Download - Operational research
OPERATIONAL RESEARCH
Dr Menaal KJR IIDepartment of SPMS. N. Medical College, Agra
12/04/23
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IntroductionIntroduction
•OR is tool of sociological science.
• It has become one of the key management
tools of modern times.
• In operational research one is concerned
all the times with the activities of a
group of people with the purpose of
inducing beneficial changes.212/04/23
•During World War II, In 1937
•At Bawdsey Research Station in the UK
•During the development of radar defense
systems for the Royal Air Force
•A. P. Rowe, a British Air Ministry official,
constituted teams to do "operational
researches" on the communication system
and the control room at a British radar
station. 12/04/23 3
HistoryHistory
• Physicist, P. M. S. Blackett
• Blackett’s convinced the authorities of the
need for a scientific approach to manage
complex operations, and
• He is regarded as the original operations
research analyst and the Father of OR.
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•Phillip Morse is widely
regarded as the “Father" of
O.R. in the United States
12/04/235
•The studies had to do with improving the
operational efficiency of systems (an
objective which is still one of the
cornerstones of modern O.R.).
•This new approach of picking an
"operational" system and conducting
"research" on how to make it run
more efficiently soon started to expand
into other arenas of the war. 12/04/23 6
Operational Research in HealthOperational Research in Health
• Provides decision-makers with information to enable
them to improve the performance of their programs.
• Helps to identify solutions to problems that limit
program quality, efficiency and effectiveness, or to
determine which alternative service delivery strategy
would yield the best outcomes.12/04/23
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What is operational/operations research ?What is operational/operations research ?
OR is defined as the systematic study by
observation and experiment of the working
of a system eg: health services, with a view
to improvement.
- John M Last in Dictionary of Epidemiology
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Goals of Operational ResearchGoals of Operational Research
•To increase the efficiency, effectiveness,
and quality of services delivered by
providers, and the availability,
accessibility, and acceptability of services
desired by users.
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ObjectiveObjective
•To provide managers, administrators
and policymakers with the information
they need to improve existing delivery
activities and plan future ones.
•Central objective always is to obtain a
better understanding of the
“operations” of programs so that,
needed improvements can be made. 12/04/23 10
Categories of Operational Research StudiesCategories of Operational Research Studies
1. Diagnostic Studies/ Exploratory: Problem
Not Known
▫ To determine the parameters of a problem
situation before programming begins
▫ Whenever there is a perceived problem but the
nature of the problem and the correct program
responses to it are not known
▫ Search for programmatically manipulable
variables
▫ Usually retrospective or cross sectional12/04/23 11
Categories of Operational Research StudiesCategories of Operational Research Studies
2. Field Intervention Studies: Program
Approach Not Known
▫ Test on an experimental basis new
approaches to overcoming a probable
problem
▫ Test new service delivery modes
▫ Studies are prospective 12/04/23 12
Categories of Operational Research StudiesCategories of Operational Research Studies
3. Evaluative studies: Impact Not Known
▫ For examining the effect of program
activities
▫ Can be done retrospectively or cross-
sectionally
Note:•These three categories not mutually exclusive
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Categories of Operational Research StudiesCategories of Operational Research Studies
4. Cost- effectiveness studies: Cost
Effectiveness Not Known
▫ Are frequently a part of intervention and
evaluation studies.
Note:•These four categories not mutually exclusive
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Methods Methods
• Qualitative methods include focus group
discussions or individual interviews with
service providers or clients or observational
studies, e.g., observing health care workers.
• Quantitative methods include structured
questionnaires or the analysis of service
statistics.
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Benefits of operational researchBenefits of operational research
• Improve Quality
•Decrease in cost or investment
• Increase revenue or return on investment
•Achieve improved utilization form limited
resources
•Demonstrate feasibility and workability
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Who does operational research ?Who does operational research ?
• Any health care provider, including the public
sector, NGOs
• A team of program implementers and
researchers.
• Stakeholders should be involved as advisors
throughout the operational research process.12/04/23
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Some topics of OR studies- examplesSome topics of OR studies- examples
1. Training Programs: to examine the content
and methods of training, or to compare one
type of training approach against another in
terms of field-worker knowledge and performance.
2. Management Information Systems: Studies
can be designed to experiment with new data
collection systems and to test new
procedures for using the information collected to
improve services.12/04/23 18
Some topics of OR studies- examplesSome topics of OR studies- examples
3. Program Impact: OR studies can test
prospectively and in field settings the impact of
different approaches to service delivery, such
as the use of community-based distributors
(CBDs) or traditional birth attendants(TBAs).
• Impact can be measured in many different ways
by examining e.g. contraceptive prevalence,
contraceptive continuation rates or increased
availability and accessibility of services.12/04/23 19
Some topics of OR studies- examplesSome topics of OR studies- examples
4. Quality of Care: OR studies can be directed at
evaluating the quality and acceptability of services
offered to clients. These studies can provide an
analysis of the current situation of health services.
5. IEC: OR studies can be designed to compare different
communication approaches in terms of message
understanding, message retention, cost-
effectiveness, and the ability to reach specific target
audiences.12/04/23
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How to carryout an OR ?How to carryout an OR ?
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Steps of Operational Research:Steps of Operational Research:
• It is a continuous process with five basic
steps:
1. Problem identification and diagnosis
2. Strategy selection
3. Strategy testing and evaluation
4. Information dissemination
5. Information utilization
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Step 1: Problem DiagnosisStep 1: Problem Diagnosis
•Potential research situation arises
when three conditions exist :
i. Perceived discrepancy between what is
and what should be
ii. Question about why the discrepancy
exists
iii. At least two possible and plausible
answers to the question12/04/23 23
What to do in step 1 ?What to do in step 1 ?
•Attempt at identifying the problem
situation by using this format:
▫Problem Situation
▫Discrepancy
▫Problem Question
▫Possible Answers
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Example Example
• Problem Situation: District A is always flooded during the monsoon season.
• Recognizing this problem, the national family planning program established a new supply logistics system for the district. Each pill user is given a four-month supply before the monsoon begins.
• During the monsoon, small motorboats are available to transport new supplies to selected distribution centers accessible to village-level family planning workers.
• Despite these new measures, this year service statistics indicated that there are no pill supplies in District A.
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•Discrepancy: The new logistics system
should be able to assure a continuous
supply of pills, but this year there are no
supplies.
•Problem Question: Why has the new
supply logistics system been incapable of
delivering contraceptive pills to users?12/04/23 26
Possible Answers:
▫An order for new pill supplies was not placed in time before the monsoon rains.
▫The riverboats used to transport the supplies are out of order.
▫Field-workers were not told about the new system and failed to give users a four-month supply of pills before the monsoon.
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In this example:In this example:
•There are several possible and plausible reasons for the problem situation
•One or more of these reasons might be correct, and
•At least two of the possible problems may be under the control of managers to fix: ordering drugs on time and improving maintenance of the boats.
•Therefore, this is a potential research situation.
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5 basic steps5 basic steps
1. Problem identification and diagnosis2. Strategy selection3. Strategy experimentation and evaluation4. Information dissemination5. Information utilization
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What to do in step 2 ?What to do in step 2 ?
• Identify potential strategies that could be used
to solve the program problem.
• Indicate which one or more of the potential
strategies are the most appropriate to solve
the program problem- Let the problem
determine the strategy12/04/23 30
Guidelines for selection of strategyGuidelines for selection of strategy
a. Review the strategies other people have used to
solve similar program problems.
b. Hold a meeting with the people who are most
affected by the problem or most concerned with it.
c. Look for strategies that can be implemented
without overburdening the implementing
institution.
d. Select strategies that can be sustained over time.
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Guidelines for selection of strategyGuidelines for selection of strategy
e. Seek strategies that are simple to implement.
f. Develop strategies where the proposed solution
is under the control of program managers.
g. Avoid strategies where the cost of a field test is
higher than the expected benefits.
h. Avoid strategies that are not consistent with the
implementing institution's goals, objectives, and
development plans.
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5 basic steps5 basic steps
1. Problem identification and diagnosis2. Strategy selection3. Strategy experimentation and evaluation4. Information dissemination5. Information utilization
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What to do in step 3 ?What to do in step 3 ?
•Write Ultimate Goals, Immediate Objectives, and hypotheses
• Intervention Description▫Who will be responsible for
implementation?▫Where will the intervention take place?▫What activities will be initiated at what
level of intensity?•Operational definitions•Sampling and data collection•Data analysis12/04/23 34
5 basic steps5 basic steps
1. Problem identification and diagnosis2. Strategy selection3. Strategy experimentation and evaluation4. Information dissemination5. Information utilization
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What to do in step 4 ?What to do in step 4 ?
•Determine :▫Who are the potential users of the
findings from the operations research study?
▫Which particular findings will be of most interest to each potential user group?
▫What are the best media channels to reach each potential user group?
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5 basic steps5 basic steps
1. Problem identification and diagnosis2. Strategy selection3. Strategy experimentation and evaluation4. Information dissemination5. Information utilization
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What to do in step 5 ?What to do in step 5 ?
▫Identify the organizations you believe will be
most interested in the study.
▫Discuss how you will involve these
organizations in the various planning,
implementation, analysis and dissemination
stages of the study.
▫Indicate the most likely policy or program
implications to arise from the study.12/04/23 38
Lets take an example:Lets take an example:
•Problem Identification: In a State, there
is a wide variation in the CPR in different
villages. Although all villages get same level
of health& FP services, some villages have a
CPR of 80% while others have it as low as
5%
• Immediate Objective: to study the social,
economic& health factors associated with
the variation in CPR12/04/23 39
Lets take an example:Lets take an example:
• Implication: the ultimate objective is to
provide policymakers and program
administrators with a better understanding of
the reasons why the national FP program is
successful in some areas but not in others.
• This information will be used to develop
educational strategies& modify existing
service delivery approaches to uniformly
raise the CPR in all regions
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In Conclusion…In Conclusion…
•Whenever social medicine passes from the
stage of observation and classification to
that of discovering and recommending
appropriate action, it is involved in
Operational Research
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