The organization is a dynamic process in which various managerial activities bring people together and binds them together for the achievement of a common objective or common goals. The pattern of a hospital organization is identical to that of an industrial plant; only the difference is of nomenclature of position. For example, the Director or Administrator of a hospital may be the General Manager of an industry. Less administrative position is needed in a smaller hospital. Private hospitals are organized by a corporation or board of trustees. Government hospitals are usually managed by a board of trustees but no corporate body.
A successful hospital is based upon good
community-oriented planning, good design and construction, and good
administration. A progressive hospital will build its service on the certain
knowledge of the community it is to serve. The ultimate aim of the hospital is
to provide optimum health care.
Its organization is based upon the following principles:
Team Coordinator:
An individual supervises a professional team of medical/paramedical staff. The
services are integrated and coordinated.
Division of Services: The
hospital undertakes several activities like; diagnosis, treatment or therapy, rehabilitation,
education, and prevention. These activities are further sub-classified. Groups
and sub-groups are formed to carry out these activities.
Homogenous Approach:
A hospital caters to both ambulatory and bed patients (outpatients and inpatients). The
organization should form a homogenous approach with common or integrated
services.
Evaluation of Services:
Services provided by the hospital should be rated in terms of quality and
adequate for meeting the patient's and community's requirements.
Administrative Responsibility:
The relations among the various people and takes in a hospital must be carefully maintained.
Responsibility should be assigned appropriately. Once responsibility is
assigned, accountability should be reported to the superior for its
performance. This is necessary to ensure a high quality of patient care.
Budget Preparation and Financing:
Large hospitals treat almost 15 lacs of patients per year, and perform 18
thousand major surgeries and 33 thousand minor surgeries. Their yearly budget
is about Rs. 16-18 crores. Many hospitals have their finance. There should be
budgeting and a planned program for capital financing.
Talent Search:
A hospital should be staffed by competent medical experts and nonmedical staff.
The organization should formulate a program to attract good physicians and
surgical specialists as well as to attract patients.
Governing Body:
Each hospital has the top management to decide its course of action, and policy guidelines and to exercise overall
supervision and control. It is the legal and moral responsibility the conduct
of the hospital as an institute.
Organizational structure is the framework that defines
formal reporting relationships between different levels of management of the
organization. Organizational structure is the mechanism that operationalizes
the management of the organization.
The most important body of a hospital is the governing
body or board of directors or board of trustees. This is the major
decision-making body of the hospital. It comprises various outstanding
personalities in the field of medical education, research, and administration.
The following block diagram depicts the organizational structure of the hospital.
Fig.1: Block Diagram Depicts the Organizational Structure of Hospital
The complexity of organizational structure depends on the
size of the healthcare facility; large acute care hospitals have complicated
structures, whereas, smaller institutions have a much simpler organizational
structure. Common organizational categories might include:
•Administration Services (often referred to simply as
“administration”)
• Informational Services
• Therapeutic Services
• Diagnostic Services
• Support Services (sometimes referred to as
“Environmental Services”)
Administration Services
Business people who “run” the hospital.
• Hospital Administrators manage and oversee the
operation of departments.
• Oversee budgeting and finance.
• Establish hospital policies and procedures.
• Perform public relations duties.
• Generally, include: Hospital President, Vice
Presidents, Executive Assistants, and
Department Heads.
Informational Services
Documents and process information.
• Admissions: often the public’s first contact
with hospital personnel checking patients into the hospital. Responsible for
obtaining vital information (patient’s full name, address, phone number, admitting doctor, admitting
diagnosis, social security number, date of birth, and all insurance
information). They frequently; admissions will assign in-house patients to their
hospital rooms.
• Billing and Collection Departments: Responsible for billing patients for services rendered.
• Medical Records: Responsible for maintaining
copies of all patient records.
• Information Systems: Responsible for
computers and hospital networks.
• Health Education: Responsible for staff and
patient health-related education.
• Human Resources: Responsible for recruiting/
hiring employees and employee benefits.
Therapeutic Services
Provides treatment to patients.
• Physical Therapy (PT): Provide treatment to
improve large-muscle mobility and prevent or limit permanent disability. PT
treatments may include; exercise, massage,
hydrotherapy, ultrasound, electrical stimulation, and heat application.
• Occupational Therapy (OT): The goal of
treatment is to help the patient regain fine motor skills so that they can
function independently at home and work. OT treatments might include; arts and
crafts that help with hand-eye coordination, games, and recreation to help
patients develop balance and coordination, and social activities to assist
patients with emotional health.
• Speech/Language Pathology: Identity, evaluate
and treat patients with speech and language disorders and also help patients
cope with problems created by speech impairments.
• Respiratory Therapy (RT): Treat patients with
heart and lung diseases. RT treatment might include; oxygen, medications, and breathing
exercises.
• Medical Psychology: Concerned with the mental
well-being of patients and treatments might include; talk therapy, behavior
modification, muscle relaxation, medications,
group therapy, and recreational therapies (art, music, dance).
• Social Services: Aid patients by referring
them to community resources for living assistance (housing, medical, mental,
financial). Social worker specialties include; child welfare, geriatrics,
family, and correctional (jail).
• Pharmacy: Dispense medications per written
orders of a physician, dentists, etc.
Provide information on drugs and correct ways to use them and ensure
drug compatibility.
• Dietary: Responsible for helping patients
maintain nutritionally sound diets.
• Sports Medicine: Provide rehabilitative
services to athletes, and teaches proper nutrition. Prescribe exercises to increase strength and
flexibility or correct weaknesses. Apply tape or padding to protect body parts
and administer first aid for sports injuries.
• Nursing: Provide care for patients as
directed by physicians. Many nursing specialties include; nurse practitioner,
labor and delivery nurse, neonatal nurse, emergency room nurse, nurse midwife,
surgical nurse, and nurse anesthetist. In some facilities, Nursing is a service in and of itself.
Diagnostic Services
Determines cause(s) of illness or injury.
• Medical Laboratory (MT): Studies body tissues
to determine abnormalities.
• Imaging: Image body parts to determine
lesions and abnormalities and includes;
Diagnostic Radiology, MRI, CT, and Ultra Sound.
• Emergency Medicine: Provides emergency
diagnoses and treatment.
Support Services
Provides support to the entire hospital.
• Central Supply: In charge of ordering,
receiving, stocking, and distributing all equipment and supplies used by the healthcare
facility. It also sterilizes instruments or supplies and is responsible for
cleaning and maintaining hospital linen and patient gowns.
• Biomedical Technology: Design and build
biomedical equipment (engineers) and diagnose and repair defective equipment
(biomedical technicians). It provides preventative maintenance to all hospital
equipment (biomedical technicians) and is responsible for the pilot use of
medical equipment by other hospital employees
(biomedical technicians).
• Housekeeping and Maintenance: Maintain a safe clean environment. It works with cleaners, electricians, carpenters, and gardeners.