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Discuss the Managerial issues in Disaster Management?

Examination Paper of Health & Hospital Management1IIBM Institute of Business ManagementIIBM Institute of Business ManagementExamination Paper MM.100Hospital AdministrationSection A: Objective Type & Short Questions (30 marks) This section consists of Multiple Choices and Short Notes type Questions. Answer all the questions. Part One carries 1 mark each and Part Two carries 5 marks each.Part One:Multiple forms:1. Low growth low market share products are termed as___________a. Starsb. Cash cowsc. Dogsd. None2. To improve organizational performance „Alfred Sloan‟ introduced „3S term‟ as doctrine ofstrategy, structure and?a. Systemb. Solutionc. Shared. None3. Overburdening may occur due to too many group members seeking out an individual forinformation and assistance, a solution to such problem is_____________a. Linear organizationb. Circular organizationc. Elliptical organizationd. None4. NHS stands for_________________5. ICU in medication stands for Internal cure union.(T/F)6. There are 4 levels of strategic consensus that have been identified among the managers, one levelin which managers are informed about the strategy but they are not willing to act iscalled___________a. Blind devotionb. Informed scepticismc. Weak consensusd. None7. OCB stands for Organization citizenship behavior.(T/F)Examination Paper of Health & Hospital Management2IIBM Institute of Business Management8. BPR stands business process re enforcement.(T/F)9. The best way to avoid conflict and there by preserve relationship with in the health careorganization is____________a. Spiral of silenceb. Web of solutionc. Web of solutiond. None10. IPE stands for inter disciplinary education.(T/F)Part Two:1. Discuss the Managerial issues in Disaster Management?2. What do you understand by the Outpatient Department (OPD)?3. Write short note on Quality Assurance in a Hospital?4. Briefly describe the importance and functions of Housekeeping department in the Hospital?END OF SECTION ASection B: Caselets (40 marks) This section consists of Caselets. Answer all the questions. Each caselet carries 20 marks. Detailed information should form the part of your answer Caselet 1CULTURAL BELIEFSAn organization‟s culture can be studied at three levels: artefacts, values and assumptions. Artefactsare the organizational structures that are visible to the members of the organization. Values are thestrategies, goals and philosophies of the organization‟s members. The basic, underlying assumptionsof group members include taken-for-granted beliefs, perceptions, thoughts and feelings. Even thoughcertain basic assumptions are evident, taken for granted and are not normally confronted or debated,the culture of the organization will become evident at the level of observable artefacts and in theshared values, norms and rules of behavior of the organization‟s member. Group norms are sets ofshared values that have been valedated through a consensus process. The social validation of groupnorms arises when certain values are confirmed by the shared experiences of the group and thesenorms are passed onto new members as being the correct way to do things. This mechanism ofembedding and meshing culture is undertaken at an unconscious level in most organizations.Examination Paper of Health & Hospital Management3IIBM Institute of Business ManagementAlthough culture resides in the minds of the members of the organization, it is transmitted throughvisible expressions, such as formal and informal routines and everyday rituals of existence undertakenby members of the organization. Over time, shared experiences develop into a set of core values thatbecome embedded in individual and organizational philosophy and ideology that ultimately serves toguide action and behavior. This process is an important mechanism in the transmission of sharedprofessional assumptions, values, artefacts and symbols from the master to the student and in thedevelopment of the socialization process that professional clinicians undergo. Therefore, the internalorientation of employees is based primarily on the culture, values, beliefs, ethics and assumptions ofthe organization‟s staff; this is particularly evident amongst health service employees, although theorientation may differ between clinicians and non-clinicians.1. Why according to you Artefacts are essential for the development of an organization‟s culture?2. Elaborate the cultural beliefs of your company?Caselet 2There are many ways of managing change. Few organizational changes are complete failures, andfew are entirely successful. The management of change draws from psychological, behavioral,political, social and culture dimensions, many of which may be conflicting. A realization that changeis the result of competition between driving and restraining forces is evident in much of the literature.Lewin noted some forces drive change whilst others resist change. A change agent is required tofecilitate change, to manage the restraining forces, and to drive change through. The change isrequired to understand change as a phenomenon, identify the key emotional reactions associated withchange, such as resistance, and know how to manage change in a positive manner. Kotter contendsthat both leadership and management skills are required to effectively and positively manage change,particularly in a volatile environment. He further argues that the change process is deductive; it isabout managing complexity and is often undertaken in order to prevent a more chaotic reality thanthat presently in force. If change is approached with a certain level of excitement and enthusiasm, itwill create opportunities that will make patients lives better. However, change is often introducedwithout due regard for the realities of individual areas of health care practice. Some managers maynot have an insight into the effect of the change on the lives of individuals or realizations that evenminor change may have unintended consequences for the individual and the organization. Mostresistance to change occurs not because of the proposed change, but as a result of individualperceptions of expected outcomes due to the change and on how this is likely to impact on their lives.Therefore, an accurate assessment of the environment, both internal and external to the organization,is required prior to the change, thus preventing negative consequences for individuals.1. Why there is a need of change?2. With reference to your company, what changes you prefer?END OF SECTION BSection C: Applied Theory (30 marks)Examination Paper of Health & Hospital Management4IIBM Institute of Business Management This section consists of Applied Theory Questions. Answer all the questions. Each question carries 15 marks. Detailed information should form the part of your answer 1. What do you mean by Emergency Department Planning? How would you explain the managerialissues in Emergency department?2. Write short note on the following terms:1) Central Sterile Supply Department (CSSD)2) Total Quality Management in Health Care3) Medical Audit and its AdministrationEND OF SECTION CExamination Paper of Health & Hospital Management5IIBM Institute of Business ManagementIIBM Institute of Business ManagementExamination Paper MM.100Principles of Hospital Administration and PlanningSection A: Objective Type & Short Questions (30 marks) This section consists of Multiple Choices and Short Not type Questions. Answer all the questions. Part One carries 1 mark each and Part Two carries 5 marks each.Part One:Multiple Choices:1. A method of collaborative work in which visual display of information on flip charts or othermedia to which other group member can use is__________a. Decision matricesb. Multivotingc. Boardingd. Brainstorming2. A tool for Data collection which summarise perception of a large sample of peopleis___________a. Surveysb. Interviewsc. Check sheetd. Data sheets3. Members of Inspection control committee_________a. Microbiologist, O.T. incharge, Medical Superintendentb. Representative from Nursing Service, CSSD in charge, Representative from major clinicaldepartmentc. Both (a) & (b)d. None of the above4. MRD stands for___________a. Medical Records Departmentb. Medicine Records Departmentc. Medicine Release Departmentd. None of the above5. Format for appraisal in which rank order is establish of employees based on their relativemerit_________a. Forced Distribution Techniqueb. Graphic Rating Scalec. Ranking methodsd. Free Written RatingsExamination Paper of Health & Hospital Management6IIBM Institute of Business Management6. Analytical technique in Materials Management in which all items in inventory on the basis ofannual usuage time cost is________a. FSN Analysisb. ABC Analysisc. VED Analysisd. None of the above7. Planning tool used in Quality Management in which the items are written on individual cards anddisplayed on a flip chart__________a. Relations Diagramb. Process Decision Program chartc. Affinity Diagramd. Activity Network Diagram8. Method of filing of Medical records in which involves filing of records in exact chronologicalorder according to unit / serial number___________a. Middle Digit filingb. Terminal Digit filingc. Straight Numeric filingd. None of the above9. Type of hospital in which the number of beds is over 300 beds is known as___________a. Large hospitalb. Medium sized hospitalc. Small hospitald. None of the above10. Meeting in hospital whose purpose is to pass on information received from agencies is_________a. Informative Meetingb. Consultative Meetingc. Executive Meetingd. None of the abovePart Two:1. What are the factors affecting “Retraining” in a hospital?2. Write short note on Finance in Hospitals?3. Describe the Negotiating system for Hospitals rates?4. Write down the different members of Appointment committee of the hospital?END OF SECTION ASection B: Caselets (40 marks)Examination Paper of Health & Hospital Management7IIBM Institute of Business Management This section consists of Caselets. Answer all the questions. Each caselet carries 20 marks. Detailed information should form the part of your answer Caselet 1Rakesh and Gagan were two brothers who had graduate in Medicine in the year 1979. Bothestablished themselves as successful practitioners. In 1992, they decided to set up their own hospitalas both were familiar with the nitty-gritty of the profession after spending a decade as successfulpractitioners. In the year 1994, the concept was concretized when three floors Arogya Hospital with abed capacity of 60 came into existence at Gwalior. The facilities provided by the hospital werepathology, X-ray, blood bank and ICU. In the year 1998, the number of beds were increased to 100with the addition of a fourth floor. In the year 2005, a fifth floor was added and the hospital startedoffering services like radiology, 3D spiral, C. Tscan, colourdoppler, pathology, blood bank, C.C.U.,O.T., maternity unit, emergency and trauma services, in-patient accommodation, canteen,telecommunication and entertainment.The hospital had 35 nurses and 55 class four employees. The main task of the class fouremployees was to maintain the cleanliness of the hospital. Besides this, they were also entrusted withthe task of sponging, bed setting and shifting of the patients. Salary paid to these employees wasbetween Rs. 1200/- to Rs. 1800/- per month. The hospital staff was divided into different classes ofemployees. Class one comprised of MBBS, MD, MS, and Administrative Officers. Class threecomprised of Technicians and Nurses. Class four comprised of Ayabais, Sweepers and Guards.Hospital had 11 full time doctors, out of whom 7 were duty doctors (MBBS), 2 full time MD for ICUand 2 full time in-house surgeons (MS). Besides this, the hospital had 50 visiting doctors whooperated on a turnkey basis. These doctors had their own clinics in different parts of the city and asper requirement, they admitted their patents in the hospital. There was a mutual agreement betweenthe doctors and the hospital that the hospital would charge the patients and out of it the doctors wouldreceive their fees along with a percentage from the hospital share. The patients treated by the hospitalwere patients requiring intensive care and minor illnesses. Out of the cases reported in the hospital,60-75% were maternity and were referred to the hospital by leading gynaecologists of the city, Dr.Savita and Dr. Manorama. To help the doctors in the treatment of patients, work-instructions forResident Doctors, Supervisors, Wardboys / Ayabais and Sweeper boys/ bais were prepared by thenewly appointed Hospital-Administrator Priya. These instructions were prepared in English and werehung on the walls of the enquiry counter. After a span of one month, Priya resigned from the hospitalon account of some personal reasons.By the end of the year 2004, Ritu, a fresh post-graduate in Hospital-Administration fromGwalior, was appointed as an Administrative Officer or take charge of the overall activities of thehospital. Her role was to monitor the activities of employees of class three and four and various otheractivities related to the functioning of the Hospital. The first task before her was to improve thecleanliness of the hospital. She found that the toilets were not cleaned properly and the room hygienewas dismal. She started making regular visits to all the wards and rooms in the hospital to observe andmonitor the employees lacked a human touch. To add to this, the patients also complained that theemployees demanded money for the services. After analyzing the situation, she came to theconclusion that lack of motivation among the class four employees was one of the major factorsresponsible for the pathetic condition prevailing in the hospital. Lack of motivation among the classfour employees was also visible in the form of high employee turnover, work negligence, absenteeismand complaining behaviour. High absenteeism among the class four employees resulted in workoverload for sincere employees, as they were forced to work in the next shift. This was a regularfeature in the hospital as a result of which employees often remained stressed and therefore, lesscommitted towards their work. Although, they were being provided with dinner and snacks at theExamination Paper of Health & Hospital Management8IIBM Institute of Business Managementexpense of the hospital, as a gesture of goodwill for those who worked over time for the hospital. Shealso found that the workers were not reporting for their duty on time, despite their arrival in thehospital on time.The second reason, which she identified for lack of hygienic condition in the hospital was that thevisiting hours for the visitors were not specified, so there was a continuous flow of visitors round theclock, which hampered and affected the cleaning activity of the hospital. It was found that thepatients‟ rooms were always full of visitors who would not mind taking their meals in the room/ward.She felt that there was no solution to visitors‟s problem, as this was an integral part of thepromotional strategy of the management. She also found that the work-instructions given to thehospital-staff was in English language and it was difficult for class four employees to understandthem. Ritu translated all these instructions in Hindi so that class four employees could understand andimplement them.Ritu had the daunting task to reduce the absenteeism and make the employees more committed totheir work and felt that a reward of Rs. 200, if given to an employee who remained present for 31days could perhaps motivate the employee to remain regular at the work place. Further, to motivate toperform, she decided to systematize the performance appraisal system by identifying performers andnon-performers. This being her first job, she was apprehensive about performance appraisal. Theemployees were to be classified into three groups A, B and C, „A‟ was for high performers, „B‟ wasfor average performers and „C‟ was for poor performers. It was decided that the employees in thegrade „A‟ would receive the highest increment followed by „B‟ and „C‟. To make the performanceappraisal objective, she identified various activities on which the employees could be appraised. Tomake the performance appraisal system more objective, a two-tier appraisal system was developed byher. In the first phase, the employees were to be rated regularly on the identified activities by patientsand their attendants. In the second phase, observation of doctors and nurses was to be considered.Although Ritu had full cooperation from the hospital management, yet she was apprehensive aboutthe employee‟ acceptance of the new system. She had to wait and watch.1. Critically evaluate the factors identified by Ritu for enhancing organizational effectiveness?2. Describe a performance appraisal system that you will recommend to Ritu for evaluating theemployees?Caselet 2The management of a hospital, faced with a resource crunch embarked on a cost containmentprogramme. Instructions were issued to various clinical, supportive and utility services to identify theareas where cost containment could be effectively implemented without compromising with thepatient care facilities.The hospital had both the centralized and the decentralised purchasing system. The officer-inchargeof the Emergency Department of the hospital, Dr. Systematic was a qualified and trainedhospital administrator. He systematically commenced analysis of the various activities and proceduresin vogue in the Emergency Department.Dr. Systematic found out that the Emergency Department in addition to the glass syringespurchased 9000 disposable syringes per annum. The interval of ordering was 30 days. The cost ofeach disposable was Rs. 20/-. The ordering cost per order was Rs. 15/- and the carrying cost were15% of the average inventory per year. He calculated the Economic Order Quantity, lot size ofinventory per month, storage cost and other inventory related costs and analysed the optimum intervalof ordering. He forwarded these results along with the other cost containment measures of theEmergency Department to the hospital management. The recommendations of Dr. Systematic wereimplemented and used as a model for other departments of the hospital. Dr. Systematic for effectiveanalysis and appraisal was honoured with the Doctor of the year award by the Hospital Management.Examination Paper of Health & Hospital Management9IIBM Institute of Business Management1. What are the assumptions made by Dr. Systematic for their inventory model?2. Do you recommend any further suggestion for inventory costs in a hospital?END OF SECTION BSection C: Applied Theory (30 marks) This section consists of Applied Theory Questions. Answer all the questions. Each question carries 15 marks. Detailed information should form the part of your answer 1. Write in brief about structure and function of Hospital organization?2. Write down the following terms:1) Labour Relation System.2) Organization of Hospital Workers.END OF SECTION CS-2-300813

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