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Management Control Systems




                    Notes          3.  Key success factors: A key success factor for many non-profit institutions is the number of
                                       volunteers that it is able to attract and the number of  volunteers; it is able  to train at
                                       various levels of quality.
                                       Another crucial variable is fund development, since most rely heavily on the support of
                                       the people, especially the volunteers, for contributions to support its paid staff and its
                                       programme.
                                       Another critical variable is the ability to attract the quantity and quality of board member
                                       it needs.
                                   4.  Performance measures: Performance measures should be established for each critical success
                                       factor for  each goal.  Reports on these performance measures should be prepared  and
                                       distributed to those responsible for their management.
                                       We should attempt to quantify as many measurements as possible. Some are quite easy to
                                       quantify.

                                          Example: The number of patients attended to by the physician during a specified period
                                   of time.
                                       Others (example:  the quality of care) are not so easy to measure but are  nevertheless
                                       critical. But even these critical variables that are not easily quantified may have quantitative
                                       surrogates.
                                   5.  Infrastructure: Non-profits tend to have flatter organizational structures. Organisations
                                       tend to be functional and the functions are headed by professionals (e.g. doctors, social
                                       workers, ministers, professions). Typical responsibility centres in a child care agency are
                                       social work, operations, administration and education. They tend to be cost centres unless
                                       revenue is generated, in which case they are either revenue centres or contribution centres.

                                       The modern hospital has a dual organisation structure, one for the medical side of the
                                       institution and the other for administrative services. The medical side is dominated by
                                       physicians and a broad range of technical and support staff. Administrative services include
                                       housekeeping, food service, maintenance, billing and accounting. A good deal of autonomy
                                       is usually granted to the hospital departments headed by professionals such as: nursing,
                                       laboratory, pathology, radiology, surgery and so on. Most of these departments are cost
                                       centres where quality of care and overall cost performance is the key performance measures.
                                       Many hospitals  have created  SBUs for identifiable segments  of the  hospital such  as
                                       outpatient surgery, obstetrics, pharmacy, emergency room, physical medicine, etc. which
                                       are profit centers and are established for strategic planning and implementation purposes.
                                   6.  Management style and culture: The small and mid-sized ones tend to take on the personality
                                       traits of the executive director and if he is a professional, there is a tendency to  place
                                       primary attention upon his area of interest or training with little regard for management.

                                       In case of hospital, dual structure results in an adversarial but co-dependent style.

                                       !
                                     Caution  To manage the institution effectively, control must be maintained on the medical
                                     side of the organisation.
                                       A general theme that seems to be pervasive in all departments of hospitals is that they are
                                       delivering health care of the highest quality possible.






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