BMIS-Nov 2024-L1-Q1C- Decision-Making in Hospital Management

Centralised vs Decentralised decision-making in hospital management.

Question

For each of the decisions below, identify whom you would expect to make the decision and briefly explain why.

Decisions about the medical treatment or surgical treatment for individual patients.
Establishing policy on hygiene standards in the hospitals.
Scheduling operations in the operating theatres of each hospital.
Discharging patients from hospital.
Deciding the visiting times for patients in each hospital.
Prescribing drugs for the treatment of patients.
Hiring new staff, such as hospital porters and nurses.
Dealing with payments from insurance companies for the treatment of insured patients.

Answer

Medical staff (doctors) – Medical decisions related to individual patient treatment are generally made by the medical team, based on patient condition.
Head office management – Policy decisions such as hygiene standards should be set centrally to ensure consistency across all hospitals.
Hospital management – Scheduling operations falls under hospital management, though it could be centralised in certain cases.
Medical staff – Discharging decisions should be made by medical personnel who assess the patient’s health condition.
Head office or hospital management – Visiting policies can either be centralised or decentralised based on the hospital’s autonomy.
Medical staff (doctors) – Prescription of drugs is within the remit of medical staff but could be governed by head office policies on drug usage.
Head office or hospital management – Hiring decisions may be centralised for uniformity or decentralised depending on the hospital’s structure.
Head office accounts department – Managing insurance payments should ideally be centralised to prevent duplication and errors across multiple hospitals.