This presentation is for understanding basics of Hospital Management

1. HOSPITAL
MANAGEMENT
Dr Vilas K Lachake
BAMS, DHM, PGDLMS, MBA
vilaskl@gmail.com
9373912840, 9763013680

2. Professional Certificate
Course on
Hospital Management
20/07/2019
To
21/07/2019
Venue: IK London
Residency,
Somajiguda,
Hyderabad
Dr Vilas Lachake vilaskl@gmail.com 9373912840, 9763013680

3. SESSION 1:
INTRODUCTION TO
HOSPITAL MANAGEMENT

4. HEALTH
 Health is not
merely
absence of
diseases but
physical,
mental, social
and spiritual
wellbeing of
the people -

5. Meaning of Hospital
 The expert committee on organization of
medical care constituted by W H O in 1956,
defined the hospital as “an integral part of a
social and medical organization, the
function of which is to provide for the
population complete healthcare, both
curative and preventive, and whose
outpatient services reach out to the family in
its home environment; the hospital is also a
centre for the training of health workers and
for bio social research.”

6. Meaning of Hospital
 The word ‘Hospital’ has got it’s origin from Latin
word ‘Hospes’ which means guest. A place
where guest is accommodated is called
hospital.
 Patient comes to hospital like guest for some
days and after getting cured he goes back to
his home.
 While in hospital he should be treated with
dignity & honor which we give to our guests.
 In Indian culture guest is supposed to be God
& the word ‘Rugnalaya’ means ‘temple of
rugnas’.
 Patient should be treated not only as a
diseased person but as a guest or moreover as
a God. Service of a patient is not less than
worshipping God

7. Current strength of Health Industry
 The private health care industry is valued at $40 billion
and is projected to grow to $ 280 billion by 2020 as per
market sources.
 The current growth rate of the healthcare industry is at
14% is projected to be 21% in the next decade.
 Even during the global recession of 2008, this sector
remained relatively recession-proof
 4 million employments in the sector
 Diversification in the field (diagnostic, pharmaceuticals,
medical equipments, TPA, Insurance, healthcare
tourism)
 The private health care industry is complex and includes
insurance and equipment, which accounts for about
15%, pharmaceuticals which accounts for over 25%,
about 10% on diagnostics and about 50% is hospitals

8. Hospital as an Organisation
 The hospital is very complex organization where men of
different strata, education, philosophy, skill, and experience
work in different ways to achieve same goal of patient care.
 The management looks at the hospital as the feather in their
cap and wants return on the investment.
 The medical men took it as a place to try their own skill &
knowledge and to make money.
 Non medical and Para medical staff it is the place to earn
bread & butter for their family.
 Suppliers think it as a good place for dumping their
products.
 Patient seeks care and cure at the lowest possible cost.
 Relative also seek for patient care at free or lowest cost.
 Community thinks hospital as their place of right.
 Government implements different Acts and collects tax.

9. Complexity in Hospital Organization
 Complexity in a staff: There are Medical,
Para medical and Non medical personnel.
Highly educated and skilled doctors and
other Para medical staff at one side and low
educated, semi skilled or non skilled staff at
other side,
 Material wise on one side there are highly
sophisticated & technical instruments with
very high cost, on the other side crude
routine instruments of lower price on other
side

10. Functions of Hospital
 Patient care
 Education / training of doctors, nurses and
paramedical
 Prevention of diseases
 Health promotion
 Research
 Health education of community
 Rehabilitation

11. Types of hospitals
 A: Ownership – Government
– Non Government
 B: Teaching – Non teaching – Research
 C: Specialty – Single specialty
- Multispecialty
- Super specialty
 D: Pathywise – Allopathic, Ayurvedic,
Homeopathic, Naturopathy
etc

12. The Changing Role of
Hospitals
 Acute to Chronic illnesses
 Curative to Preventive medicine
 Restorative to Comprehensive
medicine
 Inpatient care to Daycare
 Individual to community orientation
 Tertiary and secondary care to
Primary care
 Episodic care to total care

13. Factors Leading to Changing
Role
1. Expansion of clientele from dying, destitute,
poor and needy to all classes of people
2. Improved economic and social status
3.Control of communicable diseases and
increase in chronic degenerative diseases
4.Progress in means of communication and
transportation
5.Political obligation of the govt. to provide
comprehensive health care
6. Increasing health awareness
7.Rising standard of living results in higher
expectation of people for better services and
facilities in healthcare institutes

14. Factors Leading to Changing
Role
8.Control and promotion of quality of care by
statutory and professional associations
9. Increase in specializations where need for
team approach is required
10.Rapid advances in medical science and
technology
11. Increase in population
12. Sophisticated instrumentation, equipments
and better diagnostic and therapeutic tools
13. Advances in administrative procedures
and management techniques
14. Awareness of community

15. HOSPITAL MANAGEMENT
1. Change in role from medical and clinical
assistance to healthcare with concern for
people who need it.
2. Hospitals required to run as business
Institutions with the mission of the best
healthcare for people.
3. Scope of services now include healthcare
guidance, preventive care, post-clinical
attention, care and advice.
4. Person visiting a Hospital is a customer.
He/she may include patient, doctor,
consultant, a paramedical personnel, a
medicine supplier and others

16. HOSPITAL MANAGEMENT
5. A customer can easily discriminate between the
quality of care, quality of caring; between being
treated medically and being treated personally;
between being served at least cost and served with
efficiency and effectiveness.
6. The customer aims at the terminal result of the
service and evaluates management on the quality of
the service process.
7. Like any other business, the management of
Hospitals has changed from an art to a science and
now a technology.
8. Healthcare decisions are based on diagnostic aids
and assistance through scanning, pathological tests
etc. and knowledge base of the case history.

17. HOSPITAL MANAGEMENT
9. The operational aspect of healthcare is supported by a
lot of equipment and instruments to help in diagnosis,
prescriptions and treatment.
10.Management of equipment, instruments etc. is very
important management function supporting the effect of
offering a distinctive service to customer.
11.Unlike a manufacturing unit, service quality in hospitals
depend on the people who provide it. Most of the issues
are related to manpower and human resource planning.
If this aspect is not taken care of, the service would
suffer badly despite the best physical resources
available
12.It is a business of “non standard” activity, where every
customer needs a unique approach; the steps of service
may be common but the process may differ putting
strain of the facilities
13.Hospital management is a high risk business – the risk
spreads from business risk to survival of the patient.

18. Aspects of
Health care
Patient
Care
Financial
Challenge
s
Patient
Satisfaction
Ethical
Challenges
Hospital
Security
Hospital
Productivity
Regulatory
Standards

19. MAJOR ISSUES IN
HOSPITAL MANAGEMENT
1. FINANCIAL ISSUES –
• Government Hospitals
a. lack of funding infrastructure
b. lack of incentives for practitioners to
provide care in rural areas
c. bureaucracy
d. Corruption
 Private Hospitals
a. overutilization of resources to maximize
profits
b. quality of care differs by economic class or
ability to pay class system
c. low staffing levels

20. MAJOR ISSUES IN HOSPITAL
MANAGEMENT
FINANCIAL ISSUES – In developed countries
and in India also to some extent -
a. System controlled by Insurance Companies
who dictate care
b. Insurance Companies restricts physicians
professional judgments
c. Reimbursement by Insurance Companies is a
major issue
d. Low levels of staffing
e. Litigation by patients
f. Physicians to go for special malpractices
insurance
g. price of care is highly inflated
h. Dynamic funding criterion by government
i. India has an inverted pyramid – increase in
elderly population

21. MAJOR ISSUES IN HOSPITAL
MANAGEMENT
CLINICAL / OPERATIONAL: Patient Care
a. Wrong patient / site surgery
b. Patient falls
c. High infection rates
d. Misidentification of patients
e. Medication errors
f. Pain management ; genuine vs. drugs
dependents
g. Sexual abuse
h. Patient neglect ; those needing long-term care
I . Radiation safety
j. Lack of communication: especially during shift
changes

22. MAJOR ISSUES IN HOSPITAL
MANAGEMENT
4. HOSPITAL SAFETY:
a. Facilities open 24 x 7
b. Those visiting under great stress – life and
survival at stake
c. Violence
d. Infant abductions
e. Patient wanderings
f. Pilferage of drugs and other assets

23. MAJOR ISSUES IN HOSPITAL
MANAGEMENT
5. PATIENT SATISFACTION :
Depends on
a. Well-being of patients
b. Reducing length of stay
c. Preventing re-admissions
 “Patient satisfaction affects hospital
revenues”

24. MAJOR ISSUES IN HOSPITAL
MANAGEMENT
5. REGULATORY STANDARDS:
Non-compliance to standards can lead to
disruptions, poor quality of care, safety
issues, and substantial fines.
 Meeting Legal and ethical standards
 Meeting energy standards
 Need to implement a sustainability strategy

25. Objectives of Hospital
Management
General Objectives of Hospital Management
in India are:
 To increase level of satisfaction of Patient
 To use modern management methods for
improving the quality of patient care
 To reduce the congestion and waiting time
of outpatients
 To cut down the costs where ever possible
 Optimum utilization of resources and
additional mobilization of resources

26. Major problems in hospital
management
 Leadership in the hospitals
 Lack of funds for hospitals
 High degree of turn over and job dissatisfaction
in professional staff
 Stringent controls
 Ineffective allocation of work and manpower
utilization
 Absence of policies for motivating employees,
and employee friendly personnel policies
 Difficulty in adaptation of external pressures

27. Concerns in healthcare management
 Changing lifestyle, life style related
diseases
 Changing disease pattern
 Introduction of new diseases
 Increasing cost of treatment
 Increase in adult population
 Technological innovations sooner become
obsolete
 Immigration of patients and diseases
globally

28. Top 10 causes of death
&disabilities
Projection by Harvard School of Public Health
1. Respiratory
infections
2. Diarrhoeal diseases
3. Heart Diseases
4. Complications of
birth
5. Severe depressions
6. Stroke
7. Tuberculosis
8. Measles
9. Traffic accidents
10.Congenital
1. Heart diseases
2. Severe depressions
3. Traffic accidents
4. Stroke
5. Respiratory
infections
6. Tuberculosis
7. War injuries
8. Diarrhoeal diseases
9. HIV/AIDS
10.Complications of
birth

20001990

29. Patient Care
 Patient care is prime concern of hospital
management.
 All functions of hospital management are
patient centric.
 Care of patient gives satisfaction to patient and
their relatives.
 This help to build reputation of hospital in
community.
 Satisfied patients became brand ambassador
of hospital.
 Proper housekeeping also plays important role
in increasing satisfaction level of patient and to
build reputation of hospital

30. Humanistic approach
 Humanistic approach of staff is essential in hospital
while dealing with patients and their relatives.
 When Patients come to hospital they are having
fear, tensions, worries about their dear ones,
financial constraints and lot many negative things
in their mind
 Empathetic behaviour by hospital staff help to
relieve their tensions and reassure them.
 Any arrogant reply of hospital personnel may burst
out their anger and law & order situation in hospital
may be disturbed and reputation of hospital may be
ruined.