Organizational structure and mission of a nonprofit hospital facility

Bed -Profit Health Care Organization

A detailed organizational chart for your new facility

Each and every department of the hospital is responsible for performing certain type of assigned tasks but still departments are grouped together according to the similarity of tasks. Grouping of the departments also aim to provide health care facility with more efficiency. For this hospital the following are the organizational policies:

Services related to administration; which includes business people who are involved in the running of the business.

Informational services; which includes documentation and processing of information.

Therapeutic service; under which treatment is provided to the customers.

Diagnostic Services; these are the services under which the illness is identified.

Support services; these can also be referred as environmental services, which provide support to the entire hospital.

A mission, vision, and values statement for the new entity

The aim of this Healthcare facility is to provide their people with first class healthcare services, along with research and education. The hospital puts in great effort to protect the health of their community. The people on whom more focus is given include those who belong to rural, remote, metropolitan and indigenous areas.

The strategic plan of this hospital is broadly prepared on the basis of U.S. Government Health System. The success of strategic plan relies to a great extent on strong partnerships. These partnerships are based on collaboration and consultation with all people who are working in the hospital.

The main aim of the hospital is to meet its targets and these targets can only be achieved by taking strong measures. Strong measures need to be taken by the greatest assets of the hospital which are the staff members and the volunteers.

The hospital receives its award by providing best services to its patients and then getting thanks from all the patients. The demanding services along with the funding pressure makes the entire job quite tough, but still the hospital people work with determination to meet their target.

Success can be achieved by working together in light of a unique vision.

Vision statement

This Healthcare facility is committed to distinction in health care

Mission Statement

This Healthcare facility is a highly specialised hospital:

Emergency and elective services are offered to the local community

Ensures that proper health care services are provided to the community of inner city health district.

Communities which live in remote and rural areas receive special health care services.

On behalf of Community, the hospital advocates for better health.

Our Customers

The patients coming to the hospital are mostly the people of local community; predominantly people are from the Inner City and from areas of South Metropolitan Health Service. The people coming to the hospital mostly belong linguistically and culturally to diverse backgrounds.

For the achievement of the vision the hospital need to work according to the requirements of the customers and in collaboration with the staff members so that the targets are achieved with excellence.

The Values

The motto Servio of this Healthcare facility was initiated before its inception, and it aimed to encourage the pride of the nursing staff. To this day, Servio symbolises the pride of the staff members working in the hospital. The following values are represented by the Servio:

Service: With complete care health care needs are fulfilled of the people of Western Australia.

Excellence: Consistent performance at high standards.

Respect: Respecting the patients, their careers, their families as well as the staff members who are working together in collaboration.

Valuing our staff: The staff members and the volunteers are appreciated at all times and are asked to behave with integrity.

Organizational Learning: In all aspects of the work, a continuous learning approach is promoted.

Procedures that govern the hospital-physician and physician-patient relationship including negligence and liability issues

Hospital-physician relationship

Health Care reforms encourage the hospitals to work on cost control, maintain good relationship between the physician and the patient and deliver high quality health care. There is no standard according to which doctor and patient relationship is managed, this is because there are varieties of ways in which delivery can be made. Many hospitals are following aligned strategies with other doctors; this secures referrals, and enables negotiation of better rates and brings an increase in the market share. These days, hospitals are competing a lot with each other, especially in large multi-speciality physician practices and surgery centres. Physicians are aware of their negotiating power that is why they are keen to develop strong relations with other hospitals.

A variety of services can be provided if there is a co-management service agreement established between the physician group and the health system. Examples of services include, strategic planning, staffing, scheduling, human resource activities, and director services.

Such arrangements can be simple ones, or could be in a form of directorship, or complex enough under which entire profits responsibility lies on the physician group. One should be aware of the legalities while working on co-management services, because if the arrangement is not up to the standard then legal issues may arise. Co- management service agreements are made under regulatory guidance which is provided by federal physician self-referral law, this law is also known as the Stark Law, the civil monetary penalty statute (CMP Statute), the Anti-Kickback Statute (AKS), the False Claims Act, an entity's tax-exempt status and Medicare's provider-based requirements. An antitrust risks lies in such agreements which completely depend on the topics that are covered in the agreement.

Direct Hospital Employment Model

In this healthcare facility, Physicians will be appointed directly by the hospital's administrative departments. In fact, it is the most easy and convenient model that can be adopted, if the state regulative authorities allow. Since the local state laws allow such a model, therefore this facility will adopt and use the Direct Hospital Employment Model.

Furthermore, the local laws even allow physicians to be appointed even if the physician is practicing privately. Therefore, this hospital can buy his practice as an extension to his employment service. Direct employment allows greater integration needed to maintain consistent and reliable medical practice, assessing the performance of these practices, developing HIT (Health Information Technology) solutions, creating P4P bond between payer and contractor, smoothing the recruitment of physicians and retaining them. Moreover, the payment regarding the office expenses and supplementary services are recorded as provider based instead of a free standing one that allows greater chances of reimbursement of the paid amount.

Physician-patient relationship

Some of the legal limitations regarding the attitude of physicians towards their patients are applied through the laws put forth by judges or the legislative laws. In this section of brief, few common reasons behind civil actions, are highlighted, that are against the physicians. If we move forward with in this discussion, we come to notice several overlaps in the definition of physician's liability towards the patients, as per civil and common laws.

Negligence

Injury is defined as any action that is meant to cause harm to a person (patient) and that too for unjustifiable reason by another person (physician). In the eyes of local courts, what matters most is whether the physician has breached the law of maintaining the responsibility of care or not. If he has done so through any sort of carelessness or neglect, he is liable for his actions. Following are the some questions that may be asked on behalf of court to the defendant to examine the liability of such negligence.

If the plaintiff was under the supervision of the defendant?

If defendant's action has breached the responsibility?

If such breach has caused any injury to the plaintiff?

Whether the breach by the dependant and injury to the plaintiff has any sort of causal connection between them?

Breach of Fiduciary Duty

One unique type of legal relationships is Fiduciary relationships. In this relationship, one individual has an authority over the other regarding his interests including financial, medical and legal ones. The court uses two questions to determine whether the there is any liability for a defendant towards his plaintiff in the event of breach of fiduciary duty. The hospital will therefore ask these questions as well to determine the validity of the breach. These questions include;

1. Whether the connection between the dependant and plaintiff a fiduciary one?

2. Whether the defendant has actually breached his duty?

Public Health

According to local laws, physicians are bound by 2 types of obligations. First one is towards their patients regarding their due care. These obligations are further explained and discussed in the upcoming sections. Moreover, they are also indebted towards the state. They need to work towards the progress of public health along with the support of governance. At few occasions, the obligations towards patients and public are in the state of conflict and even try to outclass each other. The obligations of physicians towards public/state are explained in charter of public health statuses (215). An equilibrium state needs to be maintained by this healthcare facility while securing state interest and individual rights.

Describe referral services that will be offered

At this facility, healthcare services are offered by specialists to the patients. The hospital often receives referral of patients particularly from less established areas. The reason behind is that advance and complex treatments are not available in these less established areas. Referral hospitals operate at tertiary or secondary level.

Services at these hospitals are not specified particularly. However, every referral hospital offers different services depending on the availability of technology and resources.

Services offered at local referral hospitals are:

Emergency and general surgery

Gynaecology and obstetrics

Internal medicine

Paediatrics

Other health care facilities according to the medical practices provided available in the country.

Services at tertiary hospitals include:

A highly intensive care unit

CT scanners and MRI's along with specialized diagnostics

Intensive care for specialized burns

Neurosurgery and other specialized ones

Gastroenterology, oncology and various medical specialities.

Furthermore, the hospital can also refer patients to other facilities. Decisions for these types of referrals are made by the specialists.

How HMO insurance will be handled

HMO comprises of doctors, healthcare workers, professionals and specialists who perform duties for set fees. Independent HMOs are also in existence, where the workers are functioning unswervingly for private HMOs. Those hospitals which do not have their own HMO, they agree with HMO planned companies on a set fee for the service. HMOs aim to save people's money while they get the health care they need.

For visits and for prescriptions the company makes the payment, of which nothing is deductable. The prescriptions are pretty low in this case. Despite of all the good qualities and the merits there is a downside of HMO as well. One cannot deny the fact that HMOs exist to earn money, therefore if one has much health issues then acceptance is doubtful.

When chronic medical issues are there then tests, visits and treatments cost a lot to the HMO. HMOs manage this by keeping tight control on the health care, and it approves the visit before the patient goes to the hospital.

If one wants HMO to make the payment, then there are a set of strict rules which are put forward by the HMO which needs to be followed. This healthcare facility will follow all such rules and regulations. First of all only those doctors can be referred who are mentioned in the HMO list, and no matter what the situation is the first reference should be taken from the primary doctor.

If the primary doctor refers the patient to any other doctor then he may go in there. A number of people consider these rules as very strict, and prefer not approaching the HMO at all. If one thinks that a specialist reference is important in his case, then at first permission from the primary doctor should be taken, so that the chances to go to the expensive doctors are minimized.

By taking such steps the HMO confirms that the health needs of the patient are under the doctor not under himself. Most of the doctors are outstanding as they hand out the referrals to the patients. Many doctors now days are enrolled in HMO plans, thus making it easy for the people. If a patient is not much lucky then getting care might be difficult for them.

If one wants to change his primary doctor, then HMOs can be fussy at times. Therefore, the patients need to be sure of their doctors and they should take advices and opinions of other people who are under that doctor.

Most of the HMOs have patient quotas which are to be followed by the doctors. Doctor has to set the number of patients he/she has to see per day to avoid any kind of penalization or to minimize the chances of being removed.

The doctors have to see a fixed number of patients that is why there is often less time available for the patients to ask questions from their doctors. There is even a concept of capitation, under which a fix amount is paid to the doctor for each patient every month, irrespective of the fact that patient visits the doctor or not.

A patient should make sure that tests are covered fully in the plan, because if they are not covered then they would not be reimbursed or paid by the HMO. Many people have awesome doctors, so they do not face any kind of problem at all.