Hospital as a Complex Organisation PDF

Hospital as a complex Organization Hospital is a social and medical organisation and a rational combination of the activities of a number of persons with different level of knowledge and skills for achieving a common goal of patient care through a hierarchy of authority and re...

Hospital as a complex Organization Hospital is a social and medical organisation and a rational combination of the activities of a number of persons with different level of knowledge and skills for achieving a common goal of patient care through a hierarchy of authority and responsibility. Hospital is an organization that mobilize the skills of number of widely divergent groups of people – professionals, semi- professionals, and non-professionals to provide a highly personalized service to the individual patients Distinguishing characteristics of the hospitals  Hospitals provide highly personalized service, no two situations are alike  The output of the hospital is the services, which is highly unpredictable. The outcome is not predictable with accuracy  The interest of the patients is supreme  The volume of work is difficult to predict and regulate. In emergency situation and in mass casualties, the situation is critical to manage  The principal workers of a hospital are doctors and nurses, they might not be the employee of the organization. Hence difficult for manager to control over the activities and behavior of these people  Distinguishing characteristics of the hospitals  The administrator has much less authority, power and discretion than his managerial counter part in other industries  Hospital can’t be organized on the basis of single line of authority  Activities of the hospitals are highly interdependent, controlling the sub-systmes of the hospital require lots of coordination  Emergence of new disciplines like bioinformatics, telemedicine, e-health, medical tourism making the work multi dimensional and of complex nature.  Law of the land favours the patients. There are many enactments which protect the rights of the citizen in regard to health. The hospital cannot refuse any patient from seeking treatment in emergency situation Hospital – A Highly complex organisation To the community it is an important social and medical asset To patients it is a place to receive care To physicians it is a place to treat patients To employees it is a place to work To managers it is a multi – faceted organization embracing clinical, financial, ancillary and supportive activities  Hospital – A Highly complex organisation cont… Hospital is a place where sophisticated equipment, technology and personnel are organized to provide health services Advances in technology and medical science have caused the hospitals to become the central and primary provider organizations in health services delivery.  Hospital – A Highly complex organisation cont… There are diverse goal among individuals, professional groups and various sub systems. The hospital is responsible for :  Patient care  Disease Prevention and health promotion  Medical education  Training  Research  Hospital – A Highly complex organisation cont…  The personnel in a hospital ranging from highly educated, technical, skilled to just literate or illiterate  Various departments/units having different work  At one end the hospital owners want to serve the humanity and the at the other end they want that hospital should be productive, self supportive and profit making  Hospitals operate continuously day and night without a break cause personnel and scheduling problems  The principle of line of authority and unity of command are difficult to practice  People visiting hospitals under tremendous mental stress, they consider the doctors as the only answer to their problem and perfectionists.  Hospital – A Highly complex organisation cont…  The output of the hospital is the service rendered to the patients, which is difficult to manage  Increasing role of IT and increased awareness among the people for their rights, make them more conscious and it tends to raise the expectations of the beneficiaries.  The providers (hospitals) have their own constraints, have to provide the best possible services within in the limited resources.  Providing Quality care- Means are limited, expectation are much and people are armed with legal protection like RTI make the providers very vulnerable to the litigation. Peculiarity of Hospital as an organisation Source: Dr N C Das,PPT Hospital as an organization Hospital - A highly complex organisation Extensive Division of Labor High interdependency of services A mix of autocratic and democratic style of functioning Public demand of efficiency Needed coordination Professionalization No single line of authority Difficulty in administration Delicate balance of power Hospital - A highly complex organisation Extensive Division of Labor: There are many departments, staff, offices ad positions and coordination of tasks functions and interactions. High interdependence of services: Nobody whether professional, or non-professional can work in isolation, every body is dependent upon somebody else for completion of tasks The clinical services departments, diagnostics, therapeutics, support and utility services, all are interdependent and interrelated. A mix of autocratic and democratic style: Normal time vs emergency situation Authoritarianism: Even though modern management techniques and professionalism much of the authority is still exercised in hospital on traditional senior-junior relationship. Public demand of efficiency: Increasing concerns about the efficiency in hospital operations by the community. Disappointment by community with sharp rise of cost of treatment. Coordination: Due to high degree of specialization and functional interdependence found in hospital coordination of skills, tasks and activities is indispensible. Professionalization: Complementary expectation: No single line of authority: Difficulty in administration: Delicate balance of power: