2nd CLASS

Topic: Infrastructure (part 1.1): the administrative process and the

resources that are managed.

Objective: The student will define the stages of the administrative

process in the context of health services.

Activity: The student will answer a series of questions related to the

administrative process.
Key points
- The company.
- Know the concept of Universal Administrative Process and each of its phases.
- Planning.
- Organization.
- Direction and Control. (these phases are reviewed in the 3rd session)

Hospitals, like any other type of social organization that has production and service
purposes to obtain a profit, are considered and should be managed as "companies".
Therefore, it is necessary to understand what the characteristics of a company are before
continuing. There are different classifications, but in a generic way they are classified
according to their activity in:
1. Industrial
2. Commercial
3. Services

The term company can be defined as the organized set of physical, human, technological
and financial resources, oriented to economic, social, cultural, religious or any other
objectives that generate benefits through the production of goods or the provision of
services.
Industrial: when they produce, by extraction (primary sector) or manufacturing (secondary
sector), specific goods.
Commercial: they are the intermediaries, whose task is to make the products available to
the end user, they buy manufactured products or even services at a price (generally
cheaper by wholesale volume) and then sell them at a higher price to offset the costs of
logistics and make a profit (profit). In this area, for example, insurers can be located, which
act as intermediaries between patients and medical service providers. They are located as a
"tertiary" sector.
 Services: also located in the tertiary sector, not necessarily for profit, they provide
services. In this group are located financial institutions, transportation, tourism, education,
health, public services such as water, energy and communications.

The word administration is of Latin origin, it implies the idea of obtaining results through
others. By definition it means the action and effect of "administering something", and the
word administer comes from the Latin "administrare" which means to govern and exercise
authority or command. More broadly, administration is a discipline that seeks to achieve
objectives, through a "coordinated" and systematic structure and human effort. The
administration is carried out through a set of rules, techniques and orderly and
systematized practices, in order to support the achievement of the objectives, through the
provision of necessary means to obtain the maximum possible efficiency, to ensure the
success of the company.

The goal of management is to achieve results; it has a social aspect, in this sense it is said
that it is always necessary in human groups; The collaboration of the human element is
essential that, combining efforts, moves the company; Coordination, the systematization of
resources is also necessary; And to close with the attributes or elements of the
administration, we will say that it does not base with the search for results, but that these
results are obtained with the optimal use of resources (that is, efficiency).
Before entering fully into the administrative process, it is important to clarify that this
discipline (administration) is not something new, because since man has struggled to
survive on the face of the earth, a certain degree of administration has been essential. The
need to defend himself or to protect himself from threats from the environment, forced
him to group together in societies with common objectives, whether for hunting, food or
defense. It could be said that the survival of the human species was the product, not only
of a biological evolutionary process, but of a certain degree of "administrative" maturity
reached by primitive societies. A highly respected professor would say: "administration for
survival."
The struggle for the survival of the human species motivated the evolution of
administrative thought up to the present day. At present, this discipline is applied
consciously or unconsciously to all activities of organized life and coexistence. The larger
and more complex an organization is, the more necessary the administration becomes,
applying the administrative process effectively leads to the adequate use of resources,
increases productivity, increases the possibilities of growth and development of the
company and its results impact on the well-being of the communities .
From all of the above, the importance of proper administration becomes evident, but at
this point, it is pertinent to clarify that the object of administration is "eminently practical",
that is, it is a means to achieve achievements and is not due to it. Treat as an end in itself,
the latter is a risk that is run when someone starts in the discipline and if it is not corrected
it can lead to defects that, far from paying for the correct development of programs and
projects to achieve the objectives, will hinder the dynamics of the company.
Some "symptoms" that you are losing your way are known in the colloquial language of
administrative jargon as: a) junctitis: excessive meetings are called that rob employees of
time without reaching objective conclusions or results; b) formatitis: nonsense formats are
designed and far from facilitating the processes, they fatten and hinder them; c)
committees: for all matters a committee is generated, meaningless and without objectives
d) war of offices: offices are generated to answer everything that is instructed or
requested, but in a belligerent and defensive attitude. I could mention much more but, in
experience, I consider these to be the most frequent.

As a practical advice, a basic principle that the student can use, without so much
sophistication of terms, is the following: "get organized, organize, delegate and supervise";
In my student days this principle helped in the different groups where I had the opportunity
to participate as an activist in various projects, first in the medical school and later in the
social field, even up to my years of residency in the medical specialty this simple The
principle served effectively group development purposes.
But it was not until my first opportunity as a public official, working as a medical deputy
director in a small hospital of trunk specialties (10 beds) that I had the opportunity and also
the need to study and start the formal administrative process as part of my responsibilities
in the public service; I remember my first years as an "administrator of something",
because those experiences helped me to understand and optimize the exercise of
administrative discipline in a more practical way. Next, we will get to know the theory of
the administrative process.

The administrative process is unique, dynamic, continuous, cyclical, simultaneous and

practical.
I will do my best, not to discourage those who have the illusion of becoming bosses one
day, for now I will talk about the theoretical part, the characteristics and their virtues,
because in the end there are lessons that cannot be learned if they are not experienced. in
own flesh.
Some theorists divide the administrative process into a phase→
1. Mechanics: planning and organization
2. Dynamic: Management and control.

-Planning: The course to follow and what has to be done to achieve the objectives is
established. Sometimes it is confused with just making a calendar (it implies setting the
course, establishing the desirable and feasible future).
-Organization: The way in which the work will be done is defined. Sometimes it is confused
with just an organization chart (it implies delegating authority and sharing responsibilities).
-Management: See that what has to be done is done. Sometimes it is confused with just
giving orders (it implies making things happen and not remain in the inkwell or on the desk,
it implies being committed to the results through lawful means, the end does not justify the
means).
-Control: Supervise the work carried out, its results and its impact on the objectives.
Sometimes it is confused with just sitting and waiting for the productivity numbers
(analyzing and comparing results, requires an objective exercise of self-criticism and the
attitude of improving to correct, retake or continue the course).

Next, we will go on to describe each stage of the universal administrative process, I insist
that this process can be applied to any area of life, personal, family, social, political and
work. For this reason, I recommend that you take special interest in the next part, as it
represents the core and starting point for this matter.
Planning: It is the initial stage of the administrative process. It is the starting point of formal
administration. It consists of determining the course of action to be followed to achieve the
objectives, establishing the basic guiding principles, activities, times, units and resources.
All future administrative actions are started, it establishes the foundations for the
development of the following phases. It consists of determining the specific course of
action to be followed, setting the principles that will preside over and guide them, as well
as the sequence of activities necessary to achieve the objectives and the setting of times
and units for their realization. At this stage, the following are established: objectives,
policies, strategies, programs, procedures and budgets. When planning, the objectives
must be specified and prioritized. The planning allows to reduce the uncertainty, since the
correct planning must anticipate future situations of risk, which forces to have prepared
alternatives of solution before a crisis to act in a timely manner without improvisations,
avoiding making decisions based on "intuition or personal experience. "with subjective
appreciations or moved in despair by the stress that causes a crisis.
Proper planning avoids leisure, routine, since from it specific calendars and regulated
periods of work intensity are established to optimize times, in this way it helps to improve
productivity and reduce costs by making the most of available resources.
It is from this moment that the bases for the control stage must be set. Remembering that
famous passage from the tale of Alice in Wonderland, when it asks the cat: «which way
should it follow ?, to which the cat asks: where do you intend to go? and Alicia responds:
that doesn't really matter, and finally the cat answers: if you don't know where you want to
go, it doesn't matter which way you should take ». In other words, "he who does not know
what he is looking for does not understand what he finds"; that is, if you do not carry out
adequate planning, then your control stage will not do you much good to deliver good
results. Let's move on ...

Stages of planning
Determination of objectives: results expected in a period of time. They must be
accompanied by their quantitative expression in the form of goals.
In military discipline it is defined as a point or area that is intended to be reached or
occupied as a result of a military operation, it implies independence and dispassion.
Policy formulation: According to the dictionary of the Spanish language, the word "politics"
has different meanings, most of them related to public affairs; however, in this case the
term "policies" refers to orientations or guidelines that govern the actions of a person or
entity in a matter or field. They are a guide-to-guide actions, it is also said that they are
criteria to follow to make decisions. They are part of the regulatory structure of the
company, their non-observance leads to sanctions. E.g. the policy of "zero rejection" in
emergency services, who does not comply with it is subject to sanctions determined by the
corresponding regulatory framework. From the Greek strategía (office of the general), and
from the Latin: province under the command of a general. It means the art of directing
military operations, it is also the trace to direct a matter. It is an adjustable process, a set of
rules that ensure an optimal decision at all times. It consists of the predefined course of
action, considering its alternatives to guide the use of the resources of the entire
organization, optimizing efforts to achieve the objectives. There is a whole discipline to
define strategies, Strategic Planning, consisting of analysis of the internal and external
context.
Preparation of programs: The programs establish the sequence of actions according to an
established period of time. A program is the prior declaration of what is intended to be
done in some matter or occasion, it is also defined as the ordered series of operations
necessary to carry out a project. In this section we must specify some important concepts,
to avoid confusion in the future.
It is necessary to clarify certain concepts, which are defined below:
• Plan: refers to decisions of a general nature, that is, of a global nature. For example
a National Health Plan.
• Program: try to specify, in general terms, the content of a plan. Therefore, a plan is
made up of several programs. In turn, a program is made up of an organized and
coherent set of services that is made up of several projects of a similar nature.
• Project: set of specific activities, related and coordinated with each other, carried
out in order to solve problems. Every project has a specific duration, requires the
coordinated action of human, technical, financial and material resources. The
projects conclude with products and results according to what was foreseen from
their design. An ordered set of interrelated activities, which requires the
coordinated participation of human, technical, material and financial resources,
whose development is intended to achieve a certain objective or result, always
framed within the limits of budget and calendar.
• Activity: it is an action to intervene in reality, necessary for the performance of a
project.
• Task: action with the minimum degree of precision and specificity, that is,
specialized and concrete action. A set of tasks make up an activity.
Establishment of procedures: A set of specific, ordered, hierarchical, regularized and
standardized activities to be carried out repeatedly. They give certainty to the personnel,
define actions, organize them, define routes, decision algorithms and those responsible for
each action. Each procedure has scopes and operating policies. The organization manuals
define the anatomy of the company (components of its organic structure), and the
procedure manuals describe its physiology, that is, how the organic structure interacts with
the technological and material resources to achieve the objectives of the company.
Procedures manuals can be designed in a simple way, first establishing the objective (the
purpose) and scope (who should apply it and in what stages of care) the policies or rules of
the procedure, description of the activities with those responsible for each one , finally a
graphic illustration called a "flow chart". In the KNOW MORE you will find examples of
organization and procedure manuals, I recommend you review them because as part of the
activities of this course you will have to design a small organic structure (organization chart
with functions) and some procedures (including its flow chart).
The normative structure of any institution has a hierarchical order, in such a way that the
supreme norm is the political constitution and the rest of the legislation emanates from it:
1) political constitution of the United Mexican States, 2) general laws, national plans of
development, 3) regulations, 4) organization manuals, 5) procedures manuals, 6) circular
letters. Therefore, when designing the regulatory structure of a hospital in the form of
organic statutes, organization manuals and internal policies and procedures, they must be
aligned with the regulatory framework, otherwise provisions contrary to the laws would be
established.
Budgeting: It is the relationship between costs and expected results. They translate the
plans into financial terms, to project the necessary resources in a specific period of time for
the plans, programs, projects, activities and tasks to achieve the established objectives.
Budgets are also control tools. When they are projected in currency (expenses, costs,
profits) they are called "financial", the "non-financial" include production, sales, man-hours.
In the public sector there is a budget law that must be known, as well as the corresponding
operating rules for spending.

Organization: As mentioned previously, during the organization stage the anatomy of the
organization is defined. It is the technical structure of the relationships that must exist
between the different functions, levels and activities of the material elements. In this
process the plans are activated; the scaffolding of inter-departmental relations and
between hierarchies is created, without this "scaffolding" there will be anarchy and
uncertainty, even power and merit struggles if the attributions are not clear, remember
that authority is delegated, but responsibility is shared .
It is the means to carry out to its last details what is indicated in the planning. Although
there are authors who place this stage as the mechanical part of the administrative
process, it is still dynamic and continuous, it must be constantly updated, but never on a
whim, for example: if each change of owner or manager or director means a change in the
structure organic, over time the talents and experience of human capital will be lost as
every so often a learning curve will start again that also implies risks for the company.

Organization:
In this stage, the mechanisms and means for the supply of resources are defined, to avoid
slowness or inefficiency in the activities. The organizing process can be described in two
stages:
1. the division of labor
2. coordination
We will describe the process below:

Division of labor:
As its name indicates, it consists of separating and distributing the workloads, it is
recommended that this division be carried out under the principles of precision and
efficiency, in order to favor the specialization and improvement of the tasks. At this stage,
hierarchies are designed, substantive functions are departmentalized, and functions are
clearly defined.
• Hierarchical: It is essential to clearly define authority and responsibility, specifying
the degree of responsibility assigned to each boss (responsibilities are defined for a
position or command unit, therefore, whoever arrives at the position must meet
the necessary competencies for their optimal performance and never the opposite
trying to adjust the position to the person). The authority delegated to the position
 must also be firmly defined, to give certainty and that the position is held efficiently,
having the ability to command and exercise acts of authority.
• Departmentalize: common activities are grouped, framed in a substantive function,
to give the workforce greater efficiency through the specialization of tasks.
• Define functions: having defined the hierarchies and departments, now functions
must be assigned to each specific work unit (position), according to the
corresponding hierarchy and department, for this it is essential to define these
functions in a clear, precise, coherent way and congruent with the rest of the work
units.

Coordination:
It is the way in which individual and collective efforts are tuned to work harmoniously
towards established goals. Proper management of "interrelations" will result in concerted
actions through well-integrated and balanced combined efforts. It is important to know
that the number of administrative units dependent on a higher body (control section) must
be rationally calculated, since an excess can lead to problems with communication
channels, a fundamental element for proper coordination.
The span of control is determined by the organic relationships between a higher body
(chief, eg, head of the emergency department) and his subordinates (workers, eg,
emergency base doctor). Today companies prefer more horizontal structures, this means
not exaggerating with the number of positions, excess personnel, can lead to lack of
control, inefficiency and conflicts by exponentially increasing the number of relationships
or interactions.
Organization….
But the organization stage does not end with the design of the organic structure of the
company, it is important to review it periodically. There are many reasons for its revision;
For example, technological advances have led to the disappearance of some trades, the
evolution of institutions with new customer expectations, legal requirements and
technology have modified the necessary skills of certain professions and thus bring the
need to modify functions and responsibilities.
Other reasons for the review are the needs and financial situation of the companies that
may require reduction of staff and with it the modification of the functions of their work
units, these staff reviews, either to expand or reduce (more frequent) command posts must
be accompanied by a method called "process re-engineering" by means of which processes
are improved to make them more efficient, when doing the job reduction review, the
processes should be reviewed to redistribute the functions with The purpose of avoiding
problems due to inefficiency of the processes after the reduction of staff.

Reflection space:
Then I share the following video: [Administrative Process: Planning and Organization], in it,
the revised topic is synthesized in a general and very practical way.
https://www.youtube.com/watch?v=6wzBVQNsQa8
Referencias:
– Capítulo 3.- El hospital como empresa. En: Fajardo Dolci. Dirección de Hospitales. Editorial
Manual Moderno. 2008. (Págs: 29 a 38).