Hospital Business Management

Published by: Cygnus Business Consulting and Research

Published: Jan. 1, 2009 - 241 Pages

Table of Contents

EXECUTIVE SUMMARY

HIGHLIGHTS

1. Functions of hospitals

1.1 Patient Care

1.2 Training

1.3 Medical Research

1.4 Health Education

2. Medical Specialities

2.1 General Medicine

2.2 Surgery

2.2.1 Types of Surgery

2.2.1.1 Amputation

2.2.1.2 Replantation Surgery

2.2.1.3 Reconstruction Surgery

2.2.1.4 Elective Surgery

2.2.1.5 Emergency Surgery

2.2.1.6 Minimally invasive Surgery

2.2.1.7 Laser Surgery

2.2.1.8 Microsurgery

2.2.1.9 Robotic Surgery

2.3 Pathology

2.3.1 Anatomical pathology

2.3.1.1 Surgical pathology

2.3.1.2 Cytopathology

2.3.1.3 Forensic pathology

2.3.2 Clinical Pathology

2.4 Obstetrics & Gynaecology

2.4.1 Obstetrics

2.4.2 Gynaecology

2.4.3 Oncology

2.5 Paediatrics

2.5.1 Paediatric plastic surgery

2.6 Orthopaedics

2.6.1 Orthopaedic surgery

2.7 Ophthalmology

2.7.1 Astigmatism

2.7.2 Cataracts

2.7.3 Glaucoma

2.8 ENT (Ear Nose Throat)

2.8.1 Otology and Neurotology

2.8.2 Paediatric Otolaryngology

2.8.3 Rhinology

2.8.4 Laryngology

2.8.5 Inhalant Allergy

2.9 Dermatology

2.9.1 Venereology

2.9.2 Phlebology

2.9.3 Cosmetic dermatology

2.10 Cardiology

2.10.1 Interventional cardiology

2.10.2 Electrophysiology

2.10.3 Nuclear cardiology

2.10.4 Echocardiography

2.11 Oncology

2.11.1 Medical oncology

2.11.2 Surgical oncology

2.11.3 Radiation oncology

2.12 Psychiatry

2.12.1 Biological psychiatry

2.12.2 Child and adolescent psychiatry

2.12.3 Community psychiatry

2.12.4 Cross-cultural psychiatry

2.12.5 Emergency psychiatry

2.12.6 Forensic psychiatry

2.12.7 Geriatric psychiatry

2.12.8 Liaison psychiatry

2.12.9 Military psychiatry

2.12.10 Neuropsychiatry

2.12.11 Social psychiatry

2.13 Neurology

2.13.1 Neurosurgery

2.14 Gastroenterology

2.14.1 Surgical Gastroenterology

2.15 Others

2.15.1 Endocrinology

2.15.2 Pulmonology

2.15.3 Nephrology

2.16 Co-ordination among Specialties

2.17 Constraints and Limitations in Successful Treatment

2.17.1 Patient satisfaction

2.17.2 Throughput vs. cost control

2.17.3 Financial leverage

3. Classification of Hospital Services

3.1 Line Services

3.1.1 Outpatient Services

3.1.2 Inpatient Services

3.1.3 Emergency Services

3.1.4 Intensive Care Units

3.1.5 Operation Theatre

3.2 Supportive Services

3.2.1 Nursing Services

3.2.2 Central Sterile Supply Management

3.2.3 Diagnostic Services

3.2.4 Pharmacy Services

3.2.5 Radiology

3.2.6 Diet Management

3.2.7 Laundry

3.2.8 Stores

3.3 Auxiliary Services

3.3.1 Records Management

3.3.1.1 Classification of records

3.3.1.2 Advantages and uses of record keeping

3.3.1.3 Mechanism of record management

3.3.1.4 Contents of medical records

3.3.1.5 Issues & problems in maintaining medical records.

3.3.1.6 Maintenance of hospital statistics and its uses

3.3.2 Ambulance & Transport

3.3.3 Security

3.3.4 Engineering and Maintenance Services

3.3.5 Mortuary

3.3.6 Waste Management

3.3.6.1 Industrial waste / Hazardous waste

3.3.6.2 Municipal solid waste

3.3.6.3 E-waste

3.3.6.4 Biomedical waste / Hospital waste

3.3.6.5 Elements of a comprehensive waste management system

3.3.6.6 Techniques for Treating Hospital Waste

4. Administration of Outpatient Services

4.1 Managing Patient Inflows

4.2 Time Management

4.3 Ambience Management

4.3.1 Beautification

4.3.2 Noise Levels

4.3.3 Courtesy

4.3.3.1 Maintaining a healthy relationship

4.3.3.2 Importance of human relationships in hospitals

4.3.3.3 Relationship between Doctor/Nurse and Patient

4.4 Need for Regionalisation & Referral System

4.5 Facilities for Attendants and Visitors

4.6 Maintenance of Quality and Image

4.7 Public Relations Management

4.7.1 Hospital and Media Relations

5. Administration of Inpatient Services

5.1 Ward Administration

5.1.1 Emergency and Trauma Services

5.1.1.1 Objectives of emergency and trauma services

5.1.1.2 Planning parameters for trauma centre

5.1.1.3 Essential requirements for trauma centre

5.2 Nursing Department

5.2.1 Structure of Nursing Department

5.2.2 Communication and Coordination

5.2.3 Supervision and Control

5.2.4 Patient Nurse Ratio

5.3 Operation Theatres

5.3.1 Biomedical & Diagnostic Equipment

5.3.1.1 Procurement

5.3.1.2 Handling

5.3.1.3 Maintenance

5.3.2 Central Sterile Supply Department (CSSD)

5.3.2.1 The Scope

5.4 Measuring Efficacy of Hospitals

5.5 Medical Audit

5.5.1 Definition:

5.5.2 Purpose

5.5.3 Importance of Medical Audit

5.6 Discharge Planning

5.6.1 Meaning of Discharge Planning

5.6.2 People Involved in Discharged Planning

5.6.3 Timing of Discharge

5.7 Resources Mobilisation and Cost Consciousness

6. Materials Management

6.1 Materials Management & Its Objectives

6.1.1 Essential Principles

6.1.2 Procedure

6.1.3 Procurement

6.1.4 Materials Management Interventions

6.1.5 Methods of Classification of Inventory

6.2 Materials Management in Hospitals

6.2.1 Drugs Management

6.2.1.1 Educating the Staff Regarding the Use of Drugs

6.2.1.2 Controlling Life-Saving Drugs

6.2.1.3 Pre-packaging Drugs for Outpatient Department

6.2.2 Consumables Management

6.2.3 Equipment Management

6.2.3.1 Equipment Planning

6.2.3.2 Factors to be considered for Equipment Purchase

6.2.3.3 Managing Equipment

6.2.3.4 Ordering Equipment

6.2.3.5 Storing Equipment

6.2.3.6 Issuing Equipment

6.2.3.7 Codification not Standardisation

7. Hygiene Management

7.1 Sterilisation

7.1.1 Methods of Sterilisation

7.1.1.1 Dry heat sterilization

7.1.1.2 Steam sterilisation

7.1.1.3 Gaseous sterilisation

7.1.1.4 Irradiation sterilization

7.1.1.5 Pasteurisation sterilization

7.1.2 Choice of Sterilising Method

7.2 Washing, Drying & Packaging

7.2.1 Washing and Drying

7.2.2 Cleaning Facilities

7.2.3 Chemicals Used in Cleaning and Washing

7.2.3.1 Abrasives

7.2.3.2 Soaps

7.2.3.3 Neutral cleaners

7.3 Linen Bank Referral Systems

7.3.1 Laundry Management System

7.3.2 Historical Perspective

7.3.3 Conventional Technology

7.3.4 State-of-the-Art Technology

8. Setting up A new hospital

8.1. Key criteria Introduction

8.1.1 Planning of a New Hospital

8.1.2. Planning & Construction of Wards

8.1.3 Infrastructure Requirements

8.1.3.1. Land Requirements

8.1.3.2. Equipment Requirements

8.1.3.3. Skill Requirements

8.2. Financial Analysis

8.2.1. Revenue Models (w.r.t cases)

8.2.2 Revenue streams

8.2.3 Cost Structures

8.2.4. Funding of New Hospital Project

8.3 Critical Success Factors

9. Manpower Planning

9.1 Definition and Importance of Manpower Planning

9.1.2 Steps in Manpower Planning

9.1.3 Factors which Affect the Efficiency of Employees

9.2 Planning for Medical Personnel

9.2.1 Factors Affecting Manpower Planning in Hospitals

9.2.2 Effective Utilisation of Manpower

9.3 Types of Medical Staff

9.3.1 Medical Staff

9.3.2 Paramedical Staff

9.3.2.1 Physiotherapists

9.3.2.2 Prosthetic and orthotic engineering

9.3.2.3 Occupational therapists

9.3.2.4 Medical technologists

9.3.2.5 Radiographers and radiotherapists

9.4 Competencies of Medical Staff

9.4.1 Patient Care

9.4.2 Medical Knowledge

9.4.3 Practice-Based Learning and Improvement

9.4.4 Interpersonal and Communication Skills

9.4.5 Professionalism

9.4.6 Systems-Based Practice

9.5 Training and Retention at Hospitals

9.5.1 Types of Training Needs

9.5.1.1 Soft skills

9.5.1.2 Leadership programs

9.5.1.3 Internal team-building

9.5.1.4 Technical training

9.5.2 Some Approaches to Training in Indian Hospitals

9.5.3. Newer Methods of Training

9.5.4 The Challenges

9.6 Appraisal and Feedback System

9.6.1 Need for Feedback System

9.6.2 Need for Designing an Effective Appraisal System

9.7 Keeping up the Morale of Employees

9.7.1 Support from the Top

9.7.2 Intangible Incentives

9.7.3 Employee Motivation that Works

9.7.4 Communication is Critical

9.7.5 Personalised Motivation

10. Hospital Administration during Disaster

10.1 Meaning

10.2 Role of Government & Infrastructure Framework

10.3 Preparedness and Mitigation

10.3.1 Elements of Disaster Preparedness

10.3.1.1 Vulnerability Analysis

10.3.1.2 Establishment of a National Coordination Mechanism

10.3.1.3 Preparation of Operation Plans

10.3.1.4 Hospitals

10.3.1.5 Stockpiling

10.3.1.6 Background Data and Inventory of Resources

10.3.1.7 Training of Health Personnel and the Public

10.3.2 Hospital Disaster Drills

10.3.3 Mitigation

10.4 Patient Education.

10.5 Role & Responsibilities of Medical & Health Officers

10.6 Rehabilitation

10.7 Healthcare Administration and Planning during Disaster

10.7.1 Goals of the OMP in Hospital

10.7.2 Disaster Plan of a Hospital

10.7.2.1 Basic requirements

10.7.2.2 Organisation and structure of management in hospital

10.7.2.3 Alarm and mobilization

10.7.2.4 Competencies and emergency rights

10.7.2.5 Admission and treatment capacities

10.7.2.6 Admission and registration of patients

10.7.2.7 Predefined patient transportation routes

10.7.2.8 Medical measures including sorting

10.7.2.9 Areas

10.7.2.10 Communication

10.7.2.11 Protective measures

10.7.2.12 Medical, operational and general resources

10.7.2.13 Internal and external information

10.7.2.14 Social Care

10.7.2.15 Traffic control and cordoning off

10.7.2.16 Substitute measures and redundancies

10.7.2.17 Task-books and checklists

10.7.2.18 Training concept

10.7.2.19 Particularities of internal disasters

10.7.2.20 Evacuation in the hospital

10.8 Indicators for Impact Measurement

11. Marketing and Branding Management

11.1 Marketing in Healthcare

11.1.1 Marketing Mix Healthcare Industry

11.2 Marketing Strategies of Healthcare Industry

11.2.1 Market Penetration

11.2.2 Market Development

11.2.3 Product Development

11.2.4 Diversification

11.2.5 Strategic Alliances

11.2.6 Consolidation strategies

11.3 Marketing of Hospitals

11.4 Branding of Hospitals and Services

11.4.1 Branding

11.4.2 Tools of Branding in Hospitals

11.5 Marketing Strategies of Few Hospitals

11.5.1 Fortis Healthcare, Noida

11.5.2. Jaslok Hospital, Mumbai

11.5.3. Apollo Hospital, Chennai

11.5.4. Wockhardt Hospital

11.5.5. Christian Medical College (CMC), Vellore

Bibliography

LIST OF FIGURE

Figure 3.1: Activities in Outpatient Department

Figure 3.2: Flow Chart-Inpatient Services

Figure 3.3: Flow Chart of Emergency Service

Figure 3.4: Organisational Structure of CSSD

Figure 5.1: Flow Chart of Nursing Department

Figure 8.1: Revenue Model & Income Calculation

Figure 10.1: White water-resistant patient-pouch of CHS

LIST OF TABLES

Table 3.1: Categorisation and colour coding of the container

Table 3.2: Protocol for Management and Handling of Hospital Waste

Table 6.1: Vendor Rating: Parameters

Table 6.2: Selective Inventory control

Table 8.1: Manpower Requirement

Table 8.2: Estimated Manpower & Cost

Table 10.1: Potential Injury-Creating Event Algorithm

Table 11.1: USP of few Major Hospitals

Abstract

• In the present scenario, management of healthcare services has become a big challenge for corporate hospitals.
• In late 1980s, Apollo Hospital was the only private hospital for profits started in Chennai.
• In multi-speciality hospitals, medical specialty like general medicine, surgery, pathology,paediatrics, orthopaedics, ophthalmic, ENT, dermatology, cardiology, neurology, oncology, gastroenterology and others like endocrinology, Pulmonology & nephrology are covered.
• Constraint Management is a process methodology that is especially useful for planning, organising, evaluating and controlling complex systems in an organisation.
• Emergency and trauma services consists of specialists’ team from Anaesthesiology, Cardiology, Cardio-Thoracic Surgery, Gastroenterology, Internal Medicine, Neurology, Neurosurgery, Orthopaedics, Plastic Surgery, and Traumatology.

• Covers concepts of production management in a pharma company, marketing and its distribution channels, inventory management and its importance, and above all, environment management, which is critical to any pharma company
• Provides insight into the key concepts of pharma business management in a comprehensive manner
• Prepares students and budding management executives to face the industry confidently

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