From the very start of their training, all Managing Directors have learned about the 4 fundamental aspects of a hospital: it is a medical institution, a social institution, an educational institution and must be managed like a business.Based on more than 30 years' experience, this manual sets out the guidelines for managing human resources, patient flow, logistics (drugs, supplies and equipment) and finances. New information technology concepts have also been added. The examples and simulations provided are for guidance only, and can be adapted to suit the context of each institution.