Hospital administration has emerged as a field with immense scope. Hospitals are hope for people suffering from pain and illness. It is not merely the treatment provided to the patients but the overall atmosphere of a hospital that a patient remembers after discharge.
What then makes a hospital good or bad? The quality of doctors, medical facilities or its administration? The answer is: All. Inefficiency or inadequacy even in one area can mar the image of an institution.
Every sphere of work demands a specialist, and the Healthcare and Hospital sector is not an exception. Right person with right qualifications must be available at right place, at right time, and for right job to provide efficient, effective and high quality health care services to the public. Worldwide, the healthcare system is undergoing a tremendous change due to population increase, increasing burden of disease, economic growth and technology. There is manifold increase in the complexity and processes that take place in the successful management of a modern day hospital. The requirement of qualified professional hospital administrators in the hospitals is growing briskly, mostly because the nature of work in hospitals is quite different from other organizations. All the Hospitals are expected to deliver quality services round the clock.
New reforms are taking place in health sector worldwide and new courses are being introduced in medical curriculum to provide quality health care services to public. This in turn has led to an increased demand for efficient Professional Hospital Administrators who can handle the day-to-day management of the hospital and healthcare delivery system. Highly trained professionals are needed for the smooth operation/ functioning of a Hospital and Health care delivery system.
Curricula in health professional education should keep pace with the changing dynamics of disease pattern and health care delivery system. Earlier simple MBBS doctors were given responsibility to perform the role of hospital administrators apart from their normal medical duties. However, times have changed and professional Hospital administrators are being employed in hospitals world over to provide quality healthcare and to boost the professionalism in Hospital and Health Administration.
AIIMS New Delhi took the lead by starting MD (Hospital Administration) degree in 1963-64. Other Medical Institutes like NIMS Hyderabad, AFMC Pune, NIHFW New Delhi and SKIMS Srinagar followed it. At present there are several Medical Colleges & Institutes awarding MD (Hospital Administration)/ Health Administration / Community Health Administration in the country.
Nowadays a professional Postgraduate Degree in Hospital Administration i.e. MD (Hospital Administration) duly recognized by Medical Council of India is considered the “standard credential” for posts of faculty and consultants in Hospital Administration as well as Health administration in India. Today, Doctor of Medicine (MD) course in Hospital Administration is considered and recognized by Medical Council of India as a separate specialty like any other medical specialty and is the fourth most sought after degree worldwide.
Jammu and Kashmir Scenario
In keeping with the latest trends, SKIMS (Srinagar) established Department of Hospital Administration in 1992 & started MD (Hospital Administration) course since 1994 recognized by MCI with an aim to provide qualified hospital management experts and administrators to the J&K state for future health care delivery system so that quality healthcare services are provided to public at affordable cost. At present four Postgraduates take admission for MD (Hospital Administration) in the Department of Hospital Administration at SKIMS yearly and several doctors have been trained in the discipline of Hospital Administration at the expense of state exchequer till date at SKIMS. Some of them are utilizing their services in SKIMS, while other qualified hospital administrators are posted in periphery as medical officers and are waiting for their proper utilization by Government. Many Professionally qualified hospital administrators, who completed their MD degrees from SKIMS, are serving as medical superintendents and deputy medical superintendents in the state while some of them have been selected for faculty at AIIMS.
At present, the hospitals in the State of J&K are managed by doctors who have attained positions of Deputy Medical superintendents, Medical Superintendents by virtue of seniority or specialization in a clinical discipline. Besides that Clinical doctors occupy positions of BMO’s, Deputy CMO’s and CMO’s in peripheral health. These doctors don’t have the professional training and knowledge to ensure economic use of resources, standardization of hospital services and equipment design, prevention and control of over use of expensive drugs and collection of data for evaluation of performance etc. Doctors from clinical side lack qualified administrative experience as well as skills and by occupying administrative positions they actually jeopardize their own clinical skill which they have acquired. This arrangement has badly affected the health care in peripheral setup as clinical doctors are seen mostly busy with administrative matters.
In the state of J&K there has been a sea change in the health infrastructure and most of the district hospitals have been upgraded having bed capacity ranging from 100-350. Many new hospitals including MCH centers are being constructed. The ministry of health and family welfare GOI has sanctioned five medical colleges and two AIIMS for the state of Jammu & Kashmir and to run the affairs of the health department there is an urgent need for concerned authorities to awake at the earliest to achieve the desired results.
The health care institutions with bed capacity more than 50 require the qualified hospital administrators for their effective management. Similarly all the new facilities/hospitals require proper planning and execution under the supervision of qualified hospital administrators.
By considering Professionally Qualified Hospital Administrators for BMOs, CMOs, Deputy MS , MS, will lead to following benefits:
• A dedicated Public Health & Hospital Administration Cadre will be created from amongst the Medical Officers possessing Post Graduate Degrees in Hospital Administration/ Health Administration / Community Health Administration.
• The services of doctors who are trained at the expense of state exchequer will be utilized in a more efficient and effective manner
• The District Hospitals will be managed in a more professional manner
• Clinical doctors will be relieved of additional administrative responsibilities and will concentrate more efficiently and effectively in treatment of patients
• Equal & fair opportunity will be provided to all the Medical Officers possessing Post Graduate Degrees in Hospital Administration, Health Administration & Community Health Administration
• There will not be any financial burden on state exchequer as no extra posts need to be created.
• The brain drain of trained professional hospital administrators will be curb
Creation of Hospital Administration Department in Govt Medical Colleges
The necessity of creating a department of Hospital Administration in Government medical colleges of J&K state was recognized by then Honorable Health minister of a state in 2015 in the first review meeting of health sector wherein it was observed that in Govt. sector the significant expenditure on hospital involve the great amount of waste of resources due to technical and managerial inefficient system in hospitals and in order to have effectiveness, efficiency and quality in delivery of health services , a need to strengthen the hospital administration in the state was recognized which will respond to proper management of hospitals, cost containment, patient satisfaction and improvement in patient care. The proposal in this regard was moved by Health and medical education department in 2015 where in the then Honorable health minister desired to establish the department of hospital administration in Government medical colleges ( reference No; HD/plan/46/09, dated 29-06-15). The proposal was discussed and Govt. was at the verge of establishing the hospital administration department in Govt. medical colleges but no progress in this regard was seen after that. The process needs to be started and taken to its logical conclusion at the earliest in the interest of health care in the state.
Establishing a department of Hospital Administration in GMC Srinagar and Jammu is the need of hour because :
• MCI is in process of introducing hospital administration as a subject in medical schools. In due course of time, Hospital administration will be taught as a subject in medical course in order to get acquainted with the field.
• Health services in J&K work in tandem with teaching institutions in State, so professionally trained and qualified hospital administrators can smoothly run the health administration at all levels, thereby sparing the clinical doctors to utilize their clinical skill properly.
• As trainees, administrators are taught about public health problems of the community. This expertise can be utilized wherever they are posted in health administration.
As such, Health & Medical education recruitment rules should be reviewed and professionally qualified hospital administrators need to be posted at various positions for the overall betterment of health care in the state and process of establishing a Hospital Administration Department in Government Medical Colleges of state needs to be hastened.
Dr. Shahnawaz Hamid is Senior Resident, Deptt of Hospital Administration, SKIMS