2/3/2022

Hospital Design and

Management
By
Dr. Waleed M. AL-Talabi

Sana’a Community College

Biomedical Engineering 4th Level
2021-2022

An Overview of
Hospital
Management
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Agenda
• Introduction

• Hospital Management

• The Importance of Managers

• Managers Functions

• The Effective Manager

• Management Positions
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Introduction
Management has been defined as the
process, comprised of social and technical
functions and activities, occurring within
organizations for the purpose of
accomplishing predetermined objectives
through human and other resources.

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Introduction
Health care management
is the profession that provides leadership and
direction to organizations that deliver personal
health services and to divisions, departments,
units, or services within those organizations.
Health care management provides significant
rewards and personal satisfaction for those who
want to make a difference in the lives of others.

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Introduction
Health care management
Direct care settings Non–Direct care settings
• Those organizations that provide • Are not directly involved in
care directly to a patient, resident providing care to persons
or client who seeks services from needing health services, but
the organization. rather support the care of
individuals through products and
services made available to direct
care settings.

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Introduction
• Hospitals will experience a large number of
managerial jobs because of the hospital sector’s
large size.
• Since the number of direct care managerial
positions is expected to increase significantly, it
is expected that growth will also occur in
managerial positions in non–direct care settings,
such as consulting firms, pharmaceutical
companies, associations, and medical
equipment companies.

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Hospital Management
Hospital Management
is a dynamic application of the principles of
management (Planning, organizing, staffing,
directing, controlling, and coordinating) in the
context of hospital to ensure efficient and
effective patient care services.

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Hospital Management
• Hospital Management occurs through
many others who may not have “manager”
in their position title.
• Examples of some of these managerial
positions in hospitals include supervisor,
coordinator, and director, among others.

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The Importance of Managers

• Hospitals are complex and dynamic, requires
that managers provide leadership, as well as the
supervision and coordination of employees.
• Moreover, the necessary tasks in producing
services in hospitals require the coordination of
many highly specialized disciplines that must
work together seamlessly.

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The Importance of Managers

Managers are needed to ensure organizational
tasks are carried out in the best way possible to
achieve organizational goals and that appropriate
resources, including financial and human
resources, are adequate to support the hospital.

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The Importance of Managers

Hospital managers have authority, where they
manage the hospitals by making important
decisions.
e.g., to recruitment and development of staff, acquisition
of technology, service additions and reductions, and
allocation and spending of financial resources.
Ultimately, decisions made by an individual manager
impact the organization’s overall performance.

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The Importance of Managers

• Hospital managers must consider two domains
as they carry out various tasks and make
decisions.
• Keeping the dual perspective requires significant
balance and effort on the part of management in
order to make good decisions.

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The Importance of Managers

Managers Domains
External Internal
• Refers to the influences, • Refers to those areas of focus
resources, and activities that that managers need to address
exist outside the boundary of the on a daily basis, such as
hospital but that significantly ensuring the appropriate number
affect the hospital. (community and types of staff, financial
needs, population performance, and quality of care.
characteristics, and
reimbursement from commercial
insurers, as well as government
plans)

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Managers Functions
Managers implement six management functions
as they carry out the process of management:
1. Planning:
This function requires the manager to set a direction and
determine what needs to be accomplished. It means
setting priorities and determining performance targets.

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Managers Functions
Managers implement six management functions
as they carry out the process of management:
2. Organizing:
This management function refers to the overall design of
the organization or the specific division, unit, or service
for which the manager is responsible.
Determining positions, teamwork assignments, and
distribution of authority and responsibility are critical
components of this function.

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Managers Functions
Managers implement six management functions
as they carry out the process of management:
3. Staffing:
This function refers to acquiring and retaining human
resources.
It also refers to developing and maintaining the
workforce through various strategies and tactics.

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Managers Functions
Managers implement six management functions
as they carry out the process of management:
4. Controlling:
This function refers to monitoring staff activities and
performance and taking the appropriate actions for
corrective action to increase performance.

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Managers Functions
Managers implement six management functions
as they carry out the process of management:
5. Directing:
The focus in this function is on initiating action in the
organization through effective leadership and motivation
of, and communication with, subordinates.

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Managers Functions
Managers implement six management functions
as they carry out the process of management:
6. Decision making:
This function is critical to all of the aforementioned
management functions and means making effective
decisions based on consideration of benefits and the
drawbacks of alternatives.

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The Effective Manager

The manager needs to possess several key
competencies in order to effectively carry out
the management functions, including:
 Conceptual,
 Technical, and
 Interpersonal skills.

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The Effective Manager

Conceptual skills
Are those skills that involve the ability to
critically analyze and solve complex problems.
e.g., a manager conducts an analysis of the
best way to provide a service or determines a
strategy to reduce patient complaints regarding
food service.

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The Effective Manager

Technical skills
are those skills that reflect expertise or ability to
perform a specific work task.
e.g., a manager develops and implements a new
incentive compensation program for staff or
designs and implements modifications to a
computer-based staffing model.

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The Effective Manager

Interpersonal skills
are those skills that enable a manager to
communicate with and work well with other
individuals, regardless of whether they are peers,
supervisors, or subordinates.
e.g., a manager counsels an employee whose
performance is below expectation or communicates
to subordinates the desired performance level for a
service for the next fiscal year.

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Management Positions
Management positions within hospitals are not
confined to the top level (senior management),
management positions are found throughout
the hospital.

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Management Positions
The hierarchy of management means that
authority, or power, is delegated downward
in the hospital, and lower-level managers
have less authority than higher-level
managers, whose scope of responsibility is
much greater.

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Management Positions
e.g., a vice president of Patient Care
Services in a hospital may be in charge of
several different functional areas, such as
nursing, diagnostic imaging services, and
laboratory services; in contrast, a director of
Medical Records a lower-level position has
responsibility only for the function of patient
medical records.

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Management Positions
The hierarchy of management includes:
 Functional structure,
 Matrix, or team-based structure, and
 Service line management structure.

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Management Positions
Functional structure
An organizational design which identifies the
functions carried out within the Health Services
Organization (HSO) in a division of labor, where
positions are arranged in a hierarchy, managers
are assigned authority and responsibilities by
function, and a clear chain of command exists.

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Management Positions
Matrix structure
An organization design which arranges staff in a
team-based structure, where functional staff
from several functions are assigned to program
or service managers.

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Management Positions
Service line management structure
An organizational design where a manager
heads a specific clinical service line and has
supervisory responsibility for all functional staff
assigned to the services line, as well as
responsibility for resources acquisition, budgets
and financial control of all diagnostic and
treatment services provided under that service
line.

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Management Positions
• The size and complexity of the specific hospital
services will dictate the particular structure.
• e.g., large community hospitals, hospital
systems, and academic medical centers will
likely have deep vertical structures reflecting
varying levels of administrative control for the
hospital.

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Management Positions
• The most common organizational structure for
hospitals is a functional organizational structure.
• The Functional Organizational Structure offers
key advantages, such as specific divisions of
labor and clear lines of reporting and
accountability.

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Management Positions
• The Matrix Structure recognizes that a strict
functional structure may limit the organization’s
flexibility to carry out the work, and that the
expertise of other disciplines is needed on a
continuous basis.
• e.g.1,: when functional staff, such as nursing
and rehabilitation personnel, are assigned to a
specific program, such as geriatrics, and they
report for programmatic purposes to the
program director of the geriatrics department.

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Management Positions
• e.g., when clinical and administrative staff are
assigned to a team investigating new services
that is headed by a marketing or business
development manager.
• In both of these examples, management would
lead staff who traditionally are not under their
direct administrative control.
• Advantages of Matrix Structure include improved
lateral communication and coordination of
services, as well as pooled knowledge.

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Management Positions
• In the Service Line Management Structure, a
manager is appointed to head a specific clinical
service line and has responsibility and
accountability for staffing, resource acquisition,
budget, and financial control associated with the
array of services provided under that service
line.

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Management Positions
• Typical examples of service lines include
cardiology, oncology (cancer), women’s
services, physical rehabilitation, and behavioral
health (mental health).
• Service lines can be established within a single
organization or may cut across affiliated
organizations, such as within a hospital system
where services are provided at several different
affiliated facilities.

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Management Positions
• Some facilities have found that the service line
management for selected clinical services has
resulted in many benefits, such as lower costs,
higher quality of care, and greater patient
satisfaction, compared to other management
structures.
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Structure Functional
Comparing
Goal / Priority Organize by function or specialty
provided patients within the
hospital.
Context Departments providing a similar
(Who? When? functions in the hospital report to
Where?) one manager or executive.
Process – Decisions made by one manager
Steps or executive for Individual major
functions w/in the hospital
(nursing, finance, HR, IT).
Benefits • Supports professional
expertise.
• Encourages advancement.
Limits • Delays in decision making b/c
of "silo mentality" if issues
must be raised to senior
management before a
2/3/2022 decision can be made.
Matrix
Integrated organization based on
both function and service.
Superimposes horizontal program
management over traditional vertical
hierarchy
Personnel from various functional
departments w/in the hospital are
assigned to a specific program or
project (service) and become
responsible to two supervisors to
form an interdisciplinary team:
• a functional department head
• a program (service) manage
Decisions are made based on
directions from both a functional
manager and a service manager.
• Enables timely response to
patient demands.
• Facilitates internal efficiency and
effectiveness through promotion
of cooperation among disciplines.
• Well-developed collaboration and
coordination skills are necessary
for managers and nurses.
• Complex relationships require
knowledge and skill in
interpersonal relationships and
teamwork.
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Service-Line
Organize by service or product provided a type
of patient.
All professional, technical, and support
personnel providing service to a type of patient
report to one manager.
Decisions are made by one manager for
providing a type of patient service (cardiology,
ortho, etc.) across departments.
Manages budget and facilities for service
throughout the hospital.
Coordinates services for physicians and other
providers who admit and care for all these
patients within the hospital.
• Coordination of services .
• Faster decision making.
• Clarity of purpose.
• Increased expenses associated with
duplication of services
• Loss of professional or technical affiliation
• Lack of standardization
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Structure Functional
Comparing
Goal / Priority Organize by function or specialty
provided patients within the
hospital.
Context Departments providing a similar
(Who? When? functions in the hospital report to
Where?) one manager or executive.
Process – Decisions made by one manager
Steps or executive for Individual major
functions w/in the hospital
(nursing, finance, HR, IT).
Benefits • Supports professional
expertise.
• Encourages advancement.
Limits • Delays in decision making b/c
of "silo mentality" if issues
must be raised to senior
management before a
2/3/2022 decision can be made.
Hospital Design and
Management
Matrix
Integrated organization based on
both function and service.
Superimposes horizontal program
management over traditional vertical
hierarchy
Personnel from various functional
departments w/in the hospital are
assigned to a specific program or
project (service) and become
responsible to two supervisors to
form an interdisciplinary team:
• a functional department head
• a program (service) manage
Decisions are made based on
directions from both a functional
manager and a service manager.
• Enables timely response to
patient demands.
• Facilitates internal efficiency and
effectiveness through promotion
of cooperation among disciplines.
• Well-developed collaboration and
coordination skills are necessary
for managers and nurses.
• Complex relationships require
knowledge and skill in
interpersonal relationships and
teamwork.
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Service-Line
Organize by service or product provided a type
of patient.
All professional, technical, and support
personnel providing service to a type of patient
report to one manager.
Decisions are made by one manager for
providing a type of patient service (cardiology,
ortho, etc.) across departments.
Manages budget and facilities for service
throughout the hospital.
Coordinates services for physicians and other
providers who admit and care for all these
patients within the hospital.
• Coordination of services .
• Faster decision making.
• Clarity of purpose.
• Increased expenses associated with
duplication of services
• Loss of professional or technical affiliation
• Lack of standardization
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Task 1 for Next Week

List three latest researches in 2020 and 2022
related to healthcare management system.
Choose one of them and write a brief abstract.

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Hospital Design and

Management
Thank You

Questions