Planning and management

Planning and Management

Dr. Shyamsundar J RaithathaHead, Extension Programmes DepartmentAssistant Professor, Community MedicineH M Patel Center for Medical Care and EducationKaramsad – [email protected]

Outline

Class 1 : Introduction

– What is planning, management, leadership, administration ?

– Planning Cycle

Class 2: Time management

Class 3: Programme Evaluation

Class 1: Introduction

What is Administration, Management, Leadership ?

Planning cycle

Administration

The activities that relate to running a company, institution, or other organization

Implementing decisions/strategies Maintenance – Implementation Used interchangeably with management

Management

Coordination of the efforts of people to accomplish goals and objectives by using available resources efficiently and effectively

Getting things done efficiently Goals are predecided – strategies formed and

identified Used interchangeably with leadership at times

Leadership

Leaders set direction and help themselves and others to do the right thing to move forward through motivation and inspiration

Defining goals Transformation

Example

Leadership Management

Administration

Planning

The process of setting goals, developing strategies, and outlining tasks and schedules to accomplish the goals

First step of management

Planning

Deciding in advance

What to do ?

How to do ?

Who is to do it ?

Planning Cycle

Steps in a planning cycle

Example of a planning cycle for TB

Step 1: Assess needBurden of TB

- Prevalence, Mortality




Step 2: Identify & Prioritise

Treatment of cases


Treatment of cases


Treatment of cases





Treatment of cases


Treatment of cases


Treatment of cases

Step 3: Goals and Objectives

70% Detection rate, 85% cure rate





Treatment of cases


Treatment of cases


Treatment of cases



Step 4: Develop Strategy

DOTS





Treatment of cases


Treatment of cases


Treatment of cases




DOTS

Step 5: Implement

Pilot and scale up





Treatment of cases




DOTS

Step 6: Monitor and Evaluate

Indicators – Detection rate, Cure rate

Step 5: Implement

Pilot and scale up

Goals, Objectives and Targets

Example

An oral cancer prevention and care programme is being implemented in Anand district with the purpose of reducing the burden of oral cancer in the district. Two approaches are followed for achieving the purpose viz. Reducing the tobacco addiction prevalence in the community and early detection of cancer through screening. Several activities will be undertaken as listed below

Education of school children on hazards of tobacco

Creation of tobacco free zones in the community

Providing de-addiction facilities at health centers

Organising screening camps in villages for oral cancer

Providing diagnostic facility through biopsy for those identified as screen positive at the health centers

Helping the patients identified as oral cancer to reach a cancer hospital – Government hospital for poor patients and other hospitals for affording patients

Example: Cancer Programme

Reduce the burden of oral cancer in Anand district

Reducing the prevalence of tobacco addiction Education of school

children on tobacco

Tobacco free zones

De-addiction facilities

Early detection and treatment of cancer

Screening camps for cancer

Biopsy for confirmatory diagnosis at centers

Referral of diagnosed patients to cancer centers

Example: Cancer Programme

Reduce the burden of oral cancer in Anand district

Reducing the prevalence of tobacco addiction Education of school

children on tobacco

Tobacco free zones

De-addiction facilities

Early detection and treatment of cancer

Screening camps for cancer

Biopsy for confirmatory diagnosis at centers

Referral of diagnosed patients to cancer centers

Objective

Objective

Goal

Target

Target

Target

Target

Target

Target

Goals, Objectives and Targets

Goal: Ultimate desired state towards which all objectives and resources are directed

Objective: A planned end-point of all activities

Target: An indicator which describes a specific number of a discrete activity

Time Management

What do you understand by time management ?

What is Time Management ?

Multitasking

Being continuously busy – ensuring every second is used

properly

Working extremely hard

Achieving more in limited amount of time

Using to-do lists

What is Time Management ?

Multitasking

Being continuously busy – ensuring every second is used

properly

Working extremely hard

Achieving more in limited amount of time

Using to-do lists

Time Management

“Working smarter to enhance your effectiveness”

Prioritization – First things first Sharpening the saw

Why time management ?

Limited life time

Many things to achieve

The Last Lecture – Randy Pausch

Prioritization – First Things First

Video




Sharpen the saw

Sharpen the saw

Sharpen the saw

Some homework for you !


Step 1: Take one hour out of your routine and go to place

where you can sit alone and think. It can be a library, your

room, terrace, garden, .. any thing where you can be alone

and talk with your mind and think yourself. Take a

notebook (hard/soft) with you.


Step 2: Imagine that you are celebrating your 71st birthday. You

have invited your friends, family members, relatives, colleagues,

students, teachers, sub-ordinates, etc... all those whom you have

known in the last 70 years. Everybody is happy and wishing you

on your birthday. Now you ask them to say a few words about

yourself – like how you have been with them – a feedback on you,

etc.

--> Now take the notebook and start writing down as to what you

would like them to say about you. What words would you like

them to use for you?

Thank you !

“Imagination is more important than knowledge.”

- Albert Einstein

Programme Evaluation

What is programme evaluation ?

A systematic assessment of the effectiveness of processes and/or outcomes of a program with the intent of furthering its development and improvement





Treatment of cases


Treatment of cases


Treatment of cases




DOTS

Step 5: Implement

Pilot and scale up

Evaluation of health services

Health Programme - <Add images>

Health facility – Hospital / Heath center / clinic

Types of Evaluation

Formative

Summative

Types of Evaluation

Types of Evaluation

Formative: Evaluation is done before the beginning of the programme or during the implementation of the programme to improve the delivery of the programme

– Structure

– Process

Summative: Evaluation is done at the end of the programme to assess the extent to which the programme was effective in achieving its objectives

– Outcome

What is to be evaluated ?

Structure: Facilities, Equipment, Manpower and organisation meet a standard

Example – NABH, NAAC, IPHS

Process - Output

The way in which an activity is being carried out Target achievement

Outcome

– The end result of activities – objectives

Impact

Goal achievement

Programme Indicators

Example – Diagnosis and treatment of malaria by ASHA workers as a part of the Malaria control programme

Output Indicators No. of blood smears collected by ASHA workers

No. of patients administered anti-malarial treatment

Outcome Indicators Percentage of fever cases underwent malaria testing

Percentage of malaria cases received treatment

Impact Indicators Malaria mortality rate

Elements of evaluation

1. Relevance

2. Adequacy

3. Accebility

4. Acceptability

5. Effectiveness

6. Efficiency


1. Relevance – Appropriateness of the service – Whether the service is needed at all from the perspective of location, time and person

Eg: Kala Azar treatment facility may not be required in Gujarat

2. Adequacy - Whether the service is available in adequate quantity

Eg: Vaccine demand of a PHC/SC


3. Accessibility: The extent to which a service is usable.

– Physical – Distance, availability of transport

– Economic – charges

– Cultural – Caste/Language barrier

4. Acceptability:

Eg: Screening for cervical cancer by male doctors


5. Effectiveness – Degree of attainment of the objectives and targets of the programme, service or institution in real life situation

Eg – Cure rate in RNTCP

6. Efficiency – How well are the resources ( money, men, material and time) are utilised to achieve a given effectiveness

– Eg – Cost effectiveness

Methodology of evaluation

Quantitative – Surveys, Experiments, Case Control studies, etc.

Qualitative – Focus Group Discussions, In-depth interviews, observations, etc.

Assignment

What is cost effectiveness analysis ?

What is cost benefit analysis ?

Healthcare

Planning and management