CASE STUDY ANSWERS
ASSIGNMENT SOLUTIONS
PROJECT REPORTS AND THESIS
ISBM / IIBMS / IIBM / ISMS / KSBM / NIPM
SMU / SYMBIOSIS / XAVIER / NIRM / PSBM / NSBM / ISM / IGNOU / IICT / ISBS / LPU / ISM&RC/ LPU / NMIMS / ISBS / MANIPAL / GARUDA
MBA -
EMBA - BMS - GDM - MIS -
MIB
DMS - DBM - PGDM - DBM – DBA -
PGDBM
ARAVIND
09901366442 - 09902787224
Examination Paper: Health and Hospital Management
1
IIBM Institute of Business Management
IIBM Institute of Business Management
Examination Paper MM.100
Hospital Administration
Section A: Objective Type (30 marks)
· This section consists of Multiple choices questions & Short notes type questions.
· Answer all the questions.
· Part One questions carries 1 mark each & Part Two questions carry 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 summarize perception of a large sample of people is:
a. Surveys
b. Interviews
c. Check sheet
d. Data sheets
3. Members of Inspection control committee are:
a. Microbiologist, O.T. in charge, 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
Examination Paper: Health and Hospital Management
2
IIBM Institute of Business Management
6. Analytical technique in Materials Management in which all items in inventory on the basis of
annual usage 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. What is the optimum composition of the Drugs and Therapeutics?
3. What do you understand by outdoor patient department?
4. Write down the different members of Appointment committee of the hospital.
END OF SECTION A
Examination Paper: Health and Hospital Management
3
IIBM Institute of Business Management
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 150 to 200 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 was 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 gynecologists of the city, Dr.
Savita and Dr. Manorama. To help the doctors in the treatment of patients, work-instructions for
Resident Doctors, Supervisors, Ward boys / 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 behavior. High absenteeism among the class four employees resulted in work
Examination Paper: Health and Hospital Management
4
IIBM Institute of Business Management
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
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 visitors’ 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.
Questions:
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 decentralized 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
Examination Paper: Health and Hospital Management
5
IIBM Institute of Business Management
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 analyzed 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.
Questions:
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 200 to 250 words).
1. Write in brief about structure and function of Hospital Organization.
2. Write in brief about process of Material Management in a hospital.
END OF SECTION C
Examination Paper: Health and Hospital Management
6
IIBM Institute of Business Management
IIBM Institute of Business Management
Examination Paper MM.100
Principles of Hospital Administration and Planning
Section A: Objective Type (30 marks)
· This section consists of Multiple choices and short notes type questions.
· Answer all the questions.
· Part One questions carry 1 mark each and Part two questions carry 5 marks each.
Part One:
Multiple Choices:
1. Public Health Services are concerned with the:
a. Control of communicable diseases
b. Maternal and child health
c. Occupational health and reduction of health hazards
d. All of the above
2. The service of an OPD is affected by the:
a. System
b. Arrival pattern
c. Appointment System
d. None of the above
3. CSSD stands for:
a. Central Sterile Supply Department
b. Circular Sterile Supply Department
c. Central Site Survey Department
d. All of the above
4. ICU Incharge responsibility should cover:
a. Continuity of care
b. Administrative matters
c. Care and maintenance of equipments
d. All of the above
5. According to which method one nurse is assigned to a group of patient to provide total nursing
care:
a. Functional Assignment Method
b. Team Nursing Method
c. Group Assignment Method
d. Primary Nursing Method
Examination Paper: Health and Hospital Management
7
IIBM Institute of Business Management
6. Break-even point analysis, analyses the relationship between revenue and ______.
a. Variable Cost
b. Expenses
c. Cost
d. Volume
7. MRI stands for:
a. Medical Resonance Imaging
b. Magnetic Resonance Imaging
c. Medical Reasonable Imaging
d. None of the above
8. Ultrasonography waves are mechanical pressures waves whose frequency ranging from:
a. 10-100 MHz
b. 2-50 MHz
c. 100-150 MHz
d. 2-10- MHz
9. The Hospital laboratory works generally falls under the which divisions:
a. Hematology, cytology & Microbiology
b. Clinical Chemistry, Histopathology & Biochemistry
c. Urine and stool analysis
d. All of the above
10. ____________ is a dry type filter with a rigid casing enclosing the full depth of accordion type
filter pleats.
a. OT Suite
b. HEPA filter
c. Cleaner’s closet
d. Electrical outlets
Part Two:
1. What are the importances of Outpatient Services?
2. Define Hospital as a Social System.
3. What are the main functions of the Nursing Services?
4. Explain the classification of Ward Accommodation?
END OF SECTION A
Examination Paper: Health and Hospital Management
8
IIBM Institute of Business Management
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 150 to 200 words).
Caselet 1
Mr. Naveen Desai is the current president of Medicare Memorial Hospital’s board of trustees.
Medicare Memorial is a 200-bed voluntary short-term general hospital serving an area of
approximately 50,000 persons. Mr. Naveen has just begun a meeting with the administrator of the
hospital, Mr. Tarun. The purpose of the meeting is to seek an acceptable solution to an apparent
conflict-of-authority problem within the hospital between Mr. Tarun and the chief of surgery, Dr.
Mathew.
The problem was brought to Mr. Naveen’s attention by Dr. Rajeev. The problem that concerned Dr.
Mathew involved the operating room supervisor, Ms. Meetha. Ms. Meetha schedules the hospital’s
operating suite in accordance with policies that she “believes” to have been established by the
hospital’s administration. One source of irritation to the surgeons is her attitude that maximum
utilization must be made of the hospital’s operating rooms if hospitals cost are to be reduced. She
therefore schedules in such a way that operating room idle time is minimized. Surgeons complain that
the operating schedule often does not permit them sufficient time to complete a surgical procedure in
the manner they think desirable. More often than not, insufficient time is allowed between operations
for effective preparation of the operating room for the next procedure. Such scheduling, the surgical
staff maintains, contributes to low-quality patient care. Furthermore, some of the surgeons have
complained that Ms. Meetha shows favoritism in her scheduling, allowing some doctors ore use of the
operating suite than others.
The situation reached a crisis when Dr. Mathew following an explosive confrontation with s. Meetha
made an appeal to the hospital administrator, who in turn informed Dr. Mathew that discharging
nurses was an administrative prerogative. In effect, Dr. Mathew, was told he did not have authority
over any issue affecting medical practice and good patient care in Medicare Hospital. He considered
this as a medical problem and threatened to take the matter to the hospital’s board of trustees.
As the meeting between Mr. Naveen and Mr. Tarun began, Mr. Tarun explained his position on the
problem. He stressed the point that a hospital administrator is legally responsible for patient care in
the hospital. He also contended that quality patient care cannot be achieved unless the board of
trustees authorized the administrator to make decisions, develop programs, formulate policies and
implement procedures. While listening to Mr. Tarun, Mr. Naveen recalled the position belligerently
taken by Dr. Mathew, who had contended that surgical and medical doctors holding staff privileges at
Medicare would never allow a ‘layman’ to make decisions impinging on medical practice. Dr.
Mathew also had said that Mr. Tarun should be told to restrict his activities to fund raising, financing,
maintenance – administrative problems rather than medical problems. Dr. Mathew had then requested
that Mr. Naveen clarify in a definitive manner the lines of authority at Medicare Memorial.
As Mr. Naveen ended his meeting with Mr. Traun, the severity of the problem was unmistakably
clear to him, but the solution remained quite unclear, Mr. Naveen knew a decision was required – and
soon.
Questions:
1. According to you, what conflict had developed at Medicare Memorial Hospital?
2. What should Mr. Naveen do?
Examination Paper: Health and Hospital Management
9
IIBM Institute of Business Management
Caselet 2
Outpatient service is one of the rapidly growing services of the hospital. Therefore in many instances,
outpatient departments built in the recent past have been found to be too small over the years because
of increasing demands, growth of new specialties and the desirability of carrying out an increasing
range of diagnostic and therapeutic procedures on outpatient basis. The department must, therefore,
be planned for a substantial capacity for growth.
In the general hospital, the outpatient department will consist of general outpatient clinic as well as
specialty clinics, in the form of a polyclinic. The structural requirement of outpatient department
incorporating a polyclinic will depend upon the extent of the services provided. The primary aim
should be to provide large floor areas free of structural members to give the maximum adaptability
for changing requirements.
In many hospitals, poorly planned physical relationship of the OPD are responsible for increasing the
work of staff and causing embarrassment and unnecessary movements for patients. On outpatients
visits, patent flow usually progresses from Enquiry and Registration to Waiting, then to examination
rooms and thereafter to investigation facilities, and lastly the pharmacy. In comparison to the other
departments of the hospital, viz. wards, diagnostic and service departments combined, the percentage
of space occupied by the outpatient department of most existing public hospitals varies from 12 to 18
per cent.
The area required for the outpatient department should be adequate to accommodate the reception and
waiting hall, waiting rooms, registration and outpatient medical records, clinics, toilet facilities and
the injection and dressing room, pharmacy, minor OT and circulation routes. Scales of space for
outpatient department can hardly be standardized in view of the varied requirements and range of
services provided. For planning premises, half square foot for each expected annual outpatient visits
is considered to provide adequate space in case of most general hospitals. A hospital expecting 500
outpatients per day over 300 normal working days in a year would thus require upto 75000 square
feet (6975 sqm) of space for its outpatient department.
Questions:
1. What will be procedures that could be performed on outpatient basis?
2. Outpatient Services is important in Hospitals. Why?
END OF SECTION B
Examination Paper: Health and Hospital Management
10
IIBM Institute of Business Management
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 200 to 250 words).
1. What are the role and functions of an ICU?
2. What are the Ethical and Legal Aspects of Hospital Administration?
END OF SECTION C
S-3-010711
No comments:
Post a Comment