THEME 7.

THE ORGANIZATION AND Indications for referral to the hospital:

CONTENT OF THE HOSPITALS OF
DIFFERENT LEVELS, RECORDING 1. Presence of urgent or emergency
AND ANALYSIS OF THEIR indications.
ACTIVITIES 2. Necessity for complex researches.
Hospital (inpatient) care is provided 3. Application (to use) of intensive
to patients requiring long-term treatment.
(constant/permanent) follow-up, using of 4. Social and living conditions of the
complicated methods of examination and patient.
intensive treatment, and also operative
interventions that cannot be performed in II. Subdivisions of the hospital and their
out-patient conditions. functions (structural units).
Patients can be treated in the hospitals Subdivisions of the hospital:
with various pathological conditions or with 1. Admission room (department).
one certain pathology.
Kinds of the hospital care: 2. Medical departments.
1. Total health care.
2. Specialized care. 3. Auxiliary diagnostic subdivisions.
Hospitalization (admission) is carried
out by doctor’s referral of out-patient clinics 4. Administrative subdivisions.
and ambulance service, transfer from
another hospital, and also at the direct
address to the doctor in the presence of
Amount of work (workload) and
emergency indications.
Admission room functions:
Hospital tasks:
• Admission, registration and
1. Providing of the specialized round-the-
distribution of the patients admitted to
clock stationary care in sufficient
the hospital
volume
• Establishment of the provisional
2. Approbation (testing) and introduction
(preliminary) diagnosis
of modern methods of diagnostics,
• Decision of a question of need for
treatment and prevention.
stationary or out-patient treatment
3. Comprehensive rehabilitation treatment
• Providing of necessary medical care
4. Disability expertise
• Sanitization patients which are
5. Hygienic education of the population
hospitalized to non-infectious
Hospital functions (examples):
(noncommunicable) department
1. Therapeutic and recovery (Diagnostics
and treatment of diseases, medical and
• Implementation of measures to
social rehabilitation, emergency care)
prevention of introduction and
2. Preventive (Prevention of infectious
prevalence of infectious diseases
diseases, prevention of transition of
acute illnesses to chronic, reducing
• Organization the evacuation of the
morbidity of temporary inability and
patients requiring treatment in other
disability)
medical institutions
3. Educational (Preparation of the medical
• Discharge of patients and making
personnel and improvement of
medical certificates
professional skills of medical workers)
• Providing information of the
4. Scientific Research functions.
hospitalized patients

Management of hospital is carried out
by the head physician who organizes the
work of institution in accordance with
regulations on it, orders and instructions of
controls public health services and is guided
by the current legislation. He (she) is
responsible for therapeutic-and-
prophylactic, administrative activity of
establishment.
The assistant to the head physician
by a medical part
chief medical officer
directly supervises and is responsible
for quality medical-and-prophylactic and
sanitary and antiepidemic hospital works. It
supervises over activity managing branches
and doctors, supervises quality of
diagnostics, treatment, a food and care of
patients, with that end in view regularly
spends detours, checks case records (quality
of their conducting, correctness and
timeliness of medical appointments and
applied methods of treatment).
The special attention addresses on
timeliness of hospitalization, the analysis of
cases of divergences of diagnoses, analyzes
the remote results of treatment. The assistant
to the head physician provides carrying out
of actions for improvement of professional
skill of the medical personnel, develops the
plan of conferences and employment with
doctors and supervises its performance. It is
responsible for correct statement of the
medical account and the reporting, makes
reports.
Staff the medical personnel of branch
is established depending on number of beds,
type and an establishment profile.
The cores in regular structure of branch
of a hospital are posts of head of
department, the attending physician, the
head nurse, the matron.
The content and organization of doctor-in
attendance and head of department work.
The Attending physician:
1) diagnoses and cures of patients in the
hospital;
2) Participates in doctors round,
consultations, production meetings,
pathoanatomical conferences,
specialization of doctors-interns;
3) discharges patients from hospital;
4) write up documents, epicrisis, makes
medical reports;
5) Represents patients to Medical consultative
board and Disability Determination Services
.
head (chief) of department
1) Carries out a direct management of
activity of the medical personnel of
branch;
2) Bears full responsibility for quality of
treatment - organizes and provides
timely correct inspection and treatment
of patients, does detours of patients
together with the attending physician,
examines again arrived and seriously ill
patients, validity of the appointed
researches and treatment methods
checks, regularly supervises work of
attending physicians;
3) Writes out patients from branch;
4) write-up and signs documents,
эпикризы, makes medical reports and
analyzes overall performance of branch;
5) Makes the schedule of work;
6) Solves questions of examination of work
capacity;
7) Advises doctors;
8) Organises production meetings;
9) Spends pathoanatomical conferences;
10) Carries out specialisation of doctors-
interns.
 All treatment-and-prophylactic institutions
Number of the kojko-days spent for a year
regularly submit forms of the state statistical ___________________________________________________
= _____ days
reporting. The basic is the form № 20 «The Number of the patients who have passed through a
Report of a treatment-and-prophylactic hospital (Written out + died) ________
institution» that contains tables with the
information about:
3. Cot turn:
 Medical staff, departments,
preventive medical examinations, Number sick, written out and died,
performed operations; For a year
____________________________________________
= ___ time
 Activity of dispensaries, consultations Mid-annual number of cots ________
(doctor’s advices) of polyclinics,
dental offices and hospital;
 Quantity of patients, newborns,
invalids. Mid-annual employment of a cot (efficiency of use
The hospital assessment of works is койкового fund - 330,6 days)
given on the basis of the analysis of two - Average duration of stay of the patient in a
groups of the indicators one of which hospital (12,8 days in Ukraine, 5,9 in Denmark, 6,6
in Sweden)
characterizes bedspace and its use, and - A cot turn (average of the patients staying on one
another - quality of medical-diagnostic cot) (25,8)
work.
The analysis of indicators of work of a Overall performance indicators:
hospital is spent by comparison with the - The general death rate (1,1 % in Ukraine)
similar data on:
 in this hospitals for the past year;
 of other hospitals or specialized
departments;
 of the areas or republics as a whole.
Except calculation and the analysis of the
indicators set forth above at a hospital
assessment of works экспертно each case is
estimated:

The treatment estimation is spent on

the end result according to the state medical
standards including diagnostic procedures,
medical procedures, requirements to results
of treatment.

Indicators of the organization of work:

1. Mid-annual employment of a cot:

Number of the kojko-days spent for a year

___________________________________________________
= ____ days
Mid-annual number of cots ________

2. Average duration of stay in a hospital: