Lecture 2Mrs: Asma A. Alderaa

2011-2012

Hospital Hospital AdministrationAdministration

INTRODUCTIONINTRODUCTION

Many aspects of health organizations are managed by health professionals, all need management skills.

Management or administration, on a planned

and scientific basis, in necessary for the smooth

running of every institution, including hospitals.

Hospital administration is a complex task and can causes

headaches and one is likelihood of developing high blood

pressure or ulcers if it is not handled properly.

It involves planning, organizing, controlling and evaluating and this can be done better by knowing the principles of management and administration.

Administration is tense. Things happen in spite of the best rules. Problems do not respect rules and regulations, or

procedures. One may win or lose, depending on how one

handles people and problems. Insolvable-looking problems may melt away with

surprising ease, like the shadow at dawn. Problems, which look small and simple, may

snowball into extremely difficult issues for which one should be watchful and deal with the problems more efficient and effectively without making any premature assumption and one should be open to all suggestion and comments.

Failure is a part of human experience and if it is seen as a challenge, one will find that it is truly a step on the road to success and personal growth.

One should not become miserable if something goes wrong. It can happen to the best of administrators.

Nobody is infallible; nobody is right all the time. One has the right to make mistakes and the only person who never makes a mistake is the man who does nothing. But one should learn and profit from the mistake, which is a learning experience.

Hospital personnel, medical staff, para-medical or general employees, must all be concerned with one goal:

Providing the best possible

patient care.

Distinction between Hospital & Industrial Distinction between Hospital & Industrial OrganizationOrganization::

The difference between administrative work in hospital and in other organizations can be attributes to the existence of some conditions peculiar to hospitals.

The consumers of the services provided in a hospital (the patients) are physically or mentally ill and are rendered services within the four wall of the hospital.

As compared with most other institutions of business, government and education, this is an unusual situation and present quite different problems of management.

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The customers of the hospital (the patients) have individual needs and require highly personalized and custom-made services.

The diagnostic, therapeutic and preventive services provided by physicians, nurses and technicians, and the aid of expensive and specialized equipments and medication are tailored to the need of each individual consumer.

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The hospital provides a wide range of scientific and technical services such as:

Nursing, diet therapy, anesthesiology, pharmacy, radiology, clinical laboratory, physical therapy and medical social work.

Many of its services are provided continuously, round the clock, every day of the year.

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Nurses and certain other personnel must accept direction from both the matron and the physicians under whom they work closely every day.

They also have to fulfill the emotional, physical, mental and medical needs of the patients.

The human relations problems in such situations of dual authority are much more frequent, delicate, varies and complex than in organization where this situation does not exist.

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Handicapped by low wages, rigid discipline and some apprehension of exposure to disease, hospital personnel are expected to:

Maintain a very high level of efficiency, as

their functioning affects the lives of

patients.

The amount and the variety of training programmers that the hospital has to provide.

Training is provided for medical interns and residents (6 months to 1 year), technicians (2 years), medical laboratory technicians (2 years), physical therapists, pharmacists, medical social workers, dieticians and nurses. Classrooms, clinical and different training methods are used in varying combinations.

The administrator is responsible for planning and operating these various training programmers.

Very few other types of institutions combine such major educational responsibilities with other operating activities.

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The efficiency and quality of health care services in any hospital is directly dependent on the use of bio-medical equipment in diagnosis, surgery and therapeutic process.

These equipment employ sophisticated technology made of complex systems. The problem of maintenance and management of these bio-medical equipment is complex because there is acute shortage of technical hands who have suitable and adequate training in the maintenance and repairing of these specialized hi-tech equipment.

Hospital administration should be entrusted on those who have the necessary training and the right kind of attitude to perform this vital task.

Definition of ManagementDefinition of Management

is an art with a scientific base

a science can be learned through the study of basic

rules, principles and formulas

acquired through trial-and-error & years of experience

Definition of ManagementDefinition of Management

It is a process, with both interpersonal and technical aspects, through which the objectives of the health services organization are specified and accomplished by utilizing human and physical resources and technology.

Management ProcessManagement Process

It must be designed to meet all the needs of people it is to serve.

It must be a size which the people can afford to build and operate.

It must be well-staffed with a sufficient number of physicians, nurses and other trained personnel to give adequate and efficient service.

Reasons for inadequate hospital service

• Lack of planning.• Lack of locally available funds.

Principles of Planning Hospital Facilities & Services

1. Patient care of a high quality.

2. Effective community orientation.

3. Economic viability.

4. Sound architectural plan.

1 -Patient Care of High Quality:

1. Provision of competent professional and technical staff and of the equipment and facilities necessary to support the hospital's patient care.

2. An organizational structure that assigns responsibility appropriately and requires accountability for the various functions within the institution, including those particularly related to the patient care.

3. Interaction of members of the medical staff with each other and with other members of the health team through consultations and conferences.

4. Continuous review by appropriate persons of the adequacy of care provided by physicians, nursing staff and paramedical technicians.

5. Educational activities designed to improve patient care and to keep the hospital' professional and technical staffs abreast of new medical and technological knowledge.

2 -Effective Community Orientation:1. A governing board made up primary of persons who have

demonstrated concern for the community as well as leadership ability.

2. Policies that assure availability of services as needed to all of the people in the hospital service area.

3. Participation of the hospital in community programs to provide preventive, emergency and casualty care and to teach good health and health care practices to community residents.

4. Service programs extend beyond the walls of the hospital into the community, and that complement and are coordinated with service programs of other hospitals, mental facilities, rehabilitation centers, nursing homes, homes for the aged, community clinics, home-health services and health departments.

5. A public information program that keep the community informed about and identified with the hospital's goals, objectives and plans.

3-Economic Viability:1. A corporate organization that accepts responsibility for

sound financial management with optimum quality of care and the hospital's responsibility for community services and that raises funds, when necessary, to supplement the hospital's earned income.

2. Patient care objectives that are consistent with projected services demands and the availability of operating financing for adequate personnel and equipment required to maintain patient care of a high quality.

3. A program to attract the medical staff, an adequate number of physicians engaged in family practice as well as the essential medical-surgical specialists to maintain optimum occupancy of inpatient facilities and a full utilization of outpatient services.

4. A planned program of expansion or development of facilities and services based on community need and other community health resources to avoid unnecessary duplication.

3-Economic Viability:

5. Community participation in the hospital's programs through sponsors, contributions, auxiliaries and volunteers.

6. An annual budget plan for maintaining:

◦ Services at a high level of quality.

◦ Appropriate standby equipment and services.

◦ Competitive salary and wage scales and employee benefits.

◦ Interest and payments on mortgage and other indebtedness.

4 -Sound Architectural Plan:

1. Retention of an architect experienced in hospital design and construction.

2. Selection of a site large enough to provide for parking and future expansion and readily accessible to water and sewage lines and to population concentrations through highway, rail, rapid transit or bus lines.

3. Determination of facility size appropriate to the demands of the hospital's service area and of departmental areas large enough to provide the diagnostic and treatment services required by the hospital's medical staff on an emergency and day-to-day basis.

4. Recognition of the importance of establishing convenient traffic patterns, both within and outside the hospital, for movement of physicians, hospital staff, patients and visitors and for efficient transportation of food, laundry, drugs and other supplies.

4 -Sound Architectural Plan:

5. Adequate attention to important hospital concepts such as: Infection control. Disaster planning. Use of hospital services by ambulatory inpatients as well

as outpatients. Intensive and extended care units. Psychiatric care programs.