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Problem Solving Dr Kithsiri Edirisinghe MBBS, MSc , MD ( Medical Administration )

Problem Solving Dr Kithsiri Edirisinghe MBBS, MSc , MD ( Medical Administration ). “ Add Scientific thinking to sixth sense …. ………………… the commonsense”. Session outcomes. Complete knowledge in “Defining and Identifying problems “ Development of the skill in “Analyzing problems “

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Problem Solving Dr Kithsiri Edirisinghe MBBS, MSc , MD ( Medical Administration )

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  1. Problem SolvingDr Kithsiri EdirisingheMBBS, MSc , MD ( Medical Administration ) “Add Scientific thinking to sixth sense …. ………………… the commonsense”

  2. Session outcomes • Complete knowledge in “Defining and Identifying problems “ • Development of the skill in “Analyzing problems “ • Insight to “ finding Solutions to a problem”

  3. Session 01 • “Defining and Identifying problems “ • What is problem ?

  4. What is a problem ? “An observed gap between what is expected and what actually exits”

  5. The definition • A perceived gap between: • the existing state and a desired state • , or a deviation from a norm, standard, or status quo. • Many problems turn out to have several solutions • (the means to close the gap or correct the deviation),  • difficulties arise where such means are either not obvious or are not immediately available.

  6. The Equation • P = ( E – A ) C P – problem E- expected level A- actual Level • C = Concern level • Influenced by many factors • Political • Social • Professional • Organizational • Individual

  7. Problemand solution • Problem need to be solved • completely • partially • Objective • is the quantified level improvement expected of the problem situation

  8. Problem Solving process : the steps • Identify the problem • Analyze the problem • Set objectives • Identify the solutions • Select the options • Implement the solution

  9. Problem solving Techniques • Go to this link and study all the PS techniques • http://www.youtube.com/watch?v=dENYL2mk4OE&list=PL5E8E6546FDB5B1D2 • http://www.mindtools.com/pages/article/SubscriptionProcessedProblem.htm

  10. Problem solving Techniques • Pareto analysis • Cause and effect analysis • Histogram's • Scatter diagrams • Floor charts • Control charts check sheet • Cost benefit analysis

  11. 1. Identifying the Problem Situational analysis Formal recognition Definition Watch V 01 for use of PDS document

  12. a. Situational analysis • “ Snap shot “ of the problem - Situational Analysis • Noticing something is not right • Information flow from the others • Observation • Information • Complains • Conflicts

  13. a. Situational analysis • Identify • Stake holders • Scope of work • Expectation – out come • Examine the current state • Constrains • Time available to solve the problem

  14. Hospital clinic Let s identify issues !

  15. b. Formal Recognition • Convinced that there is a problem • Use experience personnel to prioritize problem • Use Pareto analysis for a complicated issue • 80 to 20 rule • V 02 & V 03

  16. c. Definition of the Problem • Clearly indicate the extent of the problem. • Qualify and quantify

  17. 2. Problem Analysis Cause and effect diagram Place objectives Study and analyze the problem

  18. Methods and Tools Analysis...... • Identify a “core” or central problem • List all the problems related to or stemming from the core problem • Determine which related problems are causes and which are effects of the core problem • Arrange the problems in a cause-effect heirarchy around the core problem

  19. Study the problem • Identify key stakeholders and ensure the ‘right’ people participate • Collect relevant background information • Ensure lessons learned from previous similar issues are considered • Prepare a problem tree / fish bone which provides a simplified but robust version of reality

  20. Methods and Tools Analysis ..... Purpose:toidentify major problems and their main causal relationships. Output:a graphical arrangement of problems differentiated according to ‘causes’ and ‘effects

  21. Analysis • List causes • Main causes – categories • Sub causes • List effects • Main Causes – categories • Sub effects

  22. Methods and Tools Problem Tree Example

  23. Fish bone Diagram

  24. Fish Bone diagram Doctor centered culture Unknown patient choice behaviour High Patient Expectations Poor regulation Poor Quality in Private hospitals Untrained staff Lower Perception of the Administrator Widening demand gap Resource constrains

  25. 3. Set objectives Expected problem improvement SMART Specific M – measurable A- achievable R- reliable /realistic T – time bound

  26. Problem Tree

  27. 4. Identify the solutions Identify the solutions Select the options

  28. Determine options • Solutions • Convert • The cause a solution • Effect to a good result • Be Creative

  29. Solution and objective tree Solutions Good results

  30. 5. Evaluate & Select options • Debate ,study, agree • ECT matrix- • Effect, • Time • Cost

  31. ECT Matrix

  32. 5. Implementation • Implement • implementation plan • Inauguration • Monitor • Monitoring systems • Control • Mechanisms • Feed back • Regular and adaptations

  33. Activity You are requested by the DG of health services to solve the issue given below • Dengue epidemic • RTA – Road traffic accident • HAI – Hospital Acquired Infections • Rising cost of health care • Shortage of nurses

  34. Thank You !

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