Introduction To Radiologic Technology

INTRODUCTION TO RADIOLOGIC TECHNOLOGY PRELIM  Objectives: student will have a general understanding on radiological science, its scope and outputs, practices and limitations relative to Radiologic Technology and its role and professional responsibilities in the healthcare delivery sy...

INTRODUCTION TO RADIOLOGIC TECHNOLOGY PRELIM  Objectives: student will have a general understanding on radiological science, its scope and outputs, practices and limitations relative to Radiologic Technology and its role and professional responsibilities in the healthcare delivery system. CHAPTER I:THE HEALTH CARE ENVIRONMENT HEALTH CARE SETTINGS The term healthcare setting represents a broad array of services and places where healthcare occurs, including acute care hospitals, urgent care centers, rehabilitation centers, nursing homes and other long-term care facilities, specialized outpatient services (e.g., hemodialysis, dentistry, podiatry, chemotherapy,... HEALTH SYSTEM: all the activities whose primary purpose is to promote, restore or maintain health (The World Health Report 2000 – Health systems: improving performance)  Day care. Medical and paramedical services delivered to patients who are formally admitted for diagnosis, treatment or other types of health care with the intention of discharging the patient the same day.  Long-term care. Long-term care encompasses a broad range of help with daily activities that chronically disabled individuals need for a prolonged period of time. Long-term care is primarily concerned with maintaining or improving the ability of elderly people with disabilities to function as independently as possible for as long as possible Nursing homes, visiting nurses, home intravenous and other services provided to chronically ill or disabled persons.  The definition of palliative care is medical care that relieves pain, symptoms and stress caused by serious illness. TYPES OF PATIENT CARE Inpatient. A person who is formally admitted to a health-care facility and who is discharged after one or more days. Outpatient. A person who goes to a health-care facility for a consultation, and who leaves the facility within three hours of the start of consultation. An outpatient is not formally admitted to the facility. 14 Types of Healthcare Facilities Where Medical Professionals Provide Care 1. Ambulatory surgical centers Ambulatory surgical centers, also called outpatient surgical facilities, allow patients to receive certain surgical procedures outside a hospital environment. These environments often offer surgeries at a lower cost than hospitals while also reducing the risk of exposure to infection—since patients are there for surgery, not to recover from sickness and disease.  2. Birth centers A birth center is a healthcare facility for childbirth that focuses on the midwifery model, according to the American Association of Birth Centers. They aim to create a birth environment that feels more comfortable to the mother and allows for a cost-effective, family- inclusive birth.  3. Blood banks Blood banks allow donors to donate blood and platelets while also storing and sorting blood into components that can be used most effectively by patients.  4. Clinics and medical offices The definition of a clinic is “a facility for diagnosis and treatment of outpatients.” There are many healthcare facilities that fit that definition across a wide variety of treatment specialties.  5. Diabetes education centers. Since diabetes is so widespread, diabetes education centers rose up to help patients manage their disease and to help people at risk for diabetes to avoid it, if possible. Diabetes education centers typically offer classes, education, support groups and a variety of resources to help patients manage their diabetes and live as complication-free as possible.  6. Dialysis Centers Patients with kidney disease often need regular treatments of dialysis. Dialysis is a process that filters and cleans the blood artificially—the work functioning kidneys normally take on..  7. Hospice homes Hospice can be a particularly confusing title. It represents a package of insurance benefits that deals with an end-of-life trajectory. It also represents a philosophy of care provision for dying patients as well as official networks that offer hospice care. Hospice is also a designation for specific healthcare facilities that specialize in end-of- life care.  8. Hospitals Hospitals are the ultimate “catch-all” healthcare facility. Their services can vary greatly depending on their size and location, but a hospital’s goal is to save lives. Hospitals typically have a wide range of units that can be loosely broken into intensive care and non-intensive care units.  Intensive care units deal with emergencies and the most serious illnesses and injuries. Patients with imminently life-threatening problems go here. Non-intensive care units include things like childbirth, surgeries, rehabilitation, step-down units for patients who have just been treated in intensive care and many others. Typically, most hospital beds could be classified as non-intensive care.  9. Imaging and radiology centers These facilities, much like their hospital counterparts, offer diagnostic imaging services to patients. Diagnostic imaging includes CT scans, ultrasounds, X-rays, MRIs and more. While hospitals and even clinics have imaging centers, outpatient facilities help keep costs lower and allow more convenient scheduling for patients.  10. Mental health and addiction treatment centers Mental health treatment facilities sometimes exist as a general institution for any mental health issue and are sometimes specialized.  11. Nursing homes Nursing homes offer a living situation for patients whose medical needs aren’t severe enough for hospitalization, but are too serious to manage at home. Some nursing homes offer services for heavier medical needs, such as speech and occupational therapy. Other nursing homes try to create a homier atmosphere, and might operate like an apartment complex with medical staff on hand.  12. Orthopedic and other rehabilitation centers Orthopedic medicine deals with muscles and bones. Physical therapists are typically the practitioner patients see for problems in these areas of the body. If you are experiencing chronic lower back pain, for example, you might see a physical therapist at an orthopedic center or clinic to get a diagnosis and a plan of treatment.  13. Urgent care Urgent care (UR) facilities exist for on-demand healthcare needs that aren’t severe enough for the emergency room, but are too severe or concerning to wait for a scheduled appointment at the doctor’s office. Urgent care is a common choice when children get sick, for example, and need an immediate diagnosis or relief from symptoms.  14. Telehealth While telehealth isn’t really a type of healthcare facility, it is worth mentioning in its potential for serious growth in the coming years. Telehealth, telemedicine and remote healthcare can represent a digital type of healthcare facility.  Those patient limitations, the push to lower costs in healthcare, and new technological capabilities have all come together to motivate telehealth applications. This might look like live video conferencing between patient and physician. Or a patient with an illness might wear a device to allow remote monitoring from their medical team. For quick consultations, telehealth can be an ideal option even for patients with easy access to their doctors. “When you log into a web-based service, the doctor or nurse practitioner can prescribe medications, suggest home care strategies or recommend additional medical care,” the Mayo Clinic writes. CHAPTER II: HOSPITAL organization HOSPITAL is an institution for the care, cure and treatment of the sick and wounded , for the study of diseases and for the training doctor and nurses. PHILOSOPHY To maintain the highest quality of services of curative, restorative and preventive services to all persons who seek in services. To render high standard of patient care in all functional areas of the hospital. Commitment to research in patient care, educational training and management Commitments as screening and referral center for patient suffering from particularly complex health problem. OBJECTIVES Provide optimum health services Provide care ,cure, and preventive service Protect the human rights of clients Provide training for professionals Provide in-service/continuing education in all discipline professional technical personnel Participate /conduct research CLASSIFICATION OF HOSPITAL Length of stay of patient Clinical basis Ownership/control basis Objectives Size Management System of medicine  Length of stay * long-term *short term Clinical basis *general ACCORDING TO OWNERSHIP/CONTROL PUBLIC HOSPITALS Run by the central or state governments or local bodies on noncommercial lines VOLUNTARY HOSPITALS Established and incorporated under the Societies Registration Act 1860,or Public Trust Act 1882 or any other appropriate act of central or state governments Run with public or private funds  PRIVATE NURSING HOSPITALS/NURSING HOMES Generally owned by an unindividual doctor or a group of doctors. Run the hospital or nursing home on a commercial basis. CORPORATE HOSPITALS Hospitals which are public limited companies formed under the companies act Run on commercial lines. They can be either general or specialized or both. ACCORDING TO OBJECTIVES Teaching –cum-Research Hospital College is attached for medical/nursing/dental/pharmacy/education Main objective is teaching based on research and the provision of health care is secondary  General hospitals Provide treatment for common diseases and conditions. Provide active medical and nursing care for more than one category of medical discipline such as general medicine, general surgery, obstetrics and gynecology, pediatrics etc. Main objective is to provide medical care ,teaching and research is secondary and incidental.  SPECIALIZED HOSPITAL Provide medical and nursing care primarily for only one discipline or a specific disease or condition of one system Concentrate on a particular aspect or organ of the body and provide medical and nursing care in that field. Ex. Tb, ENT , Optha, Ortho, maternal etc.  ISOLATION HOSPITAL Person suffering from infections/communicable disease requiring isolation of the patients. ACCORDING TO SIZE Small hospitals: less than 20 beds. Medium hospitals: 20- 100 beds. Large hospitals: above 100 beds (up to 1000 and more). In the Philippines, hospitals fall under 3 different levels as set out by DOH guidelines. Level 1 is the most basic. According to Dr. Hartigan-Go, hospitals under this bracket don’t require intensive care units (ICU), and cater to patients who need minor care and supervision. If there’s a need for a referral, a patient can go to a Level 2 hospital. A Level 2 hospital contains all the elements of Level 1, as well as additional facilities like an ICU for critically ill patients and specialist doctors for gynecology and pediatric services.  If you need a high-level specialty intervention like physical rehabilitation or dialysis treatment, then you go to a Level 3 hospital. Some hospitals also serve as training facilities for nurses and doctors. Regardless of classification, all hospitals need to have emergency room services.  What is a level 4 hospital in the Philippines? (h) "Tertiary Level IV hospital" refers to a tertiary hospital with expensive and sophisticated diagnostic and therapeutic facilities for a specific medical problem area.  What is the vision of the hospital? "To serve and enrich the quality of life of patients suffering from diseases, through the efficient deployment of technology and human expertise, in a caring and nurturing environment with the greatest respect for human dignity and life."  What is a vision and mission? What are mission and vision statements? A mission statement defines the organization's business, its objectives, and how it will reach these objectives. A vision statement details where the organization aspires to go. Why does your company exist? What do you hope to accomplish in the next several years? ADMINISTRATIVE SERVICES Administrative services play a key in delivering the top notch clinical services to the communities we serve. Works closely with the front line departments to ensure patient safety, clinical quality and patient satisfaction They are necessary to the hospitals business and physical plant management The CEO leads these administrative services and directly responsible for the day to day operations of the facility. GOVERNING BOARD CEO—(Board of director) Board Chair- Board of trustees-  BOARD OF DIRECTOR Or governing board, which is authorized by law to operate a hospital The board chair is a member of the board of trustees. The person filling this role presides over board and executive committee meetings. The board chair has many duties. One of the primary duties is to guide the board’s work by steering the board’s priorities, annual objectives and strategic plans.  Serving as the hospital’s public spokesperson, the board chair is the voice of the board to hospital staff, stakeholder groups and the community at large. As a leader, the board chair serves the best interests of the organization and the board, placing their own interests aside.  Typically, the board chair develops a special relationship with the hospital CEO. The board chair offers the CEO advice about governance matters and garners support for the CEO from the rest of the board. Regular communication between the board chair and the CEO facilitates the setting of clear goals and objectives, which the CEO then communicates to upper management.  Roles and Responsibilities of the Board of Trustees The board directors of hospitals are sometimes referred to as trustees because the owners and community entrust them with overseeing the hospital’s best interests. The board of trustees is the governing body of the hospital. They are responsible for developing and reviewing the hospital’s overall mission and strategy. The board guides the long-term goals and policies for the hospital by making strategic plans and decisions.  CEO OR PRESIDENT- defines how the operation of the hospital is being maintained and conducted. Hospital Clinical administration-------------office administration ORGANIZATION The nature and size of the organization of a hospital differ according to the requirement. The organization of a big hospital has two separate wings, one for the clinical administration and the other for office administration. The structure of these wings is given below: The clinical administration and office administration both have multiple divisions or departments and every section is headed by a qualified person with specialization and experience in the particular subject. Needless to point out, large administrative bodies require individuals with special training and education in hospital administration.  Apart from this, various subcommittees are also formed at various levels of the hospital for the same reason e.g.: Finance committee, purchase committee, development committee, ethical committee, etc. Thus, big hospitals are well- organized and function smoothly.  ORGANIZATIONAL CHART- of a hospital demonstrates how employees carry out the functions within the institution in an organized and logical manner. FLOW CHART OF A HOSPITAL ORGANIZATION Government/trust Dean/superintendent/director Office administrative officer clinical administrative officer Finance Purchase resident medical officer (RMO) Stores H.O.D H.O.D H.O.D H.O.D Maintenance Medicine Pharmacy services nursing dietary Transport Surgery Manufacturing services Services Public relations gynecology stores Hostels pediatrics dispensary Security, etc. Ophthalmology clinical pharmacy orthopedics central sterile service dental drug information center ENT skin Radiology Pathology Microbiology Blood bank ADMINISTRATION The above committees regularly conduct meetings and forward their recommendations to the Governing Council or Board of Directors, where these recommendations are considered, approved, modified or rejected. The approved decisions are then implemented by the Deans, either through their office administrative or clinical administrative wing. Only policy matters and/or the decisions involving a huge sum of money are thus routed through the governing council. While the other small issues and day to day affairs are decided by the Deans themselves and implemented accordingly. However, Deans report all the important matters to the Council or Trust or Government through on a periodic basis  The major functions of a hospital are, 1. Treatment of patients 2. Prevention of diseases and 3. Education of public MEDICAL STAFF AND THEIR DUTIES As already given in the organizational structure of the hospital, there are scores of medical and paramedical departments in a hospital. For all practical purposes, both these departments can be referred to as medical departments, as there are a significant number of non- medical staff working in any hospital who are not directly involved in the treatment of patients.  Medical staff list of the hospital starts from the top administer -- the dean or superintendent or director of the hospital and goes on to include HODs, Surgeons, Assistant surgeons, and House surgeon, who are listed at the bottom of the hierarchy. Similarly, there are a number of individuals heading the departments of non-medical and Paramedics, with junior pharmacists, nursing orderly or Lab technicians working according to the authorities they have in these departments. They all work in coordination with the sole aim of giving the best treatment to the patients coming to the hospital  If it is a teaching or a medical college hospital, senior doctors teach the medical students during and after the hospital hours. They teach by demonstrating the conditions of patients that come to the hospitals and also via lectures in medical colleges in the afternoons.  Among all the departments, medical and surgical departments hold the major share of functions and responsibilities of the hospital. The concerning medical professionals first attend to the patients in the out-patient department and either start the treatment right away or refer the patient to other specialization departments like skin, Gynecology, etc. If required, they admit the patient in the wards. After conducting the required diagnostic tests, the prescription is given if it is an outpatient or documented in the case sheets of in- patients in the ward.  This is done after the OP hours during the ward rounds. After performing similar tasks in the surgery department, surgeons perform surgeries programmed for the day. These patients are then transferred to the post-operative wards. There, they are taken care of until complete recovery or whenever they are fit enough for discharge. Thus, treating outpatients in OPD, inpatients in the wards, performing surgeries, and other clinical procedures are the routine functions of the medical staff. That apart, they attend to the administrative functions of the hospital and all the important meetings of staff or management  Most of the time, junior staff of both medical and non-medical departments work during the night shifts and seek the help of the senior staff if required during the functional hours. Occasionally, staff also perform special tasks assigned to them like organizing and conducting medical camps in villages. They also organize and attend seminars and conferences in their fields of specialization.  While performing all these functions, Paramedical staff are contributing their expertise routinely. Nurses take care of inpatients in the wards; administer drugs to patients both in OPD and wards. Pharmacists procure and keep the required drugs ready, dispense them to patients and perform the clinical pharmacy. Physiotherapists offer required therapy to the patients which are referred to them and the lab technologists help the doctor by performing diagnostic tests prescribed for a patient and their work is complemented by Radiology technologist in x-ray, scan, etc.  Dieticians order and supervise the preparation and distribution of nutritious food required for all inpatients and also advises the food regimen to be followed by selected outpatients. All the staff members of the hospital work as a team and ensure that the patient is cured as early as possible and thus, the disease is contained and not allowed to spread or damage the society. That’s why the medical profession is called a noble profession by the people.  In order to achieve the aim of ‘Health for all’, prevention and treatment alone are not sufficient unless the general public is aware and cooperative with the medical schemes. Hence, large scale education campaign is carried out to create awareness among people about diseases, preventive methods, nutrition, and personal and social hygienic practices via multiple communication methods like posters, cinema, TV and other media by the hospital and public health authorities.  A hospital is composed of many departments and services organized to provide care and clinical support services to its patients and clients. Most of a hospital are interrelated , and some of its departments and services are directly dependent on each other.  HOSPITAL ADMINISTRATION A hospital administrator is a professional who oversees the daily operations of a hospital by planning, directing, and coordinating health services. While other health care professionals like physicians and registered nurses (RNs) provide care directly to patients, hospital administrators ensure that the health facility itself functions smoothly and that the medical staff is properly supported and trained.  Hospital administrator duties Hospital administrators play an important role in the delivery and functioning of health services within a hospital. While the exact duties they perform vary from role to role, here are some of the most common duties that you can expect from the job:  Directing and supervising the work of medical staff Establishing organizational goals Planning and implementing programs, such as human resources (HR) administration Overseeing finances and related operations, such as budget planning, authorizing expenses, and creating financial reports Communicating with staff, departments, and board members Hiring and training staff Monitoring resource use and allocation Ensuring that facilities are up to standard and meet current regulatory requirements  Admissions Representative (Hospital) Job Description The Admissions Representative plays a critical role in the efficient and smooth operation of a hospital by ensuring the seamless admission process for patients. They serve as the first point of contact for patients seeking medical care and are responsible for collecting accurate patient information, verifying insurance coverage, and providing excellent customer service. This role requires exceptional communication and organizational skills to efficiently handle admissions while creating a positive patient experience.  INFORMATION SYSTEMS Information system, an integrated set of components for collecting, storing, and processing data and for providing information, knowledge, and digital products. Business firms and other organizations rely on information systems to carry out and manage their operations, interact with their customers and suppliers, and compete in the marketplace.  PROCUREMENT Procurement is the process of purchasing goods or services, usually in reference to business spending. Business procurement requires preparation, solicitation, and payment processing, which usually involves several areas of a company.  ACCOUNTING Accounting is the process of recording, classifying and summarizing financial transactions. It provides a clear picture of the financial health of your organization and its performance, which can serve as a catalyst for resource management and strategic growth.  SUPPORT SERVICES The different types of supporting services such as housekeeping and maintenance, food services, laundry and linen services, and patient transportation services have an important role in hospital operations.  Within a hospital, different departments are responsible for providing the levels of service that make a hospital run, from environmental services, equipment distribution and linens to biomed/clinical engineering, facilities and many others. All these support services are necessary to keep the hospital going, so that hospital staff can provide care and patients can receive treatment. These support services also have an opportunity to drive operational improvement. DEPARTMENTAL ROLES At a high level, you can look at a healthcare system as three pieces of a pie: 1. Clinical. The clinical piece of the pie focuses almost exclusively on patient care and the use of clinical documentation systems such as EPIC and Cerner. 2. Finance. The financial piece includes billing, accounts receivable, accounts payable and purchasing/supply chain/materials management, all important aspects of managing the financial health and prosperity of a hospital. 3. Operations. The operational slice is comprised of a wide variety of support services, including biomedical engineering, facilities engineering, equipment distribution, environmental services, linens, dietary, courier service, security, IT, and others.  HUMAN RESOURCES DEPARTMENT (Formerly personnel department) responsible for finding, recruiting, screening, and training job applicants and administering employee benefit programs. The primary goal of HR is to support employee recruitment, retention, engagement, and overall productivity, which can vary between organizations and positions.  MEDICAL SERVICES Medical services means medical and health care services provided to a Person, including, but not limited to, medical and health care services provided to a Person which are covered by a policy of insurance, and includes, without limitation, physician services, nurse and therapist services, dental services, hospital services, skilled nursing facility services, comprehensive outpatient rehabilitation services, home health care services, residential and out-patient behavioral healthcare services, and medicine or health care equipment provided to a Person for a necessary or specifically requested valid and proper medical or health purpose.  PHYSICIANS A physician, medical practitioner, medical doctor, or simply doctor is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through the study, diagnosis, prognosis and treatment of disease, injury, and other physical and mental impairments.  CLINICAL SERVICES Clinical Services means counseling, assessment, group therapy, family therapy, medication management, and other specialized services requiring knowledge and training in the treatment of mental health and substance use disorders. Means all and any part of the services described in this service schedule to be provided to clients, subject to and in accordance with the provisions of this services schedule. CLINICAL SUPPORT SERVICES The Clinical Support Services Department includes the Occupational therapy, Physiotherapy, Psychological Services and Social Work Services. Laboratory service management Radio-Diagnosis services Central sterile supply department Hospital pharmacy  Others support service department: Medical records- House keeping Dietary service department Hospital waste management Hospital infection control IT and medical equipment management Medico social services  MEDICAL RECORDS- are the document that explains all detail about the patient’s history, clinical findings, diagnostic test results, pre and postoperative care, patient’s progress and medication. If written correctly, notes will support the doctor about the correctness of treatment.  DIETARY SERVICE DEPARTMENT- is an integral part of the hospital supportive services which deliver, organizes and promotes optimal nutrition to patients, through the administration of a high quality food service. (Sharma et al. 2004)  HOSPITAL WASTE MANAGEMENT- Hospital waste management is defined as the systematic handling, segregation, treatment, and disposal of waste generated in healthcare settings. This includes everything from general waste to more hazardous materials such as sharps, pharmaceuticals, and chemical waste.  HOSPITAL INFECTION CONTROL- Infection control refers to the policy and procedures implemented to control and minimize the dissemination of infections in hospitals and other healthcare settings with the main purpose of reducing infection rates.  5 Standard Precautions for Infection Prevention & Control 1.Hand hygiene and cough etiquette 2.The use of personal protective equipment (PPE) 3.The safe use and disposal of sharps 4.Routine environmental cleaning 5.Incorporation of safe practices for handling blood, body fluids and secretions as well as excretions.  IT AND MEDICAL EQUIPMENT MANAGEMENT Medical equipment management (sometimes referred to as clinical engineering, clinical engineering management, clinical technology management, healthcare technology management, biomedical maintenance, biomedical equipment management, and biomedical engineering) is a term for the professionals who manage operations, analyze and improve utilization and safety, and support servicing healthcare technology.  MEDICO SOCIAL SERVICES Assess, interview and classify patients according to their economic and other needs and as mandated by RA 747 s. 1952. An act to regulate fees in Government hospitals and charity clinics and its current rules and regulations. Implementing guidelines on classification of patients and on Availment of Medical Social Services in Government Hospitals.  The Medical Social Worker is responsible for the classification of admitted patients. They prepare social case studies, perform assessment of the psychosocial condition of patients and families and facilitates their needs as necessary.  RADIO-DIAGNOSIS SERVICES The practice of modern medicine and surgery has increased the use of such specialized services as Radiology Diagnostic and therapeutic arms of the hospital The radiology services maybe organized as three separate departments, namely, diagnostic radiology, therapeutic and interventional radiology. FUNCTIONS OF RADIOLOGY DEPARTMENTS The main function is to assist the physician in diagnosis and treatment of a patients disease through the use of radiography, fluoroscopy , radioisotopes and high voltage acceleration. The primary function is to provide reliable radiological services to the patient. Second to engage in essential research for medical advancement Participate in educational program for hospital resident and service program for medical staff.  Flowcharts and Organizational Charts Organizational charts and departmental flowcharts establish clear lines of authority, responsibility, and accountability to provide proper spans of control, create appropriate independence of operations, and define administrative record-keeping responsibilities. A plan for internal control should be implemented. This plan establishes the methods and procedures necessary to safeguard assets, monitor the accuracy and reliability of accounting data, promote managerial efficiency, and encourage adherence to managerial policy. RADIOLOGY DEPARTMENT FLOW CHART  CHARACTERISTICS OF GOOD EMPLOYEES 1. Good knowledge of the required technical skills 2. superior skills in interactive relationships.  DONE CHAPTER 2  https://www.ncbi.nlm.nih.gov/books/NBK144006/ https://www.rasmussen.edu/degrees/health-sciences/blog/types-of- healthcare-facilities/ https://www.slideshare.net/slideshow/hospital-10172343/10172343 https://www.boardeffect.com/blog/roles-responsibilities-board- directors-hospital/ https://www.bspublications.net/downloads/05f00535a96ab5_Ch- 1_A%20TB%20of%20Pharmacy%20Practice_Balasubramanian.pdf  https://www.coursera.org/articles/hospital-administrator https://www.britannica.com/topic/information-system https://www.accruent.com/resources/blog-posts/whats-possible- support-services-hospital-management https://www.investopedia.com/terms/h/humanresources.asp https://www.lawinsider.com/dictionary/medical-services https://www.slideshare.net/slideshow/clinical-supportive-service- department/39416742  QUESTIONS 1. Define hospitals. 2. Draw a flow chart of Hospital Administration. 3. What are secondary care hospitals? 4. What is the significance of the term referral in referral hospitals? 5. Classify hospitals and explain each one of them in detail. 6. What are the functions of a hospital? Explain. 7. How are big hospitals administered? Enumerate the role of various committees formed in hospitals. 8. Explain the functions of Medical staff of a hospital. HOD-head of department