Healthcare Administration
Functions of healthcare administration: Executive, legislative, and judicial functions
Executive
A healthcare organization's administrative body makes day-to-day executive decisions regarding the running of the facility. Such decisions can encompass areas pertaining to general management, human resources, marketing and budgeting functions. It must allocate scarce resources amongst competing priorities of different departments, such as requests for funding of new equipment, proposed hikes in employee salaries, and new types of advertising. The board may act as a general liaison with the community in developing programs to serve the greater population, such as overseeing education and wellness efforts in the schools. It may also engage in dialogue with local universities regarding the future of higher-level healthcare education.
Either the entire board or different parts of the administration will be charged with executing the functions of managing, implementing, and planning programs. Smaller facilities may have managers that act as generalists, while larger facilities may have general executive managers and lower-level functionaries that handle the more everyday executive functions. Even if they are not physicians, the administrators should have sound knowledge of best scientific practices regarding priority items to fund, what to look for when hiring different types of staff, and what healthcare innovations to explore in the future. Policy analysis and an understanding of scientific research are especially essential for general administrators in facilities that do clinical research studies. Best practices must be observed in all aspects of management.
Legislative
A healthcare administrator may set hospital policies including (to cite only a few examples) policies on patient admittance and discharge, appropriate times to dispense palliative care, and how, when, and where procedures are performed. Although specialists will certainly give vital input regarding such decisions, administrators have the duty of transforming good science into good legislative policy for the institution. Administrative boards routinely reevaluate general institutional compliance with federal and state legislative statutes and also with stated hospital policies. Ethics guidelines regarding procedures, treating minors, and admission to clinical research trials are only some of the legislative guidelines necessary when making healthcare decisions. Chains of command, appropriate disciplinary and appeals procedures, and health and safety guidelines for patients and employees are some examples of legislative functions a board may perform. Additionally, conduct between employees will also be governed, including sexual harassment policy, chains of command regarding institutional decisions, and human resource policies such as bonuses, performance reviews, and seniority.
Judicial
The judicial roles of the administration involve evaluating specific individual's compliance with legislative policies, and the legality or wisdom of institutional policies in general. For example, an appeal might be made about the justice of certain guidelines, like the maximum amount of hours nurses may work, the institution's policies regarding living wills, organ donation policies, sexual discrimination laws, or safety. During disciplinary hearings compliance or noncompliance with institutional polices and mission statements may be evaluated.
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