What is a hospital

WHO DEFINITION OF HOSPITAL: “A hospital is an

integral part of a Social and Medical organization ,
the function of which is to provide for the population
complete health care , both curative and preventive ,
and whose outpatient services reach out to the family
and its home environment ; the hospital is also a
centre for the training of health workers and bio-
social research.”
Organizational Structure refers to
levels of management within a hospital.

Levels allow efficient management of

hospital departments.

The structure helps one understand

the hospital’s chain of command.
Organizational structure varies
from hospital to hospital.
Large hospitals have complex
organizational structures.

Smaller hospitals tend to have much

simpler organizational structures.
Grouping of Hospital Departments
Within the Structure:
Hospital departments are grouped in
order to promote efficiency of facility.

Grouping is generally done according

to similarity of duties.
Common Categorical Grouping:
Administrative Services
Informational Services
Therapeutic Services
Diagnostic Services
Support Services
Administrative Services
Hospital Administrators
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
Informational Services
 Document and process information
Includes:
1. Admissions
2. Billing & Collection
3. Medical Records
4. Computer Information Systems
5. Health Education
6. Human Resources
 Provides treatment to patients
Includes following departments:
1. Physical Therapy - treatment to improve
large muscle mobility
2. Occupational Therapy - treatment goal is
to help patient regain fine motor skills
3. Speech/Language Pathology - identify,
evaluate, treat speech/language disorders
4. Respiratory Therapy - treat patients with
heart & lung disease
5. Medical Psychology - concerned with
mental well-being of patients
6. Social Services - connect patients with
community resources (financial aid, etc.)
7. Pharmacy - dispense medications
8. Dietary - maintain nutritionally sound
diets for patients
9. Sports Medicine - provide rehabilitative
services to athletes
10. Nursing - provide care for patients
Diagnostic Services
 Determines the cause(s) of illness
or injury
Includes:
1. Medical Laboratory - studies body tissues
2. Medical Imaging - radiology, MRI, CT, Ultra
Sound
3. Emergency Medicine -provides emergency
diagnoses & treatment
 Support Services
 Provides support for entire hospital
Includes:
1. Central Supply - orders, receives, stocks &
distributes equipment & supplies
2. Biomedical Technology - design, build repair,
medical equipment
3. Housekeeping & Maintenance - maintain
safe, clean environment
 Board

Administration

Information Therapeutic Diagnostic Support

Services Services Services Services

Admissions Billing, PT, OT Speech/Lang. Med. Lab Central Supply

etc. Med. Records Resp. Therapy Radiology Biomedical
Computer Info. Pharmacy Nursing Nuclear Med ER Housekeeping
Health Ed. Human Dietary Cardiology Maintenance Dietary
Resour. Neurology Transportation
Functions of Hospital

Pt.
Pt. CARE
CARE

TEACHING
TEACHING RESEARCH
RESEARCH

FUNCTIONS
FUNCTIONS

HEALTH
HEALTH SYST
SYST EMPLOYMENT
EMPLOYMENT
SUPPORT
SUPPORT

SOCIETAL
SOCIETAL
FUNCTIONS OF HOSPITALS

1.Medical Care Of Sick And Injured or patient care

2.Prevention Of The Patient -Primary And Secondary
3.Education – Professional And Public
4.Research
5.Support to the other health systems
6.Employment
7.Social functions
8.supportive functions
9.some other important functions
 SUPPORTIVE SERVICES:

 (a) Maintenance of public relations:

(I)Proper relations with patients.
(II)proper relations with police.

 Proper communication with both patients and police is important

because it can lead to conflicts especially in medico-legal cases.

 That’s why doctors should in advance explain the condition of patient to

the attendants and should be taken consent.
(b)Maintenance of medical records

(c)Nursing services

(d)Intensive care unit

(e)House keeping arrangement

(f)Waste disposal

(g)Dietary service
(h)Laundry linen services

(i)Sterilization and supply department

(j)Pharmacy department

(k)Biomedical engineering services

(l)Laboratory functions

(m)Blood bank

(n)Autopsy functions

(o)Safety functions

(p)some more important functions like reporting to police,

magistrate and maintaining media spokes person
MEDICAL CARE

BASIC FUNCTIONS:

1.Early Diagnosis And Treatment ,

2.Promotion Of Health,

OUT PATIENT DEPARTMENT:

The principles of planning:

‘form follows functions’ The building and its facilities must express
the functions to take place within it.
Maximum flexibility and expansibility are paramount.
Simple external and internal traffic pattern.
Adopting labour saving devices to reduce operational costs.
FUNCTIONS:

To provide diagnostic,curative,preventive and

rehabilitative services on an ambulatory basis to
the peopleof the community.

1. CARE OF THE SICK

2.PROTECTION OF COMMUNITY HEALTH

3.EDUCATION AND RESEARCH

IN PATIENT DEPARTMENT:
 Inpatient care remains an essential function of a hospital.
 An inpatient on the other hand is "admitted" to the hospital and stays overnight or for
an indeterminate time usually several days or weeks.

 FUNCTIONS:
patients will be kept on drugs and planned diet in ward till recovery.
 Regular rounds by doctors,nurse,paramedics,dieticians and physiotherapists to check
the condition and advice further plan.
 Ward will contain all emergency drugs ,oxygen,trays,monitors,to deal in emergency
situations.
 A team of specialists,duty doctors,paramedics,physiotherapists,and technicians are
always available in shifts.
 Concerned dept will be called for referral cases.
 Training medicos,paramedics,and nurses will be done in wards in cases of teaching
hospitals.
 SUPPORTIVE SERVICES IN HOSPITAL:

MAINTAINANCE OF MEDICAL RECORDS:

USES:
 For further study by specialists
 educatory purposes
 assistance of medico-legal cases.
 Utilisation for planning and administrative purposes.

 GUDELINES FOR RECORDS MAINTAINANCE:

 Desirable to have uniformity with criteria and guidelines for
investigations,procedures,format,contant,statistics,adequacy,completeness
filing,indexing,evaluation of care through medical audits.

 It is better to have medical records committee in hospital.

 NURSING CARE:

Nursing education and nursing care are like the two

wheels of a cart.

It is essential to give good training to nurses and utilise

them in departments properly.
 RESPONSIBILITIES OF AN ADMINISTRATOR IN
FUNCTIONS OF HOSPITAL:

Selects workers

Orients workers of all grades

He trains all workers so that they will be most

efficient,effective and satisfaction as well.

He provides and maintains the best possible

working conditions.
He practises effective methods of joint consultation.

He trains supervisors so that they are properly

trained for their duties and responsibilities.

He sees that methods of determining remuneration

are euatable.

He sees for in-job training and in-service education

in the organisation.

He encourages the provision of social and

recreational activities.
z
 DIETARY SERVICES:

This department is responsible for selection and

purchase of food.

Reposible for receipt and storage of food.

Responsible for preparation and distribution of

food.

Responsible for cleanliness and cleaning utensils

required for day to day diet.

Educating the patients regarding proper diet

requirement.
CENTRAL STERILE SERVICE DEPARTMENT:

 It provides and promotes an efficient equipment.

 It provides sterile, economic and uniform equipment

required for the care of the patients.
Work Flow – Patient comes to a hospital
Main Entrance

Registration Reception
Main waiting
Area
Admission OPD

Ward Investigatio
X-Ray Lab
n
BEST ATTRIBUTES OF A HOSPITAL
 Efficiency and cost effectiveness
 Flexibility and expandability
 Therapeutic environment
 Cleanliness and sanitation
 Controlled circulation
 Aesthetics
 Security and safety
 Sustainability
 Relevant codes and standards
Reception & Enquiry desk
 It serves the reception ,information, and
communication needs of patients and visitors.
It should be easily accessible as they enter the
lobby.
It’s position should govern the horizontal and
vertical routes linking the lobby with the main hospital
and other areas.
Enquiry desk
It should posses all information regarding
hospital services, transportation timing .
A good map of the places in the city for
patient guidance.
It can be a see through cubicle with glass
paneled wall. above a height of 1.10 meter
with a swinging door .
In small hospital an open counter serves
the purpose.
Hierarchical structure of reception
Reception Manager

Receptionist

porter
Activities of a Receptionist
Should be a good communicator.
Pleasant personality.
A high level of personal grooming.
Intelligent and smart.
Positive attitudes
Calm and composed
Physically fit
Can handle pressure situation smartly
Quick decision making ability
Remembering patients by names and
faces
NURSING SERVICES
➲ Main aim is to help the patients in restoring good
health by providing services as per patients need
which are-
a- Basic human needs
b- Social needs
c- Need for conservation of patients energy
d- Need for maintenance &restoration of body
structure &function
 Operation Theatre

OPERATION THEATRE
FUNCTIONS & PRINCIPLES
• CONDUCTING SURGICAL OPERATIONS
• MAJOR
• MINOR
• TRIVIAL
• TOTAL ASEPSIS
• SCHEDULING OT PROGRAMMING
• PLANNING
• THEATRE PRACTICES
• STAFFING PATTERNS
• TRAINING & TEACHING
• ADMINISTRATION
• UTILIZATION OF OTS-SPACE & TIME
• OT RESOURCES- MATERIAL & MAN POWER
• DOCUMENTATION
BASIC FUNCTIONS
• RECEPTION
• PATIENT IDENTIFICATION
• PRE-OPERATIVE SUPERVISION
• DEPILATION
• TRANSFER - OT / INDUCTION
• ADMINISTRATION OF ANAESTHESIA
• INTUBATION
• POSITIONING
• PREPARATION OF OPERATING AREA & SURROUNDING SKIN
BASIC FUNCTIONS
• DRAPING
• SURGERY
• SEWING & DRESSING
• DRAPES REMOVAL & BAGGING
• EXTUBATION
• TRANSFER - POST-OP / STEP-DOWN
Patient Flow in O.T.

Wards-------→Reception-------→Preop
waiting-----→Anaesthesia-------→O.T.------
→Post op.area-------→ICU/ Wards
 CORE COMPONENTS OF AN ICU
constant monitoring

rapid skilled intervention

multi disciplinary team work

 ACCESSORIES
3 oxygen outlets, 3 suction outlets (gastric, tracheal &
underwater seal), two compressed air outlets and 16
power outlets per bed.

storage by each bedside (built in / alcove).

hand rinse solution by each bedside.

equipment shelf at the head end (mind the height of the

care giver).
hooks & devices to hang infusions / blood bags –
suspended from the ceiling with a sliding rail to position.

infusion pumps to be mounted on stands / poles.

 PERSONNEL
 Nurse patient ratio – 1: 1.

 ICU nurse manager

 Definition
Centre where there are facilities for collection, processing,
storage, supply and administration of blood to patients, as
well as offering facilities for giving training to staff in blood
bank techniques.

Dr. Pradeep Maurya, Dr. Tushar

Dr. Pradeep
GawadMaurya, Dr. Tushar Gawad
 Functions of Blood Bank
Prompt disposal of unsafe blood
Research and Development
Promptly provide blood as and when required 24x7
Co-operation between blood bank and clinicians

Dr. Pradeep Maurya, Dr. Tushar

Dr. Pradeep
GawadMaurya, Dr. Tushar Gawad
[CSSD]
CSSD of a hospital receives, stores, processes, controls
and distributes professional supplies and equipment
(both sterile and non- sterile) to all departments of the
hospital for care and safety of patients.
FUNCTIONS
 Promote and provide efficient, economic and uniform source of sterile and
non- sterile supply of equipment

 To maintain an uninterrupted supply of bacteriologically safe supplies at all

times

 To undertake studies for improvement of sterilization practices

 To impart training to hospital personnel in safe hospital practices

 To participate in hospital infection control programme

 To advise hospital administration on suitability of supplies and equipment

from sterilization point of view
CHARACTERISTICS OF GOOD MEDICAL RECORDS:
Complete: Sufficient data to identify the patient, justify
diagnosis & warrant treatment & outcome
Adequate: All necessary forms & all relevant clinical
information
Accurate: Capable of adequate analysis
Comprehensive- Easily understood when retrieved back for
planning, policy making & decision making.
Properly planned- In sequence, easy to understand & in order.
Economical- Record should be managed economically so that
we may achieve more with minimum efforts.
Timely- Reducing retrieval time is essential for effective
material management
CLASSIFICATION OF MEDICAL RECORD-
For easy analysis, compilation & storage.

Vital records- protected & preserved for long time

Important records- not currently in use but are of high
value to retain
Useful records- currently used correspondence
Transit records- useful only for short period till the
subject is alive or active
IMPORTANCE OF MEDICAL
RECORDS
Patients
Administration
Medical professions
Legal aspects
Research
For patients: It is used to identify the history of illness, the
physical findings & treatment given to the patients.
 
 Functions of MRD
• Primary • Secondary
1. Standardizing various 1. Providing data for
forms & formats calculating efficiency
2. Giving information base
2. Providing forms for MR
for future programs
3. Supervising the record 3. Providing data related to
collection functioning of various
4. Maintaining complete & sources
accurate records 4. Making data available
5. Making the MR available for medical auditing,
as & when required research & educational
purposes
6. Providing patients with 5. Preparing daily
MR summary, monthly
7. Maintaining statistical bulletin & annual reports
information 6. Helping in comparison
8. Providing legal with other hospitals
protection 7. Issuing different
9. Corresponding with certificates & injury
reports
courts & police
authorities 8. Deciding about
destruction of records
AN INTRODUCTION
Definition
 pharmacy is the art of preparing and dispensing drugs

Importance
One of the highest revenue generator
Key stake holder in the healthcare delivery system
Importance of planning
STAFFING
 Functional Programming
 After thrust areas analysis, one needs to identify functional areas under
following categories
 Core Areas (Directly Related to Thrust area)
 General (Where no special design effort required) – OPD/IPD
 Specialized (Where some specialized design effort required) –
ICU/HDU/Casualty
 Highly Specialized (Here specific design efforts are required) – OT/Daycare
etc
 Support Areas
 General – Circulation spaces, waiting areas, administrative areas
 Specialized – Engineering requirements, Rehabilitation
 Highly Specialized – Diagnostic departments (Imaging/Laboratory)
LABORATORY SERVICES
AIMS & OBJECTIVES
1. Quick, Reliable & Accurate reports
2. Early Diagnosis
3. Shortening Patient’s stay
4. Rapid Turnover
5. Future References
6. Urgent Tests
7. Revenue Generation
8. Research & Academics
TYPES OF LABS
1. Based on specific areas of disease spectrum:

HEMATOLOGY GENETICS

BIOCHEMISTRY ENDOCRINOLOGY

MICROBIOLOGY IMMUNOLOGY

HISTOPATHOLOGY RADIOISOTOPE

CYTOLOGY FORENSIC

ROUTINE URINE & STOOL AUTOPSY

TYPES OF LABS

2.Based on nature of test :

Routine
Specialized

3.Based on Organizational setup :

Centralized
Decentralized
Radiology/Diagnostic
Imaging
Types of Imaging Services:
•Basic imaging, special imaging and nuclear imaging.
•Basic imaging includes routine procedures. (R/F, USG etc.) that are
of short duration.
•Special imaging includes procedures (for example, magnetic
resonance imaging (MRI), computed tomography (CT) and
interventional imaging)
•Nuclear medicine is a unique form of imaging that measures
radiation emitted from an internal source of radioactivity.
•Centralized and decentralized imaging services.
•Additionally, in some cases, special zones within the department
are dedicated to certain patient groups
Imaging Sciences Department
This is is a place where patients go through various types
of diagnostic procedures, and are called procedure
rooms.

Types of Procedure Room’s are:

1. X-ray
2. Fluoroscopy
3. CT scan
4. MRI
5. USG (Sonography)
6. Mammography
 Dr. Sandhya M. S.
Dr.Shweta Bahirune .
12/08/21
 Hospital Catering Services
Relation of patient to different departments
Pharmacy Medical
staff

Diagnostic
Services Patient Food
services

Physical
therapist Nursing

12/08/21 75
Coordinated food service

Patient
Physician

Patient’s
Catering diet
department
Nurse

Dietitian
department
Perishable foods from Non-Perishable foods from
Outside sources Outside & hospital sourceses

Receiving & checking

Storage & Refrigeration

Preproduction/preparation room

Diet kitchen Main kitchen

Special diet Food production

Tray assembly & food transportation

Nursing units Dish washing Cafeteria

Patient’s Pot washing Personnel &visitors

12/08/21 Garbage disposal

Organization & personnel
Administrator

Dietician

Catering
Officer

Main Kitchen Therapeutic Food service

Chief cook Chief Diet cook workers

Pantry boys,
2 Assistant 2 Assistant
service boys
cooks cooks
Dish- washing ,etc
The basic duties of maintenance engineers can be
categorized as below
Maintaining water supply
Maintaining electrical supply
Maintaining continuous supply of medical gases like
oxygen, nitrous oxide, compressed air, and vacuum
Maintaining air conditioning and ventilation
infrastructure
Civil works
Maintaining Tele communication networking
Maintaining fire detection & protection systems
Services to be performed consists of two main
elements as follows

• Medical technology management

Inspection on all incoming medical devices
Performances of acceptance test
Installation and/or management of medical devices
Provide a technology assessment
Maintaining a risk management programme
HOUSEKEEPING MANAGEMENT IN
HOSPITALS
HOUSE KEEPING
Housekeeping is defined as the provision of a clean,
comfortable and safe environment for the patients,
public and hospital personnel in a hospital setup.
RESPONSIBILITIES…

Daily cleaning
Periodic cleaning
Trash and garbage removal including proper hospital waste
disposal
Discharge cleaning
Exterminating bugs and pests
Preventing spread of infection
Creating healing environment
Gardening
Interior decoration
LOCATION
Housekeeping serves all areas and departments of the
hospital. It is centrally located and close to the vertical
transport system to facilitate easy movement of
housekeeping materials and equipment.
ORGANIZATION CHART
ADMINISTRATOR

HOUSEKEEPING
MANAGER

HOUSEKEEPER

SANITORY
GARDENAR
WORKER
HOUSEKEEING PRACTICES IN KEY
AREAS
Out Patient Department and Clinical area
Operation Theater
Ward

Laboratory
Office area
Sanitary area

Outside area
Basic Cleaning Procedures
Dusting
Sweeping
Mopping
Scrubbing
Waxing
Washing
Transport department
Location – Preferably basement / ground level.
Staff
Transport supervisor
Driver of the General Ambulance
Driver of the Cardiac ambulance.
Driver of the Biomedical waste van.
Driver of the catering service van.
Driver of blood bank ambulance.
Maintenance and Cleaning staffs.
Types of Internal Transport Systems used in a
Hospital
Elevators.
Dumbwaiters.

Pneumatic Tube systems

Pneumatic linen chute system
 Types of Elevator Systems

Passenger type elevators

Hospital service type elevators
Combination of passenger and service type elevators
BIO MEDICAL WASTE TRANSPORT
What is an Ambulance?
 An Ambulance is a vehicle for transporting sick or injured people to
from or between places of treatment for an illness or injury. The term
ambulance is used to describe a vehicle used to bring medical care to
patients outside of the hospital or to transport the patient to hospital
for follow-up care and further testing. In some jurisdictions there is a
modified form of the ambulance used, that only carries one member of
ambulance crew to the scene to provide care, but is not used to
transport the patient. In these cases a patient who requires
transportation to hospital will require a patient-carrying ambulance to
attend in addition to the fast responder.
Different types of Ambulances
 Staffing
 Emergency care practitioner, Doctor.
 Emergency medical technician.
 Paramedics.
 Ambulance care assistant.
 Ambulance driver.
 First responder (may or may not be a staff of a hospital)