Hospital Administration

HOSPITAL ADMINISTRATION

Introduction

• WHO Definition: “A hospital is an integral part of a social and medical organization, which provides for the population complete health care, both curative and preventive, and whose out-patient services reach out to the family in its home environment.”
• General Definition: A hospital is a health care institution providing patient treatment with specialized staff and equipment for inpatients and outpatients.

Organizational Structure of a Hospital

A. Medical Staff Structure

• Medical Superintendent/CMO: Head of medical services.
• Consultants: Senior specialists in different departments.
• Registrars/Residents: Middle-level doctors.
• Interns/House Officers: Fresh medical graduates.
• Support: Lab technicians, radiologists, pharmacists.

B. Nursing Staff Structure

• Chief Nursing Officer (CNO): Head of nursing department.
• Nursing Superintendents: Oversee nursing services.
• Ward Sisters: Manage nursing staff in specific wards.
• Staff Nurses: Provide direct care to patients.
• Nursing Assistants: Help with patient hygiene and support tasks.

Governing Body of the Hospital

• Composition: Board of Directors, Trustees, or Management Committee depending on hospital type (public/private/charitable).
• Roles:
• Policy formulation
• Budget approval
• Monitoring performance
• Appointing top executives (MS, CEO)
• Ensuring compliance with laws and ethics

Hospital Committees

Committee	Members	Purpose
Medical Audit	Doctors, MS, QA Officer	Review treatment quality
Infection Control	Microbiologist, Nurse, Housekeeping, MS	Prevent HAIs
Quality Assurance	MS, QA Officer, Department Heads	Implement NABH/NABL
Mortality Review	Doctors, MS	Analyze deaths & reduce preventable causes
Biomedical Waste	MS, Nursing, Housekeeping, Safety Officer	Safe disposal of hospital waste
Ethics Committee	Doctors, Legal Expert, Layperson	Oversee clinical research & ethics
Safety Committee	Engineer, Fire Officer, Safety In-Charge	Monitor fire and workplace safety
Pharmacy & Therapeutics	Pharmacist, Clinicians, MS	Rational drug use
Disciplinary Committee	Admin, HR, Union rep	Resolve staff issues

Hospital Functionaries

Functionary	Role
Hospital Administrator	Overall management and coordination
Medical Superintendent	Head of clinical operations
Chief Nursing Officer	Leads nursing services
HR Manager	Staffing, payroll, appraisals
Finance Manager	Budgeting, billing, accounting
Biomedical Engineer	Equipment maintenance
Quality Manager	Accreditation, audits
IT Officer	HIS, network support
Security Officer	Safety of staff & premises

Functions of a Hospital

• Medical Care: Diagnosis, treatment, surgeries
• Nursing Care: Continuous bedside care
• Preventive Services: Immunization, health education
• Teaching & Training: For doctors, nurses, interns
• Research: Clinical trials, public health studies
• Rehabilitation: Physical, mental recovery
• Support Services: Labs, radiology, pharmacy, food, housekeeping

Classification of Hospitals

A. By Ownership

• Government (e.g., AIIMS)
• Private (e.g., Apollo)
• Charitable/Trust (e.g., Mission hospitals)
• Corporate (e.g., Fortis)

B. By Level of Care

• Primary: Basic outpatient care
• Secondary: Specialist consultation, minor surgeries
• Tertiary: Super-specialty care (e.g., cancer, transplant)

C. By Length of Stay

• Acute Care (≤30 days)
• Chronic/Long-Term Care (>30 days)

D. By Bed Strength

• Small: <100 beds
• Medium: 100–500 beds
• Large: >500 beds

E. By Specialization

• General Hospital
• Multispecialty Hospital
• Super-Specialty Hospital (e.g., Oncology, Cardiology)

Healthcare Providers in the Hospital

• Doctors: Diagnosis and treatment
• Nurses: Patient care
• Pharmacists: Dispensing medicines
• Technicians: Lab, radiology, physiotherapy
• Administrators: Operations and finance
• Housekeeping & Support: Cleanliness, security, transport
• Volunteers/NGOs: Patient welfare activities

Specialties in a Multispecialty Hospital

Department	Services
Internal Medicine	General diseases
General Surgery	Appendectomy, hernia, etc.
Pediatrics	Child care
Obstetrics & Gynecology	Pregnancy, delivery
Orthopedics	Bone fractures, arthritis
Cardiology	Heart diseases
Neurology	Brain, spine conditions
Nephrology	Kidney care, dialysis
Urology	Urinary system issues
Oncology	Cancer treatment
ENT	Ear, Nose, Throat
Ophthalmology	Eye care
Dermatology	Skin diseases
Psychiatry	Mental health
Radiology	CT, MRI, USG
Pathology	Lab investigations
Emergency Medicine	Trauma, urgent care
ICU & Critical Care	Ventilator, life support

Scope of Hospital Administration

• Planning, organizing & supervising hospital services
• Budgeting and financial control
• Human Resource Management
• Facility Management (infrastructure, maintenance)
• Quality and Accreditation (NABH/NABL)
• Legal Compliance & Medico-Legal issues
• Patient Satisfaction & Grievance Handling
• Health Information Systems (HIS/ERP)
• Infection Control & Risk Management
• Community outreach and CSR programs

Patient-Related Procedures

A. Admission Procedure

1. Registration: Patient details entered
2. Consent Forms: Signed by patient/guardian
3. Allotment of Bed/Ward
4. Initial Assessment: By doctor and nurse
5. Documentation: IP file created

B. Transfer Procedure

• Types:
• Intra-hospital (e.g., ward to ICU)
• Inter-hospital (e.g., referral to higher center)
• Process:
• Physician’s order
• Transfer form
• Handover between departments
• Ambulance with escort (if external)

C. Discharge Procedure

1. Doctor's Approval
2. Discharge Summary: Final diagnosis, treatment, follow-up
3. Billing Clearance
4. Patient Counseling
5. Feedback Form
6. Handing Over Medicines/Reports

Video Description

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