Orientation to Hospitals

8/7/2019 Orientation to Hospitals

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WHO DEFINITION OF HOSPITAL: A hospital is anintegral part of a Social and Medical organization , thefunction of which is to provide for the populationcomplete health care , both curative and preventive ,

and whose outpatient services reach out to the familyand its home environment ; the hospital is also acentre for the training of health workers and bio-social research.

What is a hospital


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yLevels allow efficient management ofhospital departments.

yThe structure helps one understand thehospitals chain of command.

Organizational StructureOrganizational Structure refers torefers tolevels of management within a hospital.levels of management within a hospital.


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Organizational structure varies

from hospital to hospital.

yLarge hospitals have complexorganizational structures.

ySmaller hospitals tend to have muchsimpler organizational structures.


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Grouping of Hospital Departments

Within the Structure:

yHospital departments are grouped inorder to promote efficiency of facility.

yGrouping is generally done according tosimilarity of duties.


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Common Categorical Grouping:

yAdministrative Services

yInformational ServicesyTherapeutic Services

yDiagnostic ServicesySupport Services


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Administrative ServicesyHospital AdministratorsCEO, Vice President(s), Executive

Assistants, Department HeadsyBusiness people who run the hospital

yOversee budgeting and finance

yEstablish hospital policies and procedures

yOften perform public relation duties


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Informational Servicesy Document and process informationIncludes:

1. Admissions

2. Billing & Collection

3. Medical Records

4. Computer Information Systems

5. Health Education6. Human Resources


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y Provides treatment to patients

Includes following departments:

1. Physical Therapy - treatment to improvelarge muscle mobility

2. Occupational Therapy - treatment goal is

to help patient regain fine motor skills3. Speech/Language Pathology - identify,

evaluate, treat speech/language disorders


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5. Medical Psychology - concerned with

mental well-being of patients6. Social Services - connect patients with

community resources (financial aid, etc.)

7. Pharmacy - dispense medications

4. Respiratory Therapy - treat patients withheart & lung disease


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Diagnostic Servicesy Determines the cause(s) of illness

or injury

Includes:1. Medical Laboratory- studies body tissues

2. Medical Imaging - radiology, MRI, CT, UltraSound

3. Emergency Medicine -provides emergencydiagnoses & treatment


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Traditional Organizational Chartof a Hospital


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Board

Administration

TherapeuticServices

InformationServices

DiagnosticServices

SupportServices

Admissions Billing, etc.

Med.

RecordsComputer Info.Health

Ed.Human Resour.

PT, OT Speech/Lang.

Resp.T

herapyPharmacy Nursing

Dietary

Med. Lab

Radiology NuclearMed ER

Cardiology

Neurology

Central Supply

BiomedicalHousekeeping

Maintenance Dietary

Transportation


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TEACHING

HEA

LT

H SYST

SUPPORT

SOCIETAL

E PLOY ENT

RESEARCH

Pt. CARE

FUNCTIONS

Functions of Hospital


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FUNCTIONS OF HOSPITALS

1.Medical Care Of Sick AndInjured 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.Employment7.Social functions

8.supportive functions

9.some other important functions


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SUPPORTIVE SERVICES:

y (a) Maintenance of public relations:

(I)Proper relations with patients.

(II)proper relations with police.

y Proper communication withboth patients and police is importantbecause

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

y Thats why doctors should in advance explain the condition of patient to

the attendants and should be taken consent.


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(b)Maintenance of medical records

(c)Nursing services

(d)Intensive care unit

(e)House keeping arrangement

(f)Waste disposal

(g)Dietary service


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(h)Laundry linen services

(i)Sterilization and supply department

(j)Pharmacy department

(k)Biomedical engineering services


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(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


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MEDICAL CARE

BAS

ICFUN

CTIONS:

1.Early Diagnosis And Treatment ,

2.Promotion Of Health,

OUT PATIENT DEPARTMENT:

The principles of planning:

form follows functions The build

ing and

its facilities must express thefunctions 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.


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y IN PATIENT DEPARTMENT:

y Inpatient care remains an essential function of a hospital.

y An inpatient on the other hand is "admitted" to the hospital and stays overnight or for

an indeterminate time usually several days or weeks.

y FUNCTIONS:

patients will be kept on drugs and planneddiet in ward till recovery.y Regular rounds by doctors,nurse,paramedics,dieticians and physiotherapists to check

the condition and advice further plan.

y Ward will contain all emergency drugs ,oxygen,trays,monitors,to deal in emergency

situations.

y A team of specialists,duty doctors,paramedics,physiotherapists,and technicians are

always available in shifts.

y Concerneddept will be called for referral cases.

y Training medicos,paramedics,and nurses will be done in wards in cases of teaching

hospitals.


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NURSING

CA

RE:

y Nursing education and nursing care are like the two

wheels of a cart.

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

them in departments properly.


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y RESPONSIBILITIES OFAN ADMINISTRATOR IN

FUNCTIONS OF HOSPITAL:

y Selects workers

y Orients workers of all grades

y He trains all workers so that they will be most

efficient,effective and satisfaction as well.

y He provides and maintains the best possible

working conditions.


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z

y He practises effective methods of joint consultation.

y He trains supervisors so that they are properlytrained for their duties and responsibilities.

y He sees that methods ofdetermining remuneration

are euatable.

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

in the organisation.

y He encourages the provision of social and

recreational activities.


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DIETARY SERVICES:

y

Thisd

epartment is responsible for selection and

purchase of food.

y Reposible for receipt and storage of food.

y Responsible for preparation anddistribution offood.

y Responsible for cleanliness and cleaning utensilsrequired for day to day diet.

y Educating the patients regarding proper dietrequirement.


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Work Flow Patient comes to a hospital

Admission

Main Entrance

Registration Reception

Main waitingArea

Ward

OPD

X-Ray aInvestigatio

n


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BEST ATTRIBUTES OFA HOSPITALy Efficiency and cost effectiveness

y Flexibility and expandability

y Therapeutic environment

y Cleanliness and sanitationy Controlled circulation

y Aesthetics

y Security and safety

y Sustainability

yRelevant codes and standards


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Reception & Enquiry desky It serves the reception ,information, and

communication needs of patients and visitors.

y It should be easily accessible as they enter thelobby.

y Its position should govern the horizontal and

vertical routes linking the lobby with the main hosp

and

other areas.


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Enquiry desky It should posses all information regarding

hospital services, transportation timing .

yA good map of the places in the city patient guidance.

y It can be a see through cubicle with glasspaneled wall. above a height of1.10 meter

with a swingingdoor .y In small hospital an open counter serv

the purpose.


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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 bodystructure &function


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OPERATION THEATRE

Operation Theatre


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FUNCTIONS & PRINCIPLES CONDUCTING SURGICAL OPERATIONS MAJOR

MINOR

TRIVIAL

TOTAL ASEPSIS

S

CHEDULIN

GOT PRO

GR

AMMIN

G

PLANNING THEATRE PRACTICES

STAFFING PATTERNS

TRAINING & TEACHING

ADMINISTRATION UTILIZATION OF OTS-SPACE & TIME

OT RESOURCES- MATERIAL & MAN POWER

DOCUMENTATION


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BASICFUNCTIONS RECEPTION

PATIENT IDENTIFICATION

PRE-OPERATIVE SUPERVISION

DEPILATION

TRANSFER - OT / INDUCTION

ADMINISTRATIONOF ANAESTHESIA

INTUBATION

POSITIONING

PREPARATION OF OPERATING AREA & SURROUNDINGSKIN


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Patient Flow in O.T.

Wards-------Reception-------Preop waiting----

-Anaesthesia-------O.T.------Post op.area---

----ICU/ Wards


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CORE COMPONENTS OF AN ICUy constant monitoring

y rapid skilled intervention

y multi disciplinary team work


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PERSONNELy Nurse patient ratio 1: 1.

y ICU nurse manager


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Functions of Blood Banky Prompt disposal of unsafe blood

y Research and Development

y Promptly provide blood as and when required 24x7

y Co-operation between blood bank and clinicians

Dr. Pradeep Maurya, Dr. TusharGawadDr. Pradeep Maurya, Dr. Tushar Gawad


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[CSSD]


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CSSD of a hospital receives, stores, processes, controlsanddistributes professional supplies and equipment

(both sterile and non- sterile) to all departments of the

hospital for care and safety of patients.


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Functions of MRD


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Functions of MRD

Primary1. Standardizing various

forms & formats

2. Providing forms for MR

3. Supervising the record

collection

4. Maintaining complete &

accurate records5. Making the MR available

as & when required

6. Providing patients with

MR

7. Maintaining statistical

information

8. Providing legal

protection

9. Corresponding with

courts & police

authorities

Secondary1. Providing data for

calculating efficiency2. Giving information base

for future programs

3. Providing data related tofunctioning of varioussources

4. Making data available formedical auditing,research & educationalpurposes

5. Preparing dailysummary, monthlybulletin & annual reports

6. Helping in comparisonwith other hospitals

7. Issuing differentcertificates & injuryreports

8. Deciding about

destruction of records


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STAFFING


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Chief pharmacist

Staff pharmacist

Ph

armacy aides

storekeepers

clerks

STAFFING


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Functional

Programmingy After thrust areas analysis, one needs to identify functional areas under

following categories

y Core Areas (Directly Related to Thrust area)

y General (Where no special design effort required) OPD/IPD

y Specialized(Where some specializeddesign effort required)

ICU/HDU/Casualty

y Highly Specialized(Here specific design efforts are required) OT/Daycare

etc

y Support Areas

y General Circulation spaces, waiting areas, administrative areas

y Specialized Engineering requirements, Rehabilitation

y Highly Specialized Diagnostic departments (Imaging/Laboratory)


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LABORATORY SERVICES


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TYPES OF LABS

HEMATOLOGY

BIOCHEMISTRY

MICROBIOLOGY

HISTOPATHOLOGY

CYTOLOGY

ROUTINE URINE & STOOL

1. Based on specific areas of disease spectrum:

GENETICS

ENDOCRINOLOGY

IMMUNOLOGY

RADIOISOTOPE

FORENSIC

AUTOPSY


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2.Based on nature of test :

y Routine

y Specialized

3.Based on Organizational setup :

y C

entralized

y Decentralized

TYPES OF LABS


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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


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Imaging Sciences Department

This is is a place where patients go through various types

ofdiagnostic procedures, and are called procedure

rooms.

Types ofProcedure Rooms are:

1. X-ray

2. Fluoroscopy

3. CT scan

4. MRI

5. USG (Sonography)

6. Mammography


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Dr. Sandhya M. S.

Dr.Shweta Bahirune .2/26/2011

l


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2/26/2011 75

Hospital Catering ServicesRelation of patient to different departments

Patient

Pharmacy

Diagnostic

Services

Medical

staff

Food

services

NursingPhysical

therapist


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Organization & personnel

Administrator

Main KitchenChief cook

TherapeuticChief Diet cook

Food serviceworkers

Dietician

Catering

Officer

2 Assistant

cooks2 Assistant

cooks

Pantry boys,

service boys

Dish- washing ,etc


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The basic duties of maintenance engineers can be

categorized as below

y Maintaining water supply

y Maintaining electrical supply

y Maintaining continuous supply of medical gases likeoxygen, nitrous oxide, compressed air, and vacuum

y Maintaining air conditioning and ventilationinfrastructure

y Civil worksy Maintaining Tele communication networking

y Maintaining fire detection & protection systems


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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


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HOUSEKEEPING MANAGEMENT INHOSPITALS


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HOUSE KEEPINGHousekeeping is defined as the provision of a clean,clean,

comfortable and safe environmentcomfortable and safe environment for the patients, public

and hospital personnel in a hospital setup.


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LOCATIONy Housekeeping serves all areas anddepartments of the

hospital. It is centrally located and close to the vertical

transport system to facilitate easy movement of

housekeeping materials and equipment.


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HOUSEKEEINGPRACTICES INKEY

AREASy Out Patient Department andClinical area

y Operation Theater

y Ward

y Laboratory

y Office area

y Sanitary area

y Outside area


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Basic Cleaning Proceduresy Dusting

y Sweeping

yMopping

y Scrubbing

y Waxing

y Washing


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Transport departmenty Location Preferably basement / ground level.

y Staff

y Transport supervisor

y Driver of the General Ambulance

y Driver of the Cardiac ambulance.

y Driver of the Biomedical waste van.

y Driver of the catering service van.

y Driver of blood bank ambulance.

y Maintenance andCleaning staffs.


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Types ofInternal Transport Systems used in a

Hospitaly Elevators.y Dumbwaiters.

y Pneumatic Tube systemsy Pneumatic linen chute system


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Types of Elevator Systems

y Passenger type elevators

y Hospital service type elevators

y Combination of passenger and service type elevators

BIO MEDICAL WASTE TRANSPORT


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What is an Ambulance? An Ambulance is a vehicle for transporting sick or injured people tofrom 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 hospitalfor 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.


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Different types ofAmbulances


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Staffing

y Emergency care practitioner, Doctor.

y Emergency medical technician.

y Paramedics.

y Ambulance care assistant.

y Ambulance driver.

y First responder (may or may not be a staff of a hospital)


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Orientation to Hospitals

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