The document discusses hospital planning and administration. It begins by defining a hospital and the roles of various healthcare professionals. It then covers topics like hospital organization, managing patient care, support services, and administrative responsibilities. Key aspects of hospital planning discussed include need analysis, site selection, equipment planning, interior design, and managing quality patient care. The document emphasizes the importance of policies, guidelines, staff training, and monitoring in delivering efficient patient care services.

1. Health Care Management- A
Young Challenge
Sunil Joshi
Shree Krishna Hospital,
Karamsad

2. “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

3. Learning Objectives
 Career in Health care – Challenges and Future
 Hospital Planning-
Hospital & Its Organization
Hospital Administration
 Managing Patient Care
Quality Patient Care
Management
Policy & Consideration
 Managing Support Services

4. Hospital
Hospital is a place for the diagnosis and treatment of human ills and
restoration of health and well-beings of those temporarily deprived
of these

5. Genesis of Health Care & Administration
 One of the Fastest growing sectors in India
 “HIDDEN” career as per the American college of Health Care Executives.
 Hospitals have become large, complex organizations
 Technology has advanced exponentially
 Government has taken on a larger role in healthcare delivery.

6. Roles of Today’s Professionals
 Human resources management
 Financial management
 Cost accounting
 Data collection and analysis
 Strategic planning
 Marketing
 Maintenance functions of the organization.
 Maintaining the moral and social order of healthcare organizations
 Serving as patient advocates.
 Serving as arbitrators in situations where there are competing values.
 Serving as intermediaries for the various professional groups.

7. Hospital Administrator's Toolbox
 Ability to manage operations, budgets, staffing issues.
 Being able to work closely with a variety of strong personalities
 Peace making skills
 Sensible listener
 Detail-oriented
 Strong analytical skills
 Able to sum up a situation very quickly- Decision Making.
 Rationale
 Top-notch communication skills
 Ability to lead- Accountable and assertive

8. Challenges
 Ensuring effective, efficient healthcare
services for communities
 Shortages of nurses and other healthcare
workers
 Concern for the safety and quality of
healthcare services
 Rising healthcare costs
 An aging population
 Rapidly changing medical terminology and
practice

9. Current Trends in Hospital Administration
 Cost-Cutting Focus
 Man-power Shortage
 Health Care IT Management Professionals in Demand
 Drug Shortage Becomes Top Priority
 Social Media in Health Care
 Population Health Management Strategies to Advert
Readmissions
 Privacy Becomes More Important
 Compliance to State and Federal Laws
 Process Improvements
 Implementation of Technological Advancements
 Evolving Leadership Opportunities

10. Choosing a Career in Health Care Administration

11. Hospital Planning
A design expert says-
“we’ve got to design ‘smart’
hospitals that respond to
present needs while
anticipating future changes.

12. PLANNING A HOSPITAL
 A good hospital is built on a triad of good
planning, good design & construction &
good administration
 Designed to serve people and for
promoters to build in the first place &
sustain later
 Competent and adequate number of
Manpower
 A strong management- For everyday
operations.

13. Classification
There are various classifications to the types of hospital
 According to Objectives- Teaching Hospitals, General
Hospital, Specialized Hospital etc.
 According to Ownership- Government hospitals, Semi-
Government hospitals, Voluntary Agencies’ hospitals,
Private/Charitable hospitals
 According to Systems of Medicine- Allopathic,
Ayurveda, Unani, Homeopathy etc.
 According to size- Teaching Hospitals(500 beds),
District Hospitals(200 beds), Taluk Hospitals(50 beds),
PHCs(6 beds)

14. Need Analysis- Does
Community need a Hospital?
There are two methods to estimate
the need for hospital in a
population:
• Analytical method: Taking
feedback and analysis of data
collected through survey e.g.
distributing questionnaire.
• Estimation method- needs of the
community

15. THE 5W-1H Approach
 What we expect to do?
 Why it will be done ?
 Where will it be done ?
 When we expect to do it?
 Who all are going to do it ?
 How will it be done ?

16. Guiding principles to hospital planning
High Quality Patient Care
Effective Community Orientation
Economic Viability
Sound Architectural Plan
Excellent firms don’t believe in excellence – only in
constant improvement and constant change
-Tom Peters

17. Data required in hospital
Planning
Demographic Details
Population Strength
Sex & Age Ratio
Geographic Data
Morbidity & Mortality Status
Need & Demand
Details of existing Facilities
Financial Feasibility

18. Meeting Fundamental
Needs-
Must meet the needs of the
patient it is going to serve
adequately.
It must be in a size and
proportions which the
owners or promoters will be
able to build and operate

19. PLANNING TEAM
• Hospital administrator
• Specialists from various clinical
branches
• Nursing advisor
• Civil and electrical engineers
• Representative of local body
• Senior architect

20. OBJECTIVES OF PLANNIG TEAM
Existing facilities & its adequacy
Asses the needs of area
Needs of new facilities so as to
provide
Adequate, qualitative health are
services

21. MARKET SURVEY
One the first tasks of the any organization is
to survey the service area of the proposed
hospital.
Following bodies helps in market survey-
• Banks
• CA firms
• Financial Institutions
• Consultant
Since major decisions will be on the result of
the survey, it must be done in a professional
manner.

22. FINANCIAL PLANNING
• Financial planning must take precedence
over every other consideration.
• Financial planning must cover the following
three areas:
Constructing, Equipping & Furnishing the
Hospital
Operating Funds
Financial Assistance

23. EQUIPMENT PLANNING
 The term ‘equipment’ means all items
necessary for the functioning of all services of
the hospital.
 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 & render the
necessary services.
 A room by room equipment list is then
complied & reviewed by the administration,
medical & departmental staff

24. Types of Equipment to be installed…….
 Built-in Equipment's- Usually included in the
construction contract and is responsibility of
architect. For e.g. cabinets, incinerators, coolers,
pharmacy, Lines, fixed sterilizing equipment's etc.
 Depreciable Equipment's- equipment’s that has
life of five years and is not purchased through
contract like laboratory and diagnostic equipment's,
office furniture's etc.
 Non-Depreciable Equipment’s- They include the
items with a low unit cost and life span less than five
years. They are usually under control of the store.
Like kitchen utensils surgical instruments, waste
basket

25. SITE SELECTION
 Accessibility to transportation &
communication lines
 Parking facilities
 Availability of public utilities
 Proper elevation for drainage & general
sanitary measures
 Freedom from smoke, noise, vapours &
other annoyances
 Future expansion
 Total cost

26. INTERIOR & FURNISHING
In a patient centred environment,
design solutions will respond to the
needs of the patients profile both
architecturally and through material
selections. Should consider the
following-
 Infection control standards
 Design story
 Healing environment
 Physical environment
 Organizational planning understanding
 Cost analysis

27. GENERAL FEATURES
• Environment
• Screened windows
• 4 separate entrance
• Exit point
• Attractive entrance
• Traffic flow
• Corridors
• Visitors control
• Running physical part
• Fire escape

28. OPERATION PROGRAM
Admission Administration Stores Human Resources
General
Engineering
Laundry Maintenance Purchasing
Clinical
Services
Pharmacy Fire and Safety Waste Disposal
Nursing
Services
Records Dietary Services Information
Public
Relations
Employee facilities Clinical Engineering Disaster Plan

29. SHAKE DOWN PERIOD
After the commissioning of hospital some time is taken for
functional integration of different units, services, staff, patient &
community.
 Machine are tested
 Staff recruited & trained
 Standard operating procedures are made
 Maintenance service is put in place
 Materials, linen & stationary procured
Then starts the routine & regular functioning of the hospital.

31. MANAGING QUALITY PATIENT CARE
• The degree to which health services for individuals and populations
increase the likelihood of desired health outcomes and are
consistent with current professional knowledge.”

32. Issues that need to be addressed to
improve patient care
• Access. Accessibility and availability of both the hospital and the physician
• Waiting. Waiting times for all services should be minimized
• Information. Patient information and instruction about all procedures, both
medical and administrative, should be made very clear
• Administration. Check-in and check-out procedures should be ‘patient
friendly’
• Communication. Communicating with the patient and the family about
possible delays is a factor that can avoid a lot of frustration and anxiety.
• Ancillary Services. Other services such as communication, food, etc.
should be accessible both to patients and to attending families

33. ADMINISTRATIVE ELEMENTS

34.  Planning needs knowledge, experience, foresight, reasoning
and the mastering of special skills and techniques. Its must be :
 Futuristic
 Decision Making Process
 Dynamic
 Flexible
 The Organizational process is classified into:
Structural organization
Functional organization
 There must be a good Co-ordination.

35.  Staffing is the process of “personalizing” the organization, by hiring the
right type and adequate number of workers to each unit for the time
required
 Budgeting is the financial administration. About 60 percent of total
budget is spent in wages & salaries of the staff in a hospital.
• To ensure adequate care & treatment there must be:
• Regular Auditing
• Purchasing of modern equipments and maitainance
• Supervision of both work & workers by the Executive
• Evaluation of activities, characteristics, outcome of the health care
process to improve effectiveness & make decision for efficient planning.

36. Administrative Structure

37. THE MEDICAL STAFF
• The physician is the leader of the
clinical team and the major agent
working on behalf of the patient.
• The physician's responsibility is to
diagnose the patient's condition
accurately and to prescribe the
best and most cost-effective
treatment plan

38. NURSING SERVICES
• Nurses are one of the few blessings of
being ill.
• Nursing services employees are
responsible for carrying out the
treatment plan developed by the
physician.
• Nursing services, also called patient
care services, is the largest component
of the hospital

39. ALLIED HEALTH SERVICES
• The clinical laboratory is a
diagnostic centre that performs a
variety of functions, including
autopsy, clinical cytology, and
clinical pathology.
• Also medical technologists,
radiology department and
rehabilitation services.

40. CLINICAL SUPPORT SERVICE
• The hospital pharmacy purchases
and dispenses all the medications
used to treat patients in the hospital.
• The pharmacist works directly with
the medical staff in establishing a
formulary, the listing of drugs
chosen to be included in the
pharmacy

41. LINE SERVICE
• Emergency services Diagnosis & treatment of illness
of an urgent nature & injuries from accidents
• Out-Patient services Provision of diagnostic,
curative, preventive and rehabilitative services
• In-patient services (Wards)
• Intensive care unit Those who need Acute,
multidisciplinary and intensive observation and
treatment
• Operation theatres Should have a pre anaesthesia
room and sterilization room and a scrub room for
doctors and nurses

42. Managerial
Considerations
OVER
CROWDING
STAFF
TRAINING
MOTIVATION
APPOINTMENT
SYSTEM
SIGNAGES
PROPER
MANAGEMENT
STRUCTURE
MONITORING/S
UPERVISOR
QUALITY OF
CARE
POLICY AND
GUIDELINES

43. POLICY AND GUIDELINES
Healthcare managers of all levels and specializations are critical to
guarantee a hospital functions in a competitive, effective,
profitable and satisfactory manner.

44. • Modern well equipped
technology and methods
• Obtain total patient satisfaction
• Sustained and continuity of high
standard patient care
• Highly motivated and trained,
skilled hospital staff
• Manual of procedures for
hospital staff
• Periodic training and review
system
• Morning and afternoon clinics

45. • Modern System of
appointment. e.g. e-
hospital management
• Proper Fire system and
well maintained
evacuation plans

46. ADMINISTRATIVE RESPONSIBILITIES
 Procedure manual of patient care
at various areas of health care
 Advisory responsibility, planning and
budgeting
 Nursing training and research in
services
 Recruitment, promotion and
development of nursing staff

47. •Staff meetings,
monitoring &
evaluation of service
•Maintenance of
discipline, reward and
punishment

48. Welfare measures, residential accommodation, health
promotion, recreation and other utility service like canteen,
pharmacy, bank etc.

49. Florence Nightingale quotes-
“The very first requirement in a hospital that it should do the sick
NO HARM”