Unit 1a- Hospital and its organization.pdf

Pharmacy practice, PCI Syllabus, B. Pharmacy, 7th semester, Unit 1, Hospital and its organization, Goal of hospital, Definition of Hospital, Classification of Hospital, Organization of hospital, Structure of hospital, Function of Hospital, Board of Hospital, Administration of hospital, Information services, Therapeutic services, Diagnosis services, Support services, Medical staff in hospital and their functions, Doctors, Nurses, Pharmacist, etc.

1. Pharmacy Practice (Unit I-a)
Ms. Munjewar Seema
(Assistant Professor)
Hospital and it’s Organization

2. According to WHO, "the hospital is an integral part of a social and medical organizations,
the function of which is to provide for the population complete health care, both 'curative'
and 'preventive' and whose outpatient services reach out of the family and it's environment;
the hospital is also a center for the training of health workers and biosocial research".

3. ❑Goal of Hospital
The common goal is to restore and maintain good health of the people who comes in hospital for their
relief from pain, sufferings and diseases.
❑What is Hospital ?
The word “Hospital” derived from the Latin word ‘hospitalis’ which in turn derived from French
word ‘hospes’ that means ‘a host or guest’.
So It can be defined as an institution of community health or a specialized complex organization which
includes physicians, surgeons, and a team of technical staff. It also provides facilities for diagnosis,
treatment, therapy, rehabilitation, prevention, education and research.

4. ❑Functions of Hospital:
1.Main function of hospital is to provide the population with complete healthcare.
2.Diagnosis of diseases.
3.Treatment of patients.
4.Lowers the incidences of disease (Prevention of disease).
5.Provide patient care through treatment, therapy, rehabilitation, etc.
6.Centre for training of health workers.
7.Provide outpatient services.
8.Stimulate growth of medical science.
9.Education (undergraduate, postgraduate).
10.Research (basic research, clinical research, health services research, educational research).

5. Classification of Hospitals
Based on level of care
Primary
hospitals
Secondary
hospitals
Tertiary
hospitals
Based on clinical and non-clinical basis
Clinical
hospitals
specialty
length
of stay
Non-clinical hospitals
ownership
different
system of
medicines
size cost
medical
staff

6. A. Based on level of care
1.Primary care Hospital: Primary Health Centre & Rural Hospital
2.Secondary care Hospitals: Dist. Hospitals (Zilha shaskiya rugnalay in every dist.)
3.Tertiary care Hospitals: Medical college Hospitals, most of the giant private care hospitals: KEM
hospital (Pune), Sahyadri hospital (Nashik).
Primary care hospital Secondary care hospital Tertiary care hospital

7. B. Based on Clinical and Non-clinical basis:
I. Clinical classification:
1.Medicine based hospitals
2.Surgery based hospitals
3.Maternity hospitals
4.Pediatrics
Based on Specialty
1.Short stay hospitals
2.Long stay hospitals
Based on length of
Stay

8. I. Clinical classification:
a. Based on specialty:
1. Medicine based hospitals: general hospitals/family physicians, communicable disease hospital,
mental/psychiatric disease hospital, dental hospital, cancer hospital, etc.
2. Surgery based hospital: General surgery of any kind, orthopedics, cardiothoracic, neurological,
kidney hospital, otolaryngological, etc.
3. Maternity hospital: obstetrics, antenatal, neonatal, gynecological services, etc.
4. Pediatrics: (From birth upto adolescent or age of 18)
b. Based on length of stay:
1. Short stay hospitals: (less than 30 days)
2. Long stay hospitals: (more than 30 days)

9. a. Ownership
Government
Ownership
Non-
government
Ownership
Semi-
government
Ownership
b. Different
systems of
medicine
Allopathic
Ayurvedic
Homeopathic
Unani
c. Size
Very small
hospitals
Small hospitals
Medium
hospitals
Large hospitals
d. Cost
Elite hospitals
Budget
hospitals
e. Medical
staff
Open-staff
hospitals
Closed-staff
hospitals
II. Non-clinical classification:

10. a. Based on ownership:
1. Government or public ownership: Owned or controlled by government
i. Central government: CGHS hospitals, AIIMS, Railway hospitals (central railway hospital in Pune),
Defense hospitals (military hospitals for army, navy and air force, Post-graduation institute of medical
sciences at Pondicherry, Lucknow and Chandigarh.
ii. State government: Civil hospitals at district headquarters, JJ hospital Mumbai, Sasson hospital Pune.
iii. Local self government: NDMC hospital in Delhi, BMC in Mumbai.
2. Non-government or private ownership:
i. Charitable trust hospitals: Bombay hospital in Mumbai, Jaslok hospital in Mumbai
ii. Religious hospitals: Christian medical college hospital (Vellore & Ludhiana), Ram Krishnan mission
hospital (Calcutta)

11. iii. Limited companies: Apollo hospital ltd. (Chennai & Delhi), Modi hospital in Delhi
3. Semi-government ownership: Cantonment board hospitals in Pune Mumbai, Delhi, etc.
b. Based on different systems of medicine:
Allopathic system was introduced by British rulers. Before them ayurvedic, homeopathic and unani
medicine systems are used in India. These systems are yet popular in rural areas.
c. Based on size:
1. Very small hospitals: less than 100 beds
2. Small hospitals: 100-500 beds
3. Medium hospitals: 500-1000 beds
4. Large hospitals: above 1000 beds

12. d. Based on cost:
1. Elite hospitals: Apollo hospital in Chennai, Hyderabad & Bengaluru
2. Budget hospitals: Civil hospital and charitable hospitals



Elite hospital room Budget hospital room

13. e. Based on medical staff:
1. Open staff hospitals: in this hospitals other physicians in the community having permission to
admit the patients in hospital and provide treatment to them. (no matter to which hospital they
belongs).
2. Closed staff hospitals: in this hospital only physicians in the hospital are responsible for all medical
activities including diagnosis and treatment on fee paying basis. (the other physicians in the
community who are not in the hospital staff does not have any access or privilege at that hospital).

14. ❑Organizational Structure of Hospital
Board
Administration
Information
services
Admissions, Billing, etc.
Medical records
Computer information
Health education
Human resources
Therapeutic
services
Physical Therapy
Occupational Therapy
Speech/Lang. Therapy
Resp. Therapy
Pharmacy
Nursing
Dietary
Diagnostic
services
Med. Laboratory
Radiology
Nuclear Med.
ER cardiology
Neurology
Support
services
Central supply
Biomedical
Housekeeping
Maintenance
Transportation

15. 1. Board:
•Governing board/ Board of directors/ Board of trustee.
•Various eminent personalities in the field of medical education, research and administration becomes
the part of the governing body.
•It may also include politicians, social workers and personalities of different fields.
•Board take decisions to hospital, create strategic plans, invest funds into the hospital.
•The organization of a hospital can be broadly classified into the following categories:
1. Administrative services
2. Informational services
3. Therapeutic services
4. Diagnostic services
5. Support services

16. 2. Administrative services:
•Includes Hospital administrators (CEO), vice presidents, executive assistants, department heads,
business peoples who run the hospital.
•They oversee budgeting and finance, set up hospital policies and procedures to perform public
relation duties.
•CEO represent the hospital to the community and the external environment for its growth.
•CEO should co-ordinate effectively with the hospital staff.
•Administrative services delivers the strategic plans, goals and decisions established by the Board to
the medical staff.

17. a. Informational services:
Various departments comes under informational services to perform document and process related
duties.
i. Admissions: in this department admission related information of patients are included like full
information and history of patient.
ii. Billing & Collection: it is the separate department to charge the bill for provided services by the
hospital.
iii. Medical records: maintains the medical records of all patients.
iv. Computer information system: in this department personnel is responsible for maintenance of
computer and hospital network.
v. Health education: the staff involved in these departments is responsible for providing health related
information to patients and other workers and staff in that hospital.
vi. Human resources: this department interacts with all departments in the hospital to ensure the
effective applications of quality services provided to patients.
•They also motivate the staff working at the hospital.
•They also responsible for recruiting the employees and look towards the benefit of employees.

18. b. Therapeutic services:
•Includes services related to treatment to patients.
•According to type of service provide various departments comes under therapeutic services.
i. Physical therapy: Treatment to enhance large muscle mobility/flexibility.
ii. Occupational therapy: the goal of this treatment is to help patients in regaining or recovering their
fine motor skills.
•Motor skills is required to perform a certain task for e.g. swimming requires movement of eyes, hands,
wrists, fingers, feets, toes, etc.
iii. Speech or language pathology: identify, evaluate and treat speech or language related disorders.
iv. Respiratory/cardiothoracic therapy: treat patients with heart & lung diseases.
v. Pharmacy: compounding & dispensing of medicines.
vi. Nursing: Provide take care of patients admitted in the wards under the supervision of physicians
vii. Dietary: maintains nutritionally sound diets for patients.

19. c. Diagnostic services:
•determines the cause of illness or disease or injury
•Include following departments.
a. Medical laboratory: Deals with study of body tissue
b. Medical imaging: Deals with providing services related to Radiology, MRI, CT scans,
ultrasound, etc.
c. Emergency department (ER): Deals with providing services related to emergency diagnosis and
treatment.

20. d. Support services:
•include non-medical staff involved in the management of admitting & discharging of patients,
record maintenance, handling of the accounts related to the third party payers like insurance
companies.
a. Central supply departments: provide services related to giving orders, receiving stocks and
distribute equipment's and supplies.
b. Biomedical technology: involve in services related to design, build and repair medical equipment's.
c. Housekeeping & maintenance: maintain safe and clean environment.
d. Transportation: responsible for taking care of patients while lifting and during transport.

21. ❑ Medical staff involved in the hospital and their functions:
•There are many peoples who work together in hospital to provide successful treatment in a hospital.
Doctors
Nurses
Pharmacists
Allied health professionals
Supportive staff

22. A. Doctors:
Play different roles and responsibilities based on their level of experience and their medical specialty:
a. Senior consultants: these are specialist doctors who see patients at specific times. Mostly during the
ward rounds and meetings.
b. Registrars: these are senior doctors who are responsible for supervising residents, interns and student
doctors.
c. Residents: they are responsible for take care of patients in wards and are under training for
specialization.
•patients are in more contact with resident doctors as they are always available in wards.
d. Interns: these are the medical students who completed their studies and practicing in hospital after
graduation or in final year.
e. Student doctors: these are undergraduate medical students who are supervised by the attending
physicians.

23. B. Nurses:
Most of the care of admitted patients are taken by nurses and play important role in
•Maintaining the ward
•Take care of the inpatients in the ward
•Responsible of carrying out the treatment plan established by the physicians
•Administer drugs to patients both in IPD (wards) and OPD
•Perform clinical works like giving injection, doing bandages and helping doctors in operation
theaters
•Provide basic medical care like checking Blood pressure, body temperature and blood glucose under
the supervision of doctor

24. C. Pharmacists:
•They supervise the use of drugs
•Play role in education on how to safely and effectively consume the prescribed drugs
•Provide counselling of patients
•Compounding and dispensing of medicines
D. Allied health professionals:
These are licensed health care professionals who provide medical or health related services to diagnose,
treat or prevent diseases or disabilities.
•Dieticians
•Occupational therapists
•Physiotherapists
•Speech pathologists

25. E. Other supportive staff:
•Clinical assistants (housekeeping)
•Patient service assistants (meal & other requirement of patients)
•Porters (lifting & transport)
•Volunteers (fund raising & ward visit)
•Ward boys (available for 24 hours on the ward reception desk).

26. ❖ Questions:
1.Define hospital & give a detailed account on classification of hospitals: 10M
2.Define hospital. Describe the organization structure and functions of hospital: 10M
3.Add a note on responsibilities of medical staff involved in a hospital: 5M

27. ❖ References:
1.A textbook of pharmacy practice by S. Balasubramanian, BSP books Pvt. Ltd., 2020, ISBN:
9389974380, 9789389974386.
2.Textbook of pharmacy practice by Rakesh Saini and Sagar Singh Jough, New Delhi New
Age International (P) Limited, Publishers 2022, ISBN: 9789389802344.
3. Principles of pharmacy practice by Dr. Ramandeep Singh, Satinder Kakar and Bhumika
Mangla, PV publication, 2018, ISBN: 9781543342659.
4.Textbook of pharmacy practice by Gaurav Agarwal, CBS publishers and distributers Pvt. Ltd.,
2020, ISBN: 9789389941913.

28. Thank You !