Hospital Management Located in Tropical Rural Areas - Essay Example

A hospital refers to a health where the doctors and nurses work and where the sick people seek medical attention. The sick persons are referred to as the patients while the doctors and nurse are the persons who treat and administer drugs to the patients. Persons that are sick are administered for drugs and they are given medical and surgical care so that they can receive treatment from injuries that arise either from accidents or through any other form of occurrence. A case study of a hospital. The hospital is located in tropical rural areas and therefore it does not have the facilities needed to serve its customers in the right way. This hospital is isolated from the public during the rainy seasons since the roads are impassible. It receives funds for running its affairs from various organizations. Simple information system that would be used to allow the finance director to audit the hospital's activity and the payment collection systems. The bed management system is a system that involves crucial issues that improve on the rate of efficiency at the hospitals projects. The problems within the hospital can be solved though implementing the bed management system. With the introduction of the bed management system, an auditor may be in a position to audit the transactions taking place in the right way in the institution. The value of this system is to provide the organization with proper management techniques through determining the hospitals capacity and having a current and forecasted program that indicates the number of beds that are demanded by the source and the status of the pending discharges. The incorporation of sophisticated workflow system and rules that are tailored towards improving the status of the organization should also be incorporated within the organization. It has been observed that the hospital looses their patients due to diversion, delay, cancellations and isolations during the rainy seasons but the problem can be solved through optimally utilizing the beds turns, eliminating the hidden costs and unnecessary holds as well as accelerating the rate of the discharges within the hospital. Through an efficient bed management system, the management can be in a position to search for an ideal patient placement location or even initiate the prioritized discharges within the hospital. The implementation of the management or the patient in ternary module can be used to reduce the unnecessary delays through having a central expediting care process and also help in the discharge of the tasks of the hospital in the right way. The patient management system can be used to ensure that tasks are completed at the right time through making proper coordination programs, real-time communications, task queuing and the escalation of the notifications in the appropriate way (Wolper, 2004: 866). Electronic management system would ensure that the hospital is in a position to cut the cost of operations and ensure that the affairs of the organization are undertaken in the right manner. The operation would ensure that the response time required to process the patient's information is indeed the right one and therefore the process of collating, collecting and retrieving of information would be undertaken in the right way. The system helps in the provision of the process management tools such as the modeling, analysis and simulation of information within an organization. The usefulness of implementing the above systems is that it would provide proper delivery of services to the patients, improve the health status of the patients, increase the rate of productivity of the nurses and the doctors and it reduces the time spent when filling in the patients details in the forms. The patients may also be given proper care at the hospital and this would enable it to reduce its costs of operation. The auditor would be in a better position to understand the way the transactions take place to reduce time spent while tracking hospitals activities. The Centralized Admission System This system would ensure that the activities within an organization are carried out at a central location. Physicians would be charged with the responsibility of admitting new patients and the admission of the patients would be based on the individuals' clinical needs. This evaluation process would be undertaken by adhering to the state laws, rules and regulation as well as the accepted standards of quality for their clients' health care. The details that relate to the admission process should be in the admission policies and the procedures manual so that the right procedures are followed in order to undertake the tasks that have been stipulated in the manual. The information that relates to the clients should to be prescreened and later on be handed over to the Area program staff so as that they perform their duties efficiently, while the persons who may have not been admitted into the main hospital seek assistance from the Community Service Board. The computer system can be used to record the details of a patient that include: their age, name and other crucial information that relates to them. The electronic database would be used to store the information that relates to the patient so that it can be retrieved anytime when need arises. The type of information that can be fed into the computer system includes the examinations done on a patient by physicians, the patient's medications from the pharmacy, order laboratory tests, x-rays, dietary restrictions as well as the specific nursing care administered to the patient (Wolper, 2004: 866). The importance of the central admissions office is that the employees would be in a better position to serve its clients in the right way. The auditor would also be in a better position to audit all financial statements since returns of all departments' expenditure and returns can be accounted for in the right way. Payment collection system at the hospital Finance department is also an important department as all the payments are made at this unit by the patients. In this department also, the suppliers collect their money for the goods and services supplied to the hospital. The health care services are becoming extremely expensive to maintain due to the rising cost of living as well as the lack of employment for the majority of people in the society thus, most people do not have enough income to meet to meet their medical needs. The physicians should establish an accounting system that can be used to record all the pertinent information that relates to patients details. A Chart of accounts system can be established so as to record all the transactions taking place within the hospital. Gross charges are said to be the full value of the medical services that are offered to the patients before any adjustments are made on them. The items that are reduced from the gross charges include: charity adjustments, contractually agreed -upon reimbursements, courtesy, as well as the employees discounts. The results achieved are net charges for the actual amount of money that is to be paid by the patient. The importance of the computerized collection system is that they help in reducing the labor costs that are associated with the use of the manual systems. Submission of the insurance claims on behalf of the patients requires both the repetitive entry of the demographic as well as the policy formulation strategies. The system is said to generate the insurance claim forms any time they are needed thus it hastens the payment process of the physicians' services to the patient (Wolper. 2004:866). The institution should not necessarily own computerized billings and collections systems but the system can be contracted from an independent billing organization that is referred to as the service bureau. The functions of the service bureau are to collect the payments that are owed to the physicians and other healthcare service providers by the patient. Service bureaus are normally paid on a percentage -of-collection bases as this activity motivates the clients to collect the payments efficiently and promptly. The objective of undertaking this task is to ensure that patients' records are properly maintained as it ensures prompt payments are being made at the right time. The Medical Group Management Association (MGMA) is an organization that can be used to collect the median data that indicates the gross adjusted collection rates as well as the receivable ageing data for the patients (Gordon, 2006: 90). It is therefore evident that the implementation of the information systems within the organization would enable the auditor to audit all the transactions taking place within the organization. The hospital relies on external funds for running of its operation, but it is not sufficient to meet its financial obligation thus, its expenses exceed the earnings of the organization. Section2 Current ratio It is a ratio that is used to measure the financial strength of a company .The measurement is aimed at determining the amount of the current assets that can be used to make the payment of the current debts that are incurred by an organization. The formula for calculating the current ratio is current assets divided by the current liabilities. Current assets are the assets that can be converted to cash within a financial period of one year while the current liabilities are the financial obligations that should be met within a period of one year. An incongruous current ratio is a ratio that is not suitable in its current situation as stated in the financial statements of an organization. The factors that are responsible for the presence of this kind of ratio are that the company is not in a position to meet its current obligations within a stipulated period of time. The positive incongruous current ratio results from having high debts that arise from borrowing therefore having more expenditures than revenue .For instance, the patients are directly admitted to the hospital before making any initial deposits for their admissions. The huge debts can be avoided through establishing the profit generating projects that would be in a position to sustain them while undertaking the tasks that have been assigned to them. In situations where a patient is not in a position to pay up their bills, then a provision for bad debts should be established so as to overcome this problem. Patients should also be asked to make initial deposits when they are being admitted into the hospitals, as it would prevent the company from incurring huge losses while carrying out their activities. The public should be informed about the services that are offered by the insurance companies, so can they can register and become members so that they can be offered the right services at the right time and place. Insurance companies normally give discounts to the healthcare services that are offered to the workers that are registered under them. The discounts arise from the act of exchanging the patients' referrals within a specified period of time. It has been observed that most families normally incur huge debts while trying to pay for the health care services for their family members. The bills of the hospital can be managed through establishing the budget that stipulates how the organization will generate its income as well as determine the way it will expend the revenue generated within a specified period of time. The accounting system can be used to make entries that relate to employees payroll so as to pay them at the right time .The huge number of sickness and absenteeism can be managed by ensuring that the roads are constructed so they are not inconvenienced by rains or other environmental factors taking place within the organization. The supplies management should ensure that there is enough stock to meet the demand of its customers at the right time and place. In cases of large amounts of stocks being supplied to the organization, they should be closely verified so that the correct orders are checked to identify the orders made by the company and also to overcome the supplies that are inappropriate or expired getting access into the organization. The placing of enough stocks would help in serving the customers in the right way during the emergency and the rainy seasons. Where there is huge number of creditors, then, it means that the management of the company has borrowed funds as well as supplies and this would have an effect in the way operations of the company are operated. The creditors can be managed through ensuring they establish projects that can generate for them income in order to cut down cost of running their operations in the right way. Some of the services that can generate income to the organization includes: selling of services at a primary level, providing consulting services at a fee and conducting training programs to both the staff and non-staff at a fee that is affordable to clients. The accounting procedures that can be used to discover the financial difficulties within the organization involve use of the accounting systems to enter all transactions taking place within an organization. The financial difficulty experienced within the organization involves an organization running out of funds despite having many sources of funds to run its operations. This occurs when there are insufficient funds to pay its staff, and when the expenses are more than the income generated within the organization. There are also disagreements on the amount of funds collected since the director states that there is more revenue being generated but the records indicates insufficiency in provision of the funds. The accounting procedures include bank reconciliation for the purpose of ensuring the bank statements are as per bank ledger so as to avoid fraudulent practices. Financial reports should be prepared on a monthly basis so as to determine the financial state of a company so as to be in a position to identify all the financial difficulties facing an organization. Incongruous current ratio can be rectified through paying up the company's debt and increasing the current assets from the loans and other borrowings that have got a maturity date of more than one year. The noncurrent assets should be converted into current assets while the current assets should also be increased to new equity contributions as well as ploughing the profits back into the business operations within a stipulated period of time (DeThomas, and Derammelaere, 2008: 176). Section 3 Forecasting for the clinicians Forecasting refers to the predictions that are made involving the future events and kind of quantifications that are required when carrying out the planning process within an organization. It plays a significant role in ensuring the management cycle is maintained in the right way. The importance of the forecasting systems is to enhance proper decision-making process, to inform customers about issues taking place as well as to allocate appropriate resources within an organization. It also provides assurances about how an organization is progressing in trying to achieve its goals through taking necessary measures so as to carry out the tasks that they have been assigned to them in the right way. The factors that lead to the establishment of the health forecast includes: cold temperatures, virus load, humidity, boundary layer as well as the seasonal variation factors that may be taking place within the hospital. The full implementation of the health forecasting methods can be achieved through delivering the participatory care services that are based on the forecasts on risk, while the low risk patients should be targeted within a specified period of time. The anticipatory care method is a method that is used to determine the health status of a patient that involves calling or visiting them so as to prevent and cure the diseases that they may be suffering from. The calls to the patients can be undertaken by the clinical and non-clinical staff that uses the out-sourced to out-of hours call centres. The other method that can be used involves the use of the automated telephone calls, electronic mails and the use of the texting method for the patients that require the medical assistance (Simmers, 2003: 54). The clinicians may use the multimode assessments that incorporate information from multiple sources then determine a patient's likelihood of involving themselves in the risk of dangerous and self-injurious behaviors. However, some of the sources may not be relied upon to improve on the rate of prediction models and therefore such information may not be relied upon while making assessments about the patient's behavior. Clinicians should rely upon the history behavior of the patient rather than the relying on the forecast of the future behavior that can determine the kind of medicines that can be prescribed. In case a patient has consumed alcohol for a long period of time and later on stopped the consumption, the clinician can be in a position to predict the kind of behavior they will portray in the future. The self-injurious thoughts and behaviors that are both suicidal and non-suicidal self-injurious are difficult and dangerous to predict thus it is not possible to predict the future behavior of the patients (Mentzer, 2001: 490). Budgeting from the Finance Department. The factors that led to the setting up and managing a budget indicated the use of the comparative benchmarks, the expenses that are incurred while undertaking the operations of an organization, monitoring of variations as well as employing the scorecards within the organization. Operating budget process is basically composed of two parts that involves setting up and managing of the budget. Setting up of the budgets involves the establishment of budgets at the beginning of every fiscal year while the management of budget refers to the process of monitoring and controlling the way the budgets are prepared within a given financial period of an organization (Simmers, 2003: 54). The preparation of the hospital budget should be based on a five-year strategic plan. The reason for its establishment is to understand the capital needs, gain the buy-ins and the managerial support systems that are meant for the establishment of the budget targets. The strategic plan is aimed at integrating all the crucial information that can be used to calculate cash, debt, capital and profits used to fund the routine and the five-year strategic plans as well as maintaining the financial integrity of the organization. Budgets of the hospital should also be established on the basis of its mission statement, strategy and the financial plan of the entire health system. For instance, the hospitals vice-president should be involved in the preparation of budget that indicates the activities taking place and the amount of funds that should be allocated to them (Rosdahl and Kowalski 2007: 741). In the management of the budget, the top officials should determine the best budgets that should be set in order to achieve the goals and objectives of an organization within a stipulated period of time. Individual department budgets should reflect on the costs incurred as a result of undertaking the tasks that have been assigned to them. The employees should be rewarded on the basis of their performance for not exceeding the budgets limits and this can be measured by using a balanced scorecard. The variance and action plans should be followed consistently so as to ensure that the goals of the organization are achieved. The flex and the master budgets should be constantly used so as to determine the rate of productivity and the cost per unit of service that is needed to complete tasks within a stipulated period of time. Supply management It refers to the methods and processes that are followed when carrying out the modern and corporate buying within an organization. These processes involves purchasing of supplies for domestic use, purchasing of raw materials for the industrial purposes as well as purchasing inventories that are later on sold as products in the distribution and retail processes (Cohn, and Hough,2007: 60). The ways in which the supplies and inventory management can be reviewed so as to improve on the contributions being made to the hospitals financial status involves; implementing information technology facilities, processing policies and procedures that would improve on the performance of the organization accordingly. There should be structured relationships between suppliers and the management in ensuring that the activities are carried out in the right way (Frazelle, 2001:117). The way in which the supplier systems and the inventory management systems can be used to improve on the hospitals financial status include the recruitment of qualified personnel that would run the operations of the organization, through using information technology to take stock and also to determine the number of stocks that should be supplied within the organization. The pricing process of the inventory of the hospital should be used so as to be determine the inventory management systems, vendor relationships, inventory reporting systems and purchasing systems that are needed while carrying out the supply chains programs within the premises (Rosdahl and Kowalski 2007: 741). Section 4 Integrated approach This is an approach that involves embodying and mastering the best practices that can ensure that problems are solved appropriately. It helps an organization to achieve its set objectives; it helps individuals leave a legacy as well as to assist people to achieve the best results possible for their organization. The implementation of an integrated management system helps in ensuring that the resources are properly utilized. The various departments that should be integrated within the hospital organization include; finance, supply, clinical, estate and the human resources departments. In the finance department, the processing of the transactions takes place in this department. This department allocates enough financial resources to the entire department so that they can acquire the necessary facilities that would enable them to run their operations in the right way. Human resources department is a useful department that takes into consideration the recruitment procedures and how the staff should be maintained and motivated in order to undertake the tasks that have been assigned to them efficiently and effectively. Clinical data is the department where patient's affairs are addressed as well as the place where their data is stored for future reference. The clinical data can be maintained through using the electronic tracking and digitized systems to ensure safety and ease of retrieving the information when it is required. The Supply department is the department that supplies the necessary equipments, facilities and drugs required within the hospital. There should be a good inventory management system that maintains the stock levels in order to overcome stock outs that can have a negative impact within the hospital (Simmers, 2003:546). The estate department supplies its employees with information that relates to land, property, equipment and the procurement of facilities that are needed for a hospital. The information derived helps in utilizing and the management of property of the hospital. The use of the integrated approach within an organization helps in the avoidance of the duplication of services like the competitive advertising programs that would hinder an organization from achieving its goals and objectives. Integrated health care systems also help in ensuring that the primary care services are provided within a stipulated period of time. Patient's database is useful in ensuring that all the data is kept in the right way thus helps in the utilization of the resources of the organization in the appropriate way. Having the departments integrated would avoid wastage of time and money incurred while running the operations of the company. The human resource for instance would be used to recruit the right personnel that would handle all issues that relate to hospital activities as such as recruitment of doctors, nurses, clinical officers who are conversant with issues that relates to the hospitals activities. There would also be proper coordination between departments therefore; there is savings on cost of when running the operations of the organization. For instance, the supplies department can be in a position to receive payments from the finance department in a cost effective manner. The number of patients that visit the organization can be effectively tracked so that enough materials and equipment would be provided to the company thus reducing the chances of loosing patients. The clinicians would also not be in the problem of running out of supplies during the rainy seasons or other unavoidable circumstances. References. Cohn, K. H. and Hough, D. E. (2007) The Business of Healthcare . United States of America: Greenwood Publishing Group. DeThomas, A.R. and Derammelaere, S.A. (2008) Writing a Convincing Business Plan Edition 3, United States of America: Barron's Educational Series. Frazelle , E. (2001) Supply Chain Strategy: The Logistics Of Supply Chain Management. United States of America: McGraw-Hill Professional. Gordon, S. (2006) Nursing against the Odds: How Health Care Cost Cutting, Media Stereotypes, And Medical Hubris Undermine Nurses And Patient Care. United States of America Cornell University Press. Johnston, M. (1997) Let's Talk About Going to the Hospital. United States of America: The Rosen Publishing Group. Jonathan, J. C. (2005) Improving Hospital Budgeting and Accountability: A Best Practice Approach: If you're Organization. Healthcare Financial Management. Available at: (Accessed: May 15 2009). Mentzer, J. T. (2001) Supply Chain Management .United States of America: SAGE. Rosdahl, C. B. and Kowalski, M. T. (2007) Textbook of Basic Nursing Edition 9 .United States Of America: Lippincott Williams & Wilkins. Simmers, L. (2003) Introduction to Health Science Technology Edition. United States of America: Cengage Learning. Tartaglia ,R. (2005) Healthcare Systems Ergonomics and Patient Safety .United States of America: Taylor & Francis. Wolper. F. (2004) Health Care Administration: Planning, Implementing, and Managing Organized Delivery Systems Edition 4. United States of America: Jones & Bartlett Publishers. Read More