1, DIFFERENT DEPARTMENTS OF HOSPITAL 1.1 X-ray Department ‘The main function of this department is to assist clinicians in the diagnosis of diseases through radiography, ultra sonography, computerized axial tomography, magnetic resonance imagining, etc. ‘While deciding the number of employees in an x-ray department, the following tasks should be taken into consideration: . Reception of patients .. Recording the history ofa patients, as concemed with x-ray Prepare necessary paper, the slip to be pasted on the x-ray request entry in the register . Taking film from stock, putting the same in the x-ray cassette . Explaining to the patients about x-ray procedure and taking the x-ray 5. Processing film . Sorting film . Reporting to the radiologist . Typing of report 10.Charting report or dispatching report One senior X-ray supervisor is required for 7 X-ray technicians, to supervise and execute radiographic work, to maintain efficiency and high quality of work. ‘Also required are one receptionist-cum-typist to take care of reception, clerical and typing work and also one X-ray aide to fetch up to 25 patients from the wards during the day. 1.2 Physiotherapy Department ‘The main objectives of physical therapy is as follows: 1, To minimize physical disability through exercises \ 2. To assist each patient so that he may reach maximum functional level 3. To contribute to the comfort and well-being of the patient 4, To re-train him in activities of daily living 5. To accelerate the patient’s recovery and decrease his length of stay in the hospital ‘The main function of this department are to rehabilitate or activate various limbs/parts ‘of human body which might have become inactive due to accident/disease/ageing process et. ‘The department is generally directed and supervised by a chief physiotherapist. He is assisted by a number of physiotherapists depending upon the work load. One or more receptionists for receiving patients, their scheduling and clerical duties. ‘Therefore, the following are the main functions of the physiotherapy department: 1. To speed up recovery of patients 2, To prevent and minimize residual physical disabilities 3. To restore physical functions of the body 4, To make an individual return to his optimum way o g the physical therapy department, hospital planners should pay attention to ‘ix major functional areas. They are: |. Treatment area consisting of cubicles . Gymnasium . Hydrotherapy area . Space for office where clerical and administrative work can be carried out Sufficient changing rooms Sufficient number of toilets ‘The department is generally directed and supervised by a Chief Physiotherapist. One physiotherapist can treat about 25 patients in a day during his 8 hours duty. Before ‘siving treatment to patients, he has to do some preparatory work: 1. Examination of the patients 2. Entry into register: + Name, age, sex ‘© Present history of iliness ‘© Past history of illness ‘© Family history if any * Diagnosis 3. Aim of treatment 4, Planning of treatment 5, Progress report ‘One Chief Physiotherapist is required for 7 physiotherapists to supervise their working ‘and to maintain a high standard.1.3 Medical Laboratory The primary function of medical laboratory is to perform laboratory tests in the eight main fields of hematology, parasitology, urinalysis, histopathology, serology, biochemistry, bacteriology, cytology, etc. to assist medical staff in making or confirming diagnosis. In all hospitals, a pathologist is incharge of the laboratory. At the middle level there is a chief laboratory technician who looks after the section heads of various sections of the laboratory. Each section head has a number of laboratory technicians, laboratory aides and bottle washers, but secretarial staff can be common for all the section. One medical laboratory technician can do approximately 35 tests per day. If he does less than 35 tests, it means that his performance is below average. If he does more than 35 tests, the accuracy of his results should be questioned. In one day, one technician can do: 45 hematology tests; or 50 urine analysis tests; or 50 parasitology tests; or 20 blood-bank tests; or 40 serology tests; or 30 biochemistry tests; or 20 histopathology tests. Also required are one section head over 7 laboratory technicians, clerical staff and bottle-washers, keeping in view the workload and technology used in the department. 1.4 Pharmacy To run the pharmacy of a hospital, the head of the hospital requires qualified pharmacists, organization structure, cooperation of the medical and nursing staff of the hospital. The number of pharmacists to be employed in a hospital depends upon the policy of the hospital. It has been observed that one pharmacist can dispense medicines to 150 patients per day. One pharmacist can dispose of one prescription of a patient, whether an out or an in- patient in approximately 2 minutes. Thus, one pharmacist who works 8 hours a day can take care of 100 out-patients as well as 50 in-patients. If the number of pharmacists in a hospital exceeds 7, the Chief Pharmacist should employ one senior pharmacist to assist him in supervision so that the efficiency of the department may be maintained.1.11 Admitting Department The functions of the admitting department generally consist of giving information, admitting, transfer and discharge of patients. At the time of admission, the admission desk collects data during the admission process. Once the admission formalities are over, one person from the admitting department accompanies the patient to the ward and hands over the admitting papers of the patient to the ward incharge concerned. The main functions of the admitting department are: 1. Admission of patients, transfer from one place to another because of the condition of patients and discharge of patients from the hospital. 2. Collecting information from patients at the time of admission. 3. Generating appropriate patient’s records to pass on to the department concerned 4. Collecting advance from patients at the time of admission as per the policy of the hospital, if any. 5. Booking patients for planned surgeries and deliveries on the basis of written instructions by the doctors concerned. 6. Maintaining a bed index showing current occupy of beds ward wise in order to assign beds for other patients. 7. Arranging some one to take the patient and his family members to the patient’s room where he has been allotted a bed. 8. Providing information about the hospital and its doctors to patients. 1,12 Medical Records Department The medical records department maintains records and document relating to patient care. Its main functions are filing, indexing and retrieving medical records by i. Developing a procedure for the proper flow or records, ii, Developing a statistical reporting systems iii. Preparing births, deaths and communicable diseases reports iv. Preparing statistical reports in relation to admission, discharge, coding all diagnosis.1.5 Laundry ‘The following lists show the space and equipment required in a hospital laundry: 1. Clean cloth processing area Drying area Folding area Pressing area Material storage area Laundry supervisor area Laundry personnel’s rest room Solution preparation and storage room Boiler area List of equipment for laundry: 1. Washing machines Hydro extractors Ikon for pressing clothes Dryers ‘Sewing machines Boiler ‘The number of personnel required in the laundry department depends upon the frequency of changing cloths in the wards, the quality of cloths, as well as upon its laundry ‘equipment. However, one laundry operator can wash the cloths of 25 to 30 beds and one laundry orderly can assist in washing the cloths of 50 to 60 beds. One shift supervisor, one laundry mechanic and one laundry clerk are required in each shift. Some staffing norms based on the workload being followed at various hospitals are: 2 3 4. 5 6 1 8 ‘One washerman can take care of: 150 to 200 kg cloths per day. Each operation in Operation theatre: 7 to 8 kg of soiled cloths Each delivery in Labour Room 710 8kg of soiled cloths Each ward patient 5 to 6kg of bed cloths 1.6 Food Service ‘The food service department receives a substantial amount of supplies. Therefore, it requires large enough area for handling supplies. ‘The storekeeper of the food service department should also be present so that he can ‘check the quantity and quality of the supplies. ‘The food service department in most of the hospitals is divided into: i. Supply receiving area ii, dry storage area iii, refrigerated storage area iv. cooking area: a) for vegetarian cooking 1) for non-vegetarian cooking ©) for western cooking 4) for special diet cooking for employees cooking patients serving rooms food service manager office dietician office dishwashing area x. _ peeling of vegetables area xi, Visitor's canteen xii, pot washing area Itis difficult to generalize on the size of staff required in the food-service department of a hospital, ‘The staff strength depends upon the number of medicated diets required, the education programme, research work, and the type of equipment used in the department. However, one dietary staff member is required for approximately 15 to 20 patients. Generally, in the food-service department of a hospital, the dietician, food storekeeper, ‘cook, cook helpers, bearer and dish washer work in close co-ordination. ‘One dietician can look after upto 200 beds. If the bed strength exceeds 200 beds, another dietician should be appointed. One cook, one cook helper, one bearer and one dishwasher are sufficient to prepare and, serve meals for 20 patients/staff members.