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THEORETICAL CONCEPTS AND MODELS OF OPERATIONAL MANAGEMENT
E. Baimagambetova1, S. Tultabaev2
1NcJSC "Social Health Insurance Fund", Kazakhstan, ZOOT6E5, Nur-Sultan, Imanov street, 13
2Almaty Management University, 50060, Kazakhstan, Almaty, Rozybakiyeva street, house
227
Elmira Baimagambetova - Deputy Director of the Department of Drug Provision of NcJSC "Social Health Insurance Fund", Nur-Sultan, Kazakhstan. Email: elmira.ghs@gmail.com
2Sultanbek Tultabaev - Ph.D., Associate Professor, Almaty Management University, Almaty, Kazakhstan. E-mail: tsultanbek@mail.ru.
Implementation of process management system in health care system requires development of process system through allocation, classification and definition of business processes of organization. The process approach allows an organization to plan its processes and their interaction. A key advantage of using any process framework is having a common language and clarity about an organization's processes.
Key words: operational management, business processes, quality management system, process approach.
ТЕОРЕТИЧЕСКИЕ КОНЦЕПЦИИ И МОДЕЛИ ОПЕРАЦИОННОГО МЕНЕДЖМЕНТА
Э.Ш. Баймагамбетова1, С.Ч. Тултабаев2
1НАО "Фонд социального медицинского страхования", Казахстан, ZOOT6E5, Нурсултан, улица Иманова, дом 13
2Almaty Management University, Казахстан, 50060, Алматы, Розыбакиева, 227
1 Баймагамбетова Эльмира Шатыбаевна - Заместитель директора департамента лекарственного обеспечения НАО "Фонд социального медицинского страхования", Нур-Султан, Казахстан. Электронная почта: elmira. ghs@gmail.com
2Тултабаев Султанбек Чуманович - к.т.н., доцент, Almaty Management University, Алматы, Казахстан. Электронная почта: tsultanbek@mail.ru.
Внедрение системы процессного управления в системе здравоохранения требует разработки системы процессов через выделение, классификацию и определение бизнес-процессов организации. Процессный подход позволяет организации планировать ее процессы и их взаимодействие. Ключевым преимуществом использования любой структуры процессов является наличие общего языка и ясности в отношении процессов организации.
Ключевые слова: операционный менеджмент, бизнес-процессы, система менеджмента качества, процессный подход.
ОПЕРАЦИЯЛЬЩ БАСЦАРУДЬЩ ТЕОРИЯЛЬЩ ТYСIНIКТЕРI МЕН МОДЕЛЬДЕР1
Е.Ш. БаймаFамбетова1, С.Ч. Тултабаев2
^сЭлеуметпк медициналы; сактандыру коры» КеАК, Казакстан, ZOOT6E5, Нурсултан, Иманов кешеа, 13
2Алматы Менеджмент Университетшщ, Казакстан, 50060, Алматы, Розыбакиев, 227
1 Баймагамбетова Эльмира Шатыбаевна - «Элеуметпк медициналык сактандыру коры» КеАК Дэрьдэрмекпен камтамасыз ету департамент директорыныц орынбасары, Нур-Султан, Казакстан. Электронды; поштасы: elmira. ghs@gmail.com
2Тултабаев Султанбек Чуманулы - п.г.д., Алматы Менеджмент Университетшщ доценп, Алматы, Казакстан. E-mail: tsultanbek@mail.ru.
Денсаульщ сактау жYЙесiнде процестердi баскару жуйесш eHri3y ^йымныц бизнес-процестерiн белу, ж1ктеу жэне аныктау аркылы процесс жYЙесiн дамытуды талап етедi. Процесстiк тэсш ^йымга ез процестерiн жэне олардьщ езара эрекетш жоспарлауга мYмкiндiк береди Кез келген процесс к¥рылымын пайдаланудьщ басты артыкшылыгы ^йымныц процестерi туралы ортак тiл мен тYсiнiктi болу болып табылады.
ТYЙiн сездер: оперативп баскару, бизнес-процестер, сапа менеджментi жYЙесi, процесс тэсiлi.
The Author for correspondence: Elmira Baimagambetova - Deputy Director of the Department of Drug Provision of NcJSC "Social Health Insurance Fund", Nur-Sultan, Kazakhstan. Email: elmira.ghs@gmail.com
Received: 22.05.2022
Accepted: 05.06.2022
Bibliographic reference: E. Baimagambetova, S. Tultabaev Theoretical concepts and models of operational mamgement/М.стана медициналык журналы. - 2022. - Т. 112, № 2. - С.4-10
To date, increased interest in effective health care management is due to a number of factors, among which, first of all, it should be noted the market reorientation of the economy of Kazakhstan, which entails the introduction of fundamentally new approaches to management in health care organizations, their adaptation to the conditions of competition and increasing requirements for the quality of medical care. The necessity of development of organizational technologies is unprecedented, which requires improvement of technologies of operational management from the point of view of quality of provided healthcare services [1].
The effectiveness of operational management in healthcare is in most cases determined by the degree of development of key sections of management, which should be based on continuous improvement of production processes and their optimization. Using such approach will allow the organization to achieve strategic goals and solve its current problems. Currently, the issue of business process management of the organization in the health care system of the Republic of Kazakhstan is one of the hot topics for study. Low competence in the culture of process management among healthcare managers and not flexible functional organizational structure of organizations in the healthcare system, cannot contribute to the improvement of operational activities and implementation of changes that are initiated in the organization.
Implementation of a process management system requires the development of a process system through the allocation, classification and definition of the organization's business processes. In this regard, following the international standards ISO 9001:2015 expands the possibilities of process understanding [2].
The process approach allows an organization to plan its processes and their interaction. The generally accepted definition of a process as set out in the international standard ISO 9001:2015: "A set of interrelated and interacting activities that uses inputs to produce a planned result" [3].
The concept of quality management is based on three basic principles: process approach, PDCA cycle and thinking based on analysis and risk assessment.
The steps to apply the process approach are outlined in the international quality standard ISO 9001:2015, taking into account the PDCA cycle and include all activities from determining the context of the organization to improving the existing business processes.
In the practice of modern management, reference process models of organizations are presented and standard business processes are developed. These models are formed on the basis of generalization of existing world experience and presented in the form of international standards [5]. The most widespread are 13, 8-process models and Porter's model [6].
According to ENAPS (European Network of Advance Performance Studies) reports, a key benefit of using any process framework is having a common language and clarity about an organization's processes. Without specific definitions, processes are still difficult to interpret, limiting a company's ability to standardize processes, compare and evaluate performance, and identify and prioritize improvement opportunities. The process structure in the classifier created by the American Productivity and Quality Center (APQC) helps in this aspect for organizations
seeking to define their process elements by using or adapting existing elements. This process directory is constantly updated, adjustments are made for new processes, the processes in it are divided into 3 types of top-level processes, which in turn are defragmented into 13 groups of business processes as presented in table 1.
Table 1 - American Productivity and Quality Center (APQC) business process structure.
I. Management processes - 1. Developing goals and strategies
in order to achieve the company's strategic goals and manage business opportunities 2. Developing and managing business opportunities
II. Service business 3. Development and management of goods and services
processes - to ensure the 4. Marketing and sales of goods and services
continuity of basic processes, but 5. Provision of material goods
have no cost 7. Customer service management
III. The company's core 8. Training and management of human resources
business processes - processes 9. IT systems management
for creating products / in or services that have value / value. 10. Financial resources management
11. Asset management
12. Risk management
13. Managing relationships with external stakeholders
It should be taken into account that this guide is characterized by difficulties in implementation of the process approach due to its complex architecture [7,8].
The model developed by the consulting company BKG Profit Technology is of interest, which can also be used when reengineering processes in a company. The principle of this model is to identify the main objects of operational management, their relationship with the main business processes, and defragmentation to subsequent levels [5].
Porter's model distinguishes top-level processes and decomposes them into primary processes (production processes, internal and external logistics processes, marketing, sales and post-sales service) and supporting processes (providing internal infrastructure of the company, its material and technical service, human resources and their development, as well as development of information technology and management technology). The concept of Porter's model represents the processes as basic actions, the purpose of which is to add value to the product, and their optimization will help the company to increase profits and minimize costs [5].
The above models can be used when building processes in the organization, or serve as a model for developing your own process model, taking into account the specifics of the organization.
In the system of logistics and procurement is often used the model of operational management - House of procurement and supply. This concept was developed at the A. T. Kearney, the world leading company, which renders management consulting services for the world's leading corporations on key strategic issues. The concept was developed in 1996 on the basis of the conducted research with participation of 77 companies of North America and Europe with high performance. The model uses such basic processes as direction, procurement and support processes.
This model is well suited for large international organizations in the field of supply, as it is used to describe the depth and scope of the company's supply functions and to determine the level of professionalism of employees [9].
In their author studies M. Hammer and J. Champy proposed the definition of business process re-engineering (BPR) in terms of improving the current cost, quality, service and time performance, as a fundamental revision and radical modernization of organizational processes carried out to improve operational management [10].
G. van de Berg and P. Pietersma [11] recommend the use of BPR in the following cases:
1. In organizations there are frequent conflicts of a working nature.
2. Frequent meetings are held to eliminate errors.
3. There is a large amount of communication in the form of memos, letters, etc.
4. Occurrence of duplicate processes or functions.
Since employees, managers and organizational structure are considered to be the key levers for business process reengineering, the authors point out that there is a general condition without which the implementation of process reengineering will not succeed, and that is: understanding the need for modernization by managers and the active involvement of all employees of the organization. BPR is difficult to implement in practice, as noted by the authors, who cite three main reasons: the low competence of managers managing this project, the limited support of management and the delegation of reengineering projects to information technology specialists.
Considering the management model "Lean Approach/Timely in Time", (also "lean thinking", "lean production", "Toyota philosophy") it is important to emphasize that this model has proved its high efficiency and any organization can use it. At the heart of the Lean Approach is a strategy to continually identify and eliminate sources of loss, which ultimately leads to the "seven zeros". The main goal of this approach is to reduce losses, especially due to excessive inventory.
At the same time W. Assen, N. Notermans, R. Wigman note that the successful use of this model in the management of the organization, not only requires a perfect control system, but also constant demand and the appropriate organization of business processes [12].
When performing operational analysis, when reengineering business processes, organizations can apply the widespread model of root cause analysis/Pareto analysis (RCA). The basis of this model is the study of the cause-and-effect relationship of negative events, which allows to detail the causes of certain problems with high accuracy. By results of this analysis recommendations are given on optimization of business processes, their reengineering and elimination of deviations. In the initial stages it is recommended to conduct this analysis on the most critical and problematic processes [13].
When analyzing the literature sources describing the existing classifications, there are different aspects that consider business processes according to a variety of criteria. Thus, according to the classification proposed by V. A. Gagarsky [14], top-level business processes in companies are divided into five groups: basic, supporting, servicing and operational management and development processes.
For convenience, A. Gagarsky, when using definitions, offers a simpler classification of business processes (table 2), as well as the relationship of these two classifications to each other.
Table 2 - Classification of business processes by A. Gagarsky.
Detailed classification Simple classification
1. Basic business processes Basic processes
2. Related business processes
3. Auxiliary business processes Auxiliary processes
4. Supporting business processes
5. Managing business processes Control processes
6. Business development processes
In their works, S. M. Kovalev and V. M. Kovalev cite the classification of business processes focused on: increasing the profitability of companies, its resource provision, management processes are the management of a single business process and the business system as a whole, as well as the processes of development of the company [15]:
B. G. Eliferov and V. V. Repin [16] in their classification of business processes offer approaches in relation to the customers of the processes, the extraction of added value and the levels of detail of the processes.
In his work, A.V. Scheer [17] gives a model of 2 main business processes: the process of order logistics and the process for new product development, which are focused on operational subprocesses, consisting in management and coordination.
Professor at the Norwegian University of Science and Technology A. Björn [18] in his book gives examples of the following classifications of business processes:
1. Plymouth University (USA), which consists of 5 levels with grouping into "Production", "Management", "Support".
2. Classification of the Norwegian project TORR (based on the work managed by the Norwegian organization NTNU/SINTEF), this model is based on Porter's theory of the value chain, which consists of two main groups: primary (creating value) and support (not creating value).
3. The classification of the European Network of Advanced Indicator Studies (ENAPS) based on the developments of the TORR project.
Conclusions
Thus, the successful implementation of a process-oriented approach in health care organizations requires the direct involvement of all stakeholders involved in the provision of health care services, including drug coverage.
All the great variety of process models and a wide range of tools for building companies' business processes have one goal in common - to provide a service that creates value for clients at minimal cost. Application of such approach and implementation of already known process methodologies and methods in medical organizations will allow to provide patient-centered approach of domestic health care system. Reengineering of business processes will allow medical organizations to effectively build operational management, especially in conditions of transformation, new perspectives of development and in general, to improve the quality of services provided to the end user.
Moreover, organizations with well-documented processes and immediate recovery plans are largely more resilient and flexible to external factors, as these organizations have laid a solid foundation for responding to new demand signals and new regulations in the face of the COVID-19 pandemic and global geopolitical crisis.
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