ADMINISTRATION IN

CLINICAL SERVICES

- Dr. Haryax Pathak

COMPONENTS OF
CLINICAL SERVICES
• OUT-PATIENT DEPARTMENT
• IN-PATIENT DEPARTMENT
• LABORATORY SERVICES
• RADIOLOGICAL SERVICES
• OUTREACH AND COUNSELING
 Patients receive elective/emergency care

Can be diagnostic, therapeutic or

preventive health-care

OUT-PATIENT For patients not under admission in the

DEPARTMENT hospital

First point-of-contact between patient

and hospital

For patients who can receive health-care

without the need for hospital admission
 Types of OPD Patients

GENERAL OUT-PATIENT EMERGENCY OUT-PATIENT REFERRED OUT-PATIENT

All patients who report directly to OPD All patients who present to Trauma and All patients who are referred to the
with or without prior appointment Emergency Centre and receive OPD from lower centres or other
emergency medical care departments for specialised and
specific diagnostic/therapeutic care.
Types of Out-Patient
Departments

CENTRALIZED
OPDs of all clinical departments grouped
into a single large OPD complex
Services available for all major and minor
clinical fields in a single OPD complex.
DE-CENTRALIZED
OPDs scattered across the hospital complex
with the respective clinical departments.
 Provide specialist diagnostic, therapeutic and preventive healthcare to outpatients

OPD - Rapid screening and diagnosis of ailments

FUNCTIONS Treatment of patients on ambulatory basis

Follow-up care for discharged patients and rehabilitation

Provision of Primary Health Care, by:

• Health Education and Behaviour Change Communication
• Maternal and Child Immunisation
• Ante-natal and Post-natal services
• Voluntary counseling & Testing Centre for HIV/AIDS

Facilitate the training & education of medical, paramedical & nursing staff

Collection, compilation, and analysis of Medical Records

Epidemiological study of diseases

Surveillance and monitoring of communicable diseases to prevent and mitigate outbreaks

OPD Services
Ambulatory Care Centre -
Medical care provided on
out-patient basis – diagnosis,
observation, consultation,
investigation, treatment,
advanced procedures,
rehabilitation etc.
Walk-in-clinic - No prior
appointment required.
Polyclinic - Clinic providing
general and specialist care –
usually independent of a
hospital.
Day Hospital - Outpatient
facility – patients attend for
assessment, treatment or
rehabilitation during the day,
return home or spend night
in another hospital.
Health Centre - Clinic
offering services by general
practitioners and nurses in a
given area – covers family
practice and dental health.
Dispensary - Office in
schools, offices, industries
that supplies over the
counter medications, medical
supplies and imparts basic
medical care.
Process of
OPD
Facilities in OPD

CLINICAL
ADMIN AREA
AREA

OPD

PATIENT CIRCULATION
ARREA AREA
 Medical Staff

Nursing Staff

OPD Staff
Paramedical Staff

Public Relations Officers

and Administrators
IN-PATIENT To provide accommodation for patients at the point in an illness when
dependence on others is highest
DEPARTMENT
IPD - Components

Nursing station The beds

Public areas needed

Necessary services,
to carry out the
storage work
nursing care
 To provide highest quality of medical and nursing care

To provide essential equipments, drugs and other materials

IPD - required for patient care

Functions To provide comfortable env.-eating, sleeping, toilet

To provide facilities for visitors

To provide highest degree of job satisfaction

Meticulously maintaining medical records

To provide opportunity for education, training and research in

the field of medicine, nursing and hosp. admin.
 Nightingale
Rig’s pattern
Modified Rig’s pattern
IPD – Forms Racing track ward
of Wards ‘T’ and ‘Y’ shaped ward
Single straight corridor ward
‘L’ shaped plan
Cruciform plan
‘H’ shaped plan
‘E’ shaped plan
Box plan
Central corridor multiple rib pattern
 Nursing station
Treatment Room
Clean Utility Room
Ancillary
Services Ward Kitchen / Pantry

Attached To Stores

Wards Duty Room for Doctors

Seminar Room
Attendant’s Room
Side Room Laboratory
Locker Room for Staff
Wheelchair / Trolley Bay
 Specialty nursing units designed, equipped and staffed
Intensive Care with especially skilled personnel for treating very critical
Unit patients or those requiring specialized care and
equipment
 Close observation and treatment of critically ill patients

To provide specialized treatment with specialized highly skilled

manpower and equipment
ICU -
To utilize skilled staff more effectively and efficiently
Functions
Surveillance of critically ill patients

Care for postsurgical operations

To provide care for medical emergencies

Care for cardiac emergencies

To provide support to critically ill patients

ICU - Types

NICU: Neonatal Intensive Care Unit

PICU: Paediatric Intensive Care Unit
SICU: Surgical Intensive Care Unit
CCU: Coronary Care Unit
 Provide diagnostic and management information for the
LABORATORY physicians to aid in the patient care with respective
SERVICES investigations and examination of bodily tissues, samples
and specimens.
LABS - Functional Components

Histopathology – Examination of solid tissues of body

Clinical Pathology – Examination of body fluids – blood, urine, sputum, stool, pleural fluid,
peritoneal fluid
Microbiology – Study of bacteria, viruses, fungi, parasites as well as serology and immunology

Haematology – Study and examination of blood and blood components

Biochemistry – Measurement and estimation of various chemical components of like hormones,

enzymes, electrolytes, vitamins, etc
Research laboratories – Clinical research related to patient care, study of diseases, medicines,
vaccines, diagnostic and therapeutic procedures
LABS – Organizational Structure
Laboratory Hazards

Handling of infectious material.

Handling of broken glassware.

Accidental spill over of corrosive reagents.

Swallowing of corrosive material such as concentrated Sulfuric acid, Hydrochloric acid, Sodium Hydroxide; Trichloro
acetic acid etc.
Inhalation, inoculation, swallowing of infectious material - bacteria; viruses (HBsAg, HIV etc.)

Inhalation of poisonous fumes.

Potential hazards in the form of inflammable chemicals and gas leakages.

LABS – Quality Control

Internal Quality Control

External Quality Control

Calibration

Evaluation

Accreditation and Certification

RADIOLOGICAL
SERVICES

Imaging of the human body –

Sequence of multiple tests that
captures the images of different
body parts.
Types of Radiological Services

Diagnostic Interventional Radiation

Radiology Radiology Oncology
Radiology - Functions

High quality imaging Aiding, establishing or

services confirming diagnosis

Provide high-quality
Training, Education
therapeutic radiological
and Research
services
Common Radiological Elements

Radiography Sonography MRI CT

Endoscopy PET Angiography

Radiology – Applications
and Organization
 ACUTE EFFECT –

• Heavy dose in short period of time

• Cerebral – Convulsions, Blurring, Headache
• Gastric – Nausea, Vomiting, Colicky abdominal
pain
• Blood – Aplastic anemia, blood dyscrasias,
marrow depression
Radiological
Hazards CHRONIC EFFECT –

• Due to continuous short exposure

• Skin – Loss of hair, burns, brittle nails,
amputation of fingers.
• Blood – Anemia, Leukemia, Leucopenia.
• Eye – Cataract, Iridocyclitis.
• Others – Sterility, Obesity, Cancer