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Thursday 21 January 2016

IIBM Exam papers: contact us for answers at assignmentssolution@gmail.com


Attempt Only 4 Case Study

CASE – 1    BHEL’S Strategic Intent

Bharat Heavy Electricals Ltd (BHEL) is major Indian public sector enterprise in power, engineering, and manufacturing divisions and centres spread all over the country. It exports to more than 45 countries.

The Vision 2001 statement of BHEL is as below.

MISSION:  To be the leading engineering enterprise providing quality products, systems, and services in the fields of energy, transportation, industry, infrastructure, and other potential areas.

VALUES:
-    meeting commitments made to external and internal customers
-    foster bearing, creativity, and speed of response
-    respect for dignity and potential of individuals
-    loyalty and pride in the company
-    team playing
-    zeal to excel
-    integration and fairness in all matters

BUSINESS MISSION:  To maintain a leading position as suppliers of quality equipment, systems, and services in the field of conversion, transmission, utilisation, and conservation of energy for application in the areas of electric power, transportation, and gas exploration and industries. To utilise company’s capabilities and resources to expand business into allied areas and other priority sectors of the economy like defence, communication, and electronics.

COMPANY OBJECTIVES:
Growth
To ensure a steady growth by enhancing the competitive edge of BHEL in existing business, new areas, and international operations.
Profitability
To provide a reasonable and adequate return on capital employed primarily through improvement in operational efficiency, capacity utilisation, and productivity and generate resources to finance the company’s growth.
Customer
To build a high degree of customer confidence by providing increased value for his money through international standards of product quality, performance, and superior customer service
Technology
To achieve technological excellence in operations by development of indigenous technologies and efficient absorption and adaptation of imported technologies to suit business needs and priorities and provide a competitive advantage to the company.
Image
To fulfill the expectation which stakeholders like government as owner, employees, customers, and the country at large have from BHEL.


Question:-

Analyses the vision statement of BHEL and comment on its positive and negative features.

CASE – 2    The Troubled Soap Opera

Doordarshan (DD) is India’s public service broadcaster (PSB) with 1,000 transmitter covering 90 per cent of the country’s population across an estimated 70 million homes. It has 21,000 employees managing its metro and regional channels.
Recent years have seen growing competition from private channels, now numbering more than 60, and the cable and satellite (C & S) operators. The C&S network reaches nearly 30 million homes and is growing fast.
DD’s business model is based on selling half-hour slots of commercial time to the programme producers and charging them in minimum guarantee. For instance, the present tariff (i.e., in 2001), for the first 26 episodes of a programme, is Rs 42 lakh plus the cost of production of the programme. In exchange, the producer gets 720 seconds of commercial time that he can sell to advertisers and generate revenue. Break-even point for producers, at the present rates, thus is Rs 70,000 for a 10-second spot in order to break-even. It is at this point that advertisers face a problem: the competitive rate for a 10-second spot is Rs 50,000. Producers are cagey about buying commercial time on DD. As a result, DD’s projected revenue growth is just 6 to 15 per cent as against 40 to 50 per cent for the private sector channels. Software suppliers, advertisers, and audiences are deserting DD owing to its unrealistic pricing structure.
Clearly, DD has three options if it is to survive. The first is to privatise and the other is to become a pure PBS. In between is the third option of a middle path.
The SWOT factors of DD, analysed by Business World in its issue of March 19, 201, are as below.

Strengths    Opportunities     Weakness     Threats
?    Its 1,000 transmitters cover90 per cent of the country’s population across an estimated 70 million homes against C & S’s tally of 30 million homes.    ?    Cable distribution along with MTNO and DoT
?    Leasing infrastructure, time blocks to other broadcasters like Channel 9
?    Digital terrestrial transmission
?    Syndicating programming     ?    Too much political interference
?    Muddled programming and commercial strategy
?    Low credibility
?    Gross over-staffing
?    Little stability    ?    Producers and advertisers are deserting DD in droves
?    C & s Continues to attract a larger portion of advertising, and now pay revenues

    Privatisation could fetch the government a tidy sum and solve many of the managerial and operational problems of DD. Yet, no government can be expected to let go the reins of mass media owing to its political ramifications. If DD is to be a pure PSB, then it needs to have just a news-focussed channel letting its metro and regional channels become autonomous entities. The middle path would mean that DD tighten up its management by reducing its bloated workforce, diversifying into other media, creating marketing function, and overhauling its programming function.



    The challenge seems to be to leverage DD’s immense potential and emerge as a formidable player in the mass media in India.

Question: Analyse the SWOT factors and the options before DD. What, in your opinion, is the best strategic alternative before DD? Why do you think the proposed alternative to be the best?

CASE – 3    Managing Cultural Changes at Procter & Gamble

In September 1998, the Procter & Gamble Company, Cincinnati, USA, announced a major global structural change programme, “Organisation 2005”. The mission of the programme was to take P & G’s global turnover from $ 38 billion to $ 70 billion by 2005. The objective was to raise profitability by changing the work culture at P & G. The change drivers identified were the attributes of Stretch, Innovation, and Speed (SIS). The structural changes to be initiated included setting up of four global business units based on product lines, eight market development organisations based on regions, and one global business service centre. A 14-member cross-functional team named as the Culture Team was set up to oversee the management of change.

    The achievements of the Organisation 2005 programme were to be seen in terms of:
1.    changing P & G from being a misaligned organisation to one aligned on common goals, with trust as the foundation
2.    evolve from an intense inspection-led organisation where everything is kept under control to one that is a team-collaborating unit
3.    shift from a risk-avoiding culture to a stretch-taking one
4.    move from running down on complexities to taking on challenges
5.    heave from a slow-moving organisation to one which hurtles through stretch, innovation and speed to breakthrough goals

As the news of Organisation 2005 programme reached the P & G Hygiene and Health Care headquarter at Mumbai, India, there was a lot of apprehension among the employees. Uncertainty and suspicion arose with regard to their own future and related to the continued existence of the business division they worked in. It took about a year for the apprehensions to fade away and be replaced by clarity and confidence.

P & G, India adopted the global motto of SIS of its parent. A cultural team was set up to communicate the goals of SIS to the employees and to seek their involvement in creating a new P & G. The team set out to identify projects to help achieve the goal of SIS and to get employee feedback periodically. Outdoor meetings of all P & G India employees were conducted to drive home the SIS message. Weekly indoor meetings were held both department-wise and across hierarchies and categories. Team members were made responsible for communicating formal and informal feedback to and from their department. Monthly updates and communication through newsletters were extensively used. Reassurance of employees thus became an on-going continual process.

Says a P & G employee: “Initially, when the global changes were announced, we were a little skeptical as to what will be its impact on the Indian operations. Now after so much communication and interaction at all levels, we are confident and look forward to this change.”


Question:
1.    Comment on whether the cultural changes at P & G are supportive of the strategy being implemented.
2.    What, in your opinion, are the chances of the cultural change being successful? What needs to be done additionally to ensure success?



CASE – 4    What do You Know about Knowledge Management

Shailesh Gupta was quite impressed on meeting T Rajashekhar who was a knowledge management consultant. The chance meeting took place after the annual Laghu Udyog Sangh (Small-industries association) function, which Shailesh was attending. Shailesh requested Rajashekhar to find time to visit his factory to which the latter readily agreed.
Shailesh belonged to an old and established business family of Mahanagar where his grandfather had set up a cooking oil business. The business grew and prospered well. Shailesh’s father was prudent enough to provide him with good education. After graduating in commerce, Shailesh was sponsored by the family business to do a year’s management education programme at Manila. On his return, Shailesh was eager to implement new ideas to his family business and to the real estate and construction business that his father had started.
When Rajashekhar arrived at the appointed time, the first question that Shailesh asked him was about his specialization—knowledge management (or KM, as Rajashekhar referred to it). “KM”, said Rajashekhar, “is a fairly new concept in large corporations that are looking to maximise returns by turning all the data available internally into useful and productive information, which can help predict market trends and competitor moves.” Shailesh immediately related this to his own problem of managing the real estate business that was facing intense competition from newer companies that had come up in the last few years. He was eager to know how KM was implemented.
Rajashekhar cautioned by saying “A formal KM system requires a lot of planning and a sound framework in order to be successful. The process involves planning and gathering of data to an organisation available in any form such as text, graphics as well as audio-visual. Once this has been done, the next step is to collate the data in a format that can be catalogued, indexed, filtered, or linked in a manner that makes sense. Then the information has to be refined and projected in a manner that can be easily disseminated throughout the organisation. The purpose is to help managers take better decisions on the basis of the information provided.”
At this point, Shailesh was excited enough to ask why should decision-makers apply KM within their companies. What Rajashekhar told created some apprehension in Shailesh’s mind. He said, “KM is important for organisations—big or small—that strive to achieve competitive advantage. KM enables corporate and market intelligence to be used in strategic planning.” Shailesh was quick to interject with a query about KM’s applicability to a small business like his own. Rajashekhar agreed by saying “KM is easier for large organisations as they already have a network that helps them share information through e-mail, intranet, and the Web. But any committed organisation, even if small, could apply KM if determined to do so.” He continued, “Once a company has a KM process in place, it will be able to empower its employees with information on various aspects of decision-making related to the strategic as well as operational activities.”
The meeting ended but Shailesh kept on thinking about what Rajashekhar had told him about KM. A thought that lingered for long was whether his employees, long used to working in the traditional environment, would readily share information that they had. And whether they would be

willing to adapt to the sophisticated technology involving, what Rajashekhar informed, datamining, intranet, video-conferencing, and webcasting that the KM process was based on.

Question:
How do you respond to Shailesh’s predicament expressed at the end of the case?




CASE – 5   Supply Chain Management at Hindustan Levers

The final year class of MBA students was quite excited on hearing that the head of information systems and the infotech manager (sales and distribution) of Hindustan Lever Limited (HLL) were coming to address them on the application of supply chain management (SCM) at HLL.
The mini auditorium was full when the lecture started. The first thing the managers did was to introduce the company to the audience of students and faculty members of the business school. They also suggested that any one could ask question during the presentation they were going to make.
The head of information systems started by saying “as you must be aware, HLL, subsidiary of Unilever, is India’s largest fast-moving consumer goods (FMCG) company. We are the leaders in home and personal care products, foods and beverages, and specialty chemicals. Armed with a portfolio of 110 brands, HLL’s has a vision to meet everyday needs of people everywhere by anticipating the aspirations of customers and responding creatively and competitively with branded products and services that raise the quality of life.” He went to relate the experience of HLL at restructuring its businesses by informing that HLL initiated Project Millennium focussing on the four areas of growth, knowledge, talent, and cost. On being asked whether that was the first time that HLL was restructuring its businesses, the head of information systems replied that business restructuring is a continual process and HLL invested close to Rs 10 crore over a period of a year on the process itself. The process resulted in HLL moving out of its non-core areas, integration of existing core areas, and exploring new potential areas.
At this point, the infotech manager took over and explained the marketing set up of the company. He said, “Owing to the nature of our business activities, we need to launch several new products every year. Streamlining procurement, operations management, and marketing are mammoth operations. It is here that an operational effectiveness technique like SCM came to our aid. With SCM solutions, we are able to monitor all our production lines and manage existing distribution network to make way for new products.” On being asked to relate how HLL was using information technology (IT), the infotech manager said, “SCM mainly relies on the use of IT. For support, there is a satellite based communication system that offers voice and communication facilities linking over 200 locations all over the country. Other initiatives on the IT front have been taken to support the streamlining of the whole process. E-commerce and B2C portal are used to reduce the inventory levels and the working capital cycle. Continuous innovation in process and product management are the other supporting initiatives.”
Some of the students were interested in knowing the software used by HLL for SCM. To this, the infotech manager said that Mfg Pro, a software similar to Enterprise Resource Planning, was introduced in 1998. With this HLL has been able to reduce the duration of production runs. “Constant monitoring of inventory levels and servicing demand is done so that no bottlenecks hold up the supply lines so crucial to an FMCG company such as ours,” he added.
The students were quite impressed to know that the SCM system links the HLL’s headquarter at Mumbai with its 50 factories, an equal number of depots, and 200 sites. More than 750 of the larger


stockists have also been linked through a TCS EX software package. From the enthusiasm of the infotech manager, the audience could surmise the continual search for a software solution to enable seamless operations of its value chain seemed to be a fetish with HLL.
A young faculty member interjected at this stage to ask about the difficulties faced in SCM implementation is not always smooth. “The process involves changing established ways of working and it could turn out to be quite painful. The success of the SCM system depends on the quality of data provided to it. Training in error-free data logging is essential.” The head of the information systems added, “Then, there is a bigger challenge of decentralisation of decision-making to the shop floor level.

The fear of making mistakes and getting one’s inefficiencies exposed are the behavioural snags that any company implementing SCM has to contend with.” The presentation ended with the head of information systems encouraging the students to learn more about SCM as it offered a viable approach to managing the value chain in an integrated way.

Question

Suppose you were a student at the business school and a member of the audience at the presentation on SCM at HLL. In the business policy the next day, the professor asks anyone to say how SCM is related to business strategy. What would be your reply?


Sunday 3 January 2016

IIBM exam papers: contact us for the answers at assignmentssolution@gmail.com

Examination Paper of Health & Hospital Management
1
IIBM Institute of Business 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)
Examination Paper of Health & Hospital Management
2
IIBM Institute of Business 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  organization‟s  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 organization‟s 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 organization‟s 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.
Examination Paper of Health & Hospital Management
3
IIBM Institute of Business 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 organization‟s 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 organization‟s

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)
Examination Paper of Health & Hospital Management
4
IIBM 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 (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
Examination Paper of Health & Hospital Management
5
IIBM Institute of Business 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 
Examination Paper of Health & Hospital Management
6
IIBM Institute of Business 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)
Examination Paper of Health & Hospital Management
7
IIBM 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 (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
Examination Paper of Health & Hospital Management
8
IIBM Institute of Business 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  visitors‟s  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.
Examination Paper of Health & Hospital Management
9
IIBM Institute of Business 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