DEFINITION OF HEALTH CARE SYSTEM 

:
A health system, also sometimes referred to as health care system or as healthcare
system, is the organization of people, institutions, and resources that deliver health care
services to meet the health needs of target populations.
There is a wide variety of health systems around the world, with as many histories and
organizational structures as there are nations. Implicitly, nations must design and
develop health systems in accordance with their needs and resources, although
common elements in virtually all health systems are primary healthcare and public
health measures. In some countries, health system planning is distributed among
market participants. IHowever, health care planning has been described as often
evolutionary rather than revolutionary. As with other social institutional structures,
health systems are likely to reflect the history, culture and economics of the states in
which they evolve. These peculiarities bedevil and complicate international
comparisons and preclude any universal standard of performance.

HOSPITAL ADMINISTRATORS :
Hospital administrators are individuals or groups of people who act as the central point
of control within hospitals. These individuals may be previous or current clinicians, or
individuals with other healthcare backgrounds. There are two types of administrators,
generalists and specialists. Generalists are individuals who are responsible for
managing or helping to manage an entire facility. Specialists are individuals who are
responsible for the efficient and effective operations of a specific department such as
policy analysis, finance, accounting, budgeting, human resources, or marketing.
It was reported in September 2014, that the United States spends roughly $218 billion
per year on hospital's administration costs, which is equivalent to 1.43 percent of the
total U.S. economy. Hospital administration has grown as a percent of the U.S.
economy from .9 percent in 2000 to 1.43 percent in 2012, according to Health Affairs. In
11 different countries, hospitals allocate approximately 12 percent of their budget
toward administrative costs. In the United States, hospitals spend 25 percent on
administrative costs.

Generally, hospital administrators must do the following:

• Set budget and departmental goals
• Strategize to improve efficiency and quality of care
• Oversee finances such as patient fees, billing and fundraising
• Ensure the facility’s compliance with laws and regulations
• Communicate effectively with departments and staff regularly
• Represent the organization to investors or governing boards
• Oversee work schedules, supplies and budgets
• Educate the community on important health
A successful hospital manager adapts to change and stays current on healthcare laws,
regulations and technology, and coordinates with staff.

Defining and measuring performance

In general, performance measurement seeks to monitor, evaluate and communicate the
extent to which various aspects of the health system meet their key objectives. Usually,
those objectives can be summarized under a limited number of headings – for example,
health conferred on people by the health system, its responsiveness to public
preferences, the financial protection it offers and its productivity. Health relates
both to the health outcomes secured after treatment and to the broader health status of
the population. Responsiveness captures aspects of health system behaviour not
directly related to health outcomes, such as dignity, communication, autonomy, prompt
service, access to social support during care, quality of basic services and choice of
provider. Productivity refers to the extent to which the resources used by the health
system are used efficiently in the pursuit of effectiveness. Besides a concern for the
overall attainment in each of these areas, The world health report 2000 (7) highlighted
the importance of distributional (or equity) issues, expressed in terms of inequity in
health outcomes, responsiveness and payment.
Various degrees of progress have been made in the development of performance
measures and data collection techniques for the different aspects of health
performance. In some areas, such as population health, there are well-established
indicators – for example, infant mortality and life expectancy (sometimes adjusted for
disability). Even here, however, important further work is needed. A particular difficulty
with population health measures is estimating the specific contribution of the health
system to health. To address this, researchers are developing new instruments, such
as the concept of avoidable mortality .

Aspects of health performance measures :

Measuremen Description of measures Examples of indicators
t area
Population health Measures of aggregated data on the Life expectancy
health of the population Years of life lost
Avoidable mortality Disability-
adjusted life-years
Individual health Measures of individual’s health status, Disease-specific measures:
outcomes which can be relative to the whole • arthritis impact measurement
population or among groups scale
Indicators that also apply utility
rankings to different health states

Clinical quality and Measures of the services and care Outcome measures:
appropriateness of patients receive to achieve desired • health status
care outcomes • specific post-operative
Measures used to determine if best readmission and mortality rates
practice takes place and whether Process measures:
these actions are carried out in a • frequency of blood pressure
technologically sound manner measurement

Responsiveness of Measures of the way individuals are Patient experience measures

health system treated and the environment in which Patient satisfaction measures
they are treated during health system
interactions
Measures concerned with issues of
 patient dignity, autonomy,
confidentiality, communication, prompt
attention, social support and quality of
basic amenities
Equity Measures of the extent to which there Utilization measures
is equity in health, access to health Rates of access
care, responsiveness and financing Use–needs ratios
Spending thresholds
Disaggregated health outcome
measures

Productivity Measures of the productivity of the Labour productivity

health care system, health care Cost–effectiveness measures (for
organizations and individual interventions) Technical
practitioners efficiency (measures of
output/input) Allocative efficiency
(measured by willingness to pay)
Tips for Running an Effective Hospital :

1. Make sure your records don't accumulate unwanted depreciation. If a piece of

equipment or other asset is no longer in use, or in existence, it should be physically
disposed of and removed from the books.  For instance, if the hospital once owned a
building and it wasn't remove from the records when it was replaced or sold, the
hospital may have paid several years worth of insurance on the old building.  In addition
to placing a strain on the hospital's finances, this carries accumulated depreciation on
the hospital balance sheet making it appear older than it really is. "Having fully
depreciated assets, such as old MRIs, on the books make hospitals seem like they are
dated and worn .For one client, Principle Valuation identified $31 million in disposals to
remove from the books, and almost all of it was fully depreciated. When the disposals
are removed, the hospital's books more accurately reflected their real situation. Taking
care of the books puts you in the best light.

The amount of expensed and accumulated depreciation effects a hospital’s financial

statements. For audit purposes it is important that processes and procedures are in
place to maintain an accurate asset record.  In addition, when hospital or health system
executives are seeking debt financing, financial intermediaries, capital sources and
rating agencies scrutinize the financial statements impacting the cost of capital and
possibly access to capital.
2. Minimize staff turnover. Best practices across the board say that high staff turnover
is bad for business because it takes time and energy to train employees, and losing
their expertise is a drain on hospital resources. There are several reasons why a
surgical hospital might have high turnover rates, including low employee satisfaction
and higher wages at competing facilities. To meet these challenges head-on, hospital
CEOs must have a sophisticated HR professional who is able to work with employees
and executives to keep the turnover rate low.

3. Develop a strong managed care team. Failure to develop and utilize a well-

managed care team is one of the most damaging practices when it comes to OR
efficiency. If a surgical team is delayed from starting their next case because the
anesthesiologist is still finishing up one patient or the next patient isn't ready for surgery,
it creates an unnecessary roadblock that derails the surgical schedule and can leave
both surgeons and patients dissatisfied. The concept of care team should also be
extended to include a strategic partnership with OR leadership and care providers. For
example, the anesthesia team can often partner with the OR circulating nurses to
streamline throughput and reduce redundant activities. A care team approach allows
anesthesiologists and OR clinicians to coordinate patient care to optimize OR time.

4. Take control over the elements of competition that you can influence. There are
certain competitive strategies that the hospital can't influence — including geography,
demographics and payor competition — but they can influence the relationship between
the hospital, payors and area physicians. Many times, this includes a physician-hospital
alignment strategy. The hospital can also explore alignment with other tertiary providers
in the community to provide a seamless continuum of care.  All of this requires access
to information across the continuum.

Additionally, hospital executives can influence how they develop the different
departments. Many departments are modernized when the hospital partners with
surgeons to perform new procedures, purchases new technology and updates data
collection capabilities. "Timely access to the right information is key, but don't forget to
have the right human resources assets in place and the right people in leadership
positions to focus on advancing care and improving the department's culture," says Mr.
Peterson.

5. Conduct department evaluations before lay offs. One of the biggest mistakes

hospitals can make when cutting jobs is establishing a fixed percentage cut in each
department, according to Sherilynn Quist, workforce efficiency practice leader at
management and consulting company Quorum Health Resources. This tactic may
exacerbate staffing issues by eliminating positions in departments that are understaffed,
which may jeopardize quality and patient safety. It never works,. You'll end up right
back [where you started].  Instead, suggest using benchmarks and thorough
evaluations of departments to identify areas where cuts would have the least negative
impact or have a positive impact. Understand what departments [you] can go after
without affecting clinical quality or patient satisfaction

6. Consider partnering with a BPO. When deciding on a Business Process

Outsourcer, it's important to understand the strength of each company's balance sheet
and compare their performance to others in the industry, according to a report from
National Patient Account Services. A good BPO should focus on healthcare, have
early-out services and use state-of-the-art technology to serve you.

Tips for Managing a Successful Small Hospital :

1. Devise a strategic plan. Once you've gathered a great deal of information about the
needs of the community, develop a strategic plan for enhancing or implementing
needed services. "Every hospital needs to have a very thorough and thoughtful
strategic plan that examines the environmental factors that a hospital might be facing in
any given market, Listen to the medical staff and professionals because they know what
is sustainable from a clinical and financial standpoint.

Hospital executives should listen to the medical staff and their community members to
assess what services are needed most at the hospital. Talking and listening with the
medical staff is important because they work with patients from the community every
day, Also, listen to board members because they are out there in the community and
they can be a voice of what they are hearing. To best collect this information, create a
forum for the community to easily interact with the hospital.

2. Keep employees engaged. Employee engagement is an important aspect of

employee satisfaction and low turnover rates. Several factors can spark malcontent
among the employees that require delicate HR handling. In some cases, as was
mentioned in the previous point, the central administration can cause stressors on the
employees that need fixing. In other cases, department heads or managers may lack
the necessary leadership skills to keep their employees happy, even if they are brilliant
medical professionals.
3. Work with a good BPO. When deciding on a Business Process Outsourcer, it's
important to understand the strength of each company's balance sheet and compare
their performance to others in the industry, according to a report from National Patient
Account Services.

Here are four other important aspects of a good BPO include:

1. A focus on healthcare entities—not all industries are the same and companies
focused on healthcare can help hospitals with their unique needs.
2. Early-out services—the company should be able to work accounts during the first 90
days after discharge at a reduced rate, according to the report.
3. Use state-of-the-art technology—success is incumbent on the ability to employ
modern technology for increased efficiency.
4. Recorded calls—recording calls allows you to review work done by your BPO and
examine customer complaints.

EFFEICENT MANAGEMET STRUCTURE :

 BORD OF
DIRECTORS

PRESIDENT
OF THE
BORD

VP/DIAGNOSTI VP/ADMINISTRA
VP/THERAPEUTIC VP/FINANCIAL VP/SUPPORT
C SERVICE TIVE SERVICE
SERVICE CENTER SERVICE CENTER CENTER
CENER CENTER
EMERGENCY
THERAPY RADIOLOGY FACILITIES BILLING
PREPAREDNE
CENTER CENTER CENTER CENTER
SS
CLINICAL
PHARMACY CARDIOLOGY INFORMATIO
ACCOUNTING ENGINNERIN
CENTER CENTER N CENTER
G
FACILITIES
NURSING NEUROLOGY ADMISSIONS PAYROLL
AND
CENTER CENTER CENTER SERVICE
PLANING

DIETARY
HR CENTER SAFETY
CENTER

PURCHASING
DONE BY :HARCHE MOHAMED MOUNIR