Health Care Management Advisor GD Mogli
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ge1Health Care Management Advisorge2
ge3Health Care Management Advisor
GD Mogli PhD MBA FHRIM (UK) FAHIMA (USA) Visiting Professor, Medical Informatics Mahatma Gandhi Institute of Medical Sciences Sevagram, Maharashtra, India Chief Executive Officer and Managing Director Dr Mogli Healthcare Management Consultancy Hyderabad, Andhra Pradesh, India wwwdrmogliit.com gdmogli@yahoo.com Senior Consultant eHealth Management HEARTCOM INC. (USA) Formerly served as WHO Consultant and Senior Consultant/Adviser to the Ministries of Health of India Afghanistan, Iran, Kuwait, Saudi Arabia, Oman, Bahrain Qatar and United Arab Emirates (UAE)
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This book has been published in good faith that the contents provided by the author contained herein are original, and is intended for educational purposes only. While every effort is made to ensure accuracy of information, the publisher and the author specifically disclaim any damage, liability, or loss incurred, directly or indirectly, from the use or application of any of the contents of this work. If not specifically stated, all figures and tables are courtesy of the author. Where appropriate, the readers should consult with a specialist or contact the manufacturer of the drug or device.
Health Care Management Advisor
First Edition: 2013
9789350902752
Printed at
ge5Dedicated to
Sick and Injured
Hospital is a magnificent place, thousands of sick and injured benefit enormously. But there are, at times, many patients and their close associate's forbearance during the care period; some undergo incredible psychological, emotional, social and financial issues that are immeasurable. Those who are lucky might gain back gradually to normalcy and some blessed get beyond that, some, forego everything, and leave beyond unforgettable memories that should be eye-opener for all of us. Hospital is a complex organization with excellent motive to care the sick and injured and provide curative, preventive, rehabilitative, promotive and palliative soothing care.
The author's five decades involvement directly and indirectly in hospitals and healthcare affairs, have taught him a lesson that if, all the hospital personnel including medical, nursing, paramedical, administrative and others work as a good team with modest commitment, the healthcare consumer will benefit immensely, if not, whatever extraordinary efforts made including finance, will not only be lost, but will leave a scar on everyone involved in the team that would be difficult to wipe out.
Every one should revolve around a patient whether it is; architect, constructor, interior designer, policymaker, care provider or care receiver and others involved in patient care directly or indirectly as Patient is the nucleus in the field of world health.ge6
ge7Preface
A hospital is an institution for health care providing patient treatment by specialized staff and equipment. Hospitals are becoming complex institutions where people from diverse backgrounds interact with each other including the administrators, doctors, clinical and other nonclinical staff and coordinate their services to deliver the best possible patient care. There are many hospitals which are improving day by day and are functioning efficiently meeting their laid out policies; on the other side, there are hospitals which are being downsized or are being closed completely because of not being able to function properly which could be due to lack of basic policies or not adhering to the policies.
This book Health Care Management Advisor is useful for planning a new hospital to meet the needs of the patient in the current-day situation, and also for upgrading an already functioning hospital. This book can also be used as a handbook for the hospitals, so that they can ensure they are functioning correctly. This can be used by all the professionals including hospital administrators, doctors, hospital planners, engineers, and also those involved in organizing the hospital systems. In fact, there is something for everyone involved with a hospital. The book provides a holistic view of the hospital and goes onto cover every aspect of the hospital. Having served many countries as Sr Consultant/Advisor to the Ministries of Health to oversee the development of health institutions, the experience and expertise I gained has been given in this book in some key points which are generally neglected, but which will prove to be detrimental for a hospital. The book is supplemented by case studies as and where required which gives information about my experiences at various national and international organizations. These case studies along with the theory will be an effective guide for implementing the theories.
This book can be used by any person even if he is not related to the medical field or if he is a beginner or an expert in the medical field.
Chapter 1 deals with the commissioning of a new hospital, the policies to be laid beforehand and some important precautions to be taken in developing a new hospital.
Chapter 2 deals with the organization of a hospital, dealing with the governing body in a hospital.
Chapter 3 deals with the organization of medical staff which contains information about the medical staff organization.
Chapter 4 gives insights of the most important staff in the hospital next to doctors that is the nursing staff. It highlights how to organize this department so that the nurses will accurately do their duties and will not be burdened by unnecessary work which generally happens in many hospitals.
Chapter 5 gives an overview of the hierarchical structure in a hospital which is very important for effective administration and to ensure proper patient care.
Chapter 6 deals with the most important and most neglected aspect in a hospital that is regarding the medical records. This chapter gives a detailed information of the design of medical record forms which is very important since it should not contain all the unnecessary information and should not miss out any important information; also, the cost of this department is given.
Chapter 7 is mainly concerned with the most important factor in a health care organization which is necessary to ensure a proper care, reduce errors and also provide timely care that is the Hospital Information System (HIS). It describes in detail what the HIS should contain and how the use of latest technology will make it useful for the organization and to the patient.
ge8Chapter 8 deals with the statistical formulae which will be required for calculating the various important factors that will be useful for effectively running a hospital; also, this deals with the bed allocation which is very much important for a hospital.
Chapter 9 provides an in-depth understanding of what some important departments in a hospital should do and what are the factors they should consider in their functioning such as the records to be maintained, etc.
Chapter 10 is mainly concerned with the most important factor the hospital should consider that is the patient safety. With my rich experience in the health care field, I have provided this information, which is not generally found in many other books.
Chapter 11 deals with the cost analysis of medical record department, where the total cost incurred by the hospital is analyzed and compared to the cost incurred on the medical records.
Chapter 12 is mainly for the health care administrators. This is mainly focused on how to provide good quality patient care at minimized expenditure. Also, I have provided information which is usually neglected by the administrators and thus leads to much of the expenditure.
Chapter 13 gives useful tips to the administrator which will prove to be very useful in running the hospital effectively.
Chapters 14 and 15 are concerned with the qualities which an effective administrator should possess or in general every person who is the head of a department in a hospital should possess to make the entire process of health care delivery a smooth and effective one.
Chapter 16 deals with an important aspect of health care delivery that is the quality assurance. This chapter provides insights into how this process should be carried out to effectively ensure a qualitative care.
Chapter 17 deals with the medical audit which is important to detect any loopholes in the health care delivery process and also understand the problems faced by the staff.
Chapter 18 deals with the important aspect of patient care evaluation to ensure that the patients are treated with care and also to ensure that the patients receive the best care. A novel method proposed by me is also discussed in it.
Chapter 19 is related to my idea to establish Central Medical Record Archives Training and Research Department (CMRATRD) by which the hospitals can be benefited immensely.
Chapter 20 deals with how the healthcare scenario will be beyond 21st century and what will be the challenges faced then and how we should be prepared to face these challenges.
GD Mogli
ge9Acknowledgments
Affinity to profession coupled with non-availability of books on practical professional guidance, the book Health Care Management Advisor mainly deals with commissioning of new hospital, organization and hierarchical structure of a hospital, medical and nursing staff, medical record forms design, estimation, and cost, hospital information system (HIS), statistics and bed allocation, standard operating procedures, patient safety, cost analysis of medical record department, how to economize health service expenditure, tips to the hospital administrator, leadership, motivation, quality assurance, medical audit, patient care evaluation, establishment of CMRATRD and challenges of the health care delivery beyond 21st century.
At the outset, my grateful thanks to M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, for bringing out this invaluable book. My sincere gratitude to the state administrators and professional colleagues of India, Afghanistan, Kuwait, Kingdom of Saudi Arabia, Sultanate of Oman, Bahrain, Qatar, United Arab Emirates, for their encouragement and cooperation.
My special thanks to Mr Ramalingam Selva Kumar, MA, MS, BMRSc, PGDHM, AHRIM (UK), CHRIM (UK), currently working as Clinical Coder Aberdeen Royal Infirmary Hospital, Aberdeen- AB16 5 HN, Scotland, UK. He formerly served as Medical Records Officer, Riyadh Central Hospital, Riyadh, Saudi Arabia.
Mr Narendar Kumar Sampath, MA, BMRSc, PGDCS, CHRIM (UK), Medical Record Manager, Welcare Hospital, Dubai, UAE.
Mrs Marie Stella Alexander, BSc, BMRSc, CHRIM (UK), currently working as Medical Record Manager, Hamad General Hospital, Doha, Qatar. She formerly served as Medical Records Officer, IBN SINA Hospital, Kuwait.
Ms Swadhura V, B Tech (Biomedical Engineering) working as Research Assistant in Dr Mogli Healthcare Management Consultancy, Hyderabad, India, for her dedicated work in bringing out this book.
Last but not least, I owe my sincere gratitude to my family.ge10ge11ge12ge13ge14ge15ge16