ROJoson's Lecture on The Surgery Department - UP College of Public Health Master in Hospital Administration circa 1995

1. The
Surgery
Department
Reynaldo O. Joson, MD, MHA, MHPEd, MScSurg

2. All students of hospital administration
must be knowledgeable of the
surgery department.
•Objectives
•Physical and personnel requirements
•How it should function

3. Learning Objectives
• Define objectives of surgery
department
• Discuss physical requirements in
relation to objectives
• Discuss personnel requirements in
relation to objectives

4. Learning Objectives
• Explain importance of manual of
policies and procedures
• Discuss competencies required of
department chairman
• Discuss present trends in
management of surgery
department

5. Learning Objectives
• Define objectives of the clinical
department (Surgery, ENT, IM, OB-
GYN, OPHTHA, etc.)
• Discuss physical requirements in
relation to objectives
• Discuss personnel requirements in
relation to objectives

6. Learning Objectives
• Explain importance of manual of
policies and procedures
• Discuss competencies required of
department chairman
• Discuss present trends in
management of the clinical
department (Surgery, ENT, OB-
GYN, IM, etc)

7. Department of Surgery
Goal and Objectives

8. Department of Surgery
Goal
To provide proper medical service to
all patients with surgical diseases
who seek consultation and
treatment in the hospital.

9. Department of Surgery
Main Objectives
1. To examine all patients with a
possible surgical diseases and
afterwhich, to make a
rational and accurate
diagnosis.

10. Department of Surgery
Main Objectives
2. To provide treatment to all
patients with surgical
diseases.

11. Department of Surgery
Other Objectives
• To provide training in surgery.
• To promote research in surgery.

12. “Surgery Department”
usually refers to
General Surgery and its
subspecialties.

13. Department of Surgery
Physical
Requirements

14. Department of Surgery
Physical Requirements
1. Operating rooms
2. Surgical patient beds
3. Consultation rooms in
3.1 Outpatient department
3.2 Emergency room

15. Department of Surgery
Physical Requirements
•Location within the hospital
•Quantity
•Size
•Design
•Equipment
dependent on

16. Department of Surgery
Physical Requirements
General Determining Factors:
•Government regulations
•usual and anticipated increase in patient
load
•needs and expectations of the community
•allowance for expansion
•cost-benefit considerations

17. Department of Surgery
Physical Requirements
for training and research
•Conference room
•Library
•Internet

18. Department of Surgery
The
Operating Room

19. Department of Surgery
The Operating Room
Place where
diagnostic and therapeutic
surgical procedures
are performed

20. The Operating Room
Siting
Most important consideration:
Accessibility to patients of surgery
department
Not far from the emergency
trauma unit

21. The Operating Room
Number of Rooms
Most important consideration:
Cost-benefit analysis
usual patient load of surgical
department
to
investment in spaces

22. The Operating Room
Number of Operating Rooms
Several department ORs
vs
One operating room complex?
One complex is better
cost-benefit wise!

23. The Operating Room
Design
one that will best achieve
• effectiveness and efficiency
• sterility standards and requirements
•traffic flow
•from outside to inside
•from dirty to clean zones to sterile areas

24. The Operating Room
Basic Architectural Design
Aseptic / Antiseptic
Rationale

26. Match
1. Most sterile zone
2. Most unsterile zone
A. Zone I - outer
B. Zone II - middle
C. Zone III - inner

27. Match
1. Most sterile zone - C
2. Most unsterile zone - A
A. Zone I - outer
B. Zone II - middle
C. Zone III - inner

28. The Operating Room
Essential equipment and facilities:
•Anesthesizing equipment
•Operating equipment
•Supplies for anesthesia and operation
•Monitoring devices
•Drugs, parenteral fluids, and gases
•Recovery room beds

29. Department of Surgery
Personnel
Requirements

30. Department of Surgery
Personnel Requirements
At least
• Surgeons
• Nurses
• Nursing Aides
Adequate in number and in competency

31. Department of Surgery
Personnel Requirements
General Determining Factors:
•Government regulations
•usual and anticipated increase in patient
load
•needs and expectations of the community
•cost-benefit considerations

32. Department of Surgery
Personnel Requirements
For training objective
- trainors
For research objective
- researchers
Adequate in number and in competency

33. Operating Room
Personnel Requirements
• Surgeons
• Anesthesiologists
• Nurses
• Nursing Aides
Adequate in number and in competency

34. Operating Room
Personnel Requirements
• Surgeons
• Anesthesiologists
Minimum qualification:
Phil. Specialty Board certification

35. Operating Room
Personnel Requirements
Number of Personnel
cost-benefit considerations:
usual as well as anticipated increase
in patient load
in the surgery department

36. Operating Room
Personnel Requirements
Governance of OR
• Department OR
- Department Chair or Rep
• OR Complex
- OR Management Team or Com

37. Department of Surgery
The
Chairperson

38. Department of Surgery
The Chairperson
Qualifications: Must
•Be a surgeon
•Know administration or management
•Know andragogy
•Know how to do research
consider objectives, activities, personnel

39. Department of Surgery
Manual of
Policies and Procedures

40. Department of Surgery
Manual of Policies and Procedures
Importance
•Guide for present and future staff
•Promotes effectiveness and efficiency
Should be reviewed and revised periodically

41. Department of Surgery
Manual of Policies and Procedures
• Service
• Training
• Research
• Governance

42. Operating Room
Manual of Policies and Procedures
• Safety - explosions and infections
• Scheduling of cases
• Operating room privileges
• Records
• Charging
• Instruments and equipment
• Traffic

43. Department of Surgery
The Trends

44. Department of Surgery
The Trends
Objectives NOT limited to service.
Training and research are usually
included because they contribute
to perpetuation and
quality of service.

45. Department of Surgery
The Trends
All training programs must be accredited
by the Specialty Board or
Organization.
Accredited training programs attract
trainees more than
non-accredited ones.

46. Department of Surgery
The Trends
ONLY board certified surgeons are
accepted for active and permanent
staff in the hospitals.
Medicolegal reasons

47. Department of Surgery
The Trends
Operating room complex is the trend and
this is being managed by an
operating room management team.

48. Thank You for
trying to
appreciate what I
am trying to
impart to you!

49. on
The Surgery Department
(from hospital administration
point of view)
Reynaldo O. Joson, MD, MHA, MHPEd, MScSurg

50. For those interested:
R.O. Joson’s Website
http://members.xoom.com/rjoson/hospadm/hospadm.htm
http://web.pacific.net.ph/~rjoson