Hospital: Organisation and Functions

HOSPITAL: ORGANIZATION AND FUNCTIONS

Definition of Hospital

According to the World Health Organization:

"A hospital is an integral part of a social and medical organization whose function is to provide complete healthcare, both curative and preventive, to the population. Its outpatient services reach out to the family and home environment, and it is also a center for training of health workers and for biomedical research."

Functions of Hospital

The major functions of a hospital are:

1. Patient Care Services

• Diagnosis of diseases.
• Treatment of diseases.
• Rehabilitation services.
• Emergency care.
• Specialized healthcare services.

2. Preventive Services

• Immunization programs.
• Health education.
• Disease prevention and screening.
• Maternal and child health services.

3. Promotion of Quality Medical Care

• Improves standards of medical practice.
• Provides evidence-based treatment.

4. Teaching and Training

• Training of doctors, nurses, pharmacists, and allied health professionals.
• Continuing medical education (CME).

5. Research Activities

• Clinical research.
• Drug utilization studies.
• Epidemiological studies.
• Biomedical research.

6. Administrative Functions

• Planning and policy formulation.
• Estimation of manpower and equipment requirements.
• Resource utilization and evaluation.

7. Community Services

• Acts as a link between the public and health policymakers.
• Community outreach programs.

8. Maintenance of Records

• Clinical records.
• Administrative records.
• Statistical reports.

9. Safety Programs

• Infection control.
• Biomedical waste management.
• Patient safety initiatives.

10. Development of Healthcare Policies

• Formulation of hospital policies and procedures.
• Maintenance of adequate and competent staff.

Classification of Hospitals

Hospitals can be classified based on:

1.     Clinical grounds

2.     Non-clinical grounds

3.     Size

4.     Cost

5.     System of medicine

1. Based on Clinical Grounds

A. Medicine-Based Hospitals

• General medicine hospitals
• Pediatric hospitals
• Psychiatric hospitals
• Neurology hospitals

B. Surgery-Based Hospitals

• Orthopedic hospitals
• ENT hospitals
• Gynecology and Obstetric hospitals
• Surgical specialty hospitals

C. Maternity Hospitals

• Short-term maternity hospitals
• Long-term maternity care centers

2. Based on Non-Clinical Grounds

A. Government Hospitals

• District hospitals
• Civil hospitals
• Army hospitals
• Navy hospitals
• Railway hospitals

B. Non-Government Hospitals

Private Hospitals (For Profit)

• Corporate hospitals.

Non-Profit Hospitals

• Charitable hospitals.
• Community hospitals.
• Mission hospitals.
• Trust hospitals.

3. Based on Size

Type of Hospital	Number of Beds
Large Hospital	More than 1000 beds
Medium Hospital	500–1000 beds
Small Hospital	100–500 beds
Very Small Hospital	Less than 100 beds

4. Based on Cost

A. Elite Hospitals

• Highly advanced technology.
• Deluxe facilities.
• Specialized services.
• Example: Apollo Hospitals.

B. Budget Hospitals

• Affordable treatment.
• Government and charitable hospitals.

5. Based on System of Medicine

• Allopathic hospitals
• Ayurvedic hospitals
• Homeopathic hospitals
• Unani hospitals
• Siddha hospitals

Organization of Hospital

Definition

Organization is a dynamic process in which various managerial activities bind people together for achieving common goals and objectives.

 

Governing Body of Hospital

The highest authority of a hospital is the:

• Governing Board
• Board of Directors
• Board of Trustees

Composition of Governing Body

Members may include experts in:

• Medical education
• Research
• Administration
• Finance
• Law
• Public health
• Government representatives

Functions of Governing Body

1.     Formulates policies and procedures.

2.     Plans hospital development.

3.     Approves budgets.

4.     Appoints hospital administrator.

5.     Monitors hospital performance.

6.     Ensures quality patient care.

Hospital Administrator

Responsible for:

• Clinical services
• Nursing services
• Pharmacy services
• Financial management
• Human resource management
• Hospital operations

Services Performed by Hospital Organization

1. Nursing Services

Characteristics

• Largest department of the hospital.
• Functions 24 hours a day.
• Provides direct patient care.

Functions

• Bedside nursing care.
• Prenatal and postnatal care.
• Patient observation.
• Drug administration.
• Health education.

Head of Department

Director of Nursing Services (DNS).

2. Outpatient Services (OPD)

Functions

• Diagnosis and treatment of minor illnesses.
• Preventive services.
• Follow-up services.
• Health education.
• Referral services.

Importance

Acts as the first point of contact between hospital and community.

3. Radiological Services

Performed under a qualified radiologist.

Facilities

• X-ray
• Ultrasonography (USG)
• Electrocardiography (ECG)
• CT Scan
• MRI
• Mammography

Functions

• Diagnosis.
• Monitoring treatment.
• Screening programs.

4. Central Supply Services (CSSD)

Central Sterile Supply Department (CSSD)

Functions

• Collection of instruments.
• Cleaning and sterilization.
• Storage.
• Distribution of sterile supplies.

Importance

Prevents hospital-acquired infections.

5. Hospital Pharmacy Services

Hospital pharmacy is responsible for safe and effective medication management.

Functions

Administrative Functions

• Drug procurement.
• Inventory control.
• Drug storage.
• Budget management.

Clinical Functions

• Dispensing.
• Patient counseling.
• Drug information services.
• Adverse drug reaction monitoring.
• Medication error prevention.
• Therapeutic drug monitoring.

Manufacturing Functions

• Preparation of sterile products.
• Compounding.
• Repackaging.

6. Medical Record Services (MRD)

Medical records contain:

• Patient history.
• Physical examination findings.
• Laboratory reports.
• Diagnostic reports.
• Physician orders.
• Medication records.
• Discharge summary.

Importance

• Continuity of care.
• Research.
• Legal purposes.
• Education.
• Quality assurance.

7. Store Services

Functions

• Receiving materials.
• Storage of supplies.
• Distribution to departments.

Types

• Medical stores.
• Surgical stores.
• General stores.

Importance

• Maintains buffer stock.
• Ensures uninterrupted patient care.

8. Miscellaneous Services

Dietary Services

Provides therapeutic diets.

Ambulatory Services

Transportation of patients.

Laundry Services

Cleaning of hospital linen.

Transport Services

Movement of patients and materials.

Mortuary Services

Storage and handling of dead bodies.

Library Services

Educational resources for healthcare professionals.