Organizational Hierarchy in Different Types of Hospitals

Topics: Medicine, Tertiary referral hospital, Health care Pages: 5 (1362 words) Published: October 15, 2012
COURSE TITLE: Nursing Administration 2

← Hospital
- An integral part of a social and medical organization, the function of which is to provide for the population it serves, complete health care, both curative and preventive, and whose out-patient services reaches out to the family in its home environment: it also a center for the training of health workers and bio-social research (WHO)

- A place devoted primarily to the maintenance and operation of facilities for the diagnosis, treatment and care of individuals suffering from illness, disease or deformity, or in need of obstetrical or other medical and nursing care (Hospital Licensure Law, Republic Act 4226)

← Level 3 Hospital
- Departmentalized hospital that provides clinical care and management on the prevalent diseases in the locality, as well as particular forms of treatment, surgical procedures and intensive care - Clinical services provided in Level 2 hospitals as well as specialty clinical care - Appropriate administrative and services (tertiary Clinical laboratory, second level radiology and pharmacy) - Nursing Care provided in Level 3 hospitals as well as continuous and highly specialized critical care


a. A hospital is classified as a Tertiary Care Hospital if it has the appropriate Administrative, Clinical and Nursing Services, and it has an Accredited Training Program for Physicians, Nurses or Medical Technologists. b. It must have Subspecialty Clinical Care under its Clinical Service. At least one subspecialty will suffice, and this can be any Section in any of the Departments, e.g. Section of Cardiology in the Department of Medicine, Section of Urology in the Department of Surgery, etc. The Subspecialty Section must be reflected in the organizational chart of the Clinical Service. c. Tertiary Care Hospitals shall be given until 2010 to comply with the requirement of a Department of Emergency Medicine. d. General Dentistry under Clinical Service may be contracted out, but must be located within hospital premises. e. The Rehabilitation Service may be contracted out. If it is contracted out, it may or may not be located within hospital premises. f. The organizational structure of the Nursing Service shall provide for departments similar to those in the Clinical Service. This must be reflected in the organizational chart. g. The Accredited Training Program may be any Accredited Training Program for Physicians (at least one specialty), Accredited Training Program for Nurses, or Accredited Training Program for Medical Technologists. h. Housekeeping, Laundry and Linen, Engineering, Security, and Dietary Services may be contracted out. i. The Ambulance Service may be contracted out, but the ambulance must be available for 24 hours and physically present in the hospital premises. j. A Tertiary Care Hospital must have a Tertiary Clinical Laboratory, Third Level Radiology facility, and a Pharmacy, all of which must be licensed. These ancillary services may be contracted out but must be situated inside the hospital or within the hospital complex to ensure availability and timeliness of services.

a. Administrative Service
i. The Chief of Hospital and the Administrative Officer must have completed at least twenty (20) units towards a Master’s Degree in Hospital Administration or a related course OR must have at least five (5) years of experience in a supervisory/managerial position. ii. The Medical Records Officer must be trained in ICD-10. iii. The services of the following personnel may be contracted out: Laundry Worker, Utility Worker, Security Guard, Engineer, Medical Equipment/Biomedical Technician, Mechanic, and Driver. iv. The Driver refers to the driver of the ambulance.

v. There must be at least one in-house Maintenance Personnel per shift who...
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