ATIHBC Module 2 - Hospital Structure & Culture: Understanding the Hospital System

Course overview

In this class, students will be introduced to the three main power structures that drive administrative and clinical decision-making in a hospital.  These are:  institutional accreditation, including different types of standards that hospitals must meet depending on their financial structure and payer mix; internal chains of command including executive/administrative, medical and nursing; and the evidence-based guidelines for clinical practice which guide inpatient care across disciplines. ‘Systems-based practice’ situates how one’s own clinical care relates to the hospital system for a given patient.  This is a competency required for all physicians and other hospital-based health care providers including LIPs.  Class handouts include background reading on key points of evidence-based practice and systems-based practice, as well as illustrations and explanations of hospital command structures, how a hospital guides staff to survive accreditation visits by The Joint Commission (TJC) and Department of Health (DOH). Objectives: • Learn the context of hospital structure and institutional accreditation • Understand administrative, medical and nursing chains of command in typical teaching and non-teaching hospitals. • Understand the importance of evidence-based medicine as a force that shapes clinical decision-making in the hospital. • Understand what is meant by ‘systems-based practice’, why it is important, and how to operate as an acupuncturist within a medical team. ¥ Become aware of unwritten rules that may not be immediately apparent