Hospital- Its Type & Functions

Dr. Bhupesh Chandra Semwal

• The word “hospital “derived from the Latin word
hospitalis which in turn derived from french word
“hospes” that means “ a host or a guest.
• A hospital is a health care institution providing
treatment to patients with specialized staff and
equipment
• An institution of community health organization,
which produces use of physicians, surgeons and team
of technical staff, and produces facilities for
diagnosis, therapy, rehabilitation, prevention,
education and research centre.
 WHO Expert Committee, 1963
• Hospital is an integral part of social and
medical organization
• To supply to the population complete
healthcare, both curative and preventive
• Centre for the training of health workers and
for bio-social research
 WHO expert committee, 1963
• A hospital is a residential establishment which
provides short-term and long-term medical
care consisting of observational, diagnostic,
therapeutic and rehabilitative services for
persons suffering or suspected to be suffering
from a disease or injury.
• It may or may not also provide services for
ambulatory patients on an out-patient basis’.
 CLASSIFICATION OF HOSPITALS
• Care, clinical and non clinical ground, size,
cost and system of drugs
• Primary care- Consist of basic curative care,
simple diagnosis and treatment
• Secondary care- More sophisticated and
complex diagnosis
• Tertiary care- Intensive care unit (ICU)
Neonatal Intensive care unit (NICU)
• Classification is mainly based on
i. Based on clinical grounds
ii. Based on non-clinical grounds
iii. Based on Objective
iv. Based on Administration, ownership, control or financial
income
v. Based on Length of Stay
vi. Depending on Type of Medical Staff
vii. Based on bed capacity
viii.Based on System of Medicine
ix. Based on Cost
x. Based on Size
xi. As per WHO Classification
1. Based on clinical grounds

A. MEDICINE-BASED
Pediatrics
Psychiatric and other nervous diseases
General medicine
B. SURGERY-BASED
Orthopedics
Gynecology & obstetrics
ENT
C. MATERNITY
Short-term & Long-term
• Based on non-clinical grounds

1. GOVERNMENTAL HOSPITALS
Army hospital City hospital
Navy hospital Civil hospital

2. NON-GOVERNMENTAL HOSPITALS
Private hospitals(for profit)
Non-profit hospitals (Church hospital,
Community hospital, hospital, Charitable
hospital)
3. Based on Objective
General hospitals
Special hospitals
Teaching cum Research Hospital
4. Based on Administration, ownership, control or
financial income
Governmental or public
Non-governmental or private
Semi Govt Hospital
Voluntary Agency Hospitals
5. Based on Length of Stay
Short-term (Stay less than 30 days)
Long-term (Stay more than 30 days)
6. Depending on Type of Medical Staff
Closed-staff hospital
Open-staff hospital
7. Based on bed capacity
Small hospital (Upto 100 beds)
Medium hospital (More than 100 to less
than 300 beds)
Large hospital (More than 300 beds)
• Supported Cost-
Elite hospital: Accommodate technology and
life science advancement
Comprise delux room, with T V telephones and
refrigerator
i.e. Apollo, Medanta

Budget Hospital- Low budget

 Supported system of Medicine
• Allopathic
• Ayurvedic
• Homeopathic
• Unani
• Supported Region-
• Regional
• District
• Community clinics
Organization structure of a hospital
• Organization structure varies from hospital to
hospital
• Grouping of hospital department within the
structure
• Administrative- CEO, vise president
• Informational – HR, health education, medical
record, admission, billing etc.
• Therapeutic- provide treatment to patient and include-
• Physical therapy- to enhance large muscle mobility
• Occupational- to assist patient regain fine motor skills
• Language therapy- identify, evaluate and treat language
disorder
• Respiratory therapy
• Dietary
• Diagnostic-
• Support- provide support for entire hospital, includes
• Central supply
• Biomedical technology
• housekeeping
• Medical staff involved in the hospital and their
function
• The medical unit of the hospital comprises the
following personnel according to their  designation
and they are assigned to  perform various activities as
• Doctors
• Nurses
• Allied Health Professionals
• Support staff
• The doctor can be the consultant as a specialist, the registrar of a hospital, the resident. All of
them assess the patient’s medical care. Depending upon the type of hospital, interns or student
doctors may also provide the treatment to the patients under the supervision of senior doctors .
• Depends upon the level of experience and their medical specialty: 
• Senior Consultants: These are the specialist doctors who see the
patients at specific time intervals mostly during the ward rounds and
meetings.
• Registrars: These are the senior doctors and are responsible to supervise
residents,  interns, and student doctors.
• Residents: The resident doctors are responsible to look after patients on
the ward and are under training for specialization. The resident doctor is
based on the ward and is typically the patients often get in more contact.
• Interns: These are the medical students and they are engaged in further
training after finishing graduation.
• Student Doctors: These are undergraduate medical student doctors who
are supervised by the attending physician.
• Nurses manage most of the ongoing care and treatment services in a
hospital. They assess,  plan and administer the dose of the drug on a daily
treatment basis. 
• Functions: 
• Nurses are responsible for carrying out the treatment plan established by
the physician.
• Nurse Unit Manager – runs the ward.
• Associate Nurse Unit Manager – helps and acts as nurse unit manager
when he/she is off-site.
• Nurse Practitioners – highly skilled, have an advanced level of training.
• Special Nurses – such as; clinical nurse specialists, clinical nurse
consultants, clinical nurse educators, triage nurses, emergency department
nurses.
• Registered Nurses – provide a high level of day-to-day care and perform
some procedures.
• Enrolled Nurses – They are responsible for the provision of basic medical
care facilities under the observation of more senior nurses. 
• Allied Health Professionals
• They are educated practitioners who work as a part of a
multidisciplinary healthcare team.  They assess, diagnose and
treat health conditions and work to prevent disease and
disability.
• Dieticians: They have specialized nutritional and medicinal
training which helps them to determine and establish the
person’s dietary needs and accordingly design the dietary
plans. In which, dietician decides which food will satisfy the
requirements and which they should avoid.
• Occupational Therapists: These practitioners are responsible
to assess people’s ability to do their daily activities.
• Pharmacists: They supervise the use of drugs in the hospital.
They are also involved in the provision of education on how to
safely and effectively consume the prescribed drugs.
• Physiotherapists: They examine and treat the people who have
difficulty in physical movement and also help them to function
better physically and become more independent.
• Speech Therapists: They work closely with patients who have any
disorder that interferes with communication or swallowing issues.
They also evaluate the thought process involved in communication.
• Interpreter Services: The hospital provides an interpreter who has
special skills in medical terminology for an unresponsive patient
(hard hearing issues) and for people who are not able to
communicate in the commonly spoken language.
• Rapid Response Team: These are the groups of designated hospital
staff, mostly a  doctor, nurses, and respiratory therapists. These
teams are very alert and quickly come to a patient’s room if there is
any warning that the patient’s condition is deteriorating.
 Other Hospital Staff
• Clinical Assistants: They are responsible to take care of ward housekeeping.
• Patient Service Assistants: Takes care of meals and any other requirements of
patients.
• Porters: Responsible for taking care of the patient when lifting and during transport.
• Volunteers: help with fundraising and ward visits.
• Ward Clerks: These are the hospital staff and are available 24 hours on the ward
reception desks.
• Following are the overall functions of the medical staff with respective of patient
care and hospital management policy. 
• To advise the governing body on medical concerns.
• To manage the accountability of the quality care services to the patients of the
hospital.
• To request, assess and perform upon medical staff committees’ reports.
• To examine the professional ethics of hospital staff and to take corrective action as
indicated.
• To design, implement, and evaluate the policies of medical staff.
• To advise the administrator (CEO) on all medical administrative matters.