Illustrate the Meaning and significance of Healthcare Administration and the factors influencing it. ANSWER -

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HEALTHCARE MANAGEMENT
Questions(4X 10=40)
1. Illustrate the Meaning and significance of Healthcare Administration
and the factors influencing it.
2. Healthcare Administration is a Science and an Art. Comment.
3. Describe the various principles and objectives of a Healthcare
Administration.
4. Healthy Environment is an important aspect as a concern for the
Healthcare. How would you address this issue effectively?
Case Study.( 2x 20=40)
Case No 1
Implementing an Integrated Human Resources System: Recognizing
that the manager/employee relationship is key in creating a great place
to work, the group XYZ has devoted a great deal of time and energy to
redefining managers' roles in the organization in an effort to improve that
relationship. It has stressed the importance of an integrated Human
Resources System, where the key human resources functions of
selection, appraisal, reward, development, organizational development,
communication, and employee relations must be closely inter-related and
mutually supportive and where the manager must play a key role. This
has been a driving force in the implementation of several key initiatives.
AN ISO 9001 : 2008 CERTIFIED INTERNATIONAL B-SCHOOL
In addition, XYZ conducted a workplace culture assessment and
integrated the results from that survey into those same initiatives. The
survey used was the Competing Values Model survey. The results of that
survey yielded four imperatives: they are - increase the level of
accountability to get things done; continue to enhance collaboration
throughout the organization; decrease the amount of bureaucracy; and
increase the amount of innovation and risk-taking.
Several initiatives were launched to accomplish the above objectives. The
first was re-designing the performance management process. XYZ
transitioned from a once-a-year performance review document to a yearround,
two-way communication process that emphasizes performance
improvement and individual development. To begin the process,
managers met with their employees to collaboratively set performance
expectations, the aim being to be as specific and measurable as possible.
Managers now meet at least twice each year to discuss performance.
Ratings were removed from the performance review document to
facilitate discussions that were more qualitative in nature and that
focused on feedback and coaching. In addition, considerable time is
devoted to creating and discussing individual development plans that
emphasize professional and personal growth. These changes in the
performance management process allow for more interaction between an
employee and his/her manager to discuss issues that are most important
to the employee. Communication and trust are enhanced as a result.
Because organization improvement is based on the quality of the
managers and their relationships with their employees, the second
initiative was created: to develop a robust management development
curriculum. This curriculum was closely linked to the culture survey so
that the culture imperatives are reinforced throughout the year. New
managers to the organization attend monthly development sessions that
range from half days to full days in order to become acculturated to XYZ¡¦s
way of managing. Experienced managers are able to choose from a menu
of learning opportunities that best fit their development needs and their
learning styles.
Finally, efforts to lessen the amount of control and bureaucracy have
begun which ultimately transitions more decision-making ability to the
managers and further reinforces their ability to make decisions that are in
the best interest of their own employees. Human Resources recognized
that to give managers the level of control necessary to affect the changes
desired, a close examination of the policies and procedures needed to
take place with the goal of eliminating unnecessary controls or increasing
manager discretion/input wherever possible. For example, managers are
now collaborating with Human Resources to a much greater extent to
decide pay issues as opposed to relying on decisions based, in large part,
on system-wide HR policies/guidelines.
Workforce Problem the Program/Initiative Was Designed to
Address
„h How to best engage the workforce to achieve the mission and vision
„h How to recruit and retain the best employees
„h How to create a great place to work
Major Objectives
„h Implement an Integrated HR System approach
„h Redefine the managers' role in the organization to devote increased
time and energy to managing their Human Resources
„h Develop managers so that they can fulfill their critical role in
creating a great place to work
„h Transition to a true Performance Management process to engage the
workforce so that it can achieve its strategic vision
Significant Results
„h Executives and managers are clear about the organizational culture
and in agreement with where it is headed.
„h An entirely new performance management process was created, and
all managers were trained in the process.
„h Employee opinion survey results have improved, and in some areas
the organization is approaching world-class benchmarks.
Limitations or Problems Encountered
„h The program takes time. It is difficult in complex organizations with
multiple sub-entities, and it takes a lot of time to see results.
„h The health system has limited resources and had to do much of the
work itself.
„h It is difficult for some to understand that this is a long-term effort,
and when people already have projects on their plate, it is important
to work to prevent them from burning out.
Issues to be discussed
1. Facts of the case
2. Discuss the various initiatives as enumerated in the case based on
your analysis.
3. Establish whether the integrated Human Resource system for the
Health care is effective or not. Justify your view.
Case No 2 Referral System in Health Services: A Case Study of
Punjab
Punjab is one of the vital states of Indian Union consisting of 17
districts. Punjab has a vast network of public health care facilities
comprising of 217 hospitals excluding three tertiary level hospitals, 104
community health centres, 484 primary health centres and 1462
subsidiary health centres, dispensaries. The teritary care facilities in
Punjab consists of three Govt. Medical Colleges, two private medical
colleges and a prestigious Post-Graduate Institute of Medical Education
and Research (PGIMER), Chandigarh under the Ministry of Health and
Family Welfare, Government of India.
Punjab Health Systems Corporation established under the world bank
project aims to develop secondary health care. It has taken up 151
health institutions including all district hospitals. 42 Sub-divisional
hospitals and 87 Community, Health Centre, 6 Area hospitals. Under the
World Bank project, Punjab Health Systems Corporations is responsible
for:
1. Renovation of hospital buildings to provide appropriate space
for services.
2. Upgrading and updating of clinical skills of Medical Officers and
staff nurses through an effective training programme.
3. Provision of ambulances for transporting critical patients.
4. Installations of phone, fax in hospitals.
5. Strengthening of Secondary level health care shall support the
primary health care and thus there is need to formulate and
implement an ideal and effective referral system. This is the right
time and situation for Referral System to work and is the rationale
for this system to develop.
THE REFERRAL SYSTEM IN PUNJAB
The Punjab Health Systems Corporation has initiated to strengthen the
functioning of the hospitals for referral system through the following
measures:
„h Renovating and upgrading hospital buildings to provide appropriate
space for services.
„h Upgrading and updating clinical skills of medical officers and staff
nurses through an effective training programme.
„h Providing ambulances for transporting critical patients.
„h Installing phone, fax and paging systems in hospitals.
„h Financial powers to Senior Medical Officers in charge of the hospitals
to accord necessary single sanction up to Rs. 5,000 (Rs. Five
thousand only) and Deputy Medical Commissioners, Civil Surgeon,
Medical Superintendent up to Rs, 10,000 (Rs. Ten thousand only) to
meet the emergency.
„h The user¡¦s charges are to he retained at the site of collection. These
are to be used by the Senior Medical Officer In charge of the
hospital. Norms of services have been designed for each level of
faculty.
FEATURES OF REFERRAL SYSTEM
I. Referral Network and Zoning
To identify the various referral levels, the whole district is divided
into several zones and the referral levels are indicated for each
zone. To facilitate and for convenience of patients, certain number
of Primary Health Centres are grouped and linked to community
health centre (C.H C.) /Tehsil Hospital/Area Hospita ls / District
Hospitals depending upon the distance, availability of services,
facilities of transportation, etc. But adopting a grouping system,
uniform referral pattern has been developed. In this system the
patient will know the course of further treatment, in case one is
referred for some special procedure at appropriate level of care.
Similarly, a good rapport and faith in the referral system will be
developed. This is called zoning.
It helps in evolving a chain for the health units beginning at the
primary level moving up through the middle tier and finally reaching
the tertiary hospitals. Let us explain it with the help of Kiratpur
Sahib.
After dividing the district into zones, the same is to be depicted on
the map. The map should reflect all the health institutions, roads,
river, bridges, Bus Stand, Railway route, Railway station, Police
station, Post offices, etc.
These maps will have to be displayed at the reception counter in
each of the health institutions.
2. Transportation Facilities
lo build up an effective Referral System, a dependable
transportation arrangement has been provided where the health
personnel shall be able to send the patients to the next appropriate
level of care at the earliest, as the flow of patients is expected to be
from primary health centres to the tertiary level.
3. Referral-cum-Feed-back Card
Referral system is a two way process. The patient referred will be
given the referral-cum-feed card. The colour coding has been done.
The patient referred from CHC shall get blue cards. The patients
referred from Tehsil hospital/Area hospital shall get green card. The
patients referred from Distt. hospital shall get white card. The
patient referred from P.H.C. or Subsidiary Health Centres shall have
pink card.
The referral card contains¡XGeneral information about the patients
such as name, age, gender, address, Chief complaints, clinical
findings, vital signs. Investigations done, Treatment given,
procedure done where referred, and purpose of referral, i.e. for
admission, Investigation or expert opinion.
At the referred hospital, patients could report directly to the unit or
department to which he or she has been referred through a special
counter for referred patients.
4. Referral Procedure
In the referral procedure, there are two types of referral¡X (i)
Emergency, (ii) Routine referral. In routine referral the patient will
have to make his own transportation arrangement, however proper
counseling needs to be done. The patient shall be given referral
card. The regular hospital hours 8.00 a.m. to 2.00 p.m. In
summer and 9.00 am to 3.00 p.m. in winter with half an hour break
L30 p.m. to 2.00 p.m. For investigations, the best suitable time 9.00
AM. to 11.30 A.M. However emergency patients who are to be
attended round the clock.
5. Receiving of Referred Patients
Referral units should receive the patients directly at a place
identified in each hospital without waiting in general outdoor patient
department (OPD).
The receiving hospital must ensure that a referred patient enjoys
the following privileges.
(i) Queue Jump: The referred patient will not stand in queue
for general out-patients. He/She directly goes to the doctor
referred on priority through a special counter of referred
patients on routine.
(ii) No need of new OPD ticket. The referral card itself to he
used as OPD ticket. The entry is to be made in the referral
registers at the reception counter.
(iii) No purchee fee for referred patient with referral card.
(iv) Feed-back¡X¡XAfter dealing with patient and at the time of
discharge in case of admission, the doctor should fill up
referral-cum-feed-back card. This will help the referring doctor
to know whether the patient that he had referred, had got the
relief. The specialist may send the feed back on slip (from slip
pad) through S.M.O. 1/C of the health institution.
(v) Provision of low cost transportation¡Xin emergency patients,
it is clear that the actual fuel charges are to he paid by the
patient. In poor patients (unknown, yellow card holders,
natural Calamities, Disaster), this can be exempted.
(vi) From jail Hospitals, the patients are referred through the
Police guard.
6. Norms of Service
Norms of Services have been worked out for institutions at various
levels in terms of facilities, staffing, equipment, services, etc.
7. Maintenance of Registers
Two registers both by referring institutions and referred institutions
are to be maintained to keep a proper records. Besides, there are
large number of details which have been drawn to make the system
functional. However, the systems has not taken roots and is still in
its infancy.
For making referral system successful, Punjab Health System
Corporation has taken the following steps:
1. Intensive Training ro all personnel from top to bottom to make
them aware of the potentialities and limitations of referral systems.
2. Equipping the health institutions with the prescribed norms of
services.
3. Making the people aware through maps of zoning and also
through a video cassette ¡§Know your Hospital¡¨.
4. Arranging transport facilities.
5. Delegation and decentralisation of administrative and financial
powers.
6. Overseeing the implementation.
7. Conducting research to diagnose the problems which stand in
the way of efficient functioning of referral system.
By now, referral system has been introduced in all districts of Punjab. It
is hoped that this would bring a revolution in health services in Punjab.
Issues to be discussed
1. Facts of the case.
2. Analyse the Referral System based on the case and taking out of
case examples as well.
3. Based on the analysis do you perceive increased effectiveness in the
health services? Justify your view.




General Management
Total Marks: 80
Note : All Questions are Compulsory
Each Question Carries Equal Marks 10 Marks
1. What are the methods of gathering job information?
2. What are the direction of communication?
3. What are the characteristics of the integrating leadership style?
4. Explain quality control
5. Explain some of the management games
6. What are the methods of performance appraisal?
7. What is the significance of HRM?
8. What are the models of effectiveness?


Financial Management
Total Marks: 80
Note :All Questions are Compulsory
Each Question Carries Equal Marks 10 Marks
1. Compare and contrast the potential liability of owners of
proprietorships, partnerships (general partners), and corporations.
2. What is meant by Working capital? How is it calculated? Explain the
determinants of working capital requirements.
3. Are the share holders of a company likely to gain with a debt component
in the capital employed ? Explain with the help of an example?
4. What do you mean by yield to maturity (YTM) of a bond? Explain
briefly.
5. What can a financial institution often do for a deficit economic unit
(DEU)that it would have difficulty doing for itself if the DEU were to deal
directly with an SEU?
6. Why would an analyst use the Modified Du Pont system to calculate ROE
when ROE may be calculated more simply? Explain.
7. How are financial trades made in an over-the-counter market? Discuss
the role of a dealer in the OTC market.
8. What is a portfolio? Why an investor should invest his/her funds in a
portfolio rather than in the stocks of a single corporation.

Corporate Law
Total Marks: 80
Note : All Questions are Compulsory
Each Question Carries Equal Marks 10 Marks
1. What are the functions of controller.
2. Distinguish cheque and bill of exchange
3. Discuss power to impose lesser penalty
4. State the miscellaneous provisions as regards charges.
5. How to convert public company in to a private company.
6. How to employ a controller and other officers.
7. What are the liability of members
8. What are the functions of controller.