contents Introduction Strategic initiatives for Hospitals Infrastructure of Hospital Health Information technology HIT functional units Benefits of HIT Essential manpower Medical equipments for Hospitals Patient Care Introduction: From its gradual evolution through the 18th &n19th centuries the hospital has come of age only recently during the past 50 years A hospital is an integral part of a social and medical organization, the function of which to provide for the complete health care, both curative and preventive and whose outpatient services reach out to the family and its home environment; the hospital is also a center for training of health workers and biosocial research. Hospital management is the field relating to leadership, management and administration of public health systems, health care systems, Hospitals and hospital networks in all the primary, secondary and tertiary sectors. The Clinical Establishments (Registration and Regulation) Act, 2010 has been enacted by the Central Government to provide for registration and regulation of all clinical establishments in the country with a view to prescribe the minimum standards of facilities and services provided by them. The minimum standards for Allopathic hospitals Under Clinical Establishment Act, 2010 are developed on the basis of level of care provided, as defined below General Medical services with indoor admission facility provided by recognised allopathic medical graduate(s) and may also include general dentistry services provided by recognized BDS graduates. Example: PHC, Government and Private Hospitals and Nursing Homes run by MBBS Doctors etc. Aims and activities : Improve the patient experience. Measure and report quality performance. Adopt to new payment models. Address the possible impact of health insurance exchanges. Work on an approach to population health management. Focus on clinical integration Explore new physician alignment strategies. Respond to an aging population. some of the strategic issues that must be considered are – • Regionalization • Pre- planning consideration • Need assessment • Plot ratio • Design for flexibility and expandability • Fulfill the demand functions • Emphasize on patient focused hospital • Focus on energy conservation Intelligent buildings • Create a healing architecture • Aesthetic – an essential requisite • Hospital architecture • Go green Protection from unwanted and unnecessary disturbances in order to help speedy recovery Separation of dissimilar activities Control – the nurses station should be positioned strategically to enable proper monitoring of visitors entering and leaving the ward, infants and children should be protected from theft and infection etc. Circulation- all the departments of a hospital must be properly integrated. (“separate all departments, yet keep them all together; separate types of traffic, yet save steps for everybody; that is all there is to hospital planning “– Emerson Goble) IT App

1. HOSPITAL MANAGEMENT
STRATEGIES
Presenter: Dr.Soumya P
Guide : Dr SunilKumar M Chabanur

2. Contents
• Introduction
• Strategic initiatives for Hospitals
• Infrastructure of Hospital
• Health Information technology
• HIT functional units
• Benefits of HIT
• Essential manpower
• Medical equipments for Hospitals
• Patient Care

3. INTRODUCTION
• From its gradual evolution through the 18th &n19th
centuries the hospital has come of age only recently during
the past 50 years
• A hospital is an integral part of a social and medical
organization, the function of which to provide for the
complete health care, both curative and preventive and
whose outpatient services reach out to the family and its
home environment; the hospital is also a center for training
of health workers and biosocial research.
• Hospital management is the field relating to leadership,
management and administration of public health systems,
health care systems, Hospitals and hospital networks in all
the primary, secondary and tertiary sectors.

4. CEA
• The Clinical Establishments (Registration and
Regulation) Act, 2010 has been enacted
by the Central Government to provide for
registration and regulation of all clinical
establishments in the country with a view to
prescribe the minimum standards of facilities and
services provided by them.
• The minimum standards for Allopathic hospitals
Under Clinical Establishment Act, 2010 are
developed on the basis of level of care provided,
as defined below

5. Hospital Level 1 (A)
• General Medical services with indoor
admission facility provided by recognised
allopathic medical graduate(s) and may also
include general dentistry services provided by
recognized BDS graduates.
• Example: PHC, Government and Private
Hospitals and Nursing Homes run by MBBS
Doctors etc.

6. Strategic initiatives for Hospitals
• Improve the patient experience.
• Measure and report quality performance.
• Adopt to new payment models.
• Address the possible impact of health
insurance exchanges.

7. Cont…
• Work on an approach to population health
management.
• Focus on clinical integration
• Explore new physician alignment strategies.
• Respond to an aging population.

8. Strategies
some of the strategic issues that must be
considered are –
• Regionalization
• Pre- planning consideration
• Need assessment
• Plot ratio
• Design for flexibility and expandability
• Fulfill the demand functions
• Emphasize on patient focused hospital
• Focus on energy conservation

9. • Intelligent buildings
• Create a healing architecture
• Aesthetic – an essential requisite
• Hospital architecture
• Go green

10. Principles of hospital planning
• Protection from unwanted and unnecessary disturbances in
order to help speedy recovery
• Separation of dissimilar activities
• Control – the nurses station should be positioned strategically
to enable proper monitoring of visitors entering and leaving
the ward, infants and children should be protected from theft
and infection etc.
• Circulation- all the departments of a hospital must be
properly integrated.
(“separate all departments, yet keep them all together;
separate types of traffic, yet save steps for everybody; that is
all there is to hospital planning “– Emerson Goble)

11. INFRASTRUCTURE REQUIREMENTS
Sl no ward area
1 Ward bed and surrounding space 6sqm/ bed;
Desirable: in addition circulation
space of 30% as indicated in
total area shall be provided for
Nursing
station, Ward store, Sanitary etc
2 OT for minor procedures (where
applicable)
10.5sqm(Desirable)
3 Labour Table and surrounding space 10.5 sqm/ labour table
4 Other areas- nursing station, doctors’ duty
room, store, Clean and dirty utility,
Circulating area, Toilets
10.5 sqm for clean utility and
store and 7 sqm for dirty utility
and 3.5 sqm for toilet

12. Wards
• The ward shall also have designated areas for nursing station,
doctors’ duty room, store, clean and dirty utility, janitor room,
toilets and this shall be provided from circulation area.
• For a general ward of 12 beds, a minimum of 1working counter and
1 hand wash basin shall be provided.
• Distance between beds shall be 1.0 metres(Desirable).
• Space at the head end of bed shall be 0.25 metres.
• Door width shall be 1.2 metres(Desirable) and corridor width 2.5
metres(Desirable).

13. Bed planning
Bed: Population = A x S x 100
365 x PO
A= number of inpatient admissions/1000
population/year
S= average length of stay
PO= percentage occupancy

14. Health information technology
• Health Information Technology uses computers and
computer programs to store, protect, retrieve, and transfer
clinical, administrative ,and financial information
electronically.
• New ways for providers and their patients to readily access
and use health information.
• IT (Information technology) allows health care providers to
collect, store, retrieve and transfer information
electronically
• Health Information Technology (HIT) has the potential to
improve the health of individuals and the performance of
providers, yielding improved quality, cost savings of
patients in their own health care.

15. Need for IT in hospital

16. IT APPLICATIONS IN HEALTH CARE
•ELECTRONIC MEDICAL RECORDS
•HOSPITAL INFORMATION SYSTEM
•INTRANETS
•PUBLIC NETWORKS
•HEALTH DECISION SUPPORT
•EXPERT SYSTEMS
•TELEMEDICINE
•COMMUNITY HEALTH
•INFORMATION SYSTEM

17. Electronic medical records
ELECTRONIC MEDICAL RECORDS (EMR)
The IOM 2003 Patient Safety Report describes an EMR as
1. A longitudinal collection of electronic health
information for and about persons,
2. Immediate electronic access to person- and
population-level information by authorized users,
3 Provision of knowledge and decision-support systems
that enhance the quality, safety, and efficiency of patient
care,
4. Support for efficient processes for health care delivery.

18. Electronic health records
EHR (Electronic Health Record) is term applied to electronic patient care
systems
Primary uses
• Patient care delivery
• Patient care management
• Patient care support processes
• Financial and other administrative
• processes
• Patient self-management
• Secondary uses
• Education
• Regulation
• Research
• Public Health and Homeland Security
• Policy Support

19. H.I.T. functional Units.
• Computer Services.
• Project Management Team
• Information Technology Application support
and training Department.
• Web services.

20. Benefits of H.I.T
• Patient Monitoring: With the help of a
Computerized system. We can react much
more quickly and Accurately.
• Reduction of errors in the patient care.
• Assisting the physicians in medical diagnosis.

21. Cont…
• Digitalized reception counters.
• Laboratory.
• Radiology Department.
• Well developed OPDs.
• Pharmacy
• Billing Counter
• Special and General wards
• Nursing Chamber and Doctors rooms.

22. Essential manpower
• Health manpower means people who are trained
to promote health, to prevent and cure disease
and to rehabilitate the sick.
• Health manpower includes:
• Those health workers who are already working in
the field of health services.
• Prospective health workers, i.e., those who are
receiving education and training that will prepare
them for employment in the health sector

23. Human resource
1. Doctor Qualified doctor shall be available round the clock on
site(Desirable for 1A). Level 1A shall have a MBBS
qualified doctor. (Qualified doctor is a MBBS
approved as per state government rules &
regulations as applicable from time to time).
Level 1B shall have MBBS doctor with
required post-graduation qualification.
2. Nurses Qualified nurses per unit per shift shall be available as
per requirement laid down by “The Indian Nursing
Council, 1985”, occupancy rate and distribution of
bed.(Desirable)
3. Pharmacist (If in house
pharmacy available)
1 in a hospital
4. Lab Technician (if in house
laboratory service available)
1 in a hospital (minimum DMLT) BSc, MSc
,MLT(Desirable)
5. X-ray Technician (if in house
X-ray facility available)
1 in a hospital (minimum Diploma in X Ray
Technician course)
6. Multi Task staff Minimum 1

24. SLNO STAFF 50 BEDDED 100 BEDDED
1 Hospital superintendent 1 1
2 Medicine specialist 1 1
3 Surgery Specialist 1 1
4 O&G specialist 1 1
5 Dermatologist/Venereologist 1
6 Paediatrician 1 1
7 Anesthetist (Regular/trained) 1 1
8 ent surgeon 1 1
9 Opthalmologist 1 1
10 Orthopedician 1 1
11 Radiologist 1 1
12 Casualty Doctors/General Duty Doctors 7 (3 lady MOs) 9(atleast4
female doctors
from allopathy)
13 Dental surgeon 1 1

25. ADMINISTRATIVE STAFF
Sl. No. S
T
A
F
F
31-50 Bedded Sub-
district
Hospital
51-100 Bedded Sub-
district
Hospital
1 Junior Administrative
Officer/Office
Superintendent
1 1
2 Accountant 2 2
3 Computer operator 4 6
4 Driver 1 2
5 Peon 2 2
6 Security Staff* 2 2
Total 12 15

26. MAN POWER BLOOD STORAGE UNIT
Sl. No. Item 31-50 Bedded Sub-
district Hospital
51-100 Bedded
Sub-district
Hospital
1 Staff Nurse 1 1
2 Attendant 1 2
3 Blood Bank/Storage
Technician
1 3
4 Safai Karamchari 1 2

27. Medical Equipments for Hospital
• Examination Table
• Writing tables
• Chairs
• Almirah
• Waiting Benches
• Medical/Surgical Beds
• Labour Table- if applicable
• Wheel Chair/Stretcher
• Medicine Trolley,
Instrument Trolley
• Screens/curtains
• Foot Step
• Bed Side Table
• Baby Cot- if applicable
• Stool
• Medicine Chest
• Examination Lamp
• View box
• Fans
• Tube Light/ lighting fixtures
• Wash Basin
• IV Stand
• Colour coded bins for BMW

28. Emergency equipment
S. No. Name of Emergency Equipment
1 Resuscitation equipment including Laryngoscope, endotracheal tubes, suction equipment,
xylocaine spray, oropharyngeal and nasopharyngeal airways, Ambu Bag- Adult &Paediatric
(neonatal if indicated)
2 Oxygen cylinders with flow meter/ tubing/catheter/face mask/nasal prongs
3 Suction Apparatus
4 Defibrillator with accessories (Desirable)
5 Equipment for dressing/bandaging/suturing
6 Basic diagnostic equipment- Non mercury Blood Pressure Apparatus,
Stethoscope, weighing machine, thermometer (Non mercury)
7 ECG Machine
8 Pulse Oximeter (Desirable)
9 Nebulizer with accessories

29. Patient Care
• Respect for patients values, preferences and
expressed needs : Should treat patients with
dignity, respect and sensitivity to his/her
cultural values and autonomy.
• Coordination and integration of care: Should
be proper coordination of clinical care and
coordination of front – line patient care.

30. Cont…
• Information and Education: Should educate
the patient regarding suffering disease and
Give information about the medical
procedures.
• Physical Comfort: Pain management in
treatment aspect, Hospital surroundings and
environment. These two points have major role
in patient caring.