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SEMINAR ON HOSPITAL AS A SYSTEM

Subject: - Health Management and Leadership Unit: - IV

Chairperson- Mr. Gayanand Mandal Assistant Professor, College of Nursing, BPKIHS

Prepared By: - Ms. Tilarupa Bhattarai M. Sc. Nursing First Year, College of Nursing, BPKIHS Date and Time of Presentation: - 17th March. 2010 at 8 am Venue: - College of Nursing, BPKIHS, Dharan

WELCOME TO the seminar on Hospital as A system


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ALL INDIA INSTITUTE OF MEDICAL SCIENCES

Contents

Meaning of Hospital Definition of Hospital Introduction of System Principles of System System Theory Input Process Output Feedback Types of System Organization as a System Hospital Viewed as a System Hospital as a Social System Sub-System in a Hospital

Summary Referrence

MEANING OF HOSPITAL
word HOSPILE Hospital, hostel, hotel, all are derived from same source Used in different sense, Basically the meaning of the word is the same i.e. to provide the service and care to their client. The term hospital means an establishment, temporary space occupied by sick or injured people.
Latin

DEFINITION OF HOSPITAL

A hospital is an institution for health care providing patient treatment by specialized staff and equipment, and often, but not always providing for longer-term patient stays.

According to WHO, Hospital is an integral part of a social and medical organization, the function of which is to provide for the population complete health care, both curative and preventive, and whose out-patient services reach out to the family and its home environment, the hospital is also a centre for the training of health worker and for biosocial research.

SYSTEM : INTRODUCTION

A system is a collection of parts (or subsystems) integrated to accomplish an overall goal (a system of people is an organization). There are numerous types of systems. For example, biological systems (cardiovascular, etc.), mechanical systems (thermostat, etc.), human/mechanical systems (riding a bicycle, etc.), ecological systems (predator/prey, etc.), and social systems (groups, supply and demand, friendship, etc.). A pile of sand is not a system. However, a functioning car is a system. 6

PRINCIPLES OF A SYSTEM

The system's overall behavior depends on its entire structure (not the sum of its various parts).

There is an optimum size for a system. If we try to make the system any larger, it'll try to break itself up in order to achieve more stability.
Systems tend to seek balance with their environments - Systems that do not interact with their environment (e.g., get feedback from customers) tend to reach limits. A circular relationship exists between the overall system 7 and its parts.

SYSTEM THEORY

General systems theory was originally proposed by biologist Ludwig von Bertalanffy in 1928, specifically following the World Wars. Systems theory is an interdisciplinary theory about the nature of complex systems in nature, society, and science, and is a framework by which one can investigate and/or describe any group of objects that work together to produce some result. The systems framework is also fundamental to organizational theory as organizations are complex dynamic goal-oriented processes.
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ELEMENTS OF A SYSTEM

Output Process Input


FEEDBACK

Input 1. Human 2. Capital 3. Managerial 4. Technological

ENVIRONMENT(Culture)

Feedback ENVIRONMENT, Goal, Strategies INPUT PROCESS OUTPUT

Output 1. Products 2. Service 3. Profits 4. Satisfaction 5. Goal Integration

Goal Input of Claimants 1. Employees 2. Consumers 3. Suppliers 4. Stockholders 5. Government ENVIRON MENT 6. Community

ENVIRONMENT Communication

External Variables & Information 1. Opportunities 2. Constraints 3. Others

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TYPES OF SYSTEM
Open System Closed System
Doesnt receives/ give input/ output from/to the environment Minimum Interactions with in its subsystems

Receives/ give input/ output from/to the environment

Dynamic Interactions with in its subsystems

Tends toward higher level

Can only maintain or decrease in organization

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SYSTEM THEORY: IN ORGANIZATION

1.

2.

3.

4.

An organization is a system, which is partly economic, partly technical, partly social. It consists of parts, each of which is a sub-system. The organization is itself, part of a larger system- the environment, society, government, and so on. There are inter-relationships among the parts of each system so that a change in one part leads to change in another. It is the function of management to bring about the integration of
Different parts of each sub-system. The different sub-systems with the organization, Among the different sub-systems themselves Between the system and its environment.

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HOSPITAL VIEWED AS A SYSTEM

A hospital can be variously described as a factory, an office building, a hotel, an eating establishment, a medical care agency, a laboratory, a university, a social service institution and a business institution. The major hospital embraces multiple goals, chiefly patient care, teaching, and research. Hospitals are among the most complex organizations in modern society, characterized by extremely fine division of labor and an exquisite repertory of technical skill. Because the institution's work is so specialized, staffed by a variety of professional and technical personnel, there are 13 very important problems of co-ordination and authority.

Input
People
A. Staff Physician Nurses

Process-Transformation
Communication between
Physicians and patients Nurses/ paramedical staff and patients Physicians and nurses

Output
E
F F I C I

Paramedical
Supportive B. Patients attendants their

Physicians/ nurses and paramedical staff


Physician/ nurse/ administrators paramedical staff and

E N T

Administrator and community

Material
Drugs chemicals Equipments Diet Money

Decision Making
and Cure: Diagnosis, treatment Care: Creation of comfort to the patient, diet Procurement of materials in the right places at the right time. Action

P
A T I E N

To maintain staff, Putting decisions in to practice facilities and procure materials Balance mix of communication, decision making

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CARE

PECULIARITIES OF HOSPITAL SYSTEM


A hospital system is more than the sum of its parts. Open system The boundaries separating the hospital system from other systems are not clear but fuzzy. The output of a hospital is not clearly measurable. It remain in a dynamic equilibrium with the wider social system. It must function, as a part of the larger health care system, not as a end. A hospital system like other open social systems tends towards elaboration and differentiation.

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Perspectives of Hospital

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Collective Oriented

Organization Oriented

Provider Oriented

Client Oriented Perspective


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HOSPITAL AS A SOCIAL SYSTEM


Sociologists have considered hospital as a social system based on bureaucracy, hierarchy and superordination and sub-ordination. In order to continue in a orderly fashion, every social system has to fulfill the functional needs of that system, viz. the need for adaptation, for goal attainment and integration. In a hospital system, the patients needs determine the interactions with in the system. There is considerable restriction in communication among people in the hospital. In the course of interaction among the various units of a hospital social system, tensions and conflicts emerge. 18

One occupational group can not be promoted to the other group, e.g. laboratory technician can not become a nurse and nurse can not become a doctor.

Achieving their goals through reliance upon such structural devices as systems of division of labour, an elaborate hierarchy of authority, formal channels of communication and sets of policies, rules and regulations.
The two lines of authority (viz. administrative and professional) come into conflict.

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SUB SYSTEM IN HOSPITAL


Hospital System

Care System Nursing Subsystem


Diagnostic Subsystem Minor Subsystem

Cure System Supportive Sub-system

Therapeut ic Subsystem

Administr ative

Circulation

Environ ment

Technical

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Social

FUNCTIONS OF HOSPITAL
Extramural Function Intramural Function

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SUMMARY
Hospital can be viewed as an open system having various subsystems, all those interacting with each other to achieve a common goal. Like other system, hospital has also input, process and output. The input comes from environment and output also reaches to the environment. This approach can be utilized to identify the factors affecting any hospital activities. This knowledge guide the manager while planning the programmes and activities of it.

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REFERRENCES
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Books Banerjee M. Essential of Modern Management, Kali Press, SitaRam Ghos Street Kalcutta, Second Edition, 1986, Koonz H. Cannice M. V. Weirich H. Management : A Global and Entrepreneurial Perspectives. Tata McGrawHill Publishing Company Limited. New Delhi 12th Edition. 2008. Sakharkar BM, Principles of Hospital Administration and Planning, Jaypee Brothers, Medical Publishers, New Delhi, First Edition, 1998. Basvanthappa BT, Nursing Administration, Jaypee Brothers Medical Publishers, New Delhi, First Edition, 2000.

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Website System Theory, Available at, http://en.wikipedia.org/wiki/Systems_theory, Retrieved on 15 th March, 2010 file:///f:/New%20Folder/New%20Folder/org_sytm.htm, Retrieved on 15 th March, 15th March, 2010 Hospital as a social system, http://www.jstor.org/pss/1032618, Retrieved on 15th March, 2010 Hospital, Available at http://en.wikipedia.org/wiki/Hospital, Retrieved on 15th March, 2010 System Theory, http://en.wikibooks.org/wiki/Systems_Theory/Inputs-Outputs, Retrieved on 15th March, 2010 http://www.online-pr.com/Strategic%20Comm%20Course/InputOutput%20Diagram.htm, Retrieved on 15th March, 2010 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2781730/, Retrieved on 15th March, 2010
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CANCER HOSPITAL AT UNIVERSITY OF FLORIDA

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