Concept on management

INTRODUCTION Management and administration sometimes appear to be synonymous, but they are not synonymous terms. If we consider the administration is the coin the organization are management are the two sides of the same coin. To translate any policy into action, people need structure that is organization, when structure is there; there are some functions to be performed to accomplish goals that functional aspect of organization is dealt by management. Administration refers to the activities of the higher level in the managerial skills and also refers to determination of major aims and policies while management to the carrying to the carrying out of the operation designed to accomplish the aims and effectuate the policies.

DEFINITION The following definitions of management can be understood and applied by health administration and managers. Management may be defined as the art of securing maximum results with a minimum of effort so as to secure maximum prosperity and happiness for both employer and employee and give the public the best possible service. -john Mee F 1963 Management is a distinct process consisting of planning, organizing, actuating and controlling, performed to determine and accomplish the objectives by the use of people and resources. George, Gerry,R 1963 Management is principally the task of planning, coordinating, motivating, and controlling the efforts of others towards a specific objective. James lundy 1963 Management is the creation and control of technological and human environment of an organization in which human skill and capacities of individuals and groups find full scope for their effective use in order to accomplish the objective for which an enterprise has been set up. It is involved in the relationship of the individual, group, the organization and the environment. -A dasgupta 1969 Management is a good planning, organizing directing, co ordinating and controlling to eliminate chaos, errors and waste and get better utilization of manpower and materials. -George A Melresh

Management is the process and agency which directs and guides the operations of an organization on the realizing established aims.. -ordway tead On the basis of above definition, management is getting a group of people to work together harmoniously and efficiently to accomplish a common purpose. The purpose of management is the effective allocation and collective utilization of human resources and material in an effort to reach the goals. PRINCIPLES OF MANAGEMENT o Meaning of management principles : Management principles are statements of fundamental truth which act as guidelines for taking managerial action. o Management principles are derived and developed in the following two steps. (a) Deep Observations (b) Repeated experiments o Management principles serve as guidelines for the managers to manage with different situations. It helps in understanding of Nature of management. o Management Principles aimed at influencing human behavior.

o Management principles improve the managers efficiency who will work for social objectives. o Management principles provide new ideas, imagination and visions to the managers and the organization. o Guide to rese

FAYOLS 14 PRINCIPLES OF MANAGEMENT: 1. Division of Work. Specialization allows the individual to build up experience, and to continuously improve his skills. Thereby he can be more productive. 2. Authority. The right to issue commands, along with which must go the balanced responsibility for its function. 3. Discipline. Employees must obey, but this is two-sided: employees will only obey orders if management play their part by providing good leadership. 4. Unity of Command. Each worker should have only one boss with no other conflicting lines of command. 5. Unity of Direction. People engaged in the same kind of activities must have the same objectives in a single plan. This is essential to ensure unity and coordination in the enterprise. Unity of command does not exist without unity of direction but does not necessarily flows from it.

6. Subordination of individual interest (to the general interest). Management must see that the goals of the firms are always paramount. 7. Remuneration. Payment is an important motivator although by analyzing a number of possibilities, Fayol points out that there is no such thing as a perfect system. 8. Centralization (or Decentralization). This is a matter of degree depending on the condition of the business and the quality of its personnel. 9. Scalar chain (Line of Authority). A hierarchy is necessary for unity of direction. But lateral communication is also fundamental, as long as superiors know that such communication is taking place. Scalar chain refers to the number of levels in the hierarchy from the ultimate authority to the lowest level in the organization. It should not be over-stretched and consist of too-many levels. 10. Order. Both material order and social order are necessary. The former minimizes lost time and useless handling of materials. The latter is achieved through organization and selection. 11. Equity. In running a business a combination of kindliness and justice is needed. Treating employees well is important to achieve equity. 12. Stability of Tenure of Personnel. Employees work better if job security and career progress are assured to them. An insecure tenure and a high rate of employee turnover will affect the organization adversely. 13. Initiative. Allowing all personnel to show their initiative in some way is a source of strength for the organization. Even though it may well involve a sacrifice of personal vanity on the part of many managers. 14. Esprit de Corps. Management must foster the morale of its employees. He further suggests that: real talent is needed to coordinate effort, encourage keenness, use each persons abilities, and reward each ones merit without arousing possible jealousies and disturbing harmonious relations.

TYPES OF MANAGEMENT In Health care delivery system, the management is mobilizing, protecting and utilizing men, money, materials, machines and other resources and methods in an efficient and effective manner to provide proper health services to the citizens and manner to provide proper health services to the citizens. The types of management as follows: 1. 2. 3. Personal management Material management Financial management

Personal Management

Man is the most crucial factor in management because he is the main centre of any organization, without man organization cannot function. The group of men (persons) called personnel. Hence personnel means a body of persons, engaged in any service or employment especially in public institution, who perform, their function to achieve the objectives of institution or organization. Personnel management is that part of management, which is concerned with increasing the effectiveness of human performance in any organization. It is the heart of all managerial action. Personnel management deals with personnel of the organization. The purpose of personnel management is to guide human and physical resources into dynamic organization units which attain their objectives to the satisfaction of those served and with a high degree of moral and sense of attainment on the part of those rendering the service. Personnel management to become effective, requires planning, organizing, directing and controlling efforts of management with regard to the personnel function as it deals with the hiring and firing, training and placing, compensating and promoting, as well in disciplining and motivating the personnel of the organization. Personnel management lie in securing the greatest human performance through the selection of right man for the right place, through the provision of adequate training and working relationships as well as through the maintenance of will to do in the mind of workers employees. Management of health personnel should ensure that people planned and trained in view of needs must be properly utilised which means personnel should be managed for maximum effectiveness of the health service. Management sub-systems provides for mechanisms for the employment, retention, support and development of health care personnel. Brief description of these elements as follows: Employment i) Job description: For optimal utilization of health services, it is very essential that the role of each category of health manpower should be classified. This may be done through delineating job descriptions, training and through participative approaches. Health personnel which include nursing personnel may be motivated to perform, may have the technical skills, and may not be able to fulfil the management expectations on his/her, because of lack of clear understanding of his or her role in the organizations. A job description is a statement of the basic purpose of the job, the significant tasks to be carried out, authority vested in the job and the upward, downward and horizontal relationship, necessary for the performance of the job. ii) Establishment control: Establishment control is concerned with the authorization of the health personnel posts in different cadres, services and locations. The efficient delivery of health services requires continual adjustments in the distribution and use of resources to cater for. Changing demands, unexpected problems and opportunities. iii) Recruitment procedures: Recruitment procedures include the processes and the methods by which vacancies are notified, posts are advertised, applications are handled and screened,

interviews are conducted and appointments are made. Recruitment covers both the filling of new posts which fall vacant. It includes the filling of posts both from internal or in-service candidates and from external candidates or direct recruitment. The steps of recruitment process are as follows: Processing vacancy information and information on newly created positions, Formulation/ascertaining recruitment procedures for each position.

Notifying recruiting authority according to their level and disseminating vacancy information and soliciting application, Selection or personnel on the basis of required qualification by experience, through written test, interview followed by issuance of appointment orders and finally, Conducting an orientation/induction program which may be formal or informal. Retention 1. Career structures: A career structure means a recognized promotional path for a cadre of health personnel formalized through the grading structure of the cadres, e.g. a career structure of community health nurses at district levels would be as follows:

District Public Health Nursing Officer/DHS Assistant District Public Health Nursing Officer/PHN supervisors Senior Public Health Nurse/PHN Junior Public Health Nurse/LHV/HA (F)

2. Promotional procedures: Each grade within a career structure should have clearly laid down duties and responsibilities- recorded in the job description together with a specification of the qualifications and experience required of the post holder. Promotion in all cases should be based on whether the individual meets the requirements as specified in the job description. 3. Living and working condition: The living and working conditions of many health personnel are often totally inadequate, particularly in the rural areas where there has to be the greatest expansion in numbers employed for the development of primary health care services. These inadequate living and working conditions in rural area have led to the spatial distortions. These inadequacies increase the sense of isolation both physical and psychological of rural health personnel. Supporting i. Supervision: Supervision involves making sure that staffs performs their duties effectively. Besides ensuring an effective and efficient performance of duties by the staff, a supervisor should

also help and guide the staff in performance of their duties, detect and remove lacunae in the performance and also train them in such a way that they become more competent in their work. ii. Communication and consultation: Good human relations and communication skills are helpful in generating interest in health programmes. Poor human relations skills of staff imply lack of harmony among them, low wastage of time in unnecessary conflicts.

iii. Logistic support: The performance of the health personnel, sometimes depends upon the logistic support, e.g. a nurse working in remotest areas needs to improve the communications, which means they should be provided with proper transport facilities, adequate supply of drugs and other supplies, good working space at the health centre. This facilitates the effective performance of the health personnel. iv. Continuing education: Continuing education should aim at and should be concerned with the updating of existing skills and also acquisition of new skills and knowledge. Developing Career development: It has been observed that in most of the categories in the health department, there is a swan neck situation in which there are almost no avenues for further career development. There is a need for the potential ability of each member of the health staff should be recognised and full scope accorded for development. Recognition of the validity of promotion from within,

Recognition of variations among individuals in relation to career incentives, capacity for leadership, and pattern of work. Recognition and stimulation of special talent or interest, Qualitative development as well as change in grade, Agency responsibility for providing the means for development,

It is very essential that the team of health personnel develops a proper cadre taking into consideration the community needs, employment opportunities, promotional career prospects and a well defined career structure, for which on the job training of successful candidates for a period of 3-6 months should precede confirmation in the designated job. These continuing education programs should be developed with major emphasis on: a. b. c. d. e. Refresher courses In-service training Bridge courses for advanced professional education Provision of study leave after 3-5 years of service Dissemination of new information.

Performance appraisal is a formalized system of review of an individuals strength and weakness in his work and of joining to meet his development needs.

MATERIAL MANAGEMENT Material management is concerned with providing the drugs, supplies and equipment needed by health personnel to deliver health services. Without proper material, health personnel cannot work effectively, they feel frustrated and the community lacks confidence in the health services and unless appropriate materials are provided in proper time and are required quantity, productivity of personnel will not be up to expectation. Good material managers adopt the following procedures: Taking inventory regularly and systematically, Requisitioning at indenting according to actual needs Receiving and inspecting incoming items, Storing and protecting items, Issuing items for use, Proper use of items.

INTRODUCTION Materials are an essential resource to achieve the objectives of a health care organization. While about 60% of the funds of health sector are consumed to provide manpower, health care being a labour intensive activity, almost 40% of the funds are used up for providing materials. Good material managers adopt the following procedures: Taking inventory regularly and systematically Requisitioning at indenting according to actual needs Receiving and inspecting incoming items Storing and protecting items Issuing items for use Proper use of items.

The Main Purpose of material management: 1. Cost reduction

2. 3.

Avoidance of wastage and shortage Ensuring adequate quality and quantity of material without delay in procurement

OBJECTIVES OF THE MATERIAL MANAGEMENT: Material management brings about control over the acquisition, storage, retrevability, distribution, use and disposal of supplies and equipment in order to carry out the primary responsibilities of the organisation in an efficient, effective and economical manner. Material management seeks to ensure availability of the right materials at the right time, to the right place at the least cost. ORGANISATION Material management entails two basic functions: Purchase and Stores. These two functions maybe carried out independently through a separate store department and a purchase department, or the two functions may be integrated into a single store purchase department. Separate departments for purchase and store functions ensure minimisation of confusion, formalisation of data necessary for making effective purchases and specialisation of each of the two functions, which intrinsically are independent in nature. An integrated store purchase department has the following advantage: 1) A single authority can be held responsibility for the availability and control of materials. Thus there will be less chance for shifting blame from one department to another and there will be better coordination between the purchase and store functions. 2) Less paper work, as common recurs can be maintained (purchase and receipt registers can be combined). 3) The speed of transactions can be expedited as common information can be shared easily and informally between purchase and store personal.

PROCESS OF MATERIAL MANAGEMENT: The process of material management involves planning, review and control of 1. 2. 3. 4. 5. 6. Budgeting and material planning. Demand forecasting. Procurement, receipt, inspection and payment. Storage and inventory control. Issue and distribution. Usage.

7. 8. 9.

Maintenance. Disposal. Pilferage.

MODERN TECHNIQUES OF MANAGEMENT 1. MANAGEMENT INFORMATION SYSTEM

In todays formal organization the information on which crucial decisions may depend, are not only increasing day by day but the nature and the type of information cover a wide range. Consequently the volume and the range of information which generate the database on which vital decisions are dependent, are vast. Needled to add, therefore, that in order to plan, control and monitor the quality of services rendered in an organization, it is necessary that complete information or facts or data which are accurate, reliable, relevant and are made available timely. There is not only close relationship between these two administrative and management functions but the need for the use of accurate and timely, the relevant information assumes an equal and crucial importance for these two functions. These data needed by the managers for; i. ii. iii. iv. v. vi. Recommending course of action Recommending changes in courses of action Making predictions Drawing conclusions Taking decisions administrative /corrective/budgetary Taking decisions for taking action

MEANING OF MIS AND HIMS MIS means a formal system that provides timely and necessary information to the managers for making decisions. Health management information system (HMIS), a part of MIS is a formal system that supplies timely and necessary health information to the health planners through surveillance for monitoring and making decisions in the area of health care delivery system.

The inter relationship of MIS and computer technology in the present day context cannot be over emphasized. Computer technology today has brought in a revolution. For handling the variety and the quality of information as well as for making this information available whin required, this technology has become indispensable in MIS, it is also a time saving device, as with proper

development of software it saves man hours and supplies the information within the minimum possible time. HEALTH MANAGEMENT INFORMATION SYSTEM This is a MIS, which deals with health information for health management. Let us reproduce below the text given in this context in the national health policy of India. Management information system appropriate decision making and programme planning in the health and related fields is not possible without establishing an effective health information system. A nationwide organizational setup should be established to procure essential health information. Such information is required not only for assisting in planning and decision making but also to provide timely warnings about emerging health problems and for receiving, monitoring and evaluating the various ongoing health programmes. The building up of a well conceived health information system is also necessary assessing medical and health manpower requirements and taking timely decisions on a continuing basis regarding the manpower requirements in the future. SURVEILLANCE Surveillance has immense importance in MIS as surveillance is an integral part of the MIS. One of the modules of the child survival and safe motherhood programme (CSSM), states an effective surveillance system is essential to achieve the above goals as reliable epidemiological data are necessary for effective planning, monitoring the quality of services and documentation of impact.

IMPORTANCE OF SURVEILLANCES i. they ii. iii. iv. v. vi. vii. The data generated through surveillance are important in planning health services because

Highlight the magnitude of an illness as a public health problem Help in planning appropriate programme interventions based on epidemiological data. Monitor the quality of community and institutional health services being rendered. Identify pockets of high risk for additional and specific actions. Estimate programme needs for drugs Help in accomplishment of national health policy goals.

viii. Document impact of health services reduction in mortality and morbidity rates, declining trends of diseases, prevention of cases, complications and death etc.

TYPES OF SURVEILLANCE Surveillance is of two types, ACTIVE and PASSIVE

Nurses particularly public health nursing personnel are very much a part of the HMIS, which in turn is a part of MIS, because nurse at the periphery generate information by making conscious additional efforts for collecting epidemiological indices. This type of surveillance, where active participation of the concerned personnel come into play is known as active surveillance e.g. collecting information on fever cases and blood slides for detection of malaria. Passive surveillance on the contrary is that type of surveillance, where health data are available from hospitals and other health facilities, where consumers come on their own seeking necessary health related interventions.

Relationship of MIS with the planning, organizing and the controlling functions with surveillance is shown diagrammatically.

Active

passive

2.

MANAGEMENT BY OBJECTIVES

The concept MBO is a way of practicing five basic management functions;

Planning, organizing, leading and controlling . George S. odiorne has stated MBO as A process where by the superior and the subordinate managers of an enterprise jointly identify its common goals, define each individuals major areas of responsibility in terms of the results expected of him, and use these measures as guides for operating the units and assessing the contribution of each of its members.

BASIC TENENTS OF MBO 1. RESULT ORIENTATION

One of the basic tenets of MBO is result orientation the other is the concept of human behavior and motivation . MBO is thus the result orientation and motivation or aims at achieving the laid down objectives influence policy, organization personnel, leadership. And control.

2.

HUMAN BEHAVIOUR AND MOTIVATION

The second basic tent that supports the concept of MBO is human behaviour and motivation. In this respect let us discuss the theory of Abraham Maslow which is popularly known as Needs Theory. The need theory is considered as a type of internal motivation because an individuals wants and needs exist within herself or himself. He or she is consciously aware of some of his or her needs but not conscious about others. Need theory is based on certain assumptions like: No need can ever be completely satisfied; hence only partial fulfilment of a need is required before another need is allowed to appear. Needs are constantly changing within an individual, and they are often hidden from ones consciousness. Since needs are often group related, they are often interdependent. How a person satisfies his/ her social needs is determined by his/ her socio-economic status. Maslows theory of Hierarchy of Human Needs was formulated in 1943. Kalish has further defined these needs into: 1) 2) 3) 4) 5) Survival needs Stimulation needs Safety needs Love and belongingness needs Esteem needs

6)

Self actualisation needs

Fredrick Herzberg is another pioneer who has developed the Motivation-Hygiene Theory. The development of the MBO concept owes a lot to the motivation theories. The assumptions that MBO takes into account about human behaviour are also dependent on these theories. MBO is essentially achievement and participation oriented. In practising MBO, it is essential that the employees are directly and actively involved in planning, directing and controlling of their jobs. Involvement brings in commitment, which in turn acts as the motivator for achievement of the organization objectives. What is the MBO System? MBO is the process by which the members of an organization jointly formulate the organizational goals. With the assistance from his/her supervision, each member: Define his/her area of responsibility accountability. Formulates specific objectives which he/ she is expected to accomplish.

Develops performance measures to be used as standards for evaluation of his/her performance in terms of his/her contribution towards achievement of goals.

Programme implementation

Setting objectives

Action planning

Periodic review

Performance appraisal

3. 4.

System approach to management Computer technology in management

MISSION OR PURPOSE MISSION STATEMENTS A Mission Statement defines the organization's purpose and primary objectives. Its prime function is internal to define the key measure or measures of the organizations success and its prime audience is the leadership team and stockholders. Mission statements are the starting points of an organisations strategic planning and goal setting process. They focus attention and assure that internal and external stakeholders understand what the organization is attempting to accomplish. Dimensions of Mission statements: According to Bart, the strongest organizational impact occurs when mission statements contain 7 essential dimensions. Key values and beliefs Distinctive competence Desired competitive position Competitive strategy Compelling goal/vision Specific customers served and products or services offered Concern for satisfying multiple stakeholders

The mission statement of an; organization describes the purpose for which that organization exists. Mission statements provide information and inspiration that clearly and explicitly outline the way ahead for the organization. They provide vision. Individuals want productive and meaningful lives .therefore, the purpose of the organization and of each of its units should be defined a teamwork approach should be properly trained: and all individuals within the organization should be treated with respect. Organizational purpose moves and guides the organization toward a perceived goal. Many writers indicate that the purpose or mission statement should be created from mission statement should be properly trained and all individual s within the organization should be treated with respect.

Organizational purpose moves and guides the organization toward a perceived goal. May writers indicate that the purpose or mission statement should be created from a vision statement that tells what the company stands for. The vision statement is created with the customers needs in mind. To determine these needs ask and listen to the customer. External customers who purchase the products or service may be given a tour. In nursing, external customers are prospective patients and families, accreditation and licensing officials, faculty and students, and even taxpayers and shareholders. Employees are internal customers. The mission or purpose statement incorporates the culture of the organization, including strong leadership, rules and regulations, achievement of goals, and the notion that people are more important than work. Employees who participate in developing the vision statement believe in their own abilities and are more committed to the organization. The vision statement is shared companywide so that employees live the vision. It is kept updated to keep pace with technology and trends. A vision statement is sometimes considered more strategic than a mission statement. The mental exercise of creating one is more meaningful than the contents of the statement itself. Vision, values, mission or purpose statements are meaningful only to the creators. VISION Employees who participate In developing the vision statement believe in their own abilities and are more committed to the organization than employees who do not participate. The vision statement is shared companywide so that employees may live the vision. It is updated to keep pae with technology and trends. A vision statement is sometimes. The mental exercise of creating one is more meaningful than are the contents of the statement itself. Vision values, mission, or purpose statements are meaningful only to the creators. Translated for the community, these statements place value on the way nurses care for people. It follows that ethnic populations are considered in developing vision and values statements for nursing entities. Nursing education teaches the meaning of values such as tolerance and compromise. Examples of values are informality, creativity, honesty, quality, courtesy, and caring.

CONCLUSION The above principles and techniques are stepping stone to effective management. Effective management provides satisfaction to the employees as well as the management as targets are fulfilled, schedules are honoured, postive image is build and a sense of pride develops in the minds of all concerned.

BIBLI0GRAPHY 1. Basavantappa B.T. Nursing Administration Ist Ed., Jaypee Brcthers, Medical Publishers, New Delhi, 2000;

2. Russel c.swansburg, richardj. Swansburg management and leadership for nurse management. 3rd edtion. Jones and bartlet publishers; Canada: 2002. 3. TNAI. Nursing administration and management. First edition. Ideal 2 images publication; new delhi:2000. 4. McQuaillan Florence. The realities of nursing management How to cope, Robert J Brandy Co., London, 1978.