Date post: | 17-Feb-2017 |
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TheSurgery
Department
Reynaldo O. Joson, MD, MHA, MHPEd, MScSurg
All students of hospital administration must be knowledgeable of the
surgery department.
•Objectives
•Physical and personnel requirements
•How it should function
Learning Objectives
• Define objectives of surgery department• Discuss physical requirements in
relation to objectives• Discuss personnel requirements in
relation to objectives
Learning Objectives
• Explain importance of manual of policies and procedures• Discuss competencies required of
department chairman• Discuss present trends in
management of surgery department
Learning Objectives
• Define objectives of the clinical department (Surgery, ENT, IM, OB-GYN, OPHTHA, etc.)• Discuss physical requirements in relation
to objectives• Discuss personnel requirements in
relation to objectives
Learning Objectives• Explain importance of manual of
policies and procedures• Discuss competencies required of
department chairman• Discuss present trends in
management of the clinical department (Surgery,
ENT, OB- GYN, IM, etc)
Department of Surgery
Goal and Objectives
Department of Surgery
GoalTo provide proper medical service to
all patients with surgical diseases who seek consultation and treatment in the hospital.
Department of Surgery
Main Objectives
1. To examine all patients with a possible surgical diseases and afterwhich, to make a rational and accurate diagnosis.
Department of Surgery
Main Objectives
2. To provide treatment to all patients with surgical diseases.
Department of Surgery
Other Objectives
• To provide training in surgery.
• To promote research in surgery.
“Surgery Department”
usually refers to
General Surgery and its
subspecialties.
Department of Surgery
Physical Requirements
Department of Surgery
Physical Requirements1. Operating rooms
2. Surgical patient beds
3. Consultation rooms in
3.1 Outpatient department
3.2 Emergency room
Department of SurgeryPhysical Requirements
•Location within the hospital
•Quantity
•Size
•Design
•Equipment
dependent on
Department of SurgeryPhysical Requirements
General Determining Factors:
•Government regulations
•usual and anticipated increase in patient load
•needs and expectations of the community
•allowance for expansion
•cost-benefit considerations
Department of Surgery
Physical Requirementsfor training and research
•Conference room
•Library
•Internet
Department of Surgery
The Operating Room
Department of Surgery
The Operating Room
Place where
diagnostic and therapeutic
surgical procedures
are performed
The Operating Room Siting
Most important consideration:
Accessibility to patients of surgery department
Not far from the emergencytrauma unit
The Operating Room Number of Rooms
Most important consideration:
Cost-benefit analysis
usual patient load of surgical department
to
investment in spaces
The Operating Room Number of Operating Rooms
Several department ORs
vs
One operating room complex?
One complex is better
cost-benefit wise!
The Operating RoomDesign
one that will best achieve
• effectiveness and efficiency
• sterility standards and requirements •traffic flow
•from outside to inside
•from dirty to clean zones to sterile areas
The Operating Room
Basic Architectural DesignAseptic / Antiseptic
Rationale
Match
1. Most sterile zone
2. Most unsterile zone
A. Zone I - outer
B. Zone II - middle
C. Zone III - inner
Match
1. Most sterile zone - C
2. Most unsterile zone - A
A. Zone I - outer
B. Zone II - middle
C. Zone III - inner
The Operating RoomEssential equipment and facilities:
•Anesthesizing equipment
•Operating equipment
•Supplies for anesthesia and operation
•Monitoring devices
•Drugs, parenteral fluids, and gases
•Recovery room beds
Department of Surgery
Personnel Requirements
Department of SurgeryPersonnel Requirements
At least
• Surgeons
• Nurses
• Nursing Aides
Adequate in number and in competency
Department of SurgeryPersonnel Requirements
General Determining Factors:
•Government regulations
•usual and anticipated increase in patient load
•needs and expectations of the community
•cost-benefit considerations
Department of SurgeryPersonnel Requirements
For training objective
- trainors
For research objective
- researchers
Adequate in number and in competency
Operating RoomPersonnel Requirements
• Surgeons
• Anesthesiologists
• Nurses
• Nursing Aides
Adequate in number and in competency
Operating RoomPersonnel Requirements
• Surgeons
• Anesthesiologists
Minimum qualification:
Phil. Specialty Board certification
Operating RoomPersonnel Requirements
Number of Personnel
cost-benefit considerations:usual as well as anticipated
increase in patient load in the
surgery department
Operating RoomPersonnel Requirements
Governance of OR
• Department OR
- Department Chair or Rep
• OR Complex
- OR Management Team or Com
Department of Surgery
The Chairperson
Department of Surgery
The ChairpersonQualifications: Must
•Be a surgeon
•Know administration or management
•Know andragogy
•Know how to do research
consider objectives, activities, personnel
Department of Surgery
Manual of Policies and Procedures
Department of SurgeryManual of Policies and Procedures
Importance
•Guide for present and future staff
•Promotes effectiveness and efficiency
Should be reviewed and revised periodically
Department of SurgeryManual of Policies and Procedures
• Service
• Training
• Research
• Governance
Operating RoomManual of Policies and Procedures• Safety - explosions and infections
• Scheduling of cases
• Operating room privileges
• Records
• Charging
• Instruments and equipment
• Traffic
Department of Surgery
The Trends
Department of Surgery
The TrendsObjectives NOT limited to service.
Training and research are usually included because they contribute to perpetuation and
quality of service.
Department of Surgery
The TrendsAll training programs must be accredited
by the Specialty Board or Organization.
Accredited training programs attract trainees more than non-accredited ones.
Department of Surgery
The Trends ONLY board certified surgeons are
accepted for active and permanent staff in the hospitals.
Medicolegal reasons
Department of Surgery
The TrendsOperating room complex is the trend and
this is being managed by an operating room management team.
Thank You for trying to
appreciate what I am trying to
impart to you!
on The Surgery Department
(from hospital administration point of view)
Reynaldo O. Joson, MD, MHA, MHPEd, MScSurg
For those interested:
R.O. Joson’s Websitehttp://members.xoom.com/rjoson/hospadm/
hospadm.htm
http://web.pacific.net.ph/~rjoson