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Ensuring
better output in hospitals
Dr
M Mariappan -
With the widening role role of health care organisations,
the work method and procedural part are consuming large
manpower right from skilled to unskilled for providing
of better patient care. On the other hand, the output
of the health care organisations cannot be measured
directly and quantitatively. It is important for an
organisation to ensure its resources utilised efficiently
as it is important to measure the productivity of the
manpower required to deliver health care services. As
human sources is vital sources, it is necessary to measure
the work/service provided by individual and group. The
best method which can be applied for this purpose is
the Time and Motion study techniques.
Time
and Motion study
Time and Motion study also called as Work study is preferred
for such job where it is possible to measure the work.
Time study was originally developed by F W Taylor and
motion study was by Gilbreths. Later Time study and
Motion were combined into Time and Motion Study. In
the earlier stage, the time and motion study was applied
to measure work only in engineering and manufacturing
industries. Today the study can be applied to any field.
Definition
Time and Motion study is the systematic study of work
systems with the purposes of u developing the preferred
system and method - usually the one with the lowest
cost; and time u standardizing this system and method
udetermining the time required by a qualified and properly
trained person working at a normal place to do a specific
taste or operation u assisting in training the worker
in the preferred method.
Scope
of the Study
This can be applied in hospitals where the work can
be measured quantitatively. The study can perfectly
fit for laboratory, radiology, (X-ray, ultrasound, ECG,
CT Scan, MRI) radiotherapy, operation theatre, housekeeping,
front office (registration, billing, telephone), nursing
services and outpatient areas.
Advantages
of the Study
-
It helps the hospital management to fix the standard
time for the work for example a technician can perform
how many test in a specified time (standard time)
u The salary/ wages/ incentives can be fixed based
on the outcome of time and motion study. u It helps
the management of unnderstanding the wastage of time,
resources. The management can take necessary steps
to control the cost or cost reduction by techniques.
- It
aids the management to identify the training need
for the employees.
-
By conducting this study one can understand how many
persons are required to carry out a particula job,
or task.
The
method of Study
The study can be carried out by preparing process chart,
which is a chart which is records a process in a compact
manner, as a means of understanding and improving it.
The process chart explains systematically the series
of actions done during the work process and also gives
the information graphically. After the completion of
process chart, one can easily understand how the various
activities were done. Analysing the chart will be knowing
number of activities repeated, the activities taken
more time and cost, and any such activity can be eliminated
so that there can be an The process chart is prepared
based on certain number of symbols i.e. Operation. Transportation,
Inspection, Delay and Storage. Sometimes few \activities
may be combine also.
Operation: An operation represents the real work
that is carried out, mainly the time spent on treatment
to patient directly.
Transportation: The staff move or move certain
object or moving one place to another place, except
when the movement is not part of the operation and inspection.
Inspection: Inspection means a person who examines
the work accuracy or checking the materials required
or checking and comparing with a standard as quantity
or quality.
Delay: There may be some gap between activities
or before performing the next action some delay due
to various reasons.
Storage: Storage occurs when the activity is
stopped and it is not performed. Usually when we carry
out time and motion study in health care industries
we can combine delay and storage into single process.
Represents a combined operation and inspection.
Practical application: An X-ray technician who is getting
ready to take X-ray. We can record what are the activities
he performs during his eight hours duty. Finally, we
get to know, the time spent on each process and ultimately
the quantity, i.e. time spent on taking one X-ray and
total number of X-rays done during the 8 hours work.
Illustration
For completing one x-ray the time spent on Operation
= 7 minutes
Transportation
= 4 minutes
Inspection
= 9 minutes
Delay
= 5 minutes
25 minutes
As per this analysis we can understand the total time
required for doing one x-ray. 25 minutes. This exercise
to be repeated at least three times by different three
separate technicians. After doing this the time spent
by each technician to be analysed among that the least
time can be considered as standard time.
Productivity Analysis
As per standard time fixed by previous exercise every
technician or employee work can be compared with standard.
The person who does the work within the standard time
with required accuracy and quality would be efficient
worker and others employee need to improve their working
practices. It is necessary that standard time to verified
in a regular interval also it helps to identify time
wasted on which aspect then that can be eliminated.
This study can be conducted by a trained person in the
field of time and motion study or a management consultant
or senior most experienced person in the same field.This
type of study is not normally carried out in hospital.
It is necessary the management science techniques be
utilised in health care industries to achieve greater
out with required quality.
(The author is an economist with the department of health
services studies at the Tata Institute of Social Sciences.
He can be contacted at marim@tiss.edu)
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