the surgery department

TheSurgery

Department

Reynaldo O. Joson, MD, MHA, MHPEd, MScSurg

All students of hospital administration must be knowledgeable of the

surgery department.

•Objectives

•Physical and personnel requirements

•How it should function

Learning Objectives

• Define objectives of surgery department• Discuss physical requirements in

relation to objectives• Discuss personnel requirements in

relation to objectives

Learning Objectives

• Explain importance of manual of policies and procedures• Discuss competencies required of

department chairman• Discuss present trends in

management of surgery department

Learning Objectives

• Define objectives of the clinical department (Surgery, ENT, IM, OB-GYN, OPHTHA, etc.)• Discuss physical requirements in relation

to objectives• Discuss personnel requirements in

relation to objectives

Learning Objectives• Explain importance of manual of

policies and procedures• Discuss competencies required of

department chairman• Discuss present trends in

management of the clinical department (Surgery,

ENT, OB- GYN, IM, etc)

Department of Surgery

Goal and Objectives

Department of Surgery

GoalTo provide proper medical service to

all patients with surgical diseases who seek consultation and treatment in the hospital.

Department of Surgery

Main Objectives

1. To examine all patients with a possible surgical diseases and afterwhich, to make a rational and accurate diagnosis.

Department of Surgery

Main Objectives

2. To provide treatment to all patients with surgical diseases.

Department of Surgery

Other Objectives

• To provide training in surgery.

• To promote research in surgery.

“Surgery Department”

usually refers to

General Surgery and its

subspecialties.

Department of Surgery

Physical Requirements

Department of Surgery

Physical Requirements1. Operating rooms

2. Surgical patient beds

3. Consultation rooms in

3.1 Outpatient department

3.2 Emergency room

Department of SurgeryPhysical Requirements

•Location within the hospital

•Quantity

•Size

•Design

•Equipment

dependent on

Department of SurgeryPhysical Requirements

General Determining Factors:

•Government regulations

•usual and anticipated increase in patient load

•needs and expectations of the community

•allowance for expansion

•cost-benefit considerations

Department of Surgery

Physical Requirementsfor training and research

•Conference room

•Library

•Internet

Department of Surgery

The Operating Room

Department of Surgery

The Operating Room

Place where

diagnostic and therapeutic

surgical procedures

are performed

The Operating Room Siting

Most important consideration:

Accessibility to patients of surgery department

Not far from the emergencytrauma unit

The Operating Room Number of Rooms

Most important consideration:

Cost-benefit analysis

usual patient load of surgical department

to

investment in spaces

The Operating Room Number of Operating Rooms

Several department ORs

vs

One operating room complex?

One complex is better

cost-benefit wise!

The Operating RoomDesign

one that will best achieve

• effectiveness and efficiency

• sterility standards and requirements •traffic flow

•from outside to inside

•from dirty to clean zones to sterile areas

The Operating Room

Basic Architectural DesignAseptic / Antiseptic

Rationale

Match

1. Most sterile zone

2. Most unsterile zone

A. Zone I - outer

B. Zone II - middle

C. Zone III - inner

Match

1. Most sterile zone - C

2. Most unsterile zone - A

A. Zone I - outer

B. Zone II - middle

C. Zone III - inner

The Operating RoomEssential equipment and facilities:

•Anesthesizing equipment

•Operating equipment

•Supplies for anesthesia and operation

•Monitoring devices

•Drugs, parenteral fluids, and gases

•Recovery room beds

Department of Surgery

Personnel Requirements

Department of SurgeryPersonnel Requirements

At least

• Surgeons

• Nurses

• Nursing Aides

Adequate in number and in competency

Department of SurgeryPersonnel Requirements

General Determining Factors:

•Government regulations

•usual and anticipated increase in patient load

•needs and expectations of the community

•cost-benefit considerations

Department of SurgeryPersonnel Requirements

For training objective

- trainors

For research objective

- researchers

Adequate in number and in competency

Operating RoomPersonnel Requirements

• Surgeons

• Anesthesiologists

• Nurses

• Nursing Aides

Adequate in number and in competency

Operating RoomPersonnel Requirements

• Surgeons

• Anesthesiologists

Minimum qualification:

Phil. Specialty Board certification

Operating RoomPersonnel Requirements

Number of Personnel

cost-benefit considerations:usual as well as anticipated

increase in patient load in the

surgery department

Operating RoomPersonnel Requirements

Governance of OR

• Department OR

- Department Chair or Rep

• OR Complex

- OR Management Team or Com

Department of Surgery

The Chairperson

Department of Surgery

The ChairpersonQualifications: Must

•Be a surgeon

•Know administration or management

•Know andragogy

•Know how to do research

consider objectives, activities, personnel

Department of Surgery

Manual of Policies and Procedures

Department of SurgeryManual of Policies and Procedures

Importance

•Guide for present and future staff

•Promotes effectiveness and efficiency

Should be reviewed and revised periodically

Department of SurgeryManual of Policies and Procedures

• Service

• Training

• Research

• Governance

Operating RoomManual of Policies and Procedures• Safety - explosions and infections

• Scheduling of cases

• Operating room privileges

• Records

• Charging

• Instruments and equipment

• Traffic

Department of Surgery

The Trends

Department of Surgery

The TrendsObjectives NOT limited to service.

Training and research are usually included because they contribute to perpetuation and

quality of service.

Department of Surgery

The TrendsAll training programs must be accredited

by the Specialty Board or Organization.

Accredited training programs attract trainees more than non-accredited ones.

Department of Surgery

The Trends ONLY board certified surgeons are

accepted for active and permanent staff in the hospitals.

Medicolegal reasons

Department of Surgery

The TrendsOperating room complex is the trend and

this is being managed by an operating room management team.

Thank You for trying to

appreciate what I am trying to

impart to you!

on The Surgery Department

(from hospital administration point of view)

Reynaldo O. Joson, MD, MHA, MHPEd, MScSurg

For those interested:

R.O. Joson’s Websitehttp://members.xoom.com/rjoson/hospadm/

hospadm.htm

http://web.pacific.net.ph/~rjoson