Modern Management Techniques.pptx

MODERN MANAGEMENT TECHNIQUES
APPLICATION OF MMT IN HEALTHCARE
Dr. Immanuel Joshua. E
Junior Resident (PGT-3)
Dept. of Community Medicine
Banaras Hindu University
1

CONTENTS
Definition Relevance in healthcare Traditional vs Modern techniques
Description of each technique Classification
Challenges
References
"The first rule of management is delegation. Don't try and do everything yourself because you can't." —
Anthea Turner
Estimated time: 90-120 minutes
2

“Management is getting the right things done
 in right way,
 in right time,
 by right persons,
 with right amount of resources and
effective use of resources.”
MANAGEMENT
It is the efficient use of resources and to get people to work harmoniously
together in order to achieve objective 3

Applications of management techniques
Marketing
Operations
Finance Human Resource
Information Technology
Management Science
4

Why we need management in healthcare? 5

"Management is the opportunity to help people become better people. Practiced that way, it's a
magnificent profession" — Clayton Christenson
RELEVANCE IN HEALTHCARE
• Overlapping, conflicting and competing organizations within Health system
• Widely scattered funding mechanism with little control over costs
• Decisions on the mixture of facilities and services without reference to population
need and with no information about those who do not use the services
• It has been proved that these techniques are useful in increasing the efficiency
by cost reduction as well as ensuring better health care
6

Traditional vs Modern Management Techniques
Based on behavioral sciences
(Personnel selection, training & retraining,
motivational methods, leadership
development, supervision etc..)
TRADITIONAL MODERN
Based on sociology, psychology, educational
technology, economics and statistics
Needed for larger and complicated organizations
with their own unique organizational and
structural issues
The conventional methods of management
are no longer adequate to meet the
demand of today’s projects
7

Classification of
MMT
01
02
03
04
05 Miscellaneous
Financial techniques
Mathematical techniques
Activity analysis
Statistical techniques

Miscellaneous
Activity analysis
1) Time trends and forecasting
2) Decision theory and tree
1) Time and Motion study
2) Work sampling and activity analysis
3) Queuing theory
4) Gantt chart and work schedule
1) Simulation study/ model
2) System analysis
3) Linear programming
4) Inventory control
5) Network analysis
6) PERT
7) CPM
9

Miscellaneous
1) Cost accounting and analysis
2) Cost Benefit Analysis
3) Cost Effective Analysis
4) Zero base budgeting
5) Input output analysis
1) Management by exception
2) Situation analysis
3) SWOT Analysis
4) Log frame Analysis
10

TIME TRENDS AND FORECASTING
(Eg: Seasonal trend, Cyclical trend, Secular trend)
Based on past experience, predictions can be made about
the expected occurrence, by using mathematical methods
(Eg: Demographers made projections about population,
epidemiologists anticipation of epidemic)
Based on information on occurrence of certain events, certain patterns can be recognized
12

DECISION TREE A decision tree is a flowchart that starts with
one main idea and then branches out based on
the consequences of your decisions
It’s called a “decision tree” because the model
typically looks like a tree with branches
It enables people to decompose a large complex
decision problem into several smaller problems
13

Types of environment:
1. Decision making under certainty
2. Decision making under uncertainty
3. Decision making under risk
Decision tree
A method for determining the optimal course of action when a number of alternatives
are available and their consequences cannot be forecast with certainty
14

DECISION TREE SYMBOLS
•Decision nodes: Squares that represent a decision being made on tree.
Every decision tree starts with a decision node.
•Alternative branches: Lines that branch out from decision node. These
branches show two outcomes that stem from the initial decision.
•Chance nodes: Circles that show multiple possible outcomes.
•End nodes: Triangles that show a final outcome.
15

Decision node
Chance nodes
End nodes
Alternative branches
16

Surgery
Drug
Disease absent
Disease present
Disease present
Disease absent
Survive
Operative death
Cure
No cure
Curative
Palliative
Survive
Operative death
Cure
No cure
Survive
Operative death
Cure
No cure
17

Surgery
Drug
Disease absent
Disease present
Disease present
Disease absent
Survive
Operative death
Cure
No cure
Curative
Palliative
Survive
Operative death
Cure
No cure
Survive
Operative death
Cure
No cure
Each path through the tree defines a unique potential result
18

Surgery
Drug
Disease absent
Disease present
Disease present
Disease absent
Survive
Operative death
Cure
No cure
Curative
Palliative
Survive
Operative death
Cure
No cure
Survive
Operative death
Cure
No cure
10%
10%
90%
90%
90%
90%
90%
90%
99%
98%
10%
1%
10%
2%
10%
10%
Insert probabilities at each chance node based on data
from literature, modeling, expert judgment, etc.
19

Surgery
Drug
Disease absent
Disease present
Disease present
Disease absent
Survive
Operative death
Cure
No cure
Curative
Palliative
Survive
Operative death
Cure
No cure
Survive
Operative death
Cure
No cure
10%
10%
90%
90%
90%
90%
90%
90%
99%
98%
10%
1%
10%
2%
10%
10%
Assign a value to the outcome at each end points
20 LY
0 LY
20 LY
20 LY
2 LY
0 LY
0 LY
20 LY
20 LY
2 LY
2 LY
Average outcome:
Operative death = 0 LY
Death from progression of disease = 2 LY
Cure = 20 LY
20

Surgery
Drug
Disease absent
Disease present
Disease present
Disease absent
Survive
Operative death
Cure
No cure
Curative
Palliative
Survive
Operative death
Cure
No cure
Survive
Operative death
Cure
No cure
10%
10%
90%
90%
90%
90%
90%
90%
99%
98%
10%
1%
10%
2%
10%
10%
20 LY
0 LY
20 LY
20 LY
2 LY
0 LY
0 LY
20 LY
20 LY
2 LY
2 LY
Compute average results, working from right to left
Average LY
= 10% (20) + 90% (2)
= 3.8 LY
21

Surgery
Drug
The outcome for each decision is more apparent now
19.46 LY
18.38 LY
Surgery (intending cure) produces average of 19.46 LY
Medical management yields an average of 18.38 LY
The incremental benefit of surgery versus medical
management is 19.46 – 18.38 = 1.08 LY
22

• Simple to understand and interpret
• Useful to analyze the possible outcomes of complex decisions
• Possible scenarios can be added
• Most rational decision is taken in terms of resource and effectiveness
• Worst, best and expected values can be determined for different scenarios
ADVANTAGES OF DECISION TREES
23

Miscellaneous
Activity analysis
3) Queuing theory
2) System analysis
5) Network analysis
6) PERT
7) CPM
24

BASIS TIME STUDY MOTION STUDY
Meaning
Time study is conducted to find
out the standard time for
performing a task
Motion study is conducted to find out
total movements of workers while they
are performing the task
Purpose
To find out standard time to fix
day’s work for the workers
To eliminate wasteful and unproductive
movements of workers to increase their
efficiency level
Method of
conducting
It is conducted with the help of a
stopwatch
It is conducted with the help of a moving
camera which keep eyes on movements
“Time is what we want most but what we use worst” – William Penn
TIME AND MOTION STUDY
26

Modification: One servant from the central lab goes to different ward with trolley
at predetermined time. Reports delivered in same way
Example: From each ward, lab samples are sent with a servant to central
laboratory. Servants take excessive time to return
ADVANTAGES
• Reduction of physical effort
• Time saving
• Increase productivity
27

Work sampling is a method of finding the percentage occurrence of a certain activity
by statistical sampling and random observations
WORK SAMPLING
Technique in which a large number of instantaneous observations are made at random intervals over
a specified period of time on a group of workers machines and processes
Each observation records what is happening at that instant (Working/ Not working)
The percentage of observations recorded for a particular activity is the measure of
percentage of time during which that activity occurs
28

STEPS
• Determine the main objective of the study
• Define each activity to be measured
• Obtain the approval of the supervisor of the department where work sampling is to be
performed
• State the desired accuracy limits for the ultimate RESULTS
• Conduct a pilot study to
i. Estimate the approximate percentage occurrence of the activity (p)
ii. Estimate the required number of observations for the desired accuracy set
iii. Ensure that the workers have become habitual to the visits of work study engineer
• Design the actual study
• Calculate the number of observations (N) to be made by using the following formula N = 4pq/L2
29

ADVANTAGES
• Work sampling is a low cost alternative to continuous monitoring, just as sampling
in the audit context is a low cost alternative to 100% evaluation of an account
• A simultaneous work sampling of several operators or machines can be made by a
single observer
Ex: There is complain that nursing officers are working only 70% of their duty time in wards
Number of observations required for work sampling (N) = 4 (0.7) (0.3)/ (0.05)2 = 336
Results: Nursing officers were seen working on 252 observations (=75% of the time)
Out of the total working time, 35% were spent on bedside and 65% on clerical ward work
30

• Queuing theory was first introduced in the early 20th century
by Danish mathematician and engineer Agner Krarup Erlang.
• Erlang worked for the Copenhagen Telephone Exchange and
wanted to analyze and optimize its operations.
• He sought to determine how many circuits were needed to
provide an acceptable level of telephone service, for people
not to be “on hold” (or in a telephone queue) for too long.
• Also to find out how many telephone operators were needed
to process a given volume of calls.
•"Start with the end in mind." — Stephen Covey 33

His mathematical analysis
culminated in his 1920 paper
“Telephone Waiting Times”, which
served as the foundation of applied
queuing theory. The international
unit of telephone traffic is called the
Erlang in his honor.
34

Queuing theory is a mathematical approach applied to the analysis of waiting lines
At its core, a queuing situation involves two parts
Someone who requests a service Someone who delivers the service
Customer Server
Doctor
35

Cost associated with patients having to wait for service
• Loss of business to HCO.
• Costs incurred by society.
• Decreased patient satisfaction and quality of care.
Cost of providing the services (capacity cost)
• Salaries paid to employees.
• Salaries paid to employees or servers while they wait for service from other
server, for eg: waiting for the pathology report, radiology report, labs, etc.
• Fixed costs – cost of waiting space, facilities, equipment, and supplies.
COSTS OF WAITING IN LINES OR QUEUE
36

•"It's easy to solve a problem that everyone sees, but it's hard to solve a problem that almost no one sees."
— Tony Fadell
Arrival rate
Customers
Queue discipline Service rate
Queue Service facility Served customers
Queuing theory scrutinizes the entire system of waiting in line, including elements like
customer arrival rate, number of servers, number of customers, capacity of the waiting area,
average service completion time, and queuing discipline.
37

The Gantt chart can also include the start and end dates of
tasks, milestones, dependencies between tasks, and
assignees.
GANTT CHART
Devised by Henry Gantt, an
American engineer and
project management
consultant
A project management tool that illustrates work completed over
a period of time in relation to the time planned for the work
It typically includes two sections:
• Left side outlines a list of tasks
• Right side has a timeline with schedule bars that visualize work
38

CHARACTERISTICS
39
• The bar in each row identifies the corresponding task
• The horizontal position of the bar identifies start and end times of the task
• Bar length represents the duration of the task
• Task durations can be compared easily
• Good for allocating resources and re-scheduling
• Precedence relationships can be represented using arrows
• Critical activities are usually highlighted
• Slack times are represented using bars with doted lines
• The bar of each activity begins at the activity earliest start time (ES)
• The bar of each activity ends at the activity latest finish time (LF).

Choose research area
Preliminary research
Decide research topic
Decide methodology
Submit/present proposal
Finalize methodology
Conduct research
Analyze data
Write up
Submit assignment
10 11 12 13 14 15 16 17 18 19 20
9
8
7
6
5
4
DURATION (in weeks)
40

Miscellaneous
Activity analysis
3) Queuing theory
2) System analysis
5) Network analysis
6) PERT
7) CPM
41

SYSTEM ANALYSIS
• Set of objectives to be achieved is defined and alternatives to
achieve these are formulated
• Alternatives are evaluated in terms of cost-effectiveness
• Mathematical models may be used
43
Study of inter relationships operating in the various components
within a system and also between a system and other systems
System: An arrangement and set of relationships among multiple parts functioning as a whole

LINEAR PROGRAMMING
44
It is a useful tool for deciding the course of action for a problem in which there are
competing alternatives uses for limited resources
Mathematical tool where components of a system and its constraints are depicted in a
linear equation and the desirable combination of activities with regard to certain given
set of objectives and constraints is arrived
Linear Programming (LP) problems are optimization problems in which the objective
function and the constraints are all linear

A Company manufacturers two types of drugs A and B. Each product uses Machine X and
Machine Y. The process time per unit of drug a on Machine X is 10 hours and on the
Machine Y is 8 hours. The processing time per unit of drug B on Machine X is 15 hours and
on the Machine Y is 10 hours. The maximum number of hours available per week on
Machine X and Machine Y are 80 hours and 60 hours respectively. Also the profit per unit of
selling Drug A and Drug B are Rs 25 and Rs 35 respectively. Formulate a LP model to
determine the production volume of each of the drugs such that total profit is maximized.
45

46
Machine
Machine hours/ unit Limit on
machine
hours
Drug A Drug B
Machine X 10 15 80
Machine Y 8 10 60
Profit/ unit (Rs) 25 35
Maximize Z = 25(A) + 35 (B)
10 (A) + 15 (B) ≤ 80
8 (A) + 10 (B) ≤ 60
A and B  0

ABC
analysis
VED
analysis
SDE
analysis
FNSD
analysis
HML
analysis
XYZ
analysis
SOS
analysis
Types
Method of maintaining of stock at a
level at which purchasing and storing
costs are the lowest possible without
interference with supply
Objective : To maintain optimum stock
INVENTORY
MANAGEMENT
47

ABC METHOD
ITEM % COST %
A 10% 70%
B 20% 20%
C 70% 10%
A items: Less quantity; more resources
• Tight control
• Rigid estimate of requirement
• Strict & closer watch
• Low safety stock
• Managed by top management
Also known as ‘Proportional Part Value’ method
C items: More quantity; less resources
• Ordinary control measures
• Purchase based on usage estimates
• High safety stocks
Different items categorized into three
groups based on annual expenditure
incurred on these items
48

V = Vital life saving drugs
(Absence of which cannot be tolerated)
E = Essential items
(Absence can be tolerated for a short time period)
D = Desirable
(Non availability can be tolerated for a longer period)
VED Analysis
Based on criticality in patient care
49

A
B
C CV CE CD
BV
AV
V E D
AD
BD
BE
AE Category I
Category II
Category III
Close monitoring & control
Combination of ABC & VED
Analysis
Moderate control
No control needed
CV CE CD
BV
AV AD
BD
BE
AE
50

It looks at quantity, consumption rate and how often the item is issued and used
F = Fast moving (needs constant monitoring)
N = Normal moving (consumed on regular basis; purchased once or twice a year)
S = Slow moving (periodically reviewed to prevent expiry & obsolescence)
D = Dead stock (Items which is no longer required)
FNSD Analysis
Inventories are classified on the basis of product’s unit price
H = High value of inventories (High cost)
M = Medium value of inventories (Medium cost)
L = Low value of inventories (Low cost)
HML Analysis
51

Materials are categorized based on the nature of supply
Seasonal and Off-Seasonal materials
Helps to manage purchases and storage of materials which are seasonal in nature
SOS Analysis
Classification is based on the scarcity of supply
This technique handles problem faced in lead time analysis and purchasing strategies
S – Scarce (imported; longer time to arrive; supply irregular)
D – Difficult to procure
E – Easy to procure
SDE Classification
52

Materials are categorized according to variability of their demand or forecasted consumption
X – Very little variation (future demand can be reliably forecasted)
Y – Some variation (demand can be predicted to some extent)
Z – Most variation (demand forecasting is impossible)
XYZ Analysis
53

The activities are interrelated in a logical sequence which is known as
“Precedence relationship”
Project is represented in the form of network for the purpose of analysis to get
solutions for scheduling and controlling its activities
PROJECT MANAGEMENT (NETWORK ANALYSIS)
A project consists of interrelated activities which are to be executed in a certain
order before the entire task is completed
54

PHASES OF PROJECT MANAGEMENT
PLANNING
• Dividing the project into distinct activities
• Estimating time requirement for each
activity
• Establishing precedence relationships
among the activities
• Construction of arrow diagram (Network)
SCHEDULING
CONTROLLING
• Determines the start and end time of each and
every activity
• Uses the arrow diagram and time chart for
continuous monitoring and progress reporting
55

GUIDELINES FOR NETWORK CONSTRUCTION
• The starting event and ending event of an activity are called tail event and
head event respectively
• The network should have a unique starting node (tail event)
• The network should have a unique completion node (head event)
• No activity should be represented by more than one arc in the network
• No two activities should have the same starting node and same ending node
56

ACTIVITY
PREDECESS
OR
DURATION
A - 1
B - 2
C - 3
D A 4
E B 5
F B 4
G C 6
H D, E 6
I G 2
J F, H, I 3
 Construct the CPM network
 Determine Critical path and Project completion time
57

1
5
2
7
4
3 6 8
A = 1 day
C = 3 days
B = 2 days
D = 4 days
E = 5 days
F = 4 days
G = 6 days
H = 6 days
I = 2 days
J = 3 days
58

CPM
The critical path of a project network is the longest
path in the network
59

1
5
2
7
4
3 6 8
A = 1 day
C = 3 days
B = 2 days
D = 4 days
E = 5 days
F = 4 days
G = 6 days
H = 6 days
I = 2 days
J = 3 days
1
5
2
6 8
7
4
3
1
5
2
6 8
7
4
3
7
4
60
CRITICAL PATH

Program Evaluation and
Review Technique
61

Under PERT, three time-estimates are made
1. Most Likely Time: Time taken most frequently in completing a particular activity.
2. Optimistic Time: Time in which an activity can be completed, if all goes as per the
predetermined plan.
3. Pessimistic Time: Time taken to complete an activity under most adverse
conditions. This is thus the longest possible time taken to complete a project.
Activity Time= [Optimistic time + 4 x (Likely expected time) + Pessimistic time] /6
62

Consider the following table summarizing the details of a project:
ACTIVITY PREDECESSOR
DURATION (WEEKS)
OPTIMISTIC MOST LIKELY PESSIMISTIC
A - 5 6 7
B - 1 3 5
C - 1 4 7
D A 1 2 3
E B 1 2 9
F C 1 5 9
G C 2 2 8
H E, F 4 4 10
I D 2 5 8
J H, G 2 2 8
• Construct the project network
• Find the expected duration of
each activity
• Find the critical path and the
project completion time
63

1
5
2
6 8
7
4
3
A
H
G
F
I
D
E
B
C J
64

ACTIVITY PREDECESSOR
DURATION (WEEKS) EXPECTED
TIME
OPTIMISTIC MOST LIKELY PESSIMISTIC
A - 5 6 7 6
B - 1 3 5 3
C - 1 4 7 4
D A 1 2 3 2
E B 1 2 9 3
F C 1 5 9 5
G C 2 2 8 3
H E, F 4 4 10 5
I D 2 5 8 5
J H, G 2 2 8 3
Expected time =
[O + (4 x M) + P] / 6
65

1
5
2
6 8
7
4
3
A = 6
H = 5
G = 3
F = 5
I = 5
D = 2
E = 3
B = 3
C = 4
J = 3
Critical path = C-F-H-J Project completion time = 17 weeks
1
5
2
6 8
7
4
3
66

Plan service
Equipment ordered Equipment installed
Start providing service
Staff recruited Staff trained
2 months
10 months
1 month
4 months
2 months
1 month
67

Miscellaneous
Activity analysis
3) Queuing theory
1) Simulation study /model
2) System analysis
5) Network analysis
6) PERT
7) CPM
68

Miscellaneous
3) SWOT Analysis
69

Is there a good evidence of effectiveness of interventions being compared
Are the effectiveness of interventions equal?
Can the outcome be valued in monetary terms
Can outcomes be measured in terms of QALY/ DALY
Costing study
Cost minimization analysis
Cost-benefit analysis
Cost effectiveness
Cost Utility analysis
YES NO
YES
NO
YES NO
NO
YES
71

ZERO-BASED BUDGETING
Method of budgeting in which all expenses must be justified for each new year
(current need, cost, alternate options) rather than based on previous years
Setting objectives Developing decision unit Developing decision packages
Ranking decision packages
Resource allocation
Controlling and Monitoring
PROCESS
72

BENEFITS
• Efficient allocation of resources, as it is based on needs and benefits rather than history
• Drives managers to find cost effective ways to improve operations
• Detects inflated budgets
• Increases staff motivation by providing greater initiative and responsibility in decision-making
• Identifies and eliminates wasteful and obsolete operations
• Flexible technique
• Useful for government department
73

DRAWBACKS
• More time-consuming than incremental budgeting
• Justifying every line item can be problematic for departments with intangible outputs
• Requires specific training, due to increased complexity
• High administrative cost
• Increased paper work and man-power
74

INPUT-OUTPUT ANALYSIS
Input-output analysis seeks to explain how one industry sector affects others in the same nation
There is a circular relationship between inputs and output of an economy
Wassily Leontief, a Soviet-American economist developed the input-output analysis
method, earning him the Nobel Prize in economics in 1973
Output of A Input of B, C, D
75

X1 X2 FD
X1 X11 X12 F1
X2 X21 X22 F2
Balancing equation: X1 = X11 + X12 + F1
Purchasing sector
Selling
sector
An input-output table shows how much of each input is needed to produce
unit amount of each output
76

Miscellaneous
3) SWOT Analysis
77

MANAGEMENT BY EXCEPTION
Management by exception is the practice of examining the financial
and operational results of a business, and only bringing issues to the
attention of management if results represent substantial differences
from the budgeted or expected amount.
79

Efficient practices
Managers can lead their company efficiently by delegating tasks. They focus on achieving the
company's vision while other employees work on daily tasks to keep the company operational.
Sets clear priorities
For example, if an employee knows they should notify a manager if they sign a high-profile
client, the employee also understands how important that activity is.
Motivates employees
Because management by exception allows employees to work independently, it can motivate
employees to take more responsibility at work.
Quickly addresses problems
ADVANTAGES
80

DISADVANTAGES
Less focus on preventive measures
Because management by exception relies on reacting to a problem, it can neglect to
put preventative measures in place.
Requires close monitoring
Companies need to establish close monitoring practices ensuring professionals alert
the managers when a problem arises.
Requires advanced problem-solving skills
All leaders within a company are required to have exceptional problem-solving skills.
This helps them quickly address issues and find creative solutions.
81

SITUATIONAL ANALYSIS
It is an integral component of the management process to find out what the existing situation
is, analyze the same, identify, which aspects needs changing, and then plan accordingly
This method described as ‘where are we now’, is the means by which a company can identify
its own strengths and weaknesses as they relate to external opportunities and threats
82
For example, studies regarding drug prescription and consumption in different types of health
facilities. The result of these studies reveal the prescribing habits of Doctors, and the need
and ways for improving drug management to make them safer and economical

OBJECTIVE INTERVENTION OUTPUTS INDICATORS
To increase deliveries
by SBA from 20% in
2012 to 80% in 2017
• SBAs are posted at PHC
on 8 hours duty
• One MO available at PHC
on 8 hours shift basis
• Referral transport
available
• Number of deliveries
by SBA
• Expected outcome:
80% deliveries by SBA
• % of deliveries by SBA
out of total deliveries
• Verify from HMIS
LOGICAL FRAMEWORK
A logical framework or ‘Log Frame’ is a management tool for Planning, Progress
Monitoring and Evaluation of the program
This tool ensures that planning is result-oriented and outcomes are evidence-based
A Logical Framework for safe deliveries 83

It involves identifying the internal and external
factors that are favorable and unfavorable to
achieve a objective
SWOT ANALYSIS
SWOT analysis is a strategic planning
method used to evaluate the Strengths,
Weaknesses, Opportunities, and Threats
involved in a project/ program
85

HELPFUL HARMFUL
• Political will
• Commitment of key research institutes
• Framework in form of NCD programs
• Integration of all chronic diseases
• Dedicated resources
• Poor monitoring and evaluation
• Limited implementation capacity
• Low levels of community awareness
• Low utilization rates
• Low expenditure rates
• Best buys
• PEN Intervention Package
• Health system strengthening
• NCD surveillance
• Digitization
• Adherence monitoring
• Rising burden of NCDs
• Low budget allocation for NCD programs
• Diversity in sub-populations
• Absence of regulatory mechanism
SWOT Analysis of NCD program
INTERNAL
EXTERNAL
S
O T
W
86

Miscellaneous
3) SWOT Analysis
87

Globalization Technology
Human
resource
Social
responsibility
CHALLENGES
88

REFERENCES
• https://www.gantt.com/
• https://queue-it.com/blog/queuing-theory/
• WHO Modern management methods and the organization of health services
• https://www.youtube.com/watch?v=WrAf6zdteXI
• Park textbook of community medicine
• Public Health Management by Sunderlal
• Treatise on Health Management by SC Mohapatra
• Handbook of Health Planning and Management by Sukamal Bisoi
• Pdf on MMT by Dr. Sharon (shared in telegram group)
• YouTube videos (link will be provided on request)
89

SUGGESTIONS
QUERIES
IDEAS
OBSERVATIONS
90

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