SPACE AND WORK FLOW MANAGEMENT

Introduction

Workspace may not always be enough or adequate. It’s important to make use of limited available space.

The major features may include:-

• Shortage of rooms
• Small rooms

Rooms can have double functions if they are carried out at different times. Two related rooms can be combined in one room. This applies to shortage of rooms e.g. can have a morning immunization session and then after noon adolescent and reproductive health programme. Different integrated activities can be carried out under one roof.

To small rooms: – The available space, should be used more efficiently where people are few. Small rooms can be used if unnecessary people and furniture are removed from the room plus an efficient storage for files.

Rationale

• Space is a resource: rent for example Multiplex
• It is scarce
• Required for many purpose, hence competition
• Receives little attention during training and health planning
• Allocation not always a smooth process
• Conflict arise out of space management for example
• Ethiopia and Eritrea: Not yet solved
• Palestine and Israel: will (probably) never be solved

Common space problems in health facilities

• Shortage
• Inefficient use
• Congestion
• Non-transparent management

• Unplanned development

What space?

• Land
• Compound
• Parking
• Accommodation
• Office
• Desk
• Notice board
• Computer

Institutional spacing allocation

• Before attempting space allocation

• Conduct a space inventory
• Determine the space needs
  • Space needs analysis: ask what is needed
  • Space audit: check whether what is available is adequate for actual needs based on standards
• Create a space database (who is where?) Who needs how much? Where is the shortage? Etc
• Create a space allocation committee of experienced (not senior) staff
  • Set up procedures for space allocation
• Requisition
• Allocation criteria
• Eligibility and entitlement criteria
• Vocation criteria
• Re-allocation criteria

• Sharing criteria
• Allocation duration limit

Doing a space survey

• Interviews with knowledgeable departmental personnel to prepare

• Summary room list
• Draw a floor plan
• Fill the room survey form
• Group the usage into categories of functional usage
• Make an employee list

Doing a space inventory

Knowledgeable departmental employees have:

• Firsthand knowledge of how the space is used
• An understanding of the activities performed in the rooms
• Information on funding sources related to the activities for the space (grants, contracts, departmental funds etc)
• Access to the space and occupants of the space
• Knowledge on local departmental sensitivities about space

Criteria for space allocation

• Institutional goals and priorities
• Master plan for development
• Long term plans
• Program for which space is allocated
• Activity for which space is allocated
• Level of activity: performance and traffic Principles of space allocation and use Managing office and workspace

5 key principles

• Compartmentalise: Have space for each activity
• Declutlerise: use file boxes and bins
• Categorize: file inactive documents
• Utilise all space, even upwards
• Minimise time wasted by quick filing

Institutional space

• Have a master plan
• Label the buildings
• Label the paths/roads
• Indicate directions to major destinations

• Have notice boards
• Establish space management regulations
• Have space management committees

Inside the buildings

• Label departments
• Give directions to and fro
• Label rooms
• Use notice boards/bulletin boards
• Ensure labels are maintained and up to date

Notice boards

• Be
  • Placed in strategic points, likely to be seen by the target audience
  • Well maintained
  • Of good or appropriate size
• Allocate specific parts of board for certain notices
• Colour coding may be used for different types of announcements for easy notice
• Remove notices when they become irrelevant
• Avoid pinning over other notices
• Have sections for official and non-official notices
• May need to screen off part of notice board with lockable glass window

Car parking

• Allocate specific space for car parking
• Use way-finding posters to direct to parking lot
• Perimeter (outside) parking encouraged
• Park and ride also encouraged
• Metered parking (20-25 min) may be used
• Parking fees discourage use of vehicles
• Valet parking helps to reduce on poor parking
• Educate on and enforce parking regulations
• Demarcate parking space
• Label vehicle according to parking area
• Promote and prioritise ride-sharing
• Create space for motorcycles and bicycles

Access

• Access is a major concern to new visitors, the unfamiliar and the distracted
• Needed in many places: hospitals, universities etc

• In health facilities, life can be lost if access is not well managed

Access functions

• Traffic and circulation
• Public and alternative transport
• Parking
• Entrances
• Emergency activities
• Loading and unloading

Access management involves:

• Planning
• Implementing
• Integrating and
• Managing access-related functions

Regular access audit is required, to keep improving the access function

Access to final destination is an important component of perceived quality for example

• Finding parking space
• Finding the main entrance or desired door
• Obtaining direction (from signs or staff)
• Finding way to final destination

Access audit

• Regular users should also be guided because their activities may affect access to suppliers, vendors and volunteers
• Assess access functions

Work flow management in the health unit

Work flow is an arrangement in which a series of work functions are coordinated in space and time so that delays are minimal.

• The greatest obstacle to the organization of work flow is one of
• Prevent congestion and queues- they are not indicators of how busy and hard working you
• It is essential to examine the whole process- removing a queue from one stage may result only in creating a queue at another (for example if the position at the examination room is improved, patients may have to wait at the pharmacy for their drugs).
• Avoid delays (provide service with only a very short waiting time). Example in a health care facility:-
  • Label every door

• Separate rooms for new and repeat visitors. Give identification numbers usable during return. Simplified filing system …
• Establish a brief assessment room for preliminary treatment, and resorting of patients. Daily returning patients should go directly. Appointments with busy officials should be made carefully.
• In the pharmacy pre-package routine courses of drugs. Keep a stock of written instructions to patients on how to take routine course of drugs.

MANAGEMENT OF TRANSPORT

Most Health Units have some means of transport at the Health Unit level. These include:- bicycles, motorcycles and vehicles depend on level of Health facility. For such transport means to be useful for the intended results, some minimal management procedures or instructions need to be instituted these include:-

• Keeping an update inventory record of various types of vehicles, under your care as regards make up or type, registration number and other identification marks brought in and what conditions and who uses (responsible officer)
• Servicing and maintenance

This entails careful handling to prevent break down or routine maintenance, work on the vehicle should strictly be followed. Early inspection before departure for long distance should be done ensuring adequate fuel and oiling. All vehicles should have a programme travel specifying when, why, by whom and of what purpose.

For each vehicle should be maintained so as to avoid fuel wastage and unnecessary movement or unauthorized journey, with a proper working speedometer to show mile age reading on departure, on arrival and total distance covered.

This should be followed to achieve intended purpose.

Training use of vehicle:- vehicles should be handled by properly trained driver/personal who are well composed and of good integrity.

MANAGEMENT OF PERSONNEL

People are the most important resources of any country and as such should be managed properly. It’s important to manage staff properly because 80% of health budgets is spent on salaries and staff benefits, the personnel are crucial assets. Secondary, managing staff is more complex than managing other resources.

The field concerning personnel administration has subsequently changed names to management, manpower management; human resources management. All means the same i.e. the organizational function concerned with the management of employees.

When personnel are well damaged can make the best use of the available resources. Health staff management involves several approaches and sub functions which include the following functions:-

• Planning, organization, directing and controlling all the human activities of the
• It is concerned with the people at work and their relationships within the organization
• It strives to bring together and develop into an effective organization people who make up an organization as well as the well-being of individuals and working groups so as to make the best contribution to the organizations success.

MANAGEMENT RESPONSIBILITIES OF AN IN-CHARGE OF A HEALTH UNIT

The incharge is responsible for proper operation and management of a health unit ultimately the incharge is responsible for:

• Monitoring the staff in terms of the quantity of work, quantity of the work they do and punctuality
• Determining the allocation of staff on different duties
• Accounting for revenue and ensuring efficient and honest use of it
• Ensuring constant availability of drugs and other supplies
• Ensuring timely reporting, keeping the files updated and in good order (filling)
• Plan and follow up activities, ensuring that they are executed as
• Equally, the in –charge is expected create a strong bond between the Health Unit and the communities in the services which in his catchment area.
• The in –charge is entrusted to improve the coverage of preventive services g. Immunization notification of diseases etc.
• The in –charge is also entrusted to every patient (client)

MANAGING PAPER WORK

Definition of an office

• An office is a place where paper work is done, documents and letters are stored. It is not always a whole room. It may be a desk or table or a corner of a room. Paper work mainly correspondences and maintenance and use of records, is an essential part of management of a health service and almost all health activities involve paper work.
• Its quantity and efficiency play a large role in the effectiveness of health care activities and programmes. Without a well arranged record’s system, neither clinical care nor community health work can be monitored or controlled. Paper work is the communicator, (correspondence, the information system (reports) and the memory system (records and registers) of a health service.
• We shall deal writing referral letter and other official letters, plus organization of record system. Down is the functions of an office and the corresponding paper work.