Professional Documents
Culture Documents
Submitted to: Prof. Nirav Joshi Prepared by: Milan Padariya Roll No: 63
Ganpat University
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As other areas of health planning, formulating an essential service package is a value-laden exercise, even when wrapped in apparently objective cloths. Negotiation plays a central role in it.
The packages eventually chosen at the end of long and labour-intensive formulation processes are frequently unimaginative versions of the standard set of PHC services. Even components of arguable effectiveness, like ante-natal care, growth monitoring, TBAs and CHWs, tend to be maintained, instead of being suppressed, at least on paper.
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The formulation of basic packages may incur in high opportunity costs, particularly during transitions from war to peace, when many pressing priorities compete for the attention of decision-makers, and existing technical capacity is overstretched.
The choice of launching a package formulation exercise may represent a decisionpostponing tactic, rather than a priority-setting effort. Additionally, the elaboration of a package may contribute to disguising (rather than clarifying) crippling levels of under-resourcing.
Packages may include all basic services seen as desirable by health professionals, without paying adequate attention to what might be affordable, given existing and foreseeable resource constraints. Packages without a cost attached are meaningless, whereas optimistically-costed ones are misleading. A rule of thumb worth considering is that health service packages tend to cost more to deliver in field conditions than reckoned at the drawing board. The roots of this recurrent underestimation of true costs are frequently traceable in political expedience, rather than in technical flaws.
Essential packages rarely if ever fully translate into service delivery realities. Patient pressure force health workers to pay attention to conditions not included in the package. Professional preferences expand the weight given to complex conditions and sophisticated treatments, regardless of their importance and effectiveness. And capacity constraints inadequately taken into account during the formulation of the package jeopardise its delivery.
Package formulation exercises fail often to consider the variety of settings that exist within a country, particularly a large one. The single package eventually chosen may be appropriate only to a sub-set of situations. Additionally, disease patterns may vary within a country to such an extent, that they impose the formulation of multiple packages, or the neglect of the standard one. In Southern Sudan, three service packages must be developed, for densely-populated areas, for sparsely-settled ones, and for nomadic groups. To these packages, a fourth one
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The package formulation exercise has rarely if ever the political clout to challenge established special programmers. The services provided by them are therefore included in the package, regardless of their objective worth. And the management arrangements of special programmes remain in most cases separated from those of standard services. Behind the supposedly integrated package of basic services, a patchwork of ill-assorted production lines, with nobody truly in control of delivering the full range of services, can be found.
The main challenge faced by health managers is not choosing the services to be delivered, but rather finding ways to materialize a predictable set of them within tough capacity and resource constraints. Problem-solving skills are likely to be more important than detailed blueprints for health service delivery at different levels of care. This becomes even more important in unstable environments, where health managers are not in full control of information, events and resources.
Most existing service packages fail to fully incorporate the vastly expanded financial and technical implications of handling AIDS patients in increasing number and at multiple sites. Even without providing HAART, upgrading basic health services to cope with the mounting toll of AIDS-related conditions implies massive investments in facilities, staff, equipment, drug supply and management systems, with associated soaring recurrent costs. Cheap PHC delivery in a country stricken by HIV/AIDS is now out of question. Instead of working out the implications of the epidemic for standard basic services and redesign them accordingly, the frequent response has been the introduction of special programmes, implemented by dedicated agencies and NGOs. The predictable results of this approach are high delivery costs and further damage to standard basic services starved of resources and capacity.
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Case management Structured and coded recording of clinical consultations Single and recurring appointment scheduling Embedded clinical decision support software National demographics database tracing Extensive reporting capabilities Access to Summary Care Record Patient record management Prescribing and medicines management Electronic post event messaging Interoperability with other care services Case prioritization including indentifaction of life threatening emergencies Access to view shared care records e.g. GP records via Healthcare Gateway MIG Quality audit management: personal audit and review
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environment. You must constantly deal with issues such as clinician shortages, a rise in emergency department (ED) visits and complexity of care to provide effective and efficient care to patients. CareAware Capacity Management is a suite of solutions that delivers tools and knowledge to help health care providers improve efficiency and throughput across a
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Increase revenue by maximizing throughput and length of stay Reduce costs through greater staff efficiency and better equipment use Improve care by empowering providers with actionable data Improve patient and provider satisfaction through reducing wait times
Capacity management is the ability to balance demand from customers and the ability of the service delivery system to satisfy the demand . This places an emphasis on understanding first the nature of demand by forecasting (Lovelock, 1984) and second the options for managing capacity to meet the expected demand. Sasser (1976) has suggested two basic strategies for managing capacity in services of "Level" and "Chase", the former applicable where capacity is limited and hence the focus is on influencing demand to be in line with capacity, and the latter strategy being possible when supply can be changed to keep in line with demand. Capacity management in services to match supply and demand has a direct influence on the ability of the service delivery system to achieve service quality and resource productivity targets. Capacity management in service operations is a testing activity for operations managers because the nature of the service delivery process and the involvement of the customers in the process restricts the normal options open for controlling the process to match supply with demand; namely, altering the capacity, holding and inventory in anticipation of demand, and requiring customers to wait for the service.
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The luxury hotel industry today is in the globalization market and the use of customer relationship management (CRM) has becomes an important strategy for attracting and building customers brand loyalty. Nowadays, the high quality of hotel facilities and amenities are no longer considered as luxury and has become a primary component of lifestyle. In fact, the hotels can collect and incorporate their guests information and it may be a chance for the luxury hotel to improve their profitability. Hotel may use the information about the customers to build their relationship and it will improve customers satisfaction and loyalty, and increasing their profitability. For an example, the hotel can ensure that customers will come back again while offers them with the special and unique service
As today, the best competitor advantage for the hotel industry is continuing provides excellent quality service and coming out with the innovation idea. In the competition, most of the service provider will try to offer several choices, greater value and different levels of service to attract the customers. By using price discounting and providing the special benefit will develop customer loyalty and it also the most commonly strategic used by hotel managers in order to gain the competitive advantage. Thus, value of quality service provide also become the main key point to a hotels capability to discriminate itself from competitors and build up their unique customer loyalty .Getty and Thompson (1994) found that the quality of accommodation, fulfilment provide will totally effect on the customers satisfaction and expectation. By using past personal experience
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By build special brand loyalty for customers who continue to spend time and money with the hotel, customer relationship management (CRM) will help the hotel modify the stay of loyal and valued their customer. It is important because customers will memories and keeps in mind the hotels that gave them the personalized care. Thus, by using the customer relationship management (CRM) to check and ensure hotel's equipment meet with the customer's satisfaction. The hotel industry must watchfully consider the ways they maintain the relationships and fulfil the need of their customer as the customer is important to their business .Most of the hotel organization will using the customer information data and customer knowledge to expect customer behaviour, needs and problems. In the era of globalization there is an increase in competition and with this competition the methods of operating a business organization has changed drastically. Customers are the reason for existence which has resulted in increasing Customer expectation in Global scenario. Customer Satisfaction has converted into a critical issue which decides the success of any organization. It is one of the major factors which have to be taken into consideration. It is the demand of market to find out a way to make and feel your customer satisfy. The Concept of Customer Relationship Management (CRM) has emerged as magic stick and it describes the way to reach Customer delight ness. CRM includes basically understanding the customers need and requirement and the essence of CRM is Customer Retention. The Application of CRM in Hospitality Industry is required to increase the satisfaction level of customer and resulting in maintaining long term relations, helping the Social Recognition and developing Customer loyalty too. Bottom line is that Positive Word of Mouth brings lot of advantage along with it like reducing marketing cost, increasing profitability, reducing Customer turnover, maintaining market share and a better Return on Investment
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The basic premise of Porter and Hall was that for a firm to be successful (in a market) it had to compete based on one of two sources of competitive advantage: cost, i.e., by providing low cost products, or differentiation, i.e., by differentiating its products from its competitors with respect to quality and performance. Porter also proposed that a firm needs to select its strategic target: either offering a product to the entire market (market wide), or offering a product for a particular market segment. Using these two dimensions (source of competitive advantage, and strategic target), Porter proposed the following three generic competitive strategies: Cost Leadership: offering the lowest costs products to the entire market Differentiated: offering highly unique products (as perceived by the customer) to the entire market Focus: offering products which serve the needs of a niche segment of the market Porters claim is that for a company to be successful in the industry in which it operates it must choose between one of the three generic strategies: cost leadership, differentiated, and focus. If one uses the personal computer industry in the US during the 1990s as an example, then the competitive strategies of the major players was as follows: Dell was the low-cost leader; HP had a differentiated strategy with high-quality products; Apple had a focus strategy, targeting a narrow market segment of users who whom the userexperience (look, feel, and graphical user interfaces) were extremely important; and IBM had a mixed strategy.
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Service Organization: To control service delivery, managers tend to impose rules and procedures on the contact personnel to limit their autonomy and discretion while serving the customer. Working in the sales and marketing department I feel I have pretty free reign over what I do at work. My boss has faith in everyone in our department to make the right decisions when talking to customers and pricing materials. However we don't have free reign to do whatever we would like, especially now that the market has taken a turn for the worse and what wasn't closely watched before is now more regulated.
Contact Personnel: That's me! The same rules and procedures are also intended to limit the extent of service provided for the customer and the resulting lack of customization that might result in a dissatisfied customer. One thing that is nice about what we do at are work is that there is very little customization. Basically we can or can't do it. We have limitation on what our machines are able to cut, delivery/production schedules, and what the mills are able to sell. This helps avoid upset customers because they know if we say we can't do it, we can't do it and we can recommend same one who is able to do it. Most of the time not a competitor.
Customer: Finally, the interaction between contact personnel and the customer has the element of perceived control by both parties. The contact people want to control the behavior of the customer and make their own work more manageable and less stressful; at the same time, the customer is attempting to gain control of the service encounter to derive the most
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Richard Normann, Service Management, John Wiley & Sons, New York, 1984, p. 89.
THE SERVICE ENCOUNTER TRIAD One of the unique characteristics of services is the active participation of the customer in the service production process. Every moment of truth involves an interaction between a customer and a service provider; each has a role to play in an environment staged by the service organization. The service encounter triad shown in Figure 9.1 captures the relationships between the three parties in the service encounter and suggests possible sources of conflict. The managers of a for-profit service organization have an interest in delivering service as efficiently as possible to protect their margins and remain competitive. Nonprofit service organizations might substitute effectiveness for efficiency, but they still must operate under the limits imposed by a budget. To control service delivery, managers tend to impose rules and procedures on the contact personnel to limit their autonomy and discretion when serving the customer. These same rules and procedures also are intended to limit the extent of service provided for the customer and the resulting lack of customization that might result in a dissatisfied customer. Finally, the interaction between contact personnel and the customer has the element of perceived control by both parties.
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thus, severely limiting the discretion of the contact personnel. Customers are presented with a few standard service options from which to choose, and personalized service is not available. Many franchise services such as McDonald's, Jiffy Lube, and H. & R. Block have been successful with a structural organization and environment that dominates the service encounter. Much of their success has resulted from teaching customers what not to expect from their service; however, much of the frustration that customers experience with other institutions, labeled pejoratively as "bureaucracies," is the result of contact
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W. E. Sasser, jr., C. W. L. Hart, and ]. L. Heskett, The Service Management Course, The
Free Press, New York, 1991, p. 97. mation systems is necessary to supply the front-line personnel with the ability to resolve problems as they arise and to ensure a quality service encounter.8 Empowered contact personnel must be motivated, informed/ competent, committed, and well-trained. Front-line personnel should exhibit the ability to take responsibility, manage themselves, and respond to pressure from customers. CONTACT PERSONNEL Ideally, customer contact personnel should have personality attributes that include flexibility, tolerance for ambiguity, an ability to monitor and change behavior on the basis of situational cues, and empathy for customers. The last attribute (i.e., empathy for customers) has been found to be more important than age, education, sales-related knowledge, sales training, and intelligence. Some individuals may find front-line service to be boring and repetitive, whereas others see the job as providing an opportunity to meet and interact with a variety of people. Those with the necessary interpersonal skills may gravitate toward high-contact service jobs, but a selection process still is required to ensure high-quality moments of truth. Selection No reliable tests exist to measure a person's service orientation; however, a variety of interviewing techniques have proven to be useful. Abstract questioning, the situational vignette, and role playing all have been used in evaluating potential front-line employees. Abstract Questioning The questions asked in the abstract interview are open-ended. They provide insights regarding an applicant's ability to relate the immediate service situation to information collected from past experience. An example of a question that assesses an applicant's attention to the environment would be "From your past work experience, what type of customer was most difficult for you to deal with and why?" To determine if an applicant
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Business Review, September-October 1991, p. 72. "puffery." Finally, there is no assurance that the ability to reflect on past events necessarily will guarantee that such perceptiveness and flexibility will transfer to the job. Situational Vignette A situational vignette interview requires the applicant to answer questions regarding a specific situation. For example, consider the following situational vignette: The day after a catering service has catered a large party, a customer returns some small cakes, claiming they were stale. Although the man is demanding a refund, he is so softspoken and timid that you can hardly hear him across the counter. You know that your business did not make those cakes, because they don't look like your chef's work. What would you do? Presenting a situation like this may reveal information regarding an applicant's instincts, interpersonal capabilities, common sense, and judgment. To gain more information about a candidate's adaptability, further questions about the situation can be asked: "How would
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