Nursing Hospital Administrator

Question: Discuss how you as a hospital administrator participate in the planning of a new hospital in an area servicing a population of 100,000 incorporating all the related aspects required of a hospital. Answer: Introduction This assignment aims to participate as a hospital administrator in the planning of a new hospital in an area servicing a population of 100,000 incorporating all the related aspects required of a hospital. In the present scenario, the patients know more and are well informed regarding the services of healthcare. Moreover, they want to be involved in the processes of medical care. This is the reason that they choose their doctor, make their individual decisions, and select hospital according to their own desire and convenience. More precisely, they demand care that is of a superior quality and a reasonable price. Today, the costs of healthcare are rising considerably. That is mainly due to the remarkable advances that have appeared in the equipment, technology and treatment. The individuals are glad that advanced treatment is currently available for different types of health problems. It is also apparent that when it comes to health and safety, cost is not an issue (Tompkins et al., 2010). That is specifically why individuals opt for good hospitals that encompass experienced doctors, advanced equipments and variety of services under a single roof along with overall quality care together with polite and helpful staff. The initial and necessary step to accomplish all these purposes involves a hospital, which is well planned and well designed. Constructing well-organized, efficient and cost-effective hospitals is the necessity of the present day (Carpman Grant, 2016). Concept of Planning In order to establish hospital, the initial step is forever a vision or a thought arriving in the mind of a person. The hospitals, which are successful, without exception, are constructed with the help of a good planning, design, and construction along with a good administration. The achievement of a hospital is usually measured by the excellence of patient care it offers and the effectiveness with which it work (Birnbach et al., 2010). In order to be successful, an enormous deal of planning and preliminary study is required for the construction of a hospital and must keep the following things in consideration: A new hospital must be designed in such a way that it meet the requirements of the individuals it aims to serve. It should be staffed with experienced and sufficient number of competent doctors, nurses and other healthcare professionals. The promoters must be attentive and assume responsibility for the construction of well-planned and well-designed hospitals that are proficient, efficient and cost-effective so that they will deliver quality and sufficient care to the population they serve (Jones, 2011). Guiding Principles for planning the facilities and services of a hospital 1. High quality care of the patients The high quality care of the patients can be achieved by the following: Appointing experienced and sufficient number of medical, nursing and other members of staff and offering essential facilities, equipment together with services of support. Establishing an organizational structure in which clearly defined responsibility and authority are assigned to every job, mainly jobs associated with the care of the patient. Medical staff should interact with each other and with the other professionals of healthcare. Continuous review of patient care Establishment and enforcement of standards in the patient care (Thompson et al., 2011). 2. Efficient community orientation Efficient community orientation can be achieved by the following: Governing board in which there are known and esteemed community leaders Extending programs and services of the hospital to the communities Ensuring the participation of the hospital in the programs of community, prevention of care , teaching of a good quality of healthcare along with the practice. Doctors, hospital administrators should provide assistance in the process of planning and implementation of community healthcare programs A public information program should be provided (Jrgensen, 2012). 3. Economic viability Economic viability can be realized by the following: Understanding the responsibility and accountability for a strong and feasible fiscal position, that will command the respect as well as confidence of the donors, investors and the community. A clear program for attracting and retaining experienced and enthusiastic nurses, physicians and other professionals in healthcare setting (Mestre et al., 2015). Sound Architectural Plans This can be accomplished by the following: Engaging early in the stage of planning a experienced architect who posses experience in designing and construction of the hospital Selecting a location that is easily available to population concentration, water, public transport, sewerage lines etc. and is large enough to meet the existing and expected needs and demands for road, access parking and future expansion Determining hospital size that is sufficient for diverse services, administrative as well as functional necessities of departments together with treatment and care of the patient Recognizing the significance of setting up of traffic patterns for movement of doctors, , patients, hospital staff, visitors, and effective transportation of drugs, food, linen and other supplies A plan that will avoid repetition of services Awareness to special services such as intensive care, operating rooms, obstetrics, outpatient, surgical and medical specialties together with the concepts of infection control and disaster planning (Bachouch et al., 2012). Conceptual and Basic Design The generations of ideas at the stage of conceptual study are translated into outlines, taking cognizance of every design criteria, in line with functional as well as spatial programs (Nguyen et al., 2014). Engineering Design Design detailing facilitates its analysis from the principles of basic engineering i.e. Specific requirement such as floor strength for medical equipment, optimized construction grids, elevators and openings are taken into account by civil design. All necessary services of drainage, ventilation water supply, fire fighting and air-conditioning systems are considered by the mechanical design. Cognizance of low and high voltage systems, fire-detection systems, emergency power supplies, telephone and padding systems and elevator control under electrical design IT consideration enables incorporation of state-of the art features into the system Waste management takes cognizance of potential quantum of wastes and incorporates suitable collection as well as storages, treatment and systems of disposal (Thompson McKee, 2011). Planning of equipments The selection of different types of equipments i.e. medical and clinical services in a variety of specialties, services associated with clinical support such as blood bank, and laboratories has significant bearing on every feature of engineering design. The particular concern is, the actual support services together with the Central Sterile Supply Department (CSSD), kitchen, laundry etc., given to prepare schedule of equipments according to the type of departments, organizing its logistics and planning the procedures of installation, testing and commissioning (Wurzer, 2013). Suppositions for building a Hospital for the next generation Alteration has become consistent in our surroundings and the rate of alteration is increasing, formulating the future more complex and difficult to predict The existing system of healthcare-operationally as well as economically is not sustainable and this constructs a mandate for alteration Noteworthy change or alteration will be essential. Incremental solutions would not bring about transformational change or alteration (Adida et al., 2011). Due to the existing condition of healthcare and the mandate for alteration, a riskier environment of making decisions subsists. Consequently, there is an insight that maintaining the status would minimize risk. Features of transformational alteration will encompass the following: Inclusivity and a requirement to look for contribution from thought of the future-oriented leaders and experts of processes. Incorporation that connect all constituents of the organization An approach based on a system and an incorporated plan to get outcomes. Accomplishment of goals exhibited by constructive and measurable outcomes The process of shifting towards a new state of the future would be evolutionarily; ultimately constructing an environment in which change or alteration is constantly embraced (Persson Persson, 2010). The process of planning for any project is as significant as the ultimate outcome due to the reason it by means of the process that buy-in to solutions is accomplished. Planning is lively in nature and it is based on the science of complex adaptive systems (CAS). The process of planning for a project of building a hospital offers a remarkable opportunity to cause transformational alteration or change to the stage from which the healthcare business is delivered (Hick et al., 2011). An effectual process of planning will direct to the environments or surroundings are: Competent and efficient Patient as well s family focused Flexible and adjustable Methods of planning and design Planning team and the process Team for assessment of needs The process of planning and design can be envisioned with the interaction of different groups of individual associated with the process (Elf et al., 2015). At the earliest stage, it requires an assessment team concerning the planners together with the end users like the staff of the hospital and the community ascertains an overall plan concerning the requirements, variety of services to be offered, the catchment area or the target population, the monetary viability of the project with the analysis of cost benefit and the scale of the hospital (Abdelaziz Masmoudi, 2012). Briefing team After the assessment of needs and the hospital size have been established, the briefing team consisting of engineers, architects, the staff members and the community sit together for the preparation of the key document or manuscript i.e., the brief design. It is concerned with the translation of requirements into activities, functions, distribution of space and any other information essential for the design (Carpman Grant, 2016). Design Team The team for designing consists of all the individuals involved to design the facilities, the members for producing the instruments for implementation of building, starting from initial analysis to the concluding designs with methodological specification, tendering manuscripts ort documents and comprehensive drawings of working together with the estimation of expenditure. This team primarily encompasses architects, engineers, surveyors, and staff of the hospital, the approving authority and the community (Ellen et al., 013). Construction team The team for construction comprises of architects, builders and engineers. This team executes the designs from the drawings that are approved along with the technical specifications within the given time as well as cost and create surface facility for commissioning leads to severe complications when they are not treated (Bines Jamieson, 2013). Commissioning team This team is responsible to hospital staff, commissions, obtains the furniture, equipments, and prepares them for their operation (Zilm, 2010). Planning team A large number of individuals would have given their input to the project as part of a team working as a whole together with the community by the end of the project. - The contractor/builder constructs the hospital in is physical appearance utilizing labor, materials and the equipments of construction - The procurement of members of staff together with the workforce forms part of the commissioning team, which is, concerned with the preparation of hospital for operation by the procurement of material as well the recruiting staff (Bines Jamieson, 2013). Roles of the team members In all the stages that are involved with the process of planning and design, each team member possesses the following roles: The health planner ascertains the requirements of the hospital, its responsibility with respect to the community along with the services it will provide. The functional planner ascertains the performance of various departments as well as the hospital. The financial planner ascertains the financial viability in terms of the project and is also responsible for the identification and allocation of funds associated with the project. The physical planner ascertains the association of the hospital with the town and the group of people it serves. The architect and the consultants of engineering offer proficient planning, design as well as management of the process of construction. The construction manager supervises the individuals and resources on location to make sure that the completion of project is within the stipulated time and budget. The user/client is the possessor and final user of the newly constructed hospital (Keys, 2016). Factors to be considered in locating a hospital The hospital should be within 20-30 minutes travelling time. In a district having good roads and sufficient transport facilities, this would indicate a zone of service with a radius of about 26 km. It should be linked with other institutional amenities like religious, tribal, educational and commercial centers. It must be free from the risks of water logging; hence, it must not be constructed at the lowest district points. It should be constructed in an area, which is free from any type of pollution, including water, air, land and noise pollution. It must be equipped with public utilities: electricity, water, telephone, disposal bins etc. In those areas in which these types of utilities are not available, the availability of substitutes must be established such as generators for current or electricity, deep well for obtaining water and radio communication in place of telephone (Arnolds Nickel, 2013). Criteria for Site Selection A coherent, step-by step process of selecting a site takes place only in ideal conditions. In a number of areas, site availability prevails over other logical reasons for its selection, and the arid architects of the planner are confronted with the work of reviewing whether a plot of land is suitable for constructing a hospital. In the situation of either selecting a site or evaluating adaptableness, the following things must be taken into consideration: topography, soil conditions, availability of utilities, natural calamities and limitations (Elf et al., 2015). Size of the Location The location in which the hospital is to constructed must be large enough for each of the planned requirements to be met and for some extensions envisaged within the future years. The hospitals in which there are around 150 beds must have single-storey construction if other parameters state that they must be constructed with multi-storey buildings (Escobar-Rodriguez et al., 2014). Topography It is concerned with the determination of form and space. It is easy as well as least expensive to construct a building on a flat terrain. It is difficult to construct on a sloping or rolling terrain and expensive too, but the outcome can be innovative an interesting; by utilizing the natural ground slope, the systems for disposal and drainage can be designed in an attempt to lower the costs of construction and maintenance (GneÃ…Å ¸ et al., 2014). Drainage The land must allow the uncomplicated movement of water distant from the location. A high community point is considered ideal. If in case it is not available and the location is at a point which is low, the following things must be assessed: - How the surrounding land and water channels can be utilized to shift water away from the location. - Whether the soil type permits the speedy absorption as well as disposal of water -The usage of additional technical means of making sure the drainage like the construction on platform or on stilts, or excavating temporary reservoirs At the time of deciding the level of ground floor of the buildings, it is necessary to protect against the impermanent flooding after a heavy downpour. The areas that are prone to usual flooding, it is essential to raise a ground floor, which permits for probable peak floods (Ribeiro et al., 2012). Conditions of Soil The conditions of soil assist in the determination of schemes of foundation. Preferably, the subsoil should be of a type on which conventional, economical structural design and schemes of foundation can be utilized. It is recommended to avoid swamps, water logged areas and former paddy fields (Copas et al., 2015). Utilities available The facilities of water, electricity and communication should be available. The areas in which these types of utilities are not available, the availability of substitutes must be established such as generators for current or electricity, deep well for obtaining water and radio communication in place of telephone. The facilities of healthcare are moderately ineffective in the absence of all of these facilities at the site in which the hospital is to be constructed (Buffoli et al., 2012). Limitations However, the site may be satisfactory in all the aspects, but it must be verified for potential constraints to its utilization: Does it possess a direct access from the road? Is it a contiguous piece with appropriate titles of ownership? The problems of ownership that are not solved can limit the complete use of a site. The sites having the issues of ownership must not be utilized (Van Dam, 2015). Master planning The master plan concerning a hospital is the foundation for the present as well as future decisions regarding the outline of the buildings together with the services, alterations in requirements as well as phasing (Hulley et al., 2013). It signifies the grouping and phasing of individual constructions and the modes of communication between them, the range and location of conveniences that are essential at different phases as well as directions and restrictions of possible expansion of future or modification of the hospital. Any error in placing constructions, sewer points, and access roads, facilities of parking and entry points on the location can limit opportunities of growth (Djalali et al., 2012). The engineering and architectural attributes of the project are developed within the master plan based on: Grouping major purposes such as medical services, wards, central supplies and admissions Establishing a suitable route of access foe uncomplicated orientation of visitors and patients, with particular emphasis on the individuals who are disabled. Offering scope for expansion of future, to deal with supplementary functions, increased number of beds and medical expertise, by making sure maximum communication between the different units of the hospital and services of support (Roy et al., 2012). The master plan encompasses two components: Determination of routes of circulation as well as corridor systems Location of components on the site with respect to one another The routes of circulation along with the corridor systems must be designed in such a way that the users can discover their way with least complexity (Broberg Edwards, 2012).The main loop of circulation must be apparent and the pecking order of secondary routes that consecutively break into negligible interchange paths must match with the hierarchy of the different units of the hospital they serve. The target of design should be simplicity; this lessens the needs for signs and enhances the quality of service. The positioning of elements together with the departments on a location should result in a most favorable interrelationship between the departments and offer space for expansion (Hulley et al., 2013). Zoning of elements on a site The departments that are closely associated with the community should be nearby to the main entrance: administration, emergency, outpatient department, family planning clinic and other supports of primary healthcare. The departments that receive pressure of work should be next contiguous to the main entrance: dispensary, X-ray, laboratories. In the interior zones or wards, in-patient departments should be constructed The nursery and delivery department must be separated from the operation theatre The areas of domestic service and housekeeping should be grouped in the area of service yard: Kitchen, laundry, maintenance, housekeeping, motor pool and storage. The staff facilities should be positioned on the outside edge next to public transport and roads: housing or quarters, staff dormitories. If there are any teaching facilities, it should be near to staff facilities as well as teaching areas and to public transport and roads; Training and educational components associated with primary health care, student areas. The mortuary should be in a special service yard having a cautious entrance and it should be distant from the nursery, ward block and out-patient department (Yousapronpaiboon C. Johnson, 2013). Departmental Planning and Design This segment deals with the common principles associated with planning and design. The comprehensive design should encompass an inclusive plan of accommodation of all the departments and should affirm the requirements of functional planning for all the activities to be carried out in each space (Frst, 2016). The different departments of the hospital can be grouped as follows: Outpatient department The design of this department of the hospital depends on the availability of medical staff for consultation, scheduling of consultations, the number of referrals from general units of health and general practitioners together with the tendency of the individuals to go the hospital. It may also be affected by the availability of the visiting doctors or more precisely specialists from a local base hospital, which may conduct expert clinics from time to time before a specialist refers a patient for the treatment (Hernndez-vila et al., 2013). The fundamental requirements of this department are uncomplicated and few: Waiting areas and reception Examination rooms Consultation rooms Treatment rooms Areas for staff and supplies Emergency Department This is a fast-paced department and requires a huge area, which is flexible and could be transformed into private areas when essential, typically by the usage of curtains on track around demarcated spaces. It is essential that the necessities for movement within the emergency department permit for variability, with speedy access to the X-ray, operating and other departments Kennerley de Waal, 2013). Due to the nature of the emergencies, it is suggested that if resources are accessible, beds be gathered and dutiful to specific kinds of cases of emergencies. Trauma and accident, fracture, pediatrics, gynecology and obstetrics cases need different procedures for administration and dealing with an emergency (Broberg Edwards, 2012). Administration block The administrative department is public-oriented but at the same time, it is private. Areas for accounting, business, cashiers, records and auditing, which have a practical relationship with the community, must be positioned near the main entrance of the hospital. However, the management Offices of the hospital can be located in the private areas (Conejos, 2013). Medical Record Room Well-maintained medical records are an important and crucial part of a proficient system of hospital. Every country has its individual legal requirement concerning the duration for which ten records should be maintained by the hospital. If it is feasible, there should be a creation of a full-scale computerized data bank in which all data associated with the patients of the hospital are maintained. This allows the speedy access to the previous records of the hospital in a database making the information obtainable for statistical utilization in research into the planning and design of the hospital, community health, planning of services of ambulance and use of drug. If the staffs of the hospital manually handle the medical records, sufficient space must be obtainable so that they can be preserved for the needed time (Ellen et al., 2013). This space should be present in an area that ensures that the records are not to be disclosed by any chance or until it is mandatory to do so. The be st site or location for constructing a medical record room is immediately nearby to the Admitting section for easiness of record filing of new patients and for the easiness of retrieving the records of the patients who are admitted more than once (Kennerley de Waal, 2013). Department for Radiology and imaging This department is concerned with diagnostic imaging. It is different from the departments in which radiation oncology and radiotherapy are performed. Units of X-ray, radionuclide and ultrasound scanners provide diagnostic radiology or diagnostic imaging (Turner, 2014). Laboratory services The modern medicine is more dependent on the services of the laboratory for the diagnosis, control and prevention of diseases. A central role is played by the pathology laboratories in the hospital and in the services that are associated with community health. Every hospital must comprise of a laboratory service under the supervision of a pathologist who is medically qualified (Andrade et al., 2012). An inclusive laboratory should encompass the following sections: Microbiology Hematology Morbid anatomy Clinical pathology (Titzer et al., 2014). Pharmacy The patients, particularly the outpatients can obtain drugs from the private pharmacies, if essential with the prescription of a physician. However, in several districts the hospital is the main source of obtaining the drugs in addition to the primary health centers. The staff of the pharmacy by taking advice from the physician would plan the selection and procurement of drugs that are not encompassed in the hospitals standard provision (Mestre et al., 2012). Blood bank The hospital should be provided with sufficient blood bank and particular consideration should be emphasized on the storage of blood in an appropriate manner. After correct testing procedures the supply of blood should be carried out from a centre of blood transfusion (Carpman Grant, 2016). Sterilization unit It is simple to arrange a separate unit for sterilization in the hospital. However, it is necessary to ensure that all equipments, dressings and instruments that come in association with the tissues of the patients are sterile (Adida et al., 2011). Operation theatre The design of operation theatres has turn out to be increasingly complex. The number of operation theatres required is apparently associated with the number of beds in the hospital. As a common rule, one operation theatre is needed for every fifty patients in general wards and for every twenty-five surgical beds (Thompson McKee, 2011). Intensive care unit This unit is for those patients who are seriously ill and require constant medical attention. Together with extremely specialized equipments that are intended to support breathing, control bleeding, toxemia and to prevent the patients from shock. This unit needs several services of engineering, in the form of medical gases, compressed air as well as power sources and a controlled environment. It is advised to locate this unit next to recovery room (Wurzer, 2013). Risks, Emergencies and Disasters The following three concepts should be taken into consideration in this process: It is necessary to prevent the problems through prior planning so that there is no need to give response to the problems as well as the events as they occur. It is vital that the investment of resources should take place in plans, individuals together with organizations to manage the risks before they turn out into disasters or emergencies. This expenditure can be significantly reduced if prevention and risk management is included at the early stages of development. If all the construction and plans take the hazards and risks into consideration, the additional cost of risk management will be small (Hulley et al., 2013). The range of probable risks that are faced by a facility and the variety of ways to deal with those risks is such that it is good to engage comprehensive knowledge and skills as probable to ensure an inclusive identification of risks or threats. An extensively based participation would stimulate a sense of possession or ownership in terms of the plans that are developed to deal with the potential risks. While dealing with the internal as well as external sources of risk, the group of individuals involved must differ accordingly. Those concerned with the internal consultation may be physicians, nursing professional and other staff of the hospital. Externally, the group of individuals and communities will depend on the local circumstances and situations that surround the facility. Similar to the building of a community, a hospital is a facility that has several stakeholders in its future. These are the individuals, who aspire to observe it and several of them may desire to participate to ensure the best performance in the future. For ensuring the cooperation as well as understanding of each aspect of risk and planning, there must be a majority of these groups representing the possibility of the process of planning (Ellen et al., 2013). Quantitative evaluations possess a tendency of neglecting the reality that emergencies, risks and disasters are societal issues, not simply a component of figures and costs. Qualitative explanation directs more willingly to flexible and dynamic solutions and remedies to decrease the impact of an emergency, disaster or risk. In addition, there are different problems in the estimation of numbers to the subjects that are not effortlessly appreciated. There could be an inapt flexibility for making decisions on extremely vague data. These assessments hardly ever respond to the problems or assist in deciding the actions that are needed to be taken (Ribeiro et al., 2012). Conclusion In the end, it can be concluded that the processes and roles should be clearly defined before the beginning of operational and facility planning of a new hospital as it will serve as a path for designing and implementation. Today, the costs of healthcare are rising significantly. That is mainly due to the noteworthy advances that have appeared in the equipment, technology and treatment. The individuals are happy that advanced treatment is at present available for different types of health problems. It is also evident that when it comes to health and safety, cost is not an issue. The stakeholders concerned with the design and construction of new facilities should have a shared understanding of each other respective language. The definition of common concepts is needed to reduce individual interpretation. The facility designs and operations must be equally supportive. The idea regarding the method of delivering care notifies operational planning. The design of a good facility enables t he plan of operation and supports the notion of care delivery. The external/internal policies as well as regulations must be influenced to promote development, mutual growth, progress and quality in patient care. The existing facilities must be optimized prior to embarking on constructing a new facility. Constant scanning of the environment or surrounding will recognize future trends that would create an impact on the project/processes. The trends can be integrated when probable and suitable, thus offering possible improvements in the care of the patients. Sufficient financial support should be integrated in the budget of the project along with time line. The priorities for the organization of the hospital should be based on the extensive strategic plan. Hence, by taking into consideration all these aspects, the individuals can integrate their knowledge on the planning of hospital and its related services in an efficient manner. 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