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Hospital planning has come of age and is today widely recognized as a critical
management tool in positioning the hospital for the future. In today¶s highly
competitive and volatile world, organizations operate in uncertain environments,
some of them in greater uncertainties than others. And compounding the leader¶s
problem are the many forces that are beyond his control. If the organization is to
succeed in this environment and wishes to see itself where it wants to be, say, five or
ten years hence, the leader must beyond all question accord high priority to planning.
Successful planning is the key to finding and acting on opportunities within external
constraints and uncertainties that stare many of our hospitals in the face today.

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Hospital planning has, by and large, proceeded through the following three
evolutionary stages:

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More commonly known as bricks-and-mortar planning, facility planning was heavily

oriented towards design and construction of physical facilities. The major emphasis
during this stage was on the replacement or expansion of physical facilities. The
focus on expansion of physical facilities was dictated by the growth of hospitals in
every direction coupled with capacity shortages, technological and medical advances.
Architects and engineers were the major players in facilities planning.

%)*+c, Institutional Planning: In this stage, focus of planning shifted to the planning
of programmers and departments of the hospital. This shift was characterized by the
expansion of existing programmers on one hand and exploring new types of
healthcare services on the other besides setting annual and long-term objectives for
them. As a matter of necessity, budgeting was tied to these objectives. Many
hospitals established a department of planning and created the position of Director of
Planning to coordinate and carry out the functions of planning.

%)*+c , Strategic Planning: This is characterized by the ongoing and systematic use
of planning as a top management tool to set short and long term goals of the hospital
and to attain them in order to best position the hospital.

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Strategic planning must rely on increasing emphasis on environmental assessment
and forecasting, that is, answer to the question. What will the future technological,
economical, legal and regulatory environment be? Equally important are the
development and or refinement of the organization¶s mission and objectives as well
as financial and diversification planning. Ability to attain goals and maintain good
relations between the governance and top management team is absolutely imperative.
A deep rooted reorientation in thinking throughout the organization toward strategic
management is critical to the success of strategic planning, so also the understanding
and an unflinching commitment of the chief executive, top management team and the
medical staff to the programmed.

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Organizations can neglect strategic planning at their peril. Sadly, with a few
noteworthy exceptions, most hospitals fail to go beyond the second stage, and are, as
one planning expert puts it, ³currently tottering between the second and the third
generation of hospital planning.´ Some of our hospitals of other times, which fit this
description, are a case in point. In bygone days, they catered admirably to past
disease patterns or to the specific needs of certain segments of the population. They
would not have found themselves in the throes of struggling for survival had they,
among other things, redefined their mission, objectives and long-term goals, and
worked out a strategy to attain these goals.

For example, they could have broadened their mission to provide services more
appropriate to today¶s healthcare needs. Business ventures have long woken up to
this reality and have gone the way of modernizing, specializing and diversifying,
which represent the outputs of strategic planning. It is not that these hospitals do not
have a stated mission or objectives. They are there in bold, clear language. But
having outlived their usefulness they have become irrelevant to today¶s totally
changed situation. What is now needed is a bold action to alter them to meet the
challenges of the present day.

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Organizations succeed only when they discover their distinct competencies and build
on them. This is an integral part of the strategic planning process. For this they need
to evaluate their strengths and weaknesses and use them as the basis for setting goals.
Peter Drucker, the renowned management guru, stresses two traits that are necessary
for an effective leader and a successful organization: Building on the organization¶s
strengths and concentrating on few major areas in which superior performance will
yield outstanding results. Says Mara Minerva Melum, ³If your hospital is going to
stand out in the crowd and to position itself to provide the services that are most
appropriate, you first need to recognise your hospital¶s unique strengths and to focus
your planning efforts on building on them.´ What in effect this means is that
hospitals must get rid of the idea that they are all things unto all people. The key to
future success through strategic planning is found in the leadership¶s ability to do
more with less and to find opportunities within the constraints of the hospital¶s
uncertain environment.

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coordination and supervision, which are directed towards the achievement of
organizational aims. It can also be considered as the viewing glass or perspective
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iven the state of the global economy, it is necessary for all organizations to
maximize revenue while controlling costs. Even within the healthcare field, careful
management that serves both patient needs and operational necessities is essential to
long-term survival, accomplished through intensive organizational design,
accounting controls and continued excellence in quality and service.

It is possible to efficaciously manage medical and business aspects by implementing

responsibility centers throughout the organization. There are different kinds of
responsibility centers that may be of benefit to a healthcare facility. ³In designing
accounting control systems, top managers must consider the system¶s impact on
behavior desired by the organization´ (Horngren, Sundem, Burgstahler, &
Schatzberg, 2008, p. 431).

In some cases, clinics may designate responsibility centers due to location or

function, but in a healthcare setting the centers may be designated due to the
autonomy of the managers within aspects of the organizational design.

³In the context of a medical practice, comparable categories might be satellite

offices, types of procedures (such as cataract, refractive), or categories of patients
(such as pediatric, seniors)´ (Freeman, 2004, p. 6). Within healthcare centers, there
are examples of cost centers, profit centers, revenue centers, and investment centers.

ost center managers are responsible for containing costs. An example of a

department responsible for this would be supply and requisition, or purchasing,
which is responsible for getting supplies needed for the rest of the organization.

The cost center would interact with the investment center (the esearch and
Development department, for example), by helping to manage the expenses and in
purchasing the items necessary for research and development. ikewise, the
investment center ( &D department) interacts with the revenue center in identifying
the necessary contracting for the &D projects.
 The revenue center would set the sales price of the services within the healthcare
setting, but is limited by federal regulations. Finally, the profit center would control
the costs and revenue through a collections department.

ãc The hospital must develop, implement, and maintain an effective, ongoing,

hospital-wide, data-driven quality assessment and performance improvement
program.

ãc The hospital¶s governing body must ensure that the program reflects the
complexity of the hospital¶s organization and services; involves all hospital
department and services (including those services furnished under contract or
arrangement); and focuses on indicators related to improved health outcomes
and the prevention and reduction of medical errors.

ãc The hospital must maintain and demonstrate evidence of its QAPI program for
review by MS.

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The budget has two functions. First, it estimates, as realistically as possible, the cost
of completing the objectives identified in the proposal. The sponsor will use the
budget details to determine whether the proposal is economically feasible and
realistic. Secondly, the budget provides a means to monitor the project's financial
activities over the life of the project. In this way, it's possible to determine how
closely the actual progress toward achieving the project objectives is being made
relative to the proposed budget.

The department is responsible for:

ãc The application and implementation of the provisions of the law and financial
regulations, financial systems and the law of government tenders, as well as related
rules and regulations.
ãc Preparation of annual budget of the hospital and its financial accounts.
ãc Preparation and review of bills of exchange for the hospital expenses related to
current and capital allocations.
ãc Data entry of bonds and securities registration in the consolidated financial system of
the Ministry of Finance.
ãc Preparation of cheques for payment of monthly salaries for hospital staff and other
receivables to do with payments from the treasury impress and action settlement.
ãc Presentation of financial and accounting reports and periodic review to take
appropriate decisions.
ãc Take action to strengthen the budget items and the transfer of funds between these
items during the fiscal year.
ãc Implement the financial procedures of tenders and direct bidding system according to
the governmental laws and other financial systems of relationship.
ãc Take all measures for the provision of goods and services to the hospital in light of
the specifications required by the requesting parties.
ãc ›eply to remarks of Internal Audit Department and the financial control of the state
on the observations raised during their visit to the Hospital in order to assess the
implementation of the administrative and financial work.
ãc To prepare an annual work plan of priorities for action in circuit implementation and
programming throughout the year and report on what has been accomplished and the
obstacles to overcome if any.
ãc Any other financially related tasks.
  
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Preparation of the financial and statistical measures of hospital inpatient
rehabilitation services required two research activities: identifying appropriate
financial and statistical indicators; and collecting, organizing and validating the data
needed to calculate values for the indicators.

‡ ((&-&+'-8c± defined as a comparison of hospital output with the cost of inputs

›equired to produce the output.
‡ &')'-&)#c&)9&#&%8c± defined as positive financial outcomes that ensure long-term
financial health.
‡ &:$&0&%8c± defined as the ability of an organization to meet its short-term
obligations.
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) &%)#c± defined as the capacity of the organization to acquire and manage long-
Term assets such as major equipment.
‡ $ )'c+."$1-+.c± defined as the allocation of human resources by hospitals to
Patient care and non-patient care activities.
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1. È
 
  
Measures the direct costs of providing nursing, diagnostic & therapeutic services,
and food services, to rehabilitation clients as a proportion of the total costs associated
with these clients.
2. È    
Measures the proportion of time nurses spend working in the hospital on activities
such as direct client care, charting, and in-service education, as a proportion of the
total hours earned. The hours being measured are for those nurses who normally
engage in activities related to client care, and excludes hours worked by nurses who
fill management and administrative roles.
3. È       
Measures the proportion of time nurses and therapists spend working in the hospital
on activities such as direct client care, charting, and in-service education, as a
proportion of the total hours earned. Unit-producing personnel (UPP) or unit-
producing nurses therapists are nurses therapists who normally engage in activities
related to client care, and exclude nurses therapists who fill management and
administrative roles.


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likely to stay.
ãc  %& &2+c9$0*+%., ›un "what-if" scenarios and instantly see how changes will affect
your budget.
ãc +0$-+c-".%., Save your business thousands of dollars every year by making sure
you're not overpaying low performing employees.
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ãc +%c&%c1&*/%c+!+18c%& +, Work in a secure and automated environment that eliminates
the risk of a privacy breach or human calculation error.


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1.c The hospital should reduce the complexity of the organization should be
done easily and fastly.
2.c Should maintain the smooth coordination between the different
departments.
3.c Provide the latest technology so that work become easy and safely.
4.c Organization should plane more and more cost reduction plan so that the
organization do not suffer a lot
5.c Provide proper training to the employees of the hospital so that they can
do their part of job more effectively and efficiently.
6.c ack of medicines, bad attitude of staff, overcrowding and lack of beds
should remove.
7.c Focus on privacy of female patients and they were unhappy about
women being examined by male doctors.
8.c Development of budgetary control to hospitals, increasing opportunities
for revenues generation , increasing the number of bed and increasing
specialist facilities,



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The hospital organization are some time certain and some time uncertain and their
main focus are on their control organization so for that they successfully make
planning for the organization. The very first step is take is facilitating planning in
which their major emphasis is the replacement or expansion of physical facilities.
The second step focuses on health care services and long term objectives the third is
the strategic planning in which the concentration on the long term and short term
goal. But the main effort of the hospital strategy planning is totally on building strong
organization for this they divided organization into 4 service department that is
information, Therapertic, diagnostic and support service in which all the things are to
be managed .the cost center also interact with the investment center by helping to
manage the expenses and maintain the demonstrate the evidence of it.