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0вш не мае системно! ди на нормальну флору орга-шзму. Застосування фотодинамiчноl терапп зво-дить до мшмуму ускладнення пов'язанi з виник-ненням алергiчних реакцiй, не виникае стшкосп мь кроорганiзмiв, бактерицидний ефект лiмiтуеться зоною лазерного опромшення фотосенсибшзова-них тканин, що i дозволяе уникнути при застосу-ванш даного методу побiчного ефекту прийому ан-тибiотикiв i використання антисептиков.
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СОВРЕМЕННЫЕ МЕХАНИЗМЫ ОПТИМИЗАЦИИ УПРАВЛЕНЧЕСКИХ РЕШЕНИЙ В
МЕДИЦИНСКИХ ОРГАНИЗАЦИЯХ
Ясинська Е.Ц.
ВДНЗУ «Буковинський дeржaвний MedmHuü yHieepcumem» K.Med.н., дощнт кaфeдри со^ально'1' мeдицини та ОЗО
MODERN MECHANISMS OF OPTIMIZATION OF MANAGEMENT DECISIONS IN MEDICAL
ORGANIZATIONS
Yasinska E.
Higher State Educational Establishment of Ukraine «Bukovinian State Medical University», Ph.D.,
assistant professor, Department of Social Medicine and Health Care Organization
Аннотация
В статье aнaлизирyются современные подходы к yпрaвлению медицинскими yчреждениями путем оптимизaции yпрaвленческиx решений, о6суждэются условия принятия эффективных yпрaвленческиx решений и использовaние информaционной поддержки для рaционaльного yпрaвления медицинскими учреждениями.
Abstract
The article analyzes modern approaches to the management of medical institutions by optimizing management decisions, discusses the conditions for making effective management decisions and the use of information support for rational management of medical institutions.
Ключевые слова: информaционнaя поддержи, информaционные технологии, yпрaвленческие решения, медицинские учреждения, yпрaвление медицинскими оргaнизaциями.
Keywords: information support, information technology, management decision, medical institutions, management of medical organizations.
Modern conditions of management of medical institutions significantly increase the requirements for managerial decision-making processes. The process approach, based on such a fundamental principle as the focus on the business process for the application of in-
formation technology, requires a quick response to environmental changes and the adoption of operational decisions.
The purpose of the article: to study of the essence of information support for management deci-
sions, its components in a market economy and the development of information technologies, finding ways to optimize management decision-making in medical organizations.
The functional aspect of decision making involves the process of finding optimal business options both on the basis of existing ones and on synthesizing new solutions, obtained on the basis of analyzing a problem situation. As a rule, the decision-making process includes the following functions: identifying the problem and setting the management task, identifying decision-makers, describing and searching for alternatives, choosing the optimal alternative, implementing, checking, executing and monitoring the implementation of the decision. The above functions, in turn, interact with each other and are cyclical in nature, which has significant potential for success. It is important to note that the success of the solution largely depends on the results of the analysis of the problem situation. As a rule, the process of studying the situation and developing a decision includes the analysis of the following factors: scope, deadlines, goals of the decision-making task, a list of decision-makers, the uniqueness of the management situation, the level of completeness of the initial information, the level of risk and the degree of uncertainty, the level of the time horizon (operational , tactical, strategic), the need to use information systems and technologies to support the decision-making process. The processes of market transformation in Ukraine and the increase in competition necessitate a quick and flexible response to any situation. Under such conditions, traditional organization management systems do not provide an adequate response and require the use of modern concepts, methods and tools of enterprise management, as well as information technologies, hardware and software. In this aspect, the problem of high-quality information support for the management of organizations becomes relevant. Rationally structured information support for the management of the enterprise increases the reasonableness of making management decisions and monitoring their timely implementation, helps to reduce the amount of routine workload and increase the efficiency and reliability of the results obtained. The sources of information may be: sample data on the external environment, the impact of which on the results of the company's activity is significant: regulatory and legislative acts; research and development results; special sources of information; own research and target studies of specialized organizations; conferences, fairs; reviews of periodical literature; out-of-stock and records of the internal state and processes that occur in medical institutions. As a rule, the results of data collection are recorded by reports and primary documents in paper form. Modern technologies include an automated data entry system.
Purpose of the information support:
• making informed management decisions;
• coordination of the actions of managers;
• creation of information systems oriented to interaction with the external environment.
The practice of financial and economic activities in a market-type economy shows that companies of the
same type, having approximately equal material and financial resources, often have significant differences in the level of profits. Some of them are developing dynamically, others are going bankrupt. Leading domestic and foreign economists in this regard indicate that one of the most important reasons for such discrepancies remains differences in the efficiency of management of medical institutions or, in other words, efficiency is developed and implemented by managers of management decisions. In general, the efficiency of management of medical organizations is understood as the effectiveness of the management of institutions, which is a consequence of the ability of managers to develop effective management decisions and achieve their goals. Many economists are of the opinion that management efficiency is a function of two variables: the cost of developing management decisions and the content of the management apparatus, on the one hand, and the results of management activities are reflected in changes in the values of indicators that evaluate the state of the management object — from other. The level of economic efficiency is the most important characteristic of the management system and the quality of management decisions. In assessing the effectiveness of management decisions, it is necessary to provide a synthesis of the economic and social aspects of management. In accordance with this, a system of performance evaluation criteria should be developed. As criteria of efficiency, such indicators as profit growth, production volumes and product sales, change in pay-back periods of capital investments, increase in working capital turnover, increase in economic profitability, reduction of expenses for the maintenance of administrative apparatus and others can be used. As a base for determining the economic effect, the values of indicators of financial and economic activity at an existing enterprise or similar enterprises for newly established firms are taken. Everyone acknowledges that the process of evaluating the effectiveness of management decisions is not an end in itself, but acts as a lever for using reserves to increase the efficiency of social production. Evaluation of the effectiveness of a management decision serves as a measure of the expediency of changes in the system of management of an enterprise, a firm, and, ultimately, should determine the nature and content of specific changes in the activity of an enterprise or organization. Economic evaluation of the effectiveness of management decisions cannot be considered in isolation from the assessment of production efficiency. But the direct use of production performance evaluation may be insensitive to changes in management. Therefore, it is necessary to look for more specific, narrow indicators of the effectiveness of management itself.
It is advisable to highlight some principles for evaluating management decisions. These include: 1) the complexity of assessing the effectiveness of management decisions;
2) the objectivity of the assessment of management decisions;
3) the obligation to evaluate the effectiveness of management decisions;
4) conformity of the method of estimating the nature of the control object;
5) comparability of indicators of evaluation of various managerial decisions;
6) accounting of individual features of an enterprise, management situation in constructing a model for assessing the effectiveness of management decisions.
Analysis of the problem of assessing the economic efficiency of management decisions allows us to distinguish the following elements of the content of performance evaluations:
1) criteria (as measures of objectives) of economic performance evaluation;
2) effects as descriptions of the consequences resulting from the implementation of management decisions.
Depending on the nature of the activities of medical institutions, one or another method of evaluating the effectiveness of a management decision is selected. In terms of the role of methods in the evaluation process, they are divided into:
• methods of accounting for the connection of social and political factors with the assessment of economic efficiency;
• methods for selecting criteria for evaluating the effectiveness of management decisions;
• methods of selecting the effects of the implementation of management decisions;
• methods for determining criteria values; o methods for calculating effects.
By the nature of the work performed assessment methods can be divided:
• methods of selection and identification in the process of developing an effectiveness evaluation;
• calculation methods in the evaluation process;
• description methods in the evaluation process.
From the point of view of the role of the person in the assessment process, the methods are divided into formal and informal. Accuracy achieved in the process of evaluating the results distinguish accurate and approximate methods. From the point of view of expenses, methods are distinguished which require considerable time for specialists, complex computer equipment and financial resources, and methods that do not require significant expenses. If possible, the implementation methods can be divided into complex and simple. The variety of methods requires the inclusion in the assessment team of various specialists and the harmonization of methods used at various stages of the assessment. Professionals who are part of the assessment team must be professionals in their field, have appropriate education and experience in this field. With constant work as part of a team of specialists, they not only improve their knowledge and skills, supplement their practical experience, but also acquire new methods for evaluating their effectiveness. According to the functional nature of the stages of the effectiveness evaluation process and the content of the methods used at these stages, it can be concluded that the assessment team must be comprehensive. This corresponds to the complex nature of the subject property. The adoption of a management decision, in essence, is an intermediate
phase between management decisions and management influence. Based on this, the effectiveness of management decisions should be characterized as a combination of the effectiveness of the development of management decisions and the effectiveness of the implementation of these management decisions.
The nature of the managerial decisions made is influenced by the completeness and reliability of the information available in this situation. Proceeding from this, management decisions can be made under conditions of certainty (deterministic decisions), and in conditions of risk or uncertainty (probabilistic solutions). The process of making managerial decisions is a cyclic sequence of actions of the subject of management aimed at solving the problems of this organization and consists in analyzing the situation, generating alternative options and choosing from them the best option, and then implementing a chosen management solution. The practice of preparing and executing managerial decisions gives numerous examples of errors at all levels of economic management. This is the consequence of the action of many reasons, as the development of the economy consists of a large number of different situations requiring their permission. The most important place among the reasons for the adoption and implementation of ineffective management decisions is ignorance or non-observance of the technology for their development and organization of their implementation. An important role is played by the cybernetic approach to the development of managerial decisions, which has become known as decision-making theory. It is based on the widespread use of mathematical apparatus and modern computer technology.
An effective management decision can be made: compliance with the hierarchy in decision making; o use of cross-functional groups; o straight horizontal connections; o centralized leadership. The hierarchy in decision-making, the delegation of authority to make decisions is closer to the level at which there is more necessary information and which is directly involved in the implementation of the decision. In this case, the executives of the decision are employees of adjacent levels. Contacts with subordinates that are more than one hierarchical level below (above) are not allowed. Target cross-functional groups are used, whose members are selected from various departments and levels of the organization. In addition, there should be direct (direct) horizontal communication. In this case (especially at the initial stage of the decision-making process), the collection and processing of information is carried out without recourse to top management. Such an approach contributes to decision-making in a shorter time and increases the responsibility for their implementation. The decision-making process should be in the hands of one (common) manager. In this case, a hierarchy is formed in decision making, that is, each subordinate manager solves his problems (makes decisions) with direct management, and not with a high-level manager. As already noted, the best option is when a solution is chosen due to the consistent evaluation of each of the proposed ones. This determines how each solution provides for achieving the goal. Thus, the solution must meet the requirements arising from the situation itself and the
goals of the organization, namely: o efficiency, that is, more fully ensure the achievement of the goal set by the organization; o cost-effectiveness, that is, to ensure the achievement of the goal at the lowest cost; o timeliness, that is, to mean not only the necessary moment of its adoption, but also the timeliness of the achievement of goals. When a problem is solved, events continue to evolve. It may happen that a great idea will become obsolete and lose meaning over time, although at first it was good; o reasonableness, that is, performers must be sure that the decision is justified. In this connection, one should not confuse actual validity and its perception by performers - their understanding of the arguments that motivate the manager to make just such a decision; o reality, that is, you can not make unrealistic, abstract decisions. These solutions annoy the performers and are fundamentally ineffective. The decision must be consistent with the forces and means performed by his team. A special role in the effectiveness of decisions is played by methods of communicating decisions made to the implementers. Bringing decisions to performers, as a rule, begins with the division into group and individual tasks and the selection of performers. As a result, each employee receives a specific task, which is directly dependent on his official duties. It is believed that the ability to transfer tasks to performers remains the main source of effectiveness of the decision. In this regard, there are four main reasons for failure to comply with decisions: o the decision was not clearly formulated by the manager; o the decision was clearly and precisely formulated, but the performer did not understand it well; the decision was clearly formulated and the performer understood him well, but he did not have the necessary conditions and means to carry it out; o the decision was correctly formulated, the performer assimilated it and had all the necessary means for its implementation, but he did not have internal agreement with the solution option proposed by the manager. The executor in this case can have his own, more effective, in his opinion, solution to this problem.
Conclusions: the effectiveness of the decision depends not only on its optimality, but also on the form of bringing it to the executors (design decisions and personal qualities of executives and performers). The organization of the implementation of decisions taken by the management as a specific activity of the manager assumes that he keeps the vision of the decision, finds a way to influence them, manage them.
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