organizational structure.pdf

ORGANIZATIONAL STRUCTURE OF HOSPITAL By Dr. Reham Elkalla Objectives By the end of this lecture the student will be able to ▪ Realize the Importance of understanding organizational structure of hospital. ▪ Identify the common organizational categories in hospital. ▪ Clarify the role of each categ...

ORGANIZATIONAL STRUCTURE OF HOSPITAL By Dr. Reham Elkalla Objectives By the end of this lecture the student will be able to ▪ Realize the Importance of understanding organizational structure of hospital. ▪ Identify the common organizational categories in hospital. ▪ Clarify the role of each category of organization structure ▪ Recognize the three components of hospital system ❖ ❖ Health services should be designed to meet the health needs of the community through the use of available resources and knowledge. Health care is provided through health system comprising of • A. Organization • B. Management Organizational structure of hospital  A hospital is a multifaceted organization comprising many committees, departments, types of personnel, and services.  It requires highly trained employees, efficient systems and controls, necessary supplies, adequate equipment and facilities, and, of course, physicians and patients.  It is a business as well as a caring, people-oriented institution and it has a similar structure and hierarchy of authority as any large business. Importance of understanding organizational structure of hospital A. Facilitates the understanding of the hospital’s chain of command. B. Shows which individual or department is accountable for each area of the hospital. Grouping of hospital departments within the organizational structure  Although each hospital department performs specific functions, departments are generally grouped according to similarity of duties.  Departments are also grouped together in order to promote efficiency of the healthcare facility.  Complexity of Organizational Structure Depends on Size of Healthcare Facility; large acute care hospitals have complicated structures, whereas, the smaller institutions have a much simpler organizational structure  Common organizational categories might include: 1. Administration Services (often referred to simply as “administration”) 2. Informational Services 3. Therapeutic Services 4. Diagnostic Services 5. Support Services (sometimes referred to as “Environmental” traditional Hospital organizational structure Example of symbolic representation of organizational structure 1- Administrative Services Hospital Administrators (Chief Executive Officer) CEO, Vice President(s), Executive Assistants, Department Heads ✓ Business people who “run the hospital. ✓ Oversee budgeting and finance. ✓ Establish hospital policies and procedures. ✓ Often perform public relation duties. BOARD OF TRUSTEES  The "board of trustees," or governing board, operates the hospital in trust for the community and has a fiduciary duty to protect the assets of the hospital through efficient operation.  The trustees are responsible for establishing the hospital's mission and establishing its bylaws and strategic policies.  Trustees select the administrative leader of the hospital and delegate the hospital's daily operations and budgeting to the appointed executive. Levels of organizational structure of administration A. The uppermost level of hospital management: The hospital director = Chief Executive Officer (CEO) or president B. Second level managers: Chief Operating Officer (COO) Chief Financial Officer (CFO) C. Bigger hospital may have third level management to assist second level and called as Hospital Assistant Director D. The next level of management: Department heads or directors (pharmacy, nursing, other clinical and support services) They have responsibility for managing and directing all aspects of particular service such as pharmacy services CHIEF EXECUTIVE OFFICER (CEO): ✓ Sets direction by creating vision & mission . ✓ Reports to the hospital’s board of directors . ✓ Submitting for board approval a plan of organization and recommending changes when necessary . ✓ Provides leadership in implementing the strategic goals and decisions set by the Board. ✓ Represents the hospital to the external environment and the community. ✓ Responsible for :  Budget :Submitting for board approval an annual budget expressing both expenditures and revenue. ▪ Personnel : Selecting employing, controlling, and discharging employees.  Operations : must coordinate the collective effort of the hospital's personnel & Maintaining all physical properties (plant and equipment) in safe operating condition . ROLES CHIEF OPERATING OFFICER (COO), CHIEF FINANCIAL OFFICER (CFO) & HOSPITAL ASSISTANT DIRECTOR  Chief operating officer (COO) ✓ responsible for daily operations  Chief financial officer (CFO) ✓ responsible for financial management  Hospital Assistant Director ✓ Responsible for direct patient care departments (pharmacy, nursing etc). Administrative Support Services  Non-medical administrative services are necessary to the hospital's business and physical plant management*.  The CEO leads these administrative services and is directly responsible for the day-to-day operations of the facility.  Business services manages the hospital's admitting and discharge functions, records charges to a patient's account, and handles accounts receivables with third-party payers such as insurance companies.  The finance department advises the CEO on financial policy and long-range planning, establishes procedures for accounting functions, receives and deposits all money received by the hospital, and approves the payments of salaries and other expenditures. * Physical Plant Management (PPM) is dedicated to maintenance of the campus's physical environment, Typical organizational chart for a hospital 2- information system Informational services—documents and process information A. Admissions- often the public’s first contact with hospital personnel & checks patients into hospital ✓ Responsibilities include: obtaining vital information (patient’s full name, address, phone number, admitting doctor, admitting diagnosis, social security number, date of birth, all insurance information) ✓ Frequently, admissions will assign in-house patients their hospital room B. Billing and Collection Departments - responsible for billing patients for services rendered C. Medical Records - responsible for maintaining copies of all patient records. D. Information Systems - responsible for computers and hospital network. E. Health Education - responsible for staff and patient health-related education . F. Human Resources - responsible for recruiting/ hiring employees and employee benefits. 2- Therapeutic services (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 treatment plan.  The medical staff is a formally organized self-governing unit within the hospital, primarily comprised of physicians, but may also include other doctoral level health care professionals such as dentists or psychologists. 3- Therapeutic services Provides treatment to patients and includes the following departments: 1. Physical Therapy (PT)  A. Provide treatment to prevent or limit permanent disability & improve large-muscle mobility  B. Treatments may include: exercise, massage, hydrotherapy, ultrasound, electrical stimulation, heat application 2. Occupational Therapy (OT)  A. goal of treatment is to help patient regain fine motor skills so that they can function independently at home and work  B. Treatments might include: arts and crafts that help with hand-eye coordination, games and recreation to help patients develop balance and coordination, social activities to assist patient’s with emotional health 3. Speech/Language Pathology  A. Identify, evaluate, and treat patients with speech and language disorders  B. Help patients cope with problems created by speech impairments CONT. THERAPEUTIC SERVICES 5. Medical Psychology a. concerned with mental well-being of patients b. treatments might include: talk therapy, behavior modification, muscle relaxation, medications, group therapy, recreational therapies (art, music, dance). 6. Respiratory Therapy (RT) a. treat patient’s with heart and lung diseases b. b. treatment might include: oxygen, medications, breathing exercises 7. Pharmacy a. dispense medications per written orders of physician, dentists, etc. b. provide information on drugs and correct ways to use them. c. ensure drug compatibility 8. Dietary - responsible for helping patients maintain nutritionally sound diets CONT. THERAPEUTIC SERVICES 9. Sports Medicine a. Provide rehabilitative services to athletes b. Teaches proper nutrition. c. Prescribe exercises to increase strength and flexibility or correct weaknesses d. Apply tape or padding to protect body parts e. Administer first aid for sports injuries 10. Nursing (RN, LVN, LPN) a. Provide care for patients as directed by physicians b. Many nursing specialties include: nurse practitioner, labor and delivery nurse, neonatal nurse, emergency room nurse, nurse midwife, surgical nurse, nurse anesthetist c. In some facilities, Nursing is a service in and of itself d. Nursing services, also called patient care services, is the largest component of the hospital. OUTPATIENT DEPARTMENTs Medical OPD Surgical OPD Ophthalmic OPD Orthopaedic OPD Cardiology OPD Neurology OPD Oncology OPD Gynaecology OPD . ◦ Psychiatric OPD Ent OPD Skin OPD Dental OPD Paediatric OPD Radiology OPD Pathology/ laboratory dept Dept of Pharmacy Rehabilitaion 4- Diagnostic Services ▪ Determines cause(s) of illness or injury Includes the following departments: 1. Medical Laboratory (MT) - studies body tissues to determine abnormalities 2. Imaging a. Image body parts to determine lesions and abnormalities b. Includes the following: Diagnostic Radiology, X-ray, Magnetic resonance imaging (MRI), computerized tomography ( CT), Ultrasound 3. Emergency Medicine - provides emergency diagnoses and treatment 5- SUPPORT SERVICES  Provides support to entire hospital A. includes the following departments: 1. Central Supply a. In charge of ordering, receiving, stocking and distributing all equipment and supplies used by healthcare facility b. Sterilize instruments or supplies c. Clean and maintain hospital linen and patient gowns 2. Biomedical Technology a. Design and build biomedical equipment (engineers) b. Diagnose and repair defective equipment (biomedical technicians) c. Provide preventative maintenance to all hospital equipment (biomedical technicians) d. Pilot use of medical equipment to other hospital employees (biomedical technicians) 3. Housekeeping and Maintenance Maintain safe clean environment. E.g. cleaners, electricians, carpenters, gardeners LINE SERVICES  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 treatment  Operation theatres : Should have a pre-anaesthesia room and sterilisation room and a scrub room for doctors and nurses AUXILIARY SERVICES  Registration and indoor case records  Stores  Transport  Mortuary (PM)  Dietary services  Engineering and maintenance services  Hospital security STAFF SERVICES  Central sterile  Supply Services.  Diet Management (Catering dept.)  Pharmacy Services.  Laundry  Laboratory facilities  Radiology  Nursing services 3-D organizational chart for a hospital