Hospital Organization

Hospital OrganizationST210Concorde Career collegeObjectivesList the types of healthcare facilities and the sources of funds for each

Describe the organizational structure of a healthcare facility

List the chain of command in the surgical settingWhere are surgeries performed?Surgical servicesNow provided in many different settingsTraditional ORsFree-standing ambulatory surgical centerFree-standing specialty centersDoctors officesDoctors clinicsLabor and delivery units 33Workplace Management Healthcare Facilities/Funding

Nonprofit not for profit

Proprietary for profit

Tax Supported not for profit

4Types of HospitalsNot-for-profitProprietary or investor-owned5Types of HospitalsPreferred provider organization (PPO)Collection of private-practice donors, labs, patient-care facilities, and hospitals Contract with insurance companies and receive an agreed set rate for servicesHealth maintenance organization (HMO)Collection of hospitals, health professionals, and doctors Work for a set fee and may require patients to use a primary care physician for all referrals 66Types of Surgical FacilitiesHospitalsAmbulatory Surgery CentersPhysician Offices

Ambulatory Surgery Center

Hospital OrganizationOrganizational Structure of the Healthcare Facility

Figure 1-8 Page 20 of ST4ST9Hospital OrganizationCharacteristicsPhilosophy and policies: typically established by a board of directors or trusteesAdministration: typically several layersSecond division for medical affairs: medical and nursing servicesSurgical services department: may be divided into units 1010Hospital Organization (contd.)Hospital departments and interdepartmental communicationDepartments can be categorized as having direct or indirect patient care responsibilitiesRefer to Tables 1-8 and 1-9

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12Hospital Organization (contd.)Financial considerations and reimbursementIntervention may be provided free of charge or as a charitable missionInsurance: one party or entity agrees to pay another for a specified loss or conditionHealth care reimbursement Government financial assistance

1313Professional Management Chain of Command in the Surgical Setting

Team members (according to the situation)Charge Nurse/Team LeaderDirector of Surgical ServicesDirector of Nursing

14All-Hazards Preparation

ObjectivesDiscuss nature-, human-, and nature/human-caused types of disastersExplain the various components of personal, health care facility, and national disaster planningDescribe the initial response and steps taken when an all-hazards event occursDiscuss the various roles the surgical technologist can fulfill during an all-hazards event

All-Hazards PreparationAll-encompassing term Refers to many different emergenciesEmergenciesThose that require the emergency response of outside assistance, which may be at the local, county, state, or federal levelsEmergency preparednessAction taken by individuals, governments, and health care facilities and systems to be prepared for an emergency18Natural DisastersMost common occurring type of disasters that can affect large populationsAvalanchesRock and land slidesWinter stormsHeat waves and wildfiresEarthquakes and tsunamisTropical storms and hurricanesFloods and tornados19Avalanche

20Tsunami

21Earthquake

Hurricane

23Man-Made DisastersDisasters caused by peopleTransportation accidents Acts of terrorism and bioterrorism Industrial incidentsCombination natural disasterman-made disasterChemical release accidentsInfrastructure incidentsRadiological injuries24Train Disaster

25Terrorism

26Personal Disaster PlanningPersonal and family preparation stepsResearch, identify, and familiarize yourself and your family with the local and regional emergencies that could occurCreate a family emergency plan for each type of emergencyPrepare emergency supplies: go-bag and in-home supplies27Individual Preparedness72-Hour Kitshttp://www.ready.gov/build-a-kit FEMA recommends all families and individuals have a kit of food, water, and supplies sufficient to last 72 hours following a disaster

Local/Community/Regional Response Response to a disaster situation Divided into the local and federal responsesLocal responseNational Incident Management SystemLocal Emergency Management AgenciesIncident Command System29Local Emergency Response

Federal Emergency ResponseFederal assistance Must be requested through formal channels by the local and state governmentsAssistance will take up to three days or possibly longerAgencies and assistance formsFederal Emergency Management AgencyNational Response FrameworkNational Disaster Medical System

31Federal Emergency Response

Local & Government Preparedness FEMA: http://www.fema.gov/ American Red Cross: http://www.redcross.org/Local Law Enforcement AgenciesFirst RespondersLocal Military Units, National Guard33Health Care Facility Emergency ResponseHealth care facilitiesEmergency action plan (EAP) follows state and federal emergency response guidelines EAP componentsMitigationPreparednessResponseRecovery34Health Care Facility Emergency Response

35Medical Office EAP Should be developed based on the community EAPs Coordinated with the local and regional health care systemComponentsProcedures for notifying employees of an emergencyProcedures for evacuating the buildingPatient evacuation procedures36Immediate Response to an All-Hazards EventImportant considerationsDisaster scene must be safe before enteringStandard Precautions and personal protective equipment Patient decontamination areaTriage of victimsPoint of Distribution (POD) siteRisk communication with the public37Immediate Response to an All-Hazards Event (contd.)Moral, ethical, and legal issues associated with providing care during a disasterEmergency System for the Advanced Registration of Volunteer Health Professionals (ESAR-VHP) and Community Emergency Response Team (CERT)

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