INTRODUCTION
The hospital is defined as an institution that provides care and treatment for sick or injured. In fact, hospital is highly complex, highly regulated people business that employ, contract, affiliate and collaborate with highly skilled, highly trained, highly credential people for purpose of providing education, prevention, care and treatment to numerous and diverse population of people.
Yet while corporate hospitals have much in common, each has a distinctly different culture. A standardized approach that includes review of common to all hospitals will provide in sight into a hospital's culture and its organizations and governance.
Factors influence a corporate hospital culture:
- Quality of relation in top management and others
- Collectively philosophies of group
- Type of ownership
- Organizational structure
- Mission and purpose
- Size and scope of facilities
- Organized medical staff
- Geography
- Availability of human and capital resource
- Corporate and local politics.
With increasingly liabilities, corporate hospital culture may enhance or impairs its ability to effectively manager risk. More importantly, a corporate hospital's culture may play a vital role as beneficial asset or disastrous liability in asserting or defencing allegations of negligence, malpractice or misconduct in corporate hospital setting.
IMPORTANCE OF CORPORATE HOSPITAL MANAGEMENT
In the era of globalization and competition, health sector is going to be a most developing and prosperous business in the world. Medical tourism turnover will be in terms of trillions in this decade. With such bright future, health sector facilities especially of hospitals turn toward most modernization and luxurious. In coming era, the hospital will not remain only for treatment but it will be for rest, peace and prevention aspect.
At that time we have to manage our hospital professionally like other corporate sector without changing our mission.
Management of corporate hospital is unique unlike other industry. It is service oriented business and production is not in form of any object but only satisfaction is parameter to evaluate the services. Here one has 3to deal with life of someone and expectancy is high. Here management has to deal with people of both extremes, sweeper to superspecialist for the smooth activities of hospital. Better planning, implementation, coordination of different departments and areas, monitoring, controlling, etc. lead us toward the success of organization.
Corporate hospital is complex of different areas, expectation of patients, visitors, doctors, staff and society is always very high in any term.
Level of satisfaction which is parameter of success is uncertain. Small mistake or error can be the issue of the discussion. And so coordination of all areas of hospital must be with fine tuning.
Safety, total quality care and corporate and corporate culture are demand of our hospitals. We have to develop our communication skill, we have to be more transparent and has to be honest to our morals and ethics so everyone can trust and faith us by all means. We have to indentify the tender areas, dark personalities and baseless talks. Here I try to understand and put the subject according to my understanding and my personal opinion. Suggestions are always welcome.
What is Hospital Management?
Hospital management is the achievement of objectives through the people (doctors, nursing staff, paramedicos, housekeeping staff, etc.) and other resources (medical equipment, instruments laboratory, blood bank, etc.). It means a process of setting and achieving goals through the execution of five basic functions:
- Planning
- Staffing
- Controlling
- Organizing
- Directing
Divison of Work
Authority mean right to give orders:
- Discipline
- Unity of command order from one superior only.
One head one plan:
- Subordination of individual interest to general interest
- Remuneration of personnel
- Centralization
- Scalar chain
- Order
- Equity
- Stability of tenure of personnel
- Initiative
FUNCTIONS OF MANAGEMENT
- Planning—To achieving objectives, i.e. to provide quality care, to get NABH accreditation, etc.
- At the planning keep in mind
- Objectives of hospital
- Resources, i.e. budget
- Manpower qualified
- Identification of leaders and motivators
- Monitoring and controlling.
Planning achieve by:- Determine of require resources
- Identify number and type of personnel require
- Organization chart of hierarchy
- Find the standard against the progress toward objectives and correct it if necessary.
Different Type of Plan
- Single use plan
- Objective, i.e. health camp
- Strategic, i.e. to develop diagnostic center
- Standing plan
- Policies, i.e. to establish new hospital
- Procedure, i.e. administrative action guide in sequence
Planning can be influenced by:
- Political events
- Technology changes
- Market condition
- International events, i.e. swine flu
Organizing
It establishes relationships between activities and authority. Four distinct activities of organizing:
- To identify activities have to be done to accomplish objectives.
- To classify the type of work and group needed.
- To assign the work to individuals and delegate.
- To design a hierarchy of decision making.
- To reporting, controlling and monitoring design.
STANDARD ORGANOGRAM OF CORPORATE HOSPITAL (Fig. 1.3)
Organogram
Every corporate sector has a definite reporting system to monitor and contrast the activities. According to management functions, management levels can be defined.
Mainly three managerial levels:
- Top manager
- Middle manager
- First line manager
The directing function is something refer to as motivating, leading guiding or human relations. Directing is most important at the first time supervisory level. As a leader directing others, one should:
- Know all the facts about the situations
- Consider the impact one's decision will have on mission
- Keep the human element in mind when taking decisions
- Assign all workers their initial task, make orders clear and concise and follow-up on each assignment giving specific directions, either verbal or written.
Guidelines for directing
Lester R Bittle and Jhon W Newstrom in their excellent work ‘What every supervisor should know’ suggests followings:
- Do not make it struggle for power—try to focus your attention and workers—on the goal that must be met. The idea to project is that it is situation importance of management functions at various levels that demands the order, not a whim of the supervisor.
- Avoid an offhand manner: If you want employee to take instructions seriously give than that way.
- Watch out for your words: Words can be unreliable massagers of your thought. Watch the tone of your voice; too most of people accept the fact that it is supervisor's job to hand out orders and instructions. Their quarrel is more likely with the way these are made.
- Do not assume that the worker understand give the employee a chance to ask questions of objectives. Have than confirm an understanding by repeating what you have said.
- Be sure to get feedback right way—give employee who wishes to complain about the assignment a chance to do so at the time you assign it. It is better to iron out resistance and misunderstanding before the job begins than after word.
- Do not give for many address: Information overload will be self defeating. Keep instructions brief and to the point.
- Provide just enough detail: For an old hand there is nothing more tiresome than having to listen to familiar details.
- Watch out for conflicting instructions check to make sure that you are telling your employees one thing while supervisors in adjoining departments are telling their people another.
- Do not choose only the willing workers: Be sure that you do not overwork the willing person. Make sure the hard to handle people get their share of rough jobs, too.
- Try not to pick on anyone: It is a temptation to punish a person by handing out an unpleased assignment. Resist this temptation if you can.
- Above all do not play the big shot.
New supervisors are sometimes quality of planting their authority. Older, more nature supervisors, usually feel more confident.9
Staffing
Attempt to indentify, attract and retain qualified personnel. Process of staffing:
- Human resource planning
- Recruitment have two devices
- Job description and
- Job specification—resulting in job analysis.
Recruitment can be through:
- Advertisement in newspapers, journals, magazine, etc.
- Campus interview at school or college
- Internet through
- Placement consultancy
Collect data according to categories.
Selection
Selection through:
- Application form
- Interviews
- Written
- Questionnaire by expert
- Group discussion
- Reference check up
- Medical examination.
Introduction
New employee must be integrated into hospital which include introduction to work group, working area acquainting him with policies and rules of the hospital.10
Training: Training to improve the skill and to prepare for additional responsibilities.
Performance apprasial: To measure performance compare to standard performance.
Control and monitor: Through transfer, rewards, promotions, demotion, termination or retirement and lay offs.
LEADERSHIP
Leadership is the ability to influence of directing to influence and directing people toward the accomplishment of a goal or objective. When one takes the initiative and organizes a group of friends or co-workers for a charity work, one has to shown leadership. Whenever one is in a supervisory or managerial position or not, one exercises leadership to some extent of some type.
Leadership Trails
There are some trials for effective leadership:
- Sense of mission: Belief in one's ability to lead and love of work of leadership itself.
- Integrity: Commitment to the highest person and professional standards.
- High character: Ability to face hard facts and unpleasant situation with courage.
- Loyalty: To supervisors, peers, subordination family and organization.
- Job competence: The foundation for follower ships experts power, referent power.
- Good judgment: Common sense, tact, foresight separation of important from unimportant.
- Energy: Enthusiasm, desire to take the initial decision a willingness to act.
- Selflessness: Sacrificing self (personal need) for a greater cause.
Some Function of Leader
- Set an example for others to follow.
- Determine goals of organization.
- Function as the resident expert.
- Educate personnel.
- Provide counseling and guidance.
- Ensure that work is done properly.
- Enforce policies and regulations.
- Act as spokesperson for workers.
- Motivate workers toward goals.
- Facility open communication.
- Establish performance standards.
- Address disciplinary problems.
Tips for Good Leadership
- Prioritize request from superiors and keep them informed of progress.
- Handle official paper only once. Get it done. This show efficiency of keeps people informed.
- Be consistent in behavior. Be predictable, be reliable—make you more confidence.
- Articulate: Do not fabricate.
- Plan your work and work your plan anticipate future needs.
- Educate and trait your people. Know how to evaluate them and the work they do.
- Motivate people to accomplish the goals—be goal of group oriented.
- Accept new responsibility, willingly.
- Be a role model set two example for your people to follow on the job and off.
Leadership: Three categories manager in corporate hospital:
- Top manager
- Middle manager
- First line manager
MANAGEMENT STYLES
There are different types management style like:
- Autocrat
- Permissive
- Directive autocrat
- Permissive autocrat
- Directive democrat
Four quadrants of situational leadership that depend at the amount of support and guidance need:
- Telling: Works best when employees are neither willing nor able to do the job (high need support and high need guidance).
- Delegation: Works best when employees are willing to do the job and know how to go about it (low need of support and low need of guidance).
- Participating: Work best when employees have ability to do job but high amount of support (low need of guidance but high need of support).
- Selling: Work best when employee are willing to do job but do not know how to do it (low need of support but high need of guidance).
ART OF NEGOTIATION
Whether it is with an employer, family member or business we all negotiate for things each day like higher salary, better service or solving dispute with co-worker or family member. Here I would like to negotiation skills, techniques and strategies as a guideline to help you handle these situations more effectively.
Negotiation is the process of searching for an agreement that satisfies various parties. An agreement may be reached either through a barter or through real negotiation. A real negotiation implies a win-win situation, which basic rules:
- Analyze the interest of parties
- Plan the negotiation and determine
- Select appropriate negotiation technique from
- Spiraling agreement
- Gathering information
- Making the cake bigger
- Commitment
Negotiate
Negotiation process:
- Preparing
- Arguing
- Signaling
- Proposing
- Packaging
- Bargaining
- Closing and agreeing
- Set out our objectives in the negotiation by indentifying one's own interests and also that of the opponent's.
- At the end in itself always remember we are going to negotiating to achieve the objective—not to show that strategy that we followed was out of the world.
- During arguing, the aim is to try and narrow down the difference between two positions to a common acceptable ground.
- During arguing stage:
- Avoid point scoring
- Avoid interruption
- Do not attack
- Being ‘too clever’
- Avoid taking too much
- Shouting your opponent down
- Avoid sarcasm and threats.
Always:- Listen, listen and listen
- Seek clarification
- Ask opponent to justify
- Summarize issues neutrally
- Be ready to provide information
- Ignoring signals would prolong arguments
- Listen more, talk less, that's the golden principle
- Respond and reciprocate, basically communicate continuously
- Be firm on generalities
- Be flexible on specifics
- Do not use weak language, i.e. we hope, we like, we prefer…
- Use strong firm language, i.e. we need, we must have….
- State conditions first and be specific
- Follow with your proposition and be tentative
- Open realistically invite a response
- Draw up our list of conditions and place them in front of the package
- Everything must be conditional. Consider this almost as firm rule—without exceptions
- Decide what we require in exchange for concessions.
- Be ready to bring back into contention any previously ‘settled’ issues if we need negotiating room under pressure of opposition on a point
- Never try to ‘cheat’ when recording the alleged agreement.
Art of Negotiation at Corporate Hospital
Few tips:
- In corporate hospital administrator has to learn the art of negotiation for:
- Land purchasing
- Building and infrastructure development
- Purchasing of hospital equipment, furniture and instruments
- Finalize the terms with consultant of different specialities
- Contract of out source services
- Mass health check up for corporate and industrial sector
- Medicolegal and legal issues at our Lok Adalat
- At health insurance conflicts
- Achieving the objectives with our staff.
- During negotiation meeting, always represent as a team. Never as a single person.
- For negotiation maximum three meetings are permitted otherwise wind up the matter provided every meeting must be a meaningful.
- Before negotiation draw a line of limit with valid and concrete arguments.
- Before the negotiation find out the interest of opponent company, personnel and group and try to find way through touchable route.
- Whenever negotiation meeting is hosted by us, never miss to offer tea, coffee or snack at the initiation or middle of meeting.
- Never participate such meeting with any complexes and prejudices.
- Always conclude the meeting positively, friendly and professionally.
