HPAD 201 Sat July 28 Session 7 Implem

7/31/2019 HPAD 201 Sat July 28 Session 7 Implem

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Health Policy and Administration(HPAd 201)

Implementation as a Management

Function

July 28, Saturday, 3:00 5:00 PM

Auditorium Francisco S. Cruz, MD., MPH.


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Health Policy and Administration(HPAd 201) 7th Session

At the end of the session, thegraduate students should beable to:

1. Discuss the concepts andguidelines in implementationphase of programmanagement;

2. Discuss budgeting andresource mobilization;

3. Discuss supervision andcompetencies of successfulsupervisors/managers and

4. Define Murphys Law, Paretosprinciple and Peter principle;

Session No. 7 Plan3:00 Review of Planning as

Management Function3:20 Concepts and Guidelines in

Implementation Phase of

Program Management3:50 Introduction to Budgetingand Resource Mobilization

4:10 Introduction to supervisorymanagement skills

4:30 Murphys Law, Paretos

principle and Peter principle4:55 Preparing for the next (8 th)session (Monitoring andEvaluation)


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Health Policy and Administration(HPAd 201) Session: Review of 6 th session

Total Quality Management Systems Approach: Inputs-->processes outputs-- outcomes Management Cycle: POSCORBE and PIE (PLAN) A major part of the management cycle (commitment)

A logical sequencing of evidence-based, analytical thinking(process)

A road- map of priorities, strategies, activities, resources andcommitments (document)

Elements: Objectives--->Strategies-->Targets-->Activities Types: Strategic, directional, operational, long-term, medium term Objectives Oriented Project Plan (ZOPP) and LFA DOH KP (strategic medium term plan), PIPH (area-based

operational plan) and LGU scorecard


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Implementation Guidelines:

1.Activities in the work plan are directly relatedto the goals, objectives, or short-term targetsdefined by the annual work plan.

2.Activities are clearly presented.3.Broken down into manageable tasks.4.Activities are presented in chronological

sequence.


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Implementation Guidelines:

5.Work plan shows which activities will becompleted, by whom, and over what period oftime.

6.Activities have been assigned to theappropriate staff members.7.Work plan indicates resource needs and

resource allocations by activity.8.Plan and scope of activities are reasonable

considering time limitations, human resources,and financial resources.


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Budget is the best manifestation of policy!


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7

A formal expression of plans, goals, andobjectives of management that covers allaspects of operations for a designatedtime period.

The common art of allocating resources tovarious users/activities.

Provides control over the immediateenvironment, helps to master the financialaspects of the job and department, and

solves problems before they occur.

Budget


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A budget:

Predicts the contribution to income which will be expected to be generated by each department and each project.Allocates to each department, project or activity an

appropriate share of the of funding in order to enable that income to be generated.It is also a management commitment

institutions socioeconomic policy priorities by

translating policies and commitments into expenditure and revenue.

GKBERK CAN. Budgeting, Financial Planning and Forecasting.


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9


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Budget Process Cyclein NGAs and LGUs

BudgetPreparation

BudgetAuthorization

Only in LGUs,Budget Review by

DBMBudget Execution

Accountability andAudit


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Essential Elements of Budgeting

1. Sources of Funds (Inflows) Government revenue collections (general income taxes, etc.) Fees for services rendered. Specific taxes (products/services liquor/cigarette taxes; flood

tax from movie houses)

Solicitations from assisting agencies. Donations (voluntarily from satisfied patients, philanthropists,

professional groups, etc.)

Investments (marketable securities bonds, time deposits,shares of stocks, etc.)

Sale of properties (land, old functional equipment, condemneditems, scrap/waste materials, etc.)

2. Estimate of future expenditures (Outflows)


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Cost-Based Budgeting versusActivity-Based Budgeting

Resources

Cost objects:products and services

produced, andcustomers served.

Activities

Resources

Forecast of productsand services to be

produced andcustomers served.

Activities

Cost-BasedBudgeting

Activity-BasedBudgeting


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Components of Line-Item Budget

1. Current Operating Expenditures (OperationalExpenditures or Recurrent Expenditures)

Represent the amount of money needed for:

personal services, operation of equipment, acquisition of supplies and materials, maintenance of facilities, etc.,

in order to deliver the services for which the agencyis responsible.It is usually estimated for one-year period.


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Components of Line-Item Budget (2)

2. Capital Outlay (Development Budget,Investment Budget, and Infrastructure Budget)

Refers to appropriations for the purchase of

goods and services of a longer life expectancyextending beyond the calendar year and whichadd to the assets of the government (ororganization)


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1. Top-down approach Upper management prepares budgets and

passes them down to individual departments

2. Bottom-up approach Each department supplies the data and

passes them up to the next level of

management

Approaches to Budgeting


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Supervisor Supervisor

MiddleManagement

Supervisor Supervisor

MiddleManagement

Top Management

Approaches to Budgeting

Top-down approach Bottom-up approach

McGraw-Hill/Irwin


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Work and Financial Plan

GOAL: Reduce EPI diseases in Municipality X by ___%Project Objective: To strengthen the EPI coverage (UCI) particularly in hard to reach barangays of Municipality X.

Component#1: Training of BHW Specific Objective#1: Recruit and train BHWs in conducting/assisting regular and special vaccinations in close coordination with RHU.

Project Activities Expected Output per activityPersons

Responsible

BudgetRequirement

(PhP)

Week 1 Week 2 Week 3 Week 4 Week 5 Week 6Remarks

1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5

1.

2.

3.

4.

Component#2: Cold chain and Logistics

Specific Objective#2: List and procure by RHU all cold chain and logistics requirements of far-flung barangays


Responsible

BudgetRequirement

(PhP)


1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5

1.

2.

3.

4.

Component#3: Project ManagementSpecific Objective#3: Develop and implement the RHU action plan for measles control including conduct of measles outbreak investigation, vaccine efficacy study and firstspecial vaccination.


Responsible

BudgetRequirement

(PhP)


1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5

1.

2.

3.

4.

Form #2: Work and Financial Plan
http://hpad%20201%20session%207/Project%20Planning%20Forms_2011.xlsxhttp://hpad%20201%20session%207/Project%20Planning%20Forms_2011.xlsx


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Supervisory Competencies

Events Manager Be involved in the

conceptualization, preparation,conduct and assessment

Act as floor director with scriptwith events management crew

Physical arrangement (stage,backdrop, sound, lights, AVsystems, seating arrangement,

exhibits, registration,secretariat, documentation),VIP list, emcee & performers

Dry run for big events; call time

Facilitator Emphasis on process and

outputs Encouraging and enabling Always redirects and recaps Good people skills Ensuring active participation of

all avoiding dominance ofcertain participants andunwarranted conflicts

Competence and expertise intopics to be discussed, ITknowledgeable


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Supervisory Competencies

Mentor/Coach Counseling and group

dynamics

Motivation and positivereinforcement Similar to doctor-patient

relationship

Focus on IP medium Effective for

underperformers and staffwith low esteem

Others: Convenor,Chair/CEO, Lead

Investigator Familiar and in rapport

with stakeholders Perceived and actual

authority Consensus builder and

conflict resolutionmanager

Focused and evidence-based


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The Supervisor as a Trainor

Focus demands sacrifice!

Training/information bulls eye: MUST KNOW,NECESSARY TO KNOW AND NICE TO KNOW

Role of Interactive Media and the NET

Learning objectives and behavioral change


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The Supervisor as a Trainor

Major Tasks of a Trainor Development: TNA, course

design and instructionalmaterials development

Execution: Learningmanagement, resourcesmanagement and teammanagement

Evaluation: Reaction, learning,

behavior and results Monitoring: Reports,

observation and coachingSource: Center for Organization

Development, DAP

Facilitating Skills1. Listening and Observing2. Questioning and Attending3. Integrating

The effective facilitator: Guides discussion. Provides the right questions. Enhances two-way

communication. Coordinates learning

activities. Is learner centered.Source: Center for Organization

Development, DAP


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Conference Leadership and Supervision:Supervisory Management Skills

Effective Mid-LevelManagers Skills

1. Planning: forecasting, objectivesetting, programming, schedulingand budgeting;

2. Leading: decision making,motivating, communicating, selectingpeople and developing people;

3. Organizing: establishing policies,establishing relationships, delegatingand administering policies and

4. Controlling: Developingperformance standards, evaluatingresults and taking corrective actions

Source: Supervisory DevelopmentProgram, DOH , 1997.

Inputs toSuccessful Supervisors

1. Good administrative skills2. Adaptability to the situation3. Stability of performance4. High standards of

performance for subordinates5. Emotional support to

subordinates6. Frequent feedback/forward7. Work resiliency8. T.E.A.M.Source: Supervisory Development

Program, DOH , 1997


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Conference Leadership and Supervision:Supervisory Management Skills

Performance Appraisal (PA) Performance assessment of the

quantity and quality of job outputagainst standards

Effective performance appraisal accurately measures currentperformance levels through

observation and identification withmechanisms for reinforcements andfeedback

Effectiveness-based appraisalprovides objective indicators(MBO/MBR) of employeescontribution; what they produce andnot what they do nor how they spendtheir time.

Pitfalls of PA human judgment,inadequate information of rater,ambiguous criteria & format andinflexibility & mismatch

Tips in Giving PerformanceFeedbacks

1. Have mutual trust: confidentiality,fairness and objective;

2. Make discussions lead tosolutions;

3. Observe two-way listening4. Support and enable ratee to

express freely;5. State feelings clearly then move

on!;6. Be descriptive and not judgmental;

7. Be specific about events and time;8. Give feedback as soon asappropriate;

9. Share ideas and informationrather than advice


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Supervisory Management Skills

Control Alter ego to planning;

regulatory in nature within themanagerial system

Dependent on management

style Monitoring, feedback, feed-forward, MIS

Impact on effectiveness andefficiency

Establishing standards,

comparing performance &standards and correctingdeviations

Accountability & Responsibility

Monitoring Process of routine periodic

measurement of program &office inputs, processes andoutputs

Focus on operations Like evaluation, baselines anddocumentation needed

Performance monitoringassesses use of inputs as toapproved budget and schedule

Process monitoring providesfeedback to managementoperational perceptions ofclientele and effectiveness ofcommunication and linkages


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Murphys Law

Origin / History of the Phrase what can go wrong will gowrong

1877 (American Dialect Society) : Alfred Holt reported at ameeting of engineering society anything that can go wrong atsea generally does go wrong

Author Arthur Block of Murphys Law And Other Reasons Why Things go Wrong (1977) attributes the Laws namesake to a1949 event at Edwards Airfore Base, Muroc CA. where Capt.

Edward Murphy, a development engineer from an aircraftlaboratory expressed his frustration at a technician who causedthe errors in his project MX981 aircraft by saying if there is any way of doing it wrong, he will


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Murphys Law

The phrase Murphys Law was coined by Edward Murphyscolleagues in adverse reaction to his excuse of blaming histechnician when his devices failed to perform in his projects

The phrase received public attention when a colleague of Murphy (Dr. Strapp) was asked by journalists how it was that, inhis watch, nobody had been severely injured during rocket tests,he replied: because they always took Murphys Law underconsideration


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Applications of Murphys Law

From the initial public pronouncement in early 1950s MurphysLaw quickly spread to various technical cultures connected toaerospace engineering

Pre-flight checks and counter checks are routine in aviations to

ensure safety In hospitals, checklists are being advocated instead of reliance to

memory, prior to any procedure to ensure patient safety

Awareness that anything that can go wrong will go wrong will make us check and double check our equipments andourselves and have a plan B or contingency for the things thatthat can go wrong


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Pareto Principle

Joseph M Juran Business management thinker

Vilfredo Pareto Italian economist, who observed in 1906 that 80%

of the land in Italy was owned by 20% of thepopulation;

he developed the principle by observing that 20%of the pea pods in his garden contained 80% of the peas

O igi ll th P t P i i l f d t th


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Originally, the Pareto Principle referred to theobservation that 80% of Italys wealth belongedto only 20% of the population. More generally, the Pareto Principle is the

observation (not law) that most things in life arenot distributed evenly . It can mean all of thefollowing things:

20% of the input creates 80% of the result 20% of the workers produce 80% of the result 20% of the customers create 80% of the revenue 20% of the bugs cause 80% of the crashes 20% of the features cause 80% of the usage

And on and on


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Also recognize that the numbers dont have to

be 20% and 80% exactly. The key point isthat most things in life (effort, reward,output) are not distributed evenly somecontribute more than others .

things arent distributed evenly ? The keypoint is that each unit of work (or time)doesnt contribute the same amount.


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So Why Is This Useful? The Pareto Principle helps you realize that the majority of resultscome from a minority of inputs. Knowing this, if

20% of workers contribute 80% of results:Focus on rewarding these employees.20% of bugs contribute 80% of crashes: Focuson fixing these bugs first.20% of customers contribute 80% of revenue:Focus on satisfying these customers.

The examples go on. The point is to realize

that you can often focus your effort on the20% that makes a difference, instead of the80% that doesnt add much.


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Peter Principle

In a hierarchy every employee tendsto rise to their level of

incompetence


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Peter Principle

By Dr Laurence Peter and Raymond Hull in a1969 book The Peter Principle

In a hierarchy, workers are promoted so longas they work competently, sooner or laterthey are promoted to a position to which he isno longer competent and there they remain

unable to get further promotion


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Work is accomplished by those employeeswho have not yet reached their level of incompetence

Everything that works will be usedprogressively in more challenging applicationsuntil it fails


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In an organization

Assessment of a potential of an employee forpromotion is based on the performance of thecurrent jobie they are promoted to the highestlevels of competence after which promotionraises them to incompetence

Incompetence is not necessary as a result thatthe higher position is more difficult, simply that

the job is different from what he previouslyexcelled inrequiring different work skills that hemay not possess


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Eg-chief resident as selected among the fourthyear senior residents based on theoreticalknowledge of cases, work habits and patientcare but fails miserably once appointed aschief resident


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Supervisory Management Skills

Supervisory skills: planning, leading, organizing and controlling Inputs to Successful Supervisors: good administrative skills,

adaptability to the situation, performance stability, high standardsof performance for subordinates, emotional support tosubordinates, frequent feedback/forward and work resiliency

Effective performance appraisal accurately measures currentperformance levels through observation and identification withmechanisms for reinforcements and feedback

Control : alter ego to planning; regulatory in nature within themanagerial system; dependent on management style;accountability & responsibility

Monitoring: process of routine periodic measurement of program& office inputs, processes and outputs; focus on operations


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Summary of Supervisor as Trainor

Focus demands sacrifice: must know/learntraining/information bulls eye

Major tasks of trainor: TNA, course design, conduct

and evaluation An effective manager is a competent trainor. Tailor-fit the course (methods and materials) based

on: traits of learners, tasks to be accomplished,context of training i.e. echo seminars, orientation,number of trainees and available resources i.e. IT.


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Principle of Health AdministrationPreparing for the Next (8th) Session

Reading Materials for August 4, 2012

Any WHO or UNDP or UNFPA article on Monitoring & Evaluation Principles and Practices in Health Administration Volumes I and II

DOH Formula1 Monitoring and Evaluation (will forward more reading materials on first week of August)

HPAD 201 Sat July 28 Session 7 Implem

Documents

Transcript of HPAD 201 Sat July 28 Session 7 Implem