HSA OHF OBJECTIVES 2 AND 3[Replica].pptx

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1. 2: APPLY KNOWLEDGE OF ORGANIZATION OF HEALTH FACILITY Introduction In this unit, you will learn how to apply knowledge of organization of health facility . This will involve demonstrating various hospital departments, functions of various hospital departments, core services and support services and understanding organizational structure of the hospital.  

2. Functions of various hospital departments OPD In this department people come to the hospital only for a consult and not admission . The patients seek medical advice from a specific department depending on their problem and doctors provide a prescription of medication for them to take for a certain period of time. Patients are then asked to come back for a follow up . Patient’s treatment within the boundaries of the hospital lasts only a day. Consultant doctors are usually brought in to handle OPD.

3. Cont…… Much of the investigative and curative work is done here without admitting the patient hence reducing medical expenses. The scope of OPD includes the following: Consultation, investigation, procedures, specialty services. Preventive and promotive health care: Clinics, which include: diabetic, antenatal, postnasal and under five. Rehabilitation services (physiotherapy, occupational therapy etc) Health education Counselling

4. In-patient This department admits patients at least overnight for treatment. Here a case history of the patient will be taken and the patient will have a case sheet in which his progress will be recorded. Patients are monitored throughout by nurses and doctors come on rounds to check on the patients conditions. The duration of stay will depend on severity of the patient’s illness.

5. Admissions department At the Admitting Department, the patient will be required to provide personal information and sign consent forms before being taken to the hospital unit or ward . If the individual is critically ill, then, this information is usually obtained from a family member.

6. Medical department The medical department has within it the various clinical services. They are: medicine, surgery, gynaecology , obstetrics, paediatrics , eye, ENT, dental, orthopaedics , neurology, cardiology, psychiatry, skin, plastic surgery, nuclear medicine, infectious disease etc. medical superintendent is a doctor who has control over all medical department

7. Nursing department The nursing department is the organizational structure through which nurses provide nursing care for clients under the jurisdiction of the institution. The nursing department consists of nursing service and nursing education. The primary purpose of the nursing service is to provide comprehensive, safe, effective and well-organized nursing care through the personnel of the department. The personnel consists of nurse in charge and staff nurses. All of these are registered nurses, other personnel who function in the nursing service department may include the health services support personnel.

8. Cont….. The nursing education section has the responsibility of preparing nursing students to become professional nurses. Uplifting the standard of nursing by inservice education and refresher courses etc., are included in the functions of this department. The personnel consists of the director of nursing education, tutors and clinical instructors.  

9. Ophthalmology This department deals with the investigation and treatment of eye problems of adults and children. Their services include: General eye clinic appointments Laser treatments Optometry Orthoptics Prosthetic eye services Ophthalmic imaging

10. Orthopedics This department deals with problems that affect the musculoskeletal system. That includes treating bones, muscles, tendons, ligaments, and nerves. Services include bone setting, surgeries to repair damaged bones or ligaments or tendons, replacing bones like hip replacement, knee cap replacement. Other outpatient services also include treating fractures and dislocated joints, musculoskeletal injuries and soft tissue injuries.

11. Maternity/Neonatal/Pediatrics All facilities concerning giving birth and child care is provided in this department. Maternity wards provide antenatal care, delivery of babies and care during childbirth, and postnatal support. In some hospitals these can be divided into three different departments but most general hospitals provide this care under one department itself. Some of the facilities or treatments include: Child birth Midwifery Antenatal and post natal care Pregnancy check ups Surgical procedures on children or mothers

12. Pathology department The following laboratories are usually found in the pathology department : Bacteriology laboratory: This laboratory studies about the bacteria and their toxins. Biochemistry : this is concerned with the chemistry of living organisms and of vital process. Haematology laboratory : it is responsible for making haemoglobin determinations, coagulation time studies, red and white cell counts and special blood pathology studies for anaemia and leukaemia etc. Parasitology laboratory: it studies the presence of parasites, the cyst and ovas of the parasites that are found in the faeces .

13. Cont….. Serology laboratory: it does blood agglutination tests, Wassermann tests, V.D.R.L. etc. Blood bank: it has the responsibility for collecting and processing all blood used in the hospital for transfusions. It makes studies on newborn infants who may have haemolytic diseases and does antibody studies on the prenatal client. Histopathology department: it prepares tissues for gross and microscopic studies.  

14. Radiology Also known as the department of diagnostic imaging, this department provides the following services: General radiology (X-rays) and their interpretations Scans for Accidents and Emergency Mammography (breast scans) Ultrasound scans Angiography (x-ray of blood vessels) Interventional Radiology (minimal invasive procedures) CT scanning .MRI scanning (3D scans using magnetic and radio waves)

15. Pharmacy Every hospital must be equipped with a pharmacy which provides drugs for the entire hospital. It not only provides medication for patients but also provides other drugs and instruments used by all the departments in the hospital for patient care or surgeries... Run by a pharmacist the pharmacy provides the following services: Purchase, supply and distribution of medication and pharmaceuticals Inpatient and outpatient dispensing Clinical and ward pharmacy Doctors are usually given a formulary of medication by the pharmacy to use as a guide.

16. Neurology Neurology deals with the human nervous system. The doctors in this department investigate and treat patients for problems that affect their brain and spinal cord . Surgical procedures on the brain and spinal cord are extremely dangerous and require highly qualified and experienced doctors and nurses to provide such special care . Neurologists examine patients who have been referred to them by other physicians in both the inpatient and outpatient settings. A neurologist will begin their interaction with a patient by taking a comprehensive medical history, and then perform a physical examination focusing on evaluating the nervous system. Components of the neurological examination include assessment of the patient's cognitive function, cranial nerves, motor strength, sensation, reflexes, coordination, and gait.

17. Oncology This department investigates and treats all kinds of cancers and provides a wide range of chemotherapy treatments and radiotherapy for cancerous tumours and blood disorders . This department is usually linked to all the other departments as referrals can be made when one department cannot diagnose the patient’s problem. The department also requires highly qualified and experienced doctors and nurses. Doctors also carry out tumour removal procedures which are then sent for biopsy to confirm whether the tumour is malignant or not.

18. Urology This department is usually a surgical department led by surgeons that perform certain specific services like: Flexible cystoscopy bladder checks Urodynamic research Prostate assessments and biopsies Shockwave lithotripsy to break up kidney stones

19. Casualty This department, also known as the accident and emergency department deals with patients who have been brought in by an ambulance in an emergency situation. Sometimes patients find their own way to this department in case they have had an accident or seek immediate treatment. This department works 24/7 and is equipped to deal with all sorts of emergencies. The patients are assessed according to the degree of injury or emergency and then provided immediate treatment before being sent to a specialized department for further treatment

20. Cardiology Department The department as the name suggests deals with problems of the human heart or circulation. It treats people on an inpatient and outpatient basis. Some of their procedures include: Electrocardiogram (ECG) and exercise tests to measure the heart function Ultrasound scan of the heart ( Echocardiogram) Scans of the carotid artery in the neck to determine risks of stroke 24 hour blood pressure tests Insertion of pacemakers Coronary angiography to see if there are any blocks in the arteries Medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease and electrophysiology Cardiac surgery

21. Obstetrics and gynecology This department deals with the investigation and treatment of problems of the female tract and reproductive system. Infertility, and endometritis are some of the problems investigated in this department . Other services include cervical smear screen and post-menopausal bleeding checks. This department usually has a special ward, day surgery unit, an emergency gynaecology assessment unit and outpatient clinics.

22. Ear, Nose and throat As the name suggests, this department deals with ailments concerned with the Ear, nose and throat and it includes treatment of a variety of ailments like: General ear, nose and throat diseases Neck lumps Cancers of the head and neck area Tear duct problems Facial skin lesions Balance and hearing disorders Snoring and sleep apnoea ENT allergy problems Salivary gland diseases Voice disorders ENT surgical procedures

23. Intensive Care unit This department is also known as the critical care department and it provides treatment for seriously ill patients. Certain patients need to be isolated and require close and individual medical attention. The ICU has very few beds and is usually manned by specialist doctors and nurses as well as consultant anaesthetists , physiotherapists and dieticians. Patients can be transferred from any department to the ICU in case the patient’s condition gets worse.

24. Psychiatry and Psychology department This department deals with investigating and treating patients with a wide range of mental illnesses and disorders. Some services include: Providing psychosocial counselling Investigating, diagnosing and treating psychiatric illnesses Conducting IQ tests Deaddiction services

25. Central sterilizing unit This department is charged with the responsibility of keeping all the instruments used in the hospital clean and sterilized to avoid spreading of infections throughout the hospital. They follow a strict procedure for sterilizing medical and surgical instruments.

26. Housekeeping This department is in charge of keeping the hospital clean and neat. It involves doing the laundry and cleaning all the rooms of the hospital and effectively disposing of medical waste according to strict hospital disposal procedures. It is the department which is also charged with the responsibility of repairing the torn linen as well as replacing the condemned linen.

27. Catering and food services  This department provides food services to inpatients, their families and staff of the hospital based on a nutritional menu provided by the Nutrition Department.

28. Medical social work This department manned with medical social workers help patients and their families deal with a broad range of psychosocial issues and stresses related to coping with illness and maintaining health. The department addresses the challenges families face, increase accessibility to healthcare, and serves as a bridge between the doctors and the individual, family, and community.

29. Physical therapy/physiotherapy This department deals with clients who have functional disabilities resulting from disease conditions/injuries and it aims at rehabilitating patients. It is mostly linked to the orthopedics department and it offers a wide range of body healing therapies that will help a patient resume normal functioning. It can have physiotherapy, occupational therapy, speech therapy and vocational training. This department will be under the direction of a well – qualified physician who has special training in the field of physical medicine and rehabilitation. His staff should include therapists with qualification in the various specialties. This department offers outpatient as well as inpatient services.

30. Medical records department This department deals with recording, and maintaining all the records/files of inpatients as well as outpatients. It is with these records that medical statistics can be formulated and it serves as a reference for future purposes.

31. Nutrition and Dietetics department This department is manned with specialist in nutrition and dietetics. They are assigned to provide professional advice on diet for hospital inpatient wards as well as outpatient departments. Certain departments require that the patient be put on a diet and therefore the team works with many other departments that treat: Diabetes Cancer Kidney problems Paediatrics Elderly care Surgery and critical care Gastroenterology These specialists can also suggest a dietary chart to be followed by the hospital canteen to ensure that all patients get nutritious food during their stay at the hospital.

32. Chaplaincy department This department is also known as pastoral care department. Under the leadership of the chaplain, the pastoral care team meets the spiritual and pastoral needs of the patients, relatives and staff.

33. Medical maintenance and engineering This department makes sure that the hospital is in operable condition. It makes plans and carries out various projects for the hospital. This department makes sure that all electrical facilities are in perfect condition, carries out repair and replacement work for air-conditioning units, plumbing, steel works, and general takes care of the overall maintenance of the hospital

34. Infection control department This department is primarily responsible for conducting surveillance of hospital-acquired infections and investigating and controlling outbreaks or infection clusters among patients and health care personnel. The department calculates rates of hospital-acquired infections, collates antibiotic susceptibility data, performs analysis of aggregated infection data and provides comparative data to national benchmarks over time.

35. Information technology & communication Most hospitals today use computers to keep track of patient records and other medically related affairs. Therefore, this department is in charge of providing technical support as when needed and keep the systems updated and provide support when systems crash. They also aim to provide effective online services for patients and help to keep the entire hospital informed of certain events that take place within the hospital.

36. Human Resource This department is given the objective of recruiting efficient human resources for the hospital. It also has the duty of creating policies and procedures that the staff have to follow in the hospital. It aims at ensuring employee satisfaction, good working conditions and provision of monetary and non monetary benefits for the employees. It is also responsible for providing compensation for the services rendered by the employees.

37. Finance department This department is sometimes called accounts office and it looks after the financial aspects of the hospital. This department has the responsibility for collecting the money which is owed to the hospital, paying for the supplies and equipment, handling all records pertaining to hospital finance, keeping records of assets and liabilities and assisting with budget. They make budgets, financial plans for the future and allocate financial resources to the various departments of the hospital for their upgradation . They also provide wage statements for the staff and oversee purchases of medical supplies and pharmaceuticals for the hospital. The business manager is responsible for the functions of the department. The accountants help him.

38. Administration The administration of the entire hospital cannot be vested on the administrator alone. It is a collective responsibility of a group of people. The administrative staff, depending upon the size of the hospital, is composed of the administrator, the assistant administrator, the business manager and the departmental heads. This department is charged with the responsibility of looking after the day to day operations of the hospital. They look after all the paper work of hospital and ensure that every department follows administrative procedures of the hospital

39. Service categories in healthcare There are two main categories of services of a hospital which include; A .Core services of a hospital B .Support services of a hospital   Core services of a hospital Core service in hospitals includes the treatment provided by the Doctors to the patients and diagnostic services. It is very difficult to measure the success rate of core services as it mainly depends on the criticality of the patient and his conditions. Core service failure might lead even to the death of the patients. In case of death of the patient or any major failures in the core service provided, since there are no recovery mechanisms possible, legal redress is available to ensure sufficient financial compensation for the loss.

40. Support services of a hospital Support service in hospitals includes Nursing Services, Operations & Administration, Food & Beverage, House Keeping Services, Facility & Maintenance, Dietary Services, and Billing and Insurance Services. These support services act as differentiators and helps define the level of service which has to be provided to the customers based on their willingness to pay. Hospitals earn their premiums only through the support services which are provided in addition to the core medical service.

41. 3: Demonstrate Functions of Health Services Support Provider

42. Introduction In this unit, you will learn how to demonstrate functions of health services support provider. This will involve demonstrating roles and responsibilities of HSS provider, documenting tasks performed as well as preparing and disseminating specific reports.

43. Definitions of terms Clinical waste : waste from healthcare facility that may contain hazardous pathogens Decontamination : Removal of soil and pathogenic microorganisms from objects so they are safe to handle, subject to further processing, use or discard. Hospital customer service: refers to the customer support and care given to people by a hospital. Medical documentation: an instrument which helps the health care staff to record all information about patients' health status and the procedures provided by the hospital staff. Medical record : the systematic documentation of a single patient's medical history and care across time within one particular health care provider's jurisdiction

44. Cont….. Triage : the process of rapidly screening sick people soon after their arrival in hospital . Health Services Support Professional (HSSP) Health professionals play a central and critical role in improving access and quality health care for the population. They provide essential services that promote health, prevent diseases and deliver health care services to individuals, families and communities based on the primary health care approach. According to WHO, there continues to be a worldwide shortage of hospital workers. This shortage can be partly addressed by having healthcare support workers who will be responsible for assisting and caring for patients. Healthcare support workers are expected to change dressings, take vital signs, and ensure that each patient has a comfortable and safe area to recover in. Some healthcare support workers assist nurses and other higher-level medical workers with day-to-day operational tasks.

45. Roles and responsibilities of HSSP Assisting patients around the hospital Orienting clients around the hospital Feeding patients Providing home based care Assist patients with basic hygiene activities Administer medication to patients Take vital signs and report findings to superiors Collect, store, and label biological specimens Sterilize medical equipment Keep hospital supplies properly stocked and organized Work closely with other healthcare professionals such as nurses, physicians, and therapists in order to provide patients with exceptional care Dispose of waste and hazardous materials Comply with all hospital rules, regulations, and procedures

46. Skills in HSA Superior communication skills Excellent bedside manners and etiquette Ability to analyze basic medical information and data Ability to successfully work in a fast-paced, high-pressure environment Willingness to maintain a professional demeanor at all times Prior experience in a hospital or clinical environment Knowledge of basic phlebotomy procedures Ability to work with other employees in order to achieve various goals Understanding of medical confidentiality laws and practices Client flow

47. Client flow Hospital signage Hospital signage is very critical in the health facility as it helps ease the anxiety of the patients, assist patients navigate through the hospital as well as inform the patients and clients on the services offered. Some of the techniques which can be used during signage include: Digital signage Way finding signage: for large hospital layouts Medical device wraps   Customer care Though not often seen as customers, patients using hospital services require the same level, if not greater, of customer service they receive elsewhere. The unique nature of these interactions and the sensitivity required make hospital customer service training imperative. Doing so will improve the quality of service customers receive during difficult times.

48. Triage When used in medicine and healthcare, the term triage refers to the sorting of injured or sick people according to their need for emergency medical attention. It is a method of determining priority for who gets care first. Triagi9ng is done in order to identify: those with emergency signs, who require immediate emergency treatment; those with priority signs, who should be given priority in the queue so that they can be assessed and treated without delay; and non-urgent cases, who have neither emergency nor priority signs. Emergency signs  include: obstructed or absent breathing severe respiratory distress central cyanosis signs of shock (cold hands, capillary refill time longer than 3 s, high heart rate with weak pulse, and low or unmeasurable blood pressure) coma (or seriously reduced level of consciousness)

49. Cont….. convulsions signs of severe dehydration in a child with diarrhoea (lethargy, sunken eyes, very slow return after pinching the skin or any two of these). Admission Day care Discharge Clearing, decontamination & storage A clean patient environment contributes to prevention of healthcare-associated infection. Cleaning in healthcare facilities aims to remove visible dirt and dust, reducing levels of harmful micro-organisms in the patients’ surroundings. Dust contains skin scales and micro-organisms, which can be spread in the environment and air by sweeping or dry dusting. When carrying out clearing and decontamination in a health facility, it is important for one to use appropriate PPEs. Decontaminants Racks Bins & bin liners Safety box Buckets Carts

50. Documentation and Report writing Medical records are the document that explains all detail about the patient’s history, clinical findings, diagnostic test results, pre and postoperative care, patient’s progress and medication . Clear and concise medical record documentation is critical to providing patients with quality care, ensuring accurate and timely payment for the services furnished, mitigating malpractice risks, and helping healthcare providers evaluate and plan the patient's treatment and maintain the continuum of care. When writing reports of a health facility, it is always important to ensure that the qualitative and quantitative data which has been documented meets the following requirements;

51. Cont…. Accuracy Reliability: Recording accurately is not the only requirement since recorded data needs to be reliable so that the conclusions drawn from analysis are not spurious Timeliness: For effective management of patients, the data collected needs to be collected in good time so as not to delay the decision-making process Completeness: it is important that the data collected is complete so that the information generated is whole. Good data should be complete, that is, it has every necessary part or every detail that is wanted. Confidentiality: For all patient records, it is important to maintain confidentiality. Medical records should also be kept under lock and key

52. Reasons to document medical records properly Communicates with other health care personnel Documentation communicates the quality of clinical care that providers are delivering to patients and serves as a means to facilitate the patient navigation continuum of care . Reduces risk management exposure Documentation mitigates risks and reduces the chance of malpractice. A well-documented record can help alleviate liability concerns in the event of a claim.

53. Cont….. Records CMS Hospital Quality Indicators and PQRS Measures Documentation captures value-based purchasing metrics that, increasingly, the government is asking hospitals to provide. Ensures appropriate reimbursement A well-documented medical record can facilitate effective revenue cycle processes, expedite payment, reduce any “hassles” associated with claims processing, and ensure appropriate reimbursement.

54. Thankyou