HEALTH SERVICES MANAGEMENT

YEAR THREE
DCM
 HEALTH SERVICES MANAGEMENT

Learning objectives
• Define Health Service Management
• Define key terms; Leadership, Management, leader,
manager
• Describe historical background of management
• Identify and explain the various functions of
management
• Describe the principles of management and their
application
 INTRODUCTION TO MANAGEMENT

The past
• In the past, managers used command and
control and it worked most of the time

• Managers had access to information which

others did not have access to

• Managers controlled people and resources

 INTRODUCTION cont.
The present
• Managers work in an environment where many
of their subordinates are free to have access to
most of the time
• The subordinates have access to almost as
much as information as the managers
• Managers must be able to rethink, redo and
reenergize and ready to change
 INTRODUCTION cont.
What is management anyway?
An organized process that guides the utilization of various resources —
human, financial and mate-
rial — to meet a desired organizational goal taking into consideration
consumers’ demands (clients’
needs), and the political and economic situation (emphasis on goal).
Or
A process which exists to get results by making the best use of human,
financial and material resource
available to the organization and individual managers. It is concerned
with adding value to these
resources, and this added value depends on the expertise and
commitment of people who are responsi-
ble for managing the business (emphasis on resources)
 INTRODUCTION cont.
• Management is the process of working with people
and resources to accomplish organizational goals
• Good managers are efficient and effective
• Effectiveness is a measure of extent of
achievement of the set organizational objectives
• Efficiency is all about the input into the work i.e.
how much have you spent in the implementation of
the project
 INTRODUCTION cont.
• Some managers are good in one of the above
and not the other and this is not good
• A good manager should be both effective and
efficient because the resources are scarce
• Therefore management is a problem solving
process of effectively achieving organizational
objectives through the efficient use of scarce
resources
 INTRODUCTION cont.
And what about leadership?
• Leadership requires directing, motivating and
communicating with people close-day-by day in
order to influence and inspire them work towards
organizational goals
• A leader is useless without followers. It is followers
who make a person as a leader and if required
overthrow him
• A leader is always ready to fight for the rights of
other employees
 INTRODUCTION cont.
• Leadership is the quality which make a person
stand out differently from other ordinary
employees

• It is associated with such a person who has

aggressiveness in speech and action, love for
the employees and who can handle pressure
under different circumstances
Leadership is the key factor differentiating the “average” from
the “excellent”. In essence, effective
leadership is about enabling ordinary people to do
extraordinary things in the face of adversity, and to
constantly turn out superior performance for the long-term
benefit of all.
Effective leadership involves choosing, and then translating, the
right strategy into action and sus-
taining the momentum. Leadership is essential in any change
process and the burden of effort in any
change process lies in its implementation
A “leader” is a person who manages people by creating high
involvement and shared commitment
that stimulates people to overcome obstacles in the way of
achieving maximum results.
The above definition recognizes “strong and effective leadership”
as one which allows active partici-
pation of all team members with a clear sense of purpose and
mutual support. In such circumstances,
team members of the organization gain experience and qualify
themselves for promotion and advance-
ment. The organizational results and goals are thus satisfactorily
met.
A manager is the person who has the responsibility of achieving certain outcomes having been
given the
authority to utilize the resources of the organization. These resources consist of human, financial,
infor-
mation and physical assets. Timely use of these resources is essential for effective management. In
an ideal
team, its members recognize the authority of the manager and support him/her in a constructive
way. A
manager is therefore a person who can organize people to work harmoniously together and make
effec-
tive use of resources to achieve laid-down objectives, through a process that includes planning,
imple-
mentation, monitoring and evaluation. A distinction should be made between a manager and an
admin-
istrator. Administration is a subset of management. An administrator is somebody who interprets
poli-
cies and directives from above for implementation, knows the rules and applies them well. The
admin-
istrator and manager do not have to be different people.
 DIFFRENCE BETWEEN A MANGER
AND A LEADER
A MANAGER A LEADER
• Carries out planning & • Charts a course providing
budgeting direction
• Oversees organizing & • Provide guidance and counsel
staffing • Encourage people to follow
their examples as a role model
• Follows orders
• Motivates and inspires
• Control & solve problems
• Crates an environment for
• Maintain control & order change
• Protect status quo • Builds relationship and trust
• Write memorandums • Trains and teaches
• Follows rule and regulations • Questions rules and regulations
 INTRODUCTION cont.
• Both leadership and management skills are
essential in effective health care delivery

QUESTIONS
Q1. What are the qualities of a good leader?

Q2. What are the qualities of a good manager?

 FUNCTIONS OF MANAGEMENT
• The basic management process consist of:
1. Planning
2. Organizing
3. Leading
4. Controlling
• The above are the traditional functions of
management
 FUNCTIONS cont.
Planning - 1
• Making systematic decisions about the goals
and activities that an individual, a group a work
unit, or the overall organization will pursue in
the future
• Planning activities involve analyzing current
situation, anticipating the future, determining
objectives, determining the kind of activities an
organization will engage in, choosing a
strategy and determining the resources needed
 FUNCTIONS cont.
Planning - ii
• When planning, it should be done for the entire
organization, departments
• All the concern individuals should be involved
• Plan may have short and long term
• It may be general or very specific
• In all cases, managers are responsible for
gathering information on which plans are
based, setting the goals to be achieved and
deciding on what needs to be done
 FUNCTION cont.
Organizing
• This is the management function which
involves assembling and coordinating human,
financial, physical information and other
resources that are essential to achieve the goals

• Activities of organizing include attracting

peoples to the organization, specifying job
responsibilities, grouping jobs into work units
 FUNCTIONS cont.
Organizing
• Sourcing and allocating resources and creating
conditions so that people and things work
together to achieve maximum success
 FUNCTION cont.
Leading
• This is the management function that involves
the manager’s efforts to stimulate high
performance of the employees
• Leading involves directing, motivating and
communicating with employees individually
and in groups
• It also involves close day-by-day contact with
people and inspiring them to work towards
organizational goals
 FUNCTIONS cont.
Controlling
• This is the management function of monitoring
progress and making the necessary changes

• It is necessary because when managers

implement plans they often find that things are
not working out as they expected or planned

• In such a case adjustment is made as needed

 FUNCTIONS cont.
Controlling
• Specific activities of controlling include:
– Setting performance standard
– Monitoring the performance of the people
and the various units
– Providing people with feedback about their
performance
– Identify performance problems and correct
them
 FUNCTIONS cont.
Controlling
• Budgeting, maintaining information systems,
cost cutting and taking appropriate disciplinary
actions when ever necessary are examples of
controlling actions that an effective manager
should be able to do
 FUNCTIONS cont.
• Effective managers should devotes their times
and resources to all the four functions
• Failure to do so means failure as a manager
• A typical manager spends about 60% of their
time meetings others & always has a lot of
interruptions
• A number of managers usually have many
things to do BUT do not seems to get to do
them because time is not enough. As a result
there is always some kind of fire fighting
 MANAGEMENT SKILLS
• Managers need a variety of skills to succeed
• There are three general categories of skills
needed by the managers and these include:
1. Technical skills
2. Interpersonal and communication skills
3. Conceptual skills
 Management skills cont.
• Technical skills is to do with performing
specialized tasks
• Conceptual skills is to do with ability to
recognize complex and dynamic issues,
examining numerous and conflicting factors
• It involves resolving problems for the good of
the organization and individuals
• Interpersonal skills is to do with ability to
lead, motivate and communicate
 CONCLUSION
• We spend time talking about management
because managers work in all types of
organizations including health care systems
• They are responsible for the success or failure of
organizations’ goals
• No matter where you intend to work, effective
management is a competitive advantage
• Management skills are essential to any one who
intends to pursue any career
 PRINCIPLES OF MANAGEMENT
• These are important things that the managers
need to put in place for the smooth running of
an organisation. They include the following:
1. Line of Authority
• In any organisation there should be a clear line
of authority from the top management to the
organisation to the lower cadres
• This is to make it easy to understand who is
responsible for what and who is answerable to
whom
 PRINCIPLES cont.
2. Responsibility
• Every member or employee of an organisation
should be assigned to be responsible to one
senior person only
3. Authority
• This is what is known as the commensurate
state to the responsibility given to the person
• When not balanced with authority, effective
and efficient work can not be discharged
 PRINCIPLES cont.
4. Information flow
• Information is a very important aspect in the
running of an organisation
• It is important that the flow of information is given
to one person so that the information is not
distorted or minimized
5. Span of Control
• To facilitate easy supervision and ensure that work
is effectively done, department or unit
administrator should not be assigned more than
what s/he could supervises
 PRINCIPLES cont.

6. Specialization
• To achieve its goal the organisation make best
use of specialization as a factor
• This is because some individuals within the
organisation may possess special abilities that
the organisation needs
• This principle is very useful for the modern
complex organisation
 PRINCIPLES cont.
7. Define roles
• This is the purpose for which one is serving
• The responsibility and authority allocated to
each executive should be specific clear and
demarcated
8. Communication lines
• This is often upwards or downwards and
sometimes horizontally
• The management must provide good lines of
communication in the organisation
 PRINCIPLES cont.
9. Work allocation
• Tasks should be given with equity and holistically.
• No tasks should be left unattended or unassigned
to some one for the purpose of accountability
10. Control
• This determine the level in which the activities,
targets and the mission of the organisation are
met.
• This must be given in an appropriate manner
 Managerial roles
Interpersonal roles:
• n Managers as figureheads who, because of their authority,
are obliged to perform a number
• of duties.
• n Managers as leaders, providing guidance and motivation.
• n Managers as liaison officers, maintaining a web of
relationships with individuals and groups.
• n Managers as disturbance handlers, dealing with
involuntary situations and change beyond their
• control
Informational roles:
• Managers as monitors, continually seeking and
receiving information as a basis for action.
• Managers as disseminators, passing factual
information to supervisors, colleagues and
• subordinates and transmitting value statements
to guide subordinates in making decisions.
• Managers as spokespeople, transmitting
information into their organization’s environment.
Decision roles:
• Managers as entrepreneurs, acting as initiators
of controlled change in the organization.
• Managers as resource allocators, making choices
about scheduling their own time, authorizing
• actions and allocating people and finance to
projects or activities.
• Managers as negotiators with other
organizations or individuals
 Levels of management
TOP-LEVEL MANAGERS
• Top-level managers, or top managers, are also called senior management or executives. These individuals are at
the top one or two levels in an organization, and hold titles such as: Chief Executive Officer (CEO), Chief Financial
Officer (CFO), Chief Operational Officer (COO), Chief Information Officer (CIO), Chairperson of the Board,
President, Vice president, Corporate head.
• Often, a set of these managers will constitute the top management team, which is composed of the CEO, the
COO, and other
• department heads. Top-level managers make decisions affecting the entirety of the firm. Top managers do not
direct the day-to-day
• activities of the firm; rather, they set goals for the organization and direct the company to achieve them. Top
managers are ultimately
• responsible for the performance of the organization, and often, these managers have very visible jobs.
• Top managers in most organizations have a great deal of managerial experience and have moved up through the
ranks of management
• within the company or in another firm. An exception to this is a top manager who is also an entrepreneur; such
an individual may start
• a small company and manage it until it grows enough to support several levels of management. Many top
managers possess an
• advanced degree, such as a Masters in Business Administration, but such a degree is not required.
• Some CEOs are hired in from other top management positions in other companies. Conversely, they may be
promoted from withi
• MIDDLE-LEVEL MANAGERS
• Middle-level managers, or middle managers, are those in the levels below top managers. Middle managers' job titles
include: General
• manager, Plant manager, Regional manager, and Divisional manager.
• Middle-level managers are responsible for carrying out the goals set by top management. They do so by setting goals for
their
• departments and other business units. Middle managers can motivate and assist first-line managers to achieve business
objectives.
• Middle managers may also communicate upward, by offering suggestions and feedback to top managers. Because middle
managers
• are more involved in the day-to-day workings of a company, they may provide valuable information to top managers to
help improve
• the organization's bottom line.
• Jobs in middle management vary widely in terms of responsibility and salary. Depending on the size of the company and
the number
• of middle-level managers in the firm, middle managers may supervise only a small group of employees, or they may
manage very
• large groups, such as an entire business location. Middle managers may be employees who were promoted from first-
level manager
• positions within the organization, or they may have been hired from outside the firm. Some middle managers may have
aspirations to
• hold positions in top management in the future.
• FIRST-LEVEL MANAGERS
• First-level managers are also called first-line managers or supervisors. These managers have job titles
such as: Office manager, Shift
• supervisor, Department manager, Foreperson, Crew leader, Store manager.
• First-line managers are responsible for the daily management of line workers—the employees who
actually produce the product or
• offer the service. There are first-line managers in every work unit in the organization. Although first-
level managers typically do not
• set goals for the organization, they have a very strong influence on the company. These are the
managers that most employees interact
• with on a daily basis, and if the managers perform poorly, employees may also perform poorly, may
lack motivation, or may leave the
• company.
• In the past, most first-line managers were employees who were promoted from line positions (such as
production or clerical jobs).
• Rarely did these employees have formal education beyond the high school level. However, many first-
line managers are now
• graduates of a trade school, or have a two-year associates or a four-year bachelor's degree from
college.
Four Key Management Activities
• There are four key activities that a manager must achieve if he/she is to be successful in achieving key organisational
objectives: POMC (Plan, Organise, Motivate and Control)

The POMC approach was derived from Henri Fayol and his Five Functions of Management as long ago as 1916. Fayol linked
strategy and organisational theory, emphasising the need for management development and qualities of leadership.
Fayol's 5 key elements of fundamentally industrial management remain the foundation stones on which all later gurus
have built.
Fayol: Five Functions of Management Additional information required
Forecast and Plan Set clear vision
SMART objectives (Specific, Measurable,Achievable, Realistic, Time-bound)

Organise Building up the structure:

divide/apportion tasks
consider resources - human, monetary, technology, materials
ensure sensitivity and equity

Command Maintaining activity among the personnel:

reporting hierarchy
controlled activity between manager and workforce
Co-ordinate Unifying and harmonising all activity and effort:
supervision and harmonisation by co-ordinated management
support
motivation
Control Everything occurs in conformity with established rule and expressed
command i.e. everything is subject to checks on the efficiency of its working (audit, quality
control, clinical governance)
ANY QUESTIONS?

Thank you