Definition

It is the systematic and analytical method based to assist in decision making the improvement of efficiency and effectiveness and in particular the conduct of the two key managerial activities of planning and control.

 

Characteristic of management techniques

1. Systematic: – It consists of specified and often sequential method of tracking a problem providing information for decision making or improving operational efficiency.  It also ensures that each step is carried out in prescribed manner.
2. Analytical: – These techniques have been developed considered what and possibly quantitative method required to deal with every aspect of a situation and achieve an end result. They subject complex situation to close and systematic exam and resolve them into their key element.
3. Quantitative: – Management technique measures in numerical or financial terms what is happening and quantify, forecast of future trends. Management techniques place monitor values on performance reports forecast and plans.

 

Applications of management techniques

1. General management 
2. Marketing management 
3. Operation management
4. Financial management
5. Human resource  management 
6. Information techniques 
7. Planning and resource allocation 
8. Efficiency and effectiveness

 

Traditional vs. Modern management technique: –

Traditional Techniques	Modern Technique
Based on behavior	Based on sociology
Sciences based	Psychology
Personal selection	Social psychology
Training	Education technique
Motivational method	Economics
Leadership	Statistical approach
Supervision

 

Traditional methods of management techniques are primarily based on behavioural sciences

1. Personal selection  
2. Training and retraining
3. Motivational method 
4. Development of communication channel and skills
5. Supervision 
6. Leadership division
7. Team building and conflict resolution 

 

Relevance of modern management techniques in health

• Overlapping conflicting and completing organization with health system.
• Widely scattered funding mechanism with little control over lost.
• Decision on the mixture of facilities and services without reference to population needs and with no information about those who cannot use the services.
•  These are quantitative hence fruitfully can be employed in management of health.
•  It has been provide that these techniques are useful in increasing the efficiency by cost reduction as well as ensuring better health care.

 

Classification of Modern management techniques

1. Statistical techniques 

   1. Time trends and forecasting 
   2. Decision theory and tree

2. Activity analysis

   1. Time motion studies 
   2. Work sampling and activities analysis
   3. Queuing theory 
   4. Gantt Chart and work schedule 

3. Mathematical technique

   1. Simulation model 
   2. System analysis
   3. Linear programming
   4. Inventory control
   5. Procedure and Arrow diagramming
   6. Network analysis ( PERT, CPM )

4. Financial techniques

   1. Cost accounting and analysis
   2. Cost benefit analysis 
   3. Cost effective analysis
   4. Performance budget 
   5. Financial analysis and control
   6. ZBB- Zero based budgeting
   7. Budgetary analysis

5. Miscellaneous

   1. MBO
   2. Break even analysis
   3. SWOT analysis

 

STATISTICAL TECHNIQUES

Time trends and forecasting

Based on past experiences, predictors can be made about the expected occurrences by using mathematical method. Example- Demography made project about population, epidemiologist’s anticipation of epidemic etc. Based on information on occurrence of certain events, certain pattern can be recognized.

• Secular trend – increased incident of Cardiac Heart Diseases, accidents, and cancers etc.
• Seasonal variation- e.g. of gastroenteritis.

Decision theory and decision tree

The method for determine the optimal course of action when a number of alternative are available and three consequence’s cannot be forecast with certainty.

Decision making under certainty: –

• Future states of nation are known.
• Will choose the alternative that has the highest pay off or the smallest loss.

Decision making under uncertainty: –

• Future states of nation are uncertain.
• Depends on the degree of decision maker’s optimism.
• Decision making can also be done under risk. 

 

Decision tree

It is a decision tool that uses a tree like graph of decision and their possible consequence (including chance, events, outcome, resource, cost, and utility. It is commonly used in operations, research especially in decision analysis to help identify a strategy most likely to reach goals. It enables the people to decompose a large complex decision problem into several smallest problems. Decision theory represent a generalised approach to decision making it is an integral part of management.

Solution steps to any decision problems: –

• Identify the problem.
• Specify the objective and decision criteria for choosing a solution.
• Develop alternative.
• Analysed and compare alternative.
• Select the best alternative.
• Implement the chosen alternative.
• Verify that desired results are achieved or not.

Advantages of decision tree: –

• Simple to understand and interact.
• Useful to analyse the possible outcomes of complex decision.
• Most rational decision is takes in terms of resource and effectiveness.
• Worst, best and expected values can be determined for different secretion.
• For example: – helpful to study alternative health strategies in disease screening immunization.

 

QUEUING THEORY

Queuing theory is basically a mathematical approach to the analysis of waiting lines of the patients. E.g. -emergency room, OPD setting, pharmacy for registration for emergency and disaster management etc.

Goals of Queuing analysis 

• Minimized costs
• Cost of waiting line
• Cost associated with patient having to wait for services
• Decreased patient satisfaction
• Quality of care
• Cost of providing the services
• Salaries paid to employees
• Fixed cost – cost of waiting space

• Facilities
• Equipments
• Supplies

Queuing theory involves the analysis of what is known as Queuing system.

 

Arrival process: – The probability of distribution that determines the customer arrival in the system.

Services process: – Probability density distribution that determines the customer service time.

Queuing discipline: – First come first served, last in first out priority basis.

 

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 and allows accessing how long a project should take. Gantt chart monitors progress it can immediately see what should have been archived at a point in time.

Characteristics of Gantt chart: –

1. The bar in each row identifies the corresponding task.
2. The horizontal position of the bar identifies start and end times of the task.
3. Bar length represent the duration of the task.
4. Task duration can be compared easily.
5. Goods for allocation resources and rescheduling.
6. Procedure relationship can be represented using arrows.
7. Critical activities are usually highlighted.
8. Slack times are represented using bars with dotted lines.
9. The bar of each activity begins at the activity earliest start time and ends at latest finest time.

Advantages of Gantt chart: –

1. Simple 
2. Good visual communication to other.
3. Good for scheduling resources.

Disadvantages of Gantt chart: –

1. Dependencies are more difficult to visualize.
2. Minor changes in data of course put major changes in the chart.

 

SIMULATION MODEL

With the help of this model impact of inputs and changes on the output can be estimated.

Objective

To forecast the probable effects of measures in terms of relative cost and benefit.

 

LINEAR PROGRAMMING 

Component of a system and its constraints are depicted in a linear programming and the desirable compensation of activities with regard to certain given set of objectives and constraints in arrived at.

Time motion studies

 It consists of observing the timing by using shop watches the physical work and movement carried out by working.

• A complex task is broken into small and simple steps.
• The sequence of movement taken by the employee in performing those steps is carefully observed and analyzed to eliminate redundant and wastefully motion.
• Precise time taken for each correct movement is measured.

Advantages: –

• Reduction of physical efforts 
• Timing saving 
• Increased in productivity

Example: – From each ward, samples used to send with a ward boy to central pathology and ward boy took excessive time to return. One peon from the central lab goes to different ward trolley at predetermined time and reports also delivered in the same way.

Work Sampling

It is commonly used industrial engineering technique designed to measure how resource equipment are utilized. The methods consist of making observation at random for appropriate length of time and recoding the utilization of equipment or activity of people during these periods.

Work sampling is used to estimate the proportion of workers time that is devoted to different elements of work activity. The Idle time of machine and equipment can be calculated.

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% evaluation of an account. Better and proper utilization of time. Example – observation among nurses, 21% of time spend on bed side nursing, 33% time spend on clerical activity in the wards.

Inventory control

Methods of maintaining of stock at a level at which purchasing and staring cost are the lowest possible without interferences with supply.

Objective: – Maintaining optimums stock.

Advantages: – The risk of out of stock avoided.

Disadvantages: –

• Locking up money in maintaining huge stock.
• Large storage space.
• Require staff to store and handle various items.
• Changes of expiry and pilferage.

Network analysis

 A technique where by objectives are identifies and tasks involved in attaining the objectives are determine and their inter relationship are presented graphically in the form of network and used as a basic of determined sequence of activity and allocated of resources. Planning and monitoring the progress of large number of different interrelated activities necessary for the completion of project with minimum time and cost.

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 and specialized staff

 

PERT 

Program evaluation review technique (PERT) shows diagrammatically the logical sequence in which different events between the start and end of the project needs to take place.

• PERT involves planning, monitoring and controlling of project where time taken for each activity in the project is not known.
• PERT is classically used in long term projects like construction of hospital, ships, roadways, in planning and launching of new health programs, Lahore exact time for each please is not known with certainty.
• PERT use probabilistic and linear programming method to assists a managerial in planning schedule and cost, determine time and cost status, forecasting skills requirements etc.

Time estimates according to PERT

• Most likely time: – Time taken most frequently in completing a particular activity.
• Optimistic time: – Time is which an activity can be completed it all goes as per determined plan.
• Pessimistic time: – Time taken to complete an activity under most average con. This is thus the largest possible time taken to complete a project.

Calculation of activity time: –

Activity time= optimistic time+4(likely expected time) +P.T 

---

 6

Advantages of PERT: –

• Aids in planning, schedule and monitoring the project.
• Provision for better communication.
• Identification potential problem.
• Furnishing continuous timely progress report.
• Enables evaluation and feedback.

Disadvantages of PERT: -over emphasis on time and almost no attention to cost.

Slack: – Amount of time by which a particular events or an activity can be developed without affecting the time schedule of the network. It is defined as the different between latest allowable and the earliest expected time.

 

CPM (Critical path method)

• Longest path in the methods.
• The process cannot end before the critical path way end.
• Red in time of a project is only possible if these are a red in the time taken the critical path.
• Red in the time may be brought about by on the resource keeping cost factoring in mind.

Path 1	A – D – H – J	1+4+6+3=14
2	B – E – H – J	2+5+6+3=16
3	B – F – J	2+4+3=9
4	C – G – I – J	3+6+2+3=14

For examples: –

 

Since critical path: – longest path is the critical path for activity.

PERT ( Program Evaluation Review techniques)	CPM (Critical Path Method)
It is technique for planning and controlling the project whose activity are subject to uncertainty in the performance hence, it is a probabilistic model.	It is techniques are  performance time is fixed. Hence it is determined models.
It is an event oriented system.	Activity oriented system.
Basically does not differenced critical activity and non-critical activity.	Differentiates.
Used in project where resources are always available when requirement.	Used where better utilization of resources is needed.
Suitable for P&D where time cannot be projects.	Suitable for civil construction installation of etc.

 

Management by objectives

Behavioural Approach to management-based concepts are –

• Emphasis on result rather than activity.
• Defining objectives for specific position.
• Participation in nature.
• Identification of key result area.
• Establishing a periodic review system 

Concept of MBO: –

• Let people know what is expected of them.
• Allow employee to participate in setting goals.
• Tell people how they are doing.
• Reward on the basis of accomplishment process.

Steps / Process: –

Identifying KRA

• By SWOT analysis
• Brainstorming expensive 
• Establishment of specific objective
• Preparation of action plan

Setting up objectives

• An objective is a statement of expected results which provides guidelines for decision and action at lower level and provides standard against which performance is assessed.
• An objective should have the following four elements – Quality, Quantity, Cost, Time

Action planning

• Action plans are the means to converts objective into reality.
• Objectives described what is to be achieved, whereas action plan described how these objectives are to be achieved.

Steps in the action planning:-

• Choose the strategy
• Fix the responsibility 
• Resources allocation 
• Scheduling of objectives

 

Total Quality management

• Quality can be defined as the totality of features and characteristics of a product / Services which have the ability to satisfy the client felt/ implied needs”.
• Total quality management as a management tools. Focus on continuous improvement of procedure and process involved in any activity or any service.

The Basic Principle of TQM: –

1. Satisfy the Consumer: – TQM involves satisfying the felt or perceived needs of the customers which tends to change with time and circumstances.
2. Management based on facts: – Every manager to needs to have access to correct facts about the product or services being offered by the organization.
3. People centric management: –

• Ongoing improvement – It is an ongoing process which aims to improve the everyday routine procedure and process involved in product/ Services.

Some important models of TQM: –

1. Acceptable Quality level (AQL): – Provide a set of predetermined rules and standard for acceptance or rejection of a product so that each item inspected for its quality is classified as acceptable or unacceptable.
2. Affinity diagram: – Provide some types of relationship to group within an organization such method are useful when a team attempts to translate the customer requirement into an organizational structure. Arrows diagram is used to depict the time required to solve a problem in the organization.
3.  Bench marking: – Provides comparison with per determined standard of qualities of product/ Services. There by focusing on overall mission of the organization and is a process which compares the performance with that of other thereby ensuring better performance through comparison.
4. Consensus: – Reaching is a way of examination alternatives so that an organization can electively reach a conclusion which is acceptable to all members of the organization.
5. Contingency planning: – It is a process of planning for unforced seen circumstance to ensure least wastage of resource and to avoid firefighting at the last moment.
6. Cost benefit analysis: – Involves the analysis of real cost and benefit involved in the project. It is used to assess if the solution is practical and achievable in terms of the cost incurred by the organization.
7. Criteria testing: – Is a process of listing the various criteria and evaluation an alternative course of action against these per-determined and per-decided criteria.
8. Deming wheel (PDCA):- It is a graphical representation of essential requirement to satisfy a customer requirement namely plans do check and action such a management tools extensively to develop new product and serviced based on the felt needs of the clients.
9. Error proofing: – It is a managerial process of designing and conducting an operation in such a manner so as to eliminate specific errors with cause major disruption of process / services there by causing dissatisfy factor to customer.
10. Gantt charts: – The graphical representation of the essential steps for completion a project  is broken down into smallest components steps and a graph is created to depicts the time schedule of each steps. Gantt chart makes it easier to identify the various steps involved and also easily indicated when the deadline for particular steps in the project has been missed.

Relevance of modern management technique in health: –

• Overlapping conflicting and competing organization with in health system.
• Widely scattered funding mechanism with little control over cost.
• Decision on the mixture of facilities and services without reference to population needs and with no information about those who do not use the services.
• These are quantitative hence fruitfully can be employed in management of health.
• It has been proved that these techniques are useful in increasing the efficiency better healthcare.