Hospital management (2)

Traditional definition of health

Traditional definition of health

Concerned with an individual body’s mechanical ability and the operation of its constituent parts and organs. An individual is unhealthy if there is a malfunctioning of any part of the body.

New definition of health

A state of complete physical, mental, social and spiritual well-being and not merely the absence of disease or infirmity.

Factors influencing health

Healthcare, Poverty, Educational level, Food intake, Employment, Access to clean water and sanitation, Lifestyle, Housing conditions

Hospitals

Facilities where patients go when they are ill and receive observation, diagnosis, and treatment.

Main departments in a hospital

Inpatient (>24 hr), Outpatient (<24hr)

Types of customers in a hospital

Internal customers (staff/ care providers), External customers (patients)

Size of the hospital

Counted by the number of beds

Types of beds in a hospital

Active beds (available for use and counted), Stand by/ spare beds (reserved for emergencies and not counted), Supportive services (newborn beds and not counted)

Horizontal integration

Alliance among several competitive hospitals and multi-hospital systems

Vertical integration

Alliances of other parties involved in healthcare provisions (payers)

Physical-hospital alliances and HMO’s (health maintenance organizations)

Integrated delivery network

Integration between a hospital and other providers

Providers of healthcare services

Physicians, Medical doctors, Nurses, Technicians

Supporting staff in a hospital

Lab technicians, Cleaners, Finance

Mission of a hospital

To improve community health, Curing diseases

Factors for rising costs in hospitals

Increased life expectancy, Cost of medical technology and equipment, Labor costs, Pharmaceutical supply expenses, Strict regulations

Types of hospitals

Community hospitals, Non-profit hospitals, General hospitals, Referral hospitals, Teaching hospitals, Missionary hospitals

Management role in hospitals

Planning, Organizing, Leading/ directing, Controlling

Administration role in hospitals

Regulators who set rules and regulations

Materials management in hospitals

Acquisition, shipping, receiving, evaluating, warehousing, and distributing goods, supplies, and equipment

Hospital business operations

Finance and accounting, Transaction processing, Analysis and reporting, Healthcare logistics and supply chain management, Physical plants or facilities

Cost efficiency

Focus on using fewer resources to achieve higher benefit

Cost effectiveness

Focus on the benefit more than the cost

Outsourcing

Using outside companies for services such as cleaners and security

Organizational structure in hospitals

Tall/flat, Top manager (CEO/COO), Mid-line managers (Board of directors), Supervisors (line managers)

Major sources of power in hospitals

Board of directors, CEO/COO, Medical staff

Board of trustees

External people who observe the function, operation, and budgeting of the hospital

Board of directors

Internal people, usually directors of departments, who have various functions in the hospital.

CEO

Chief executive officer, chosen by the board of trustees and is the daily manager and operator of the hospital.

COO

Chief operations officer, chairs the physicians.

CFO

Chief financial officer.

CNO

Chief nursing officer.

Line function

Assess regular workers/staff.

CMO

Chief marketing officer.

DON

Director of nursing.

Top-bottom decision making

Decision making approach where staff have no say in new procedures/rules/etc.

Bottom-up decision making

Decision making approach where the staff are consulted.

Turnover

The opposite of retention, high turnover is bad.

NICU

Neonatal intensive care unit.

ED

Emergency department.

SURG

Surgical.

HMO

Health management operation.

HMOC

Health management operation centers.

MRSA

Methicillin-resistant Staphylococcus aureus, a resistant bacteria that grows in hospitals.

Accreditation

Acts as the baseline for functions and operations, renewed every 3 years for hospitals.

CPD

Continuous professional development.

Benchmarking

Comparing with the best hospitals, should start before the hospital is built.

Planning

Looking at the vision and mission for the future.

Budget

Utilization of the budget is very important, done every September for public hospitals.

Human resources (HR)

Lists all employees with their information and educational background.

Operational (OPEX)

Items used on an everyday basis.

Capital (CAPEX)

Items and equipment not bought frequently.

Physician Assistant (PA)

Performs routine care.

Nurse Practitioners (NPs)

Work under the supervision of a physician.

Midwives

Provide services in obstetrics and midwifery.

Registered nurse (RN)

Trained in specific field, treat and diagnose patients with diseases and injuries.

Geriatrics

Specialty that deals with elderly patients.

ALOS

Average length of stay in the hospital.

Functional age

What a person can do in comparison to a fit person.

Nurse's aides

Provide treatment and care.

Medical technicians

Provide treatment and care.

Geriatric ward

Must have a multidisciplinary approach.

Programs

Educational courses and support services for the elderly.

Accreditation

Process of evaluating the hospital's systems, procedures, and staff to ensure quality services.

The Joint Commission (JC)

Organization that accredits hospitals and healthcare organizations.

JCAH

Joint Commission on Accreditation of Hospitals.

JCAHO

Joint Commission on Accreditation of Healthcare Organizations.

JCI

Joint Commission International.

Zero tolerance

No errors and unsafe practices should be present in healthcare institutions.

Medical Surveys

Conducted by the Joint Commission to qualify for medical funding.

Site visit

A walk-through of the hospital conducted by the survey team.

HQ

Headquarters.

Accreditation with commendation

The highest level of accreditation, indicating exceptional performance and commitment to quality.

Accredited

A level of accreditation indicating that a healthcare facility meets the required standards and is deemed competent to provide quality care.

Conditionally accredited

A level of accreditation indicating that a healthcare facility has met some but not all of the required standards and must make improvements to achieve full accreditation.

Sentinel events

Unexpected occurrences involving death, serious physical or psychological injury, or the risk thereof, that are preventable and based on competency and commitment.

Timeout

The time before a medical procedure is performed where the information is confirmed to ensure patient safety.

Documentation

The process of recording and maintaining detailed records of patient care, procedures, and other relevant information.

Evacuation plan

A plan that ensures the safety of patients during emergencies or disasters by outlining procedures for moving them to a safe location.

Root cause analysis

A process of investigating and identifying the underlying causes of a sentinel event or other adverse outcome.

Licensure

The process of obtaining a license or permit to operate a healthcare facility, indicating compliance with regulatory requirements.

Medical certification

A process that certifies hospitals to participate in federal insurance programs, based on compliance with certain guidelines.

Registration

A weak form of control for healthcare systems, involving the registration of hospitals in a planning area.

Statistics

Raw numbers that represent data, such as the number of inpatients in a hospital.

Data

Information collected and analyzed to provide insights and make informed decisions.

Health information management (HIM) professionals

Professionals who deal with data collection and reporting methods in healthcare settings.

Inpatient hospitalization

When a person stays as an inpatient in a single hospital without interruption, except for possible leaves of absence.

Inpatient admission

The formal acceptance of a patient by a hospital to provide continuous nursing services in an area where patients stay overnight.

Inpatient discharge

The termination of a period of inpatient hospitalization through the formal release of the patient.

Ambulatory care

Outpatient care provided to patients who do not require overnight hospitalization.

ICU

Intensive care unit, a specialized unit that provides intensive care to critically ill patients.

CCU

Cardiac care unit, a specialized unit that provides care to patients with cardiac conditions.

CICU

Cardiac intensive care unit, a specialized unit that provides intensive care to patients with cardiac conditions.

Inpatient census

The total number of patients in a hospital at a given time.

Average daily census (ADC)

The average number of inpatient services during a specific time period divided by the total number of days in that period.

Bed count day

The number of beds available in a hospital multiplied by the number of days in a given period.

Occupancy rate

The ratio of the number of patients treated to the number of beds available in a hospital over a specific period of time.

Bed turnover rate

A measure of hospital utilization that includes the number of times each hospital bed changes occupants.

Length of Stay (LOS)

The number of calendar days from the day of patient admission to the day of discharge.

Discharge days

The number of days of care provided to patients who have been discharged or died.