2. Objectives Identify different types of health care facilities. Describe a typical hospital organizational structure. Identify hospital departments and their relationship to surgical services. Discuss the professional development of a surgical technologist.

3. Health Care Facilities Traditional healthcare has changed dramatically. Surgical procedures, once restricted to hospitals are now provided in many different settings. –Ambulatory Surgery Center –Labor and delivery units –Specialty doctors offices

4. Health Care Facilities Hospitals are organizations with: –Governing Body –Medical Staff –Professional Staff –Inpatient facilities

5. Health Care Facilities Hospitals provide: –Medical –Nursing –Related services 24 hours a day/7 days a week

6. Health Care Facilities Hospitals are commonly described in many ways: –Ownership –Profit philosophy –Relationship to community needs

7. Health Care Facilities Non profit Proprietary (Profit) Tax supported

8. Health Care Facilities Non profit –General, acute care hospitals –Owned by private corporations –Profits are used to put back into the hospital for improvements. –Non taxable by US Gov.

9. Health Care Facilities Proprietary/Profitable –Corporation or investor-owned –Intent is to provide good patient care. –Taxable profits returned to the investors.

10. Health Care Facilities Tax Supported –Becoming less and less common. –Assisted with money from US Government. –May lend a hand to non-profit hospitals.

11. Health Care Facilities Most hospitals perform surgery in more than one setting: –Outpatient surgery –Labor and Delivery Rooms –Specialty areas

12. Health Care Facilities Ambulatory Surgery Center –Physically separate from hospital –Same Day Surgery patients that do not require hospitalization.

13. Health Care Facilities Clinics –Facility designed for diagnosis and treatment of outpatients. –Some clinics perform certain surgery like procedures.

15. Hospital Organization Policies and philosophy established by a board of directors. May be elected or appointed positions. The board hires a CEO (Chief executive officer) to put the policies into practice.

16. Hospital Organization Most hospitals have several vice presidents in charge of broad areas. –Administration –Medical affairs –Patient services –Legal services –Finances –Building and environment

17. Hospital Organization Medical Affairs may be divided into: –Medical staffing Physicians –Nursing services All other health care providers

18. Hospital Organization Medical staffing may also be divided by physician specialty. –Chief of Medicine –Chief of Surgery Medical and Surgical subspecialties may have a “Chief”. –Example: Chief of Orthopedics

19. Hospital Organization Surgeons –Medical doctors completed an education and training and have surgical privileges. –Require 4 years of college –4 years medical school –4-8 years in surgical specialty.

20. Hospital Organization Physician Assistants (PA) –20-24 month programs usually affiliated with medical school. –Works under a physicians direction, extending their capabilities. –May work with surgeon in the O.R.

21. Hospital Organization Nursing services will have a Director of Nursing (DON) that will oversee all nursing personnel. Hospital will be divided into smaller departments. –Example: Surgical Services

22. Hospital Organization Nursing staff include: –Graduate Nurses (GN) –Licensed Practical/Vocational Nurse (LPN/LVN) –Associate degree registered nurses (AND) –Bachelor’s degree registered nurses (BSN) Some of which may have special credentials –CNOR Certified Nurse Operating Room

23. Hospital Organization Anesthesia staff include: –Anesthesiologists –Certified Registered Nurse Anesthetists (CRNA) –Anesthesia technicians

24. Hospital Communication Hospital departments divided into direct and indirect patient care.

25. Hospital Communication Direct Patient Care –Nursing care units –Diagnostic Imaging –Medical Laboratory –Pharmacy –Physical/Occupational therapy

26. Hospital Communication Indirect Patient Care –Admin –Maintenance –Housekeeping –Food Services –Central Services –Medical Records

27. Financial Considerations Surgery is expensive!! Patient and insurance provider will share certain costs. Surgical technologist must keep this in mind during surgery.

28. Financial Considerations Insurance policies spell out what costs the insurance company will cover and what is not covered. Payments are made to the insurance company on an ongoing basis for coverage.

29. Financial Considerations Private insurance –Contractual relationship and mutual benefit between the person and a private company that agrees to pay for services. –These type of policies still exist but have been replaced largely by HMO/PPO.

30. Financial Considerations HMO/PPO (Health Maintenance Organization) (Preferred Provider Organization) Lower or limits costs by having a contract with health care providers. –Physicians –Hospitals

31. Financial Considerations HMO/PPO –Enrollee chooses their primary provider. –Doctors visits and services are at a set rate. –Primary provider may only refer the patient to a specialist. “Gatekeeper”

32. Financial Considerations Medicare –Federal Government sponsored through the CMS. (Formally known as the HCFA) –People 65 and older Medicaid –State and Federal Government funded –Reimburses hospitals for low income persons.

33. Professional Development for Surgical Technologists

34. Professional Development The Association of Surgical Technologists is the professional organization for surgical techs. Stresses education and certification to enhance and ensure the highest quality of patient care.

35. Professional Development Although certification is not required in all job opportunities, it is rapidly becoming a necessity. Continuing education is required for certification and improves patient safety and healthcare.

36. Professional Development Job opportunities include: –Specialization in area of interest –Private employment by surgeon –Traveling surgical techs –Veterinary Surgeon assistant –Medical representative for corporation –SPD – Sterile Processing Department –Surgical tech instructor –Volunteer opportunities

37. Opportunity awaits you…. Just open the door!