December 22, 2012

MH0052 [Hospital Organisation Operations & Planning] Set2 Q6

Q6. Ms. Margret is the executive secretary to the CEO . She is sending an e-mail to the following group of people for a meeting that is pre-scheduled. 
i. Dr. Narayanan N - CEO
ii. Mr. Krishnamurthy P.K. – Hospital Administrator
iii. Dr. Kiran Kumar – Medical Superintendent
iv. Mrs. Lilly Ivan - Nursing Superintendent
v. Ms. Ramya Kumari – Assistant Administrator
vi. Mr. Robert Antony – CFO
vii. Mr. Sathyanarayan Nair – HR Head

Answer the following questions, based on the details given above:

a. Find out the name of the committee that Ms. Margret is calling for. [2 Marks]

b. What is the purpose of this committee? [4 Marks]
c. What are the specific functions of this committee? [4 Marks]


Hospital Organizational Structure

An organization is a coherent combination of functions of a group or groups of people, who are united by a common purpose, by division of labour and function and through a hierarchy of authority and responsibility. 

A hospital organization is a systematic medical, non-medical, administrative and human resources activity that would impact the satisfaction of all its stake holders. Therefore, organizing is a process of clustering the responsibilities and activities into workable units, determining the lines of authority and communication and developing patterns of coordination. And each of these workable units needs to have constant interaction for effective functioning of the hospital. 

Organization structure in a hospital refers to the levels of management within the hospital. These levels will allow the efficient management of the individual departments. The structure will enable one to understand the chain of command. The organizational structure may vary from one hospital to the other depending on the goals and objectives and size of the hospital. The collective functions of the various departments work towards the ultimate goal of the hospital. Authority responsibility relationships should be clearly spelled. Clarity in the organizational relationship may contribute to increased productivity and reduced internal conflicts.

Functional Authority 
Figure 1 represents a pyramidal organizational hierarchy. It is a traditional organizational structure that clearly depicts the flow of authority and responsibility which is essential for delegation and accountability. 

Fig. 1: Pyramidal Organizational Hierarchies

Top management consists of: The Governing Board, CEO, and Management Team
Middle management consists of: Sr. Administrative executives, Department heads, Consultants, Nursing head, Managers
Supervisors consist of: Section heads, senior doctors, Nursing supervisors, Ward-incharges
Line workers consist of: Junior doctors, Staff nurses, Clerical staff, Housekeeping staff, and maintenance staff

An outstanding characteristic of a hospital is that it does not have a clear line of authority. Unlike other organizations, hospitals do not have a single line of authority, hence, the clutter. Sometimes it is a single line and sometimes it is a double or multiple lines. Since, hospitals have a medical line of authority and an administrative line of authority, devising an organizational chart for a hospital is significant and utmost care needs to be given. The medical services are headed by a Medical Director or Medical Superintendent and the administrative services are headed by the CEO / Administrator / General Manager based on the size of the organization. However, the ultimate authority in devising policies rests with the governing board or the policy making body. The dual lines of authority is clearly depicted in the figure 2. 

Fig. 2: Lines of authority

The two important and distinct functions of the hospital are:
1. Provision of clinical care:

  • Treatment procedures
  • Diagnostic procedures
  • Nursing care
  • Clinical support services 

2. Provision of non-clinical care:

  • Administration
  • Sanitation
  • Security
  • Stay facilities

The organizational structure of a hospital may vary depending on the goals and objectives and size of the hospital. Figure 1.5 is a sample organization structure of a hospital.

The organizational chart of a hospital may vary from one hospital to another depending on the following factors:
1. Classification and nature of the hospital
2. Objectives and goals of the hospital
3. It depends on the professional competency of the administration head. It might be different based on the fact whether the General Manager or the CEO has a medical background or not
4. Local community demand and needs, trends. 

Central Billing Department 

The Central billing department plays an important role, as liaison office between the management and the patients, in addition to its prime duty of billing. The immense patience, human relations and hospitality is the need of the hour to alleviate the problems of patients who are in distress, as the words spoken and deeds undertaken by the staff working at this department project the theme of humanity. One of the commonest problems faced by the discharged patients at all hospitals is the delay in discharge due to slow bill generation. The same can be overcome or reduced to a great extent by computerization of billing system and having a user friendly hospital information system (HIS) in place.

Admission records of patients
The admission records with complete details pertaining to the patients admitted are sent to the Billing Office from the Central Admission Office, which are filed alphabetically to serve as information to the patients party to locate their patients easily at the enquiry counter.

Volume of work
On an average, 120 to 140 patients are discharged in a tertiary care referral hospital with bed occupancy of 80 percent. The bills generated by the billing department per day are approximately 120 to 140.

Organization of billing department
The overall administration of the hospital is the responsibility of the Medical Superintendent. For the effective and smooth functioning, the Billing Office has been placed under the Finance Executive, who looks after the financial matters and accounts of the hospital.

Documentation Procedure
Compilation of Billing Data
The Billing Office receives statement of investigation charges from various wards, laboratories, operation theatre and other departments every day at a set time every day. The charges are immediately fed into the computers in the respective patient files. This system enables the Billing Office to issue interim bills and weekly reminders to patients so as to initiate payment.

Discharge procedure for inpatients
Ward Patient is advised discharge
File moves from billing section to the receiving counter
Discharge procedure initiated at billing office.
Print out of checklist generated
Checking and coding of charges which are not entered
Final entry of charges
Generation of Bills
Final Scrutiny and Re-entry if necessary
Cash collection
Patient is discharged
Dispatch of bills to accounts department

Procedure of Billing
The files of the discharged patients are received from the wards at the Billing Office after proper scrutiny and are entered in the daily discharge register. The file along with a print out of a check list of charges is made available for coding after recording the date, time and the condition of the patient in the computer, as indicated in the files.

Coding of Investigation / Procedure / Operation Charges
The patients bills are prepared according to the rate list provided by the management. With the help of a check list and inpatient file, proper coding of the charges are carried out to find out the discrepancies in charges and also for appropriateness of the charges as it is the most essential aspect in billing procedure. After codification of charges the files are passed on for final entry and then the bills are generated.

Scrutiny of the Bills
Bills are scrutinized thoroughly for accuracy of the charges to avoid short billing and omission of charges by referring the files and clarifying the doubts from the concerned department. The bills are then sorted out and distributed to the respective counters for the completion of the assigned job of discharging the cases admitted under free ward, camp case, family planning and corporate referral companies etc.

Paying Inpatient Bill
For the convenience of the general and special ward patients cash counters are functioning separately where the payments can be made according to the status of the ward.

Remittance of the Cash
The cash collected against the bills is remitted to the bank once/twice in a day. This depends on the policy adopted.

Dispatching of the Bills
The bills after payment are assembled serially and dispatched to the Accounts Section, usually on the following day, to enable the hospital to maintain the accounts and to preserve the bills. This is subject to the policy adopted by the organization.

Procedure of Billing of Investigations / Procedures
The bills of the outpatient are generated in computers on the basis of the investigations/procedure prescribed by the doctors. The charges are levied as per the rate list provided by the management.

Billing of Procedures at Various Outpatient Departments
In large hospitals for the purpose of convenience to the patients billing counters may be located floor wise, though this is not advisable. Cash memo raised by the concerned OPD against the procedures and the special consultation is sent to the outpatient cash counter for payment.

Ascertaining of the X-ray Bill
The x-ray bill along with investigation slip should be produced by the patient at the x-ray counter which is scrutinized by the technician for appropriateness of the charges before taking x-ray. For any discrepancies in charges the bill should be redirected to the Central Cash Counter by the Radiology department for ascertaining and rectification of the charges.

No comments:

Post a Comment


1st Sem (common) Subjects (150) 1st Sem BBA (10) 2nd Sem (common) Subjects (70) 2nd Sem BBA (10) 3rd Sem Banking Management (30) 3rd Sem BBA (8) 3rd Sem core/common subjects (37) 3rd Sem Environmental Management (2) 3rd Sem Event Management (8) 3rd Sem Finance Management (113) 3rd Sem HEALTH SERVICE MANAGEMENT (HSM/HCS) (65) 3rd Sem Human Resource Management (98) 3rd Sem Information Systems Management (8) 3rd Sem International Business (34) 3rd Sem Marketing Management (129) 3rd Sem Operations Management (8) 3rd Sem Project Management (103) 3rd Sem Retail Operations Management (8) 3rd Sem Supply Chain Management (SCM) (16) 3rd Sem Total Quality Management (TQM) (16) 4th Sem Banking Management (38) 4th Sem core/common subjects (65) 4th Sem Event Management (8) 4th Sem Finance Management (8) 4th Sem HEALTH SERVICE MANAGEMENT (HSM/HCS) (21) 4th Sem Human Resource Management (104) 4th Sem Information Systems Management (8) 4th Sem International Business (12) 4th Sem Marketing Management (8) 4th Sem Operations Management (37) 4th Sem Project Management (56) 4th Sem Retail Operations Management (8) 4th Sem Supply Chain Management (SCM) (8) 4th Sem Total Quality Management (TQM) (8) BBA101 - Communication Skills (2) BBA101 Set1 (1) BBA101 Set2 (1) BBA102 - Organization Behaviour (2) BBA102 Set1 (1) BBA102 Set2 (1) BBA103 - Business Environment (2) BBA103 Set1 (1) BBA103 Set2 (1) BBA104 - Quantitative Techniques in Business (2) BBA104 Set1 (1) BBA104 Set2 (1) BBA105 - Computer Fundamentals (2) BBA105 Set1 (1) BBA105 Set2 (1) BBA201 - Research Methods (2) BBA201 Set1 (1) BBA201 Set2 (1) BBA202 - Business Strategy (2) BBA202 Set1 (1) BBA202 Set2 (1) BBA203 - Financial Accounting (2) BBA203 Set1 (1) BBA203 Set2 (1) BBA204 - Marketing Management (2) BBA204 Set1 (1) BBA204 Set2 (1) BBA205 - Management Information Systems (2) BBA205 Set1 (1) BBA205 Set2 (1) BBA301 - Legal and Regulatory Framework (2) BBA301 Set1 (1) BBA301 Set2 (1) BBA302 - Human Resource Management (2) BBA302 Set1 (1) BBA302 Set2 (1) BBA303 - Quality Management (2) BBA303 Set1 (1) BBA303 Set2 (1) BBA304 - Advertising and sales (2) BBA304 Set1 (1) BBA304 Set2 (1) Differences between Managers and Leaders (1) EM0001 - Fundamentals of Environment (2) EM0001 Set1 (1) EM0001 Set2 (1) ET0001 - Human resource management for events (2) ET0001 Set1 (1) ET0001 Set2 (1) ET0002 - Corporate Event Project Management (2) ET0002 Set1 (1) ET0002 Set2 (1) ET0003 - Event marketing and management (2) ET0003 Set1 (1) ET0003 Set2 (1) ET0004 - Event Finance Management (2) ET0004 Set1 (1) ET0004 Set2 (1) ET0006 - Event Risk Management (2) ET0006 Set1 (1) ET0006 Set2 (1) ET0007 - Entrepreneurship (2) ET0007 Set1 (1) ET0007 Set2 (1) ET0008 - Special Events (2) ET0008 Set1 (1) ET0008 Set2 (1) ET0009 - Event Management for Tourism (2) ET0009 Set1 (1) ET0009 Set2 (1) IB0010 - International Financial Management (9) IB0010 Set1 (7) IB0010 Set2 (2) IB0011 - International Marketing (9) IB0011 Set1 (2) IB0011 Set2 (7) IB0012 - Management of Multinational Corporations (8) IB0012 Set1 (7) IB0012 Set2 (1) IB0013 - Export-Import Management (8) IB0013 Set1 (7) IB0013 Set2 (1) IB0015 - Foreign Trade of India (6) IB0015 Set1 (3) IB0015 Set2 (3) IB0016 - International Logistics and Distribution Management (2) IB0016 Set1 (1) IB0016 Set2 (1) IB0017 - International Business Environment and International Law (2) IB0017 Set1 (1) IB0017 Set2 (1) IB0018 - Export Import Finance (2) IB0018 Set1 (1) IB0018 Set2 (1) MA0036 - Financial Systems and Commercial Banking (14) MA0036 Set1 (7) MA0036 Set2 (7) MA0037 - Banking Related Laws and Practices (12) MA0037 Set1 (6) MA0037 Set2 (6) MA0038 - Banking Operations (2) MA0038 Set1 (1) MA0038 Set2 (1) MA0039 - Retail Banking (2) MA0039 Set1 (1) MA0039 Set2 (1) MA0040 (1) MA0041 - Merchant Banking and Financial Services (5) MA0041 Set1 (3) MA0041 Set2 (2) MA0042 - Treasury Management (14) MA0042 Set1 (7) MA0042 Set2 (7) MA0043 - Corporate Banking (9) MA0043 Set1 (5) MA0043 Set2 (4) MA0044 - Institutional Banking (10) MA0044 Set1 (8) MA0044 Set2 (2) MB0038 - Management Process and Organization Behavior (24) MB0038 Set1 (16) MB0038 Set2 (9) MB0039 - Business Communication (24) MB0039 Set1 (15) MB0039 Set2 (9) MB0040 - STATISTICS FOR MANAGEMENT (24) MB0040 Set1 (15) MB0040 Set2 (9) MB0041 - Financial Management and Accounting (24) MB0041 Set1 (15) MB0041 Set2 (9) MB0042 - Managerial Economics (30) MB0042 Set1 (15) MB0042 Set2 (15) MB0043 - Human Resource Management (24) MB0043 Set1 (15) MB0043 Set2 (9) MB0044 - PRODUCTION and OPERATIONS MANAGEMENT (16) MB0044 Set1 (8) MB0044 Set2 (8) MB0045 - Financial Management (9) MB0045 Set1 (7) MB0045 Set2 (2) MB0046 - Marketing Management (10) MB0046 Set1 (8) MB0046 Set2 (2) MB0047 - MANAGEMENT INFORMATION SYSTEMS (15) MB0047 Set1 (8) MB0047 Set2 (7) MB0048 - OPERATIONS RESEARCH (10) MB0048 Set1 (8) MB0048 Set2 (2) MB0049 - Project Management (10) MB0049 Set1 (8) MB0049 Set2 (2) MB0050 - Research Methodology (20) MB0050 Set1 (10) MB0050 Set2 (10) MB0051 - Legal Aspects of Business (17) MB0051 Set1 (13) MB0051 Set2 (4) MB0052 - Strategic Management and Business Policy (30) MB0052 Set1 (15) MB0052 Set2 (15) MB0053 - International Business Management (35) MB0053 Set1 (19) MB0053 Set2 (16) MF0010 - Security Analysis and Portfolio Management (39) MF0010 Set1 (21) MF0010 Set2 (18) MF0011 - Mergers and Acquisitions (24) MF0011 Set1 (14) MF0011 Set2 (10) MF0012 - Taxation Management (25) MF0012 Set1 (16) MF0012 Set2 (9) MF0013 - Internal Audit and Control (25) MF0013 Set1 (16) MF0013 Set2 (9) MF0014 (1) MF0015 - International Financial Management (2) MF0015 Set1 (1) MF0015 Set2 (1) MF0016 - Treasury Management (2) MF0016 Set1 (1) MF0016 Set2 (1) MF0017 - Merchant Banking and Financial Services (2) MF0017 Set1 (1) MF0017 Set2 (1) MF0018 - Insurance and Risk Management (2) MF0018 Set1 (1) MF0018 Set2 (1) MH0051 - Health Administration (15) MH0051 Set1 (5) MH0051 Set2 (10) MH0052 - Hospital Organisation Operations and Planning (26) MH0052 Set1 (12) MH0052 Set2 (14) MH0053 - Hospital and Healthcare Information Management (11) MH0053 Set1 (3) MH0053 Set2 (8) MH0054 - Finance Economics and Planning in HCS (13) MH0054 Set1 (10) MH0054 Set2 (3) MH0055 (1) MH0056 - Public Relations and Marketing for Healthcare Organisation (6) MH0056 Set1 (3) MH0056 Set2 (3) MH0057 - Management of Healthcare Human Resources (5) MH0057 Set1 (2) MH0057 Set2 (3) MH0058 - Legal Aspects in Healthcare Administration (5) MH0058 Set1 (3) MH0058 Set2 (2) MH0059 - Quality Management in HCS (5) MH0059 Set1 (3) MH0059 Set2 (2) MI0014 (1) MI0033 - Software Engineering (2) MI0033 Set1 (1) MI0033 Set2 (1) MI0034 - Database Management System (2) MI0034 Set1 (1) MI0034 Set2 (1) MI0035 - Computer Network (2) MI0035 Set1 (1) MI0035 Set2 (1) MI0036 - BUSINESS INTELLIGENCE TOOLS (2) MI0036 Set1 (1) MI0036 Set2 (1) MI0038 - Enterprise Resource Planning (2) MI0038 Set1 (1) MI0038 Set2 (1) MI0039 - eCommerce (2) MI0039 Set1 (1) MI0039 Set2 (1) MI0040 - Technology Management (2) MI0040 Set1 (1) MI0040 Set2 (1) MI0041 - Java and Web Design (2) MI0041 Set1 (1) MI0041 Set2 (1) MK0010 - Sales Distribution and Supply Chain Management (33) MK0010 Set1 (17) MK0010 Set2 (16) MK0011 - Consumer Behaviour (31) MK0011 Set1 (16) MK0011 Set2 (15) MK0012 - Retail Marketing (42) MK0012 Set1 (20) MK0012 Set2 (22) MK0013 - Market Research (23) MK0013 Set1 (12) MK0013 Set2 (11) MK0014 (1) MK0015 - Service Marketing And Customer Relationship Management (2) MK0015 Set1 (1) MK0015 Set2 (1) MK0016 - Advertising Management and Sales Promotion (2) MK0016 Set1 (1) MK0016 Set2 (1) MK0017 - eMarketing (2) MK0017 Set1 (1) MK0017 Set2 (1) MK0018 - International Marketing (2) MK0018 Set1 (1) MK0018 Set2 (1) ML0010 - Warehousing and Supply Chain Management (2) ML0010 Set1 (1) ML0010 Set2 (1) ML0011 - Buying and Merchandising (2) ML0011 Set1 (1) ML0011 Set2 (1) ML0012 - Store Operations (2) ML0012 Set1 (1) ML0012 Set2 (1) ML0013 - Retail IT Management (2) ML0013 Set1 (1) ML0013 Set2 (1) ML0014 (1) ML0015 - Services Marketing and Customer Relationship Management (2) ML0015 Set1 (1) ML0015 Set2 (1) ML0016 - Advertising Management and Sales Promotion (2) ML0016 Set1 (1) ML0016 Set2 (1) ML0017 - Mall Management (2) ML0017 Set1 (1) ML0017 Set2 (1) ML0018 - Project Management in Retail (2) ML0018 Set1 (1) ML0018 Set2 (1) MU0010 - Manpower Planning and Resourcing (31) MU0010 Set1 (16) MU0010 Set2 (15) MU0011 - Management and Organizational Development (20) MU0011 Set1 (10) MU0011 Set2 (10) MU0012 - Employee Relations Management (22) MU0012 Set1 (11) MU0012 Set2 (11) MU0013 - Human Resource Audit (25) MU0013 Set1 (15) MU0013 Set2 (10) MU0014 (1) MU0015 - Compensation Benefits (24) MU0015 Set1 (14) MU0015 Set2 (10) MU0016 - Performance Management and Appraisal (27) MU0016 Set1 (12) MU0016 Set2 (15) MU0017 - Talent Management and Employee Retention (24) MU0017 Set1 (12) MU0017 Set2 (12) MU0018 - Change Management (29) MU0018 Set1 (9) MU0018 Set2 (20) OM0010 - Operations Management (2) OM0010 Set1 (1) OM0010 Set2 (1) OM0011 - Enterprise Resource Planning (2) OM0011 Set1 (1) OM0011 Set2 (1) OM0012 - Supply Chain Management (2) OM0012 Set1 (1) OM0012 Set2 (1) OM0013 - Advanced Production and Operations Management (2) OM0013 Set1 (1) OM0013 Set2 (1) OM0014 (1) OM0015 - Maintenance Management (6) OM0015 Set1 (3) OM0015 Set2 (3) OM0016 - Quality Management (11) OM0016 Set1 (8) OM0016 Set2 (3) OM0017 - Advanced Production and Planning Control (11) OM0017 Set1 (3) OM0017 Set2 (8) OM0018 - Technology Management (9) OM0018 Set1 (7) OM0018 Set2 (2) PM0010 - Introduction to Project Management (26) PM0010 Set1 (14) PM0010 Set2 (12) PM0011 - Project Planning and Scheduling (25) PM0011 Set1 (14) PM0011 Set2 (11) PM0012 - Project Financing and Budgeting (26) PM0012 Set1 (14) PM0012 Set2 (12) PM0013 - Managing Human Resources in Projects (26) PM0013 Set1 (13) PM0013 Set2 (14) PM0014 (1) PM0015 - Quantitative Methods in Project Management (14) PM0015 Set1 (8) PM0015 Set2 (6) PM0016 - Project Risk Management (14) PM0016 Set1 (7) PM0016 Set2 (7) PM0017 - Project Quality Management (14) PM0017 Set1 (7) PM0017 Set2 (7) PM0018 - Contracts Management in Projects (14) PM0018 Set1 (7) PM0018 Set2 (7) Project (1) QM0010 - Foundations of Quality Management (4) QM0010 Set1 (2) QM0010 Set2 (2) QM0011 - Principles and Philosophies of Quality Management (4) QM0011 Set1 (2) QM0011 Set2 (2) QM0012 - Statistical Process Control and Process Capability (4) QM0012 Set1 (2) QM0012 Set2 (2) QM0013 - Quality Management Tools (4) QM0013 Set1 (2) QM0013 Set2 (2) QM0014 (1) QM0015 - ISO/QS 9000 Elements (2) QM0015 Set1 (1) QM0015 Set2 (1) QM0016 - Managing Quality in the Organization (2) QM0016 Set1 (1) QM0016 Set2 (1) QM0017 - Quality Management System (2) QM0017 Set1 (1) QM0017 Set2 (1) QM0018 - Quality Development Methods (2) QM0018 Set1 (1) QM0018 Set2 (1) SC0001 - Supply Chain Management (4) SC0001 Set1 (2) SC0001 Set2 (2) SC0002 - Outsourcing (4) SC0002 Set1 (2) SC0002 Set2 (2) SC0003 - Food Supply Chain Management (4) SC0003 Set1 (2) SC0003 Set2 (2) SC0004 - Inventory Management (4) SC0004 Set1 (2) SC0004 Set2 (2) SC0006 - Global Logistics and Supply Chain Management (2) SC0006 Set1 (1) SC0006 Set2 (1) SC0007 - Category Management in Purchasing (2) SC0007 Set1 (1) SC0007 Set2 (1) SC0008 - Purchasing and Contracting for Projects (2) SC0008 Set1 (1) SC0008 Set2 (1) SC0009 - Supply Chain Cost Management (2) SC0009 Set1 (1) SC0009 Set2 (1) SMU BBA Subjects (1) SMU MBA/PGDBA Subjects (1)

Visitor Count (since Jan 2019)