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Health Care Management- A
Shree Krishna Hospital,
“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”
Career in Health care – Challenges and Future
Hospital & Its Organization
Managing Patient Care
Quality Patient Care
Policy & Consideration
Managing Support Services
Hospital is a place for the diagnosis and treatment of human ills and
restoration of health and well-beings of those temporarily deprived
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.
Roles of Today’s Professionals
Human resources management
Data collection and analysis
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.
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
Strong analytical skills
Able to sum up a situation very quickly- Decision Making.
Top-notch communication skills
Ability to lead- Accountable and assertive
Ensuring effective, efficient healthcare
services for communities
Shortages of nurses and other healthcare
Concern for the safety and quality of
Rising healthcare costs
An aging population
Rapidly changing medical terminology and
Current Trends in Hospital Administration
Health Care IT Management Professionals in Demand
Drug Shortage Becomes Top Priority
Social Media in Health Care
Population Health Management Strategies to Advert
Privacy Becomes More Important
Compliance to State and Federal Laws
Implementation of Technological Advancements
Evolving Leadership Opportunities
Choosing a Career in Health Care Administration
A design expert says-
“we’ve got to design ‘smart’
hospitals that respond to
present needs while
anticipating future changes.
PLANNING A HOSPITAL
A good hospital is built on a triad of good
planning, good design & construction &
Designed to serve people and for
promoters to build in the first place &
Competent and adequate number of
A strong management- For everyday
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,
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),
Need Analysis- Does
Community need a Hospital?
There are two methods to estimate
the need for hospital in a
• Analytical method: Taking
feedback and analysis of data
collected through survey e.g.
• Estimation method- needs of the
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 ?
Guiding principles to hospital planning
High Quality Patient Care
Effective Community Orientation
Sound Architectural Plan
Excellent firms don’t believe in excellence – only in
constant improvement and constant change
Data required in hospital
Sex & Age Ratio
Morbidity & Mortality Status
Need & Demand
Details of existing Facilities
Must meet the needs of the
patient it is going to serve
It must be in a size and
proportions which the
owners or promoters will be
able to build and operate
• Hospital administrator
• Specialists from various clinical
• Nursing advisor
• Civil and electrical engineers
• Representative of local body
• Senior architect
OBJECTIVES OF PLANNIG TEAM
Existing facilities & its adequacy
Asses the needs of area
Needs of new facilities so as to
Adequate, qualitative health are
One the first tasks of the any organization is
to survey the service area of the proposed
Following bodies helps in market survey-
• CA firms
• Financial Institutions
Since major decisions will be on the result of
the survey, it must be done in a professional
• Financial planning must take precedence
over every other consideration.
• Financial planning must cover the following
Constructing, Equipping & Furnishing the
The term ‘equipment’ means all items
necessary for the functioning of all services of
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
A room by room equipment list is then
complied & reviewed by the administration,
medical & departmental staff
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
Accessibility to transportation &
Availability of public utilities
Proper elevation for drainage & general
Freedom from smoke, noise, vapours &
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
Infection control standards
Organizational planning understanding
• Screened windows
• 4 separate entrance
• Exit point
• Attractive entrance
• Traffic flow
• Visitors control
• Running physical part
• Fire escape
Admission Administration Stores Human Resources
Laundry Maintenance Purchasing
Pharmacy Fire and Safety Waste Disposal
Records Dietary Services Information
Employee facilities Clinical Engineering Disaster Plan
SHAKE DOWN PERIOD
After the commissioning of hospital some time is taken for
functional integration of different units, services, staff, patient &
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.
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.”
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
• 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
Planning needs knowledge, experience, foresight, reasoning
and the mastering of special skills and techniques. Its must be :
Decision Making Process
The Organizational process is classified into:
There must be a good Co-ordination.
Staffing is the process of “personalizing” the organization, by hiring the
right type and adequate number of workers to each unit for the time
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.
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
• Nurses are one of the few blessings of
• Nursing services employees are
responsible for carrying out the
treatment plan developed by the
• Nursing services, also called patient
care services, is the largest component
of the hospital
ALLIED HEALTH SERVICES
• The clinical laboratory is a
diagnostic centre that performs a
variety of functions, including
autopsy, clinical cytology, and
• Also medical technologists,
radiology department and
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
• 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
• Operation theatres Should have a pre anaesthesia
room and sterilization room and a scrub room for
doctors and nurses
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.
• 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
• Periodic training and review
• Morning and afternoon clinics
• Modern System of
appointment. e.g. e-
• Proper Fire system and
Procedure manual of patient care
at various areas of health care
Advisory responsibility, planning and
Nursing training and research in
Recruitment, promotion and
development of nursing staff
evaluation of service
discipline, reward and
Welfare measures, residential accommodation, health
promotion, recreation and other utility service like canteen,
pharmacy, bank etc.
Florence Nightingale quotes-
“The very first requirement in a hospital that it should do the sick