Examination Paper of Health & Hospital Management IIBM Institute of Business Management Examination Paper MM.100 Hospital Administration Section 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. Stars b. Cash cows c. Dogs d. None 2. To improve organizational performance Alfred Sloan introduced 3S term as doctrine of strategy, structure and? a. System b. Solution c. Share d. None 3. Overburdening may occur due to too many group members seeking out an individual for information and assistance, a solution to such problem is_____________ a. Linear organization b. Circular organization c. Elliptical organization d. None 4. 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 level in which managers are informed about the strategy but they are not willing to act is called___________ a. Blind devotion b. Informed scepticism c. Weak consensus d. None 7. OCB stands for Organization citizenship behavior.(T/F) 1 IIBM Institute of Business Management Examination Paper of Health & Hospital Management 8. BPR stands business process re enforcement.(T/F) 9. The best way to avoid conflict and there by preserve relationship with in the health care organization is____________ a. Spiral of silence b. Web of solution c. Web of solution d. None 10. 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 a short note on Quality Assurance in a Hospital? 4. Briefly describe the importance and functions of Housekeeping department in the Hospital? END OF SECTION A Section 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 (Word limit 200 to 250 words). Caselet 1 CULTURAL BELIEFS An organizations culture can be studied at three levels: artefacts, values and assumptions. Artefacts are the organizational structures that are visible to the members of the organization. Values are the strategies, goals and philosophies of the organizations members. The basic, underlying assumptions of group members include taken-for-granted beliefs, perceptions, thoughts and feelings. Even though certain 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 the shared values, norms and rules of behavior of the organizations member. Group norms are sets of shared values that have been valedated through a consensus process. The social validation of group norms arises when certain values are confirmed by the shared experiences of the group and these norms are passed onto new members as being the correct way to do things. This mechanism of embedding and meshing culture is undertaken at an unconscious level in most organizations. 2 IIBM Institute of Business Management Examination Paper of Health & Hospital Management Although culture resides in the minds of the members of the organization, it is transmitted through visible expressions, such as formal and informal routines and everyday rituals of existence undertaken by members of the organization. Over time, shared experiences develop into a set of core values that become embedded in individual and organizational philosophy and ideology that ultimately serves to guide action and behavior. This process is an important mechanism in the transmission of shared professional assumptions, values, artefacts and symbols from the master to the student and in the development of the socialization process that professional clinicians undergo. Therefore, the internal orientation of employees is based primarily on the culture, values, beliefs, ethics and assumptions of the organizations staff; this is particularly evident amongst health service employees, although the orientation may differ between clinicians and non-clinicians. 1. Why according to you Artefacts are essential for the development of an organizations culture? 2. Elaborate the cultural beliefs of your company? Caselet 2 There are many ways of managing change. Few organizational changes are complete failures, and few 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 change is 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 to fecilitate change, to manage the restraining forces, and to drive change through. The change is required to understand change as a phenomenon, identify the key emotional reactions associated with change, such as resistance, and know how to manage change in a positive manner. Kotter contends that 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 is about managing complexity and is often undertaken in order to prevent a more chaotic reality than that presently in force. If change is approached with a certain level of excitement and enthusiasm, it will create opportunities that will make patients lives better. However, change is often introduced without due regard for the realities of individual areas of health care practice. Some managers may not have an insight into the effect of the change on the lives of individuals or realizations that even minor change may have unintended consequences for the individual and the organization. Most resistance to change occurs not because of the proposed change, but as a result of individual perceptions 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 B Section C: Applied Theory (30 marks) 3 IIBM Institute of Business Management Examination Paper of Health & Hospital 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 (Word limit 150 to 200 words). 1. What do you mean by Emergency Department Planning? How would you explain the managerial issues in Emergency department? 2. Write a short note on the following terms: 1) Central Sterile Supply Department (CSSD) 2) Total Quality Management in Health Care 3) Medical Audit and its Administration END OF SECTION C 4 IIBM Institute of Business Management Examination Paper of Health & Hospital Management IIBM Institute of Business Management Examination Paper MM.100 Principles of Hospital Administration and Planning Section 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 other media to which other group member can use is__________ a. Decision matrices b. Multivoting c. Boarding d. Brainstorming 2. A tool for Data collection which summarise perception of a large sample of people is___________ a. Surveys b. Interviews c. Check sheet d. Data sheets 3. Members of Inspection control committee_________ a. Microbiologist, O.T. incharge, Medical Superintendent b. Representative from Nursing Service, CSSD in charge, Representative from major clinical department c. Both (a) & (b) d. None of the above 4. MRD stands for___________ a. Medical Records Department b. Medicine Records Department c. Medicine Release Department d. None of the above 5. Format for appraisal in which rank order is establish of employees based on their relative merit_________ a. Forced Distribution Technique b. Graphic Rating Scale c. Ranking methods d. Free Written Ratings 5 IIBM Institute of Business Management Examination Paper of Health & Hospital Management 6. Analytical technique in Materials Management in which all items in inventory on the basis of annual usuage time cost is________ a. FSN Analysis b. ABC Analysis c. VED Analysis d. None of the above 7. Planning tool used in Quality Management in which the items are written on individual cards and displayed on a flip chart__________ a. Relations Diagram b. Process Decision Program chart c. Affinity Diagram d. Activity Network Diagram 8. Method of filing of Medical records in which involves filing of records in exact chronological order according to unit / serial number___________ a. Middle Digit filing b. Terminal Digit filing c. Straight Numeric filing d. None of the above 9. Type of hospital in which the number of beds is over 300 beds is known as___________ a. Large hospital b. Medium sized hospital c. Small hospital d. None of the above 10. Meeting in hospital whose purpose is to pass on information received from agencies is_________ a. Informative Meeting b. Consultative Meeting c. Executive Meeting d. None of the above Part Two: 1. What are the factors affecting \"Retraining\" in a hospital? 2. Write a 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 A Section B: Caselets (40 marks) 6 IIBM Institute of Business Management Examination Paper of Health & Hospital Management This section consists of Caselets. Answer all the questions. Each caselet carries 20 marks. Detailed information should form the part of your answer (Word limit 200 to 250 words). Caselet 1 Rakesh and Gagan were two brothers who had graduate in Medicine in the year 1979. Both established themselves as successful practitioners. In 1992, they decided to set up their own hospital as both were familiar with the nitty-gritty of the profession after spending a decade as successful practitioners. In the year 1994, the concept was concretized when three floors Arogya Hospital with a bed capacity of 60 came into existence at Gwalior. The facilities provided by the hospital were pathology, X-ray, blood bank and ICU. In the year 1998, the number of beds were increased to 100 with the addition of a fourth floor. In the year 2005, a fifth floor was added and the hospital started offering 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 four employees was to maintain the cleanliness of the hospital. Besides this, they were also entrusted with the task of sponging, bed setting and shifting of the patients. Salary paid to these employees was between Rs. 1200/- to Rs. 1800/- per month. The hospital staff was divided into different classes of employees. Class one comprised of MBBS, MD, MS, and Administrative Officers. Class three comprised 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 ICU and 2 full time in-house surgeons (MS). Besides this, the hospital had 50 visiting doctors who operated on a turnkey basis. These doctors had their own clinics in different parts of the city and as per requirement, they admitted their patents in the hospital. There was a mutual agreement between the doctors and the hospital that the hospital would charge the patients and out of it the doctors would receive their fees along with a percentage from the hospital share. The patients treated by the hospital were 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 for Resident Doctors, Supervisors, Wardboys / Ayabais and Sweeper boys/ bais were prepared by the newly appointed Hospital-Administrator Priya. These instructions were prepared in English and were hung on the walls of the enquiry counter. After a span of one month, Priya resigned from the hospital on account of some personal reasons. By the end of the year 2004, Ritu, a fresh post-graduate in Hospital-Administration from Gwalior, was appointed as an Administrative Officer or take charge of the overall activities of the hospital. Her role was to monitor the activities of employees of class three and four and various other activities related to the functioning of the Hospital. The first task before her was to improve the cleanliness of the hospital. She found that the toilets were not cleaned properly and the room hygiene was dismal. She started making regular visits to all the wards and rooms in the hospital to observe and monitor the employees lacked a human touch. To add to this, the patients also complained that the employees demanded money for the services. After analyzing the situation, she came to the conclusion that lack of motivation among the class four employees was one of the major factors responsible for the pathetic condition prevailing in the hospital. Lack of motivation among the class four employees was also visible in the form of high employee turnover, work negligence, absenteeism and complaining behaviour. High absenteeism among the class four employees resulted in work overload for sincere employees, as they were forced to work in the next shift. This was a regular feature in the hospital as a result of which employees often remained stressed and therefore, less committed towards their work. Although, they were being provided with dinner and snacks at the 7 IIBM Institute of Business Management Examination Paper of Health & Hospital Management expense of the hospital, as a gesture of goodwill for those who worked over time for the hospital. She also found that the workers were not reporting for their duty on time, despite their arrival in the hospital on time. The second reason, which she identified for lack of hygienic condition in the hospital was that the visiting hours for the visitors were not specified, so there was a continuous flow of visitors round the clock, which hampered and affected the cleaning activity of the hospital. It was found that the patients 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 visitorss problem, as this was an integral part of the promotional strategy of the management. She also found that the work-instructions given to the hospital-staff was in English language and it was difficult for class four employees to understand them. Ritu translated all these instructions in Hindi so that class four employees could understand and implement them. Ritu had the daunting task to reduce the absenteeism and make the employees more committed to their work and felt that a reward of Rs. 200, if given to an employee who remained present for 31 days could perhaps motivate the employee to remain regular at the work place. Further, to motivate to perform, she decided to systematize the performance appraisal system by identifying performers and non-performers. This being her first job, she was apprehensive about performance appraisal. The employees were to be classified into three groups A, B and C, A was for high performers, B was for average performers and C was for poor performers. It was decided that the employees in the grade A would receive the highest increment followed by B and C. To make the performance appraisal objective, she identified various activities on which the employees could be appraised. To make the performance appraisal system more objective, a two-tier appraisal system was developed by her. In the first phase, the employees were to be rated regularly on the identified activities by patients and 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 about the 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 the employees? Caselet 2 The management of a hospital, faced with a resource crunch embarked on a cost containment programme. Instructions were issued to various clinical, supportive and utility services to identify the areas where cost containment could be effectively implemented without compromising with the patient care facilities. The hospital had both the centralized and the decentralised purchasing system. The officer-incharge of the Emergency Department of the hospital, Dr. Systematic was a qualified and trained hospital administrator. He systematically commenced analysis of the various activities and procedures in vogue in the Emergency Department. Dr. Systematic found out that the Emergency Department in addition to the glass syringes purchased 9000 disposable syringes per annum. The interval of ordering was 30 days. The cost of each disposable was Rs. 20/-. The ordering cost per order was Rs. 15/- and the carrying cost were 15% of the average inventory per year. He calculated the Economic Order Quantity, lot size of inventory per month, storage cost and other inventory related costs and analysed the optimum interval of ordering. He forwarded these results along with the other cost containment measures of the Emergency Department to the hospital management. The recommendations of Dr. Systematic were implemented and used as a model for other departments of the hospital. Dr. Systematic for effective analysis and appraisal was honoured with the Doctor of the year award by the Hospital Management. 8 IIBM Institute of Business Management Examination Paper of Health & Hospital Management 1. 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 B Section 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 (Word limit 150 to 200 words). 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 C S-2-300813 9 IIBM Institute of Business Management