Health administration, healthcare administration, healthcare management or hospital management is the field relating to leadership, management, and administration of public health systems, health care systems, hospitals, and hospital networks in all the primary, secondary, and tertiary sectors.
Terminology
Health systems management or health care systems management describes the leadership and general management of hospitals, hospital networks, and/or health care systems. In international use, the term refers to management at all levels. In the United States, management of a single institution (e.g. a hospital) is also referred to as “medical and health services management”, “healthcare management”, or “health administration”.
Health systems management ensures that specific outcomes are attained, that departments within a health facility are running smoothly, that the right people are in the right jobs, that people know what is expected of them, that resources are used efficiently and that all departments are working towards a common goal for mutual development and growth
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 countries, hospitals allocate approximately 12 percent of their budget toward administrative costs. In the United States, hospitals spend 25 percent on administrative costs.
Training and organizations
Associated qualifications
Health care management is usually studied through healthcare administration or healthcare management programs in a business school or, in some institutions, in a school of public health.
North America
Although many colleges and universities are offering a bachelor’s degree in healthcare administration or human resources, a master’s degree is considered the “standard credential” for most health administrators in the United States. Research and academic-based doctorate level degrees, such as the Doctor of Philosophy (PhD) in Health Administration and the Doctor of Health Administration (DHA) degree, prepare health care professionals to turn their clinical or administrative experiences into opportunities to develop new knowledge and practice, teach, shape public policy and/or lead complex organizations. There are multiple recognized degree types that are considered equivalent from the perspective of professional preparation.
The Commission on the Accreditation of Healthcare Management Education (CAHME) is the accrediting body overseeing master’s-level programs in the United States and Canada on behalf of the United States Department of Education. It accredits several degree program types, including Master of Hospital Administration (MHA), Master of Health Services Administration (MHSA), Master of Business Administration in Hospital Management (MBA-HM), Master of Health Administration (MHA), Master of Public Health (MPH, MSPH, MSHPM), Master of Science (MS-HSM, MS-HA), and Master of Public Administration (MPA).(Master of Hospital Management) (MHM)
Professional organizations
There are a variety of different professional associations related to health systems management, which can be sub categorized as either personal or institutional membership groups. Personal membership groups are joined by individuals, and typically have individual skills and career development as their focus. Larger personal membership groups include the Healthcare Financial Management Association and the Healthcare Information and Management Systems Society. Institutional membership groups are joined by organizations; whereas they typically focus on organizational effectiveness, and may also include data sharing agreements and other medical related or administrative practice sharing vehicles for member organizations. Prominent examples include the American Hospital Association and the University Healthsystems Consortium.
System Processes
A career in healthcare administration consists of organizing, developing, and managing medical and health services. These responsibilities are carried out at hospitals, clinics, managed care companies, public health agencies, and other comparable establishments. This job involves a lot of paperwork and minimal patient engagement. Healthcare administrators make sure to promote excellence in patient care, patient satisfaction, and relationships with their physicians. In order to do this they must make sure that their employees are willing to follow protocols and keep a positive attitude with their patients. The entire organization has a better experience when everything is organized and protocols are set into place. The dual role of physicians follows as both consumers of healthcare resources and controllers of organizational revenue with their ability to direct patients and prescribe care. This makes leader relationships with physicians fairly atypical in comparison with key stakeholder relationships in other industries. Healthcare administrators might become overworked along with physicians feeling stressed from various protocols. However, both the parties of stakeholders and patients make up the backbone of a proper healthcare administration. These administrators make sure that the doctors, insurance companies, patients, and other healthcare providers have access to the files they need to provide appropriate treatments. Multiple hierarchies of professionals, on both the clinical and administrative sides of the organization, generate special challenges for directing and coordinating the healthcare organization. A healthcare administrator has a long-term effect in improving the hospital’s process operation systems. They play a vital role in the sustainability of the institution.
Funding of Hospitals
Healthcare administrators are in charge of hospital finances and advocate various strategies to improve their facilities and resources. Hospitals provide funding for assets like marketing, charity events, equipment, medicine, payroll, etc. At the same time, an institution should not be all things to people; it has its own limitations. The management administration carefully manages these funds due to a spending limitation. The healthcare administrators control the expenditures that the hospital allows in order to meet profits. Sometimes hospitals are limited on what they can do for patients. Administrators that run these hospitals strive to achieve goals within their financial limitations. This study examines the causes of healthcare employment growth and workforce composition in the US and evaluates the labor market’s impact on healthcare spending and health outcomes. When healthcare spending reduces, employment growth will start reducing as well. The healthcare administration is critical to the lives of the people in hospitals. It contributes to cost saving practices and making sure that the necessities are brought to the institution. Healthcare management makes sure that protocols and funds are properly organized for each department. They are responsible for keeping the healthcare industry afloat. Many hospitals host charity events and donate to them as well.
Overall Goal
The fundamental goal of a hospital administrator is to create a positive work environment where patients are treated in the most efficient and cost-effective way possible. The United States leads the world in high quality and advanced level healthcare. Everyone is working towards a common goal thanks to these mission statements. This improves the organization’s efficiency and productivity. The mission statement establishes the organization’s purpose and provides employees a sense of belonging and identity. This encourages management and stakeholders to put in more effort in order to obtain success. The ultimate purpose of health care is to help individuals regain their overall health and wellbeing.
History
Early hospital administrators were called patient directors or superintendents. At the time, many were nurses who had taken on administrative responsibilities. Over half of the members of the American Hospital Association were graduate nurses in 1916. Other superintendents were medical doctors, laymen and members of the clergy. In the United States, the first degree granting program in the United States was established at Marquette University in Milwaukee, Wisconsin. By 1927, the first two students received their degrees. The original idea is credited to Father Moulinier, associated with the Catholic Hospital Association. The first modern health systems management program was established in 1934 at the University of Chicago. At the time, programs were completed in two years – one year of formal graduate study and one year of practicing internship. In 1958, the Sloan program at Cornell University began offering a special program requiring two years of formal study, which remains the dominant structure in the United States and Canada today.
Health systems management has been described as a “hidden” health profession because of the relatively low-profile role managers take in health systems, in comparison to direct-care professions such as nursing and medicine. However the visibility of the management profession within healthcare has been rising in recent years, due largely to the widespread problems developed countries are having in balancing cost, access, and quality in their hospitals and health systems.
Doctor of Health Administration
The Doctor of Health Administration (D.H.A.) is a doctoral degree focused with the development of theoretical knowledge in health administration and on the applied application of the said knowledge in the field of health administration. The D.H.A. requires significant coursework beyond the master’s level and often requires a dissertation or capstone project that contributes to knowledge or practice.
Description
The Doctor of Health Administration is a research degree. The research can be theoretical or applied. According to the United States Department of Education, research doctoral degrees such as the Doctor of Health Administration and the Doctor of Business Administration are equivalent to the PhD The PhD is just one of the many degree titles associated with research doctoral degrees. A difference between the DHA and PhD is that the DHA’s dissertation allows for a theoretical or applied approach rather than a strictly theoretical approach.
History
The Doctor of Health Administration was first introduced in the U.S. in the late 1990’s at the Medical University of South Carolina as an advanced professional doctorate in health leadership. Prior to this the only D.H.A. degrees awarded were in Canada and Europe. The American version of this doctoral degree focuses on advanced professional knowledge and applied research in health administration, policy, and leadership. New programs have been instituted at other universities providing substantial amounts of online coursework. Most D.H.A. students are working health professionals who seek doctoral education. Admission to the three year degree typically requires two years of coursework beyond the master’s degree (i.e. M.H.A., M.P.A., M.S.A., or M.P.H.) and an applied or theoretical dissertation to be completed in the third year.
Program structure
Most D.H.A. programs require about 70 credit hours beyond the master’s degree. Students are expected to take a number of core classes, electives, research/method classes, and dissertation credits. Candidates typically work with a committee and advisors throughout the process and the dissertation eventually requires an oral defense to the student’s committee. Curricula may be offered on a full-time or part-time basis. The normal duration of a doctorate should correspond to 3–5 years of full-time graduate study or 7–10 years of sustained part-time graduate study.
Purpose
The Doctor of Health Administration program prepares health professionals to become innovative leaders and problem solvers within the healthcare industry. By blending the theoretical with the practical, the coursework of this advanced doctorate of health administration degree program provides students with the holistic knowledge needed to transition into careers that improve and influence healthcare administration systems.
Health information management
Health information management (HIM) is information management applied to health and health care. It is the practice of analyzing and protecting digital and traditional medical information vital to providing quality patient care. With the widespread computerization of health records, traditional (paper-based) records are being replaced with electronic health records (EHRs). The tools of health informatics and health information technology are continually improving to bring greater efficiency to information management in the health care sector.
Health information management professionals plan information systems, develop health policy, and identify current and future information needs. In addition, they may apply the science of informatics to the collection, storage, analysis, use, and transmission of information to meet legal, professional, ethical and administrative records-keeping requirements of health care delivery. They work with clinical, epidemiological, demographic, financial, reference, and coded healthcare data. Health information administrators have been described to “play a critical role in the delivery of healthcare in the United States through their focus on the collection, maintenance and use of quality data to support the information-intensive and information-reliant healthcare system”.
History and development of HIM standards in the United States
HIM standards began with establishment of AHIMA
Health information management’s standards history is dated back to the introduction of the American Health Information Management Association, founded in 1928 “when the American College of Surgeons established the Association of Record Librarians of North America (ARLNA) to ‘elevate the standards of clinical records in hospitals and other medical institutions.’
In 1938, AHIMA was known as American Association of Medical Record Librarians (AAMRL) and its members were known as medical record experts or librarians who studied medical record science. The goal was to raise the standards of records keeping in hospitals and other healthcare facilities. The individuals involved in this profession were promoters for the successful management of clinical records to guarantee accuracy and precision. Over time, the organization’s name changed to reflect the evolving field of health information management practices, eventually becoming the American Health Information Management Association. The association’s current name is meant to cover the wide variety of areas which health professionals work in today.
AHIMA members affect the quality of patient information and patient care at every touch point in the healthcare delivery cycle. They often serve in bridge roles, connecting clinical, operational, and administrative functions.
HIMSS establishment in 1961 increased industry knowledge
The Healthcare Information and Management Systems Society (HIMSS) was organized in 1961 as the Hospital Management Systems Society (HMSS), an independent, unincorporated, nonprofit, voluntary association of individuals. It was preceded by increasing amounts of management engineering activity in healthcare during the 1950s, when teachings of Frederick Winslow Taylor and Frank Bunker Gilbreth, Sr. began to attract the attention of health leaders.
The HIMSS grew to include chapters, membership categories, publications, conventions, and continues to grow in different parts of the world via its Europe, Asia Pacific, and Middle Eastern branches.
Accredited HIM educational program development
The Commission on Accreditation for Health Informatics and Information Management Education (CAHIIM) defines standards which higher education health information management and technology programs must meet to qualify for accreditation. Students who graduate from an accredited associate’s, bachelor’s or certificate program are qualified to sit for their respective exams for certification as a Registered Health Information Technician (RHIT) – via graduation from an accredited associate or certification program or Registered Health Information Administrator (RHIA), which requires education through an accredited bachelor or certification program. Competency requirements are maintained by CAHIIM in their associate degree Entry-Level Competencies and Baccalaureate Degree Entry-Level Competencies definitions.
