Post Graduate Diploma in Hospital / Healthcare Management (PGDHHM)

ASSIGNMENT 1 BASIC PRINCIPLES OF MANAGEMENT

SUBMITTED BY:

DR. RANJIT SINGH BAJWA ROLL No. 104190

Question1. Describe the managerial levels & managerial roles in hospital administration with special reference to the 21st century.
ANSWER 1: In management, there are three broad levels viz. first line / junior management, middle management and top management. First level / Junior management : It is the lowermost level in managerial hierarchy. These managers/co-ordinators direct non-managerial employees. They do not supervise other managers. In some organizations they are called as supervisors also. They are white-collar supervisors, one step above the rank and file. Middle management: This consists of more than one level in an organization. They direct activities of junior managers and at times those of employees (doctors, nurses) also. Vast and diverse group of managers of various departments come under this head. Top management: It consists of a comparatively small group which is responsible for overall management of the organization. They are referred as Chairman, President, Vice-president, Chief Executive Officer, Managing Director, Directors, etc. They normally establish policies, strategies, coordinate activities and guide the people. MANAGERIAL ROLES A manager has to ensure that the goals of the hospital are achieved effectively as he performs the functions of planning, organizing, directing and controlling. According to Henry Mintzberg, the Managerial role are the following: 1. Interpersonal Roles a. The figurehead role: The Administrative Director performs ceremonial and social duties like opening of new wards/ receiving the visiting licensing commissions , inaugurating / launching new health service plans, diagnostic and therapeutic modalities, latest equipments etc. b. The leader role: He establishes the work atmosphere, motivates and encourages the employees to achieve the results. c. The liaison role: He develops and maintains webs of contacts outside the organization. 2. Informational Role a. The monitor role: He collects all types of information relevant and useful to the organization.

b. The disseminator role: He circulates, transmits the information collected from outside to the members in the organization. c. The spokesman role: He transmit information from inside the organization to the outsiders. 3. Decisional role a. The entrepreneur role: Innovation, seeking new ideas and initiating controlled change in the hospital to adapt to the changing environment and latest technology. b. The disturbance handler role: A manager has to seek solutions to the unanticipated and unexpected problems and to deal with sudden changes. c. The resource allocator role: He makes decisions regarding division of work etc. d. The negotiator role: Here he deals with other organizations, agencies as well as individuals etc. One has to remember that 21st century is going to be the century of customers and hence all the organizations will have to gear up for meeting this challenge. In 21st century the days of protection, licensing and nationalization are no more instead customer and his satisfaction weigh more importance. The demand of excellent products and services has necessitated a drastic shift in the working of the organizations and the style of managing. Question 2. Compare the Management theory advocated by FW Taylor and Henary Fayol. Which theory, you feel is more suitable in Hospital Management? Why? Answer: The major thinking in management thought was propagated by Frederick Taylor and Henri Fayol in the early 20th Century. Frederick Winslow Taylor (1856-1915) made great impact on the development of management thought. He believed that productivity was the right answer to higher profits and higher wages. Scientific knowledge and methods were to replace the traditional rule of thumb methods and as such his theory is known as the theory of scientific management.

TAYLORS CONTRIBUTIONS i. Time and motion study : Under this, he measured each motion in respect of the time, with the help of a stopwatch. Thus he could arrive at a standard measure for carrying out a given job and the best way to do it. ii. Differential payment : He introduced a new method to establish linkage between production and incentives. Here a worker was paid at a lower rate for standard production and at a higher rate if he exceeded the standard. He thought that this differential payment would motivate the workers to produce more.
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iii. Drastic reorganization of supervision :Taylor suggested that foreman / supervisor should plan the work and should give instructions to the workers as to how to do it. He also suggested that for different activities, there should be separate supervisors. Thus he introduced the principles of (a) separation of planning and doing and (b) functional foremanship respectively. iv. Scientific recruitment and training: Taylor stressed on the need for scientific selection and development of workers. He felt that management should develop and train every worker to enable him to bring out his best. This would make the work more enjoyable and interesting than in the past. v. Intimate friendly cooperation between management and workers: Taylor favoured harmonious relations between the management and the workers. He said that complete mental revolution both on the part of the management and workers was needed. The scientific management developed a rational approach to solving organization problems. While Taylor is considered as the Father of Scientific Management, Henri Fayol (1841-1925) is known as The Father of Administrative / Operational Management. This theory lays focus on development of administrative principles applicable to managerial levels. Henri Fayol concentrated on analysis of managerial activity of Industrial undertaking. Fayol, based upon his experience, came out with fourteen principles of management; These according to him, are flexible and not rigid, which can be applied irrespective of changing and specific conditions. These principles are as under: 1. Division of labour: In managerial process, various functions like planning, controlling, organizing, directing etc. cannot be performed efficiently by a single person or group. As such they should be entrusted to different persons. This specialisation is necessary for efficiency of labour. This increases skill and produces better and more work. Fayol applies this principle to all kinds of work, technical as well as managerial. 2. Authority and responsibility: Since management means getting work done through people, it implies that manger who has the responsibility to get the work done, should also have authority to command obedience. He may exercise formal authority and personal power. The former is derived from the official position, whereas the latter is the result of knowledge, intelligence, ability to lead, moral worth, etc. Responsibility is closely linked to authority. It arises when authority is exercised. 3. Discipline: Discipline is essential for the smooth running of business. By discipline, we mean observance of rules and regulations, compliance with systems and procedures, respect for superiors etc. Good supervision, clear and fair terms of employment and judicious application of penalties can ensure discipline. 4. Unity of command: This implies that the employees should receive instructions, directions or orders from one supervisor, manager only. If they receive orders from more than on supervisor, they may be confused and this may lead to chaos.

5. Unity of direction: Those activities or operations within the organization that have the same objective should be directed by only one manger using one plan. e.g. the personnel deptt. in a company should not have two managers each with a different hiring policy. 6. Subordination of individual interest to general interest: In any organization, the interests of the organization should get priority over the interests of the individual member of the organization. 7. Remuneration: Remuneration and methods of payment should be fair and should afford maximum possible satisfaction to both the employees and the employer. 8. Centralisation: Centralisation means that decision making is concentrated in the superiors as against decentralization where the sub-ordinates have an increasing role in decision making. According to Fayol, the responsibility of centralization rests with the manager and he will determine depending upon the circumstances, the extent to which the role can be passed on to the sub-ordinates. 9. Scalar Chain: This means that the hierarchy of authority starts from the top level and extends to the lowest level. The orders should pass through the proper channel along the scalar chain. However, in case of need, it can be short-circuited. 10. Order: It means that things should be in proper order. This requires special efforts. The principle of place for everything and everything in place should be practised in every organization. 11. Equity: It means fair treatment without any kind of discrimination. This comes from combination of kindness and justice on the part of the managers while dealing with the subordinates. 12. Stability of tenure: If the workers are assured of job security, they will be motivated to perform better. In case of insecurity of job, their morale will be low, which will affect their performance adversely and they will not have attachment with the organisation. 13. Initiative: Employees should be given freedom to conceive and carry out their ideas and plans, even if there are mistakes in their work. This will encourage them to innovate and take decisions. 14. Esprit de corps: Promoting team spirit will give the organization a sense of unity and unity is strength. Fayol says that even small factors should help to develop team spirit. He suggested use of verbal communication to develop team spirit. Thus Fayol for the first time systematized the managerial behaviour. While Taylor was more concerned about shop floor management, Fayol focused on total organizational management as this area was hitherto neglected. Prior to Fayol, there was a belief that managers are born and not made. However, Fayol strongly advocated that management can be taught and need not be inborn. Thus like Taylor, Fayols theory forms an important milestone in the development of management thought.

3. Define planning. Explain strategic and tactical planning .How will you apply them in a hospital setup?
Planning is the most basic function of management. Management is seeking of goals and achieving them which requires prior arrangement of charting out the objectives and deciding as to how to allocate the resources and identifying the people who will perform the jobs. This entire process is known as planning. Planning is required everywhere. Without planning there will be chaos, which will result in failure in a accomplishing the objectives. Thus planning is thinking in advance. It is what, when, how and by whom of doing. It is defined as choosing among the alternatives. Planning is a continuous process. According to Koontz, planning and controlling are the Siamese twins of management. As a navigator constantly checks whether the ship is going in desired direction, manager should constantly monitor the progress of his plans and initiate mid-way corrections if any. Thus a plan must be flexible so that changes can be made depending upon the situations. Importance Of Planning i. Planning minimizes risks and uncertainties. Todays business is complex and subject to many forces, both external and internal. It provides a rational, fact based procedure to take decisions. ii. Leads to success: Human behavior is goal oriented. Goals give directions to the efforts. Planning enables to perform better and leads to success. It is a proactive process. iii. Focus on organization goals: It helps the employees and all others to focus on organizational goals and activities. It enables to apply resources more efficiently. iv. Facilitates control: Planning enables to achieve the goals set by management. These goals work as the benchmark for comparison with actual performance. Thus the activities can be controlled / monitored. Strategic And Tactical Planning: Strategic planning means deciding the major goals of the organization and policies to achieve them. Tactical planning on the other hand is deciding about utilizing the available resources to achieve the strategic goals. e.g. In view of increasing proportions of HIV / AIDS, the hospital may decide to start a special cell / wing to provide preventive and curative treatment for this dreaded disease. This will be a strategic decision and once it is decided, the other detailed planning will amount to tactical planning. It involves deciding how to deploy the resources of the organization. The points of distinction between them can be described as under :

Strategic Planning 1. Deciding major goals and policies as well as strategies to achieve them 2. Done at top / higher level of management 3. Long term view 4. Broad perspectives 5. Based on long term forecasts about technology, environment, more uncertain

Tactical Planning 1. Deciding detailed use of resources and finer aspects of action 2. Done at lower level of management 3. Short term view 4. Minute & detailed perspectives 5. Based on past performance experience thereof, lesser uncertainty and

4. Write about Maslows need of Hierarchy and Herzberg Two Factor Theory
MASLOW'S HIERARCHY OF NEEDS This content theory is one of the oldest theories of motivation. Abraham H. Maslow, a psychologist formulated this theory of motivation called the Theory of Need Hierarchy. First published in the early 1940, the theory stressed two fundamental premises. The first is that humans are wanting animals whose needs depend upon what they already have. Only needs not yet satisfied can influence behavior ; an adequately fulfilled need is not a motivator .The second premise is that people's needs are arranged in a hierarchy of importance .Once a particular need is fulfilled ,another emerges and demands fulfillment .Maslow identified five levels in his need hierarchy, which are briefly explained here : i) Physiological Needs: The most fundamental of all needs are physiological needs which generally correspond to the unlearned primary needs discussed earlier .Some common examples are hunger, thirst, sleep, sex, rest etc. A person deprived of everything would want to satisfy these basic needs first. Once these basic needs are satisfied, they no longer motivate. ii) Safety and Security Needs: Once the physiological needs are basically satisfied, safety needs replace them. First there is the need for survival and second is the need for the security and this need has both physical and psychological / emotional dimensions. Once these needs are satisfied they no longer motivate. iii) Affection and Social Activity Needs: When physiological and safety needs are basically satisfied , this third level needs related to the social and gregarious nature of people become important motivators .They are seen in people's need for association or companionship , belonging to groups and for giving and receiving friendship and affections.
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iv) Esteem and Status Needs: Esteem needs are much more psychological in nature than the first three needs and these represent the higher needs for people. Needs for power, achievement and status can be considered part of this level. Maslow carefully pointed out that this esteem level represents both self-esteem and esteem from others. v) Self-Actualization Needs: The highest level of human needs represent the culmination of all the lower , middle and higher needs of humans . This need includes achieving full development of one's potential .It is evidenced by the need to be creative and have the opportunity for selfexpression.

Herzberg Two Factor Theory:

The two-factor theory (also known as Herzberg's motivation-hygiene theory) distinguishes between Motivators (e.g., challenging work, recognition, responsibility) that give positive satisfaction, arising from intrinsic conditions of the job itself, such as recognition, achievement, or personal growth, and Hygiene factors (e.g. status, job security, salary and fringe benefits) that do not give positive satisfaction, though dissatisfaction results from their absence. These are extrinsic to the work itself, and include aspects such as company policies, supervisory practices, or wages/salary Herzberg found that the factors causing job satisfaction (and presumably motivation) were different from those causing job dissatisfaction. He developed the motivation-hygiene theory to explain these results. He called the satisfiers motivators and the dissatisfiers hygiene factors, using the term "hygiene" in the sense that they are considered maintenance factors that are necessary to avoid dissatisfaction but that by themselves do not provide satisfaction. Factors would not lead to improvement in an employee's job satisfaction.If the motivation-hygiene theory holds, management not only must provide hygiene factors to avoid employee dissatisfaction, but also must provide factors intrinsic to the work itself for employees to be satisfied with their jobs. Herzberg argued that job enrichment is required for intrinsic motivation, and that it is a continuous management process. According to Herzberg: (1)The job should have sufficient challenge to utilize the full ability of the employee (2)Employees who demonstrate increasing levels of ability should be given increasing levels of responsibility (3)If a job cannot be designed to use an employee's full abilities, then the firm should consider automating the task or replacing the employee with one who has a lower level of skill. If a person cannot be fully utilized, then there will be a motivation problem. Factors leading to satisfaction: Achievement, Recognition, Work itself, Responsibility, Advancement, Growth Factors leading to dissatisfaction: Company policy, Supervision, Relationship with boss, Work conditions, Salary, Relationship with peers, Security
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IMPLICATIONS OF THE THEORY : The theory suggests that satisfied employees are not necessarily the most productive employees. Both job-satisfaction and work-motivation affect the productivity of employees. Therefore, the HRD department of every organization should not only focus on job-satisfaction but also work motivation in order to ensure productivity. In short, 'Hygiene Factors' as well as 'Motivation Factors' play an important role in helping people to work more and better.

5. What is SWOT analysis?

SWOT analysis is also considered as another form of planning. These days the business is subjected to internal and external environment. A business enterprise always carries out SWOT analysis before launching/ commencing an action. S stands for strength, W for weaknesses. Both these factors are part of internal environment. O stands for Opportunities before the enterprise and threats to it are external factors. Strengths are to be further improved, weaknesses are to be overcome, opportunities are to be judged and caught as they are like tide and time who never wait for others. Threats are to be faced and T stands for conquered. SWOT analysis, therefore, is a very useful tool in the hands of the organizations. It has to be carried out and implemented in right manner.

Question 6. Write short notes on any Two: a) Centralization & Decentralization.

When the decision making authority in an organization is concentrated in few hands at the top managerial level, the setup is called a Centralised setup. Whereas in a decentralized setup this authority is dispersed throughout the organization. Organizational authority is the power conferred on people to use their judgment in decision making. Every organization decides the extent or degree of centralization and decentralization. The degree of decentralization, according to Ernest Dale, is greater where i. the number of decisions made at the lower level is more. ii. the more important decisions are made at the lower level. iii. the functions or areas affected by the decisions at lower level are more. iv. less checking is required on a decision. Fayol says that everything that increases the importance of the role of subordinates is decentralization and everything that goes on to reduce its is centralization. These are relative terms. Absolute centralization is not possible in any organization except in a proprietary concern. Also it is not possible to have absolute decentralization in any organization.

b) Peter Druckers contribution in management.

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Peter Ferdinand Drucker (November 19, 1909 November 11, 2005) was a writer, management consultant, and self-described social ecologist. His books and scholarly and popular articles explored how humans are organized across the business, government and the nonprofit sectors of society. His writings have predicted many of the major developments of the late twentieth century, including privatization and decentralization; the rise of Japan to economic world power; the decisive importance of marketing; and the emergence of the information society with its necessity of lifelong learning. In 1959, Drucker coined the term knowledge worker" and later in his life considered knowledge work productivity to be the next frontier of management. Drucker taught that management is a liberal art, and he infused his management advice with interdisciplinary lessons from history, sociology, psychology, philosophy, culture and religion. He also believed strongly that all institutions, including those in the private sector, have a responsibility to the whole of society. The fact is, Drucker wrote in his 1973 Management: Tasks, Responsibilities, Practices, that in modern society there is no other leadership group but managers. If the managers of our major institutions, and especially of business, do not take responsibility for the common good, no one else can or will. Several ideas run through most of Drucker's writings: 1. Decentralization and simplification. Drucker discounted the command and control model and asserted that companies work best when they are decentralized. According to Drucker, corporations tend to produce too many products, hire employees they don't need (when a better solution would be outsourcing), and expand into economic sectors that they should avoid. 2. A profound skepticism of macroeconomic theory. Drucker contended that economists of all schools fail to explain significant aspects of modern economies. 3. Respect of the worker. Drucker believed that employees are assets and not liabilities. He taught that knowledgeable workers are the essential ingredients of the modern economy. Central to this philosophy is the view that people are an organization's most valuable resource and that a manager's job is to prepare and free people to perform. 4. A belief in what he called "the sickness of government." Drucker made nonpartisan claims that government is often unable or unwilling to provide new services that people need or want, though he believed that this condition is not inherent to the form of government. The chapter "The Sickness of Government" in his book The Age of Discontinuity formed the basis of the New Public Management, a theory of public administration that dominated the discipline in the 1980s and 1990s. 5. The need for "planned abandonment". Businesses and governments have a natural human tendency to cling to "yesterday's successes" rather than seeing when they are no longer useful. 6. A belief that taking action without thinking is the cause of every failure. 7. The need for community. Early in his career, Drucker predicted the "end of economic man" and advocated the creation of a "plant community" where individuals' social needs could be met. He later acknowledged that the plant community never materialized, and
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by the 1980s, suggested that volunteering in the nonprofit sector was the key to fostering a healthy society where people found a sense of belonging and civic pride. 8. The need to manage business by balancing a variety of needs and goals, rather than subordinating an institution to a single value. This concept of management by objectives forms the keynote of his 1954 landmark The Practice of Management. 9. A company's primary responsibility is to serve its customers. Profit is not the primary goal, but rather an essential condition for the company's continued existence. 10. An organization should have a proper way of executing all its business processes. 11. A belief in the notion that great companies could stand among humankind's noblest inventions.

c) Delegation
Delegation means entrusting a task to another person, when the activities increase beyond the capacities of an individual. It is an arrangement between two persons when one, normally the superior, delegates the task (responsibility) which belongs to him along with appropriate authority, to the other person. Thus it is a process of transferring certain authority to immediate capable sub-ordinate with a view to decentralization for smooth administration. Principles of Delegation a. Delegators authority only can be delegated. He has to retain the responsibility and accountability. The delegatee also becomes jointly responsible to a certain extent. Delegation, therefore, is not abdication. b. Authority can not be forced upon the delegatee. c. Delegatee should be capable of shouldering the authority of the delegator. d. The role boundaries should be made known to the delegatee. e. Delegatee can not delegate down the line. What to Delegate i. routine administrative matters ii. routine correspondence iii. staff matters where clear guidelines are available iv. expenses of routine nature Whom to Delegate a. capable, willing sub-ordinate b. should be aware of his duties and responsibilities c. experience and availability of time should be taken into consideration d. proper explanation and counseling necessary Why to Delegate - for smooth administration
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- speedy disposal - better customer service - creating confidence in the subordinate and thus developing him for future - encouraging him to take decisions - preparing a line of succession

d) Directing.
DIRECTING is said to be a process in which the managers instruct, guide and oversee the performance of the workers to achieve predetermined goals. Directing is said to be the heart of management process. Planning, organizing, staffing have got no importance if direction function does not take place. Directing initiates action and it is from here actual work starts. Direction is said to be consisting of human factors. In simple words, it can be described as providing guidance to workers is doing work. In field of management, direction is said to be all those activities which are designed to encourage the subordinates to work effectively and efficiently. According to Human, Directing consists of process or technique by which instruction can be issued and operations can be carried out as originally planned Therefore, Directing is the function of guiding, inspiring, overseeing and instructing people towards accomplishment of organizational goals. Direction has got following characteristics: Pervasive Function - Directing is required at all levels of organization. Every manager provides guidance and inspiration to his subordinates. Continuous Activity - Direction is a continuous activity as it continuous throughout the life of organization. Human Factor - Directing function is related to subordinates and therefore it is related to human factor. Since human factor is complex and behaviour is unpredictable, direction function becomes important. Creative Activity - Direction function helps in converting plans into performance. Without this function, people become inactive and physical resources are meaningless. Executive Function - Direction function is carried out by all managers and executives at all levels throughout the working of an enterprise, a subordinate receives instructions from his superior only. Delegate Function - Direction is supposed to be a function dealing with human beings. Human behaviour is unpredictable by nature and conditioning the peoples behaviour towards the goals of the enterprise is what the executive does in this function. Therefore, it is termed as having delicacy in it to tackle human behaviour.

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