PRN No. 1904076100223 Semester No.

Name of Learner: Poonam Kondalwadikar

Course Name: Principles & Practices of Management

Public Health & Healthcare Systems

Financial Management

Materials & Quality Management

Program Name: Post Graduate Diploma in Hospital & Healthcare Management

(PGDHHM)

Set of Assignment: 2nd

Course 1: Principles & Practices of Management

a. Write in detail styles of leadership?

1. Laissez-Faire or Free Rein Leadership

The laissez-faire leadership style is also known as the “hands-off” style. It is one in which the
manager provides little or no direction and gives employees as much freedom as possible. All
authority or power is given to the employees and they must determine goals, make decisions,
and resolve problems on their own.

This French phrase means “leave it be” and is used to describe a leader who leaves his or her
colleagues to get on with their work. It can be effective if the leader monitors what is being
achieved and communicates this back to his or her team regularly. Most often, laissez-faire
leadership works for teams in which the individuals are very experienced and skilled self-
starters. Unfortunately, it can also refer to situations where managers are not exerting
sufficient control. The advantage of this kind of style is positive only in the case when the
employees are very responsible and in case of creative jobs where a person is guided by his
own aspirations. In these cases, less direction is required so this style can be good. This style
has more disadvantages because usually it is the result of the lack of interest of the leader that
leads to his adopting this style. It proves poor management and makes the employees lose their
sense of direction and focus. The disinterest of the management and leadership causes the
employees to become less interested in their job and their dissatisfaction increases.

2. Autocratic or Authoritative Leadership

Under the autocratic leadership styles, all decision-making powers are centralized in the leader
as shown such leaders are dictators. Autocratic leadership is an extreme form of transactional
leadership, where a leader exerts high levels of power over his or her employees or team
members. People within the team are given few opportunities for making suggestions, even if
these would be in the team’s or organization’s interest.

Autocratic leadership style is often considered the classical approach. It is one in which the
manager retains as much power and decision-making authority as possible. The manager does
not consult employees, nor are they allowed to give any input. Employees are expected to obey
orders without receiving any explanations. The motivation environment is produced by creating
a structured set of rewards and punishments. Autocratic leaders make decisions without
consulting their teams. This is considered appropriate when decisions genuinely need to be
taken quickly, when there’s no need for input, and when team agreement isn’t necessary for a
successful outcome.

Many people resent being treated like this. Because of this, autocratic leadership often leads to
high levels of absenteeism and staff turnover. Also, the team’s output does not benefit from
the creativity and experience of all team members, so many of the benefits of teamwork are
lost.

For some routine and unskilled jobs, however, this style can remain effective, where the
advantages of control outweigh the disadvantages.

3. Democratic Leadership or Participative Leadership

Although a democratic leader will make the final decision, he or she invites other members of
the team to contribute to the decision-making process. This not only increases job satisfaction
by involving employees or team members in what’s going on, but it also helps to develop
people’s skills. Employees and team members feel in control of their own destiny, and so are
motivated to work hard by more than just a financial reward. Democratic leadership can
produce high quantity work for long periods of time. Many employees like the trust they
receive and respond with cooperation, team spirit, and high morale.

As participation takes time, this style can lead to things happening more slowly than an
autocratic approach, but often the end result is better. It can be most suitable where team
working is essential, and where quality is more important than speed to market or productivity.
b. What is SWOT analysis?

SWOT = (strengths, weaknesses, opportunities, and threats) analysis is a framework used to

evaluate a company's competitive position and to develop strategic planning. SWOT analysis
assesses internal and external factors, as well as current and future potential.

A SWOT analysis is designed to facilitate a realistic, fact-based, data-driven look at the strengths
and weaknesses of an organization, its initiatives, or an industry. The organization needs to
keep the analysis accurate by avoiding preconceived beliefs or gray areas and instead focusing
on real-life contexts. Companies should use it as a guide and not necessarily as a prescription.

SWOT analysis is a strategic planning technique that provides assessment tools.

Identifying core strengths, weaknesses, opportunities, and threats lead to fact-based analysis,
fresh perspectives and new ideas.
SWOT analysis works best when diverse groups or voices within an organization are free to
provide realistic data points rather than prescribed messaging.

SWOT analysis is a technique for assessing the performance, competition, risk, and potential of
a business, as well as part of a business such as a product line or division, an industry, or other
entity. Using internal and external data, the technique can guide businesses toward strategies
more likely to be successful, and away from those in which they have been, or are likely to be,
less successful. An independent SWOT analysis analyst, investors or competitors can also guide
them on whether a company, product line or industry might be strong or weak and why.
Analysts present a SWOT analysis as a square with each of the four areas making up one
quadrant. This visual arrangement provides a quick overview of the company’s position.
Course 2 : Public Health And Healthcare Systems
a. Chlorination

In order to combat waterborne diseases, different disinfection methods are used to inactivate
pathogens. Along with other water treatment processes such as coagulation, sedimentation,
and filtration, chlorination creates water that is safe for public consumption.

Microorganisms can be found in raw water from rivers, lakes and groundwater. While not all
microorganisms are harmful to human health, there are some that may cause diseases in
humans. These are called pathogens. Pathogens present in water can be transmitted through a
drinking water distribution system, causing waterborne disease in those who consume it.

Chlorination is one of many methods that can be used to disinfect water. It is a chemical
disinfection method that uses various types of chlorine or chlorine-containing substances for
the oxidation and disinfection of what will be the potable water source.

Any type of chlorine that is added to water during the treatment process will result in the
formation of hypochlorous acid (HOCl) and hypochlorite ions (OCl-), which are the main
disinfecting compounds in chlorinated water. More detail is provided later on in this fact sheet.

Of the two, hypochlorous acid is the most effective. The amount of each compound present in
the water is dependent on the pH level of the water prior to addition of chlorine. At lower pH
levels, the hypochlorous acid will dominate. The combination of hypochlorous acid and
hypochlorite ions makes up what is called ‘free chlorine.’ Free chlorine has a high oxidation
potential and is a more effective disinfectant than other forms of chlorine, such as chloramines.
Oxidation potential is a measure of how readily a compound will react with another. A high
oxidation potential means many different compounds are able to react with the compound. It
also means that the compound will be readily available to react with others.

For adequate chlorination, following rules should be followed:

1. The water to be chlorinated should be clear and free from turbidity.

– Turbidity impedes efficient chlorination

2. The chlorine demand of the water should be estimated first

– The chlorine demand of water is the difference between the amount of chlorine added to the
water and the amount of residual chlorine remaining in a sample of water at the end of a
specific period of contact (usually 60 min), at a given temperature and pH of the water.

– In other words, it is the amount of chlorine that is needed to destroy bacteria and to oxidize
all the organic matter and ammoniacal substances present in the water

– The point at which the chlorine demand of the water is met is called the ‘break point’

– If further chlorine is added beyond the break point, ‘free chlorine begins to appear in the
water.

3. The minimum recommended concentration of free chlorine is 0.5 mg/L for one hour

– The free residual chlorine provides a margin of safety against subsequent microbial
contamination such as may occur during storage and distribution

4. The contact period presence of free residual chlorine, for a contact period of at least one
hour, is essential to kill bacteria and viruses. Chlorine has no effect on spores, protozoan cysts
and helminthic ova, except in higher doses.

5. The sum of the ‘chlorine demand’ of the specific water plus the ‘free residual chlorine’ of 0.5
mg/L constitutes the correct dose of chlorine to be applied

b. DOTS
The Revised National TB Control Programme (RNTCP), based on the internationally
recommended Directly Observed Treatment Short-course (DOTS) strategy attacks the key
hurdle of poor drug-consumption compliance by patients.
The quality and availability of microscopic services has improved. Newer and faster methods of
laboratory diagnosis are evolving. The Mycobacteria tuberculosis, to a large extent has
developed resistance against anti tuberculosis drugs. This is creating a big impediment in
further reducing mortality due to tuberculosis, Hence, newer methods of culture and
sensitivity/resistance testing are being promoted. The risk of exacerbation of existing
tuberculosis lesions is estimated to be 30 times higher in people living with HIV (WHO). The
program gives emphasis on the coordination between tuberculosis and AIDS-control programs.
A minimum of 70% of detection of expected-tuberculosis patients and 85% treatment-success
rate are targeted in the RNTCP. Any person who has cough more than two weeks is directed to
the laboratory for examination of two sputum samples. If any sample turns out positive, the
anti-tuberculosis treatment is started. The treatment consists of multiple drugs given thrice a
week. The treatment is carried out in two phases: intensive and continuation phase. In the
intensive phase, the drugs are given in the presence of the DOTS provider, and in the
continuation phase, at least the first dose of every week is given by the DOTS provider. For
newly diagnosed patients, the intensive phase consists of five drugs for one month, and the
continuation phase consists of three drugs for five months. The treatment of resistant
tuberculosis lasts for a longer duration and requires more drugs. The Government of India, from
2012, has made the notification of tuberculosis mandatory.

Course 3: Financial Management

a. Enlist and write in details about Types of Cost.

In every business activity there are below 3 Types of Cost are seen:

1. Fixed Costs -

Fixed costs are predetermined expenses that remain the same throughout a specific
period. These overhead costs do not vary with output or how the business is
performing. To determine your fixed costs, consider the expenses you would incur if you
temporarily closed your business. You would still continue to pay for rent, insurance and
other overhead expenses like Rent / Telephone and internet costs / Insurance
/Employee Salaries /Loan Payments.
Any small business owner will have certain fixed costs regardless of whether or not there is any
business activity. Since they stay the same throughout the financial year, fixed costs are easier
to budget. They are also less controllable than variable costs because they’re not related to
operations or volume.

2. Semi-Variable Costs

A semi-variable cost, also known as a semi-fixed cost or a mixed cost, is a cost composed
of a mixture of both fixed and variable components. Costs are fixed for a set level of
production or consumption, and become variable after this production level is
exceeded. If no production occurs, a fixed cost is often still incurred.

The fixed part of the semi-variable cost usually represents a minimum fee for making a
particular item or service available. The variable portion is the cost charged for actually
using the service.

Examples of semi-variable costs include repairs, monthly telephone charges, indirect

materials, indirect labor, fuel and power. Telephone charges, for example, are made up
of a service charge plus extra charges for extra telephones and long-distance calls.

3. Variable Costs

It changes over a specified period and is associated directly to the business activity.
These are based on the business performance and the volume of services the business
generates. Some examples of variable costs include: Direct labor / Commissions /
Taxes / Operational expenses.

Since they are changing continuously and the amount you spend on them differs from month-
to-month, variable expenses are harder to monitor and control. They can decrease or increase
rapidly, cut your profit margins and result in a steep loss or a whirlwind profit for the business.
b. Break Even Analysis.
Break-even analysis entails the calculation and examination of the margin of safety for an entity
based on the revenues collected and associated costs. Analyzing different price levels relating
to various levels of demand a business uses break-even analysis to determine what level of
sales are necessary to cover the company's total fixed costs. A demand-side analysis would give
a seller significant insight regarding selling capabilities. Break-even analysis tells you at what
level an investment must reach to recover your initial outlay. It is considered a margin of safety
measure. Break-even analysis is used broadly, from stock and options trading to corporate
budgeting for various projects.
Break-even analysis is useful in the determination of the level of production or a targeted
desired sales mix. The study is for management’s use only, as the metric and calculations are
not necessary for external sources such as investors, regulators of financial institutions. This
type of analysis depends on a calculation of the break-even point (BEP). The break-even point is
calculated by dividing the total fixed costs of production by the price of a product per individual
unit less the variable costs of production. Fixed costs are those which remain the same
regardless of how many units are sold. Break-even analysis looks at the level of fixed costs
relative to the profit earned by each additional unit produced and sold. In general, a company
with lower fixed costs will have a lower break-even point of sale. For example, a company with
$0 of fixed costs will automatically have broken even upon the sale of the first product
assuming variable costs do not exceed sales revenue. However, the accumulation of variable
costs will limit the leverage of the company as these expenses come from each item sold.

Break-even analysis is also used by investors to determine at what price they will break even on
a trade or investment. The calculation is useful when trading in or creating a strategy to buy
options or a fixed-income security product

Course 4: Materials & Quality Management

a. Vital, Essential and Desirable (VED) Analysis.
It attempts to classify the items used into three broad categories, namely Vital, Essential, and
Desirable. The analysis classifies items on the basis of their criticality for the industry or
company.

Vital category items are those items without which the production activities or any other
activity of the company, would come to a halt, or at least be drastically affected.

Essential items are those items whose stock – out cost is very high for the company.

Desirable items are those items whose stock-out or shortage causes only a minor disruption for
a short duration in the production schedule. The cost incurred is very nominal. VED Analysis is
very useful to categorize items of spare parts and components. In fact, in the inventory control
of spare parts and components it is advisable for the organization to use a combination of ABC
and VED Analysis. Such a control system would be found to be more effective and meaningful.

This can be divided into 3 categories: 1. Category I - Items are most expensive and vital items,
control in the hands of top management. 2. Category II - Items are essential with low cost. 3.
Category III - Items are desirable with least cost. The model shows nine combinations out of
which five are category I. The combination of items included all vital drugs irrespective of cost
consideration and all ‘A’ items irrespective these are vital, essential and desirable. The category
II items similarly include three combinations and category III items are only desirable with least
cost only one combination.

b. Explain steps of improving Quality of Patient Care.

1 - Discover quality features - The first step is to find out quality measures, their relative
importance to patients and threshold levels for those who have received the service.
2 - Set quality standards of patient care - Basic principle is to decide how to measure each
selected quality measure.
3 - Measure performance
Measuring clinical outcomes - The measurements are usually on a scale of -5 to +5 or 1 to 10.
Evaluation of HRQoL instruments - Psychometrics, the science of assessing the measurement
characteristics of scales, is used to evaluate HRQoL instruments. Reliability refers to the extent
to which an instrument is free of measurement error. Validity is defined by the extent to which
an instrument measures what it is supposed to measure and does not measure what it is not
supposed to measure.
4 - Take action Flow process model - The flow process model is especially useful in helping staff
consider their service from a client’s point and to gain a greater understanding of their part in
the overall process. It starts with the client selecting the service.
Phase I - How many clients are turned away because they cannot be served.
Phase II - The point of entry when the client first contacts the service and makes a request.
Phase III - This phase is critical because it is the first time a client meets a person representing
the service. It is an important opportunity to influence expectations and perceptions.
Phase IV - Measures are of client perceptions of the response, of staff skills and abilities to
handle the needs and whether the response is adequate to carry out the next part of the
process - the intervention phase
Phase V - The service attempts to meet the client’s assessed needs.
Phase VI - To reassess needs and re-plan interventions to have maximum effect. To check and
influence client expectations. To judge whether service providers could use their skills to better
effect for other waiting clients.
Phase VII - Number of clients who left before this phase as well as client’s perceptions of how
their departure has handled
Phase VIII - Follow up phase involves service checking whether the client needs were met.
In summary, one of the central concepts of the quality approach is to view a service and each
person's work as a process. It can be used with staff in any service to:
1. Understand how staff can elicit and negotiate expectations
2. Work out simple and faster ways of bringing together clients, information, materials and
staff (removing bottlenecks)
3. Help staff understand how the service works and their part in it
4. Establish procedures for what should be done
5. Raise staff awareness about clients perceive the service