PRINCIPLES OF HEALTH CARE MANAGEMENT

1. Division of Work

In practice, employees are specialized in different areas and they have different skills. Different
levels of expertise can be distinguished within the knowledge areas (from generalist to
specialist). Personal and professional developments support this. According to Henri Fayol
specialization promotes efficiency of the workforce and increases productivity. In addition, the
specialization of the workforce increases their accuracy and speed. This management principle
of the 14 principles of management is applicable to both technical and managerial activities.

2. Authority and Responsibility

In order to get things done in an organization, management has the authority to give orders to
the employees. Of course with this authority comes responsibility. According to Henri Fayol, the
accompanying power or authority gives the management the right to give orders to the
subordinates. The responsibility can be traced back from performance and it is therefore
necessary to make agreements about this. In other words, authority and responsibility go
together and they are two sides of the same coin.

3. Discipline

This third principle of the 14 principles of management is about obedience. It is often a part of
the core values of a mission and vision in the form of good conduct and respectful interactions.
This management principle is essential and is seen as the oil to make the engine of an
organization run smoothly.

4. Unity of Command

The management principle Unity of command means that an individual employee should
receive orders from one manager and that the employee is answerable to that manager. If tasks
and related responsibilities are given to the employee by more than one manager, this may
lead to confusion which may lead to possible conflicts for employees. By using this principle,
the responsibility for mistakes can be established more easily.

5. Unity of Direction

This management principle of the 14 principles of management is all about focus and unity. All
employees deliver the same activities that can be linked to the same objectives. All activities
must be carried out by one group that forms a team. These activities must be described in a
plan of action. The manager is ultimately responsible for this plan and he monitors the progress
of the defined and planned activities. Focus areas are the efforts made by the employees and
coordination.
6. Subordination of Individual Interest

There are always all kinds of interests in an organization. In order to have an organization
function well, Henri Fayol indicated that personal interests are subordinate to the interests of
the organization (ethics). The primary focus is on the organizational objectives and not on those
of the individual. This applies to all levels of the entire organization, including the managers.

7. Remuneration

Motivation and productivity are close to one another as far as the smooth running of an
organization is concerned. This management principle of the 14 principles of management
argues that the remuneration should be sufficient to keep employees motivated and
productive. There are two types of remuneration namely non-monetary (a compliment, more
responsibilities, credits) and monetary (compensation, bonus or other financial compensation).
Ultimately, it is about rewarding the efforts that have been made.

8. The Degree of Centralization

Management and authority for decision-making process must be properly balanced in an

organization. This depends on the volume and size of an organization including its hierarchy.
Centralization implies the concentration of decision making authority at the top management
(executive board). Sharing of authorities for the decision-making process with lower levels
(middle and lower management), is referred to as decentralization by Fayol. Henri Fayol
indicated that an organization should strive for a good balance in this.

9. Scalar Chain

Hierarchy presents itself in any given organization. This varies from senior management
(executive board) to the lowest levels in the organization. Henri Fayol s hierarchy
management principle states that there should be a clear line in the area of authority (from top
to bottom and all managers at all levels). This can be seen as a type of management structure.
Each employee can contact a manager or a superior in an emergency situation without
challenging the hierarchy. Especially, when it concerns reports about calamities to the
immediate managers/superiors.

10. Order

According to this principle of the 14 principles of management, employees in an organization

must have the right resources at their disposal so that they can function properly in an
organization. In addition to social order (responsibility of the managers) the work environment
must be safe, clean and tidy.

11. Equity
The management principle of equity often occurs in the core values of an organization.
According to Henri Fayol, employees must be treated kindly and equally. Employees must be in
the right place in the organization to do things right. Managers should supervise and monitor
this process and they should treat employees fairly and impartially.

12. Stability of Tenure of Personnel

This management principle of the 14 principles of management represents deployment and

managing of personnel and this should be in balance with the service that is provided from the
organization. Management strives to minimize employee turnover and to have the right staff in
the right place. Focus areas such as frequent change of position and sufficient development
must be managed well.

13. Initiative

Henri Fayol argued that with this management principle employees should be allowed to
express new ideas. This encourages interest and involvement and creates added value for the
company. Employee initiatives are a source of strength for the organization according to Henri
Fayol. This encourages the employees to be involved and interested.

14. Esprit de Corps

The management principle esprit de corps of the 14 principles of management stands for
striving for the involvement and unity of the employees. Managers are responsible for the
development of morale in the workplace; individually and in the area of communication. Esprit
de corps contributes to the development of the culture and creates an atmosphere of mutual
trust and understanding.
ETHICS OF HEALTH CARE PROFESSIONALS

Healthcare Quality Professionals are defined by a standard of conduct deep-rooted in

commitment, confidentiality, and relationships. Committed to performance improvement and
maintaining integrity, the Healthcare Quality Professional recognizes personal accountability
and moral obligation to all customers servedclients, employees, employers, members of the
healthcare team, physicians, organizations, and the public.

Healthcare Quality Professionals promote the dignity of the profession and are committed to
practicing the profession with honesty, integrity, and accountability, respecting all laws and
refusing to participate in or conceal any unethical, false, fraudulent, or deceptive activity.
Healthcare Quality Professionals' primary commitment is to the health, well being, and safety
of patients. They must take appropriate actions which are consistent with organization policy
regarding any instances of incompetent, unethical, illegal, or impaired practice. They work to:

practice the profession with honesty, integrity, and accountability

maintain the level of competency as outlined in the Standards of Practice for Healthcare
Quality Professionals
seek the trust and confidence of all customers
support the Standards of Practice for Healthcare Quality Professionals
promote the right of privacy for all individuals and protect the maintenance of
confidential information to the fullest extent permitted by law
promote cultural change that encourages the reporting of events that may result in
actual or potential harm to patients or others
use expertise to inform employers or clients of possible positive and negative outcomes
of management decisions in an effort to facilitate informed decision making
give credit for the work of others to whom it is due
aid the professional development and advancement of colleagues
use the Certified Professional in Healthcare Quality (CPHQ) designation only after
passing the written examination, adhere to standards established by the Healthcare
Quality Certification Commission (HQCC), and continuing to maintain those standards
through the recertification process
maintain membership in professional organizations as a means of promoting quality and
professional growth and avoid the use of such membership for the sole purpose of
solicitation of business or for personal financial gain.

Standards of Practice for the Healthcare Quality Professional

Fundamental to practice, the Healthcare Quality Professional

maintains active personal and professional development programs in the field of

healthcare quality and exhibits a broad range of knowledge
creates and supports an environment that fosters teamwork, emphasizes quality,
recognizes the customer, and promotes learning
 maintains a commitment to the improvement of the professional through participation
in, and active support of, the local, state, and national professional organizations
addresses concerns and takes formal actions to resolve or report the unethical or
questionable practices to the appropriate channels
adheres to the Code of Ethics for Healthcare Quality Professionals.

In the area of customer focus and satisfaction, the Healthcare Quality Professional

supports customer satisfaction as a primary goal for the organization's quality activities
standardizes the approach for determining customer expectations
serves as a customer advocate in resolution of concerns and initiation of performance
improvement activities.

In the area of leadership, the Healthcare Quality Professional

pursues certification through a formal program that enhances professional

competencies and recognizes leadership in healthcare
provides for performance and quality management training and education for
organization leaders
establishes specific quality-related goals for management to measure the organization's
processes and outcomes
demonstrates management skills in the administration of programs that focus on
improved outcomes of patient care or healthcare delivery systems.

In the area of information and analysis, the Healthcare Quality Professional

exhibits skill in health information fundamentals, including application of basic statistical

processes, data analysis and reporting, and computer use
possesses excellent written and verbal communication skills, applicable in both
individual and organizational development
supports access to medical information by appropriate health providers, researchers,
and public health agencies, balanced with appropriate consumer protections.

In the area of strategic quality planning, the Healthcare Quality Professional

provides leadership and consultative services to departments and services within the
organization in achieving regulatory, accreditation, and organizational compliance in
quality and in performance management and improvement activities
seeks management involvement in the development of a planning approach that
supports healthcare quality and patient safety.
establishes quality as the guiding principle when exploring organizational efforts to
control healthcare costs
In the area of human resource development and management, the Healthcare Quality
Professional

supports programs developed to recognize achievements related to healthcare quality

exhibits a commitment to the Code of Ethics for Healthcare Quality Professionals
ensures staff involvement in all healthcare quality team efforts
mentors others in the principles of healthcare quality.

In the area of management of process quality, the Healthcare Quality Professional

ensures that customer expectations guide the development and continuous

improvement of processes, products, and services
acts as an agent of change and is effective in the change process, including the
identification of opportunities to improve, the resolution of problems, and the
evaluation of the effectiveness of change
integrates training, recognition, team approach, and customer satisfaction to create a
standard approach to the continuous improvement of organizational process.

In the area of quality and operational results, the Healthcare Quality Professional

promotes quality efforts as a proactivenot reactiveundertaking

ensures that personnel have the appropriate and necessary skills and tools to evaluate
problems and achieve improvements
seeks to identify root causes of problems rather than focus on individual members or
events.
 WHAT IS YOUR SOLICITED OPINION ABOUT HEALTH CARE MANAGEMENT,
WHAT SHOULD IT BE AND WHY?

Technical skills are important in health care management. In the healthcare delivery, healthcare
quality has two distinct facets: technical quality (also called quality in fact) and functional
quality. Technical quality refers to the accuracy of medical diagnoses and procedures, and is
generally comprehensible to the professional community, but not to patients. The patient
perceives functional quality as the manner in which the service is delivered. Functional quality
perceptions may influence future decisions to return to a facility for service. Some empirical
evidence suggests that patients' quality judgment may be positively associated with technical
quality, as reflected in outcomes such as risk-adjusted mortality among hospitalized patients for
medical conditions. Technical skills can give an impact to our career prospects, our job
performance and many other activities in life.

Technical quality cannot be attained without the technical skills of the health care personnel.
The study conducted by Chang, et. al. (2006) has looked at patients' assessment of their
physicians' technical skills and the effect on satisfaction, but the findings are contradictory. A
study found that when forced to make a trade-off, participants expressed a strong preference
for physicians who have high technical skills. The patients also indicated that a physician's
ability to make the correct diagnosis and craft an effective treatment plan were more important
than his or her "bedside manner."