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Examination Paper of Health & Hospital Management
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
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
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?
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
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
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?  
Section C: Applied Theory (30 marks)
Examination Paper of Health & Hospital Management
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
Examination Paper of Health & Hospital Management
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
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
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
a.  Forced Distribution Technique
b.  Graphic Rating Scale
c.  Ranking methods
d.  Free Written Ratings  
Examination Paper of Health & Hospital Management
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?
Section B: Caselets (40 marks)
Examination Paper of Health & Hospital Management
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
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
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
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?
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.

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