Hospitals: What They Are and How They Work

Table of Contents......Page 4
Acknowledgments......Page 14
About the Author......Page 16
Introduction to the Third Edition......Page 18
Part I: Evolution of Hospitals......Page 20
THE VERY EARLY DAYS......Page 22
EARLY AMERICAN HOSPITALS—FROM FOUNDING THE NEW WORLD THROUGH WORLD WAR II (1500–1945)......Page 23
GOVERNMENT INVOLVEMENT......Page 25
CHAPTER REVIEW......Page 26
IMPORTANT HEALTH CARE TRENDS......Page 28
HOSPITAL EXPENSES AND REVENUES......Page 31
Hospitals......Page 35
CHAPTER REVIEW......Page 36
Part II: Managing the Hospital......Page 38
INTRODUCTION—COMMON ORGANIZATIONAL MANAGEMENT PRINCIPLES......Page 40
HOW HOSPITALS ARE ORGANIZED......Page 41
THE ORGANIZATION CHART......Page 43
CORPORATE RESTRUCTURING IN THE HOSPITAL......Page 45
CHAPTER REVIEW......Page 46
INTRODUCTION......Page 48
A PROFILE OF THE GOVERNING BODY......Page 49
FUNCTIONS OF THE BOARD OF TRUSTEES......Page 50
RELATIONSHIP WITH THE MEDICAL STAFF......Page 52
HOW DOES THE BOARD OPERATE?......Page 53
CHAPTER REVIEW......Page 54
INTRODUCTION......Page 56
FUNCTIONS OF THE ADMINISTRATOR......Page 57
INSIDE ACTIVITIES OF THE CEO......Page 58
OUTSIDE ACTIVITIES OF THE CEO......Page 59
ASSISTANT ADMINISTRATOR OR VICE PRESIDENT......Page 60
CHAPTER REVIEW......Page 61
Part III: Doorways to the Hospital......Page 62
INTRODUCTION......Page 64
CLINICS......Page 65
GROUP PRACTICE......Page 66
STANDARDS OF ACCREDITATION......Page 67
CHAPTER REVIEW......Page 68
INTRODUCTION......Page 70
CATEGORIZATION OF EMERGENCY FACILITIES......Page 71
PHYSICAL FACILITIES......Page 72
ADMISSIONS......Page 73
Staffing Models......Page 74
RECORDS......Page 75
FINANCIAL IMPLICATIONS......Page 76
CHAPTER REVIEW......Page 77
THE DEPARTMENT’S ROLE IN PUBLIC RELATIONS......Page 78
FUNCTIONS OF THE ADMITTING DEPARTMENT......Page 79
PREADMISSION......Page 80
CONSENT FORMS......Page 81
CHAPTER REVIEW......Page 82
Part IV: The Medical Team......Page 84
INTRODUCTION......Page 86
BECOMING A PHYSICIAN......Page 87
CONTINUING MEDICAL EDUCATION......Page 88
MEDICAL STAFF ORGANIZATION......Page 89
CLOSED AND OPEN MEDICAL STAFFS......Page 90
MEDICAL STAFF COMMITTEES......Page 92
ALLIED HEALTH PERSONNEL......Page 93
CHAPTER REVIEW......Page 94
EARLY TRADITIONS......Page 96
NURSING EDUCATION......Page 97
DEPARTMENT ORGANIZATION......Page 99
Other Components of the Patient Care Unit......Page 100
SPECIAL CARE UNITS......Page 102
Coronary Care Units......Page 104
Case Nursing......Page 105
Primary Care Nursing......Page 106
STAFFING......Page 107
Traditional Scheduling......Page 108
TELEMONITORING AND BEDSIDE TERMINALS......Page 109
NURSE STAFFING ISSUES......Page 110
CHAPTER REVIEW......Page 111
Part V: Tests and Results......Page 112
INTRODUCTION......Page 114
Clinical Laboratory Functions......Page 115
Organization of the Clinical Laboratory......Page 116
Location and Physical Facilities of the Clinical Laboratory......Page 117
Laboratory Quality Review......Page 118
THE IMAGING DEPARTMENT......Page 119
Functions of the Imaging Department......Page 120
Nuclear Medicine......Page 121
Organization of the Imaging Department......Page 122
Staffing of the Imaging Department......Page 123
THE ANESTHESIOLOGY DEPARTMENT......Page 124
Location and Physical Facilities of the Anesthesiology Department......Page 125
Staffing of the Anesthesiology Department......Page 126
CHAPTER REVIEW......Page 127
RESPIRATORY CARE DEPARTMENT......Page 128
THE CARDIAC CENTER......Page 129
REHABILITATIVE MEDICINE—PHYSICAL THERAPY, OCCUPATIONAL THERAPY, AND SPEECH THERAPY......Page 131
THE PHARMACY......Page 132
Pharmacy and Therapeutics Committee......Page 133
Drug Distribution System......Page 134
Security of Drugs......Page 135
CHAPTER REVIEW......Page 136
IN GENERAL, WHAT ARE SUPPORT SERVICES?......Page 138
DIETARY DEPARTMENT......Page 140
Special Diets......Page 141
Types of Food Service......Page 142
Vending Services......Page 143
Contract Food Services......Page 144
Qualifications of a Medical Social Worker......Page 145
A New Role for the Medical Social Worker......Page 146
PATIENT TRANSPORTATION SERVICES......Page 147
CHAPTER REVIEW......Page 148
ENVIRONMENTAL SERVICES DEPARTMENT......Page 150
Infectious and Hazardous Waste Removal......Page 151
HOSPITAL LAUNDRY......Page 152
MAINTENANCE DEPARTMENT......Page 153
Functions......Page 154
PARKING FACILITIES......Page 155
GENERAL SAFETY......Page 156
Important Elements......Page 157
DISASTER PLANNING......Page 158
Types of Internal and External Disasters......Page 159
Functions......Page 160
CONTRACT MANAGEMENT......Page 161
CHAPTER REVIEW......Page 162
MATERIALS MANAGEMENT DEPARTMENT......Page 164
Shared Purchasing......Page 165
Storage and Warehousing......Page 166
HUMAN RESOURCES DEPARTMENT......Page 167
Creating Job Descriptions......Page 168
Motivation and Job Enrichment......Page 169
Employee Performance Appraisal......Page 170
Important Laws, Acts, and Issues......Page 171
THE VOLUNTEER ORGANIZATION......Page 173
CHAPTER REVIEW......Page 174
Part VII: Hospital Finances......Page 176
TYPES OF THIRD-PARTY PAYMENTS......Page 178
Capitation......Page 179
Medicare......Page 180
Blue Cross/Blue Shield......Page 181
Self-Paying Patients......Page 182
CHAPTER REVIEW......Page 183
TYPES OF BUDGETS......Page 184
FINANCIAL AND STATISTICAL REPORTS......Page 185
Statistical Report......Page 186
CHAPTER REVIEW......Page 188
INTRODUCTION......Page 190
Fund Accounting......Page 191
MANAGEMENT INFORMATION SYSTEMS (MIS)......Page 192
PATIENT ACCOUNTS AND BILLING DEPARTMENT......Page 193
CHAPTER REVIEW......Page 194
Part VIII: Evaluating Care......Page 196
INTRODUCTION (HIPAA)......Page 198
PURPOSE OF THE MEDICAL RECORD......Page 199
ELECTRONIC MEDICAL RECORDS......Page 200
THE MEDICAL RECORDS DEPARTMENT......Page 201
ORGANIZATION OF THE DEPARTMENT......Page 202
THE MEDICAL RECORDS COMMITTEE......Page 203
CHAPTER REVIEW......Page 204
DEFINITION......Page 206
HISTORICAL REVIEW......Page 207
Newer Approaches......Page 208
Defining Audit Terms......Page 209
The Board’s Responsibility......Page 210
NOTE......Page 211
RISK MANAGEMENT AS A TEAM APPROACH......Page 212
Overview of Malpractice (Tort Law)......Page 213
RESPONDENT SUPERIOR......Page 214
NOTES......Page 215
THE PROBLEM OF MEDICAL ERRORS......Page 216
ENDING MEDICAL ERRORS......Page 217
JCAHO......Page 218
NOTES......Page 219
INTRODUCTION......Page 220
THE PRINCIPLE OF AUTONOMY......Page 221
THE PRINCIPLE OF SOCIAL JUSTICE......Page 222
A FINAL WORD......Page 223
DISCUSSION QUESTIONS......Page 224
HISTORICAL REVIEW......Page 226
ACCREDITATION OVERVIEW......Page 227
ACCREDITATION IN MORE DETAIL......Page 228
WHAT DOES ACCREDITATION REALLY MEAN TO A HOSPITAL?......Page 229
LICENSURE......Page 230
REGISTRATION......Page 231
DISCUSSION QUESTIONS......Page 232
Part IX: Continuing to Grow......Page 234
INTRODUCTION......Page 236
Public Relations—Only One Part of the Marketing Effort......Page 237
Hospital Advertising......Page 239
SALES......Page 240
MARKET STUDIES AND MARKET AUDITS......Page 241
CHAPTER REVIEW......Page 244
THE EVOLUTION OF PLANNING......Page 246
WHO SHOULD DO THE HOSPITAL’S PLANNING?......Page 247
The Strategic Planning Process......Page 248
PLANNING NEW FACILITIES......Page 249
DISCUSSION QUESTIONS......Page 250
Part X: The US and World Health Care Systems......Page 252
INTRODUCTION......Page 254
THE SYSTEM’S GOALS......Page 255
OUTREACH ELEMENT......Page 256
OUTPATIENT ELEMENT......Page 257
INPATIENT ELEMENT......Page 258
CHAPTER REVIEW......Page 259
THE UNITED STATES......Page 262
QUALITY OF CARE......Page 263
NOTES......Page 264
Appendix A: Case Studies......Page 266
DISCUSSION......Page 268
PART 2......Page 269
PART 3......Page 270
DISCUSSION......Page 271
BACKGROUND......Page 272
PART 2......Page 273
DISCUSSION......Page 274
DISCUSSION......Page 275
Case 5: Controls and Indicators for the Ship......Page 276
DISCUSSION......Page 277
Case 6: The Case of Jill......Page 278
DISCUSSION......Page 279
Case 7: The Need to Communicate......Page 280
DISCUSSION......Page 281
DISCUSSION......Page 282
Case 9: The Case of “Baby B”......Page 283
DISCUSSION......Page 284
Case 10: The Case of the Relocated Management Team......Page 285
DISCUSSION......Page 286
Appendix B: Glossary......Page 288
Appendix C: The Hospital-URLs......Page 318
Index......Page 320