Hospital Management

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Transcript of Hospital Management

Hospital Management

Notes Compiled by Dr Nayyar Raza Kazmi MBBS, DHPM, M.Sc, MPH Assistant Professor of Public Health Abasyn University Courtesy and Thanks to Dr Mahboob Ali Khan


History and Introduction to Hospital:The word "hospital" comes from the Latin "hospes" which refers to either a visitor or the host who receives the visitor. From "hospes" came the Latin "hospitalia", an apartment for strangers orguests, and the Medieval Latin "hospitale" and the Old French "hospital." It crossed the Channel in

the 14th century and in England began a shift in the 15th century to mean a home for the elderly or infirm or a home for the down-and-out.i

Hospital is an institution or the organization for the treatment, care, and cures of the sick and wounded, for the study of disease, and for the training of physicians (teaching hospitals), nurses, and allied health care personnel.ii

What is the importance of Hospital Management? The answer to this question is simply that supervisors and managers of hospitals must not only have vocational, technical knowledge about hospitals and treatment, but also should have


knowledge about contemporary management and its functions and principles. The work module of any job is based on two pillars, namely technical work and management work. What to be managed in Hospital?Like other organizations and institution hospitals or any healthcare facility passes through the following stages or in other words they need the management of below sections for the smooth

running of their organizations, but the hospitals are very complex in its nature. Operations (actions) Finance (money and resources), Personnel(human relations) Information(needed information for wise decisions) Time (your own and that of others)

According to the Project Definition: A project is a sequence, set or series of unique, complex and connected activities, having one goal or purpose to be completed with time frame, allocated budget and according to its specification, now we can say the leading, controlling, organizing and planning of all these activities is called project management. Now we can say it easily, that a hospital or any healthcare facility is a project in its nature, therefore; applying the rule of project management will

be no far away from it.Each of these five elements mentioned, must be managed by any person, who has its own set of principles and guidelines to follow. For instance, when it comes to managing people, the teachings of Industrial Psychology become pertinent. For operations, the teachings of Operations Management as a subject become important. So, in analyzing these five elements, it also becomes evident that the teachings of Financial Management, Information Management and Time Management, are also important for the other three elements. In a nutshell, for a hospital manager it is compulsory to have the sound knowledge of Operations Management, Financial Management, Information Management, Human Resources Management, Time Management and Communication.

For the lower level jobs at hospitals and healthcare facilities, the principles of Supervision can become a starting point for teaching or studying the principles of management. A person in one of the lowest level jobs found at employers must also plan, organize and control work, even if it is just to clean an office or do some washing in one of the departments of the hospital. Top Management members of the hospitals such as Chief Executive Officer, Financial Manager etc, must be able to plan, organize, control and lead the wards and departments with a focus on understanding and influencing the environment, setting the strategy and gaining commitment, planning, implementing and monitoring strategies and evaluating and improving performance. The Top Management must therefore have high capabilities with regard to human relations inwards and outwards, strategic planning, team building, leadership, and negotiation and performance management.3

Middle Management members must be able to plan, organize, control and lead departments andsections with a focus on assistance upwards for application of scientific methods and assistance

downwards for application of scientific methods. They must have the same capabilities as Senior Managers as well as Supervisory Managers and also be good at interviewing techniques, goal achievement, conflict handling tactics and project management. Supervisory Management members must also be able to plan, organize, control and lead sections, units and individuals with a focus on operations, finance, people, information and time. Lack of Management skills in employer or employees at every hierarchy level of the hospital or healthcare facility can be detrimental. Lack of Management skills can lead to poor performance, lack of improvement, low profit, decisions making, disheartening of employees, lower productivity, and jeopardize your organization. Therefore; it is obligatory that hospital managers should have the updated and cotemporary knowledge of Management. In below sections, you will read more about hospital management, that how to manage hospitals or any healthcare facility in order to achieve the intended objectives to meet the organizational goals.

Concept of Productivity in the context of hospital:As we are discussing regarding the concept of Productivity in the context of a hospital, so we must know that every organization whether it is Profitable or non profitable, governmental or non governmental needs and uses different resources, which is classified in many groups: Manpower/Labour/Task Force Material/ Raw Material Money/Cash/Budget Machinery/Equipment

The effective and appropriate usage and utilization of the above mentioned factors or resources shows and determines the organizations effectiveness. For example if it is a profitable organization, its benefits and advantages are increased, while in case of other organizations, its costs are reduced and diminished, therefore the reliance on private sectors and donors or government grants and aids or itself the fee for its services are diminished.iii

The effective and valuable usage/utilization/consumption of the resources or assets is important and significant for every organization or association, whether it is public or private. Hospitals are not including in the row of except ness, they should be included. Actually, Health care organizations or hospitals need to give more and more concentration and attentiveness to good and better management and execution because of the shortage of resources. Usually the health related organizations are short of resources, bearing in mind the demands for services placed on them.


It is useful at this phase to comprise how management and productivity concepts as well astechniques are related to the health field. There is mistaken idea that modern management and productivity concepts and techniques are concerns to profit- making institutions and

manufacturing organizations only.Productivity or Output, in simplest terms, is the relationship or bond between the resources used and results produced. In shorter terms the productivity is the ratio or difference between Input and

output. E.g. Input + Output=Productivity.The effective usage of inputs will ultimately increase or affect the output or productivity. So it

means that we must give more concentration for the effective usage of inputs or resources, we must allocate all our resources in a better way in order to achieve our goals and objectives. So for the improvement and enhancement of the productivity it is so important to have qualifiedand well trained and skilled staff, by this way they utilize and use the resources and raw material in

a good manner. This is the responsibility of the organization to conduct seminars, workshops and trainings for their employees. Equipment: As it is obvious and more apparent that most hospital or health facilities have expensive equipment remains out of the order or inventory list because of the insufficiency of the engineering department, improper maintenance, defective service contracts and so on. The expensive and costly equipment is under utilized because often the users do no have a clear understanding of the capital cost of the equipment or machinery and the bond between these costs, capacity utilization and a fee charged from the patients. It is important to improve and enhance the quality of medical services without incensement in fees and other charges. And it is also possible to increase the quality of services without increasing the fee by improving the utilization and usage of the existing equipments and machinery. Thus the engineering department of the hospital or health facility is the most and critical department, because they are mostly involved in the maintenance and repairing the equipments and machinery, as it is usual in my hospital there is no proper system of the maintenance. A planned and scheduled maintenance can reduce the chance of breakdown and damage in of machinery and deterioration in normal routine hospital activities. All the staff of the hospital must be understand about the usage and operation of electrical/mechanical appliances and equipments. By this way we can prevent the breakdown the equipment. The most critical point is that, which the engineering department needs to keep a stock and storage of day to day requirements.


Personnel Matters: Almost all the staff who is working in the engineering department they are not satisfied from theirworks due to their small salaries, wage of disparities and lack of opportunities for development and

so on. It is a clear fact that the engineering department is so neglected, so they hospital management should in take all these concerns regarding the engineeri