Hospital Departments and Their Functions (nonclinical)

This unit describes hospital departments and their functions.  This lecture is rather long, so I have divided it into two parts.  This is the first part and it covers human resources, business office, materials/purchasing, health information management, information technology, environmental services, facilities management, materials management, admissions/patient administration, quality assurance, and disaster preparedness.

The Human Resources department at the hospital does much more than screen and select new hires.  They are also responsible for doing job analyses; job descriptions; planning of staffing levels, manpower plans, and policies; performance evaluation training and tracking; orientation and induction of new employees; benefits administration’ personnel training and development; evaluation and motivation of work force; labor relations; health and safety responsibility; and personnel policy development and maintenance.

The business office is responsible for collecting money, tracking collections and expenditures, paying for bills (supplies, utility, payroll, etc) and the hospital’s cash flow.  The business office also provides services for financial counseling, financial assistance program, billing patients for services rendered, and contacting insurance companies.  In the accounting function of the business office you will find accounts payable, accounts receivable and this is where accounting and financial reports for the hospital are generated.  Due to the huge number of assets in a hospital, the business office also has an asset management office that tracks all the depreciable assets in the hospital.

The materials management/purchasing department coordinates the purchase, receiving, and distribution of supplies and equipment used in the hospital.  The hospital orders hundreds of supplies and thousands of dollars of equipment every year so this is a very busy department.

The health information management department implements and monitors health information management systems.  There are more than one system involved, so there are many specialists employed in this department.  Along with health information, there comes many laws concerning the security, storage, retrieval, and sharing of that information.  This department is responsible for educating employees to comply with the laws and ensure that confidentiality for all records is maintained and monitored.  The biggest law that affects this department is the Health Insurance Portability and Accountability Act.

Although it sounds as though this department was already covered, the Information Technology department is quite different than the health information management department.  The information technology department is responsible for all the common computer uses we see in a business. This department is responsible for the hospital computer systems and the infrastructure of the health information system including the computer network, databases, programming, applications, network security and administration, database administration and the telecom system.  To that end, this department will have specialists for database administration, networking, applications, network security and telecommunications specialists.

This next department is one of the most important departments in the hospital.  The environmental services department employs many people who clean and disinfect all areas of the facility, clean rooms when patients are discharged,  clean the carpet and upholstery, monitor contracted services, pest control, remove infectious, hazardous, and nonhazardous waste, laundry and room setups.  These folks are probably the go-to people in every hospital.  If the facility was not kept clean and the hazardous and biohazardous wastes not removed and handled in the correct manner, the hospital would cease to function.  Most people do not give these individuals much credit for maintaining the clean, appealing environment in which they work.  The employees in this hospital make the hospital safe for all who enter and they make patient care possible.

Facilities management is another one of those overlooked departments.  This department has very specialized craftsmen such as electricians, plumbers, HVAC technicians, biomedical equipment technicians who keep the hospital functioning every day.  They keep the electricity flowing through the wires, the cool air circulating throughout the building, and clean linens in the patient care areas.  This area keeps the hospital, its patients and personnel safe through a fire safety and environmental safety program.  This department also monitors and tests the backup generators which will become a necessity if there is a natural hazard or electrical outage.

Admissions is one of the first places where patient information is collected and entered into the hospital’s health information system.  Any patients that use the ancillary services at the hospital, such as the laboratory, radiology department, or physical therapy department, must all first register and have their information entered or verified in the hospital’s health information system.  If a patient is not able to go to admissions (i.e. the patient is unconscious), then a family member needs to go to admissions and get the patient into the system as soon as possible.  If a patient is not in the system, then no requests for anything can be entered into the computer.  Admissions also maintains a liaison with physician offices.  While in the admissions area, if there are consent forms for treatment and special procedures, the patient will sign the forms here.  This will ensure the patient’s paperwork is in order before they undergo treatment or special procedures.  The admissions department also produces a daily census report that lets hospital employees know the names and locations of the patients that are in the hospital during that day.  One of the most important functions of this department is to produce the identification bracelets that are worn by all patients while in the hospital.

The Quality Assurance (or sometimes just Quality) Department is the hub for the hospital’s continuous quality improvement program.  The Joint Commission for the Accreditation of Healthcare Organizations (JCAHO) mandates that every hospital have a quality improvement program.  In the latest set of JCAHO accreditation standards, reporting on selected hospital core measures must be accomplished.  Hospitals are supposed to use these core measures in their quality improvement program.  In addition to adhering to JCAHO standards, this office is responsible for reporting and processing claims against the hospital, identifying risks, management of litigation, generating infection control reports and identifying indications for intervention.

The emergency management/disaster preparedness office has grown in importance in the last 10 years.  Hospitals are a very important partner in the aftermath of any disaster—natural or manmade.  Hospitals need to be ready to respond casualties, people sick from a pandemic flu, mass casualties, and after effects of a bioterrorism attack.  This office is responsible for preparing, modifying, implementing, and reviewing plans for internal (fire, utility failure) and external disasters (natural, bioterrorism, mass casualty) addressing 4 phases of emergency management activities—mitigation, preparedness, response, and recovery,  hazard vulnerability analysis, and training staff.

In summary, for this unit we learned about the hospital departments and their functions.  We learned about human resources, the business office, materials/purchasing, health information management, information technology, environmental services, facilities management, admissions, quality assurance, and the emergency management/disaster preparedness departments.  All have distinct and specific functions they perform to make the hospital function as a well-oiled machine.

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