A hospital is a healthcare organization that provides medical services and patient care. It is staffed by a team of medical professionals, including physicians, nurses, surgeons, and specialists, who work together to ensure the well-being of patients. The hospital's organization encompasses various departments such as emergency rooms, operating rooms, intensive care units, outpatient clinics, laboratories, radiology, and pharmacies. The hospital is responsible for patient admissions, discharge, triage, and maintaining patient safety through infection control measures. It operates within the framework of healthcare guidelines, accreditation, and regulatory compliance. Hospital management focuses on healthcare financing, budgeting, and ensuring proper staffing and resources. The hospital strives to provide patient-centered care, promote interdisciplinary collaboration, conduct research, and engage in community outreach and health education.
2. HOSPITAL
Formal institutions developed by the society for patient care
Intended to meet the complex health needs of its members
Individual-sick or injured has access to centralized medical
knowledge & technology
Society-it protects the family from many of the disruptive
effects of caring for the ill in the home and making the
problems less disruptive for the society as a whole
3. Definition
The hospital is a complex organization and an institute which
provides health to people through complicated but specialized
scientific equipments , and a team of trained staff educated in
the problems of modern medical science
They are all coordinated together for the common goal of
restoring and maintaining a good health of the people who go
there for relief from pain, suffering and disease.
Thus, hospital is a specialized body where the patient care is
the focal point and about which all activities of the hospital
revolve.
4. Classifications of health care
Primary Care Hospital
Secondary Care Hospital
Tertiary Care Hospital
Primary Care
Consists of basic curative care, including simple diagnosis and
treatment, provided at the point of entry into the health care
system.
5. Primary Care
A primary care hospital provides all the services required for
the first point of contact at hospital.
This is usually a multidisciplinary hospital providing overall
medical and small surgical services.
Some primary care hospitals may also provide obstetric and
paediatric care.
It also provides one nursing unit, 24 beds, a casualty and
emergency department.
It provides a basic diagnostic service, a clinical laboratory, an
x-ray unit and a good first-aid kit.
It has an independent administrative unit to provide support
to other non-institutional health care providers who
administer treatment and create awareness about diseases like
tuberculosis, AIDS, diabetes, cardiac problems, asthma and
bone density.
6. Secondary Care
Consists of specialized care requiring more sophisticated and complicated
diagnosis and treatment than is provided at the primary health care level.
Normally involves hospitalization. (Example: Patient ward in general
hospital).
These hospitals provide all kinds of services including some medical
research.
Secondary care hospital is generally a multidisciplinary hospital which
provides overall medical, surgical, obstetric, paediatric and orthopaedic
services.
It provides at least 2 nursing units, 24 beds, casualty and emergency ward.
It has all the elements of a hospital’s organisational structure and an
independent administrative unit.
It has tie-ups with a nearby tertiary care hospital for complicated cases and
for complex diagnostic and clinical tests.
It provides assistance to non-institutional health care activities to the
community such as health check-up camps, national health service like polio
7. Tertiary Care
Consists of highly specialized diagnostic and therapeutic
services which can usually only be provided in centers
specifically designed staffed and equipped for this purpose.
(Example: Neonatal intensive care unit).
These hospitals have all the services offered by secondary care
hospitals.
It should have 2 or 3 nursing homes, 24 to 50 beds, an advanced
diagnostic service equipped with the latest technology, highly
advanced clinical laboratory and sonagraphy Doppler studies
department.
It should have tie-ups with a teaching hospital and highly
specialized hospitals.
8. Classification of Hospitals
Clinical
basis
Ownership &
control
Systems of
medicine
Miscellaneou
s
1.Government
hospital
i. Civil hospital
ii. Military
hospital
2.Nongovernmen
t hospital
i. Private run
hospital
ii. Charitable
trust hospital
1.Maternity hospital
2. Surgical hospitals
Gynecological
Orthopedic
Otolaryngology
Cardiothoracic
General surgery
Neurological
Kidney hospital
3. Medicine
Allopathic
Homeopathic
Ayurvedic
Unani
Naturopathy
Accreditated
Non-Accreditated
Bed capacity
Large=>1000beds
Medium=500-1000
Small=100-500
Very small=<100
9. Maternity hospital
This is specialized to provide obstetrics and gynaecological services
along with antenatal and neonatal care.
Surgery
This is specialized to perform surgical operations. There are different
types of surgical hospitals such as:
a) Gynaecological
b) Orthopaedic
c) Otolaryngological
d) Cardiothoracic
e) General surgery
f) Neurological
g) kidney
Clinical basis of classifications
10. Medicine
These are general purpose hospitals that provide treatment other than
surgery. In the world of specialization there can be different types
of hospital providing specialized care for a particular type of
diseases.
1. General hospital
2. Paediatrics hospital
3. Communicable diseases hospital
4. Mental hospital or psychiatric diseases hospital
5. Drug-addiction rehabilitation hospital
6. Dental hospital
7. Cancer hospital
Clinical basis of classifications
11. Ownership and control basis of classification
Government hospitals
According to ownership and administrative control hospital may be
of two types.
Government hospitals:
These hospital may be Public health service centres or civil
hospitals
All India Institute of Medical Sciences, New Delhi, Post-graduate
Institute of Medical Education and Research, Government
Hospitals of different cities
All these hospitals may be associated with teaching institution like
Medical college.
Military Hospitals for Army, Air Force or Navy personnels.
Non-Clinical basis of classifications
Non-government
hospitals
12. Nongovernment hospital :
Private run hospitals for profit
e.g. Ramachandra Hospital, Chennai
Apollo Hospital, Escort hospital
Charitable trust hospitals
e.g. Ramakrishna Mission hospital at Coimbatore,
Christian Missionary hospital at Vellore
Non-Clinical basis of classifications
13. Organization structure of a hospital
Govt / Corporation / owners / Trustees / Board of directors ( Governing Council)
Dean / Director / Executive Director / Chair Person (Administrator)
Secretary / Superintends
Administration Clinical Service
Accounts and finance
House Keeping Clinical services Special services Pharmacy
Maintenance Surgery Nursing Drug store
Purchase (General) Pathology Physiotherapy
Manufacture
Public relation Clinical Lab Dietary
Distribution
Laundry Radiology Purchase info
14. 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
15. 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 by laws and
strategic policies.
Trustees select the administrative leader of the hospital
and delegate the hospital's daily operations and
budgeting to the appointed executive.
16. Clinical Support Services
The hospital pharmacy purchases and dispenses all the
medications used to treat patients in the hospital.
The pharmacist works directly with the medical staff in
establishing a formulary, the listing of drugs chosen to be
included in the pharmacy.
17. 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 monies received by the hospital, and approves the
payments of salaries and other expenditures.
18. Accounting is central to the hospital's financial business. Detailed and sound
accounting practices are fundamental to maintaining important
organizational statistics for administrative decision-making
Admitting services is often where the patient first has contact with the
hospital. The sensitivity and efficiency of this department can greatly
influence the patient's perception of the quality of care received.
Information services and medical record maintenance are core functions of
hospital management
The human resources department interacts with all departments in the
hospital to ensure the quality and motivation of personnel working at the
hospital.
Other important administrative and business functions may include
marketing and planning, public relations, plant and materials management,
fund-raising, housekeeping, and security.
19. Allied Health Services
A number of departments perform support functions that help
with diagnosis and treatment.
The clinical laboratory is a diagnostic center that performs a
variety of functions, including autopsy, clinical cytology, and
clinical pathology
Also medical technologists, radiology department and
rehabilitation services.
20. Nursing Services
Nursing services employees are responsible for
carrying out the treatment plan developed by the
physician.
Nursing services, also called patient care services,
is the largest component of the hospital.
21. 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.
22. Executive Administration
The chief executive officer (CEO) reports to the governing
board and provides leadership in implementing the
strategic goals and decisions set by the Board.
The CEO also represents the hospital to the external
environment and the community.
In these tasks, the CEO must coordinate the collective effort
of the hospital's personnel.
24. Residential medical staff
Available on 24 hour service
Involved in organizational and administrative duties
Visiting specialist
Experts in special branches of medicine and practicing outside
Consulting medical staff
Consist of medical practitioners of recognized professional ability
Honorary medical staff
Senior or retired medical staff.
Part time consulting medical staff
25. 1. Internal medicine
2. Cardiology
3. Gatroenterology
4. Nephrology
5. Pulmonary disease
6. Pschyshiatry and
neurology
7. Infectious disease
8. Allergy
9. Skin and veneral disease
10.Endocrinology
11.Geriatrics
12.Immunology
13.Paediatrics
1. General surgery
2. Obstetrics and
gynaecology
3. Orthopedic surgery
4. Opthalmology
5. Otolaryngology
6. Dental and oral surgery
7. Nephrology
8. Neurologic surgery
9. Cardiothoracic surgery
10.Plastic surgery
11.Anaesthetics
A. MEDICINE DIVISION B. SURGERY DIVISION
27. FUNCTIONS OF THE HOSPITAL
1) Preventive function
2) Curative function
3) Training function
4) Research function
Preventive function
It is an emerging secondary function for the hospital and concerned with
health promotion
It is geared toward providing the preventive services through a
community health center
It takes an active role to improve the health of the population
28. Curative function
It is the primary function of the hospital and
concerned with providing patient care
It refers to any type of care given to the patients by the
health team members e.g. physicians, nurses,
dietitians.
Also includes health education to patients.
29. Training function:
It is a secondary function and concerned with providing
training and educational courses for the professional and
technical personnel who provides health services (e.g.
physicians, nurses, dentists, therapist.
Research function:
It is a secondary function and concerned with conducting the
health related researches that focus on the improvement of the
health and/or prevention of diseases.