operational research

OPERATIONAL RESEARCH

Dr Menaal KJR IIDepartment of SPMS. N. Medical College, Agra

12/04/23

1

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

7

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


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


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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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

17

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


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


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

20

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.

12/04/23 27

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

12/04/23 29


• 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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•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



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•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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▫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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operational research

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