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Journal of the Academy of Hospital Administration

A Study of The Management Information System Used in the Out-patient Department

Author(s): Sweta D'Cunha*, B. Sanjeev Rai**

Vol. 16, No. 2 (2004-07 - 2004-12)

Key Words:

Management Information System, Out- Patient Department, Decision- Making

Key Messages:

  • Management Information System is the key to efficient management.
  • Management Information System is an essential tool in OPD Management.

ABSTRACT

Management Information system is vital to the success of the health institutions. It facilitates the accomplishment of organizational objectives through improved problem solving and decision-making.

At present the growing demand from patients for good hospital care, coupled with the ever rising competition has posed a need for improved hospital efficiency in terms of rendering care and utilization of resources. Hence hospitals are required to critically appraise their entire management structure, working procedures and department skills.

The study was undertaken to find out the effectiveness or otherwise of management information system in the out patient department. The study findings reveal that there were deficiencies in the information supplied to the different categories of personnel associated with the outpatient department and frequency of information made available to the personnel.

Introduction

Management Information System (M.I.S.) is a system that provides decision – makers with information necessary to take effective decisions. Such systems are competitive tools that allow organizations to create and manage innovative products and services quickly, effectively and efficiently.

The hospital is a complex organization. To achieve its ultimate objective of better patient care, the hospital has to be managed on scientific lines. To execute the managerial functions of planning, organizing, staffing, directing, coordinating, reporting and budgeting, there is a need for availability of an accurate, high quality information at the right place and at the right time. This calls for an information system that can gather, organize, analyse and summarize data into reports and assist in administrative audits and utilization reviews.

The complexity and potential impact of today's health care crisis requires a comprehensive approach to problem analysis and innovative thinking in developing solution strategies. Patient care, by its information-intensive nature, involves extensive information processing for decision-making and requires the support of an effective and efficient information system. It also requires an information system that helps match resource to need and demand, ensures efficiency in delivery of services and planning and implementation of priorities.

Aim of the Study

To study the existing management information system used in the out-patient department of a selected hospital.

Materials and Methods

The study was conducted in the out patient department (OPD) of a multi-speciality, tertiary care teaching hospital. The study was descriptive cross-sectional. Purposive sampling technique and a structured interview schedule was used to collect data. All administrative as well as medical staff associated with the OPD work, were selected in the study. They were categorized into 4 categories. Category 1 included unit heads of all clinical departments, Category 2 included incharges of all administrative departments associated with OPD, Category 3 included middle level management & category 4 included top-level management. The information received by the staff is subdivided into four components, that is utilization and statistics, finance, medical information and inventory. The data was analysed by descriptive and inferential method.

Observations

The type of information which were received by the various categories of staff as perceived by them is shown in table 1. Physicians were found to receive only a yearly report about statistics of number of new visits, revisits and total visits to OPD. The administrative staff received information about any changes made to the routine functioning of the OPD. The middle level management receive information about daily statistics and changes made in the functioning of the OPD. Top management is more informed about all aspects of the OPD. They receive daily report about statistics, financial matters, clinical attendance and monthly report on materials The distribution of information to the different categories of consumed. staff is shown in table 2, Category 1, that is, unit heads of various clinical departments were more informed about the utilization and statistics of their own unit except on a yearly basis where information about the performance of all the departments. They also had partial information about clinical attendance in the OPD but were poorly informed about the financial aspects as well as inventory consumptions in the OPD.

Table 1 : Information received by the different categories of personnel regarding the OPD as perceived by them.

Categories of Personal Information Received
Category 1 Yearly information on number of new visits, revisits and total visits in the OPD
Category 2 Information on changes in the functioning of the OPD – Change in working hours, change in tariff, change in any clinical department, appointment of new doctors.
Category 3 Daily report on number of new visits, revisits, and any changes in the functioning of the OPD.
Category 4 Daily report on number of new visits, revisits, clinical attendance in the OPD, financial aspects, monthly report about inventory consumption.

Table 2 : Percentage distribution of the four types of information received by the different categories of personnel.

Categories
of staff
Mean score Percentage of Information
Utilisation
and
statistics
Medical
Staff
Finance Inventory Utilisation
and
statistics
Medical
Staff
Finance Inventory
Cat 1 13 6 1 0 65 30 5 0
Cat 2 38 4.4 3 0.8 82 10 6 2
Cat 3 19 7 14 10 38 14 28 20
Cat 4 29 6 26 8 42 9 38 12

Fig1 : Percentage distribution of the four types of information received by the different categories of personnel

Chart

 

Category 2 that is those in charge of departments of medical records, billing accounts, stores and the supervisor of the OPD had adequate information about utilization and statistics. They also received information about inventory.

Category 3 which included middle level management received maximum information about utilization and statistics and minimum information about the medical staff. They received sufficient information about finance and inventory.

Category 4, that is , top level management received maximum information about financial aspects and were well informed about utilization and statistics but received less information about medical staff and inventory consumption.

Discussion

M.I.S is a valuable tool to any health care institution. Given the real time nature of patient care delivery, the human element involved and impact of many external factors, health care providers required timely information to anticipate potential problems and make corrections or adjustment when necessary.1

The study revealed that the top management required information about the utilization and statistics, medical staff, finance and inventory on a daily, monthly yearly basis for better management of OPD services, assuring the patient community, better health services. OPD being a useful link between community and health administrators, helps administration to assess community health needs and plan for providing comprehensive health care for the community.2

Competition in health care market increasingly requires effective work relationships between administrator and physician with information, so that they can play a more active role in pursuit of hospital's mission and objectives. Both management and physicians need to integrate their expertise in management of hospital and delivery of high quality and cost effective service. The study conducted revealed that the physicians were found to be inadequately informed about the some aspects of OPD services. This would have a implication on their active participation in better management of OPD services.3

It was found that administrative department had information that was not being processed or available to the top management. MIS helps health care administrators to do their jobs more effectively because of its features. These features are timeliness, targeted performance, comprehensive reporting system, explicitness, etc. If all information were not made available to top management, it would have an implication on decision making. The would have an implication on timely decision making.

Conclusion

The study concludes that the prevailing MIS in the OPD provides information to the different categories of personnel that is not adequate and timely. There is deficiency in the information supplied. The administrative departments associated with the OPD had a lot of information that was not processed and made available to top management. The information disseminated to the physicians was insufficient. Frequency of information made available to the various categories of personnel was found to vary.

References

  1. Whitehead J, Choosing The Right Information System, Hospitals LVIII, 1991 pg 32-3.
  2. Anand RC, OPD The Peep Window Of Community Morbidity, J. Hospital Admin, March/June 1979, pg 21-6.
  3. Hodgettes M.R, Casico Dorothy, Modern Health Care Administration, Academic press 1983, pg 357-78.

* Lecturer, Department of Hospital Administration,
Father Muller Medical College,
Kankanady, Mangalore- 575 002

** Professor & HOD, Department of Pediatrics,
Father Muller Medical College,
Kankanady, Mangalore- 575 002

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