ICU & CRITICAL CARE

UNIT MANAGEMENT:Time, Material & Personnel

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Factors affecting CCU management

1. Knowledge of all duties and activities to be conducted in the unit 2. A planned programme for each days work 3. Starting the work on time 4. Prevention of interruptions 5. Establishment of ward routine (Establish Check list) 6. Use democratic methods in establishment of ward routines 7. Orientation of new staff members- to the routine 8. Maintenance of a suitable environment
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Factors affecting CCU management

9. Provide equipments and supplies necessary for the smooth running of the unit 10. Clear cut standing orders 11. Maintenance of accurate record and reporting 12. Maintenance of high employee morale among all workers of the ward 13. Establishment of good working relationship with all employees 14. Proper delegation of responsibility 15. Well planned assignments 16. Good teaching and supervision
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Materials Management

Materials Management
It is concerned with providing the drugs, supplies and equipment needed by health care personnel to deliver health care service. The right drugs, supplies and equipments must be at the right place, at the right time and in the right quantity in order that health personnel deliver health services. Without proper material, health personnel cannot work effectively, they feel frustrated and the community lacks confidence in the health care service
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Definition
It is concerned with planning, organizing and controlling the flow of materials from their initial purchase to the service point through distribution. OR

Material management is a scientific technique,

concerned with Planning, Organizing &Control of flow of materials, from their initial purchase to destination.

AIM OF MATERIAL MANAGEMENT

To get 1. The Right quality 2. Right quantity of supplies 3. At the Right time 4. At the Right place 5. For the Right cost

PURPOSE OF MATERIAL MANAGEMENT

To gain economy in purchasing
To satisfy the replenishment To carry reserve stock to avoid stock out To stabilize fluctuations in consumption demand during period of

To provide reasonable level of client services

Basic principles of material management

1. Effective management & supervision
It depends on managerial functions of Planning, Organizing, Staffing, Directing, Controlling, Reporting & Budgeting

2. Sound purchasing methods 3.Skillful negotiations 4.Effective purchase system 5.Should be simple 6.Must not increase other costs 7.Simple inventory control programme

Materials Management- Procedures

1. Taking inventory regularly and systematically 2. Requisitioning / indenting according to actual needs 3. Receiving and inspecting incoming items 4. Storing and protecting items 5. Issuing items for use 6. Proper use of items

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Elements of material management

1. Demand estimation 2. Procurement

3. Receipt and inspection

4. Storage 5. Issue and use 6. Maintenance and repair 7. Disposal

8. Accounting and information system

Demand estimation
It should be done keeping in view the trends in consumption pattern over the last 2-3 yrs, objectives of the organization, changing clientele and changing emphasis on various programmes and activities in the health field.

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Procurement
Procurement can be defined as the purchase of services at the optimum possible lowest cost in the correct amount and quality. Organizations like Directorate General Of Supply & Disposal (DGS & D, Govt. Of India] plays a major role in purchase which involve heavy cost. Many states have Medical stores depot (M. S.D. Government

of India, Ministry of H & FW] which are centralized

agencies of procurement and stocking of medical stores
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Contractual services offered by DGSD

Normally 3 types of contractual services offered by DGSD . These are: Fixed quantity contract: This type of contract is generally entered into where firms are called upon to offer to supply a definite number of / quantity of stores by a specific date. Running contract: these are contracts for the supply of an approximate quantity of stores at a specific price during a certain period of time Rate contract: the firms are asked to supply stores at specific rate during the specific period covered by the contract.
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Objectives of procurement system

Acquire needed supplies as inexpensively as possible Obtain high quality supplies Assure prompt & dependable delivery Optimize inventory management through

scientific procurement procedures

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Receipt and inspection

The stores ordered are received in the store A reasonably sound policy of inspection of incoming stores is essential element of material management The policy should enumerate the sampling

procedure for inspection The lot thus picked by random sampling method be subjected to physical and chemical inspection
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Storage
Store must be of adequate space
Materials must be stored in an appropriate place in

a correct way
Group wise & alphabetical arrangement helps in

identification & retrieval

First-in, first-out principle to be followed Monitor expiry date

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Issue & use

Can be centralized or decentralized

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EQUIPMENT MAINTENANCE & CONDEMNATION

Purchase with warranty & spares. Safeguard the electronic equipments with: (as per

guidelines)
Voltage stabilizer, UPS Automatic switch over generator Well equipped maintenance cell must be available All equipment must be operated as per instructions with

trained staff

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CONDEMNATION & DISPOSAL

Criteria for condemnation: The equipment has become:
1. Non-functional & beyond economical repair

2. Non-functional & obsolete 3. Functional, but obsolete 4. Functional, but hazardous

5. Functional, but no longer required

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DISPOSAL
1. Circulate to other units, where it is needed 2. Return to the vendor, if willing to accept 3. Sell to agencies, scrap dealers, etc 4. Auction 5. Local destruction

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Inventory control
It means stocking adequate number and kind of stores, so that the materials are available whenever required and wherever required. Scientific inventory control results in optimal balance

Techniques in Inventory Control

1. ABC Analysis (Always Better Control) 2. VED Analysis (Vital, Essential, Desirable) 3. HML Analysis (High, Medium, Low) 4. FSN Analysis (Fast, Slow moving and Nonmoving) 5. SDE Analysis (Scarce, Difficult, Easy)

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ABC ANALYSIS (ABC = Always Better Control) This is based on cost criteria.
ABC
A N A L Y S I S
ITEM %
10 %
ITEM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 ANNUAL COST [Rs.] 90000 50000 20000 7500 7500 5000 4500 4000 2750 1750 1500 1500 500 500 500 500 500 500 500 500 CUMMULATIVE COST [Rs.] 90000 140000 160000 167500 175000 180000 184500 188500 191250 193000 194500 196000 196500 197000 197500 198000 198500 199000 199500 200000 10 % COST %

70 %

20 %

20 %

70 %

WORK SHEET

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A ITEMS
Small in number, but consume large amount of resources Must have:
Tight control Rigid estimate of requirements Strict & closer watch Low safety stocks Managed by top management

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B ITEM
Intermediate

Must have:
Moderate control Purchase based on rigid requirements Reasonably strict watch & control Moderate safety stocks Managed by middle level management

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C ITEMS Larger in number, but consume lesser amount of resources Must have:
Ordinary control measures Purchase based on usage estimates High safety stocks ABC analysis does not stress on items those are less costly but may be vital

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VED ANALYSIS
Based on critical value & shortage cost of an item It is a subjective analysis. Items are classified into: Vital: Shortage cannot be tolerated. Essential: Shortage can be tolerated for a short period. Desirable: Shortage will not adversely affect

V A B C AV BV CV

E AE BE CE

D AD BD CD CATEGORY 1 CATEGORY 2 CATEGORY 3

ITEM 10 20 70

COST 70% 20% 10%

CATEGORY 1 - NEEDS CLOSE MONITORING & CONTROL CATEGORY 2 - MODERATE CONTROL. CATEGORY 3 - NO NEED FOR CONTROL

SDE ANALYIS

Based on availability
Scarce Managed by top level management Maintain big safety stocks Difficult Maintain sufficient safety stocks Easily available

Minimum safety stocks

FSN ANALYSIS Based on utilization.

Fast moving.
Slow moving. Non-moving. Non-moving items must be periodically reviewed to prevent expiry & obsolescence

HML ANALYSIS

Based on cost per unit

Highest

Medium
Low This is used to keep control over consumption at departmental level for deciding the frequency of physical verification.

CONCLUSION

Material management is an important management tool which will be very useful in getting the right quality & right quantity of supplies at right time, having good inventory control & adopting sound methods of condemnation & disposal will improve the efficiency of the organization & also make the working atmosphere healthy any type of organization, whether it is Private, Government ,Small organization, Big organization and Household.

Even a common man must know the basics of material management so that he can get the best of the available resources and make it a habit to adopt the principles of material management in all our daily activities

TIME MANAGEMENT

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Introduction
It means doing better investment of time or making maximum use of time. Time is

precious, once it is gone, it is gone for

ever It cant be stored..

Objectives/ Principle
1. Adequately staff the ward through out 24 hours 2. Provide best possible professional

experience for each staff member

3. Provide best student experience

4. Promote
satisfaction

good

relationship

and

job
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Distribution of staff for 24 hours

Provide better nursing care through out the day by distributing the time properly. 3 steps in planning this distribution in order

that the ward will well covered are as follows:

1. Analyze activities that normally occur in 24 hour

period including the type and number of nursing

treatment measures 2. Estimate the type and number of personnel needed at various times of day. Nursing load may be heavy in the morning and is light ion the evening
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Distribution of staff for 24 hours

3. Estimate total number of nurses and aids needed to
perform the ward activities and permit off duty according to hospital policy. Plan the duty in advance Plan for orientation programme for staff and students Rotate staff evenly with all shift Over and under staffing should be avoided
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Best professional experience

All staff should have enough opportunity to work in each shift in order to get adequate experience in each shift. Duty changes should be given every 6 months in one year. Staff should be send to refreshment courses in

order to update their knowledge

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Provide student experience

Give ample opportunity for student experience. Students should never be substituted as staff. Assign a single staff for student experience. So that they can assign different student in different function based on their objective.

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Time Wasting Culprits

Telephone Interruptions Inefficient Delegation Extended Lunches or Breaks Cluttered Work Space Misfiled Information Poor Planning Waiting/Delays Paperwork

How to Use Time Effectively

Consolidate Similar Tasks. Tackle Tough Jobs First. Delegate And Develop Others.

Learn To Use Idle Time.

Get Control Of The Paper Flow. Avoid The Cluttered Desk

How to Use Time Effectively

Get Started Immediately On Important

Tasks.
Reduce Meeting Time. Take Time To Plan. Learn To Say No.

PERSONNEL MANAGEMENT

"Take away my factories, but leave my people, and soon we will have a new and better factory."

Andrew Carnegie, the American steel billionaire

Introduction
Personnel management is concerned with the management of human resources of an

organization.
It is the process of developing applying

and evaluating policies, procedures methods and

programmes relating to individuals in an organization for achievement of organizational goal in the desired manner.
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What is Personnel management ????

Personnel management is the effective use of human resources in order to enhance organizational performance. Objectives: Maximize the return on investment from the organization's human capital and minimize financial risk. To align the capabilities and behaviors of employees with the short-term and long-term goals of the retail firm.

Definition
Personnel management is the responsibility of all those who manage people as well as being a description of the work of those who are employed as specialists. It is that part of management which is concerned with people at work and with their relationship with in an enterprise. It applies not only to industry and commerce but to all fields of employment -International Institute Of Personnel Management

Major Areas of personnel management

Recruiting

Selecting Training
Motivation Evaluation Compensation

Recruiting & Selecting

Process of locating, identifying, and attracting capable candidates.

Can be for current or future needs. What sources do we use for recruitment????

Recruiting & Selecting

The process of assessing candidates and appointing a post holder. Method of Selection 1. Preliminary interview 2. Application blank

3. Employment test
4. Employment interview 5. Physical examination 6. References 7. Final Approval

Training
Training tends to be done for current job. Aims to improve efficiency. Keeps the employee up to date with changes in the field Can be external or in-house.

Motivation

Motivating employees to perform up to their potential is the key

to maintaining a productive, successful business.

Ways in which you can motivate employees Interact - Talk to your employees regularly. Recognition & Appreciation - A job well done should be

appreciated and encouraged.

Pay them Right - Pay employees for what they are worth and they will be happy to work. New challenges - Give employees new and interesting challenges to keep them stimulated and learning.

Evaluation
Establishing performance standards and reviewing the performance. Means to ensure organizational goals are being met. To identify employees who are performing well and those who arent.

Compensation
Compensation can be Commission, Bonus and stock options.

Commission is a compensation based on

fixed formula for sales. Bonus is periodical compensation based on the stores performance during that period. Stock options -employees are encouraged to buy shares of their company at discounted prices

Functions of personnel management

1. Planning manpower recruitment 2. Organizing manpower resources 3. Staffing 4. Motivating

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Functions of personnel management

1. Planning manpower recruitment
1. Function: Anticipating vacancies Objective: to anticipate and provide for future openings Operations:

2. 3. 4.

Anticipating death, dismissals, retirements and resignations Anticipating future promotions Anticipating future transfers Estimating future vacancies from the above causes Estimating additional future positions

Organizing manpower resources Staffing motivating

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Functions of personnel management

1. Planning manpower recruitment
1. Function: Anticipating vacancies

2. Function: Recruitment

Objective:

to

seek

and

attract

qualified

applicants to fill vacancies

Operations:
1. Preparing job analysis

2. Preparing job specification

3. Analysing the sources of potential employees 4. Attracting potential employees
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Functions of personnel management

1. Planning manpower recruitment

2. Organizing manpower resources

1. Function: Organizational planning Objective: to determine the organizational structure and manpower needed to effectively meet the organizational objectives Operations: Analysing organizational structure Forecasting manpower requirements Recommending organizational changes Analysing key position requirements 2.Function: Selection 3.Function: Classification of employees

Functions of personnel management

1. 2. Planning manpower recruitment Organizing manpower resources
1. Function: Organizational planning

2. Function: Selection Objective: to analyse applicants qualification for determining the suitability Operations: (Discussed earlier) 3.Function: Classification of employees Objective: to assign officially each employee to an appropriate position Operations:

Preparing job descriptions

Assigning of proper title to each position Reviewing periodically the correctness of job descriptions

Functions of personnel management

1. Planning manpower recruitment
2. Organizing manpower resources 3. Staffing 1.Function: Induction 2.Function: Transfer and promotion 3.Function: Manpower development 4.Function: Training

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Functions of personnel management

1. 2. Planning manpower recruitment Organizing manpower resources

3. Staffing
1. Function: Induction Objective: to ensure that new recruits are provided with appropriate training and information to enable them to perform their duties effectively Operations: 1. Orientation of new employees 2. Ensuring training requirements 3. Provide facility for future education and development
2.Function: Transfer and promotion 3.Function: Manpower development 4.Function: Training
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Functions of personnel management

1. 2. 3. Planning manpower recruitment Organizing manpower resources Staffing

4. Motivating
Function: Rate determination Objective : To set rupee value on job positions that are fair and equitable

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