This document discusses hospital management and the key differences between hospitals and industries. It provides objectives, outcomes, textbooks and references for the subject "Hospital Management". It also covers the basic functions of management as they relate to hospitals, including planning, organizing, staffing, directing, and controlling. Finally, it outlines some of the main differences between hospitals and industries, such as complexity, highly trained professionals, different organizational structures, emphasis on customer service, and focus on delivering healthcare services rather than products.
This document discusses hospital management and the key differences between hospitals and industries. It provides objectives, outcomes, textbooks and references for the subject "Hospital Management". It also covers the basic functions of management as they relate to hospitals, including planning, organizing, staffing, directing, and controlling. Finally, it outlines some of the main differences between hospitals and industries, such as complexity, highly trained professionals, different organizational structures, emphasis on customer service, and focus on delivering healthcare services rather than products.
This document discusses hospital management and the key differences between hospitals and industries. It provides objectives, outcomes, textbooks and references for the subject "Hospital Management". It also covers the basic functions of management as they relate to hospitals, including planning, organizing, staffing, directing, and controlling. Finally, it outlines some of the main differences between hospitals and industries, such as complexity, highly trained professionals, different organizational structures, emphasis on customer service, and focus on delivering healthcare services rather than products.
This document discusses hospital management and the key differences between hospitals and industries. It provides objectives, outcomes, textbooks and references for the subject "Hospital Management". It also covers the basic functions of management as they relate to hospitals, including planning, organizing, staffing, directing, and controlling. Finally, it outlines some of the main differences between hospitals and industries, such as complexity, highly trained professionals, different organizational structures, emphasis on customer service, and focus on delivering healthcare services rather than products.
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KGiSL Institute of Technology
(Approved by AICTE, New Delhi; Affiliated to Anna University, Chennai)
Recognized by UGC, Accredited by NBA (IT) 365, KGiSL Campus, Thudiyalur Road, Saravanampatti, Coimbatore – 641035.
Department of Information Technology
Name of the Faculty : Dr. M. Ananthi
Subject Name & Code : OBM752 / Hospital Management
Branch & Department : B.Tech & Information Technology
Year & Semester : IV / VII
Academic Year :2023-2024
OBM752/HM/IV -IT/VII SEM/KG-KiTE
OBJECTIVES • To understand the fundamentals of hospital administration and management. • To know the market related research process. • To explore various information management systems and relative support services. • To learn the quality and safety aspects in hospital.
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OUTCOMES • Explain the principles of Hospital administration. • Identify the importance of Human resource management. • List various marketing research techniques. • Identify Information management systems and its uses. • Understand safety procedures followed in hospitals. OBM752/HM/IV -IT/VII SEM/KG-KiTE TEXT BOOK & REFERENCES TEXT BOOKS: 1. R.C.Goyal, “Hospital Administration and Human Resource Management”, PHI – Fourth Edition, 2006. 2. G.D.Kunders, “Hospitals – Facilities Planning and Management – TMH, New Delhi – Fifth Reprint 2007.
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TEXT BOOK & REFERENCES REFERENCES: 1. Cesar A.Caceres and Albert Zara, “The Practice of Clinical Engineering, Academic Press, New York, 1977. 2. Norman Metzger, “Handbook of Health Care Human Resources Management”, 2nd edition Aspen Publication Inc. Rockville, Maryland, USA, 1990. 3. Peter Berman “Health Sector Reform in Developing Countries” - Harvard University Press, 1995. 4. William A. Reinke “Health Planning For Effective Management” - Oxford University Press.1988. 5. Blane, David, Brunner, “Health and SOCIAL Organization: Towards a Health Policy for the 21st Century”, Eric Calrendon Press 2002. 6. Arnold D. Kalcizony & Stephen M. Shortell, “Health Care Management”, 6th Edition Cengage Learning, 2011.
Selection, Training Guidelines – Methods of Training – Evaluation of Training – Leadership grooming and Training, Promotion – Transfer.
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UNIT IV - SUPPORTIVE SERVICES Medical Records Department – Central Sterilization and Supply Department – Pharmacy – Food Services - Laundry Services.
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UNIT V - COMMUNICATION AND SAFETY ASPECTS IN HOSPITAL
Purposes – Planning of Communication, Modes of
Communication – Telephone, ISDN (Integrated Services Digital Network), Public Address and Piped Music – CCTV. Security – Loss Prevention – Fire Safety – Alarm System – Safety Rules.
Hospital Management Hospital: The word Hospital is derived from the Latin word hospitalis which comes from hospes, meaning a host.
Hospital means an institution in which sick and
injured persons are treated.
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Hospital Management MANAGEMENT: Management is an activity which is necessary for a group of people working in an organization. The task of management incorporates: 1. Determining the goals and objectives of the organization. 2. Acquiring and utilizing resources. 3. Installing communication system. 4. Determining controlling procedures. 5. Evaluating the performance of the organization.
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Hospital Management Management is a purposive activity. It is something that directs group efforts towards the attainment of certain pre - determined goals.
According to F.W. Taylor, “Management is an art of
knowing what to do, when to do and see that it is done in the best and cheapest way”.
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Hospital Management HOSPITAL MANAGEMENT: System that encompasses organizing, planning, and monitoring a hospital's operations, including personnel, budget, medical equipment, patient care etc.,
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Hospital Management Functions of management: Management performs the following five functions: 1. Planning 2. Organizing 3. Staffing 4. Directing 5. Controlling
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Hospital Management Planning: A plan is a future course of action. It is an exercise in problem solving and decision making. Planning is determination of courses of action to achieve desired goals.
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Hospital Management Organizing: It is the process of bringing together physical, financial and human resources and developing productive relationship amongst them for achievement of organizational goals. To organize a business involves determining & providing human and non-human resources to the organizational structure. Organizing as a process involves: - Identification of activities - Classification of activities - Assignment of duties
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Hospital Management Staffing: Staffing has assumed greater importance due to advancement of Technology, increase in size of business, complexity of human behavior etc. The main purpose of staffing is to put right man on right job Staffing involves: Recruitment, Selection & Placement Training & Development Remuneration Performance Appraisal Promotions & Transfer OBM752/HM/IV -IT/VII SEM/KG-KiTE Hospital Management Directing Direction is the inert-personnel aspect of management which deals directly with influencing, guiding, supervising, motivating sub-ordinate for the achievement of organizational goals. Direction has following elements: Supervision Motivation Leadership Communication
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Hospital Management Controlling The purpose of controlling is to ensure that everything occurs in conformities with the standards. Controlling has following steps: • Establishment of standard performance. • Measurement of actual performance. • Corrective action
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DISTINCTION BETWEEN HOSPITAL AND INDUSTRY Hospitals has some difference from industries. • Hospital gives service to people by variety of skills. • Hospitals exist because people need care and nursing homes exist because of the need for long-term health care. • The nature of the demand for hospital services is also different, which cannot be provided at home. OBM752/HM/IV -IT/VII SEM/KG-KiTE DISTINCTION BETWEEN HOSPITAL AND INDUSTRY • The patient leaves home, family, friends, his work- place, his way of life for a new environment. • In this new environment, he has a definite role. • In the hospital, his role is similar to 30 or 40 others in the ward or unit in which he is a patient. • He is subjected to a new set of values and a new way of life. • A hospital deals daily with the life, suffering, recovery and death of human beings.
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DISTINCTION BETWEEN HOSPITAL AND INDUSTRY
Hospital is different in many aspects:
1. Complexity • Hospitals tend to have very complex organizational structures compared to industries. • A 400-bed hospital might have over 1,000 different job titles.
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DISTINCTION BETWEEN HOSPITAL AND INDUSTRY 2. Highly trained professionals • A large portion of the workforce- physicians, nurses, allied health and many technical positions, are highly trained and have a high level of autonomy. 3. Organization structure • Most of the time, products, services and processes are built around the customers. • But hospitals are built around doctors!
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DISTINCTION BETWEEN HOSPITAL AND INDUSTRY 4. Customer Service is no longer a 'nice to have' • Every company wants to improve customer service. • But with the new HCAHPS (Hospital Consumer Assessment of Health care Providers and Systems) requirements, patient scores are not a critical success metric for hospitals. 5. The nature of the Services • Hospitals need to deliver a combination of products, services and above all well being. • In industry, the margin of error should almost be nil
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DISTINCTION BETWEEN HOSPITAL AND INDUSTRY
Functions of Hospitals: 1. Training of Physicians, nurses and other personals 2. Prevention of disease and promotion of health 3. Advancement of research in scientific medicine 4. To provide care for the sick and injured
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CHALLENGES IN HOSPITAL ADMINISTRATION Challenges to administrative abilities have come from within the health field as well as from the public: 1. Business and professional leaders who were initiated into the hospital scene as trustees of voluntary hospitals 2. The large number of physicians who are especially worry about the facilities and services available for the care of their patients; 3. Professional organizations prescribe various standards of hospital operation while granting approval to the hospitals
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CHALLENGES IN HOSPITAL ADMINISTRATION 4. Academicians who are concerned about matching what they teach with the requirements of the patients and hospital administration; 5. Trustees of the Trust Hospitals, members of Registered Society Hospitals, shareholders of Corporate Hospitals, and other who have been their own masters and have been operating with no limits so far will have to face increasing professionalism threatening their power and existence.
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CHALLENGES IN HOSPITAL ADMINISTRATION Other Challenges: • The hospital CEO has to collect sufficient funds from patients rather than from trustees, society members, shareholders, etc. to run his hospital. • A new challenge is that of being environment friendly. Hospitals do not focus on safe environment. • The CEO of a hospital must be able to provide latest technology and vision. He should push for change when it is required in the interest of the patients, employees and the community
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CHALLENGES IN HOSPITAL ADMINISTRATION • The Chief Executive Officer of a hospital will have to serve as a catalyst for relationship building between patients and employees, government agencies and his hospital and between hospitals and his own hospital • It is also important for the hospital CEO to be a business practitioner first and then a technologist. His responsibilities include executive communication, budgeting, building relationships, management, problem solving etc. • CEO is primarily responsible to facilitate and communicate the hospital’s philosophy and vision
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CHALLENGES IN HOSPITAL ADMINISTRATION • The administrators of earlier hospitals usually were nurses who combined their nursing tasks with the performance of supervision of supply of cloth, feeding of patients and housekeeping. As the medical aspects of hospital service became more complex, physicians became administrators. • There's no doubt a hospital administrator's job is difficult and demanding, and it's only getting tougher.
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CHALLENGES IN HOSPITAL ADMINISTRATION 1. Compete for healthcare professionals: There is a real shortage of healthcare professionals, and it's hurting the profitability of hospitals as they pay more for every employee they hire. From 2008 and 2018, healthcare employment has grown by 23 percent, compared to only 9 percent in all other employment sectors, according to the Bureau of Labour Statistics. During that time, hospitals will be forced to compete for: • Registered nurses • licensed vocational nurses • Home health aides
OBM752/HM/IV -IT/VII SEM/KG-KiTE
CHALLENGES IN HOSPITAL ADMINISTRATION • Nursing aids and attendants • Physicians and surgeons
With this in mind, hospital administrators must
put a plan in place to address the shortage and compete for the best employees. As they compete, they must be skilled at recruiting and retaining qualified healthcare professionals.
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CHALLENGES IN HOSPITAL ADMINISTRATION • Hospital administrators need to build strong relationships with schools that offer healthcare-related degrees in their local communities and across the nation. • Additionally, they must make working at their hospital attractive, which means thinking beyond competitive pay and benefits to ensuring each individual employee feels connected to the hospital and has a passion for working for the organization OBM752/HM/IV -IT/VII SEM/KG-KiTE CHALLENGES IN HOSPITAL ADMINISTRATION 2. Specialize for growth: • With the rapid growth of specialty hospitals, physician-run outpatient surgery centers and diagnostic centers, traditional hospitals are facing increased competition. • To compete for patients, hospital administrators must be prepared to set their hospitals apart through a specialized care strategy. • Benchmarking best practices is essential; hospital administrators must take time to investigate other specialty healthcare providers in their local communities, identify areas of opportunity and put a strategic plan in place for building renowned specialty practices. During this process, they typically take numerous factors into consideration, including local demographics and competitors' areas of specialization. • With a specialization strategy solidified, hospital administrators must focus their efforts on recruiting specialized personnel and building a local reputation for excellence for the practice area. OBM752/HM/IV -IT/VII SEM/KG-KiTE CHALLENGES IN HOSPITAL ADMINISTRATION 3. Prepare for the future: • Hospitals are feeling the pressure to expand to meet growing demand. At the same time, hospitals are facing changes in the way they are paid. Reimbursements are shifting from a fee-for- service model to a model that is based on outcomes and overall quality of care. • When patient satisfaction plays a role in the way hospitals are paid, you can bet hospital administrators are making it a priority. • Therefore, hospitals are conducting extensive market research to ensure their expansion efforts are aligned with what consumers expect.
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CHALLENGES IN HOSPITAL ADMINISTRATION • For example, with the knowledge that women make most healthcare decisions in a family, one hospital decided to build an 18,000-square-foot imaging center for women with a spa- like atmosphere and robes. One children's rehabilitation hospital built a massive facility that comes complete with therapeutic gardens, play areas and even an all-grades school for inpatients. Other hospitals are converting semi-private rooms into private rooms, and there is a great deal of emphasis on making them safe and comfortable. • Having modern facilities with up-to-date medical equipment is crucial for hospitals that are competing for patients. With this in mind, hospital administrators must be prepared to balance current financial strain while positioning for the future. OBM752/HM/IV -IT/VII SEM/KG-KiTE CHALLENGES IN HOSPITAL ADMINISTRATION 4. Improve patient care through technology: • There's not a corner or crevice of healthcare that is not being affected somehow by technology. Medical providers throughout the country, for instance, are spending millions of dollars on electronic medical record systems that allow physicians and hospitals to seamlessly share patient information. • Ensuring that EMRs are effectively implemented within the healthcare organization is a critical role of healthcare administrators.
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CHALLENGES IN HOSPITAL ADMINISTRATION • Healthcare administrators need broad-based skills to integrate information and make evidence-based decisions. From electronic communication to order entry systems to the most advanced imaging technology, even the best technology is no good unless it's applied to improving organizational and patient outcomes. • Hospital administrators are responsible for making sure hospitals operate efficiently and provide quality medical care to patients. • As a result, they must keep up with advances in medicine, technology and government regulations and policy changes.
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HOSPITAL PLANNING The general public is now more alert to its health and in accepting the role of the hospital in its daily life. Today’s Patients are Better Informed Today’s patients are better informed and know more about health care services. This is why they make their own decisions- they shop for and select the best hospital; they choose their doctor or change him. Having become cost conscious, they demand quality care at a reasonable price. Hospitals of Yesteryear Health care has come a long way since Florence Nightingale tended the harmed soldiers in the Crimean War. There wasn’t enough of treatment and health care. The institution that we know today as the hospital is phenomenon of the last century
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HOSPITAL PLANNING Technological Advances With the rapid development and advances in technological, medical and administrative sciences and innovative techniques and therapies, today’s hospitals will become disappearing within a short time. One cannot even guess at the future miracles of medicine. That is why one planning design expert said, ”We have got to design ‘smart’ hospitals that respond to present needs while anticipating future changes.” In the early days, we talked of only general hospitals. Then came specialties in hospitals and now we are planning and designing superspecialty hospitals operated and managed by superspecialists. When our health is at stake, we want quality, whatever it takes. We demand the best and are willing to pay for it.
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HOSPITAL PLANNING Why Health Care Costs are High? • Because of the tremendous advances that have come about in treatment, technology and equipment. • For example, equipment such as the MRI, CT Scan, ultrasound, mammography, simulator and linear accelerator are so common and so necessary in today’s health care treatment requires huge investment. • On the treatment side, a cardiac patient who once would have been treated with drugs can now have a bypass operation or a pacemaker implant that would cost him a great deal of money. He recovers in the technologically advanced and sophisticated Coronary Care Unit (CCU) that would cost him Rs. 10,000 or more per day.
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HOSPITAL PLANNING • A person who at one time would have died of kidney failure now receives dialysis at considerable cost; alternatively he can have a new kidney – a transplant that would cost upward of few lakh of rupees. • Many hospitals fit the bill as “hospitals of people’s choice.” They are operated efficiently and furnish a high standard of patient care. • And yet, there are a vast number of hospitals in India in which standards of care are low. These standards must be improved if those hospitals have to meet people’s growing expectations. • Today’s patients recognize the distinction between good and common place hospitals.
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HOSPITAL PLANNING Planning for a New Hospital: • First step is always a dream or an idea born in the mind of an individual. • Gather support of other people. • A committee is then formed and is given the authority to undertake preliminary work such as a feasibility study and to raise funds to meet the expenses involved in the survey and study. • All successful hospitals, are built on a harmony of good panning, good design and construction, and good administration. • The success of a hospital is generally measured by the quality of patient care it provides and the efficiency with which it operates.
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HOSPITAL PLANNING Successful hospital: To be successful, a hospital requires a great deal of preliminary study and planning. It must be designed to meet the needs of the people it is going to serve. It must be staffed with adequate number of efficient doctors, nurses and other professionals. The staff must be able to render quality and adequate care to the community they serve.
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HOSPITAL PLANNING Planning involves six question • What we expect to do? • Why it is to be done? • Where will it be done? • When are we expected to do it? • Who all are going to do it? • How will it be done?
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HOSPITAL PLANNING Planning Team • Hospital administrator • Specialists from various clinical branches • Nursing advisor • HR manager • Civil and electrical engineers • Representative of local body • Senior architect OBM752/HM/IV -IT/VII SEM/KG-KiTE HOSPITAL PLANNING The graphic presentation of the different stages in promoting and building a new hospital is as follows:
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EQUIPMENT PLANNING • Hospital planning is not complete if careful attention is not given to the fixed and movable equipment needed for the hospital. • With the exception of items of current operating expense such as food, fuel, drugs, dressings, paper, printed forms, soap, etc.
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EQUIPMENT PLANNING • The term “equipment” means all items necessary for the functioning of all services of the hospital including accounting and records, maintenance of buildings and grounds, laundry, public waiting rooms, public health and related services. • Medical equipment is a vital component in healthcare delivery. Equipping health facilities need detail planning and coordination, clinical needs and the equipment requirements are met with the design and function. • The ultimate objective is to ensure all products selected are fit for purpose, within budget and, procured, delivered and commissioned in accordance with projects build programme. • Healthcare Equipment Planning is a specialized process and requires not only a clear understanding of the clinical need but also a knowledge of budgeting, architectural design and building process. OBM752/HM/IV -IT/VII SEM/KG-KiTE EQUIPMENT PLANNING Equipment for a new hospital may be classified into the following three groups based on the usual methods of acquisition and on suggested accounting practices with regard to depreciation. 1. Built-in Equipment: • This is usually included in the construction contracts. • Examples are cabinets and counters in the pharmacy, laboratory and other parts of the hospital, fixed kitchen equipment, laundry chutes, elevators, dumb waiters, boilers, cold rooms/walk-in coolers, deep freezers, fixed sterilizing equipment and surgical lighting. • The planning and design of fixed equipment built into the hospital facility is the architect’s responsibility.
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EQUIPMENT PLANNING 2. Depreciable Equipment: • Equipment that has a life of five years or more is not normally purchased through construction contracts. • These large items of furniture and equipment have reasonable fixed location in the hospital building but are capable of being moved. • Examples are surgical apparatus, diagnostic and therapeutic equipment, laboratory and pharmacy equipment, office equipment, etc. • Equipment that is not included in the construction contract but which require mechanical or electrical service connections or construction modifications shall, as far as is practical, be identified on the design development drawings to ensure its coordination with the architectural, mechanical and electrical phases of construction. OBM752/HM/IV -IT/VII SEM/KG-KiTE EQUIPMENT PLANNING 3. Non- depreciable Equipment: • Equipment having less than five years’ life span is purchased through ways other than construction contracts. • These are generally small items of low unit cost under the control of the storeroom. • Examples are kitchen utensils, chinaware, tableware, surgical instruments, catheters, linen, sheets, blankets, lamps, wastebaskets, etc. The consultant must prepare a list of all the items under groups 2 and 3 given above. OBM752/HM/IV -IT/VII SEM/KG-KiTE EQUIPMENT PLANNING • The first step in preparing this list is to consider each room as a separate entity and prepare a comprehensive room-by-room equipment list, which should include additional items that may be required for the hospital. Detailed specifications must be given. • This task must be undertaken at the stage of design development itself. Working closely with the architect, the consultant should test the space needed for each item of equipment on the list. • The selection of technical, scientific and medical equipment requires careful analysis of each department’s needs and conscientious study that will result in selecting equipment that will best meet the needs. • Department heads and staff members should be fully satisfied with the type and quality of the equipment. They should therefore be consulted before purchase. • It is necessary to consult with the architect designing the building early so that the facilities planned will be of sufficient size to accommodate the equipment and render the necessary service. OBM752/HM/IV -IT/VII SEM/KG-KiTE FUNCTIONAL PLANNING Functional planning in hospitals is important, and the key to this is the understanding that travel and adjacencies affect the operational cost over the life of the building. The main function of a hospital is to provide the population with complete health care; it also functions as the center for the training of health workers.
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FUNCTIONAL PLANNING Following are some of the broad categories of Hospital functions: Medical care ‐ which involves the treatment and management of patients through the staff of physicians. Patient Support ‐ which relates directly to patient care and includes nursing, dietary diagnostic, therapy, pharmacy and laboratory services. Administrative ‐ which concerns the execution of policies and directions of the hospital governing discharge of support services in the area of finance, personnel, materials and property, housekeeping, laundry, security, transport, engineering and board and other maintenance. OBM752/HM/IV -IT/VII SEM/KG-KiTE FUNCTIONAL PLANNING Functional planning covers the following activities. 1. Determining approximate section wise workload. 2. Determining services to be provided (for inpatients/ outpatients, for other departments, smaller hospitals and private practitioners). 3. Determining area and space requirement to accommodate equipment, furniture and personnel in technical, administrative and auxiliary functions. 4. Dividing the area into functional units, biochemistry, microbiology, histopathology, urinalysis, etc. 5. Determining the number of workstations in each functional unit/division and deciding the linear bench space allotted for each work station. 6. Determining the major equipment and appliances in each unit. This is generally classified into: i. Technical equipment peculiar to certain workstations ii. Other equipment and appliances e.g. (refri-gerators, hot air ovens, centrifuges) that can be jointly used by different workstations or units.
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FUNCTIONAL PLANNING 7. Determining the functional location of each section in relation to one another, from the point of view of flow of work and technical work considerations. 8. Identifying the electrical and plumbing requirements for each area/work station. Independent electric circuits are required for electronic equipment items. Location of sinks and wash areas are vital for efficient performance of workstations. 9. Considering utilities, lighting, ventilation (forced or normal exhaust, air-conditioning and air hygiene) and isolation of equipment or workstations. 10. Working out the most suitable laboratory space unit, which is a standard module for work areas. A standard module facilitates rearrangement of work units with least disruption and minimal structural changes. OBM752/HM/IV -IT/VII SEM/KG-KiTE OBM752/HM/IV -IT/VII SEM/KG-KiTE