Hospital Business Management

Content

• 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