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Health care management- a young challenge

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A Presentation for adminstrators of the hospital to understand the planning of the hospital

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Health care management- a young challenge

  1. 1. Health Care Management- A Young Challenge Sunil Joshi Shree Krishna Hospital, Karamsad
  2. 2. “Separate all departments, yet keep them all together; separate types of traffic, yet save steps for everybody; that is all there is to hospital planning” – Emerson Goble
  3. 3. Learning Objectives  Career in Health care – Challenges and Future  Hospital Planning- Hospital & Its Organization Hospital Administration  Managing Patient Care Quality Patient Care Management Policy & Consideration  Managing Support Services
  4. 4. Hospital Hospital is a place for the diagnosis and treatment of human ills and restoration of health and well-beings of those temporarily deprived of these
  5. 5. Genesis of Health Care & Administration  One of the Fastest growing sectors in India  “HIDDEN” career as per the American college of Health Care Executives.  Hospitals have become large, complex organizations  Technology has advanced exponentially  Government has taken on a larger role in healthcare delivery.
  6. 6. Roles of Today’s Professionals  Human resources management  Financial management  Cost accounting  Data collection and analysis  Strategic planning  Marketing  Maintenance functions of the organization.  Maintaining the moral and social order of healthcare organizations  Serving as patient advocates.  Serving as arbitrators in situations where there are competing values.  Serving as intermediaries for the various professional groups.
  7. 7. Hospital Administrator's Toolbox  Ability to manage operations, budgets, staffing issues.  Being able to work closely with a variety of strong personalities  Peace making skills  Sensible listener  Detail-oriented  Strong analytical skills  Able to sum up a situation very quickly- Decision Making.  Rationale  Top-notch communication skills  Ability to lead- Accountable and assertive
  8. 8. Challenges  Ensuring effective, efficient healthcare services for communities  Shortages of nurses and other healthcare workers  Concern for the safety and quality of healthcare services  Rising healthcare costs  An aging population  Rapidly changing medical terminology and practice
  9. 9. Current Trends in Hospital Administration  Cost-Cutting Focus  Man-power Shortage  Health Care IT Management Professionals in Demand  Drug Shortage Becomes Top Priority  Social Media in Health Care  Population Health Management Strategies to Advert Readmissions  Privacy Becomes More Important  Compliance to State and Federal Laws  Process Improvements  Implementation of Technological Advancements  Evolving Leadership Opportunities
  10. 10. Choosing a Career in Health Care Administration
  11. 11. Hospital Planning A design expert says- “we’ve got to design ‘smart’ hospitals that respond to present needs while anticipating future changes.
  12. 12. PLANNING A HOSPITAL  A good hospital is built on a triad of good planning, good design & construction & good administration  Designed to serve people and for promoters to build in the first place & sustain later  Competent and adequate number of Manpower  A strong management- For everyday operations.
  13. 13. Classification There are various classifications to the types of hospital  According to Objectives- Teaching Hospitals, General Hospital, Specialized Hospital etc.  According to Ownership- Government hospitals, Semi- Government hospitals, Voluntary Agencies’ hospitals, Private/Charitable hospitals  According to Systems of Medicine- Allopathic, Ayurveda, Unani, Homeopathy etc.  According to size- Teaching Hospitals(500 beds), District Hospitals(200 beds), Taluk Hospitals(50 beds), PHCs(6 beds)
  14. 14. Need Analysis- Does Community need a Hospital? There are two methods to estimate the need for hospital in a population: • Analytical method: Taking feedback and analysis of data collected through survey e.g. distributing questionnaire. • Estimation method- needs of the community
  15. 15. THE 5W-1H Approach  What we expect to do?  Why it will be done ?  Where will it be done ?  When we expect to do it?  Who all are going to do it ?  How will it be done ?
  16. 16. Guiding principles to hospital planning High Quality Patient Care Effective Community Orientation Economic Viability Sound Architectural Plan Excellent firms don’t believe in excellence – only in constant improvement and constant change -Tom Peters
  17. 17. Data required in hospital Planning Demographic Details Population Strength Sex & Age Ratio Geographic Data Morbidity & Mortality Status Need & Demand Details of existing Facilities Financial Feasibility
  18. 18. Meeting Fundamental Needs- Must meet the needs of the patient it is going to serve adequately. It must be in a size and proportions which the owners or promoters will be able to build and operate
  19. 19. PLANNING TEAM • Hospital administrator • Specialists from various clinical branches • Nursing advisor • Civil and electrical engineers • Representative of local body • Senior architect
  20. 20. OBJECTIVES OF PLANNIG TEAM Existing facilities & its adequacy Asses the needs of area Needs of new facilities so as to provide Adequate, qualitative health are services
  21. 21. MARKET SURVEY One the first tasks of the any organization is to survey the service area of the proposed hospital. Following bodies helps in market survey- • Banks • CA firms • Financial Institutions • Consultant Since major decisions will be on the result of the survey, it must be done in a professional manner.
  22. 22. FINANCIAL PLANNING • Financial planning must take precedence over every other consideration. • Financial planning must cover the following three areas: Constructing, Equipping & Furnishing the Hospital Operating Funds Financial Assistance
  23. 23. EQUIPMENT PLANNING  The term ‘equipment’ means all items necessary for the functioning of all services of the hospital.  It is necessary to consult with the architect designing the building early so that the facilities planned will be of sufficient size to accommodate the equipment & render the necessary services.  A room by room equipment list is then complied & reviewed by the administration, medical & departmental staff
  24. 24. Types of Equipment to be installed…….  Built-in Equipment's- Usually included in the construction contract and is responsibility of architect. For e.g. cabinets, incinerators, coolers, pharmacy, Lines, fixed sterilizing equipment's etc.  Depreciable Equipment's- equipment’s that has life of five years and is not purchased through contract like laboratory and diagnostic equipment's, office furniture's etc.  Non-Depreciable Equipment’s- They include the items with a low unit cost and life span less than five years. They are usually under control of the store. Like kitchen utensils surgical instruments, waste basket
  25. 25. SITE SELECTION  Accessibility to transportation & communication lines  Parking facilities  Availability of public utilities  Proper elevation for drainage & general sanitary measures  Freedom from smoke, noise, vapours & other annoyances  Future expansion  Total cost
  26. 26. INTERIOR & FURNISHING In a patient centred environment, design solutions will respond to the needs of the patients profile both architecturally and through material selections. Should consider the following-  Infection control standards  Design story  Healing environment  Physical environment  Organizational planning understanding  Cost analysis
  27. 27. GENERAL FEATURES • Environment • Screened windows • 4 separate entrance • Exit point • Attractive entrance • Traffic flow • Corridors • Visitors control • Running physical part • Fire escape
  28. 28. OPERATION PROGRAM Admission Administration Stores Human Resources General Engineering Laundry Maintenance Purchasing Clinical Services Pharmacy Fire and Safety Waste Disposal Nursing Services Records Dietary Services Information Public Relations Employee facilities Clinical Engineering Disaster Plan
  29. 29. SHAKE DOWN PERIOD After the commissioning of hospital some time is taken for functional integration of different units, services, staff, patient & community.  Machine are tested  Staff recruited & trained  Standard operating procedures are made  Maintenance service is put in place  Materials, linen & stationary procured Then starts the routine & regular functioning of the hospital.
  30. 30. MANAGING QUALITY PATIENT CARE • The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.”
  31. 31. Issues that need to be addressed to improve patient care • Access. Accessibility and availability of both the hospital and the physician • Waiting. Waiting times for all services should be minimized • Information. Patient information and instruction about all procedures, both medical and administrative, should be made very clear • Administration. Check-in and check-out procedures should be ‘patient friendly’ • Communication. Communicating with the patient and the family about possible delays is a factor that can avoid a lot of frustration and anxiety. • Ancillary Services. Other services such as communication, food, etc. should be accessible both to patients and to attending families
  32. 32. ADMINISTRATIVE ELEMENTS
  33. 33.  Planning needs knowledge, experience, foresight, reasoning and the mastering of special skills and techniques. Its must be :  Futuristic  Decision Making Process  Dynamic  Flexible  The Organizational process is classified into: Structural organization Functional organization  There must be a good Co-ordination.
  34. 34.  Staffing is the process of “personalizing” the organization, by hiring the right type and adequate number of workers to each unit for the time required  Budgeting is the financial administration. About 60 percent of total budget is spent in wages & salaries of the staff in a hospital. • To ensure adequate care & treatment there must be: • Regular Auditing • Purchasing of modern equipments and maitainance • Supervision of both work & workers by the Executive • Evaluation of activities, characteristics, outcome of the health care process to improve effectiveness & make decision for efficient planning.
  35. 35. Administrative Structure
  36. 36. THE MEDICAL STAFF • The physician is the leader of the clinical team and the major agent working on behalf of the patient. • The physician's responsibility is to diagnose the patient's condition accurately and to prescribe the best and most cost-effective treatment plan
  37. 37. NURSING SERVICES • Nurses are one of the few blessings of being ill. • Nursing services employees are responsible for carrying out the treatment plan developed by the physician. • Nursing services, also called patient care services, is the largest component of the hospital
  38. 38. ALLIED HEALTH SERVICES • The clinical laboratory is a diagnostic centre that performs a variety of functions, including autopsy, clinical cytology, and clinical pathology. • Also medical technologists, radiology department and rehabilitation services.
  39. 39. CLINICAL SUPPORT SERVICE • The hospital pharmacy purchases and dispenses all the medications used to treat patients in the hospital. • The pharmacist works directly with the medical staff in establishing a formulary, the listing of drugs chosen to be included in the pharmacy
  40. 40. LINE SERVICE • Emergency services Diagnosis & treatment of illness of an urgent nature & injuries from accidents • Out-Patient services Provision of diagnostic, curative, preventive and rehabilitative services • In-patient services (Wards) • Intensive care unit Those who need Acute, multidisciplinary and intensive observation and treatment • Operation theatres Should have a pre anaesthesia room and sterilization room and a scrub room for doctors and nurses
  41. 41. Managerial Considerations OVER CROWDING STAFF TRAINING MOTIVATION APPOINTMENT SYSTEM SIGNAGES PROPER MANAGEMENT STRUCTURE MONITORING/S UPERVISOR QUALITY OF CARE POLICY AND GUIDELINES
  42. 42. POLICY AND GUIDELINES Healthcare managers of all levels and specializations are critical to guarantee a hospital functions in a competitive, effective, profitable and satisfactory manner.
  43. 43. • Modern well equipped technology and methods • Obtain total patient satisfaction • Sustained and continuity of high standard patient care • Highly motivated and trained, skilled hospital staff • Manual of procedures for hospital staff • Periodic training and review system • Morning and afternoon clinics
  44. 44. • Modern System of appointment. e.g. e- hospital management • Proper Fire system and well maintained evacuation plans
  45. 45. ADMINISTRATIVE RESPONSIBILITIES  Procedure manual of patient care at various areas of health care  Advisory responsibility, planning and budgeting  Nursing training and research in services  Recruitment, promotion and development of nursing staff
  46. 46. •Staff meetings, monitoring & evaluation of service •Maintenance of discipline, reward and punishment
  47. 47. Welfare measures, residential accommodation, health promotion, recreation and other utility service like canteen, pharmacy, bank etc.
  48. 48. Florence Nightingale quotes- “The very first requirement in a hospital that it should do the sick NO HARM”

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