Hospitals Acute care facilities Inpatient vs. outpatient Provide care for: Severely ill or injured Those needing surgery Women delivering babies Trend: decrease in average length of stay Public vs. private, for-profit vs. nonprofit

Types of hospitals General Hospitals shorter length of stay, acute care, wide range of services Specialty Hospitals for specific illnesses or disorders, longer length of stay Government Hospitals provide care for government service personnel and their families i.e. VA hospitals University or college medical centers additionally provide research and educational services

Subacute Care Facilities Fill the gap between hospitalization & rehabilitation Provide: Extensive monitoring & IV therapy Around-the-clock supervision Typically 20% to 50% less expensive than Often an area within an extended care facility less aggressive rehab, nursing care needs, intent for patient to return home

Extended Care Facilities Provide: Health care Help with activities of daily living Basic physical and emotional care to individuals who can no longer care for themselves Social interactions in a safe & secure environment Types Nursing homes Independent-living facilities Residential institutions for mentally or physically disabled

Senior Day Care Centers activities and personal care during day hours only, patient returns home at night, on weekends Assisted Living Facilities rented or purchased apartment in a facility with services available such as housekeeping transportation, laundry, meals, social events, and minimal medical assistance (example assist with medications)

Rehabilitation Centers Provide: Physical or emotional rehabilitation Treatment of chemical dependency Goal: return healthy patients to community Acute physical rehab requires patients to participate in a minimum of 3 hours / day of therapy

Home Health Care Agencies Provide care in a patient’s home Care managed by: Community health departments Hospital case managers Home health agencies Increasing in popularity due to: Increase in early discharge from hospital Elderly living longer with chronic diseases Technology

other Ambulatory or Outpatient Care Centers several physicians w/different specialties combine practices, same day care Elderly living longer with chronic diseases Urgent or Emergency Care Clinics Municipal Health Departments Outpatient or specialty clinics (ex. Diabetes education, Dialysis center)

other Laboratories Mental Health Facilities School Health Facilities Hospice Care inpatient or in home care… for patients no longer pursuing curative treatment for their conditions Expanded list here

OUTPATIENT – discharged within 23 hours, but may require ongoing care of some kind INPATIENT – remains in facility for more than 24 hours

 Levels allow efficient management of hospital departments.  The structure helps one understand the hospital’s chain of command.  Large hospitals have complex organizational structures.  Smaller hospitals tend to have much simpler organizational structures.  Hospital departments are grouped in order to promote efficiency of facility.  Grouping is generally done according to similarity of duties. Organizational Structure refers to levels of management within a hospital. Organizational Structure refers to levels of management within a hospital.

 Administrative Services  Informational Services  Therapeutic Services  Diagnostic Services  Support Services

Those who “run the hospital”  Oversee budgeting and finance  Establish hospital policies and procedures  Often perform public relation duties  Hospital Administrators CEO, CFO, COO, Vice President(s), Directors, Executive Assistants, Department Heads

Document and process information:  Admissions  Billing & Collection  Medical Records  Computer Information Systems  Health Education  Human Resources

Provide treatment to patients:  Physical Therapy - treatment to improve large muscle mobility  Occupational Therapy - treatment goal is to help patient regain fine motor skills  Speech/Language Pathology - identify, evaluate, treat speech/language disorders

 Medical Psychology - concerned with mental well-being of patients  Social Services – counsels, connect patients with community resources (financial aid, etc.)  Pharmacy - dispense medications  Respiratory Therapy - treat patients with heart & lung disease  Sports Medicine - provide rehabilitative services to athletes  Nursing - provide care for patients  Dietary - maintain nutritionally sound diets for patients

Determines the cause(s) of illness or injury:  Medical Laboratory - studies body tissues  Medical Imaging - radiology, MRI, CT, Ultra Sound  Emergency Medicine -provides emergency diagnoses & treatment

Provide support for entire hospital:  Central Supply - orders, receives, stocks & distributes equipment & supplies  Biomedical Technology - design, build repair, medical equipment  Housekeeping & Maintenance - maintain safe, clean environment

Board Administration Therapeutic Services Information Services Diagnostic Services Support Services Admissions Billing, etc. Med. Records Computer Info. Health Ed. Human Resour. PT, OT Speech/Lang. Resp. Therapy Pharmacy Nursing Dietary Med. Lab Radiology Nuclear Med ER Cardiology Neurology Central Supply Biomedical Housekeeping Maintenance Dietary Transportation Traditional Organizati onal Chart

Admin. Services Information Services Therapeutic Services Diagnostic Services Support Services Board Pyramid demonstrates a symbolic organizational structure of hospital.

Stethoscope : DIAGNOSTIC SERVICES - diaphragm determines cause of illness Earpieces: THERAPEUTIC SERVICES - hears/interprets and decides course of treatment Tubing: SUPPORT SERVICES - supports structure of stethoscope (thus hospital departments) Head: ADMINISTRATIVE SERVICES - runs everything

This is a “symbolic” organizational structure of a hospital as planned After each group completes their drawing, they present it to the class and explain the symbolism as depicted in their picture. This drawing was rationalized as such: 1. Stethoscope : DIAGNOSTIC SERVICES - diaphragm determines cause of illness 2. Earpieces: THERAPEUTIC SERVICES - hears/interprets and decides course of treatment 3. Tubing: SUPPORT SERVICES - supports structure of stethoscope (thus hospital departments) 4. Head: ADMINISTRATIVE SERVICES - runs everything Be as creative (but logical) as possible. Other examples : roller coaster, totem pole, hamburger, tennis shoe, ice cream cone, etc.