Hospital and Health Care Management Unit 1

Introduction to Hospital and Health Care Management

Importance of Hospital Management

• Hospital management is crucial for quality patient care and productivity outcomes.
• Effective management practices are associated with better clinical outcomes, higher patient satisfaction, and better financial performance.
• Factors contributing to effective management practices include:
  • Clinically qualified managers
  • Higher levels of autonomy for managers
  • Larger hospitals
  • Private hospitals (including not-for-profits) achieving higher management scores than public hospitals

Rationale and Importance of Hospital Management

• Hospitals are complex organizations that require a separate discipline of management to ensure effective administration.
• Hospitals are unique in that they care for patients who are physically and mentally ill, and require personalized and individualized care.
• Hospitals require a combination of clinical excellence, humanitarian, social, and professional values.
• Hospital management is crucial for the success of hospitals, which are knowledge-based organizations.

What is a Hospital?

• A hospital is an institution that provides comprehensive health care, including preventive, promotive, curative, and rehabilitative services.
• Hospitals are defined by various organizations, including the Medical Dictionary, Blackiston's New Gould Medical Dictionary, and the World Health Organization (WHO).
• Common characteristics of hospitals include:
  • Providing services of curative, restorative, and preventive character
  • Conducting educational and training programs for health workers
  • Conducting research to advance medical service and hospital services
  • Conducting health education programs

Evolution of Hospitals

• Hospitals emerged in the Byzantine Empire in the 5th and 6th centuries AD.
• Hospitals in Western Europe emerged later, beginning in monasteries.
• The industrial revolution led to the growth of cities and the need for formal health services.
• Advances in medical technology, including the discovery of antibiotics and the development of surgical procedures, transformed the role of hospitals.
• By the 20th century, hospitals were providing cure rather than just care.
• Modern hospitals have evolved to provide complex and specialized services, including cancer treatment, organ transplantation, and microsurgery.

Roles of Hospitals

• The role of hospitals has changed dramatically over time.
• Hospitals now provide multiple roles, including:
  • Delivery of value-based health care
  • Primary care and home care
  • Bio-ethical and socio-ethical reflection and consultation
  • Patient-centered care
  • Education and training for health workers
  • Research to advance medical service and hospital services

Challenges of Hospitals

• Hospitals face numerous challenges, including:
  • Increasing demand for healthcare services
  • Rising healthcare costs
  • Changing demographics and disease profiles
  • Need for training and career development of human resources
  • Emergence of new professions and specializations### Changing Paradigm in Health Care
• The old paradigm in health care focuses on individual care, acute episodes of disease, and equal service providers.
• The emerging paradigm, on the other hand, focuses on the health of defined populations, care throughout the continuum, and differentiation based on added value.

Roles of a Modern Hospital

• Centre for care of the sick: providing diagnostic, therapeutic facilities, and infrastructure to care for the sick and injured.
• Primary health care: restoring health, not just treating sickness, and promoting health through preventive and curative measures.
• Education and training: providing continuous training and education for healthcare professionals.
• Research: conducting research on various aspects of disease, including physical, social, demographic, and psychological factors.
• Disease and health surveillance: monitoring and reporting on disease prevalence, incidence, and demographic data.
• Outreach centre: extending healthcare services beyond the hospital to the community through OPD services, satellite clinics, and ambulatory care centers.
• Rehabilitation: providing full-fledged physiotherapy, occupational therapy, and counseling services.

Classification of Hospitals

• Length of stay: short-term or long-term hospitals.
• Clinical basis: general hospitals or specialized hospitals.
• Ownership/control: public hospitals, voluntary hospitals, private hospitals, nursing homes, and corporate hospitals.

Public Hospitals

• Run by the government or local bodies on a non-commercial basis.
• General hospitals or specialized hospitals.
• May refer patients to specialized hospitals for treatment.

Voluntary Hospitals

• Established and incorporated under the Societies Registration Act or Public Trust Act.
• Run on a non-commercial basis.
• Managed by a board of trustees and administrators.
• Spend more on patient care than what they receive from patients.
• May charge high fees from rich patients to support poor patients.

Private Nursing Homes

• Owned by individual doctors or groups of doctors.
• Admit patients suffering from infirmity, advanced age, illness, or injury, but not communicable diseases.
• Run on a commercial basis.

Corporate Hospitals

• Formed under the Companies Act.
• Run on commercial lines.
• May be general or specialized hospitals.

Challenges of Hospital Management

• Patients are not healthy individuals and may feel compromised in their autonomy.
• Patients require highly personalized and custom-made services.
• Services are provided continuously, round the clock, every day of the year.
• Involves many stakeholders, including patients, relatives, physicians, and staff.
• Hospital is a matrix organization with dual authority.
• Service evaluation is difficult due to intangibility, inseparability, heterogeneity, and perishability.
• High dependence on service providers.

Looking Ahead

• Changes in society, medicine, and healthcare systems are challenging the supply and demand patterns of health services.
• Hospitals are shifting from inpatient care to specialized diagnostic and treatment services.
• Scientific and technological advancements are making it possible to treat conditions on an outpatient basis or with shorter hospital stays.
• Communication networks and telemedicine are allowing patients to access high-level specialist care remotely.
• Healthcare systems are facing pressure to control expenditure and improve efficiency.
• New patterns of care, such as major ambulatory surgery, day hospital services, and hospital-at-home services, are emerging.### New Healthcare Services
• New healthcare services can benefit:
  • Patients: higher quality care, faster recovery
  • Health professionals: better coordination and communication
  • Hospitals: reduced inpatient days, closer to community
  • Health systems: greater efficiency in resource use
• However, implementation clashes with:
  • Existing hospital financing patterns
  • Difficulty coordinating with private out-of-hospital practice
  • Nursing organization challenges in ambulatory care
  • Difficulty reducing acute hospital beds
  • Lack of social and welfare services
• Recommendations:
  • Encourage and lead a shift towards increasing ambulatory care services
  • Develop innovative health policymaking and management instruments
  • Apply the same shift towards increasing ambulatory care services in the social and welfare sector

Introduction to Hospital and Healthcare Management

• Healthcare industry:
  • Referred to as a crisis industry and people-intensive sector
  • Perennially hungry for quality people and capable administrators
  • Next boom industry in India
• Hospitals:
  • Quality of care is the main differentiator
  • Growing consumer expectations and regulations
  • Changing paradigm of the industry

Basics of Management

• Definition of Management:
  • Art of getting things done through and with people in formally organized groups
  • Process of creating an environment for people to perform and cooperate towards group goals
  • Art of removing blocks to performance and optimizing efficiency
• Nature of Management:
  • Process of getting things done through and with people
  • Integrating function of organizing human resources with physical resources for better performance
  • Group activity where people come together to achieve common objectives
• Functions of Management:
  • Planning, organizing, actuating, and controlling
  • Directing, coordinating, and controlling activities
  • Optimizing efficiency in reaching goals

Business Industries

• Types of Industries:
  • Primary Industries: extraction of natural resources (agriculture, mining, fishing)
  • Secondary Industries: manufacturing and processing of raw materials (analytical, synthetic, process, assembly line)
  • Tertiary Industries: services providing industries (financial, educational, information, construction)
  • Quaternary Industries: intellectual services providing industries (research and development)

Management Definitions

• Harold Koontz and Cyril O'Donnell:
  • Management is the art of getting things done through and with people in formally organized groups
• William Spriegel:
  • Management is the function of an enterprise that concerns itself with the direction and control of various activities to attain business objectives
• George R. Terry:
  • Management is a distinct process consisting of planning, organizing, actuating, and controlling performance to determine and accomplish objectives
• Dalton Macfarland:
  • Management is the process by which managers create, direct, control, maintain, and operate their organizations through coordinated, systematic, and cooperative human efforts

This unit introduces you to the basics of hospital and health care management, covering its importance, concept, roles, types, and challenges. Learn about the evolution of hospitals and how they function.