MANAGERIAL ALTERNATIVES AND THE FEASIBILITY OF THEIR APPLICATION IN THE ACTIVITIES OF A HEALTH CARE INSTITUTION

Abstract

The article reflects the role and consequences of reforms in the health care system, namely the transformation of the organizational and legal form of hospitals from budget institutions to communal enterprises of local selfgovernment bodies. It has been proven that hospitals in their current activities are obliged to use tools of strategic planning and personnel management. The development of measures by top managers within  the framework of strategic planning is illustrated on the example of the KP «Rivnе Regional Clinical Hospital named after Yuriy Semenyuk» of the Rivne Regional Council. A detailed analysis of the hospital's activities, namely  the resource potential (information, personnel, finances) and its use, was carried out. A dynamic analysis of the structure of operating costs was made, which made it possible to identify bottlenecks (limitations) in the hospital's activities as an enterprise. They turned out to be the physical and energy system of the hospital. It is proposed, taking into account the current challenges of today, to use the theory of limitations of E. Goldratt's system, to identify physical and managerial limitations in the operation of the hospital. Limitations were revealed that made it possible to offer managerial alternatives to the existing ones, which are designed according to the principle of not resolving the conflict based on compromise, but based on the «win» – «win» approach. It has been proven that all measures designed by the top management of the hospital are large in scope and do not contribute to a significant reduction of costs in the future, and under the current conditions their implementation is impossible. Three managementalternatives based on the «win» – «win» approach are designed, which are less costly compared to top management alternatives. Their implementation can save resources due to the use of an alternative source, more economical electricity consumption and another way of using the potential of junior medical personnel. The implementation of all the planned managerial alternatives will ensure the improvement of the economic and financial condition of the hospital and potentially the quality of medical services.