an integrated validation system would allow flexible configuration of verification steps to ensure all information is evaluated and necessary actions are taken.
Sample size calculation in medical researchKannan Iyanar
A short description on estimation of sample size in health care research. It describes the basic concepts in sample size estimation and various important formulae used for it.
Strategies for Analgesic Development and the FDA Guidance for Analgesic Indic...Brook White, PMP
This presentation provides a high-level review of FDA’s guidance, offers strategies for analgesic product development and shares experiences with PROs and paper vs. tablet collection.
The document discusses quality risk management (ICH Q9) and provides guidance on its goals, expectations, principles, tools, and methodology. The key goals of quality risk management are to prioritize risks based on their potential impact to patient safety, conduct scientific risk assessments, and ensure appropriate quality systems. The level of risk management should be commensurate with the level of risk and have a strong focus on protecting public health. It also outlines various risk management tools that can be used including FMEA, FMECA, HACCP, and provides guidance on how to initiate, conduct, and review a quality risk management process.
Different techniques of costing in strategic management accounting discussed.
Marginal costing,budgetary control, standard costing,Activity based costing,responsibility costing.
Cost and management accounting techniques are essential tools for effective decision making. Some key techniques discussed are:
1) Make or buy analysis which helps decide whether to produce an item internally or purchase it based on relevant costs like variable production costs and supplier prices.
2) Inventory management techniques like just-in-time and economic order quantity which aim to reduce inventory costs.
3) Budgeting allows defining goals, coordinating activities, and allocating resources.
4) Variance analysis identifies reasons for deviations from budgets.
5) Cost-volume-profit analysis uses graphs and equations to understand break-even points and profit/loss areas.
6) Activity based costing allocates overhead costs based on
The document discusses different types of audits:
- Statutory audits are legally required reviews of a company's or government's financial records to determine if they provide an accurate representation of their financial position.
- Non-statutory audits are voluntary and terms are agreed upon between the auditor and proprietor.
- Internal audits are independent reviews conducted within an organization to evaluate risk management, controls, and governance processes.
- Special audits are specifically requested to detect potential errors, irregularities, or fraud.
The document discusses several costing techniques including throughput accounting, theory of constraints (TOC), target costing, and backflush costing. Throughput accounting focuses on increasing throughput and reducing inventory and expenses. TOC identifies bottlenecks limiting throughput and ways to remove them. Target costing determines the maximum allowable cost for a new product based on the anticipated selling price and desired profit. Backflush costing calculates product costs retrospectively at the end of the accounting period without tracking costs throughout production.
The document discusses various classifications and procedures related to costing. It defines key costing terms like variable costs, fixed costs, direct costs, indirect costs, product costs, period costs, relevant costs, and more. Costs are classified based on their behavior, traceability, purpose, and controllability. The elements of cost - material, labor, and expenses - are also categorized as direct or indirect. Procedures for determining costs include identifying cost elements, classifying costs, and allocating common/indirect costs to arrive at the total cost of cost objects.
This document discusses various methods, techniques, and systems of costing. It describes job costing, contract costing, batch costing, process costing, operation costing, and others. It also covers techniques like marginal costing, direct costing, and absorption costing. For systems of costing, it explains historical costing using post-costing and continuous costing, as well as standard costing.
Chapter 11 cost methods, techniques of cost accounting and classification o...Kanav Sood
This document discusses different methods and techniques of cost accounting, including:
1) Job costing and process costing as the two broad categories of costing methods. Job costing accumulates costs by job while process costing is used for continuous production.
2) Techniques of costing include uniform costing, marginal costing, standard costing, historical costing, and absorption costing.
3) Costs can be classified in various ways, including by nature (material, labor, expenses), function (production, administration, selling), variability (fixed, variable, semi-variable), and normality (normal vs. abnormal costs).
D
A items
Tight control, low safety stock
B items
Ordinary control measures, moderate safety stock
C items
High safety stock, purchase based on usage
This document discusses various modern management techniques used in healthcare. It begins with definitions of management and describes traditional versus modern techniques. It then provides details on statistical techniques like decision trees, activity analysis methods like time motion studies and queuing theory. It also discusses mathematical techniques such as simulation, linear programming and inventory control methods like ABC and VED analysis. The document aims to explain how these quantitative methods can improve efficiency and ensure better healthcare.
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.
This document discusses various modern management techniques used in healthcare. It begins by defining management and its objectives. Management techniques are then classified into statistical, activity analysis, mathematical, and financial categories. Several specific techniques are described under each category, including time trends and forecasting, decision trees, time motion studies, queuing theory, simulation models, critical path method (CPM), program evaluation and review technique (PERT), cost-benefit analysis, and cost-effectiveness analysis. Examples are provided to illustrate how each technique can be applied in healthcare planning and management.
Dr Ayman Ewies - Clinical audit made easyAymanEwies
This document provides an overview of how to conduct a clinical audit. It defines clinical audit as a process used by healthcare professionals to systematically review, evaluate and improve patient care. The document outlines the key components of an audit, including choosing a topic, selecting standards, planning methodology, collecting data, analyzing results, and implementing changes. It emphasizes that the goal of audit is to compare current practices to standards in order to enhance quality of care and patient outcomes.
This document discusses health management techniques. It outlines the basic activities of management as planning, organizing, communicating, and monitoring. It then discusses several specific management techniques used in health including those based on behavioral sciences, quantitative methods, organizational design, personnel management, communication, information systems, management by objectives, cost-benefit analysis, cost-effective analysis, cost-accounting, input-output analysis, models, and systems analysis. The goal of management techniques in health is to maintain quality and equity while helping managers achieve goals efficiently.
The document discusses various approaches to quality improvement in healthcare, including Six Sigma, Total Quality Management (TQM), and the FADE model. Six Sigma uses statistical methods and aims for near-zero defect rates. TQM takes a customer-focused approach to continuous process improvement through methods like scientific problem-solving and participation at all levels. The FADE model outlines five steps for quality improvement projects: focus, analyze, develop, execute, and evaluate. Microsystems thinking views individual care units as the building blocks for organizational outcomes.
Quantitative techniques are statistical and mathematical methods used to support decision making, especially related to business. They help quantify planning factors and alternatives using tools like linear programming, break-even analysis, and simulation. Quantitative techniques are goal-oriented and aim to find optimal solutions under constraints using quantitative data and models. They provide a systematic approach to managerial decision making and help improve quality of solutions.
This document discusses various clinical applications of nursing informatics (NI), including assessment, documentation, planning, decision support systems, implementation, and evaluation. It focuses on using technology like electronic health records and computerized documentation to improve the efficiency and quality of nursing care. Key applications mentioned include computerized patient monitoring, point-of-care documentation systems, automated care planning, and decision support systems to aid nursing judgments. The summary emphasizes the importance of nurses identifying essential data for patient care decisions and evaluating technology to best serve nursing needs.
This document discusses cost effectiveness analysis in healthcare. It defines different types of costs, including direct, indirect, and intangible costs. It also outlines the purposes, steps, and drawbacks of conducting a cost effectiveness analysis. A cost effectiveness analysis examines both the costs and health outcomes of alternative interventions to identify the most cost effective option. It aims to maximize health benefits relative to the available resources and provides empirical evidence to compare costs and consequences of different programs.
Clinical audit is a quality improvement process that systematically reviews patient care against criteria to improve outcomes. It involves measuring performance, comparing to standards, and evaluating results to identify areas for improvement. Clinical audit is mandatory for medical practitioners in some countries. The audit cycle includes defining a question, identifying standards, measuring performance, analyzing gaps, implementing changes, and reauditing. Audits require collecting data, conducting peer review, and determining scope, standards, and resources. Opportunities from audits include education, systemic improvements, and continuing professional development.
Management information and evaluation systemGagan Preet
An MIES (Management Information and Evaluation System) helps managers collect and use data to make timely decisions. An effective MIES provides accurate, complete and timely information through various modules like registration, billing, diagnostics, and medical records. It also evaluates programs through process, output, effects and short-term impact evaluations to assess objectives and make improvements. MIES formats should include feedback mechanisms so decisions are made at all levels of the organization.
This document discusses decision making in nursing. It defines decision making as a systematic process of choosing among alternatives and putting the choice into action. Clinical decision making in nursing requires thoughtful reasoning to choose the best options for a client based on their condition and priority needs. The stages of decision making are orientation, conflict, and emergence. Principles of decision making include being purpose-driven, inclusive, educational, voluntary, self-designed, flexible, egalitarian, respectful, accountable and time limited. Common models of decision making are the descriptive, economical, and bounded rationality models. The document also outlines the decision making process and important decision making tools used in nursing.
The document discusses various business analysis methodologies and techniques used by business analysts. It describes qualitative techniques like interviewing, workshops, brainstorming and observation that are used to investigate situations and discover facts and opinions. Quantitative techniques discussed include questionnaires, activity sampling, special purpose records and document analysis for gathering numeric data. The roles of a business analyst are also summarized as investigating ideas and problems, formulating options, and producing recommendations.
This document discusses medical audits and provides information on various types of audits including internal and external audits, managerial/organizational audits, medical/clinical audits, and financial audits. It explains the need for audits to maintain safety, quality, reputation and funding. The document outlines the six stages of clinical audits including preparing, selecting criteria, measuring performance, making improvements, sustaining improvements, and re-auditing. Methods used in audits like direct observation, checklists, documentation reviews, questionnaires and interviews are also mentioned.
This document provides an overview of quality improvement (QI) concepts and tools. It discusses the key dimensions of healthcare quality and defines QI. The QI journey is summarized as building willingness for change, understanding the current system, developing aims and change ideas, testing changes using the PDSA cycle, implementing successful changes, and spreading changes. Popular QI tools introduced include driver diagrams, process mapping, the Model for Improvement, statistical process control charts, and Plan-Do-Study-Act cycles. Tips for successful QI projects emphasize clear aims, manageable scope, leadership, engagement, data, measures, and sharing learning.
1. INTRODUCTION TO OPERATIONS MANAGEMENT.pptxIvanIISeballos
The document provides an overview of operations management. It discusses the three major business functions of marketing, operations, and finance. It defines operations management as the management of systems or processes that create goods and/or provide services. Key aspects of operations management discussed include value-added, process management, supply chain management, variations in processes, and quantitative and qualitative decision-making approaches. The document also outlines how operations management has evolved with developments like e-commerce, Six Sigma, agility, and lean systems.
Operations Management A CEO Checklist for High-Value H.docxvannagoforth
Operations Management
A CEO Checklist for High-Value Health Care:
Ten Elements
Foundational elements
• Governance priority—visible and determined
leadership by CEO and board.
• Culture of continuous improvement—commitment
to ongoing, real-time learning.
Infrastructure fundamentals
• IT best practices—automated, reliable information to
and from the point of care.
• Evidence protocols—effective, efficient, and
consistent care.
• Resource utilization—optimized use of personnel,
physical space, and other resources.
Care delivery priorities
• Integrated care—right care, right setting, right
providers, right teamwork.
• Shared decision-making—patient-clinician
collaboration on care plans.
• Targeted services—tailored community and clinic
interventions for resource-intensive patients.
Reliability and feedback
• Embedded safeguards—supports and prompts to
reduce injury and infection.
• Internal transparency—visible progress in
performance, outcomes, and costs.
What is Operations Management?
• The design, operation, and improvement of
the processes that create and deliver the
organization’s services.
• The goal is to more effectively and efficiently
produce and deliver the organization’s
services.
Healthcare Management
• The management of processes or health systems
that provide care to patients.
• The use of decision tools to manage and
improve processes.
• Functional roles:
– CEO
– COO
– CXO
– Mid-level manager
– Department or function manager
Health Care Operations Management
– Process improvement.
– Quality control and outcomes .
– Patient satisfaction.
– Financial operations – cost, reimbursement.
– Supply chain management – procurement, medical supplies.
– Human resources management – productivity, motivating
employees.
– Information systems management.
– Population health.
– Physician alignment.
– Governance.
– Strategy and operations.
System Decisions
System Design
Capacity.
Location.
Proximity.
Service planning.
Acquisition and placement of
equipment.
System Operations
Personnel.
Inventory.
Scheduling.
Product management.
Quality measurement
and assurance.
There are two groups of decisions:
Applicability to Health Care
• Patient is a participant in the process.
• Production and consumption occur
simultaneously.
• Uncontrollable capacity.
• Site selection is dictated by patient location.
• Labor intensive.
INTRODUCTION TO PROCESS IMROVEMENT
Process or Performance Improvement
• Scientific management
– Mass production
• TQM, CQI, Six Sigma
• ISO 9000
• Lean
• Six Sigma
Background
• Scientific Management Techniques (1910s) – Frederic W. Taylor
• Standardization – Frank & Gillian Gilberth
• Psychological Effects of Work Conditions – Henry Gannt
• Quantitative Inventory Management (1915) – F.W. Harris
• Quality Control & Sampling (1930s) – W. Shewhart
• Operations ...
The document discusses various quality improvement tools and techniques. It describes Six Sigma, which aims to minimize process variability through statistical methods. Total Quality Management uses cross-functional teams to solve issues using statistical tools. Additional techniques covered include ISO 9000 quality standards, Quality Control Circles for analyzing work-related problems, and Kaizen for continuous incremental improvement. Quality tools like check sheets, cause-and-effect diagrams, flow charts, Pareto charts, scatter plots, histograms, control charts and brainstorming help organizations understand and improve their processes.
Management information system (MIS) is defined as a formal system for gathering, integrating, analyzing, and distributing pertinent information to support management decision making and operations. The objectives of MIS include enhancing communication, supporting strategic goals, and providing reliable health information to decision makers. Key roles of community health nurses in implementing MIS include ensuring cooperation, allocating resources, appointing coordinators, training staff, and ensuring continuous communication between developers and users.
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Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
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The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
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In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
2. PLAN OF PRESENTATION
• Definitions and concepts of management
• Relevance to health
• Traditional vs modern management tech.
• Classification
• Description of each technique
• Challenges in management
• References
3. • What is Management? “Management is
getting the right things done
– In right way,
– In right time,
– By right persons
– With right amount of resources and effective use of
resources.”
• It is the efficient use of resources and to get
people to work harmoniously together in order
to achieve objective. ( WHO)
EFFICIENCY AND EFFECTIVENESS
4. Term Modern: It is a basic principle of good management to
choose methods to suits whatever resources available and to use
them in pursuit of well-chosen objectives.
“Health System Management : is defined as purposeful & efficient
use of health system resources and to get members of the health
team coordinated to work harmoniously in order to achieve the
desired common Goals and Objectives.”
5. Importance of management in health
Human Resource management
Time management
Material management
Financial management
6. Relevance of modern management
technique in health
Overlapping, conflicting and competing organizations
within Health system.
Widely scattered funding mechanism with little control
over costs
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.
7. Emerged in the last few decades, since world war II.
These make increasing use of mathematical and
statistical concepts and methods.
These are the quantitative & semi-quantitative
methods which are fruitfully employed in management
of business, defense, industry and health.
It has been proved that these techniques useful in
increasing the efficiency by cost reduction as well as
ensuring better health care
8. Traditional vs Modern management tech.
Traditional : based on behavioural sciences eg.
Personnel selection, training & retraining, motivational
methods, leadership development, supervision etc.
Modern : based on sociology, psychology, social
psychology, educational technology, economics and
statistics
9. Modern management technique
Statistical techniques
• Time trends & forecasting
• Decision theory and tree
Activity analysis
• Time motion studies
• Work sampling and activity
analysis
• Queuing theory
• Gantt chart & work
schedule
Mathematical
techniques
• Simulation study/models
• Systems analysis
• Linear programming
• Inventory control
• Network analysis
• PERT & PEP
• CPM
10. Modern management techniques
Financial techniques
• Monitoring expenditure
• Cost accounting & analysis
• DALY
• Cost benefit analysis
• Cost effectiveness analysis
• Performance budget
• PPBS
• Zero base budgeting
• Input output analysis
• Outcome budget
Miscellaneous
• Management by objective
& appraisal by results
• Management by exception
• Situational analysis
• Current state assessment
• SWOT analysis
• Log frame analysis
11. STATISTICAL TECHNIQUES
1. Time–trends and forecasting : based on information
on occurrence of certain events, certain patterns can be
recognized eg. 1. Secular trend – increasing
incidence of CHD, accidents and cancers etc. 2.
seasonal variations of gastro-enteritis.
• 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
12. 2. Decision theory and decision tree :
• A methods for determining the optimal course of action
when a number of alternatives are available and their
consequences cannot be forecast with certainty
• Uses probabilistic analysis to help in the selection of
remedial actions.
13. Types of environment:
1. Decision making under certainty
– Future “states of nature” are known
– Will choose the alternative that has the
highest payoff (or the smallest loss)
2. Decision making under uncertainty
– Future “states of nature” are uncertain
– Depends on the degree of decision maker’s
optimism
3. Decision making under risk
Decision
theory
Applies
14. Decision Tree
• It is a decision support tool that uses a tree-like graph of
decisions and their possible consequences ( including
chance event outcomes, resource costs, and utility)
• Commonly used in operations research, specifically
in decision analysis, to help identify a strategy most
likely to reach a goal.
• It enables people to decompose a large complex
decision problem into several smaller problems
15. • Symptomatic patient:
»operate (risky)
»medical management
• If disease present at surgery, must decide whether
try for cure or palliate
• Want to evaluate surgery vs. medical
management
Constructing a decision tree
16. Three types of nodes:
1. Decision node -
2. Chance node -
3. End node -
• only splitting paths no converging path
17.
18.
19.
20.
21.
22. • Decision theory (DT) represents a generalized
approach to decision making
• Decision making is an integral part of
management:
– The decision maker selects one strategy (course of
action) over others depending on some criteria, like
utility, sales, cost or rate of return.
– Is used whenever an organization or an individual
faces a problem of decision making or dissatisfied
with the existing decisions or when alternative
selection is specified
23. Solution steps to any decision
problem
1. Identify the problem
2. Specify objectives and the decision
criteria for choosing a solution
3. Develop alternatives
4. Analyze and compare alternatives
5. Select the best alternative
6. Implement the chosen alternative
7. Verify that desired results are achieved
24. Advantages of decision trees
• Are simple to understand and interpret
• Useful to analyze the possible outcomes of
complex decisions.
• Possible scenarios can be added
• Most rational decision is taken in terms of
resource and effectiveness.
• Worst, best and expected values can be
determined for different scenarios
• For example : to study alternative health strategies
in disease screening, immunization etc.
25. ACTIVITY ANALYSIS TECHNIQUE
1. Time motion studies : it consists of observing and timing
by using stopwatches the physical work & movements carried
out by worker.
• 1) a complex task is broken into small & simple steps,
• 2) the sequence of movements taken by the employee in
performing those steps is carefully observed and analyzed to
detect & eliminate redundant and wasteful motion,
• 3) precise time taken for each correct movement is measured.
26. ADVANTAGES:
• Reduction of physical effort
• Time saving and
• Increase productivity
• Eg. From each ward lab samples used to sent with a servant to
central path lab. Servants take excessive time to return.
• Modification :- one servant from the central lab goes to
different ward with trolley at predetermined time. Reports
delivered in same way
27. 2. WORK SAMPLING AND ACTIVITY ANALYSIS
Work sampling : is a commonly used industrial engineering
technique designed to measure how resources such as people,
machines, facilities, or equipments are utilized.
• The method consist of making observation at random for
appropriate length of time and recording the utilization of
equipment or activities of a people during these periods.
• sample statistical method total activity
• Work sampling is used to estimate the proportion of workers'
time that is devoted to different elements of work activity.
• The idle time of machines and equipment can be calculated
28. • Observed activities are grouped into either of two main
classifications: working or nonworking.
• The working classification can be subdivided into
desirable or undesirable.
Advantages:
• work sampling is a low cost alternative to continuous
monitoring, just as sampling in the audit context is a
low cost alternative to 100 percent evaluation of an
account.
• Better and proper utilization of time
29. • Example: Observations among nurses :
21 % of time spent on bed side
nursing.33 % of time spent on clerical
activities in the ward
• PHC staff: 15 % of time on direct
services, 34 % on administration, 21 %
on travel, 30 % on non productive
activities.
30. 3. Queuing Theory
Queuing theory is basically a mathematical approach applied to the
analysis of waiting lines.
eg. emergency room, OPD setting, pharmacy, for emergency and
disaster management preparedness etc.
Goal of queuing analysis: to minimize costs
Costs of waiting lines or queue:
1. Cost associated with patients having to wait for service
Loss of business to HCO
Costs incurred by society
Decreased patient satisfaction and quality of care
31. 2. Cost of providing the services (capacity cost)
Salaries paid to employees.
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.
Fixed costs – cost of waiting space, facilities, equipments, and
supplies.
• It is extremely useful in predicting and evaluating performance
• Excessive queuing can quickly erode customer loyalty.
• How to minimize the time spent by customers standing in a
queue
• What is the trade-off between the time customers spend queuing
and the cost of additional capital to reduce queuing times?
32. Answer is Queuing analysis
• Queuing theory involves the analysis of what is known as a
queuing system, which is composed of a server; a stream of
customers, who demand service; and a queue, or line of
customers waiting to be served
33. Characteristics
• Arrival Process
– The probability density distribution that determines the customer
arrivals in the system.
• Service Process
– The probability density distribution that determines the customer service
times in the system.
• Number of Servers
– Number of servers available to service the customers.
• Number of Channels
– Single channel
– Multi channels
• Number of Phases/Stages
– Single Queue
– Series or Tandem
– Cyclic -Network
• Queue Discipline -Selection for Service
– First com first served (FCFS or FIFO)
– Last in First out (LIFO)
-Random
-Priority
34. Assessing the parameters
• Customer arrival rate
– The number of customers entering the system per
unit time
• Customer service rate
– The number of customers the system serves per unit
time
• Average number of customers in the system
– The number of customers either waiting in queue or
receiving service
• Average delay per customer
– The time a customer spends waiting plus the service
time
35. Little’s Law
• Example: the average number of customers (N) can be
determined from the following equation:
• N= T
• lambda - is the average customer arrival rate and
• T - is the average service time for a customer.
• Let N = the number of people seated (say 200)
• Let T = mean amount of time a person stays seated (say 90 min)
• Conclusion
– Avg . Customer arrival rate = 200/90 = 2.22 persons per minute
• Wait time
– If 100 people are waiting, you could estimate that you will need to wait
100/2.22 = 45 min
36. 4. Gantt Chart
A Gantt chart is a graphical representation of the
duration of tasks against the progression of time.
It is a type of bar chart that illustrates a project
schedule. allow to assess how long a project
should take.
Gantt charts monitor progress.
It can immediately see what should have been
achieved at a point in time.
Gantt charts allow to see how remedial action
may bring the project back on course.
Henry Laurence
Gantt (1861-1919)
37. How to make Gantt chart
• Can be created with simple tools like Excel, but
specialised tools like Microsoft Project make it easier
• Step 1 – list the tasks in the project
• Step 2 – add task durations
• Step 3 – add dependencies (which tasks cannot start
before another task finishes)
• Step 4 – lay out all of the bars on the graph
38. Choose research area
Preliminary research
Decide research topic
Decide methodology
Submit/present proposal
Finalise methodology
Conduct research
Analyse data
Write up
Submit assignment
Wk9
Wk10
Wk11
Wk6
Wk7
Wk8
Wk24
Wk23
Wk12
Wk13
Wk14
Wk15
Wk16
Wk17
Wk18
Wk19
Wk20
Wk21
Wk22
Fig. Simple research project Gantt chart
Tasks
Duration
39. • Characteristics:
– The bar in each row identifies the corresponding task
– The horizontal position of the bar identifies start and end times
of the task
– Bar length represents the duration of the task
– Task durations can be compared easily
– Good for allocating resources and re-scheduling
– Precedence relationships can be represented using arrows
– Critical activities are usually highlighted
– Slack times are represented using bars with doted lines
– The bar of each activity begins at the activity earliest start time
(ES)
– The bar of each activity ends at the activity latest finish time
(LF).
40. Advantages
Simple
Good visual communication to others
Task durations can be compared easily
Good for scheduling resources
Disadvantages
Dependencies are more difficult to visualise
Minor changes in data can cause major changes in the
chart
41. 1. Simulation Studies/Model
• Use of mathematical models to calculate
results by means of simulation of a real
situation.
• Impact of inputs and changes on the output
can also be estimated
• Objective : to forecast the probable effects of
measures in terms of relative cost and benefit.
Mathematical techniques
42. 2. Systems Analysis
• System : An
arrangement and set of
relationships among
multiple parts functioning
as a whole.
• Systems Analysis: Study
of inter relationships
operating in the various
components within a
system and also between
a system and other
systems.
• Systems: Hospital,
Community health
centre, dispensary,
43. Steps
• Set of objectives to be achieved is
defined and alternatives to achieve
these is formulated.
• Alternatives are evaluated in terms of
cost-effectiveness.
• Mathematical models may be used.
44. 3. Linear Programming
•Mathematical tool
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 at.
linear programming (LP) problems are optimization
problems
in which the objective function and the constraints are all
linear.
• It is a useful tool for deciding the course of action for a
problem in which there are competing alternatives uses
for limited resources.
45. 4. Inventory Control
• Method of
maintaining of stock
at a level at which
purchasing and
storing costs are the
lowest possible
without interference
with supply
46. Why needed?
If drugs purchased in large quantity
Adv: the risk of out of stock avoided
Disadv:
locking up money in maintaining huge stock
large storage space
require staff to store and handle various items
chances of expiry, pilferage
Objective : maintaining optimum stock
Techniques
ABC analysis
VED analysis
FSN analysis
SDE analysis
49. • A items : small in no. , but consume large
amount of resources
• Must have
• Tight control
• Rigid estimate of requirement
• Strict & closer watch
• Low safety stock
• Managed by top management
• C items : larger in no. but consume lesser
amount of resources
• Must have
• Ordinary control measures
• Purchase based on usage estimates
• High safety stocks
50. VED Analysis : based on criticality in pt. care
• VED Analysis V=10% E=39%
D=51%
• 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.
51. Combination of ABC &VED Analysis
V E D
A AV AE AD CAT I
15%
B BV BE BD CAT II
40%
C CV CE CD CAT III
45%
Cat 1 : needs close monitoring & control
Cat 2 : moderate control
Cat 3 : no need for control
52. SDE ANALYIS
Based on availability
Scarce
Managed by top level management
Maintain big safety stocks
Difficult
Maintain sufficient safety stocks
Easily available
Minimum safety stocks
FSN ANALYSIS
Based on utilization.
Fast moving.
Slow moving.
Non-moving.
Non-moving items must be periodically
reviewed to prevent expiry
& obsolescence
53. 5. Network analysis
A technique whereby objectives are identified,
activities and tasks involved in attaining the objectives
are determined and their interrelationships are
presented graphically in the form of network and used
as a basis of determining sequence of activities and
allocation of resources.
Planning and monitoring the progress of large no. of
different interrelated activities necessary for the
completion of project with minimum time & cost.
54. • Advantages
Simple to understand
Well defined in practical terms
Applies to any project where activities can be
described sequentially.
Inexpensive
Does not need very highly qualified
specialists.
56. PERT• Programme Evaluation Review Technique : Shows diagrammatically
the logical sequence in which different events between the start
and end of the project need to take place
Plan service
Staff
recruited
Equipment
ordered
Staff trained
Equipment
installed Start providing
service
2 months
4 mnths
2 months
1 months
1 months
10 months
57. • PERT involves planning, monitoring and controlling of
projects where time taken for each activity in the project is
not known
• PERT is classically used in long-term projects like
construction of hospitals, ships, roadways and buildings, in
planning & launching of new health programs, products &
services, in publication of books etc where exact time for
each phase is not known with certainty.
• PERT uses probabilistic and linear programming methods
to assist a manager in planning schedules & costs,
determining time & cost status, forecasting skill
requirements,
58. • Under PERT, three time-estimates are made,
1. Most Likely Time is the time taken most frequently in
completing a particular activity.
2. Optimistic Time is time in which an activity can be
completed, if all goes as per the pre-determined plan.
3. Pessimistic Time is the time taken to complete an
activity under most adverse conditions. This is thus
the longest possible time taken to complete a project.
• Calculation of activity time
Activity
Time= Optimistic time + 4 X( likely expected time)+Pessimistic
time
6
50 % chance (Probability of correct estimate of time)
59. • Advantages of PERT
Aids in planning,
scheduling and monitoring
the project
Provision for better
communication
Identifies potential
problems
Furnishes continuous timely
progress report
Enables evaluation and
feedback
• Disadvantage of
PERT
Overemphasis on
time & almost no
attention to cost
60. Critical Path Method (CPM)
• Longest path in the method.
• The process cannot end before the critical pathway
ends.
• Reduction in time of a project is only possible
if there is a reduction in the time taken the
critical path.
• Reduction in time may be brought about by
increase in the resources keeping cost factor
in mind.
62. EMERGING CHALLENGES FOR
MANAGEMENT
• Globalilization: Managers need to think globally and act locally.
• Technology: Management will need to manage changing
technology effectively.
• Quality: Quality assurance is getting important.
• Social responsibility: Management will pursue long term goals that
are good for society.
• Empowerment: To empower worker is a challenge to management.
• Human resource management: Management needs to deal with
diversified work force, requires visionary leadership on the part of
management
• Organization design: Organization will be lean flat and less
hierarchical
63. References
• Modern management methods and organization
of health services. WHO.pdf
• Park’s Textbook of Preventive and social
Medicine. 22nd ed.
• P. V. Sathe’s textbook of Epidemiology and
management for health care for all. 3rd edition
• Reetu Mehandiratta. Applications of queuing
theory in health care. IJCBR. May 2011. VOL2
N2.P9