8th and 9th Lecture on Hospital Organizational Structure and Evaluation PDF

BASIC ELEMENTS OF ORGANIZATIONAL STRUCTURE AND EVALUATION OF HOSPITAL SERVICES BY DR/Kamal Marie LECTURER AT AHRAM CANADIAN UNIVERSITY Objectives  Four elements of organizational structure  Hospital organization criteria  Evaluation of hospital servic...

BASIC ELEMENTS OF ORGANIZATIONAL STRUCTURE AND EVALUATION OF HOSPITAL SERVICES BY DR/Kamal Marie LECTURER AT AHRAM CANADIAN UNIVERSITY Objectives  Four elements of organizational structure  Hospital organization criteria  Evaluation of hospital services  Steps and tools of evaluation  Four basic elements of organizational structure  Functional organization structure  Under a functional organization structure, people doing similar tasks are grouped based on specialty. So all the accountants are placed in the finance department and so on for the marketing operations, senior management, and human resources departments.  The advantages of this kind of structure include quick decision-making because the group members can easily communicate. They can also learn from each other since they already possess similar skill sets and interests.  Divisional structure based on products  In a divisional structure, your company groups workers into teams based on the products or projects that meet the needs of a certain type of customer.  The division of labor in this kind of structure ensures workers making similar products can achieve greater efficiency and higher output.  Matrix Structure Combines Functional and Divisional Models  A matrix structure combines elements of the functional and divisional models, so it’s more complex. It groups people into functional departments of specialization, and then further separates them in to divisional projects and products.  Flat Organizational structure  A flat organizational structure attempts to disrupt the traditional top–down management system of most companies. Management is decentralized so there is no everyday ‘boss’ Each employee is the boss of themselves, eliminating bureaucracy and red tape and improving direct communication.  Hospital organization criteria  Board  All hospitals include some form of governing body responsible for making high – level decisions about the organization.  The board of directors is the highest in the hospital chain of command and is made up to experts in their respective fields. Religiously affiliated hospitals often include university faculty from the medical school with which they’re affiliated.  Executives  In the hospital leadership structure, executives are responsible for managing the organization, making financial decisions, and overseeing business strategy. Medical and health services managers may oversee entire practices or clinical areas.  A hospital typically has a chief financial officer who tends to the financial aspects of the business and a chief operating officer or chief executive officer responsible for high–level business strategy and decision–making.  Department Administrators  Department administrators report to the hospital executives and manage the day – to – day operations of the hospital department structure. They chief of surgery, for example, is responsible for overseeing daily activities within the surgical department as well as performing surgery.  A chief of surgery might engage in public relations activities, fundraising and recruitment. Other segments within a hospital, such as transcription or switchboard personnel, also have department administrators.  Patient Care Managers  Nurse managers and supervising physicians are both patient care managers. These individuals manage small groups of professionals who provide direct patient care.  They ensure that orders are carried out, that hospital employees are fulfilling their duties appropriately, and that employees are complying with legal requirements.  Service Providers  The vast majority of hospital workers are service providers: doctors, nurses, orderlies, physical therapists, laundry workers, and the many other people required in order for a hospital to function.  They provide patient care, maintain records, and ensure that the hospital can deliver care to patients in an effective manner.  Service providers have their hierarchical structure in healthcare. For example, doctors often give orders to stop nurses, who might delegate to orderlies.  Different types of organizational structures and charts  Organizational charts serve as a blueprint for the chain of command for an organization. Different organizations tend to have more basic structures at inception, which become more complex and hierarchical as the organization expands.  Types of Organizational structures  Pre- Bureaucratic Structures: Pre – Bureaucratic structures are common in small organizations. Such a structure includes centralized management, where the key decisions lie with the strategic leader.  Bureaucratic Structures: Unlike the Pre- Bureaucratic Structures, the Bureaucratic structures have some of standardization. Such structures are usually used in larger organizations.  Post – Bureaucratic Structures: Such structures have a strict hierarchy, with the flexibility of using more modern management techniques. One example is the use of Total Quality Management initiatives. Evaluation of Hospital Services  The last stage in the management process, evaluation is designed to measure the efficiency and effectiveness of the services after planning organizing, directing, and controlling.  Evaluation has been defined as the process of determining the degree of success in achieving predetermined objectives.  It is also defined as the ‘ Measurement of action against accepted criteria and interpretation of relationship amongst them’.  There are three main reasons which warrant objective evaluation of hospitals. 1. It is to safeguard the interests of the recipients of hospital care. 2. It is to locate inadequacies and shortcomings of the hospital staff, its plant and machinery, and what is most important. 3. It is to provide the authorities, governing body, board of trustees, or owners a sound appraisal system of the effectiveness of managerial staff at various levels, hospital administrators, and individual physicians and furnish valid facts and data to regulate their future development.  What to Evaluate?  In hospitals and health care, there are five indicators through which the quality of medical care and services can be assessed. 1. The organization. 2. The process. 3. The content. 4. The outcome. 5. The impact.  Traditionally, these can be grouped into three categories  Evaluation of the ‘Means’ covers the inputs, ascertaining whether the hospital has been provided with optimum quantity and right quality of staff and physical facilities as in the shape of buildings, equipment, drugs, diet, and supplies.  Evaluation of the ‘Methods’ is determining whether there is an effective utilization of the available human and material resources and whether the hospital’s policies and working procedures are sound and judicious.  Evaluation of the ‘End- results’ means judging the effectiveness or outcome of the benefits derived by individual patients and the community from the hospital. This is an evaluation of the ‘outcome’ and impact’.  Steps in evaluation There are five steps in the process of evaluation.  Step –I: Definition of the Purpose and Scope of Evaluation: In step I, the scope will have to be stated in such terms as whether it will be concerning technical considerations, administrative considerations, consideration of effectiveness or efficiency, or a combination of one or more of them.  Step –II: Detailed Description of the Hospital System and Its Operation: One needs to clarify and define the objectives of the hospital in as specific terms as possible, the steps, activities, and the cost of all these activities.  Step III: Determination of criteria for Measuring the Achievement of Objectives: An index is an instrument or measuring device which measures the achievement of a particular objective or set of objectives, whereas a criterion is the particular value, on the measuring scale which defines success or failure in absolute terms. For proper measurement, any index should have the following three important characteristics:  It should be specific, sensitive, and reliable.  Step - IV: Preparing and Execution of Evaluation: The plan and design of the study will now have to be prepared and executed utilizing various methods such as observations, interviews, study of documents and records.  Step – V: Reporting the Results of Evaluation: In Step- V, the reports will include broad facts of the study and conclusions reached. Recommendations if required could also be submitted, with suggestions regarding alternative courses of action and modification in the present procedures.  The Tools of Evaluation 1. Inspections. 2. Reports and return (MIS). 3. Statistical quality control (SQC). 4. Professional reviews. 5. Social surveys. 6. Cost studies. 7. Medical audit/ comprehensive. 1. Inspections of all hospitals by the administrative medical officers and even consultants provide subjective or judgmental information, and yet they serve as a useful device to locate defects, weaknesses and deficiencies in hospital operation. They also lead to improving the established standards and results in innovations and further development. A hospital inspection demands from the inspecting officer extensive knowledge and skills. Apart from the in – service experience, common sense, pragmatism and intuition. 2.Reports and Returns reports and returns from various areas of activity of the hospital are an important control device in that they are useful for assessing whether a situation is getting better or worse. They do so by comparing present performance with that of the recent past, and with that of corresponding period of previous years. 3. Statistical quality control (SQC) is a management technique based on sampling, probability and statistical inference. Simple random sampling and systemic random sampling can be utilized. 4. Professional Reviews in evaluating the process and outcome, the study of the structure of the organization, i.e. the men- material – money inputs assume only a secondary role. Professional reviews primarily evaluated performance of the medical and nursing staff, both on a concurrent and retrospective basis, thus, assuring the quality of medical care. 5.Social surveys during the recent years, social surveys have become a regular feature in public health and can be effectively put to use in the hospital sector. A series of social surveys have been conducted to elicit the extent of patient satisfaction and degree of public image the hospital enjoys among the community. The surveys are conducted through questionnaires given to the patients as well as their attendants and visitors to the hospitals. 6.Cost Studies at what cost are the hospitals administered ? it is important to know whether these costs are excessive in relation to the health benefit they render. We should also want to know whether similar benefits can be provided at lesser costs. 7.Medical Audit /Comprehensive Quality Assurance Program to most people the word ‘ audit’ is familiar in relation to financial transactions justifying use of financial resources and thereby establishing guides for further financial operations. Hospital services are no expectation to such an audit, except that this audit directly relates to patients. Viewed as a means of justifying the use of medical care resources and thereby establishing a guide for future medical care operations, it has come to be known as the medical audit.  ASSIGMENT HEALTH CARE MARKETING BENEFITS