UNIT –I Introduction to

Management
 Administration
• The word ‘administer’ is derived from the
Latin word administere, which means to care
for or to look after people, to manage affairs.
• Administration is basically concerned with the
formulation of the objectives, plans and
policies.
• A good administration in place will ensure the
success of an enterprise.
Broadly speaking, the term administration appears to bear at
least four different meanings or different senses depending
upon the context in which it is used:
As a Discipline: The name of a branch of learning or
intellectual discipline as taught and studied in colleges and
universities.
As a Vocation: Type of work/trade or profession/occupation,
especially one that involves knowledge and training in a
branch of advance learning.
As a Process: The sum total of activities undertaken to
implement Public Policy or policies to produce some
services or goods.
As a Synonym for 'word' Executive or Government: Such other
body of persons in supreme charge of affairs, for example,
Manmohan Singh Administration, Bush Administration, etc.
• According to Theo Haimann, “Administration
means overall determination of policies, setting of
major objectives, the identification of general
purposes, and laying down of broad programmes
and projects”.
• According to Newman “Administration means
guidance, leadership & control of the efforts of the
groups towards some common goals.”
• According to Pfiffner and Presthus (1967)
administration means “An activity or process
mainly concerned with the means for carrying out
prescribed ends.”
• According to Simon, Smithburg, Thompson
(1950) “Administration can be defined as the
activities of groups cooperating to accomplish
common goals”
• Thus, administration can be defined as “the
complete effort of the group to control, guide,
and adapt to accomplish the pre-determined
goals.”
 NATURE OF ADMINISTRATION
• Universal
• Holistic
• Intangible
• Continuous and an Ongoing process
• Based on objectives
• Social and Human
• Dynamic
• Creative and Innovative
 Medical Administration
• Medical administration covers a variety of health care
management jobs in a number of settings, from managing
a clinical department to overseeing a medical practice or
large hospital.
• Many medical personnel serve at the frontline of a health
care organization by directly providing patient care. Other
professionals serve in the background, ensuring that the
organization has the money, equipment, and staff
available every day to remain open and able operate
effectively. These are the medical administrators.
• Medical administrators may also be called health
care managers, health care executives, medical
practice administrators, hospital administrators, and
a number of other terms related to their specialty or
the facility in which they work.
• Medical administrators are called upon to plan,
direct, and coordinate health care delivery. They
may be in charge of specific departments or
services, or they may manage the entire facility or a
health care system.
 Management
• The term ‘management’ has been used in different
ways. Sometimes it refers to the process of planning,
organizing, staffing, directing, coordinating and
controlling, at other times it is used to describe it as a
function of managing people. It is also referred to as a
body of knowledge, a practice and discipline. There
are some who describe management as a technique
of leadership and decision-making while some others
have analyzed management as an economic resource,
a factor of production or a system of authority.
• According to Follett “Management is the art of
getting things done through others.”
• According to J.D. Mooney and A.C. Railey
“Management is the art of directing and inspiring
people.” Management not only directs but motivates
people in the organization for getting their best for
obtaining objectives.
• According to Henry Fayol “To manage is to forecast
and plan, to organize, to command, to co-ordinate,
and to control.” Fayol described management as a
process of five functions such as planning,
organizing, commanding, coordinating and
controlling.
• Management as a process: Management as a process
includes planning, controlling, coordinating, motivating,
and staffing. All these are interrelated sequential
functions. Thus, management is the efforts of the
members of the organization to accomplish the organizer’s
objectives.
• Management as a discipline: As a discipline, management
is a specific branch of knowledge which is studied in
campuses and schools like economics, sociology,
mathematics, political science etc. Experts and researchers
feel that the information gained through this discipline
helps in practical life for better functioning thereby
increasing the scope of management as a discipline.
• Management as a noun: The word management
itself is a noun. There are various kinds of
employees in an organization, where some are
involved in managerial function and some are
involved in operating functions. The individuals who
manage the organization and departments are
called as managers. In the field, as a noun the term
management is used as single name of managers,
board of directors, managing directors,
departmental managers etc.
• Thus, management involves conceiving,
initiating and bringing together the various
elements; coordinating, integrating the
diverse components in the organization while
sustaining the feasibility of the organization
towards some pre-determined goals.
Therefore, it is an art of getting things done
through & with the people in formally
organized groups.
 Objectives of Management
• Proper Utilization of Resources: The main
objective of management is to use the
available resources of the enterprise in a most
economical way. The proper use of human and
material resources will help a business to earn
profits to satisfy various interests.
• Improving Performance: Management should
aim at improving the performance of each and
every factor of production.
• Mobilizing Best Talent: The management
should employ persons in various fields so that
better results are possible. The better pay
scales, proper facilities, future growth plans will
attract more people in joining the organization.
• Planning for Future: The management should
not feel satisfied with today’s work if it has not
planned for its future. The future performance
should depend upon the present planning.
Thus, planning for future is essential to help the
organization grow.
 Difference between Mgmt & Admn
Areas Administration Management
Organization Level Top level Middle & Lower
Major focus Policy formulation Policy execution for
& objective objective
determination achievement
Nature of functions Determinative Executive
Scope of functions Broad & conceptual Narrow &
conceptual
Factors affecting Mostly external Mostly internal
decisions (pubic opinion and (objectives & policy
external forces) of organization)
 Contd…

Areas of diff. Administration Management

Skills required Conceptual and Technical and
human skills human skills

Usages Largely in public & Largely in private &

govt. sector business sector

Examples Vice Chancellor, CEO, Managing

Registrar, Governor, Director, Sales
Commissioner , Manager, Branch
etc. Manager, etc.
 Medical Care
• Medical care is a programme of services that
should make available to the individual, and
thereby to the community, all facilities of medical
and allied services necessary to promote and
maintain health of mind and body. This
programme should take into account the physical,
social and family environment, with a view to the
prevention of disease, the restoration of health
and the alleviation of disability. —WHO, 1959
 Hospital
• A Hospital is an integral part of a Social and
Medical organisation, the function of which is
to provide for the population complete health
care, both curative and preventive, and whose
outpatient services reach out to the family and
its home environment; the hospital is also a
centre for the training of health workers and
biosocial research.
—WHO definition of Hospital
• A hospital is a system with various
components that are integrated by a common
purpose of achieving a set of objectives.
• The performance of all these services is
dependent on the cooperation and coordination
of various components within the system.
• Individual sub-systems have independent goals
for providing the best patient care.
• It can be inferred that hospitals are highly
complex, social, economic and scientific
organisations whose function is to provide
comprehensive health care services.
• This explains the need for the sound
management of a hospital. It is the
management that helps in managing the
functioning of the hospital or a health unit. It
integrates various departments of a health
care unit, like clinical, non-clinical and
supporting departments.
 THE CHANGING ROLE OF HOSPITALS
role of hospital has changed, with the emphasis shifting
from:
i. acute to chronic illness
ii. curative to preventive medicine
iii. restorative to comprehensive medicine
iv. inpatient care to outpatient and home care
v. individual orientation to community orientation
vi. isolated function to area-wise or regional function
vii. tertiary and secondary to primary health care
viii.episodic care to total care.
 HOSPITAL VIEWED AS A SYSTEM
• Management science defines a system as “a
collection of component subsystem which,
operating together, perform a set of operations in
accomplishment of defined objectives.”
• A system is viewed as anything formed of parts
placed together or adjusted into a cohesive
whole. Every system is therefore a part of a large
system and has its own subsystem.
• In spite of the simple definition of a system, a
hospital system is more than the sum of its
parts. The peculiarities of a hospital system
are as follows.
– A hospital is a open system which interacts with its
environment.
– Although a system generally has boundary, the
boundaries separating the hospital system from
other social systems are not clear but rather fuzzy.
– A system must produce enough outputs through
use of inputs. But the output of a hospital system
is not clearly measurable.
• A hospital system has to be in a dynamic equilibrium with
the wider social system.
• A hospital system is not an end in itself. It must function, as
a part of the larger health care system.
• A hospital system like other open social systems tends
towards elaboration and differentiation, i.e. as it grows, the
hospital system tends to become more specialised in its
elements and elaborate in structure, manifesting in the
creation of more and more specialised departments,
acquisition of new technology, expansion of the “product
lines” and scope of services.
 Functions of a hospital
• Restorative
• Preventive
• training and research in health and medicine
 Restorative functions
• Diagnostic activity; It includes inpatient services,
involving medical, surgical and other specialties, and
specific diagnostic procedures.
• Curative activity; It involves the treatment of all
ailments or diseases.
• Rehabilitative activity; It includes physical, mental and
social rehabilitation.
• Emergency services; It comprises providing emergency
services required for dealing with accidents, natural
disasters, epidemics, etc.
 Preventive functions
• supervision of pregnancies and childbirth
• supervision of normal growth and
development of children
• control of communicable diseases
• prevention of prolonged illness
• provision of health education services
• occupational health services
• preventive health check-up
 Training and research activities
• Training activities of a hospital, generally, refer to
the training of medical, paramedical and other
support staff (clinical or non-clinical) required and
working in the facility. Training is, generally,
provided to:
– medical undergraduates
– nurses and midwives
– specialists and postgraduates
– medical social workers
– paramedical staff
• The research activities carried out by hospitals
are for the enhancement of medical
technology and services in the following areas:
– physical, psychological and social aspects of health
and diseases
– clinical medicine
– hospital practices and administration
 Classification of Hospital
1. Basing on Objective
a. General hospitals
b. Special hospitals
c. Teaching cum
2. Basing onResearch
Administration, ownership, control or financial income
a. Hospital
Governmental or public
b. Non-governmental or private
c. Semi Govt Hospital
d. Voluntary Agency Hospitals
3. Basing on Length of Stay
a. Short-term or short-stay hospitals (Stay less than 30 days)
b. Long-term or long-stay hospitals: (Stay more than 30 days)
4. Depending on Type of Medical Staff
a. Closed-staff hospital:
b. Open-staff hospital:
5. Basing on bed capacity (Size)
a. Small hospital (Upto 100 beds)
b. Medium hospital (More than 100 to less than 300 beds)
c. Large hospital (More than 300 beds)
6. Basing on type of care:
a. Primary Care
b. Secondary Care
c. Tertiary Care
7. By teaching affiliation:
a. Teaching hospital
b. Non-teaching hospital
8. Basing on system of medicine
a. Allopathic hospital
b. Ayurvedic hospital
c. Homeopathic hospital
d. Unani hospital
e. Hospitals of other
system of medicine
9. Basing on regionality
a. Regional
b. District
c. Upazila
d.Union Health
Health and Family Welfare
CentresComplex
e. Community Clinics
10. As per WHO Classification:
a. Regional Hospital
b. Intermediate/ District Hospital
c. Rural Hospital
General hospitals:
General Hospitals are meant to provide wide-range of various types of
healthcare, but with limited capacity. They care for patients with
various-disease conditions for both sexes to all ages, medical, surgical,
paediatrics, obstetrics, eye and ear etc. Usually, General hospitals are
devoid of super-specialist medical care.

Special hospitals:
They limit their service to a particular condition, orthopedics,
maternity, paediatrics, geriatrics, oncology etc.

Teaching cum Research Hospital:

College is attached for medical/ nursing/ dental/ pharmacy education.
Main objective is to provide medical care, teaching and research is
secondary
Governmental or public hospital: They are owned,
administered and controlled by the government. They
provide free care for patients. The governmental
hospitals are owned by:
• The Ministry of Health.
• The University
• Others.
A public hospital or government hospital is a hospital
which is owned by a government and receives
government funding. In some countries, this type of
hospital provides medical care free of charge, the cost of
which is covered by government reimbursement.
In Australia, public hospitals are operated and funded by
each individual state's health department. The federal
government also contributes funding.
Private Hospital:
Privately owned or controlled by an individual or group of
physicians or citizens or by private organization. eg, Square
Hospital.
Purpose is to provide services for profit making.

Semi Govt Hospital:

Hospitals run both by the govt and private entity. eg Cantt Board
Hospital.
Corporate Hospital
Hospitals which are public limited companies
formed under the companies act. Run on
commercial lines. eg, Apollo

Voluntary Agency Hospital: Not for profit

hospitals by the Voluntary Organizations. eg,
HOPE Foundation Fistula Hospital
Short-term or short-stay hospitals:
These are hospitals where over 90% of all patients admitted stay
less than 30 days.
Long-term or long-stay hospitals:
These are hospitals where over 90% of all patients admitted stay
30 days or more, i.e. mental hospital.

Closed-staff hospital:
Physicians are held responsible for all medical activities in the
hospital including the diagnosis and treatment of patient fee
paying and emergency.
Open-staff hospital:
This type of hospital permits other physicians in the community
to admit and treat patients to the hospital' and treat them.
Open Staff Hospital: Open medical staff, which
means any physician can request to practice at
the facility, regardless of their hospital
affiliation.

Close Staff Hospital: A closed hospital system is

one in which all doctors are on staff, and also
doctors that aren't on staff may not have access
or privileges at said hospital.
 According to Level of Care:
Primary Care Hospital
Primary care is the day-to-day healthcare given by
a health care provider. Typically this provider acts as
the first contact and principal point of continuing
care for patients within a healthcare system, and
coordinates other specialist care that the patient
may need.
Provides mostly basic health care. It is generally
regarded as the ‘gateway’ to receiving more
specialist care.
eg, Upazila Health Complex
These are usually 50-200 bedded hospitals.
This also includes Divisional and National Level Hospitals
 WHO Classification (Expert Committee 1957)
Regional Hospital:
Provides complex range of treatment and highly specialized services.
Serves a larger area than a localhospital. Example- Govt
Medical College Hospital

Intermediate/ District Hospital:

A district hospital typically is the major health care facility in its locality
(For Bangladesh in a district level). Specialty services in major
disciplines (eg, Medicne, Surgery, Gynae etc)

Rural Hospital:
Remote hospitals with small number of beds and limited service
capacity. It should have 20-100 beds. Upazila Health Complex in
Bangladesh