1. OPD should be located at the entrance of the hospital
2. Should be separate from inpatient area connected to it
3. Must have easy access to MRD, X-ray, laboratory, pharmacy and billing counter
4. Preferably accessible to causality, but separated from casualty
The OPD should have the following facilities:
1. Entrance-easily accessible with ramp, steps and wide door.
2. Flooring-tiled with a slope towards outlet
4. Waiting hall
5. Consulting rooms
6. Signboards and layout plan
7. Bay for trolleys and wheelchairs
8. Toilet-separate for males and females
9. Public telephone
10. Board indicating names of consultants on leave
Types of Clients in OPD
Referred cases from doctors outside and in-house
Direct OP cases
OPD is the first point of contact in the hospital and so the best impression should be given.
Flow Pattern of Clients in OPD
Enquiry – Registration – Waiting Hall – Consultation room – Investigation facilities – Pharmacy – Exit
Usual Problems in OPD
Lack of punctuality in starting OPD
Lack of appointment system
Non-availability of laboratory results
Lack of physical facilities
Proper co-ordination under expert supervision and guidance can go a long way to solve these problems.
Inpatient Service (IP)
If OPD is the show window of the hospital, the IP is the heart of the hospital. The IP service provides lodging, diet and medical care. Conveniently, it can be divided into:
Wards and rooms
Sanitary facilities and other requirements
Ward can be
Intensive Care Wards (ICU)
Intermediate Care Wards
The medical department has within it the various clinical services. They are: medicine, surgery, gynaecology, obstetrics, paediatrics, eye, ENT, dental, orthopaedics, neurology, cardiology, psychiatry, skin, V.D., plastic surgery, nuclear medicine, infectious disease etc. medical superintendent is a doctor who has control over all medical department.
The nursing department is the organizational structure through which nurses provide nursing care for clients under the jurisdiction of the institution. The nursing department consists of nursing service and nursing education. The primary purpose of the nursing service is to provide comprehensive, safe, effective and well-organized nursing care through the personnel of the department. The personnel consists of nursing superintendent, assistant nursing superintendents, head nurses and staff nurses. All of these are registered nurses, other personnel who function in the nursing service department may include the auxiliary personnel nurse aids and domestics who handle the non-nursing services.
The nursing education section has the responsibility of preparing nursing students to become professional nurses. Uplifting the standard of nursing by inservice education and refresher courses etc., are included in the functions of this department. The personnel consists of principal or director of nursing education, the associate professors, assistant professors, tutors and clinical instructors.
Paramedical departments are adjunctive to the practice of medicine in the maintenance or restoration of health and normal functioning. They include:
The following laboratories are usually found in the pathology department:
1. Bacteriology laboratory: This laboratory studies about the bacteria and their toxins.
2. Biochemistry : this is concerned with the chemistry of living organisms and of vital process.
3. Haematology laboratory : it is responsible for making haemoglobin determinations, coagulation time studies, red and white cell counts and special blood pathology studies for anaemia and leukaemia etc.
4. Parasitology laboratory: it studies the presence of parasites, the cyst and ovas of the parasites that are found in the faeces.
5. Serology laboratory: it does blood agglutination tests, Wassermann tests, V.D.R.L. etc.
6. Blood bank: it has the responsibility for collecting and processing all blood used in the hospital for transfusions. It makes studies on newborn infants who may have haemolytic diseases and does antibody studies on the prenatal client.
7. Histopathology department: it prepares tissues for gross and microscopic studies.
Laboratory services (LAB) must be available day and night. Must be located on the ground floor and should be easily accessible to the outpatients. Space requirement of Lab is:
Primary space: Required for technical work.
Secondary space: space utilized for administrative purpose.
Circulation space: for unchattered movement of personnel and equipment.
There should be sufficient staff and work arrangement for the efficient functioning of the department.
Physical Medicine and Rehabilitation Department
This department deals with clients who have functional disabilities resulting from disease conditions/injuries. This department can have physiotherapy, occupational therapy, speech therapy and vocational training. This department will be under the direction of a well – qualified physician who has special training in the field of physical medicine and rehabilitation. His staff should include therapists with qualification in the various specialties.
Operation Theatre Complex (OT)
This consists of one or more operation theatres and other facilities. OT complex must be located in a place where there is easy and quick access to the delivery suite. These should be four zone – outer zone, clean zone, sterile zone, disposal zone. There should be a sterilization room with an autoclave. The number of OT depends on many factors. There should be an arrangement for good lighting and ventilation.
Delivery suite is the place where births take place. The delivery suite is divided into three zones are first stage room, second stage room, delivery room. The room should have good lighting and ventilation. It should have adequate number of staff.
Pharmacy is a crucial factor in medical factor. It should be planned and organized well. The pharmacy department has the responsibility for selecting purchasing, compounding, storing and dispensing all drugs and medications. The pharmacy should be under the supervision of a registered pharmacist.
Radiology Department (X-ray Department)
The department must be located in a place where there is easy accessibility for OP and IP clients. Of the total space, the distribution for various rooms is as follows:
X-ray rooms: 25%
Film processing: 10%
Waiting area: 5%
Circulation area: 30%
Sufficient number of staff should be available. Staff must be protected against radiation hazards. This department has the following services.
Radiographic examinations and their interpretations
X-ray, radium, radioactive cobalt and other radioactive therapy
Ultrasonography, Echocardiogram, C.T. Scan, MRI and ECG.
The dietary department has the responsibility for the food service to the client according to their needs and doctor’s prescription. This department is responsible for the health teaching in regard to proper diet of the client upon their discharge from the hospital.
Non-Professional Services (Business Management)
The admitting department has the responsibility for admitting the client to the hospital. The importance of this department lies in the public relation that is maintained.
The client, his family and his friends must be treated with utmost respect, courtesy and tact. The enquiries made about the hospital and other clients are to be answered appropriately.
The administration of the entire hospital cannot be vested on the administrator alone. It is a collective responsibility of a group of people. The administrative staff, depending upon the size of the hospital, is composed of the administrator, the assistant administrator, the business manager and the departmental heads.
The purchasing department has the responsibility for purchasing all supplies and equipments for the hospital.
Accounts (Business Office)
This department has the responsibility for collecting the money which is owed to the hospital, paying for the supplies and equipment, handling all records pertaining to hospital finance, keeping records of assets and liabilities and assisting with budget. The business manager is responsible for the functions of the department. The accountants help him.
The housekeeping department has one main function – to keep the hospital clean.
The laundry takes care of the entire team linen of the hospital. It has the following functions:
Washing the dirty linen
Repairing the torn linen
Replacing the condemned linen
Electricity, water supply, heat, air-conditioning etc., are looked after by the mechanical department.
The maintenance department keeps the hospital in a good state of repair. Carpenters, painters, welders, gardeners etc., are included in the personnel of this department.
Central Supply Department
The purpose of the central supply department is to prepare and furnish other departments with equipment and supplies needed in the client care e.g. syringes, needles, treatment trays.
The social service department assists in obtaining financial aid for clients and their families. This department services also as a liaison between the client and community agencies.
Under the leadership of the chaplain, the pastoral care team meets the spiritual needs of the client.
Some departments function as a part of other departments already mentioned, e.g., the operating room functions as part of the department of surgery. The outpatient department is a combination of several departments. The emergency room functions along with the department of medicine. Sometimes according to the load of client care, the services may be given in special department such as intensive care, immediate care, and ambulatory care units.
Hospital Waste Management
It is newly set department which takes care of the disposal of the entire waste both solid and liquid.
Central Sterile Supply Department (CSSD)
This is important department which supplies sterile articles throughout the hospital. CSSD handles contaminated, clean and sterile articles.
Work flow in CSSD: Receiving – Washing – Drying – Accounting – Sorting – Packing – Sterilization – Sterile storage – Issue. The articles should move in one direction from receipt to issue. The location should be such that the wards and departments can have easy access.
Medical Record Department (MRD)
This is an integral part of every modern hospital. The guiding principle is “people forget, records remember.” Functionally the MRD is divided into (1) Reception (2) Medical Records Library (3) Statistical Section.
Weeding out of clients file, is done in successive years.
OP Records: 5 years.
IP Records: 10 years.
Medicolegal Records: 15 years.
Now with computerization the files can be entered into the computer and can be utilized when required.
Every health care facility should have arrangement for handling medicolegal cases. The hospital administration, as well as the doctors, nurses and other staff members should be made aware of the legal implications involved in the client’s care, so that lot of problems can be avoided.
This department in the hospital must be well versed with law of the land especially the labour laws and is responsible for recruitment, selection, promotion, transfer, termination etc. The personnel department functions under the personnel officer who is qualified in the personnel administration. The personnel department has the following functions, directed to the welfare of the personnel.
Recruitment of personnel
Interviewing prospective employees
Promotion and transfer of employees
Termination of employment
Inservice training programme
Remuneration and incentives
Organization of each hospital varies according to the ownership and administration. The governing body of the hospital which is usually called board of trustees is responsible for the policies of the institution. Under the governing body there is a head of the hospital, who is administrator or director.
It is impossible for the administration to carry out the total work involved in the hospital management. Therefore, the responsibility is delegated to the departmental heads who are specialists in their field.
List of Departments in Hospital and its Functions – A Simple Learning for Nurses.
Departments in Hospital
There are several departments are found in hospitals namely Outpatient department (OPD), Inpatient Service (IP), Medical Department, Nursing Department, Paramedical Department, Physical Medicine and Rehabilitation Department, Operation Theatre Complex (OT), Pharmacy Department, Radiology Department (X-ray), Dietary Department, Non-professional Services (Business Management), Medical Record Department (MRD) and Personnel Department.
Outpatient Department (OPD)
Most hospitals now have an OPD. The advantage of OPD is that much of the investigative unit and curative work can be done there without admitting the client, thus curtailing medical expenses.
The scope of OPD includes the following:
1. Consultation, investigation, procedures, specialty services.
2. Preventive and promotive health care: Clinics, which include: diabetic, antenatal, postnasal and under five.
3. Rehabilitation services (physiotherapy, occupational therapy etc)
4. Health education
AUTHOR : SMRITI YONZON