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Unit 1 Topic:- HOSPITALS & It's ORGANIZATION
Ms. Shweta Gawande (M Pharm Pharmaceutics)
(Assistant.professor)
[ Ishwar Deshmukh institute of pharmacy ,Digras]
1
INTRODUCTION TO HOSPITALS & HOSPITAL
PHARMACY
Section 1.1- Definition Classification Organizational structure of Hospital,
Administration and Functions of Hospitals
HOSPITAL AND ITS ORGANIZATION
Hospitals provide various facilities to the patients along with their diagnostic and
surgical facilities. Now-a-days tools like X-rays, ultrasound, E.C.G., etc., have
become an integral part of the hospitals.
HOSPITAL is defined as:
“An INSTITUTION of COMMUNITY HEALTH/ a SPECIALIZED COMPLEX
ORGANIZATION, that makes use of PHYSICIANS, SURGEONS & team of
TECHNICAL STAFF, in order to provide facilities for DIAGNOSIS, THERAPY,
REHABILITATION, PREVENTION, EDUCATION & RESEARCH
Hospital is an institution for the care, cure and treatment of the sick and wounded,
for the study of diseases, and for the training of doctors and nurses.
FUNCTIONS OF HOSPITAL :
1. To UPLIFT QUALITY OF LAW and GENERAL STANDARDS of MEDICAL
PRACTICE
2. To PROVIDE FACILITIES & GUIDANCE , by which persons can work in
GROUPS, with the intention of BETTERMENT of HOSPITAL DEPARTMENT,
PATIENT & COMMUNITY
3. To REDUCE DISEASE OCCURRENCE by early DIAGNOSIS and
TREATMENT
4. To ESTIMATE needs for FACILITIES, SUPPLIES & EQUIPMENTS, and their
UTILIZATION for EVALUATION, CONTROL & MAINTENANCE
5. To ESTIMATE DEPARTMENTAL NECESSITIES
2
6. To PROVIDE a COMMON LINK between GENERAL PUBLIC & POLICY
MAKERS
7. To SUGGEST POLICIES & PROCEDURES to maintain ADEQUATE &
COMPETENT STAFF
8. To DEVELOP & MAINTAIN an effective system of CLINICAL &
ADMINISTRATIVE RECORDS & REPORTS
9. To HARNESS growth of MEDICAL SCIENCE, by PROPER TRAINING of
DOCTORS & NURSES in large training hospitals
10. To CREATE & DEVELOP FINANCIAL PLAN for the OPERATION OF
HOSPITAL
11. To provide facilities for continuing EDUCATION of all the people
12. To PARTICIPATE & IMPLEMENT SAFETY PROGRAMMES of HOSPITAL
13. To INITIATE, UTILIZE & PARTICIPATE in RESEARCH PROJECTS, aimed
at IMPROVEMENT of PATIENT CARE, and other hospital services.
Classification Of Hospitals
A. On the basis of care
a) Primary hospital
● a primary care hospital provides all the services required for the first point of
contact at a hospital.
● This is usually a multidisciplinary hospital providing overall medical and
small surgical services. Some primary care hospitals may also provide
obstetric and pediatric care.
● It also provides one nursing unit, 24 beds, a casualty and emergency
department.
3
● 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.
● Primary hospital include care for mother and child which include family
planning ,immunization, treatment of common disease, health education etc.
b) Secondary hospital
● It 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, pediatric
and orthopedic services.
● It provides at least 2 nursing units, 24 beds, casualty and emergency ward. It
has all the elements of a hospital’s organizational 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
4
c) Tertiary hospitals:-
● Tertiary healthcare refers to a third level of health system, in which
specialized consultative care is provided usually on referral from primary
and secondary medical care.
● 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
● Specialized ICU, advanced diagnostic support services and specialized
medical personnel.
B. ON CLINICAL AND NON-CLINICAL BASIS
A) CLINICAL BASIS
● Medicine – These general purpose hospitals that provide treatment other
than surgery. providing specialized care for a particular type of disease.
1. General hospital
2. Pediatrics 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
● Surgery –Surgery This is specialized to perform surgical operations. There
are different types of surgical hospitals such as Orthopaedic, gynecology,
ENT, cardiothoracic, kidney, neurology
● Maternity:- specialized to provide obstetrics and gynecological services
along with antenatal and neonatal care.
B) NON CLINICAL BASIS
1. Government or Public Hospital:
5
• These are run by Central or State Governments.
• These are funded by the government.
These hospitals may be Public health service centers 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 institutions like Medical colleges.
● Eg. 1.Army hospital 2. Navy hospital 3.City hospital 4. Civil hospital 5. Big
hospital 6. AIIMS/PGI etc.
2. Non–Government Hospitals: Run hospital for profit
• They are supported by client’s fees, donations, or endowments (relating to funds
or property donated to institutions or individuals).
1. Private hospital for profit ,2. Church hospital3. Missionary hospital
4.Non-profit hospital.5.Community hospital 6.Charitable hospital
C. ON THE BASIS OF BED SIZE
a) Large hospitals have 1000 and above beds.
b) Medium hospitals have beds between 500-1000.
c) Small hospitals have beds between 100-500.
d) Very small hospitals have beds less than 100.
D.BASED ON COST:
A. ELITE HOSPITALS: - Consist of HIGH TECHNOLOGY & MEDICAL
SCIENCE ADVANCEMENTS - Comprise DELUXE ROOMS, with T.V,
TELEPHONES & REFRIGERATOR - Room rate : Rs. 500-1,200/ day - Also
known as “5-STAR HOSPITALS” -
Example : APOLLO HOSPITAL
B. BUDGET HOSPITALS: - Meant for MODERATE-LOW BUDGET people
(Example: CHARITABLE & CIVIL HOSPITALS )
E.BASED ON SYSTEM OF MEDICINE:
A. Allopathic Hospitals
B. Ayurvedic Hospitals
C. Homeopathic Hospitals
D. Unani Hospitals…
6
ORGANIZATION OF HOSPITALS
ORGANIZATION is defined as “A DYNAMIC PROCESS, in which various
MANAGERIAL ACTIVITIES bring & bind people together, for the
ACHIEVEMENT of COMMON GOALS & OBJECTIVES”
2. Most important BODY of a hospital is the
1. GOVERNING BODY
2. BOARD OF DIRECTORS
3. BOARD OF TRUSTEES
1. GOVERNING BODY-: Consists of various eminent personalities in the field of
: a. MEDICAL EDUCATION , ADMINISTRATION, RESEARCH,
FUNCTION of GOVERNING BODY is to FRAME all major POLICIES,
PLANS & PROGRAMMES of hospital
7
A.BOARD OF TRUSTEES.
● The "board of trustees," or governing board, operates the hospital in trust for
the community.
● 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.
B. NURSING SERVICES: -
● Largest part of a hospital - Functions all 24 hours - Nurses assigned specific
number of beds have to give personal attention to patients
8
● Nurses are trained for PRENATAL CARE, OBSERVATION, PATIENT
COMFORT DURING LABOUR,
● NURSING DIRECTOR is the in-charge of nursing services
C. OUT-PATIENT SERVICES: -
● Focus on COMFORT for OUT-PATIENTS, as the approach for major/minor
illnesses
● These services make a hospital an IDEAL COMMUNITY INSTITUTION -
Hospital is duty-bound to provide DIAGNOSTIC, PREVENTIVE &
CURATIVE measures to the OUT-PATIENTS.
D.CARDIOLOGICAL SERVICES: -
● Performed under direction of a competent RADIOLOGIST - CHIEF
RADIOLOGIST assisted by various TECHNICIANS
● Services include UTILIZATION of EQUIPMENTS like: a. SONOGRAPHY
b. X-RAY c. ECG d. CT-SCAN, etc
E.CENTRAL SUPPLY SERVICES: -
● Refers to Medical & Surgical Supply Services - Meant for DIAGNOSIS,
TREATMENT, PREVENTION, EDUCATION & RESEARCH
● Involves their COLLECTION, PROCESSING, STORAGE & ISSUANCE
against proper INDENT FORM - Qualified & skilled staff personnel are
responsible for its maintenance
F.HOSPITAL PHARMACY SERVICES: -
● Controls PHARMACY OPERATION in any hospital - FILLS
PRESCRIPTION & no. of necessities from wards.
● Functions begin from drug procurement to distribution to I.P andO.P -
Responsible for : a. Proper Drug Delivery d. Manufacture b. Information
System e. Sterilization c. Drug Storage f. advising patients on drug use.
F. MEDICAL RECORD SERVICES: -
● Valuable Materials, as they help medical & para-medical staff for evaluation
- Also used for EDUCATION, RESEARCH & TRAINING -
Consists of :
9
a. PATIENT HISTORY
b. PHYSICAL EXAMINATION DETAILS
C. LAB- TEST REPORTS
d. PHYSICIAN'S ADVICE, etc.
- It is mandatory to store medical records properly to FACILITATE EASY
ACCESS on requirements.
G. STORE SERVICES: -
Receive, store & issue materials against Requisition Forms of various departments
& Wards -
Hospital consists of:
a. MEDICAL STORE
b. STORE FOR GENERAL ITEMS
c. SURGICAL STORES,
etc - Maintain a BUFFER STOCK of certain materials, including LIFE-SAVING
DRUGs
H. MISCELLANEOUS SERVICES: -
Aimed at overall BENEFIT & PATIENT CARE -Include:
a. Dietary Services
b. Ambulatory Services
c. Laundry Services
d. Transport Services
e. Mortuary Services
f. Library Service
Medical staff involved in hospital
The health care team consists of a group of people who coordinate their particular
skills in order to assist a patient. The personnel, who comprise a particular team
will depend upon the needs of a patient.
● Physicians
● Nurses
● Social workers
● Trained dais
● Village health guides
● Health assistants
● Auxiliary personnel
10
1.Physician: - In hospital, the physician is responsible for the medical diagnosis
and for determining the therapy required by a person who is ill or injured. It is a
person who is legally authorized to practice medicine in a particular jurisdiction.
2.Nurse:- A number of nursing personnel may be involved in the health team and
may have their own nursing team. Nursing team consists of personnel who provide
nursing services to a patient. “Head nurse” is responsible for delegation of duties to
members of her team and care given to the patients.
3.The dietitian:- When dietary and nutritional services are required a dietitian may
also be a member of the health team. Dietitians supervise the preparation of meals
according to the doctor's prescription. The nutritionist in a community setting
recommends healthy diets for people and is frequently involved in board advisory
services in regard to purchase and preparation of food.
4.The Physiotherapist:- it provides assistance to a patient who has a problem
related to the musculoskeletal system. Their functions include; assessing mobility
and strength, providing therapeutic measures and teaching patients news skills and
measures.
5.The social worker:-The patient and his family member are assisted by a social
worker with such problems such as finances, rest home accommodation,
counseling or marital problems, and adoption of children.
6. an occupational therapist assists patients with some impairment of function to
gain skills as they are related to activities of daily living (ADL) and help with a
skill that is therapeutic.
7. paramedical technologist includes laboratory technologies, radio-logic
technologists. The laboratory technologists examine and study specimens such as
urine, feces, blood and discharges from wounds.
8. a pharmacist prepares and dispenses pharmaceuticals in hospital and
community settings. The role of pharmacists in monitoring and evaluating the
actions of medications on patients is becoming prominent.
11
9.inhalation therapist or respiratory technologist is skilled in therapeutic
measures used in care of patients with respiratory problems.
These therapists are knowledgeable about oxygen therapy devices, intermittent
positive pressure breathing respirators, artificial mechanical ventilators, accessory
devices used for inhalation.
10.clinical psychologist constitutes an important member in the healthcare team.
Ref:- A text book of Hospital and clinical pharmacy by Dr. Pratibha Nand and
Dr.Roop k. Khar.
A text book of Hospital pharmacy by Merchant Shah, dr. J. S Quadry, Shah
prakashan.
12

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INTRODUCTION TO HOSPITALS & AND ITS ORGANIZATION

  • 1. Unit 1 Topic:- HOSPITALS & It's ORGANIZATION Ms. Shweta Gawande (M Pharm Pharmaceutics) (Assistant.professor) [ Ishwar Deshmukh institute of pharmacy ,Digras] 1
  • 2. INTRODUCTION TO HOSPITALS & HOSPITAL PHARMACY Section 1.1- Definition Classification Organizational structure of Hospital, Administration and Functions of Hospitals HOSPITAL AND ITS ORGANIZATION Hospitals provide various facilities to the patients along with their diagnostic and surgical facilities. Now-a-days tools like X-rays, ultrasound, E.C.G., etc., have become an integral part of the hospitals. HOSPITAL is defined as: “An INSTITUTION of COMMUNITY HEALTH/ a SPECIALIZED COMPLEX ORGANIZATION, that makes use of PHYSICIANS, SURGEONS & team of TECHNICAL STAFF, in order to provide facilities for DIAGNOSIS, THERAPY, REHABILITATION, PREVENTION, EDUCATION & RESEARCH Hospital is an institution for the care, cure and treatment of the sick and wounded, for the study of diseases, and for the training of doctors and nurses. FUNCTIONS OF HOSPITAL : 1. To UPLIFT QUALITY OF LAW and GENERAL STANDARDS of MEDICAL PRACTICE 2. To PROVIDE FACILITIES & GUIDANCE , by which persons can work in GROUPS, with the intention of BETTERMENT of HOSPITAL DEPARTMENT, PATIENT & COMMUNITY 3. To REDUCE DISEASE OCCURRENCE by early DIAGNOSIS and TREATMENT 4. To ESTIMATE needs for FACILITIES, SUPPLIES & EQUIPMENTS, and their UTILIZATION for EVALUATION, CONTROL & MAINTENANCE 5. To ESTIMATE DEPARTMENTAL NECESSITIES 2
  • 3. 6. To PROVIDE a COMMON LINK between GENERAL PUBLIC & POLICY MAKERS 7. To SUGGEST POLICIES & PROCEDURES to maintain ADEQUATE & COMPETENT STAFF 8. To DEVELOP & MAINTAIN an effective system of CLINICAL & ADMINISTRATIVE RECORDS & REPORTS 9. To HARNESS growth of MEDICAL SCIENCE, by PROPER TRAINING of DOCTORS & NURSES in large training hospitals 10. To CREATE & DEVELOP FINANCIAL PLAN for the OPERATION OF HOSPITAL 11. To provide facilities for continuing EDUCATION of all the people 12. To PARTICIPATE & IMPLEMENT SAFETY PROGRAMMES of HOSPITAL 13. To INITIATE, UTILIZE & PARTICIPATE in RESEARCH PROJECTS, aimed at IMPROVEMENT of PATIENT CARE, and other hospital services. Classification Of Hospitals A. On the basis of care a) Primary hospital ● a primary care hospital provides all the services required for the first point of contact at a hospital. ● This is usually a multidisciplinary hospital providing overall medical and small surgical services. Some primary care hospitals may also provide obstetric and pediatric care. ● It also provides one nursing unit, 24 beds, a casualty and emergency department. 3
  • 4. ● 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. ● Primary hospital include care for mother and child which include family planning ,immunization, treatment of common disease, health education etc. b) Secondary hospital ● It 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, pediatric and orthopedic services. ● It provides at least 2 nursing units, 24 beds, casualty and emergency ward. It has all the elements of a hospital’s organizational 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 4
  • 5. c) Tertiary hospitals:- ● Tertiary healthcare refers to a third level of health system, in which specialized consultative care is provided usually on referral from primary and secondary medical care. ● 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 ● Specialized ICU, advanced diagnostic support services and specialized medical personnel. B. ON CLINICAL AND NON-CLINICAL BASIS A) CLINICAL BASIS ● Medicine – These general purpose hospitals that provide treatment other than surgery. providing specialized care for a particular type of disease. 1. General hospital 2. Pediatrics 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 ● Surgery –Surgery This is specialized to perform surgical operations. There are different types of surgical hospitals such as Orthopaedic, gynecology, ENT, cardiothoracic, kidney, neurology ● Maternity:- specialized to provide obstetrics and gynecological services along with antenatal and neonatal care. B) NON CLINICAL BASIS 1. Government or Public Hospital: 5
  • 6. • These are run by Central or State Governments. • These are funded by the government. These hospitals may be Public health service centers 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 institutions like Medical colleges. ● Eg. 1.Army hospital 2. Navy hospital 3.City hospital 4. Civil hospital 5. Big hospital 6. AIIMS/PGI etc. 2. Non–Government Hospitals: Run hospital for profit • They are supported by client’s fees, donations, or endowments (relating to funds or property donated to institutions or individuals). 1. Private hospital for profit ,2. Church hospital3. Missionary hospital 4.Non-profit hospital.5.Community hospital 6.Charitable hospital C. ON THE BASIS OF BED SIZE a) Large hospitals have 1000 and above beds. b) Medium hospitals have beds between 500-1000. c) Small hospitals have beds between 100-500. d) Very small hospitals have beds less than 100. D.BASED ON COST: A. ELITE HOSPITALS: - Consist of HIGH TECHNOLOGY & MEDICAL SCIENCE ADVANCEMENTS - Comprise DELUXE ROOMS, with T.V, TELEPHONES & REFRIGERATOR - Room rate : Rs. 500-1,200/ day - Also known as “5-STAR HOSPITALS” - Example : APOLLO HOSPITAL B. BUDGET HOSPITALS: - Meant for MODERATE-LOW BUDGET people (Example: CHARITABLE & CIVIL HOSPITALS ) E.BASED ON SYSTEM OF MEDICINE: A. Allopathic Hospitals B. Ayurvedic Hospitals C. Homeopathic Hospitals D. Unani Hospitals… 6
  • 7. ORGANIZATION OF HOSPITALS ORGANIZATION is defined as “A DYNAMIC PROCESS, in which various MANAGERIAL ACTIVITIES bring & bind people together, for the ACHIEVEMENT of COMMON GOALS & OBJECTIVES” 2. Most important BODY of a hospital is the 1. GOVERNING BODY 2. BOARD OF DIRECTORS 3. BOARD OF TRUSTEES 1. GOVERNING BODY-: Consists of various eminent personalities in the field of : a. MEDICAL EDUCATION , ADMINISTRATION, RESEARCH, FUNCTION of GOVERNING BODY is to FRAME all major POLICIES, PLANS & PROGRAMMES of hospital 7
  • 8. A.BOARD OF TRUSTEES. ● The "board of trustees," or governing board, operates the hospital in trust for the community. ● 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. B. NURSING SERVICES: - ● Largest part of a hospital - Functions all 24 hours - Nurses assigned specific number of beds have to give personal attention to patients 8
  • 9. ● Nurses are trained for PRENATAL CARE, OBSERVATION, PATIENT COMFORT DURING LABOUR, ● NURSING DIRECTOR is the in-charge of nursing services C. OUT-PATIENT SERVICES: - ● Focus on COMFORT for OUT-PATIENTS, as the approach for major/minor illnesses ● These services make a hospital an IDEAL COMMUNITY INSTITUTION - Hospital is duty-bound to provide DIAGNOSTIC, PREVENTIVE & CURATIVE measures to the OUT-PATIENTS. D.CARDIOLOGICAL SERVICES: - ● Performed under direction of a competent RADIOLOGIST - CHIEF RADIOLOGIST assisted by various TECHNICIANS ● Services include UTILIZATION of EQUIPMENTS like: a. SONOGRAPHY b. X-RAY c. ECG d. CT-SCAN, etc E.CENTRAL SUPPLY SERVICES: - ● Refers to Medical & Surgical Supply Services - Meant for DIAGNOSIS, TREATMENT, PREVENTION, EDUCATION & RESEARCH ● Involves their COLLECTION, PROCESSING, STORAGE & ISSUANCE against proper INDENT FORM - Qualified & skilled staff personnel are responsible for its maintenance F.HOSPITAL PHARMACY SERVICES: - ● Controls PHARMACY OPERATION in any hospital - FILLS PRESCRIPTION & no. of necessities from wards. ● Functions begin from drug procurement to distribution to I.P andO.P - Responsible for : a. Proper Drug Delivery d. Manufacture b. Information System e. Sterilization c. Drug Storage f. advising patients on drug use. F. MEDICAL RECORD SERVICES: - ● Valuable Materials, as they help medical & para-medical staff for evaluation - Also used for EDUCATION, RESEARCH & TRAINING - Consists of : 9
  • 10. a. PATIENT HISTORY b. PHYSICAL EXAMINATION DETAILS C. LAB- TEST REPORTS d. PHYSICIAN'S ADVICE, etc. - It is mandatory to store medical records properly to FACILITATE EASY ACCESS on requirements. G. STORE SERVICES: - Receive, store & issue materials against Requisition Forms of various departments & Wards - Hospital consists of: a. MEDICAL STORE b. STORE FOR GENERAL ITEMS c. SURGICAL STORES, etc - Maintain a BUFFER STOCK of certain materials, including LIFE-SAVING DRUGs H. MISCELLANEOUS SERVICES: - Aimed at overall BENEFIT & PATIENT CARE -Include: a. Dietary Services b. Ambulatory Services c. Laundry Services d. Transport Services e. Mortuary Services f. Library Service Medical staff involved in hospital The health care team consists of a group of people who coordinate their particular skills in order to assist a patient. The personnel, who comprise a particular team will depend upon the needs of a patient. ● Physicians ● Nurses ● Social workers ● Trained dais ● Village health guides ● Health assistants ● Auxiliary personnel 10
  • 11. 1.Physician: - In hospital, the physician is responsible for the medical diagnosis and for determining the therapy required by a person who is ill or injured. It is a person who is legally authorized to practice medicine in a particular jurisdiction. 2.Nurse:- A number of nursing personnel may be involved in the health team and may have their own nursing team. Nursing team consists of personnel who provide nursing services to a patient. “Head nurse” is responsible for delegation of duties to members of her team and care given to the patients. 3.The dietitian:- When dietary and nutritional services are required a dietitian may also be a member of the health team. Dietitians supervise the preparation of meals according to the doctor's prescription. The nutritionist in a community setting recommends healthy diets for people and is frequently involved in board advisory services in regard to purchase and preparation of food. 4.The Physiotherapist:- it provides assistance to a patient who has a problem related to the musculoskeletal system. Their functions include; assessing mobility and strength, providing therapeutic measures and teaching patients news skills and measures. 5.The social worker:-The patient and his family member are assisted by a social worker with such problems such as finances, rest home accommodation, counseling or marital problems, and adoption of children. 6. an occupational therapist assists patients with some impairment of function to gain skills as they are related to activities of daily living (ADL) and help with a skill that is therapeutic. 7. paramedical technologist includes laboratory technologies, radio-logic technologists. The laboratory technologists examine and study specimens such as urine, feces, blood and discharges from wounds. 8. a pharmacist prepares and dispenses pharmaceuticals in hospital and community settings. The role of pharmacists in monitoring and evaluating the actions of medications on patients is becoming prominent. 11
  • 12. 9.inhalation therapist or respiratory technologist is skilled in therapeutic measures used in care of patients with respiratory problems. These therapists are knowledgeable about oxygen therapy devices, intermittent positive pressure breathing respirators, artificial mechanical ventilators, accessory devices used for inhalation. 10.clinical psychologist constitutes an important member in the healthcare team. Ref:- A text book of Hospital and clinical pharmacy by Dr. Pratibha Nand and Dr.Roop k. Khar. A text book of Hospital pharmacy by Merchant Shah, dr. J. S Quadry, Shah prakashan. 12