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Management Concepts

for Hospital Management Staffs

 Objective
 To provide useful basic concepts for management staff to apply
in their management improvement effort.

 Main contents
 Understand management
 About being a manager
 Strategic management concepts
 The art of managing the purpose and the future of the organization
 General management concepts
 The art of managing the factors of operating the organization and
its activities

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Understand management
About manager
 Who are managers?
 Anyone who take charge of other peoples and activities.
 Not just the people who have the word “manager” on their name

 What manages do basically?

 Manager decides on the right things to do, tell the people, and make
sure that they do the right things right.
 It is about getting the right things done correctly.
 It is about getting people to do things correctly.

 What are managers’ fundamental responsibility?

 Produce desirable results.
 Management is not successful if results are not good, even if the bad
results are caused by uncontrollable factors, because it is the
manager’s job to find way to control the uncontrollable factors.

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Comparing managers and others

Managers Non-Managers
Plan and organize work activities Work according to plan

Work through others Work by themselves

Tasks are mostly non-routine Tasks are mostly routine

Instruct and direct others Follow direction and instruction

Involve in setting policies and Abide by policies and systems set by

systems managers
Take charge of all results within own Take charge of own result only
scope of responsibility

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Matrix of Management Tasks

Hardware Software
people facility material technology system management

Productivity ?
Quality ?
Cost ?
Efficiency ?
Hygiene ?
Safety ?
Functional ?

Activities ? ? ? ? ?

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Management and people
 Many things affect work results:
 Work method
 Work specification
 Conditions of equipment
 People
 Management

 People is most important because people is the one who make all
the factors good or bad.

 Management success depends on how well we manage our

people to do their works well.

 Managers depends on people to do their work. Managers

manage people and at the same time depends on people.

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Understand the needs to work effectively

Do what ?  Do what? - About requirement,

responsibility and achievement

Why ?  Why? - About purpose

What ?  What ? - About understanding of

happenings, factors, phenomenon

What to do ?  What to do? - About understanding,

analysis, priority and planning

How to do ?  How to do? - About strategy and

How to do well ?
 How to do well? - About implementation

Done ?  Done? - About result

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Management and Profession

General Director

Management Works

Department Heads


Professional Works

Junior Nurses
Work contents

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Common oversight of managers
 For examples:
 Confused about Profession and Work Appointment
 Imbalanced treatment of know-how and know-why
 Not focusing on result

 On the whole, missing the big picture is the number

one cause!

 Understanding of management and its scope is

therefore more fundamental then learning
management theories and techniques.

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Most needed management understanding

 Whatever the profession, we are at least partly


 Manager must manage – people, works,

facilities, systems and most importantly result.

 All works are done through people.

Management is about managing everything
through people.

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Strategic management concepts
What is Strategic Management

 Strategic management is about

 To achieving the organization’s purpose and

materializing our vision through the use of
 Emphasis and direction
 Optimum use of resources

 Development

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 Strategies are just complex decisions for telling the
importance things to be done and for guiding actions.

 Strategies have to base on purpose, wish and reality.

 Mission is our ultimate purpose
 Vision is our ultimate wish
 Our environment and situation are the current reality

 We set strategies to fulfill our mission and to

progressively realize our vision. We also set strategies
to alter our reality.

 Strategies have to be implemented effectively to be

meaningful. This means strategies must be realizable.
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 Strategies are restricted by the strategies of higher
 Every departments or even groups is an unit of strategic
 Departments’ strategies need to support and must not go
against the organization’s strategies.

 Strategies can be specific or broad. But they are never

detailed enough to let units know exactly what to do.

 Managers need to make decisions on their work to suit

and support the organization's strategies. They set
their own strategies to manage their department.

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Keys to effective strategy setting
 Thoroughly understand:
 Mission:
 Organization’s mission and own unit’s mission
 Ask! if unsure
 Cultivate consensus
 Vision
 Organization’s vision and own unit’s vision
 Ask! if unsure
 Cultivate consensus
 Higher organization’s strategies and wishes

 Environment and Situation

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Environment and Situation
 Environment (external)  Situation (internal)
 Political  Manpower
 Policy  Availability
 Regulations  Attitude
 Economy  Infrastructure
 Affordability  Equipment
 Prices  Technology
 Social  Facility
 Preferences  Expertise
 Demands  Specialties
 Age and sex distribution  IT
 Health  Management
 Epidemic  System
 Health management  procedure

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Reported in a conference organized
by the Ministry of Health
 A campaigns to develop “Excellent Hospitals” to ensure good
examination and treatment for the people.

 Challenges:
 Increasing number of patients, overcrowding
 Human resources lack quality, medical ethnics and attitude of some
fall short of expectation
 Inadequate and backward infrastructure and equipment.
 Nearly 50% of hospitals lack liquid waste treatment facility, more then
20% of hospitals do not have solid waste treatment facility.

 Urgent tasks:
 Improve medical ethnic and behavior of health care staff
 Modernization of infrastructure, equipment and management
 Reform administrative procedures
 Application of information technology

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Analysis for setting strategies
 SWOT analysis
 Strengths and Weaknesses (internal)
 Threats and Opportunities (external)

 Questions to ask in analysis

 How to eliminate weaknesses?
 How to use strengths better?
 How to deal with current and imminent threats?
 How to capture opportunities?

 Find pragmatic answers to fulfill the mission, to work

towards the vision, and to support the higher level
strategies. Decide on what to do basing on the
answers (i.e. set strategies), and implement the
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General Management concepts
What is General Management
 Academic management subjects include:
 Strategic management
 Operation management
 Financial management
 Human resource management
 And many more depending on teaching focus
 These subjects focus on specific areas. These areas are different
because of unique concerns, issues and concepts.
 But, there are also common needs, issues, and concepts to all
the areas. That is the ways to get things done. General
management deals with how to effectively get things done.
 General management is about doing all the right things right to
ensure the organization functions effectively for its strategies.

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Concept 1
Every work is a process

Environment, Discipline, Teamwork

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Process concept of management
 Every work is a process.

 Result of process depends on not only the process but

also the factors controlling the process.

 Management focuses on managing the factors well

and the work will be processed properly, because it is
easier to do right when conditions are right.

 Application of the process concept helps managers to

manage thoroughly.

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Concept 2
Manage the System
 System is just a way to specify and dictate how works
should get done.

 System is useful because it helps to reduce

supervision needs, and frees managers to do
improvement works or professional works.

 System is absolutely necessary in critical works where

mistakes are absolutely not permissible.

 Effective managers design system to manage

everything. They focus on managing the system.

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How system works?
 System affixes work related activities
 Predictable
 Reliable
 Transparent

 System facilitates procedural and methodological

 Certainty
 Convenience

 System provides directions

 Minimal consultation
 Minimal judgment error

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What system specifies?
 Sequence of actions
 Methodology
 Quality requirements
 Responsibilities and Authorities
 Communication and Recording requirements
 Procedures
 Normal
 Abnormal
 Communication
 monitoring

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How to ensure system works?
 Training and communication
 Objective
 Specifications
 methodology
 Expectation

 Clear documentation
 Compliance

 Enforcement

 Review and Update

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How to use system in work?
 Ensure everyone accept and respect systems

 Ensure proper operation of existing systems

 Know the dynamic nature of work and continually

update systems

 Use system to manage all routine tasks

 Improve or Add system whenever shortcoming is


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Concept 3
People is the key to management
 Organizations exist to serve people.

 We care to work because of people – our family.

 People cause success and people cause failure.

 Managers depends on people to do their work.

Managers manage people and at the same time
depends on people.

 Manager need to understand people and know how to

ensure they do well.

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Human Sphere in Work


Other managers customers

suppliers Relatives


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People are human beings
 Human nature
 value
 Idiosyncrasy
 Habit
 Mode
 Attitude
 Personality
 Physical constraints
 intelligence

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Strategies for people management
 Manage people with understanding
 But not compromising on work quality.

 Enable people to work well

 Manage people’s willingness
 This is not about motivation.
 Motivation is only needed when we want people to work
exceptionally well.
 Motivation is not needed to get people to work reasonably
well, because it is people’s responsibility to work as such.
 But it is necessary to ensure that people understand and
accept their responsibility.
 It is also necessary to help them fulfill their responsibility; with
direction, facilitation and feedback.

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What people need to do well
 Know what to do  Can do
 Instruction  Facilitated
 System  Enabled
 Common sense  Supported by other

 Know how to do  Willing to do

 Knowledge  Agree with the purpose
 Skill  Acceptance

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How to enable people to work well
 People have accepted the job. They are willing:
 When they could
 When are not unhappy (not unhappy ≠ happy)
 When they understand their responsibility
 When excessive effort is not needed

 To enable them to perform:

 Clear system and clear instructions
 Provide adequate training
 Assign works reasonably (be fair)
 Ensure they are facilitated adequately
 Give them sufficient time to accomplish their work
 Promote, encourage and enforce teamwork

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Fairness in Human Relationship
 People want to be treated nicely!
 We have a natural tendency to be nice by not
offending others to maintain relationship.
 A common result of this is we accept bad behaviors
and poor work performance.
 But, are we nice in doing so?
 We are not nice to our organization
 We are not nice to others who care to do good
 Most importantly, we are not nice to our customers (patients)
 Need to be fair. Think about every parties and be fair
to every parties. Equal is unfair. But be equitable!

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Concept 4
Need to follow up to ensure work results



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Why the management process?
 Plan
 To know what need to be done
 To know how to organize and coordinate tasks
 To know what facilitation are needed
 To enable effective communication
 Do
 To implement the plan
 See
 To monitor progress and results
 Adjust
 To adjust actions according to development during

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See and Adjust

Define Measure

Control Analyze


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 Define – to know the scope of the issue
 Measure – to describe the situation of the
issue with objective data and facts
 Analyze – to understand the issue, the
situation and also the interrelationship
 Improve – to bring the situation of the issue to
desire level
 Control – to ensure effect of improvement
stays without deterioration

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Concept 5
Need to manage performance
 Performance cannot be good unless
managers demand for performance

 Performance requirements have to be clearly


 Staffs need to be told when their performance

is not up to expectation

 Critical performance must be enforced

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Weak links limit performance
 Work results are the combine effect of all the factors
and the way they are coordinated.

 The combine effect can only be as good as the

weakest factor.

 Smart managers pay close attention to the weakest

factors and continually work on improving them or
eliminating them.

 When apply this concept to people, it is better to

eliminate a poor staff if he does not improve. This is
because an ineffective member affects the
effectiveness of the whole team.

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Control to maintain performance
 Equipment will deteriorate if not maintained. Work
quality will deteriorate if not monitored. Health will
deteriorate if not managed.

 Everything deteriorate naturally unless maintained –

maintenance is important to everything.

 Control is the maintenance need of management.

 Wise managers rely on systems to do the control.

They get to do know critical happenings from
information of their systems.

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The best control
 Performance rest on a slope all the time. It has a
tendency to slide down.

 Control acts like a brake to prevent performance from

sliding down.

 But affordable control measures are always imperfect.

Performance will still slide down.

 The best way to ensure performance does not slide

down is to always push it even higher, so that it will not
have a chance to slide below its original level.

 Continual improvement effort is the best control.

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Most important concept
Manager but not management is the key

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SUMMARY - The Gist
 Managers manage to serve some
 Management needs to flexibly device
and implement ways that FIT factors and
conditions to the purposes
 Good managers continually strive to
modify factors and conditions to achieve
the purposes better
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