Public hospitals infrastructure is the base that supports the planning, delivery, and evaluation of health activities and practices. The main elements of public hospitals infrastructure are security and building management systems, medical and administrative staff, departments, an operating theatre, facilities management, and data and information system. A building management system controls and monitors mechanical and electrical equipment.
A hospital security system is aimed at protecting personnel, patients, and visitors. It also secures sensitive information and prevents unauthorized access to medications and medical supplies. Some public hospitals use intrusion detection, access control, and video surveillance to ensure safety. Hospital staff consists of doctors, nurses, allied health professionals, and support staff.
Public hospitals consist of departments including an emergency department, cardiology, an intensive care unit, the general ward, neurology, oncology, and the maternity ward. There is also a department of nursing, which is responsible for the administration of nursing practice. Also, there are information management, the medical records department, facilities management, and maintenance. Hospital facilities management maintains a healthy environment in public hospitals ensuring that services requests are quickly processed and the schedule is efficiently set. A hospital information system manages all aspects of a hospital’s operation, including medical, administrative, legal, and financial ones.
Workflows and Processes
The main public hospital workflows and processes include administrative process, patient admission and discharge, medical procedures and operations, emergency room workflow, laboratory workflow, medication process, medical documentation, the supply of drugs, help desk process, and patient flow. The administrative process involves wide-range planning and coordination, managing the budget, hiring, and scheduling staff members. During the admission process, a nurse gathers initial patient’s assessment data to create an effective plan of care. A help desk is a customer service that deals with taking calls regarding troubleshooting and forwarding technical assistance.
Gaps and Issues
The current state of public hospitals can be hardly considered to be satisfactory due to the poor quality of care, low hospital efficiency, and redundant processes. There is a growing number of preventable medical errors made by nurses and doctors that result in human deaths (Shanafelt, Sinsky, & Swensen, 2017). Hospital personnel face excessive workloads, long working hours, burnout, and emotional exhaustion (Manyisa & Aswegen, 2017). A considerable amount of time is wasted on tasks involving indirect patient care, such as polling charts and collecting supplies. A large amount of paperwork for physicians does not allow them for serving a greater number of patients. Therefore, a lot has to be done to improve both the quality of care for patients and working conditions for staff.
Solutions for Improvement
The suggestions proposed relate to improvements in data management, as this infrastructure has to solve a lot of complicated tasks. The recommendations include the implementation of an electronic medical record (EHR) system that may be of help for nurses, physicians, and administrative personnel (Daly, 2015). Moreover, deployment of the EHR by hospitals and other healthcare facilities is encouraged by the HITECH ACT (Compliancy Group, 2018).
This would enable to reduce the number of medical errors and thus decrease the death rate among patients. The productivity of the nursing personnel will increase, as time spent on the ward round and nursing handover will be reduced. The administrative staff will spend less time on polling charts and thus will have much time for performing other working tasks. If the amount of paperwork is reduced, the productivity of physicians will increase, as they will be able to effectively coordinate care and serve more patients. However, some studies suggest that the EHR may drive professional dissatisfaction and burnout (DiAngi, Longhurst, & Payne, 2016). Therefore, public hospitals should consider investing in ongoing training, organizational changes, and automation of the EHR.
Speaking of other improvements in public hospitals, one may consider the implementation of the admission and discharge registered nurse. In order for this solution to be cost-effective, the position may be taken by any nurse in the acute care setting. The potential efficiency of such an implementation may be explained by reallocation of time, which would facilitate increased participation in direct patient care. An increase in both patient and nurse satisfaction is expected as a positive outcome.
Current Technology to Change Health Care Infrastructure
Experiencing a lack of funding, public hospitals are slowly moving into the data-driven world, though integration of big data processing approaches in existing data management architectures is associated with great advancements in healthcare infrastructure. Current technology that may change public hospital workflows and data management is business intelligence (BI) that offers an easy way to prepare, analyze, and visualize large volumes of disparate data. Therefore, BI should be viewed as a powerful tool that could enable public hospitals to reach strategic goals and reduce information asymmetry.
Using BI may help analyze public hospitals spending by department and type. According to the Society of Actuaries (2018), business intelligence (BI) will help cut costs of health organization up to 25% over the next few years. Using these systems may result in more effective care, as sophisticated algorithms determine redundancy and data accuracy, which will enable patients to receive the exact individualized kind of treatment. BI may also facilitate more coordinated treatment, so nurses and physicians will not spend much time communicating on each patient’s case with other departments. Big data technology may be of help in managing logistics, in particular, patient flow. This will enable administrative staff to know optimal patient discharge time and thus make the most effective use of bed space.
Conclusion
To sum up, in the given essay, the key elements of the infrastructure of public hospitals have been described along with the main workflows and processes. As data management is a major issue in healthcare facilities due to large volumes of information, the suggestions for future improvements in this area have been made. In particular, the implementation of the EHR may become a powerful tool in reducing medical errors and improving quality of care and nursing documentation. BI may revolutionize the way healthcare personnel interact with health-related data.
References
Compliancy Group. (2018). What is the HITECH Act?
Daly, P. (2015). Clinical nurses lead the charge with EHR. Nursing, 45(10), 25-26. Web.
DiAngi, Y. T., Longhurst, C. A., & Payne, T. H. (2016). Taming the EHR (electronic health record) – There is hope. Journal of Family Medicine, 3(6).
Manyisa, Z. M., & Aswegen, E. J. (2017). Factors affecting working conditions in public hospitals: A literature review. International Journal of Africa Nursing Sciences, 6, 28-38. Web.
Shanafelt, T., Sinsky, C. A., & Swensen, S. (2017). Preventable deaths in American. hospitals.
Society of Actuaries. (2018). 2018 Predictive analytics in healthcare trend forecast. Web.