Hospital Management

HOSPITAL ADMINISTRATION

THE HOSPITAL ADMINISTRATOR- ROLE AND RESPONSIBILITIES: [A] WORKING WITH PEOPLE:

The administrator has no direct clinical responsibility for any patients that rests firmly on the members of the medical staff who have the clinical freedom to decide who shall be treated for what, by what means & for how long. Balance the goals of the hospitals by working with patient care teams where physician is the kingpin who in turn works with others in rendering patient care.

[B] HOSPITAL ADMINISTRATION & STAFF:

Running any hospital calls for a great deal of tact and ingenuity. This is because there are many types of staff who are specialists in their own sphere and department, which function more or less as autonomous units.

[C] STAFF MOTIVATION:

Expensive facilities and equipment do not necessarily make for a good hospital; it is the people who operate them that make the hospital go. The staff needs to be motivated to give their best at all times even in trying situations. Many discouraging factors and stress situations, in which hospitals abound, tend easily to lead to erosion in motivation.

[D] DECISION MAKING:

There are several kinds of decision making. The most characteristic are the technical decision about the treatment of patients, with which he is not directly associated, but which influence overall decision making. [E] MANAGEMENT OF RESOURCES:

All decision making is limited by the humans and material resources the hospital has. The hospital administrator as an expert in the art of getting things done but assimilates, reconciles and synthesis all the view of those, who put up competing demands.

[F] NEGOTIATING:

The administrator spends considerable time negotiating both with agencies outside the hospital and with staff members within, especially regarding their working arrangements and conflict resolution. this is not to be confused with negotiating with worker’s union which is a collective bargaining process .administrator must negotiate with third party payers(insurance companies, employees)etc., Ideally, the administrator should strive for a positive problem solving.

[G] CONTAINING COSTS:

Being in charge of the business side of hospitals management, a hospital administrator is responsible fir the conduct of all the business aspects. With phenomenal rise in hospitals costs the administrator has to devote considerable time and energy to monitor and contain costs. The medical staff knows nothing about the economics of hospital care. Therefore it is necessary to make them cost-conscious, to reduce expenditure without jeopardizing patient care.

The administrator puts into practice his knowledge and skills in financial management to practical use in forecasting financial results. If the budgeting has not been carried out correctly, funds allotted for specific activities can only be diverted to other activities for smooth running of the hospital.

[H] DEALING WITH NEW TECHNOLOGY:

Hospital practice has become more and more dependent on high technology which can become rapidly outdated as the technological advance continues .medical staffs are subjected to pressure because of newer items, and they may tent to seek knowledge about technology.

[I] MANAGEMENT DEVELOPMENT:

The administrator cannot manage the institution single handedly. There is ample need to strive for better management in a hospital, which has few trained managers.

Rapid changes are occurring which necessitate upgrading the knowledge, skills and attitudes in subordinate administrative positions. So educational activities has to be directed for the staffs .personnel is encouraged to attend programmed of courses and workshops to improve their managerial and leadership skills.

[J] INVESTIGATION:

The administrator makes decisions mostly after fact finding analysis. Managerial style is an important element in investigations .if situations is consensus it is good to have group decision making process, but if situation calls for immediate decisions that cannot be delayed.

[K] SOCIAL COMMITMENT:

The hospital administrator is a part of society in which the hospital functions, he must be aware that he is a part of the wider health care system and serves the larger society through the hospital.

PROFILE OF AN EFFECTIVE HOSPITAL ADMINISTRATOR

MANAGEMENT: Effective hospital management:

To manage is to forecast and plan, to organize, to command, to co-ordinate, and to control.

[I] PRINCIPLES OF EFFECTIVE HOSPITAL MANAGEMENT:

A] DIVISION OF WORK:

The work assigned to each worker should be clearly defined and activities of he organization precisely clarified all work thus gets performed efficiently with gradual development of competence and skills.

B] AUTHORITY AND RESPONSIBILITY:

These two are inseparable, without authority one cannot discharge responsibility. C] DISCIPLINE:

Discipline as respect for agreements which are directed at achieving obedience, discipline requires good supervisors at all levels.

D] UNITY OF COMMAND:

Employee knows who is his boss and responsible to him. It means that employees should receive orders from one superior only.

E] UNITY OF DIRECTION:

Each group of activities with the same objectives must have one head and one plan. There should be team work and unity.

F] SCALAR CHAIN:

The chain of supervisors from the highest to lowest ranks in the organization.

G] CENTRALISATION OF AUTHORITY:

This refers to the extent to which authority is concentrated and dispersed. It should be clear in the organization as to who is to issue orders and the areas of authority.

H] REMUNERATION:

Equal work for equal pay to employees.

I] STABILITY OF TENTURE:

Unnecessary turnover of employees is both the cause & effect of bad management. Assurance of job and feeling of security.

J] DELEGATION OF AUTHORITY:

Managers manage through the work of others, through delegation subordinates get prepared for higher responsibility.

K] INITIATIVE:

It’s the thinking out and execution of a plan given opportunity for employees for using creative ideas.

L] INDIVIDUAL INTEREST TO ORGANISATIONAL INTEREST:

The individual must sacrifice some selfish interests in the overall interest of the organization.

[II] ACTIVITES:A) Determination of goals and objective- this consists

primarily with policy making.B) Facility and programmed planning- refers to the

activities involved in remodeling existing services, organizing new facilities , services and programmers.

C) Financial management- budgeting and costing.D) Personnel management- selection, motivation &guidance

of employees that is human resources –men, money, material.

E) Co-ordination- dealing with internal functioning of all hospital departments.

F) Programmed review and evaluation- continues process.G) Public & community activities-related to the development

and maintenance of interaction with other health service institutions.

H) Health industry activities-it includes association with insurance companies etc.,

I) Government related activities- concerned with legal problems of the hospitals.

J) Educational development- continuing education of hospital personnel.

TIME: 25%-forecasting&planning. 48% directing & co-ordination. 11% meeting. 12% control. 4% information & organization.

SKILLS OF EFFECTIVE MANAGERS:

The successful management rests on 3 basic skills. TECHNICAL SKILLS:

Technical skill is the understanding of and proficiency in specific types of activities involving methods, processes or techniques. It implies specialized knowledge in trade and proficiency in the use of techniques and tools of trade.

HUMAN SKILLS:

All MANAGERS achieve the organizational objectives through the efforts of others in the organization .It is the skill in dealing with people. It involves ability and judgment in working with and through people. This skill is demonstrated in the way the individual perceives everything and requires awareness of their attitude, beliefs and feelings.

CONCEPTUAL SKILLS:

It involves the ability to understand complexities of the whole organization and how changes in any one part of the organization affect others .This knowledge permits the manager to act according to the objectives of total organization rather than only on the basis of needs of the problems .The success of decision depends on the conceptual skill of manager who makes the decisions.

Lower level of organization =technical skills Middle level of organization=human skills Higher level of organization=conceptual skills

CHARACTERISTICS OF EFFECTIVE MANAGER:

Many factors are attributed towards success or failure in administration. Situation, circumstances, social environment and social connections have all as factors affecting success, failure, and effectiveness.

1. CLEAR AND REALISTIC GOALS:

The more clear and realistic goals are greater, the possibility of an individual trying to achieve those goals and more effective the individual would be to mobilize and effectively utilize resources.

2. PROFFESIONAL PAR EXCELLENCE:

These individuals always try to do their best and perform at their best. They believe in providing the best services keeping the patients, customers, employees or public interest in mind.

3. PROFFSESIONAL GROWTH:

These individual continuously learn about their fields, new ideas, new strategies about innovation and application in the field, they learn from discussion with colleagues, reading books, workshops etc.

4. COMMITMENT:

They show higher degree of commitment to his field .they are not ready to change from his field even if any other fields has great attraction ,salary, etc .as a result they are deeply involved in their work.

5. ATTITUDE AND CONFIDENCE:

Effective professionals have positive attitudes towards themselves, towards other and the system. Positive attitude helps to over come the obstacles and gives confidence for professional identity.

6. COMMUNICATION:

Professional exchange of ideas on problems and issues helps in effective decision making. They have oral and written communication abilities to communicate effectively.

7. DIVERSITY:

Effective individual under take several specialties .they are able to apply their knowledge in various areas. This helps in cognitive flexibility and developing perceptual ability.

8. CREATIVE ORIENTATION:

These individuals are highly creative and analytical in their approach .they always thinks of new ideas, new practices and new methods which they can use in solving problems.

9. MOTIVATION:

MOTIVATION is the inner urge, desire, drive that compels an individual to engage in a task or service .effective individuals are highly motivated .it helps to overcome frustration, dejections and failures.

10. SATISFACTION:

These individuals tend to be satisfied with self and others and the environment, they drive satisfaction and pleasure from the work they do, which serves as atonics to build up greater energy towards their work.

11. SELF ESTEEM: These individuals have degree of positive acceptance and trust in self and accept themselves and aware of their strength and limitation and also aware of the reality or environment in which they are to function.

PLANNING

PLANNING is essential in every walk of life it is the primary process. as a process it involves a conscious determination of future course of action in order to achieve desired results. Planning determines the times of action to achieve pre determined organizational goals, it answers the 6 question that is what, why, where, how, who, and when .it seeks their answers in advance.

DEFINITION:

Koontz O’Donnell – Planning is deciding in advance what to do, how to do it. It bridges the gap where we are to where we want to go.

Newman - Planning is deciding in advance what is to be done (i.e.) a plan is a projected course of action. Allen - A plan is a trap lay to capture the future.

It is an intellectual process of thinking, restored designing a course of action which helps to achieve the pre –determined objectives of organization in future.

A manager should plan all his managerial functions effectively. Plan provides the standard and degree of control. Goals are desired results, where as the plan are the means to bring about these results, plan period may be short or long depending upon the duration the plan can be categorized into the following.

1. Short time plan up to 1 year 2. Intermediate range plan 1to 5 years 3. Long time about 5 years

CHARACTERISTICS OF PLANNING:

1. Planning is looking in to the future. 2. Planning involves pre determined line of future.

3. Planning discovers the best alternative out of available many alternatives. 4. It is a continuous process. 5. Planning is done for specific period. 6. Planning requires considerable time for implementation. 7. The objectives of planning is to achieve the pre-determined objectives in a better way. 8. Planning integrates various activities of the hospital. 9. Planning is required at all level of management. 10. Growth and prosperity of any organization depends upon planning.

NATURE AND PURPOSE OF PLANNING:

1. PLANNING IS PRIMARY:

The function of management includes planning, organizing, staffing, directing and controlling. Writers of the management unanimously accept that planning is the primary function of all the other functions.

2. THINKING PROCESS:

It is an excellent exercise; it is concerned with thinking in a creative way as to how the existing combination of resources may be adjusted and adopted to match the emerging opportunity.

3. PLANNING IS FLEXIBLE:

While planning any activity, any one of the available alternative is selected. Planning selects the best alternative based on assumption. If the assumption is proved wrong, the selected alternative tends to be incorrect and vice versa.

4. PLANNING IS CONTINUOUS PROCESS:

Planning is not come to an end with the establishment of business consent. A number of decision is taken during the life time of the business consent .so planning is a continuous process.

5. COMMON TO ALL:

Planning is done by every person who works in the business unit may be the managing director or foreman.

6. BASIS FOR ALL MANAGERIAL FUNCTION:

Planning is done at all level of management.o Top management looks after strategic plan.o Middle management looks after administrative plan.o Low management looks after operational plan.

7. GET CO-ORDINATION:

Planning co-ordinates various business activities without planning anything can be co-ordinate.

8. LIMITING FACTORS:

Every plan is formulated after considering limiting factors like men, money, material and machinery.

MERITS OF PLANNING:

(a) Planning helps management to adopt modern methods and technology to improve quality. (b) Since all the activities are co-ordinate in a systemic way, the efficiency of the hospital increases. (c) Planning enables the hospital to make adequate adjustment, to adopt future changes. (d) planning provide adequate vision to the management there by eliminating any possibility of mistakes. (e) Planning increases the confidence of managers. (f) Planning eliminates wastage and time consuming process. (g) Planning helps to anticipate SWOT- weakness and threat discovers out strength and opportunity.

DEMERITS:

(a) Planning is based on assumption ,so it cannot predict the future accurately. (b) Planning is a costly function, a smaller organization cannot afford it. (c) Planning does not provide any immediate solution if any unavoidable circumstances arises.

(d) It is difficult to accommodate any changes once planning is complete. (e) Delay in action caused by planning may create misunderstanding.

BARRIERS IN PLANNING:

(a) Changing environment is one of the important barriers. (b) Poor preparation of the manager in terms of their planning, knowledge and skills. (c) Effective planning sometimes fails if any staff dominates the planning process. (d) The pressure in increasing the work is another potential barrier in planning.

FORECASTING:

Forecasting is inherent in planning .forecasting is common to all types of planning. Therefore, planning requires making assumptions about internal resources needs and external environment forces.

In middle field, the future involves addressing 2 important issues. 1. One is how far in the future it is appropriate to estimate. 2. And the other is how far into the past is it appropriate to in order to forecast.

The first issue determines - short term, medium term, or long term forecasting techniques are appropriate.

The second issue determines –which forecasting techniques are feasible depending on the amount and type of past data available. Forecasting has to rely on trends to a great extent.

FORECASTING DEMANDS:

Forecast of demand should be made as for as ahead as the maximum lead time. The period of time it will take to implement a decision .since the past alone is an unreliable basis for predicting the future, especially in longer range forecast; there is limited value in acquiring large amount of past data.

Future based forecasting techniques may require minimal data or a large number of observations. Quantity of generally adds to

knowledge about the present and past, and may not necessarily increase the accuracy of forecast of the future.

FORECASTING UTILISATION:

It has to be determined what the future utilization of a specific service will be a change in utilization in future may be expected or desired. The factors for the change need to be analyzed.

The changes in the demographic characteristics, the changes in attitude and behavior patterns of user population, changes in medical care patterns and changes in the concurrent factors affecting utilization (medical insurance, health programmed) must be incorporated in a utilization forecasting.

TYPES OF PLANNING:

(A)STRATEGIC PLANNING:

It carries a wider perspective for the whole of the organization at the highest planning level. It is concerned with developing main mission of the institution, developing broad objectives, followed by determining the services required and determining the means of fulfilling the same.

(B)OPERATIONAL PLANNING:

It is at the lower organizational level, generally focuses on programmed formulation and implementation.

It is concerned with implementing the strategic plan in all its components at the operational level.

It is independent of strategic planning because it concerns itself with systems planning at all levels of the institution. When a new services or department is added, when there is a need for upgrading of an existing services or department or when anew system of organization is being introduced.

STEP BY STEP APPROACH TO PLANNING:

(A)ANALYSIS OF THE SITUATIONS:

Whether it is strategic planning with wide perspective at the higher organizational level or operational planning, the planners do have some idea of the problem they want to solve.

Nevertheless an analysis of the situation concerned with the

broader problems must be carried out.

Analysis of the situation leads to all the facets of an institution functions and resources .the problems which are highlighted may relate to the following.

1. Personnel 2. Physical facilities 3. Equipment 4. Finance 5. Information 6. Extra mural factorsCause or effects of the core problems are likely to be mistaken for the problem itself.

(B)IDENTIFING PRIORITY PROBLEMS:

It is impossible to plan for the entire problem at all times simultaneously. In ranking the relative importance of each of the problem, certain factors should be considered.

(a) Is the problem situation really the one to be solved or larger problem which requires study? (b) Extent and nature of the benefits to be achieved? (c) Attitudes of personal towards the existing situation? (d) Are there any management policies or professional requirements that might influence this planning?

(C)FORMULATING OBJECTIVES:

After selecting the problems, the next step is to formulate objectives. A hospital achieves its objectives through the various service departments. Therefore each departmental head must establish his own departmental objectives, consistent with the institution objectives.

Objectives must be,

a) Relevant and realistic b) Feasible and achievable c) Observable and measurable

There are 3 criteria for the attainment of objectives.

1) Is that the person responsible for achieving the desired results, understand and accept the responsibility. 2) Objectives should clearly state the results to be achieved or outcomes to be anticipated. 3) The time frame in which objectives have to be achieved.

HIERARCHY OF OBJECTIVES

LINKING DEPARTMENT OBJECTIVES TO INSTITUTIONAL OBJECTIVES:

For department objectives, institutional objectives provide the over riding direction. Each departmental head establishes departmental objectives, with the process pushed down the chain in the organization from department Sub department Section Individual objective

SETTING OF GOALS:

Goals articulate a specific strategy. The management team prepares statements of goals both short term & medium term.

Some of the goals are,

A) Achieving recognition of the hospitals residency programmed by a university.

B) Completion of the new building for housing the ct scanner by end of the year etc.,

REVIEWING LIMITATION / CONSTRINTS:

MISSION OVERALL OBJECTIVES DEPARTMENTAL OBJECTIVES SECTION OR SUBDEPARTMENTAL OBJECTIVES INDIVIDUAL OBJECTIVES

No goals setting can be accomplished without anticipating and giving adequate consideration to the obstacles with may be encountered in meeting objectives & goals.

The limitation can be in the form of personnel, equipment finance, time and others.

o Identifying the external forceso Assessing impact of the forces on goalso Internal analysis o External analysis o Identification of weakness, limitation, strength etc.,

LYING DOWN OPERATIONAL POLICY & OPERATIONAL SYSTEMS:

OPERATIONAL POLICY:

It is a statement of objective and principles functions for each department. Operational policy and strategies leads to operational plans & systems at each level until the institution gets down to ‘nuts and bolts” of its operations.

OPERATIONAL SYSTEMS:

The main purpose of operational system is to determine the way the institution will ultimately operate. It is a way of laying down the intended use of each department until every detail becomes clear.

WRITING DOWN THE PLANS:

A plan has no value if it remains only in the mind of the planner. Therefore the plan must be written down and copies passed on to all concerned.

o Opportunity analysiso Establishment of objectives o Developing premiseso Alternative ideas/ identifying ideaso Evaluation and choosing best alternativeo Formulate the supporting plan

COMMUNICATION

DEFINITION

By Newman - COMMUNICATION IS THE EXCHANGE OF FACTS, IDEA AND OPINION BY TWO OR MORE PERSONS.

By Cunning - communication is the process, conveying messages from one to another, so that they are understood.

By kith Davis - The process of passing information and understanding from one person to another.

The word communication has been derived from the Latin word COMMUNIS, which can be translated as common .it also, translate the meaning of transfer, meaning and information

The communication can be defined as ‘THE PROCESS THROUGH WHICH TWO OR MORE PERSON COME TO EXCHANGE IDEAS AND UNDERSTANDING AMONG THEMSELVES’.

The basic function of management is communicating its ideas, strength and opportunities to the society through coordinating and integrating the human efforts in the organization.

PURPOSE OF COMMUNICATION:

Communication is also essential for dealing with external environment .Informational exchange permits health care organizations to become aware of the needs of the patients and consents of the community.

1) To disseminate goals and develop plans for their achievements.

2) To organize resources in the most effective and efficient manner.

3) To appraise and develop members of the organization.4) To lead, direct, motivate and create a climate in which the

people want to contribute.5) To control performance.

PROCESS OF COMMUNICATION:

Communication is the two processes, is both an originator and receiver of information.The elements are as follows:

A) The sender B) Ideas C) Encoding D) Channel E) Receiver F) Decoding G) Feedback

SENDER OF THE MESSAGE:

Communication begins with the sender. He is the person who intends to make contact with objectives of passing information, ideas to other persons. He encodes the subject matter of communication which might be opinion, attitude, feelings, suggestion etc. the subject matter into symbols such as words, action and picture.

1st phase: The sender is the person who intends to make contact with the objectives of passing information ideas to other persons. The sender initiates communication because he has some need, thought, idea, or information that he wishes to convey to other person .encoding enables the thoughts to be put in the form of symbols.

2nd phase:

CHANNEL AND TRANSMISSION: the channel is the link which joins the sender and the receiver. In the organization the channel is “FACE TO FACE”, written memos etc, Outside the organization the channels are letters, magazines, radio etc,

3rd phase:

THE RECIEVER AND DECODING:

The receiver interprets and translates the message into thoughts, understanding and derived response.

The homogenize or similarity in attitudes, experience, knowledge, environment and socio-cultural background between the sender and the receiver avoids false communication. TRANSMISSION OF MESSAGE:

The information is then transmitted through different channel via, oral form, written, telephone, telegraph, fax or computer.

Proper selection of medium of media is vital for effective communication since there are many channels available.

RECEIVER OF THE MESSAGE:

Receiver is the person to whom the message is meant for. The receiver has to decode the information into thought for action.

Accurate communication will occur only when both sender and receiver attaches the same meaning to the message. Use of technical and complicated terms may be misunderstood by the recipient of message.

FEEDBACK:

Feedback is necessary to check or to ensure the effectiveness of communication. One can never be sure whether or not a message has been effectively encoded, transmitted, decoded or understood unless it is confirmed by feedback.

Feedback also acts as an energizing factor thereby changing the cause of action in communication.

TYPES OF COMMUNICATION:

(1) DOWNWARD COMMUNICATION: This communication flows from superior to subordinate E.g.: orders, circular, policy statement, and job sheets, downward communication is eminently suited to an organization in which line of

authority runs distinctly downward with each rank clearly below another.

OBJECTIVES:

1) To gain specific directives about the job interested to the subordinate.

2) To explain policies and organizational procedure.3) To appraise subordinate of their performance.4) To give information about rationale of the job.

LIMITATIONS:

1) Downward communication is often coupled with either under communication or over communication.

2) Delay – the lines of communication is downward communication being very long, transmitting information to the lowest worker is time consuming.

3) Loss of information- unless the communication is fully written a part of it is almost certainly is lost.

4) Distortion- in the long line of communication is lost it is even distorted.

5) Building resistance- the subordinate do not get an opportunity of participating in decision making process, hey are expected to receive the policy decision and derivatives without questioning their appropriate and utility which they result

(2) UPWARD COMMUNICATION:

The communication channel which pushes the flow of information upward is known as upward communication. The manager has only recently comes to recognize the importance of upward communication.

IMPORTANCE OF UPWARD COMMUNICATION:

1) Providing feedback- this type of communication provides the management with necessary feedback.

2) Outlet for the pent-up emotions- it gives the employees an opportunity to vest their problems and grievances.

3) Constructive suggestions- often employees offer constructive suggestions to promote welfare of the organization.

4) Easier introduction of new schemes – since the employees feel themselves to be a part to the decision making process it helps the organization to introduce new schemes.

5) Greater harmony and cohesion – upward communication acts as the kind of lubricant it makes the atmosphere in the hospital, congenial. Create greater harmony and cohesion between manager and employees.

METHODS OF UPWARD COMMUNICATION:

OPEN DOOR POLICY:

The employees are given feeling that the managers door are always open to them. Whenever they like they can walk into his room without any hesitation and talk about problem.

COMPLIANCE AND SUGGESTION BOX:

At some convenient place in the office, compliance and suggestion box are installed. SOCIAL GATHERINGS:

It is frequently arranged in different department, these gatherings offers a very informing atmosphere in which the employees shed their inhibition and felt free to talk about their problem.

DIRECT CORRESPONDENCE:

Some times the manager may directly write to an employee and ask him to communicate with him.

LIMITATIONS:

(1)Employees are usually reluctant to initiate upward communication.

(2)Employees often feel if they communicate their problems to superiors it may adversely reflect on their own efficiency.

(3)Sometimes workers become to bold ignore their immediate superior and directly approach their topmost authority.

GRAPEVINE COMMUNICATION:

In every organization, an informal channel of communication called the grapevine is in operation. It is quiet natural for a group of people working together to be interested in one another and talk about appointments, promotion or even domestic affairs.Some people derive great pleasure from gathering information and transmitting to others. They are the leaders who control the grapevine.

IMPORTANCE OF GRAPEVINE COMMUNICATION:

ORGANISATIONAL SOLIDATORY AND COHESION:

The existence of grapevine prove that the workers are interested in their associates, the very fact they talk among themselves and helps to promote organizational solidatory and cohesion.

SUPPLEMENT TO OTHER CHANNELS:

All information cannot be transmitted through official channels so this type of communication is used to transmit such information.

QUICK TRANSMISSION:

The speed with which the information is transmitted through grapevine is remarkable.

FEEDBACK:

Grapevine provides feedback to the management.

DEMERITS:

1) The major drawback is that it spreads baseless2) It is usually incomplete.3) A rumor may have spread and cause serious damage before

the management could become aware of it and take steps effectively.

CONSENSUS:

In the commercial field it is felt desirable that when the board of meeting is held decision should be arrived at consensus.Unanimous decision helps to project a good image of the organization among the employees and share holders.

COMMUNICATION MODELS:

WRITTEN COMMUNICATION:

1) It can be read by a large audience, can promote uniformity in policy and procedure and provides record.

2) It has the disadvantage that it provide no immediate feedback3) It may take a long time to know whether a message has been

properly understood.4) A lot of effort is required.

Guidelines for effective written communication:

1) Use simple words and phrases.2) Use short and familiar words.3) Use short sentences and paragraphs.4) Give illustrations and examples.5) Use personal pronounces.6) Economize on adjectives.

ORAL COMMUNICATION:

1) Oral communication can be face to face meeting.2) It can also be formal or informal.3) The advantage is it provide for speedy interchange for

immediate feedback.4) However oral communication does not always save time.

Committees may be costly in term of time.

NON VERBAL COMMUNICATION:

1) It can reinforce verbal communication.2) This is achieved through gestures, facial expression and body

language.3) Attentive eye contact, active listening a show of confidence

reflect a mature person.4) Sloughing , laughter, wringing of hands reflect an immature

personality5) In addition visual aids may be used to supplement both oral and

written communication.6) When a message is repeated through several media it will be

more accurately received, comprehended and recalled.

THE ART OF LISTENING:

1) A good leader has to be a good listener.2) The art of listening requires his or her listening habits by the

manager.

The following guidelines may improve an administrator listening skills:

1) Physically show that you are ready to listen, face the speaker and show attention.

2) Ignore the speakers’ appearance or manner of delivery.3) Watch non verbal communication expressions, gesture and body

language.4) Keep the mind on what the speaker is saying. 5) Allow for your own bias. Do not always agree with everyone.6) Visualize the situation from speakers’ point of view.7) Do not interrupt immediately in an apparently wrong statement.8) Evaluate the logic and credibility of communication.9) Do not give your last word, you need time think about a problem

in different angles before you communicate.

GUIDELINES FOR EFFECTIVE COMMUNICATION:

It is essential to employ motivation, for desirable direction to organizational operations, for control and for direction. The guidelines are,

1) Clarify ideas before attempting to communicate.2) Eliminate unnecessary details and avoid information which

people cannot use.3) Plan the organizational communication in consultation with all.4) Establish two way communications- try to get feedback, ask

questions and clarify doubt.5) Understand the parties’ frame of reference- visualize from the

point of view.6) Follow up- appropriate action must follow every communication.7) Be a good listener.

BARRIERS IN COMMUNICATION:

There might be number of barriers in the organization. a) Semantic b) Emotional or psychological c) Organizational d) Personal factors

SEMANTIC BARRIER:

Semantic barrier are obstructions caused in the process of receiving or understanding of message during encoding and decoding ideas and words. These barriers arise from linguistic capacity.

BADLY EXPRESSED MESSAGE;

Lack of clarity and recession in a message makes it badly expressed. Poorly chosen and empty words and phrases, careless omissions, awkward sentences, structures inadequate vocabulary are some common false in this case.

FAULTY TRANSLATION:

Every manager receives various types of communication from superior subordinate and he must translate information detained for subordinate and superiors into language suitable to each. Hence the failure, results as the barrier for communication.

UNCLARIFIED ASSUMPTION:

There are certain excommunicated assumptions which underline particularly on all messages. Though a message appears to be specific its underlying assumption may not be clear to the receiver.

SPECIALIST LANGUAGE:

It is often form that the technical, personnel and special groups tend to develop special, peculiar and technical language of their own. This increases their isolation from others and built communication barrier.

PSYCHOLOGICAL BARRIER

PREMATURE EVALUVATION:

Evaluation is the tendency of pre maturely evaluating communication rather than to keep an uncompromised position during the interchange.

INATTENTION:

The pre occupied mind of the receiver and the result of none listening is one of the major and chronic psychological barriers. It is common phenomenon that people simply fails to react to notice bulletins and reports.

LOSS BY TRANSMISSION AND POOR RETENTION:

When the communication passes through various levels in organization successful transmission of the same message is decreasingly accurate. It is said that in case of oral communication about 30% of information is lost in each transmission.

DISTRESSED OF COMMUNICATION:

It arises out of ill considered judgment or ill- logical decision or frequent counter mantling of the original communication by the communicator, repeated experience of this kind delays the action of receiver.

FAILURE TO COMMUNICATE:

It is quite and unaccepted fact that managers often fails tom transmit needed message. This might be because of laziness on the part of communication or deliberately to embraces others.

ORGANISATIONAL BARRIERS:

ORGANISATIONAL POLICY:

The general organizational policy regarding communication acts like a overall guidelines to everyone in the organization regarding how he is normally expected to behave in this manner.

ORGANISATIONAL RULES AND REGULATION:

The rules and regulation affect the flow of communication by prescribing the subject matter to be communicated through manner which these are to be communicated. The rules may restrict the flow of certain message and leave many important.

STATUS RELATIONSHIPS:

The placing of people in superior subordinate capacity in formal , organization structures also block the flow of common and more particularly in upward direction greater to be the possibility of communication breakdown.

COMPLEXITY IN ORGANISATION STRUCTURES:

In an organization, where there are number of managerial levels communication gets delayed hence the chances of communication getting distorted are more likely.

ORGANISATIONAL FACILITY:

Organizational facility provided for smooth adequate clear and timely flow of common may take a number of forms some of these have been mentioned are like meeting conference, open door system.

PERSONAL BARRIER:

BARRIERS OF SUPERIOR:

A) Attitude of superior towards communication in general or in particular direction affect the flow of message in different direction.

B) Fear of challenge to authority the person in the organization always tries to get higher position and prestige. As such managers in general try to withhold the information coming down the line or going up.

C) Insistence on proper channel: one of the basic features of superior exercising of the authority is that they wish to remind the communication links and they do not like any type of bypassing in communication.

D) Lack of confidence in subordinate: superiors generally perceive that their subordinates are less competed and less capable were not able to advice the superior.

E) Ignoring communication: sometimes superior consciously and deliberately ignore the communication from the subordinates to maintain their importance.

F) Lack of time: superiors feel that they are over burden with work and they have little time to talk to their importance.

G) Lack of awareness: sometimes superior may lack awareness about the significance and usefulness of communication in direction of general of a matter resulting in blockage of communication flow.

BARRIERS IN SUBORDINATE

In vertical communication direction can take place when subordinates actively participate in the process. There are various factors in this subordinates that adversely affect such participation. They are

o ATTITUDEo TIME AVAILABILITYo AWARENESS ABOUT THE SIGNIFICANCE

LACK OF PROPER INCENTIVE:

Lack of motivation to communication also prevents subordinates communication of work. The reward and punishment system of organization is more responsible for this thus if suggestions by subordinate does not awoke any attention from the organization he would not convey it.

DECISION MAKING

DEFINITION

George Terry: Decision making is the selection based on some criteria from two or more possible alternatives.

Henry Sisk and C. William’s: A decision is the selection of course of action from two or more alternatives. The decision making process is a sequence of steps leaving to that selection. Daver: Decision making may be defined as the selection based on some criteria of one behavior, alternative from to or more possible alternatives. CHARACTERISTICS OF DECISION MAKING:

Decision making is the selection process.

It is an end process.

It is the application of intellectual ability to great extent.

It is situational.

It is dynamic process.

It may be positive or negative.

It is taken to achieve the objectives of an organization. STEPS IN DECISION MAKING PROCESS:

Decision making is the process through which managers identify organizational problems and attempt to resolve them.

It is the process of selecting and implementing alternatives consistence with the goal, it is a serious of activity begin with defining the purpose or goal of the decision and involves developing and evaluating alternatives, selecting and implementing the alternatives. The entire process from setting the decision goal to making sure the goal has been achieved is decision making

o IDENTIFY THE PROBLEM o GENERATE ALTERNATIVE SOLUTION

o EVALUATE AND CHOOSE AMONGo ALTERNATIVE SOLUTIONS.o IMPLEMENT AND MONITOR THE CHOOSEN SOLUTION.

Decisions are taken, the future action hence decision making is a risky and challenging task for a manager. The process of decision making manager is to make use of their knowledge of appropriateness.

(I) IDENTIFY THE PROBLEM

The first step in decision making process is identifying the problems. Problems cannot be identified without a search; organizational problems are the difference between expected result and actual situation. Identifying the problem involves three main activities.

SCANNING

Monitoring the work condition for changing circumstances that can indicate the emergency of problem.

CATEGORIZE Attempts to categorize a situation as a problem or a non-problem. DIAGNOSE

Gathering additional information and diagnose the problem nature and causes.

(II) GENERATE ALTERNATIVE SOLUTION;

The second step in decision making process is developing alternatives. A problem can be solved by different alternative solution. A manager has to develop alternative solution before selecting any specific solution a manager has to think on all the possible alternative solution. In this era of accelerating changes and global competition, the traditional solution to organizational problem has become ineffective.

Innovative alternatives need to be generated. The most familiar technique of enhancing creativity is brain storming. Brain storming is

a technique that encourages group members to generate many ideas as possible on an given topic without evaluating them.

(III) EVALUATING AND CHOOSING THE ALTERNATIVES;

When all the possible and realistic alternative has been identified, the focus of decision process shift to evaluating those alternatives to identify strength and weakness of each option.

Each alternative should be evaluated systematically according to general criteria, they are

FEASIBILITY QUALITY ACCEPTABILITY COST ETHICS

Either quantitative or qualitative approach can be used to evaluate and choose an alternative. Qualitative approach uses mathematical and statistical techniques to analyze the decision alternative.

Quantitative approaches are linear programming, break even analysis, decision tree analysis. Qualitative approach uses comparison of characteristic of alternative and takes relevant decision. A typical qualitative approach is tree chart.

(IV) IMPLEMENT AND MONITOR THE CHOOSEN SOLUTION;

A decision is just a choice unless it is implemented and monitored. Implementation of decision reveals its effectiveness and significance in achieving desired goal. Successful implementation usually depends on careful planning and sensitivity to those involved in implementation or affected by it.

Even effective implementation does not complete the action phase of the decision making process. Once it is implemented, the decision must be monitored to ensure that the alternative put into action is moving the organization closure to its goal.

It is only monitoring phase that confirm, the organizational goals have been achieved.

FACTORS AFFECTING THE RATIONAL AND DECISIONAL MAKING.

(a) INADEQUATE INFORMATION:

Decision makers may have inadequate information about the problem, possible alternative and their strengths and limitation.

(b) TIME AND COST:

Time and cost are the limiting constraint through out the decision making process.

(c) PERCEPTION OF DECISION MAKERS:

Decision maker’s perception in identifying the problem, selecting alternative may ignore the actual critical problem.

(d) EXPERIENCE OF DECISION MAKERS:

If decisions are to be taken with less information then extensive experience with situation becomes the key point. The experience of decision maker becomes the key factor. (e) VALUE OF DECISION MAKERS:

A decision maker must not reflect his own personnel values rather than companies need or personnel, both the goals and the result of decision process.

(f) CAPACITY OF DECISION MAKERS:

Even after gathering perfect information it’s the intelligent and calculating capacity of manager which limits the success of any decision.

PRICIPLES OF DECISION MAKING:

A quality decision may be taken by a manager if he adopts certain principles, they are

MATHEMATICAL THEORY

PSYCHOLOGICAL THEORY.

PRINCIPLE OF ALTERNATIVE.

PRINCIPLE OF LIMITING FACTOR

PRINCIPLE OF PARTICIPATION.

MATHEMATICAL THEORY:

Venture analysis, game theory, probability theory and waiting theory are some of the mathematical theory. A manager takes the decision on basis of mathematical theory.

PSYCHOLOGICAL THEORY:

A manager takes a decision on basis of his aspiration, technological skill, personality, social status and organizational status. Though the manager is expected to take a decision confined to the scope of his responsibility and authority, there is an impact of psychology over the decision.

PRINCIPLE OF ALTERNATIVE: If there is only one alternative to solve the problem there is no need of taking a decision. Decision is a selection process of all the alternatives are evaluated and screened on the order of their usefulness. Finally the best alternative is selected according to the circumstances and purpose.

PRINCIPLE OF LIMITING FACTOR:

The fundamentals of the problems are studies. Interference or the conclusion is drawn on basis of studies. The manager takes a decision with a help of conclusion. Decision is based on limiting factors like time, cost or resources.

PRINCIPLE OF PARTICIPATION:

This principle is based on human behavior and human relationship. Each and every person wants to be treated as an important person so the management may allow the employees to have a say or word in the process of decision making.

TYPES OF DECISION MAKING:

1. PROGRAMMED DECISION:

They are otherwise called routine or structured decision. The reason is that this type of decision is taken frequently and repetitive in nature. This decision is taken within the preview of the policy of the organization. Programmed decision has short time impact and used only by low level management. E.g. Granting overtime, placing purchase order for material. There is a clear cut procedure to take programmed decision.

2. NON-PROGRAMMED DECISION:

They are otherwise called strategic decision or basic or policy or unstructured decision. This decision is taken by top level management people whenever the need arises. A careful analysis is made by the management before taking a policy decision. The management may publish its policy in a small book known as policy manual. Policy decision includes heavy expenditure to management. E.g. Acquisition of a business or starting a new business. A slight mistake in policy decision this decision has a long-term impact on business.

3. MAJOR DECISION:

This decision is taken by top management related to the purchase of fixed asset more value. E.g. Land and building.

4. MINOR DECISION:

This is taken by low level management people related to the purchase of current asset with less value. E g. Pen, pencil.

5. OPERATIVE DECISION:

A decision which relates to day-to-day operation of an organization is known as operative decision. This is taken by middle level management people. E.g. Time of payment of overtime wages.

6. ORGANISATIONAL DECISION: The decision maker takes a decision and implements it for effective functioning or organization. It is called organizational decision.

7. PERSONAL DECISION:

A decision maker takes a decision for his personal life known as personal decision. This decision does not reflect the functioning of an organization. The decision maker is not a member of an organization while taking a personal decision.

8. INDIVIDUAL DECISION

The decision maker is member of an organization while taking an individual decision. He can implement it in the organization. He considers the policy and situation prevailing in an organization while taking individual decision.

9. GROUP DECISION:

A committee is formed by top management for specific purpose. The top management fixes the time within which the committee or group is expected to submit it’s report with concrete decision.

10. NON-ECONOMIC DECISION:

It refers to a decision which does not incur any expenses. These types of decisions are taken at all level of management. E.g. correcting moral behavior of workers.

11. CRISIS DECISION: A decision is taken to meet the unexpected situation. There is no possibility and time for the decision maker for getting through investigation while taking crisis decision .It can also be called as spot decision.

12. RESEARCH DECISION:

A decision is taken after analyzing after pros & cons of particular matter. There is no pressure on decision makers to take such decision. It requires a lot of information.

13. PROBLEM DECISION:

A decision is taken to solve a problem. The problem may be expected or unexpected.

14. CERTAINITY DECISION:

The term certainty refers to accurate knowledge of the outcome from each choice.

E. g: Maximization of profit through new product. There is only one outcome for each choice. The decision maker himself knows the outcome & consequence of choice. 15. UNCERTAINITY DECISION:

The outcome is not accurate or several outcomes are possible, whenever a decision is taken, the reason is due to incomplete knowledge and the consequence. E.g.: Marketing a new product. If the prosperity period is long the amount of profit is high and vice versa.

CONCLUSION:

Management people take a number of decisions every day. These decisions are every day. These decisions are aimed at solving the existing problem. There should be justice in taking a decision.

TIME MANAGEMANT

INTRODUCTION:

Time management refers to a range of skills, tools and techniques used to manage time when accomplishing specific task, projects and goals. This set encamps a wide scope of activities and these include planning allocation, setting goals, delegation, and analysis of time spent, monitoring organizing scheduling and prioritizing. Initially time management referred to just business or work activities but eventually the term broadened to include personal activities. A time management system is a designed combination of processes tools and techniques.

CATEGORISATION SCHEME FOR TIME MANAGEMENT APPROACHES:

1. FIRST GENERATION :

Reminders based on clocks and watches but with computer implementation possible can be used to alert of the time when a task is to be done.

2. SECOND GENERATION :

Planning and preparation based on calendar and appointment books. Includes setting goals.

3. THIRD GENERATION :

Planning, prioritizing, controlling using a personal organizer, other. Paper based object or computer or PDA based systems activities on a daily bases. This approach implies spending sometime in clarifying values and priorities.

4. FOURTH GENERATION :

Being efficient and proactive using any of the above tools places. Goals and roles as the controlling element of system and favour important over urgency.

TIME MANAGEMENT AND RELATED CONCEPTS:

Time management has been considered as subsets of different concepts such as

PROJECT MANAGEMENT : Time management can be considered as a project management. Subset and is more commonly known as project planning and scheduling. Time management is also been identified in project management.

ATTENTION MANAGEMENT :

Attention management relates to the cognitive resources and in particular time that humans allocate their mind to conduct the activity.

PERSONAL KNOWLEDGE MANAGEMENT

PERSONAL TIME MANAGEMENT:

Time management strategies are often associated with the recommendation to set goals, these goals are recorded and may be broken down into a project and action plan or a simple task list for individual task of our goals and importance may be established and dead lines may be said and priorities may be assigned this process result in a plan with a task list in a schedule or calendar of activities.

It is usually recommended daily, weekly, monthly or other planning periods usually fixed but sometimes variable. Different planning periods may be associated with different scope of planning or review; individuals may or may not emphasize reviews of performance against planning. Routine and recurring task may or may not be integrated into the time management plan and if integrated the integration can be accomplished in various way. HOW TO USE TIME:

When an individual spend time there is no improvement in deficiency productivity. Time is gone without a return administrator saves time when he performs task in less time or with less effort than previous. He uses short cuts and process that streamline activity. Administrator invests time when he take time how to save to time later.

Delegation is a valuable investment of our time when we delegate we teach some one to perform task we usually payoff later. Since we free our time to perform higher pay of activities. The goal is to look for base a person can save and invest time.

GOAL:

GOAL SETTING TIPS :

1. Set each goal as a positive statement.2. Be précised. 3. Set priorities. 4. Write down goals. 5. Keep operational goals.6. Set realistic goals.

A useful way of making goals more powerful is to use SMART. S = SPECIFIC. M = MEASURABLE. A = ATTIANABLE. R = RELAVANT. T = TIME BOUND.

FIVE PRINCIPLES OF GOALS SETTING: To motivate goals must take into consideration that the degree to which each of the following exist.

1. Clarity.2. Challenge.3. Commitment. 4. Feedback.5. Task complexity.

TASK LIST:

Task list is also called as “to do list” task list is a list of task to be completed such as step towards completing a project. It is an inventory tool which serves as an alternative or supplement to memory. Task list are used in self management, business management, project management and software development. It may involve more than one list. The traditional method is to write these on the piece of paper with a pencil or pen usually in a notepad.

Numerous digital equivalence like personal informational management application are available. There is several web based task list application. TASK LIST ORGANISATION: Task list are often tiered the simplest tiered system includes a general to do list to record all the task a administrator need to accomplish the daily to do list which is created each day by transferring task from general to do list.

An early advocate of ABC prioritization was aleulakein. In his system “A” items were the most important. “B” next most important. “C” least important. A particular method of applying ABC method assigns A - To task to be done within a day.B - To be done within a week.C - Within a month.

To prioritize daily task list or either records the task in the order of highest priority or assigns them a number after they are listed which indicates the order to excrete the task. HOW TO USE TOOL [TASK LIST]: There are four step procedures which are

1). Collection. 2). Pruning. 3). Organization. 4). Working.

1) COLLECTION: First, inventory list of all things that requires resolution are made. The administrator should collect and write down everything urgent or not big or small, personal or professional that he feels is incomplete and needs action from him to get completed.

2) PRUNING: Now, processing of the list made in step by looking carefully at each item. Decision is taken whether administrator should actually take action on it. A lot of what comes in his real levels has no real relevant or really not important in the scale of things. If that is the case, these things are then deleted from the inventory list.

3) ORGANISATION AND PRIORITIZING:

Step 3 comes in three parts which are

First of all the items in the inventory list is reviewed. For any which are separate, individual action that may make up part of a largest project, group these individual action together into their project. [At hospital administrator wants to improve the bathroom and repaint the rooms these can be categorized into hospital renovation project.]

Review these projects and allocate priorities to them depending to their importance clearly administrators personal goals are exceptionally important projects.

Third, insert your project into a formatted action programmed. This is split up into 3 parts (i.e.)

1. A “NEXT ACTION LIST”, which shows the small next actions that the administrator will take to move his project forward.

2. A “DELEGATED ACTIONA LIST”, which shows projects and actions have delegated to other people.

3. A “PROJECT CATLOGUE” that shows all of the projects that administrator is engaged in small unusual task he has identified so far that contributes to them.

Typically the project catalogue is at the back of action programmed as its often only referred to during a weekly review process. Delegated action list sits in front of the project catalogue as it is referred to quite often. The next action list goes on the front page of the net programmed as it is referred many times a day.

4) WORKING:

An action programmer is typically fairly long but administrator doesn’t have to run through the entire programmer daily. Usually he will only be dealing with top page or pages. Some activities may be day specific or time specific. Depending on the way he works these can be either maintained as a top page of action programmed or mark on calendar. It is just that only specific short action are outline here while the major projects to which the actions belong or stored in projects to catalogue.

The lead or archive items that has completed, more items from project catalogue to the front page as he makes progress in the project and adds any new action that as come this way. 5) PRIORITIZING TOOLS: While these approaches to prioritization suites many situation. There are plenty of special cases where administrator needs other tools if he is going to be truly effective.

PAIRED COMPARISION ANALYSIS:

This is most useful were decision criteria are vague, subjective or inconsistent. It helps to prioritize option by comparing each item on a list with all other items on a list individually. By deciding each case which of the two is most important. Administrator can consolidate results to get prioritized list.

GRID ANALYSIS :

This helps to prioritize list of task where the administrator needs to take many different factors into consideration.

1. ACTION PRIORITY MATRIX :2.

This quick and simple diagrammatic techniques demands administrator to plot the value of the task against the effect it will consume. By doing this he can quickly spot the “quick wins” which will give him the greatest reward in the shortest possible time and avoid the “hard slogs” which soak up time for little eventual reward. This is an ingenious approach for making highly efficient prioritization decisions.

3. THE URGENT / IMPORTANT MATRIX:

This is similar to the action priority matrix. This technique also demands to think about whether task is urgent or important. Frequently, seemingly urgent task actually are not that important and often really important activities just or not that urgent.

4. ANSOFF AND BOSTON MATRICES:

These give administrator quick “rules of thumb” for prioritizing the opportunities opened to him. The Ansoff matrix helps to evaluate and prioritize opportunities by risk. The Boston matrix does a similar job helping to prioritize opportunities based on the attractiveness of a market and administrator ability to take advantage of it.

PARETO ANALYSIS :

Where administrator is facing a flurry of problems needing to be solved Pareto analysis helps to identify the most important changes to make. It first demands to group together different types of problems faced. And then asks to count the number of cases of each type of problems by prioritizing the most common type of problem. He can focus his efforts on resolving it.

This is the idea that 80% of task can be completed in 20% of disposable time. The remaining 20% of task will take up 80% of time. The 80 -20 rule can be applied to increase productivity it is assumed that 20% of the task. If productivity is aim of time management and then these task should be prioritized higher.

NOMINAL GROUP TECHNIQUE:

This is a useful technique for prioritizing issues and project within a group, giving everyone fair input into the prioritization process. This is particularly useful were consensus is important and were the robust group decision needs to be made using this tool each group participants “nominates” his or her priority issues and then on the scale of 1-10. This score of each issue is then added up, with issues then prioritize and based on score.

ALTERNATIVE TOOL PRIORITIZING:

A complete different approach which is used against prioritizing was put forward by British

author mark Forster. This is based on the idea of operating “closed” to do list instead of traditional “open” to do list. He argues that the traditional never ending to do list virtually guarantees that some of the work will be left undone. This approach advocates getting all the works done every day and if unable to achieve it helps to diagnose where administrators are going wrong and what needs to change.

SOFTWARE APPLICATION:

Modern task list application may have built in task hierarchy may support multiple methods of filtering and ordering the list of task. And may allow one to associate arbitrarily. Long notes for each task. Task list application may be thought of as light weight personal information manager or project management software.

RESISTERS FOR TIME MANAGEMENT:

Fear of change. Uncertainty. Time pressure. Lack of will power.

DRIVERS OF TIME MANAGEMENT:

Increased effectiveness. Performance improvement. Personal responsibility development. Increased responsibilities.

CAVEATS OF TIME MANAGEMENT:

Dwelling on list :

According to sand berg’s report and estimated “30% of the listers spend more time managing their list than completing or on them” This could be caused by procrastination by prolonging the planning activity. This list akin to analysis, paralysis. As with any activity there is a point of diminishing the returns.

Rigid adherence :

Hendrickson asserts that rigid adherence to task list can create a tyranny of to do list that forces one to waste time on unimportant activities. Listing routine task is a waste time. To remain flexible a task system must allow adaptation in the form of rescheduling in the phase of unexpected problems and opportunities to save spent on irrelevant or less than optimal task To avoid getting shrunk in a wasteful pattern the task system should also include regular planning and system evaluation session to weed out inefficiency. If some time is not regularly spent on achieving long range goals individual may get struck in a perpetual holding pattern on short term plans, like staying at particular job much longer that originally planned.