A Guide to Hospital Administration and Planning

Preface
Acknowledgments
Contents
Chapter 1: Hospital Designing and Planning
	1.1 Introduction
	1.2 Need of Hospital Planning
	1.3 Hospital Planning Process
		1.3.1 Hospital Planning Team
		1.3.2 Hospital Consultant
		1.3.3 Techniques Adopted by the Planning Team
		1.3.4 Feasibility Analysis Done by the Hospital Planning Team
	1.4 Size of the Hospital
	1.5 Site Selection
	1.6 Hospital Architect
	1.7 Preparation of Detailed Architectural Report
		1.7.1 Major Departments of a General Hospital
	1.8 Identifying Equipment Needs
		1.8.1 Acquiring New Equipment
		1.8.2 Addition of Equipment
		1.8.3 Replacement of Old or Obsolete Equipment
		1.8.4 Calculation of Requirement of Equipment
		1.8.5 Collection of Information
		1.8.6 Product Evaluation and Specification Audit
	1.9 Equipping a Hospital
		1.9.1 Plants and Equipment Required in the Hospital
	1.10 Interiors and Graphics
		1.10.1 Graphic Art and Design
		1.10.2 Types of Graphics
		1.10.3 Use of Decorative Colors in Hospitals
			The Cultural Meanings of Colors in a Healthcare Setting
			Psychological Impacts of Colorations in the Healthcare Environment
			Colors as a Signage System in Hospitals
			International and NABH-Accepted Medical Institution Signage Criteria
			Chromotherapy
			Color and Health
	1.11 Construction
	1.12 Commissioning
		1.12.1 The Commissioning Team
		1.12.2 Scheduling the Sequence of the Services
		1.12.3 Categorization of Services [13]
			Shake-Down Period
	References
Chapter 2: Importance of Hospital Management
	2.1 Healthcare
	2.2 Healthcare Industry
	2.3 Classification of Healthcare Industry
		2.3.1 Based on Funding and Governance
			Public Sector in Healthcare
			Private Sector in Healthcare
		2.3.2 Based on Service Delivery
			Healthcare Providers
			Healthcare Financiers
			Life Sciences
		2.3.3 Classification of Healthcare Based on Nature of Work
	2.4 Value Chain of the Healthcare Industry
	2.5 Healthcare and National Economy
		2.5.1 Investment Opportunities in India
		2.5.2 Healthcare Drives the GDP Growth
			Quality of Care and Economy
		2.5.3 Key Drivers of Healthcare Growth
		2.5.4 Post-COVID Analysis of Healthcare
	2.6 Health System Performance
		2.6.1 Performance Management Challenges in Healthcare
	2.7 Application of Hospital Management Principles to the Healthcare
		2.7.1 Effectiveness
		2.7.2 Efficiency
		2.7.3 Equity
		2.7.4 Patient-Centric Care
	References
Chapter 3: Hospital Management Challenges
	3.1 Introduction
	3.2 Hospital Management
	3.3 Challenges in Hospital Management
		3.3.1 Demands for Change
			Demographic
			Economic
			Technological
			Trends in Healthcare Technology
			Quality Management
			Patient Satisfaction
			Patient Safety
			Human Resource Development
			Leadership and Beyond
	3.4 Conclusion
	References
Chapter 4: Human Resource Management in Hospitals
	4.1 Introduction
		4.1.1 Meaning, Definition, and Objectives
			Meaning
			Definition
			Objectives
		4.1.2 Scope and Functions
			Role of HR Managers
		4.1.3 Skills Required for HR Managers
		4.1.4 Recruitment
		4.1.5 Training and Development
			Reasons for Training
			Types of Training
		4.1.6 Performance Appraisal
		4.1.7 Laws Related to HRM
		4.1.8 Challenges for HRM in Healthcare
		4.1.9 Emerging Trends
	References
		Further Reading
Chapter 5: Quality Management and Patient Safety in Healthcare Domain
	5.1 Introduction
	5.2 Quality
	5.3 Quality in Healthcare
	5.4 Quality Improvement Strategies
		5.4.1 Patient Safety
		5.4.2 Incident Reporting in Primary Care
		5.4.3 Transition of Care
		5.4.4 Current Scenario of Patient Safety in India
		5.4.5 Strategies for Improving Patient Safety
	5.5 Conclusion
	References
Chapter 6: Dental Office Layout and Design
	6.1 Introduction
	6.2 Dental Office
		6.2.1 Administrative/Reception Areas
			Parking Areas
			Entrance
			Reception
			Concourse Area
			Main Waiting
			Public Area
		6.2.2 The Dental Operatory and Accessory Clinical Area
			Dental Operatory
			X-Ray Room
			Sterilization Area
			Changing Rooms and Washrooms
			System Room for Technological Equipment
			Laboratory
			Storage Area
	6.3 Design Considerations
		6.3.1 Layout
			Open Entry
			Single Entry
			Dual Entry
		6.3.2 Size
		6.3.3 Acoustic System Design
		6.3.4 Delivery System Style and Location
		6.3.5 X-Ray Systems
			Intraoral X-Ray Machine
			Panoramic X-Ray Machine
		6.3.6 Data Collection
		6.3.7 Waste Management System
			General Waste Management
			Infectious to Potentially Infectious Waste
			Mercury-Containing Wastes
			X-Ray Processing Wastes
		6.3.8 Internal Network for Water, Osmotic, Suction, Electricity Systems
	6.4 Summary
	References
Chapter 7: Hospital Information System
	7.1 Introduction
	7.2 Information
		7.2.1 Information vs. Data
	7.3 Management Information System (MIS)
		7.3.1 Types of MIS [7]
		7.3.2 Advantages and Disadvantages of MIS [7]
	7.4 Hospital Information System
		7.4.1 Development [8]
		7.4.2 Definition
		7.4.3 Objectives of HIS
			Characteristics of HIS [11]
			Functioning of HIS
		7.4.4 Features or Modules of HIS [12]
			Features/Outlook of the Modules
			Example of HMS Workflow with Associated Activities
				Functioning of HIS
			Benefits of HIS [14]
	7.5 Decision Support System (DSS)
		7.5.1 Introduction
		7.5.2 Definition
		7.5.3 Evolution [19]
		7.5.4 Functioning
		7.5.5 Components
		7.5.6 Types of DSS [21]
			Data-Driven DSS
			Model-Driven DSS
			Communication-Driven and Group DSS
			Knowledge-Driven DSS
			Document-Driven DSS
		7.5.7 Types of CDSS [22, 23]
		7.5.8 Features [16]
		7.5.9 Implementation [24]
		7.5.10 Functions and Advantages of CDSS
			Patient Safety
			Clinical Management
			Cost Reduction
			Administrative Tasks
			DDSS in Radiology and Imaging
			CDSS in Laboratory and Pathology
			Challenges of Clinical Decision Support System [16]
			Drawbacks of CDSS [39]
	7.6 International Classification of Diseases (ICD)
		7.6.1 ICD-11 Design
		7.6.2 Framework of the ICD-11 [40]
		7.6.3 Coding Tool as an Index
			Benefits of ICD-11 [40]
				Global Reach, Accessibility, and Standardization
				Health Metrics
				Integrated Support for Hospital Case Data
				Capability to Operate Within Health Information Systems
				ICD-11-MMS Support for Activity-Based Funding Systems
				Quantitative Derived Measures
	7.7 Conclusion
	References
Chapter 8: An Intensive Care Unit Design of the Future
	8.1 History of Critical Care
	8.2 Planning and Development Team
		8.2.1 Types of ICU
		8.2.2 Location of ICU
		8.2.3 Bed Space
		8.2.4 Patient Bed Space
		8.2.5 Heating, Ventilation, and Air-Conditioning (HVAC)
		8.2.6 ICU Power Supply
		8.2.7 Bedside Equipment
		8.2.8 ICU Beds
		8.2.9 Emerging Trends
		8.2.10 Decentralized Charting
	8.3 Conclusion
Chapter 9: Transportation in Hospitals
	9.1 Introduction
		9.1.1 Types of Medical Transportation
		9.1.2 Extramural Transport System
		9.1.3 Development of Ambulance Service
		9.1.4 Definition of Ambulance
		9.1.5 Objective of Ambulance Services
		9.1.6 Types and Classification of Ambulances
			Types of Ambulances
		9.1.7 Role and Functions of Ambulance Service
		9.1.8 Utilization of Ambulances [12]
			Scale of Authorization of Ambulance [13]
			Uses of Ambulance Services to Patients [14]
			Priority for the Usage of Ambulance [1]
	9.2 Staffing Pattern, and Equipment of an Ambulance
		9.2.1 Ambulance Staffing Pattern [1, 5]
		9.2.2 Equipping of Ambulances [15, 16] (National Source: National Health Mission)
		9.2.3 Essential Accessories in the Ambulance [17]
		9.2.4 Additional Equipment Required in the Ambulance Other Than for Patient Treatment (Emergency Ambulance) [15, 18, 19, 20]
	9.3 Intramural Transportation
		9.3.1 Wheelchair Transportation
			Wheelchair Designed for Temporary Use
			Wheelchair Designed for Long-Term Use
			Wheelchair Designed for User with Postural Support Needs
		9.3.2 Stretcher Medical Transportation
			Hydraulic Stretchers
			Scoop Stretcher
			Stretcher Trolley
			Folding Emergency Stretcher
		9.3.3 Lifts and Elevators
			General Passenger Lifts
			Bed Lifts
			Service/Goods Lifts
			Ramps
		9.3.4 Material Transport
		9.3.5 Pneumatic Transport System
		9.3.6 Dumbwaiters
	9.4 Conclusion
	References
		Further Reading
Chapter 10: Central Service Sterile Department
	10.1 Introduction
	10.2 History of CSSD [2]
	10.3 Objectives of CSSD
	10.4 Functions of CSSD
	10.5 Planning of CSSD
		10.5.1 Central Unit
		10.5.2 Peripheral Unit
	10.6 Division in CSSD
		10.6.1 Receiving Area (Red Zone Area)
		10.6.2 Packaging Area (Blue Zone Area)
		10.6.3 Sterilization Area (Green Zone Area)
			Heat Sterilization
			Ethylene Oxide Sterilization [2]
			Flash Sterilization
			Chemical Sterilization [2]
				Radiation Sterilization
		10.6.4 Storage Area (Green Area)
	10.7 CSSD Design/Layout [4]
		10.7.1 Linear Flow Instrument Processing Layout
		10.7.2 U-Shaped Instrument Processing Layout
		10.7.3 Designing of the CSSD
			Lighting
			Signage/Displays in Functional Areas
	10.8 Sterilization Monitoring
		10.8.1 Physical Monitoring
		10.8.2 Biological Indicators/Spore Testing
		10.8.3 Chemical Indicators
	10.9 Factors Affecting Efficacy of Sterilization [3]
	10.10 Special Consideration [3]
	10.11 Quality Control [3]
	10.12 Documentation
	10.13 Incident Reporting
	10.14 Recall Policy
	10.15 Condemnation Policy
	10.16 Breakdown Policy
	10.17 Classification of Patient Care Items (CDC Classification)
		10.17.1 CDC Guidelines for Sterilization and Disinfection of Patient Care Items [3, 4] (Table 10.4)
	10.18 Conclusion
	References
Chapter 11: Engineering and Biomedical Engineering Department
	11.1 Introduction
	11.2 Biomedical Engineering Department: Functions, Designs, Space Facilities, Utilities, Hospital Wiring System
		11.2.1 Planning
		11.2.2 Organizing
		11.2.3 Directing
		11.2.4 Functions
		11.2.5 Organogram
		11.2.6 Location
		11.2.7 Hospital Wiring System
	11.3 Engineering Department: Functions, Location, Design, Organization, Maintenance Management
		11.3.1 Functions of Engineering Department
		11.3.2 Organogram
		11.3.3 Location
	11.4 Summary
	Further Reading
Chapter 12: Mitigation of Fire Hazards in Hospital
	12.1 Introduction
	12.2 Potential Fire Hazards in Hospitals
		12.2.1 Medical and Surgical Equipment
		12.2.2 Hospital Kitchens
		12.2.3 Overused Sockets and Cables
		12.2.4 Smoking
		12.2.5 Fire Door Compliance
		12.2.6 Gas Cylinders and Combustible Fluid
	12.3 Fire-Prone Area of Any Hospital
		12.3.1 Central Sterile Supply Department (CSSD)
		12.3.2 Intensive Care Unit (ICU)
		12.3.3 Operation Room
		12.3.4 MRI Room
		12.3.5 Kitchen
		12.3.6 Laundry Room
		12.3.7 Basement
	12.4 Basic Principles of Fire Safety in Hospital
		12.4.1 Fire Prevention
			(a) Planning Considerations for New and Existing Hospitals
			(b) Construction and Design Considerations
				(i) New Medical Facilities
				(ii) Existing Medical Facilities
				(iii) Number of Floors
				(iv) Egress
		12.4.2 Fire Suppression
			(a) Fire Alarm Systems
			(b) Heat Detector
			(c) Smoke and Heat Detectors
			(d) Fire Extinguishers
				Water Extinguishers
				Foam Extinguishers
				Powder Extinguishers
				Carbon Dioxide Extinguishers (CO2)
				Wet Chemical Extinguishers
				Water Mist Extinguisher
				Methods of Fire Extinguisher Use
			(e) Sprinkler System
			(f) Fire Hose Reels
			(g) Smoke Extractors
			(h) Planned Preventative Maintenance
		12.4.3 Evacuation
			Notification of External Agencies
			Types of Evacuation
			Movement
			Evacuation Routes
			Level of Evacuation
			Evacuation Transport Equipment
		12.4.4 The Important Safety Measures in Hospital to Mitigate Fire
	12.5 Innovative Equipment for Firefighters
		12.5.1 Firefighting Robots
		12.5.2 Impulse Firefighting Gun
		12.5.3 Horn and Strobe
	12.6 Conclusion
	References
Chapter 13: Principles and Implementation of Quality Management and Patient Safety Systems in Hospital
	13.1 Healthcare Quality Management: Journey
		13.1.1 Components and Elements of Quality Management Program in Hospital
			The Quality Manual
			Departmental Policy and Manual
			Standard Operating Procedures
			Training and Development
			Auditing and Maintaining Quality Assurance
		13.1.2 Common Quality Improvement Methods and Tools
			Process Mapping
				Used for?
				When to Use It?
				How to Use Process Mapping Effectively?
			Flowchart
				Used for?
				When to Use It?
				How to Use a Flowchart?
			Clinical Audit
				Used for?
				When to Conduct a Clinical Audit?
				How to Use It Effectively?
			Plan-Do-Study-Act
				Used for?
				When to Use It?
				How to Use PDSA Effectively?
			Ishikawa Cause-and-Effect (Fishbone) Diagram
				Used for?
				When to Use a Fishbone Diagram?
				How to Use It Effectively?
			Statistical Control Chart
				Used for?
				When to Use Statistical Control Chart?
				How to Use It Effectively?
			Healthcare Failure Modes and Effects Analysis (HFMEA)
				Used for?
				When to Use HFMEA?
				How to Use It Effectively?
			Pareto Chart
				Used for?
				When to Use Pareto Chart?
				How to Use It Effectively?
			Six Sigma
				Used for?
				When to Use Six Sigma?
				How to Use It Effectively?
	13.2 Continue Development in Healthcare Quality
	References
Chapter 14: Barrier-Free Healthcare Design for Patients with Disabilities
	14.1 Introduction
	14.2 Need for Barrier-Free Healthcare
	14.3 Design Considerations in Barrier-Free Healthcare
		14.3.1 Anthropometric Requirements for Accessible Inbuilt Environment for Patients with Disability
			Space Required for Mobility Devices
			Wheelchair
			Crutch Users and White Cane Users
			Vision Zone
			Height of Controls
			Entrance/Exit Door
		14.3.2 External Area
			Walkways
			Barriers and Obstacles
			Tactile Ground Surface Indicators (TGSI)
			Width of the Walkways
			Lighting for Walkways
		14.3.3 Designated Accessible Parking Space
			Location
			Signage for Parking
			Space Dimensions and Surface Requirements
		14.3.4 Approach to the Building
		14.3.5 Access at Entrance and Within the Building
			Doors
			Handrails and Grab Bars
		14.3.6 Level Changes
		14.3.7 Operating Controls and Devices
		14.3.8 Seating Spaces
		14.3.9 Toilet Rooms and Sanitary Rooms
		14.3.10 Reception Areas, Counters, Desks, and Ticket Offices
		14.3.11 Lighting
		14.3.12 Emergency Evacuation in Buildings
		14.3.13 Signage
		14.3.14 Accessible Medical Equipment
	14.4 International Guidelines Related to Disabled-Friendly Infrastructure
	14.5 National Guidelines and Laws Related to Disabled Persons
	14.6 Gap Analysis
	14.7 Limitations in the Implementation of Laws
	14.8 Recommendations
	14.9 Conclusion
	References
Chapter 15: Technological Advancements and Challenges in the Management of Hospital Functions and Public Health
	15.1 Introduction
	15.2 Management in Terms of Technology
	15.3 Critical Challenges in Digital Health
		15.3.1 Factors Related to the Society
		15.3.2 Ethical Challenges in Digital Healthcare
		15.3.3 Solutions Related to Connected Health
		15.3.4 Healthcare Scrutinizing Devices
		15.3.5 Role of Artificial Intelligence (AI)
		15.3.6 The Potential of Genomics
		15.3.7 Technology and the Prospect of Progression of Healthcare
		15.3.8 Implementation of Digital Technologies and Its Effectiveness
	15.4 Conclusion
	References