Principles of Hospital Administration

Thus administration and management may be distinct activities but both pertain to the dual aspect of the same device. Hospital administration is concerned with general administration as well as to meet the special needs for efficient functioning of a health care establishment. Principles of Scientific Management F. W. Taylor gave basic principles of scientific management. A. Replacing rule of thumb with science: Organized knowledge should be applied which will replace rule of thumb, Measurement of work should be based on scientific management and not on mere estimates. B.

Harmony in group actions: Taylor emphasized that attempts should be made to obtain harmony group action. There should be a mutual give and take situation and proper understanding so that the group as a whole contributes to the maximum. C. Cooperation: Scientific management is based upon mutual cooperation, confidence and good will. Taylor has suggested substitution of war for piece, hearty and brotherly cooperation for contentment and strife, becoming friends instead of enemies. D. Maximum Output: Scientific management involves continuous increase in production and productivity.

He decried quarrel over production, but welcomed quarrel over distribution. He was in favor of maximizing the output, when the size of surplus becomes so large there is no harm in its distribution among the workers. E. Development of workers: All workers should be developed to their fullest potential. Development requires, scientific selection, providing training at work place. Despite of the scientific methods adopted, there were some shortcomings. The reminisces of scientific management were more concerned with problems at operating level and did not focus management from manager’s point of view.

Scientific management is more relevant to mechanization and automation rather than management of an organization. PRINCIPLES OF MANAGEMENT Father of Modern Management Theory, Henry Payola, looked management from the top point of view. He preferred term administration instead of management. Payola has given fourteen principles of management. 1. Division of Labor: The object of division of work is derive the benefit from the principle of peculation which can be applied not only in technical work but in all other work as well. This division of work can be applied at all levels of the organization. 2.

Authority and responsibility: Responsibility is the essential counterpart of authority and they go hand in hand. Official authority is derived from Manager” s official position and personal authority is derives from personal quality such as intelligence, experience, moral worth, past services, etc. 3. Discipline: Discipline is obedient, application, energy, behavior and outward mark of respect shown by employee. Three requisites of discipline are: a. Good supervisors b. Clear and fair agreement c. Judicious application or sanction. 4. Unity of command: An employee should received order from one supervisor only.

The more completely an individual has a reporting relationship to a single supervisor. The less is the problem of conflict in institution and the greater is the following of personal responsibility for result. 5. Unity of Direction: Each group of activities with same objectives must have one head and one plan. Unity of direction provides better coordination among various activities. 6. Sub-ordination of individual interest to general interest: Common interest must prevail over individual interest but some factor like ambition, laziness, weakness, level to reduce the importance of general interest. . Remuneration of staff: The salary of employee should be fair and provide maximum possible satisfaction to both. 8. Centralization: Centralization and decentralization are question of proportion. In small firms centralization in the national order but in larger firms a series of intermediaries is required. 9. Scalar chain: The commission ranging from highest to the lowest. It is chain of superior on the line of authority from the highest executive to the lowest one from the purpose of commotion. 10. Order: This principle relates to arrangement of things and person.

In social order, there should be right man in the right place and person. Material order require a place for everything in its place social order demand the engagement. 11. Equity: Equity is greater than Justice since it result from combination of kindness and justice. The application of equity require good sense, experience and good nature for soliciting loyalty and devotion from sub-ordinates. 2. Stability of tenure: This is very essential to get an employee accustomed to doing a new work and able him in performing it well. 13.

Initiative: Initiative increase zeal and energy on the part of human being. Initiative is concerned with thinking and execution of plan. Within the limit of authority and discipline all manager should encourage their employee for taking initiative. 14. Esprit De corps: It rest on union of strength. It is also an extension of the principle of unity of command whereby team work is ensured. Special Needs or Peculiarity of a Hospital Hospital is a social institution which facilitates interaction of a wide spectrum of society from varied cultural and socioeconomic strata.

The peculiarities of a hospital as an organization are: The product of the hospital is a ‘service’ which cannot be quantified in any economic terms, and no objective criteria can be laid down to evaluate the standard of services. The-service in the hospital is always personalized, professional and directly rendered by the medical, nursing and other specialized personnel according to the needs and requirements of each case or client. As such the hospital service cannot be mechanisms, standardized or pre- planned to meet the specific need.

The hospital service is teamwork rather than an individual service. The hospital service is normally emerging in nature and no two situations are similar requiring the same treatment. The wide spectrum of people involved in the hospital activity ranges from highly skilled professional to the man who may not have visited even a school. The dual control by way of professional authority and the executive authority in the hospital, invariably leads to management conflict, which is a peculiar situation very hospital administrator has to face in the day to day operation.

Of late, the hospital being treated as industry for profit as well for minimization of the output with minimal input, has led to application of management tools and techniques for its administration. SERVICES OFFERED BY THE HOSPITAL HOSPITAL AS A SYSTEM From a management point of view, the hospital can be treated as an organized whole and termed as an open System. This hospital system can be grouped into four distinct subsystems 1 . Clinical and nursing service-?primary services 2. Supportive services 3. General administration and business services 4. Stability services. HOSPITAL ORGANIZATION The hospital administration for the patient care services has become complex and multidimensional. It consists of co-ordinate activities provided by a variety of categories of health personnel, utilizing a variety of precision equipment and skill, and is spread over large physical area of activities. CATEGORIES OF HOSPITALS Categories of hospitals are as follows: Hospitals owned and managed by the government (centre and state). This also includes army hospitals, railway hospitals, SSI hospitals etc.

Hospitals owned and managed by the local bodies like municipalities, corporations etc. Hospitals established and created under trusts by private individuals or bodies. Hospitals owned and managed by private individuals either alone or in partnership with others. Corporate hospitals-?latest concept, they normally run on commercial lines. HOSPITAL AS AN ORGANIZATION Organization in simple means where group of people formal or informal are put together and all work together toward one common goal.

Organizing is a process of grouping the necessary responsibilities and activities onto workable units, laying of authorities with pattern of co-ordination with the aim of only satisfying the customers and employers. Organism of Dental Hospital Role of Hospital Administrator A. General Roles The hospital administrator like any other manager performs various roles; the managerial roles as described by Metzger can be grouped as follows, which are equally relevant for hospital administrator also. B. Specific Roles The hospital administrator ensures that hospital runs effectively and efficiently.

Towards patient. Create patient-friendly environment, understand patient’s hysterical needs, emotional needs, clinical needs, ensure patient satisfaction and education. Towards organization. Primary duty is to manage the hospital effectively and efficiently with available resources: staff, equipment, materials, finance, legal aspects, marketing, and quality management. I. Strategic Planning Deployment of resources for long term goals of the hospital, the administrator will have to conduct SOOT analysis, I. E. To evaluate the strengths and weaknesses with in the hospital, I. E. Internal organization and opportunities and threats outside the organization. I. Environmental Influence on the Hospital The hospital is a subsystem of large socio-technical system. The hospital gets inputs in the form of materials, manpower, machine, money (funds), minutes (time) and information from the environment. Iii. Operational Management Most of the functions of the hospital are repetitive in nature. The activities for day to day running of the hospitals are to be designed by the administrator in such a manner that these contribute for productivity and effectiveness and efficiency of the hospital. Lb.

Management of Hospital Staff The image of the hospital is not dependent on the beautiful towering buildings, landscapes and dazzling reception counter; it depends upon the doctors, nurses and staff of the hospital. V. Materials Management In Indian hospitals materials cost about 50% of hospital budget. There are two types of cost: one is cost of material and second is cost on material. The basic role of the administrator is to reduce these costs. Four steps are involved in the material management system: 1 . Demand estimation 2. Receiving and inspection 3. Storage 4. Distribution. V’. Financial Management

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