MBA in Hospital and Health Management ROLL NO- 1205

(CC 615- Essentials of Hospital Services)

Mid Term Examination
Duration: 3 hours Maximum Marks 50
Q1. Define Hospital and Enumerate the functions of Hospitals.
Ans1. Hospitals are complex Organizations, The members of the team working together in
hospitals are from varied social strata, financial and educational background, the medical science
is one of the fastest growing field of science, Expectations of clientele are mounting, Essential to
apply systems approach.
According to WHO the definition of Hospital is -
“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 and for Parturient. It may or may
not provide services for Ambulatory Patients on an Out-patient Basis.”
FUNCTIONS OF HOSPITALS-
 Hospitals should aim towards achieving a high quality of Patient care by making
technological advances and physical facilities available.
 Services should outreach the community.
 Preventive
 Health Promotion
 Specific protection
 Early Diagnosis and Treatment.
 Disability Limitation
 Rehabilitation
 Education and Research.

Q2. OPD is called “shop window” of a hospital. Discuss the various aspects which are to
be kept in mind while organizing OPD services in a multispecialty hospital. What are the
common problems faced in OPD.
Ans2. Outpatient department is defined as a part of the hospital with allotted physical & medical
facilities and other staff in sufficient numbers. Regularly scheduled hours to provide care for
patients who are not registered as inpatients.
While organizing OPD services we should keep in mind following things-
LOCATION-
  Near main road
 Separate Entry Exit Road
 One way Traffic, No back flow
 Relationship with other department of Hospital
 No or less noise.
 Address Patient Safety needs
 Natural lighting
EXTERAL FACTORS-
 Need and financial status of the population.
 Social Background
 Cost of the Services to patients
 Distance of OPD from population and means of transportation available.
 Availability of trained Manpower
 Other Hospitals in the Vicinity
 Availability of Land, Water, Electricity.
INTERNAL FACTORS-
 Expected workload.
 Specialties to be provided.
 Level of Diagnostic facilities to be provided.
 Planned Waiting time for Consultation.
 Service time.
 Timings and working hours.
 Provisions for future expansion.
 Flow of patients and staff.
 Relationship of different departments.
 Immunization, Counseling Antenatal Checkup
 School Health Programs.
 Health camps.
 Control Epidemics-extending advice to health authority.
LAY OUT-
 Avoid bottle necks.
 Keep Workflow in mind.
SPACE REQUIREMENT-
 Inquiry, Reception, Registrations.
 Waiting, Examination, Treatment
 Minor OT, Diagnostic Facilities.
 Toilets Circulation.
  ½ Sq Ft Annual Footfalls.
 ½ x 4000=20000 Sq Ft= 2000 Sq M.
PHYSICAL FACILITIES/ ZONING-
 Public Area- Parking, Stretcher, Wheelchair, Inquiry, Reception, Medico-social worker,
Snack's shop, Public telephone, Waiting Area,
 Clinical Area- Sub waiting area, Consultation, Examination Room, Support services,
Detention Room etc.
 Administrative Area- Work place for Admin staff, Resting space for staff,
Housekeeping storage, Bulk Drugs.
 Circulation Area- Staff security, Corridors, Lifts, Staircase, Ramps for Patients.
PROBLEMS FACED -
 Delay and wastage of time
 Inadequate Diagnostic Services.
 Coordination Problems.
 Lack of faith in doctors.
 Dull and Awful atmosphere.
 Insufficient Sign posting.
 Delay in locating Old records.

Q3. Describe various functional areas of Operation Theater.

Ans3. Various Functional areas of Operation Theater are-
 Reception- For changing from street clothes to grown and to provide staff lockers and
lavatories for staff.
 Holding Area- This area is planned for waiting and IV-line insertion, preparation,
catheter/ gastric tube insertion, connection of monitors, and shall have O2 and suction
lines. Facility for CPR should be available in this area.
 Induction Room (Anesthetic room): It should have facilities as in OT, provides space for
anesthetic trolleys and equipment, located with direct access to circulation corridors and
ready access to the operating room, cleaning testing and storing of anesthesia equipment,
Hand washing facility,
 PACU- Post anesthetic care unit is preferably adjacent to recovery room.
 Staff room- Men and women change dress from street cloth to OT attire, lockera and
lavatory in proximity are essential.
 Sanitary facility for staff- One wash basin and one water closet should be provided for 8-
10.
 Toilet facilities in changing room is not acceptable.
 Offices
  Rest rooms
 Laboratory
 Seminar room
 Storeroom
 Theatre Sterile Supply Unit (TSSU): Temperature in range 18-22 degree centigrade,
humidity of 40%-50%, Air conditioned with 10-12 air exchanges per hour, proper
inventory provision and control.
 Flash sterilization.
 Scrub room- Scrubs are the sanitary clothing worn by surgeons, nurses, physicians and
other workers involved in patient care in hospitals. Originally designed for use by
surgeons and other operating room personnel, who would put them on when sterilizing
themselves, or "scrubbing in", before surgery, Scrubs are designed to be simple (with
minimal places for contaminants to hide).
 Operating room- The room size depends on the type of surgical use and economic
consideration as the larger ones to maintain in terms of air conditioning.
Size- Minimum 400 sq ft for special procedures 600 sqft,.
Central zone centered around the table. Parking space- 36 inches wide around the walls
for keeping equipment not of immediate use. Doors of OT should me 4-5 feet wide. Sliding door
to prevent disturbances, Ceiling should be smooth and impervious, Joints between walls, celing
and floor are to be watertight junctions.
 Ventilation- Laminar Air Flow ventilation is used in modern operating theatres to reduce
the number of infective organisms.

Q4. Write short notes on any of the two topics given below :-
(a) Flow chart of patients in Accident and Emergency Department.
(b) Discuss advantage and disadvantages of open ward (Nightingale ward,
(c) Enumerate various services provided by hospital.
Ans 4. b) Advantages of Open ward-
 Nurses have view have all the patients.
 Well lighted and ventilated
 Economic to construct and maintain,
 Patient feels secure in presence of other patients.
Disadvantages of Open ward-
 No privacy for the patients
 Nurses/Other staff Fatigue Factor
 Danger of Cross Infection
  More serious patients are accommodated close to Nurse station for Observation
 And are exposed to maximum noise and traffic.

c) Various services provided by the hospitals are-

 Clinical and Nursing Services
 Supportive Services
 Utility Services
 Administrative Services
Clinical and Nursing Services-
 Outpatient Department
 Indoor Patient Department
 Accident and Emergency Services
 ICU
 Operation Theatre
 Nursing Services
Supportive Services-
 Laboratory services
 Blood bank
 Radio-diagnosis and imaging dept
 Pharmacy
 CSSD
 Medical Records
 Physical medicine and rehabilitation
 Sanitation and waste management.
Utility Services-
 Communication
 Laundry and Linen Services
 Dietary Services
 Transportation
 Fire and safety
 Emergency Maintenance
Administrative Services-
 Personnel Management
 Financial Management
 Public Relations
  Medical Social Work
 Material Management

5. Write short notes on any of the two topics given below

(a) Qualities of a good Hospital Administrator.
(b) Triage.
(c) What are the different zones in OT ?

Ans5.a) Qualities of a good Hospital Administrator are-

Industry Knowledge. The health care industry can be extremely competitive and receiving a
master's degree can take your career even further.
 Leadership. ...
 Critical Thinking. ...
 Relationship Building. ...
 Ethical Judgment. ...
 Adaptability. ...
 Quick Thinking
He should have all the qualities that Lord Ganesha possess-
 Large Ears- Listen more
 Big head- Think big.
 Small Eyes- Concentration
 Small Mouth- Talk less
 Trunk- Intensive strength and no discrimination
 Blessings- for all those choosing right path.
 Large Belly- Digest both good and bad experience.
 Broken Trunk- Sacrifice for good cause.
Ans c) Different zones of OT are-
 Protective zone
 Clean Zone
 Aseptic Zone
 Disposal Zone
Protective zone-
 Reception
 Waiting room for patient and relatives.
  Rooms for administrative staff
 Stores and Records.
Clean zone-
 Pre- and post-operative rooms
 Stores and cleaner room.
 Equipment and store room.
 Emergency Exits.
 Office rooms for staff.
 Closed circuit TV control area.
 Kitchenette.
Aseptic Zone-
 Operating room
 Scrub room
 Anesthesia induction room.
 Flash sterilization of instruments.
Disposal zone-
 Dirty Utility room
 Disposal corridor
--------------------------------------- -------------------- ---------------- -------------------------------
Thank you