HOSPITAL

ADMINSTRATION
COURSE INSTRUCTOR: DR TAHIR AHMAD WANI
What is a hospital
Hospital is an Institution for The Care, Cure,
and Treatment of the Sick and Wounded,
for the Study of Diseases and for the
Training of Doctors And Nurses.
(STEADMAN’S MEDICAL DICTIONARY)
What is a hospital
‘ The hospital is an integral part of a social and medical
organization, the function of which is to provide for the
population complete healthcare, both curative and
preventive, and whose out- patient services reach out to the
family in its home environment; the hospital is also a centre
for the training of health workers and for bio- social
research’.
-WHO Expert Committee, 1956
What is a hospital
A hospital is a residential establishment which provides
short-term and long-term medical care consisting of
observational, diagnostic, therapeutic and rehabilitative
services for persons suffering or suspected to be suffering
from a disease or injury and for parturient. It may or may
not also provide services for ambulatory patients on an out-
patient basis’.
-WHO Expert Committee, 1963
 Philosophy
To maintain the highest quality of services of curative, restorative and
preventive services to all persons who seek its services.
To render high standard of patient care in all functional areas of the
hospital.
 Commitment to research in patient care, educational training and
management.
Commitments as screening and referral centre for patient suffering
from particularly complex health problem
 OBJECTIVES
 Provide optimum health services
 Provide care, cure, preventive service.
 Protect the human rights of clients.
 Provide training for professionals.
 Provide in-service/continuing education in all discipline professional
technical personnel.
 Participate/conduct research
Classification of Hospital
1. Based on Objective
a. General hospitals
b. Special hospitals
c. Teaching cum Research Hospital
 Classification of Hospital
2. Based on Administration, ownership, control or financial income
a. Governmental or public
b. Non-governmental or private
c. Semi Govt Hospital
d. Voluntary Agency Hospitals
 Classification of Hospital
3. Based on Length of Stay
a. Short-term or short-stay hospitals (Stay less than 30 days)
b. Long-term or long-stay hospitals: (Stay more than 30 days)

4. Depending on Type of Medical Staff

a. Closed-staff hospital:
b. Open-staff hospital:
 Classification of Hospital
5. Based on bed capacity (Size)
a. Small hospital (upto 100 beds)
b. Medium hospital (More than 100 to less than 300 beds)
c. Large hospital (More than 300 beds)
6. Based on type of care:
a. Primary Care
b. Secondary Care
c. Tertiary Care
 Classification of Hospital
7. By teaching affiliation:
a. Teaching hospital
b. Non-teaching hospital
8. Basing on system of medicine
a. Allopathic hospital
b. Ayurvedic hospital
c. Homeopathic hospital
d. Unani hospital
e. Hospitals of other system of medicine
 Classification of Hospital
9. Basing on regionality
a. Regional
b. District
c. Family Welfare Centers
d. Community Clinics
 Classification of Hospital
10. As per WHO Classification:
a. Regional Hospital
b. Intermediate/ District Hospital
c. Rural Hospital
Functions
of a
Hospital
Functions of Hospitals
1. Intramural: Services within the wall of hospital
2. Extramural: Services outside the wall of hospital. eg, OPD,
Outreach services, Medical Camps, Immunization Program
 Hospitals

Primary Role Changing Role

• Curative Services
Internal External
Function Function
• Curative Services • Health Education
• Preventive Care • Attending Referrals
• Health Promotion • Specialist Support
• Rehabilitation • Outreach Services
 Organizational Structure
• Organizational Structure refers to levels of management within a
hospital.
• Levels allow efficient management of hospital departments.
• The structure helps one understand the hospital’s chain of command.
• Organizational structure varies from hospital to hospital.
• Large hospitals have complex organizational structures.
• Smaller hospitals tend to have much simpler organizational structures.
Organizational Structure Board

Administration

Information Therapeutic Diagnostic Support

Services Services Services Services

Admission Central Supply

Billing etc. Medical PT, OT Speech/Lang, Med. Lab, Radiology, Biomedical,
Records, Computer Respiratory, Pharmacy, Nuclear Med, Housekeeping,
Info, Health Education, Nursing, Dietary Cardiology, Neurology Maintenance, Dietary,
Human Resources Transportation
 Organizational Structure
• Grouping of Hospital Departments Within the Structure.
• Hospital departments are grouped in order to promote efficiency of facility.
• Grouping is generally done according to similarity of duties.

• Common Categorical Grouping:

• Administrative Services
• Informational Services
• Therapeutic Services
• Diagnostic Services
• Support Services
 Hospital as a System
• Hospital is an organisation that mobilises the skills and efforts of
widely divergent group of professionals, semi- professionals and non-
professionals so as to provide highly personalised services to
individual patients.
• It is therefore , essential to bring to- gather the various components
to a unified whole to achieve the objective through the authority of
control and co-ordination.
• This warrants a systemic functioning of hospital as an Institution.
 System
• A system is a hierarchical chain of units and sub units inter connected, inter
dependent having clear cut objective at each level.
• It obtains inputs from its internal and external environment to process it’s
output.
• It operates with varying processes or methods to achieve the ultimate
objective of the system.
• Hospital has its external environment and linkages also.
• Hence called an open system in the socio-technical environment.
 System
• A system is a hierarchical chain of units and sub units inter connected, inter
dependent having clear cut objective at each level.
• It obtains inputs from its internal and external environment to process it’s
output.
• It operates with varying processes or methods to achieve the ultimate
objective of the system.
• Hospital has its external environment and linkages also.
• Hence called an open system in the socio-technical environment.
 Hospital as a Social System
• Every social system interacts directly with the society directly or indirectly.
• It’s a give an take process,
• Hospitals as a part of social system:
1. Contribute to the community.
2. Work towards public welfare.
3. Work towards advancement of the civilization.
If hospitals cease to exist, it will immediately affect the society at a large in terms of
health, employment, business and general well being of the citizens.
 Adminstration
• The administration is a systematic process of administering the
management of a business organization, an educational
institution like school or college, government office or any non-
profit organization.
• The main function of administration is the formation of plans,
policies, and procedures, setting up of goals and objectives,
enforcing rules and regulations, etc.
• Administration lays down the fundamental framework of an
organization, within which the management of the
organization functions.
 Administration
• Both ‘Management’ and ‘Administration’ were
synonymously used until 1923.
• Oliver Sheldon- “The Philosophy of Management”
differentiated the two.
• Administration as decision making function and
management as execution function
 Administration
• The nature of administration is bureaucratic. It is a broader term as
it involves forecasting, planning, organizing and decision-making
functions at the highest level of the enterprise.

• Administration represents the top layer of the management

hierarchy of the organization.

• These top level authorities are the either owners or business

partners who invest their capital in starting the business.

• They get their returns in the form of profits or as a dividend.

 Administration
• The nature of administration is bureaucratic. It is a broader term as
it involves forecasting, planning, organizing and decision-making
functions at the highest level of the enterprise.

• Administration represents the top layer of the management

hierarchy of the organization.

• These top level authorities are the either owners or business

partners who invest their capital in starting the business.

• They get their returns in the form of profits or as a dividend.

 MANAGEMENT ADMINISTRATION
Meaning An organized way of managing people The process of administering an organization by a group of
and things of a business organization is people is known as the Administration.
called the Management.
Authority Middle and Lower Level Top level
Role Executive Decisive
Concerned with Policy Implementation Policy Formulation
Area of operation It works under administration. It has full control over the activities of the organization.
Applicable to Profit making organizations, i.e. Government offices, military, clubs, business enterprises,
business organizations. hospitals, religious and educational organizations.
Decides Who will do the work? And How will it What should be done? And When is should be done?
be done?
Work Putting plans and policies into actions. Formulation of plans, framing policies and setting objectives
Focus on Managing work Making best possible allocation of limited resources.
Key person Manager Administrator
Represents Employees, who work for Owners, who get a return on the capital invested by them.
remuneration
Function Executive and Governing Legislative and Determinative
Nature of Administration
 PRINCIPLES OF ADMINISTRATION
1. Division of work.
2. Authority, responsibility & accountability.
3. Discipline.
4. Unity of command.
5. Unity of direction.
6. Subordination of individual interest to organizational interest.
7. Remuneration of personnel.
8. Centralization.
9. Scalar chain of command.
10. Order.
11. Equity.
12. Stability of tenure of personnel.
13. Initiative.
14. Esprit de corps.
Key Differences Between Management and Administration
The major differences between management and administration are given below:
1.Management is a systematic way of managing people and things within the organization. The administration is
defined as an act of administering the whole organization by a group of people.
2.Management is an activity of business and functional level, whereas Administration is a high-level activity.
3.While management focuses on policy implementation, policy formulation is performed by the administration.
4.Functions of administration include legislation and determination. Conversely, functions of management are
executive and governing.
5.Administration takes all the important decisions of the organization while management makes decisions under
the boundaries set by the administration.
6.A group of persons, who are employees of the organization is collectively known as management. On the other
hand, administration represents the owners of the organization.
7.Management can be seen in the profit making organization like business enterprises. Conversely, the
Administration is found in government and military offices, clubs, hospitals, religious organizations and all the
non-profit making enterprises.
8.Management is all about plans and actions, but the administration is concerned with framing policies and
setting objectives.
9.Management plays an executive role in the organization. Unlike administration, whose role is decisive in
nature.
10.The manager looks after the management of the organization, whereas administrator is responsible for the
administration of the organization.
11.Management focuses on managing people and their work. On the other hand, administration focuses on
making the best possible utilization of the organization’s resources.
• Behavioral Theory of the
Administration has its greatest exponents in
Herbert A. Simon, Chester Barnard, Douglas McGregor, Chris
Argyris and Likert Rensis.
1. The human being is endowed with a social animal needs. Among
these needs emerge gregarious needs, ie, tends to develop
cooperative and interdependent relationships that lead to living in
groups or social organizations,
2. Man is an animal endowed with a psychic system, ie, is able to
organize their perceptions in an integrated manner that allows a
perceptual and cognitive organization common to all human beings,
3. Human being has the ability to articulate language with abstract
reasoning, in other words, has communication skills
4. Man is an animal with a willingness to learn, ie to change their
behavior and attitudes toward higher standards and effective;
5. Human being has his goal-oriented behavior, very complex and changeable.
Hence the importance of understanding the goals of basic human society in
order to clearly understand their behaviour.
6. Humans characterized pair a dual pattern of behavior: both can cooperate to
compete with others. Cooperates when their individual goals can only be
achieved through the joint efforts and collective responsibility when their goals
are pursued and contested by others. The conflict becomes a virtual part of all
aspects of human life.
7. It is with the behavioural approach that the concern shifts from structure to
processes and organizational dynamics, ie with the organizational behavior.
8. Although the predominant emphasis on people, opened to the Theory of
Human Relations, but within an organizational context
• The behavioural theory is a perspective on management that emphasises the
importance of attempting to understand the various factors that affect human
behaviour in organisations”.

• The employees behaviour was not affected by job conditions alone, there were
internal reactions to the job situation also, that affect their behaviour.

• Human relations refer to the way in which managers interact with their
subordinates. When the focus of management is human beings and human
relations, the morale of workers goes up and is positively reflected in increased
productivity and efficiency of the organisation.
• Elton mayo is regarded as the father of human relation approach. He conducted a
series of experiment at the Hawthorne plant of the GE company to study the
impact of illumination and other working conditions on the productivity of
workers. Known as Hawthorne studies.

• Experiment concluded that : Informal and social groups were an important

complement to the formal groups.
• Social pressure were more important than the financial incentives that motivated
the workers to work in a given direction.
• There is no direct relationship between worker productivity and physical factors .
• Worker is not a rational man but is a social man
 Medical Services:
A. Medicine Division
• Internal Medicine
• Cardiology
• Gastroenterology
• Nephrology
• Pulmonary
• Psychiatry and Neurology
• Infectious diseases
• Allergy Skin
• Endocrinology,
• Geriatrics
• Immunology
• Paediatrics
 B. Surgery Division
• General surgery
• Obstetrics and Gynecology
• Orthopedic surgery
• Ophthalmology
• Otolaryngology (ENT)
• Dental and Oral Surgery
• Nephrology
• Neurologic surgery
• Cardiothoracic surgery
• Plastic surgery
• Anesthetics
 Ancillary Services:
i. 50-60 per cent attend the dispensary
ii. 10-20 per cent are administered injections
iii. 30-40 per cent require pathological investigations and
X-ray
iv. 5-15 per cent need dressings
v. 2-5 per cent minor surgical procedures.

-Injection Room -Outpatient Radiology

-Dressing Room -
-Minor Operation Theatre
-Dispensary
-Laboratory Sample Collection centre
 Ancillary Services:
• Air Conditioning
• Lightening & Electrification
• Diagnostic Support
• Equipment Maintenance
• Standby Generator
• Visitor Lounge
 Ancillary Services:
• Apart from a nurses station, ancillary facilities in a patient
care unit include the bathrooms and toilets, dirty and clean
utility rooms, pantry, dressing/treatment room, linen and
store room, toilet for staff, office for head nurse, an
interview room which can also be used as a seminar room.
Spatial relationship of all these to each other has to be
thought of at the outset.
Nursing Services
 Hospital Administration:
The task of the management of any enterprise
incorporates:
i. determining the goal and objectives of the enterprise,
ii. acquisition and utilisation of resources
iii. instituting communication systems,
iv. determining control procedures, and
v. evaluating the performance of the enterprise
 Hospital Administration:
The following activities are common to the management of all hospitals.
• Determination of goals and objectives: This consists primarily with policy making.
• Facility and programme planning: This classification refers primarily to the activities
involved in remodelling existing services, organising new facilities, services and
programmes.
• Financial management: This relates to financial affairs of the hospital. It includes
budgeting and costing.
• Personnel management: This category relates to the selection, motivation and guidance
of employees. It includes
• wage and salary administration.
• Coordinating departmental operation: This category includes interdependent activities
dealing with the internal functioning of all hospital departments. Frequent meeting with
departmental heads would be one example.
 Hospital Administration:
Programme review and evaluation: The review and evaluation relates to the functioning of
the clinical services and programmes, and is a continuous process.
Public and community activities: This concerns activities related to the development and
maintenance of interaction
with other health service institutions including shared-service arrangements with other
hospitals.
Health industry activities: This classification refers to activities that are external to the
hospital. It includes participation in hospital associations, third party payers (insurance
companies, employers), etc.
Government–related activities: This activity is concerned with the legal problems of the
hospitals and dealing with
local, state and central government agencies.
Educational development: The category includes all teaching and lecturing responsibilities,
continuing education of hospital personnel and participation in professional conferences
and continuing medical education (CME).
 Hospital Administrator:
• The job of the administrator is to plan, to organise, to direct and to control—
functions which are inherent to the job of every administrator.
• As a general manager, he represents the organisation to higher authorities and
to the outside world.
• He is responsible for policies and procedures, the overall administrative
structure, financial management, personnel management, reporting to the
board, relations with the medical staff, overseeing medical care, maintaining the
physical facilities, legal matters and maintaining good public relations.
Time distribution on administrative functions
ROLES OF A HOSPITAL ADMINISTRATION

Role
Towards
Patient

ROLE

Role Role
Towards Towards
Organization Community
 ROLES TOWARDS PATIENTS

Clinical Needs

Safety Needs

Emotional Needs

Educational Needs

Staff Attitude

Patient Satisfaction
 ROLES TOWARDS COMMUNITY

Supporting Community Health Needs

Integration with other healthcare

institutions

Supporting Primary Health

Out reach Services

Community Education
 ROLES TOWARDS ORGANISATION

Patient Care StaffMgt

Legal responsibilities Finance

Ethics
Public Relations
Quality
marketing Decision Making

MIS
 MANAGERIAL FUNCTIONS OF HOSPITAL ADMINISTRATION

1. Working with People: Balance the goals of the hospitals by working with patient care teams
where physician is the kingpin (who in turn works with others in rendering patient care).
Understand workers, their motivations and aspirations, and knit them together as a team.

2. The Enabling Role: Ensure the provision of necessary physical facilities and ensure that the
supportive services are available in the right amount, of the right quality, and at the right
time and place.

3. Hospital Administration and Staff: Understand the staff and understand variations in styles
of administration.

4. Staff Motivation: Develop measures to keep up motivation of all categories of staff, and be
constantly on the look-out for cases of dissatisfaction and conflict.
 ROLES AND FUNCTIONS OF HOSPITAL ADMINISTRATION

5. Facilitating Decision Making: Provide appropriate inputs to decision making at the clinical
departmental level, and coordinate decision making at the interdepartmental level.

6. Management of Resources: His judgement may not necessarily be superior to that of the
experts who propose the case, but his position is the most appropriate one from which to
make it.

7. Negotiating: Steer closer to “creative problem solving” situation, rather than turning to a
“choice” situation. Emotions do play a part in negotiation sessions, but guard against them..

8. Containing Costs: Exercise control over financial matters through costing, cost-control,
budgeting and judicious investment of hospital funds.
 ROLES AND FUNCTIONS OF HOSPITAL ADMINISTRATION

9. Understanding ‘Efficiency’ and ‘Effectiveness’

10. Dealing with New Technology
11. Establishing Managerial Climate
12. Management Development
13. Evaluation
14. Fact-finding and Investigation
15. Social Commitment
 Professional Bodies of Hospital Administrators
• Healthcare associations or professional bodies represent a collection of professionals who work
towards the common goal of promoting and improving the medical profession they are associated
with.
• These healthcare organizations champion their members by providing resources, information and
opportunities they might have not had otherwise.
• Members are bonded together as they advocate for their peers and share their challenges and
triumphs among one another.
• Joining an association provides members with a competitive advantage because they become active,
informed members within their industry.
• Many association members who lead busy professional lives depend on their association to brief them
on important industry trends, new legislative rulings and advances in technology.
 Professional Bodies of Hospital Administrators

• Indian Society of Health Administrators – ISHA

• Association of Healthcare Providers (India)
• National Accreditation Board for Hospitals & Healthcare Providers
• MCI
 Code of Ethics of Hospital Administrator (Management)
• Conduct professional activities with honesty, integrity, respect, fairness and good faith in a manner that will reflect
well upon the profession;
• Comply with all laws and regulations pertaining to healthcare management in the jurisdictions in which the
healthcare executive is located or conducts professional activities;
• Maintain competence and proficiency in healthcare management by implementing a personal program of
assessment and continuing professional education;
• Avoid the improper exploitation of professional relationships for personal gain;
• Disclose financial and other conflicts of interest;
• Use the Code to further the interests of the profession and not for selfish reasons;
• Respect professional confidences;
• Enhance the dignity and image of the healthcare management profession through positive public information
programs; and
• Refrain from participating in any activity that demeans the credibility and dignity of the healthcare management
profession.
 Code of Ethics of Hospital Administrator (Patients)
A. Work to ensure the existence of a process to evaluate the quality of care or service rendered;
B. Avoid practicing or facilitating discrimination and institute safeguards to prevent discriminatory organizational
practices;
C. Work to ensure the existence of a process that will advise patients or others served of the rights, opportunities,
responsibilities and risks regarding available healthcare services;
D. Work to ensure that there is a process in place to facilitate the resolution of conflicts that may arise when values of
patients and their families differ from those of employees and physicians;
E. Demonstrate zero tolerance for any abuse of power that compromises patients or others served;
F. Work to provide a process that ensures the autonomy and self-determination of patients or others served;
G. Work to ensure the existence of procedures that will safeguard the confidentiality and privacy of patients or others
served; and
H. Work to ensure the existence of an ongoing process and procedures to review, develop and consistently implement
evidence-based clinical practices throughout the organization.
 Code of Ethics of Hospital Administrator (Organization)
A. Provide healthcare services consistent with available resources, and when there are limited resources, work to
ensure the existence of a resource allocation process that considers ethical ramifications;
B. Conduct both competitive and cooperative activities in ways that improve community healthcare services;
C. Lead the organization in the use and improvement of standards of management and sound business practices;
D. Respect the customs and practices of patients or others served, consistent with the organization’s philosophy;
E. Be truthful in all forms of professional and organizational communication, and avoid disseminating information that
is false, misleading or deceptive;
F. Report negative financial and other information promptly and accurately, and initiate appropriate action; Prevent
fraud and abuse and aggressive accounting practices that may result in disputable financial reports;
G. Create an organizational environment in which both clinical and management mistakes are minimized and, when
they do occur, are disclosed and addressed effectively;
H. Implement an organizational code of ethics and monitor compliance; and
I. Provide ethics resources and mechanisms for staff to address ethical organizational and clinical issues.
 Code of Ethics of Hospital Administrator (Employees)
Healthcare executives have ethical and professional obligations to the employees they manage that encompass but
are not limited to:
A. Creating a work environment that promotes ethical conduct;
B. Providing a work environment that encourages a free expression of ethical concerns and provides mechanisms for
discussing and addressing such concerns;
C. Promoting a healthy work environment which includes freedom from harassment, sexual and other, and coercion o
any kind, especially to perform illegal or unethical acts;
D. Promoting a culture of inclusivity that seeks to prevent discrimination on the basis of race, ethnicity, religion,
gender, sexual orientation, age or disability;
E. Providing a work environment that promotes the proper use of employees’ knowledge and skills; and
F. Providing a safe and healthy work environment.
 Code of Ethics of Hospital Administrator (Community)
A. Work to identify and meet the healthcare needs of the community;
B. Work to support access to healthcare services for all people;
C. Encourage and participate in public dialogue on healthcare policy issues, and advocate solutions
that will improve health status and promote quality healthcare;
D. Apply short- and long-term assessments to management decisions affecting both community
and society; and
E. Provide prospective patients and others with adequate and accurate information, enabling them
to make enlightened decisions regarding services.
 Evaluation of Hospital Services
• Evaluation is central to the concept of hospital quality improvement; it
provides a means to define what hospitals actually do, and to compare
that with the original targets in order to identify opportunities for
improvement.
• The principal methods of measuring hospital performance are regulatory
inspection, public satisfaction surveys, third-party assessment, and
statistical indicators.
 Evaluation of Hospital Services
• Inspection of hospitals measures minimal requirements for the safety of
patients and personnel; it does not foster innovation or information for
consumers or providers.
• Surveys usually address what is valued by patients and the general public.
Standardized surveys measure specific domains of patient experience and
satisfaction. There are also standardized surveys that reliably measure hospital
performance against explicit standards at a national level.
 Evaluation of Hospital Services
• Third party assessments may include measurement by standards, by peer review or by
accreditation programmes.
• ISO standards assess compliance with international standards for quality systems, rather than
hospital functions per se.
• Peer review is generally supported by clinical professions as a means of self-regulation and
improvement, and does not aim to measure the overall performance of hospitals.
• Accreditation programmes are managed by independent agencies in several countries. They
focus on what may be improved rather than on failures, and are oriented toward the patient, the
clinical procedures, outcome and organizational performance.
 Evaluation of Hospital Services
• Statistical indicators can suggest issues for performance management, quality improvement &
further scrutiny; however, they need to be interpreted with caution.
• Much of the current evidence on the effectiveness of performance indicators is based on
observational or experimental data.
• Experience suggests that indicators such as guidelines to standardize management of common
conditions may reduce length of stay and episode costs without detriment to clinical outcome.
• They should be designed to measure the achievement of predetermined objectives, but in practice
they are often selected on the basis of whatever data are routinely available.
• Standardization is essential for measurements within hospitals, and critical for measurements
between hospitals.
 Monitoring versus Evaluation
Monitoring Evaluation

A planned, systematic A process that assesses an

process of observation achievement against
that closely follows a preset criteria.
course of activities, and Has a variety of purposes,
compares what is and follow distinct
happening with what is methodologies (process,
expected to happen outcome, performance,
etc).
 Evaluation
• A systematic process to
determine the extent to which
service needs and results have
been or are being achieved and
analyse the reasons for any
discrepancy.
• Attempts to measure service’s
relevance, efficiency and
effectiveness. It measures
whether and to what extent the
programme’s inputs and
services are improving the
quality of people’s lives.
Monitoring
• The periodic collection and
review of information on
programme implementation,
coverage and use for
comparison with
implementation plans.
• Open to modifying original
plans during implementation
• Identifies shortcomings before it
is too late.
• Provides elements of analysis as
to why progress fell short of
expectations
When Is Evaluation Desirable?

• Program evaluation is often used when programs have

been functioning for some time. This is called
Retrospective Evaluation.

• However, evaluation should also be conducted when a

new program within a service is being introduced.
These are called Prospective Evaluations.

• A prospective evaluation identifies ways to

increase the impact of a program on clients; it
examines and describes a program’s attributes; and, it
identifies how to improve delivery mechanisms to be
more effective.
Prospective versus Retrospective Evaluation

• Prospective Evaluation, determines

what ought to happen (and why)

• Retrospective Evaluation, determines

what actually happened (and why)
Who conducts evaluation?
Who conducts evaluation?

• Internal evaluation (self evaluation), in

which people within a program sponsor, conduct
and control the evaluation.

• External evaluation, in which someone from

beyond the program acts as the evaluator and
controls the evaluation.
Tradeoffs between External and Internal
Evaluation
Tradeoffs between External and Internal
Evaluation

Source: Adapted from UNICEF Guide for Monitoring and Evaluation, 1991.
Guidelines for Evaluation (FIVE phases)
Phase A: Planning the Evaluation

• Determine the purpose of the evaluation.

• Decide on type of evaluation.
• Decide on who conducts evaluation (evaluation
team)
• Review existing information in programme
documents including monitoring information.
• List the relevant information sources
• Describe the programme. *
• Assess your own strengths and limitations.
Phase B:Selecting Appropriate Evaluation Methods

• Identify evaluation goals and objectives.

• Formulate evaluation questions and sub-
questions
• Decide on the appropriate evaluation
design
• Identify measurement standards
• Identify measurement indicators
• Develop an evaluation schedule
• Develop a budget for the evaluation.
Phase C: Collecting and Analysing Information

• Develop data collection instruments.

• Pre-test data collection instruments.
• Undertake data collection activities.
• Analyse data.
• Interpret the data
Quantitative tools:
• “Quantitative, or numeric information, is obtained from various
databases and can be expressed using statistics.”

• Surveys/questionnaires;
• Registries
• Activity logs;
• Administrative records;
• Patient/client charts;
• Registration forms;
• Case studies;
• Attendance sheets.
Phase D: Reporting Findings

• Write the evaluation report.

• Decide on the method of sharing the evaluation results and on
communication strategies.
• Share the draft report with stakeholders and revise as needed to
be followed by follow up.
• Disseminate evaluation report.
Phase E:Implementing Evaluation
Recommendations

• Develop a new/revised implementation plan in partnership with

stakeholders.
• Monitor the implementation of evaluation recommendations and
report regularly on the implementation progress.
• Plan the next evaluation
 Time Management
• Time management has been defined as ‘a set of related common
sense skills that helps you use your time in the most effective and
productive way possible’.

• Time management is the act or process of planning and

exercising conscious control over the amount of time spent on
specific activities, especially to increase effectiveness, efficiency
or productivity
 Skills
• Be on Time
• Adjust your Attitude
• Be Goal Oriented
• Prioritize
• Divide Large Tasks
• Plan your Activities
• Be Organized
• Manage your Workload
• Learn to say ‘no’
• Follow a Routine
• Delegate Effectively
• Documentation
• Manage Meetings
• Control Interruptions
• Manage your Health
• Organize your Home
Life
• Track what you Do
• Be flexible
 Time Management
• Administering an hospital is very busy, and the more productive
an administrator can be, the more effective they are in their job.

• HA is a demanding career and requires you to practice a lot of

patience as well as learn and apply a highly effective time
management system to truly stay on top of the game.
 Time Management
• Administering an hospital is very busy, and the more productive an
administrator can be, the more effective they are in their job.

• HA is a demanding career and requires you to practice a lot of

patience as well as learn and apply a highly effective time
management system to truly stay on top of the game.
• The HA have dual roles, i.e., patient care provider and organizational
employee.
 URGENT NON-URGENT

IMPORTANT

NOT-
IMPORTANT
 Recent Advances
1. Cost-Cutting Focus
2. Health Care IT Management Professionals in Demand
3. Drug Shortage Becomes Top Priority
4. Social Media in Health Care
5. Population Health Management Strategies to Advert Readmissions
6. Privacy Becomes More Important
7. Compliance to State and Central Laws
8. Process Improvements
9. Implementation of Technological Advancements
10.Evolving Leadership Opportunities
11.Medical Tourism
12.Outsourcing Hospital Services Public Private Partnership
13.Hospital Accreditation and Quality Control.
14.Hospital Disaster Management.
 Recent Advances
1. Clinical Decision Support Design, Development and Implementation
2. Decision Support Systems
3. E-Health and M-Health
4. IS in Healthcare
5. IT Applications in Health Organizations and Practices
6. IT Applications in Physical Therapeutic Treatments
7. IT security and privacy issues
8. Management of Emerging Health Care Technologies
9. Medical informatics
10.Nursing Expert Systems
11.Pharmaceutical and Home Healthcare Informatics
12.Rehabilitative Technologies
13.Role of informatics specialists
14.Telemedicine
15.Virtual health technologies
 Corporate Social Responsibility
1. India is the first country in the world to make corporate social responsibility (CSR)
mandatory, following an amendment to The Company Act, 2013 in April 2014.
2. Businesses can invest their profits in areas such as education, poverty, gender equality,
and hunger.
3. The amendment notified in the Schedule VII of the Companies Act advocates that
those companies with a net worth of US$73 million (Rs 4.96 billion) or more, or an
annual turnover of US$146 million (Rs 9.92 billion) or more, or a net profit of
US$732,654 (Rs 50 million) or more during a financial year, shall earmark 2 percent of
average net profits of three years towards CSR
• Getting license to operate– from key stakeholders not just shareholders
• Reputation Management
• More Efficient use of resources
• Enhanced patient loyalty
• Increased Ability to Attract and Retain Quality Employees
• Responsible Competiveness
• Attracting Investors and Business partners
• Governmental Support