Seminar on application of mordern techniques in nursing

8/14/2019 Seminar on application of mordern techniques in nursing

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Seminar onApplication of Modern

techniques in nursing service

ByKarthikeyaprasath.P

M.Sc IInd year


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INTRODUCTION

Management , which basically is concernedwith administration. pervades all spheres of life and activity.

Likewise , nursing too is a field wheremanagement plays a pivotal role inaccomplishing organizational goals


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Management techniques are systematicprocedures of investigating, planning,controlling and supervising which can beapplied to the problems, managementtechniques are two types,

Based on the principle of behavioral sciences.

Quantitative methods


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METHODS BASED ONBEHAVOURIAL SCIENCES

Organizational design Personnel management

Communication Information system Management by objectives (MBO)


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Organizational design

poor organization results in waste of resources.

Its is a theory of management that organization

must be suited to its current situation and theneeds to be serviced. The organization of thehealth needs and demands of the people.

Further the organizational design should be

reviewed every few years because of changingconcepts of purpose, Changing problems andchanging technology.


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Communication

Better communication contributes toeffective functioning of an organization.

Communication barriers are responsiblefor delays in regular reporting andnotification, delays in the compilation of statics, delays in the institution of promptremedial measures, and release of supplies and salaries


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Information system

Information is needed for the day to daymanagement of health system.

The function of an information system consists

of collection, classification, transmission,storage, retrieval, transformation and display of information.

A good information system provides data for

monitoring and evaluation of health programmesand gives the requisite feedback to healthadministration and planners at all levels


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Management by objectives(MBO)

It is a participants approach for developing andsharing performance expectations among staff members at all the levels of.

The concept was developed by Drucker and alsoadvanced by Odiorne and humble. MBO is defined by odiorne as a process,

whereby superiors and their followers jointly

identify and set goals, define individual areas of responsibility, plan strategies and designatetasks for achieving goals and measure theevaluates success.


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The MBO approach, when effectivelyimplemented enables expectation betweenfollowers and superiors to be public.

Potential conflict is hereby reduced because of negotiation between involved parties and then acontract is set, mutual commitment is thereforegained.

MBO can provide a framework for achievingorganizational goals and employee satisfaction


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The process of MBO

Setting of organizational purposesand objectives Key result areas

Setting subordinates objectives Matching resources with the

objectives

Appraisal Recycling


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Setting of organizationalpurposes and objectives

the first basic step in MBO is thedefinition of organizational purposes andobjectives.

Questions such as why does theorganization exist? what business arewe in? and what should be our business? provides guidelines for thestatement of purpose.


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Key result areas

organizational objectives and planningpremises provide the basis for theidentification of key result areas(KRAs).

KRAs are derived from the expectations of various stake holders and indicate thepriorities for organizational performance.

KRAs also indicate the present state of anorganizations health and the topmanagement prospective in future


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Setting subordinates objectives

The organizational objectives are achievedthrough individuals. Therefore, eachindividual manager must know in advance

what is expected to achieve. Every manager in the managerial hierarchyis both superior and subordinate, except the

person at the top level and lowest level.Therefore there is a series of superior andsubordinate relationships.


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The process of objectives setting brings withsuperiors proposed recommendations for hissubordinates objectives.

In turn, the subordinate states his ownobjective as perceived by him.

Thereafter a final objective for the subordinateis set by the mutual negotiation betweensuperior and subordinate.


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Matching resources with theobjectives

When objectives are set carefully, theyalso indicate the resource requirement.

Resource availability is an importantaspect of objective setting as it is theproper application of resources, whichensures objective achievement.

Therefore there should be matchingbetween objectives.


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A superior manager is better able tosee the need and economy of allocating resources.

The allocation and movement of resources should be done inconsultation with the subordinatemanager


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Appraisal

Appraisal aspect of MBO tries to measurewhether the subordinate is achieving hisobjectives or not.

If not what are the problems can beovercome,

Appraisal is undertaken as an ongoing

process with a view to find out deficiencyin the working and also to remove itpromptly


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Recycling

Though appraisal is the last aspect of MBO process. It is used as an input for recycling

objectives and other actions. The three objectives involved in recycling

process include setting of objectives atvarious levels, action planning, which inturn, gives basis for objectives and actionplanning.

This process goes on a continuous basis


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Benefits of MBO

Better managing

Clarity in organizational action

Personal satisfaction

Basis for organizational changes


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Clarity in organizational action

MBO tends to provide the KRAs whereorganizational efforts are needed.

Since organizational objectives aredefined clearly, they help in relating theorganization with the environment


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Personal satisfaction

MBO provides greatest opportunity for personal satisfaction.

This is possible because of two closelyrelated phenomena participating inobjective setting and rational performanceappraisal


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Basis for organizational changes

MBO simulates organizational change andprovides a framework and guidelines for planned charge, enabling the topmanagement to initiate, plan direct andcontrol the direction and speed of change


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Problems and limitations of MBO

Time and cost Failure to teach MBO philosophy

Problems in objective setting Inflexibility Emphasis on short term objectives

Frustration


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QUANTITATIVE METHODS

Quantitative methods are derived from thefield of economies. Operation, researchand budgeting. Some of these techniqueshave a great role in a management of health services, those are


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Cost benefit analysis Cost effective analysis

ABC analysis Cost counting Input- output analysis

Systems analysis Net work analysis


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Cost benefit analysis

This is a management technique , whichhas attracted the widest attention for application in health field.

The economic benefits are expressed inmonitory terms to determine whether agiven programme is economically soundand to select the best out of severalalternative programmes


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A cost benefit ratio (Z) is defined as the ratio of the value of benefits of an alternative to thevalue if alternative cost.

PRESENT VALUE OF ECONOMIC BENEFITS

Z=---------------------------------------------------------------PRESENT VALUE OF ECONOMIC COSTS


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The analysis consists of the following steps:

A clear statement of objectives. Identifying all alternative actions that can

achieve the objectives.

Identifying all costs and all benefits with eachalternative.


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Converting all costs and all benefits for each alternatives to monetary value andquantitative evaluation of cost and benefitsof each

Selection of the best effective approach


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Drawback of cost benefit analysis

The main draw back with this technique isthat the benefits in the health field.

As a result a particular programme cannotalways be expressed in monetary terms.We generally express the benefits in termsof births or death or illness avoided or over come.

Hence the scope of applying this methodis rather vague


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Cost effective analysis

it is the technique for choosing. Fromalternative courses of action, a preferredchoice when objectives are not very clear in such areas as scales, costs or profiles.

This is more promising tool for applicationin the health field than the benefit.


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For example number of life saved or number of days free from disease.

Cost effectiveness analysis is easier tomake as it clear. It helps the administrator in managing his resources at the locallevel.


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ABC analysis

it is a technique which would enable abusy executive to choose those activitiesardently which would enable the wheels of

administrative machinery. by arranging his work in to an order of

priorities he can decide on which item toconcentrate first, which others to deal later and which others to delegate to hisassistants.


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ABC analysis sorts items on cost criteria.

A -Item which are of high cost. B - Items which are intermediate cost. C - Items which are low cost.


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ContdIn so for inventory control is concerned,

following guide lines will help in keeping thesystem optimum:

A items tight control Rigid estimates Strict and close watch

Management of items should be done at topmanagement level

C d


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B items moderate control Reasonably strict watch and control. Safety stock moderate Management should be done at middle level .

C items ordinary control measures Purchase based on used estimates

Control exercise by store keeper Safety stock high Management should be done at lower level


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Cost counting

it provides basic data on cost structure of day programme.

Financial records are kept in manager permitting costs to be associated with thepurpose for which they incurred.

The important purposes of cost

accounting in health services are costcontrol and planning, and the allocation of people and the financial resources.


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Input- output analysis

input analysis is an economic technique in thehealth field input refers to all health serviceactivities which consume resources {manpower,

materials and time} And output refers to such useful outcomes as

treated lives saved or inoculations performed. input output table shows how much of each

input is needed to produce a unit amount of each output


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Systems analysis

The purpose of systems analysis is to keep thedecision maker to choose an appreciate courseof action by investigating his problems,

searching out objectives , finding out alternativesolutions , evaluation of alternative terms of costeffectiveness,

re examination of objectives if necessary andfinding out the cost effectiveness of availablealternatives.


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Net work analysis

A network is a graphic plan of all events andactivities to be competed greater discipline in planning. The two commontypes of network techniques are:

Programme evaluation review technique(PERT)

Critical path method (CPM)


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Programme evaluation reviewtechnique (PERT)

PERT is planning tool developed in the1950s as a method used by the US Navyto and control the Polar Missile program

me. PERT can be considered as a roadmap of

a particular project in which all major events have been identified andrelationship among events clearlyindicated


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The main elements of PERT areactivities and events

An activity is a factor ,which takes time tocomplete and usually demands resources.Anevent is a notional point in time at which one

set of activity gives way to another. The important point is that no activity

subsequent to an activity can begin, until all

activities before that event have beencompleted


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the longest pathway between events is thecritical path. It is used as a planning,scheduling, organizing, coordinating andcontrolling technique.

A typical PERT analysis may run in tohundreds of events

Ad


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Advantages

Provides logical sequence activities. Clarifies where delays are permissible and

where not, essential deadlines becomeevident. Clsrifies where additional resources are

required to complete the task on time.


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depicts a larger number of independentactivities that makes up the total task.

Every principal activity can be assigned toa person whose attention is constantlydrawn to deadlines in particular areas


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Critical path method (CPM)

CPM is the most versatile planning andcontrolling technique used in business. It wasfirst employed in USA in 1958 by E.I. du Pont de

Nemous Company. Unlike PERT it is applied in those projects

where activity timings are relatively well known. It is used for planning and controlling the most

logical sequence of activities for accomplishingthe project


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Contd Under CPM the project is analyzed in to different

operations or activities and their relationships aredetermined and shown on the network diagram.

The network or flow plan is then used for

optimizing the use of resources and time. CPMmarks critical activities in a project andconcentrates on them.

It is based on the assumption that the expectedtime is actually the time taken to complete theproject,CPM is suitable for construction of projectsand plant maintenance


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CPM requires greater planning than requiredotherwise.

Thus it increases the planning cost, but this

increase in cost is justified by concentrating oncritical paths and avoiding expenses on the strictsupervision and control of the whole project.

Besides ascentaining time schedule CPMprovides standard method of communicatingproject plans, schedule and costs


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Advantages

It provides on analytical approach to theachievement of project objectives whichare defined clearly.

It identifies most critical demands andpays more attention on these activities.

It helps in ascertaining the timeschedules.


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It makes use of better and detailedplanning.

It assists avoiding waste a time, energyand money on unimportant activities.

It provides a standard method for communicating project plan, schedulesand costs.


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Steps in PERT/CPM

Identification of componentsThe first step in the application of PERT/CPM is

identification of all key activities and phases

or events necessary for the completion of theproject.

For example, a construction company having aproject for the construction of a two-storiedcommercial complex can identify the broadactivities from A to J


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Sequencing of activities and eventsA network diagram is prepared to show the

sequence of activities and events. It has a

beginning point and a termination point of the project.

It also depicts a number of path or activities

from beginning to completion of theproject. Each event is given a serialnumber for the sake of convenience.


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Determination of estimated time :

It is essential to determine the expected timerequired to completer each activity.


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Determination of critical path : Under this stage, it is required to identify the

sequence of those activities whose

completion is critical for the timelycompletion of the project. The lines in the network diagram connecting

the critical activities from start to finish of the

project denote the critical path. In the figurethe pick line joining the activities A,B,C,D,H,I&J represent the critical path.


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Controlling the project: The project manager as to be in constant

touch with the person engaged in criticalactivities .if they have been any difficultiesor obstacles these are to be removed


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Job analysis : It is the process of gathering information on all

aspects of a specific job. It is a scientific study andstatement of all the facts about a job. Which revealits content and modify factors which surrounded it.

One of the purposes of job analysis andmeasurement is to set standards for a specific job.There are no of methods measuring work & settingstandards as follows.


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Analyses of past production records : It is perhaps the strongest method of

measuring works and setting standard

production records on the activities of thedepartment can be maintained and analyzed. The manager can select the best past

performance and used as a standard on theassumption that if it was done before workersshould be able to do it again.


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The advantage of this is that it is easilyused and at a relatively low cost with noneed for highly person ale to administer it.

The disadvantage is of course thatexisting in efficiency are not corrected

they are merely recorded an analyzed


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Time analysis method : Here various work activities done by an

individual during the day are identified and

placed on the form. Then worker records theactual time spend and units produce.


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Work sampling method : It is specific of observation and recording of

activities of one or more individual carried

out at predetermined or random interval itprovides quantitative measurements of various activities. The major parametersthat are analyzed are the time needed to dospecific jobs or the type of activitiesperformed.


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Times study : It is a method of measuring job performance

to establish the time required for performing

for each operation at an average pace. Thepurpose is to measure the output of aworker of average skill who0 is performing iswork with average effort under standardizedcondition so that standard time can bedetermined.


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Motion study : It goes beyond mere measurement. Its purpose is

to make work performance easier and moreproductive by improving manual motion.

During the end or 19th century Frank gilbreth madea detailed motion study and consider it a scientificmethod of eliminating wasted effort in work.

He suggested that motions study Consists of dividing the work in to the most fundamentalelements possible, studying these elementsseparately and in relation to one another, and fromthese studies building methods of least waste.


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Advantages of job analysis:

Job analysis helps the management in manyways:

It provides solid base upon which to

choose the right people and to plan theright training for them. It reveals the inessentials, the irrelevant

practices,which often encounter the job inactual performance.

It shows where there is overlapping.

d


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It provides the basic material for procedure manual.

It helps to promote good morale thatenables the administrator to dealintelligently with complaints.

It also keeps to administrator to establishdefinite even for promotion.

Documents

Seminar on application of mordern techniques in nursing