Hospitals : What They Are and How They Work

by Snook, I. Donald

• ISBN13: 9780763745592
• ISBN10: 0763745596
• Edition: 2nd
• Format: Hardcover
• Copyright: 2003-10-01
• Publisher: Lightning Source Inc

Summary

This latest edition includes chapters on managed care and hospitals and alternative delivery systems. Topics addressed include responsibilities of hospital trustees, hospital consolidations and reorganizations, physician bonding, ambulatory care centers, hospital payment systems, computerized medical records, utilization review, risk management, and market research.

Table of Contents

Introduction	xi
PART I---WHERE DID THE HOSPITAL COME FROM?	1	(14)
A Brief History	3	(6)
The Beginning (Birth of Christ--Middle Ages)	3	(1)
Early American Hospitals (Founding of the New World--World War II)	4	(2)
The Modern Era (Post World War II--Present)	6	(3)
Today's Hospital	9	(6)
How Big Is the Hospital Industry?	9	(1)
Growth in the Hospital Industry	10	(1)
What Kind of Services Does the Hospital Industry Provide?	10	(1)
What about Hospital Finances?	11	(4)
PART II---MANAGING THE HOSPITAL	15	(24)
Organization	17	(8)
Introduction	17	(1)
How Hospitals Are Organized	18	(2)
Line and Staff Functions	20	(1)
The Organization Chart	20	(1)
A Team of Three	21	(1)
Power	21	(2)
Corporate Restructuring in the Hospital	23	(1)
Multihospital Systems	24	(1)
The Governing Body	25	(8)
Introduction	25	(1)
A Profile of the Governing Body	26	(1)
Functions of the Board of Trustees	27	(3)
Selection and Evaluation of the Chief Executive Officer	30	(1)
Relationship with the Medical Staff	30	(1)
How Does the Board Operate?	31	(2)
The Chief Executive Officer	33	(6)
Introduction	33	(1)
Functions of the Administrator	34	(3)
Assistant Administrator or Vice President	37	(1)
The Future for Chief Executive Officers	38	(1)
PART III---DOORWAYS TO THE HOSPITAL	39	(24)
Outpatient Areas	41	(6)
Introduction	41	(1)
Ambulatory Surgery	42	(1)
Clinics	42	(1)
Ancillary Outpatient Services	43	(1)
Group Practice	43	(1)
Medical Office Buildings (MOBs)	44	(1)
Standards of Accreditation	45	(1)
Major Growth Areas in the Future	46	(1)
The Emergency Department	47	(10)
Introduction	47	(1)
Emergency Room Utilization	48	(1)
Categorization of Emergency Facilities	48	(1)
Physical Facilities	49	(1)
Organization	50	(1)
Admissions	51	(1)
Physician Coverage of the Emergency Department	51	(1)
Records	52	(1)
Financial Implications	52	(1)
Legal Implications	53	(2)
Handling Disasters	55	(2)
The Admitting Department	57	(6)
Introduction	57	(1)
The Department's Role in Public Relations	57	(1)
Functions of the Admitting Department	58	(1)
Types of Admissions	58	(1)
Preadmission	59	(2)
Consent Forms	61	(1)
Bed Assignments	61	(2)
PART IV---THE MEDICAL TEAM	63	(28)
The Medical Staff	65	(10)
Introduction	65	(1)
Becoming a Physician	66	(1)
Continuing Medical Education	67	(1)
Organized Medicine	68	(1)
Medical Staff Organization	68	(2)
Closed and Open Medical Staffs	70	(1)
Medical Staff Committees	71	(1)
The Medical Director	72	(1)
Allied Health Personnel	72	(1)
Legal Restrictions on Physicians	73	(2)
Nursing Services	75	(16)
Introduction	75	(1)
Early Traditions	75	(1)
Nursing Education	76	(2)
Department Organization	78	(1)
The Nursing Unit	79	(2)
Other Components of the Nursing Unit	81	(2)
Special Care Units	83	(2)
Modes of Nursing Care Delivery	85	(1)
Terms and Standards	86	(1)
Staffing	87	(1)
Scheduling	87	(2)
Telemonitoring and Bedside Terminals	89	(1)
Nurse Manpower Issues	90	(1)
PART V---TESTS AND RESULTS	91	(28)
Key Ancillary Services	93	(16)
Introduction	93	(1)
Clinical Laboratories Department	94	(5)
Radiology Department	99	(5)
Freestanding Imaging Centers	104	(1)
Anesthesiology Department	104	(5)
Other Ancillary Services	109	(10)
Respiratory Care Department	109	(1)
Electroencephalography	110	(1)
Heart Station	110	(2)
Rehabilitative Medicine	112	(1)
The Pharmacy	113	(6)
PART VI---BEHIND THE SCENES	119	(34)
Patient Support Services	121	(10)
What Are Support Services?	121	(1)
Dietary Department	122	(5)
Social Service Department	127	(2)
Pastoral Care Services	129	(1)
Patient Escort Services	129	(1)
The Patient Representative	130	(1)
Facilities Support Services	131	(10)
Environmental Services Department	131	(2)
Hospital Laundry	133	(1)
Maintenance Department	134	(2)
Plant Engineering	136	(1)
Parking Facilities	136	(1)
Security	137	(1)
Fire Safety	137	(1)
Clinical Engineering Department	137	(1)
Contract Management	138	(3)
Administrative Support Services	141	(12)
Materials Management Department	141	(1)
Organization	141	(1)
Purchasing Section	142	(1)
Centralized Purchasing	143	(1)
Receiving Section	143	(1)
Inventories and Inventory Management	144	(1)
The Storeroom	145	(1)
Human Resources Department	145	(2)
Hospitals and Unions	147	(1)
Government Involvement and Regulations	148	(1)
Occupational Licensure	148	(1)
Volunteers	148	(2)
Auxilians	150	(1)
Telecommunications Management	150	(3)
PART VII---HOSPITAL FINANCES	153	(20)
Generating Revenue	155	(6)
Types of Third-Party Payments	155	(1)
The Major Payers	156	(5)
Hospital Budgeting	161	(6)
Types of Budgets	161	(1)
Financial and Statistical Reports	162	(5)
Business Functions	167	(6)
Introduction	167	(1)
The Accountant	168	(1)
Hospital Accounting	168	(1)
Hospital Information Systems (HIS)	169	(1)
Patient Accounts and Billing Department	170	(3)
PART VIII---EVALUATING THE CARE	173	(26)
Medical Records	175	(8)
Introduction	175	(1)
Purpose of the Medical Record	175	(1)
Definition of a Medical Record	176	(1)
Manual Medical Records	176	(1)
Electronic Medical Records	177	(1)
The Medical Records Department	178	(1)
Organization of the Department	179	(1)
The Medical Records Committee	179	(1)
Legal Requirements	180	(1)
Medical Records and Quality Assurance	180	(3)
Quality Assurance	183	(6)
Definition	183	(1)
Historical Review	184	(1)
Classical Techniques	185	(1)
Defining Audit Terms	186	(1)
The Board's Responsibility	187	(1)
Automated Quality Assurance	187	(1)
The Future of Quality Assurance	188	(1)
Risk Management and Malpractice	189	(4)
Risk Management	189	(1)
Risk Management As a Team Approach	189	(1)
Risk Management vs. Quality Assurance	190	(1)
Risk Management and Malpractice	190	(1)
Defensive Medicine	191	(1)
Hospital Liability for Physicians' Acts	191	(1)
Role of the Medical Record	192	(1)
Accreditation and Licensing	193	(6)
Historical Review	193	(1)
The Accreditation Process	194	(1)
What Does Accrediation Really Mean to a Hospital?	195	(1)
How Does a Hospital Become Accredited?	195	(1)
Licensure	196	(1)
Certification	197	(1)
Registration	197	(2)
PART IX---CONTINUING TO GROW	199	(22)
Hospital Marketing	201	(10)
Introduction	201	(1)
What Is Marketing?	202	(4)
Sales	206	(1)
Market Research	206	(1)
Marketing Concepts	207	(1)
Fundraising	208	(3)
Planning	211	(10)
Introduction	211	(1)
The Evolution of Planning	211	(1)
The Hospital's Long-Range Plan	212	(1)
Who Should Do the Hospital's Planning?	213	(1)
Contents of a Long-Range Plan	214	(1)
Benefits from Planning	215	(1)
Planning New Facilities	216	(1)
Government Involvement in Planning	216	(5)
PART X---THE HEALTH CARE SYSTEM	221	(10)
The Medical Care System	223	(8)
Introduction	223	(1)
The System's Goals	224	(1)
Outreach Element	225	(1)
Outpatient Element	226	(1)
Inpatient Element	227	(1)
Extended Element	228	(1)
Community Element	228	(3)
Appendix A--Glossary	231	(28)
Index	259