Bed -Profit Health Care Organization a Detailed

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.

A peer review system

There is a long history about peer review. The techniques and methods used in improving health care services were used a decade back. Nowadays, majority of the hospitals consider and adopt the management practices of peer review. The main practise of referral hospitals should be that their management must follow the federal and state laws along with policy of hospitals. The policy includes the guidelines; moreover other techniques should be adopted to make the process better.

One should look at the peer review procedure just like a business process. The adoption of such an approach brings about efficacy in the performance of the procedures and this in turn brings about quality in everything that is done. One should assure that the following things are provided:

Peer review cases should be referred as per the hospital policy.

Hospital policy and the panel manual provide a schedule for the peer review. Peer review is done quarterly or monthly as they are driven by case volume.

The hospital policy and the current literature quote the objectives and external views whenever they are needed.

Balance so that the reviews of the physicians are recorded properly.

A true peer review should take place, like for instance; an orthopaedic surgeons review should be done by an orthopaedic surgeon and only not by a gynaecologist.

Useful suggestions should be put forward so that the other physician also gets a chance to polish his skills, techniques and potential to obtain the required level of excellence.

Regular audits, which would increase the quality of care provided to the patients, would reduce the liability. It would address the media's negative comments and even the concerns of raucous families on internet. Auditing would also identify any peer review breakdowns and would make better suggestions for future.

When peer review is connected with credentialing then a threshold is set for the physicians and it is assured in this way that no troublesome physicians would be entered into the hospital. Troublesome, here refers to those physicians who are lacking in terms of behaviour, credentials, training, education and references. This thus becomes a useful method for filtering troublesome physicians.

Clear mentioning of terms and expectations: Description of the terms like service quality, quality of care, citizenship, safety of patient, practicing standards, professional conduct, resource utilization and peer relationships differ by backgrounds and experiences and from hospital to hospital.

The responsibilities of the peer review committee should be clearly defined. All the committee members should be well aware of their responsibilities towards their profession and towards the hospital at large.

A sense of urgency should be created for peer review. Peer reviews would detect weaknesses or educational short comings before time, therefore giving the physicians a chance to correct themselves before any blunders are made.

It should be assured by the management that the peer review committee is properly trained. Proper training would provide the team members with confidence to perform timely reviews as they would be specializing in their knowledge after training.

Policies should be set, so that they can be referred while external reviews are done. Hospitals have a great responsibility to meet the high quality standards. Therefore, it is important for all the health care providers' and hospitals to have an objective of expert source which could enable them to perform a quality control review. Many of the hospitals have gone far beyond to include an IRO (Independent review organization) in the organization, so that an unbiased review could be conducted. This is done whenever there is:

Uncertainty about case analysis

Economic or other conflicts of interest

A necessity for taking a second opinion

When group of specialists is small or appropriate peers are not available.

A reviewing specialist making an appeal

Qualified staff members are lacking to review a particular speciality

Need of objectivity for disciplinary action

Staff is not expert in using the new technology

A Chance of legal issue to arise

Either a specific or general concern about the clinical outcome.