The National Board of Examinations (NBE) has released the Curriculum for DNB Hospital Administration.
I. PROGRAMME GOAL & OBJECTIVES
1. Programme Goal
The candidate after 03 years of DNB training should acquire the competencies so that the trainee is able to carry out the job functions of a healthcare administrator, including planning and management of services within the ethical as well as legal framework.
2. Programme Objective
• To manage operations of hospitals and other healthcare establishments including their human, finance, and materials resources
• To apply principles of management to plan, implement and control systems as well as processes in healthcare settings
• To plan hospitals and healthcare establishments
• To plan and implement healthcare programmes
II. TEACHING AND TRAINING ACTIVITIES
The fundamental components of the teaching programme should include the following: –
1. Case presentations & discussion- once a week
2. Seminar – Once a week
3. Journal club – Once a fortnight
4. 15 days rotation in all wards and departments of hospital as well as supportive services with a view to understand and resolve administrative issues. The findings to be documented for assessment by the faculty.
5. Faculty lecture teaching- Once a week
6. Audit of medical records and administrative issues of the Hospital – Once a Month
7. One poster and one oral presentation at least once during their training period in a recognized conference.
8. Study visits to the following nearby healthcare facilities: –
(a) Sub Centre
(b) Primary Health Centre
(c) Community Health Centre
(d) District Hospital
(e) Government Medical College
(f) Super Specialty Private Hospital
(g) Under construction Hospital Project
Theoretical: The theoretical knowledge would be imparted to the candidates through discussions, journal clubs, symposia and seminars. The students are exposed to recent advances through discussions in journal clubs. These are considered necessary in view of an inadequate exposure to the subject in the undergraduate curriculum.
Symposia: Trainees would be required to present a minimum of 20 topics based on the curriculum in a period of three years to the combined class of teachers and students. A free discussion would be encouraged in these symposia. The topics of the symposia would be given to the trainees with the dates for presentation.
Journal Clubs: This would be a fortnightly academic exercise. A list of suggested Journals is given towards the end of this document. The candidate would summarize and discuss the scientific article critically. A faculty member will suggest the article and moderate the discussion, with participation by other faculty members and resident doctors. The contributions made by the article in furtherance of the scientific knowledge and limitations, if any, will be highlighted.
Research: The student would carry out the research project and write a thesis/ dissertation in accordance with NBE guidelines.
III. SYLLABUS
1- General Administration and Management
Sl.
Topic
Contents
1.
Development of Management Concept
History and growth of Management science
Traditional vs. modern management
Evolution of management theory
Management as a profession
Ethics in management
2.
Management Function & Tools
Management levels and skills
Functions & Principles of management
Challenges to a manager
Systems Approach
Role of the executive
Management tools
Styles of management
Committees
3.
Fundamentals of Planning and Decision Making
Hierarchy and Types of Plans
Steps in planning
Managerial decision making
4.
Organization Structure
Organizational design and function
Hospital Organization
Matching structure and strategy
Functional organization
Line and staff authority
Delegation/ Decentralization
5.
Office procedure and Disciplinary proceedings
Definition of Office & office procedures
Drafting official letters
Service rules & procedure
Conduct rules
Disciplinary proceedings
6.
Communication
Basic concepts
Types of communication
Barriers of communication
Principles of good communication
Communication in Healthcare
7.
Personnel Management & Human Resource Development
Definition & Importance
Work study & Method study
Manpower planning
Recruitment & selection
Job analysis
Job description
Job evaluation
Job enrichment
Training & development
Performance Appraisal
Grievance Redressal
Absenteeism
8.
Organisational Behavior and Group Dynamics
Basics of sociology, anthropology, psychology
Characteristics of workgroups
OB labs
Dynamics of organizational behavior
Motivation & Leadership
Conflict management
Transactional analysis
Team building
Change Management
Johari Window
Grievance redressal systems
9.
Financial Management
GDP, GNP, National Economic Policies
Budgeting, types of budget
Working Capital, Cash flow analysis
Financial Statement and Ratios
Balance Sheets
Elements of cost, cost accounting
Fixed assets and Depreciation
Break even analysis, Cost effectiveness, Cost benefit analysis
Financial Management in hospitals
Cost containment in hospitals
10.
Material Management
Importance of Material Management
Theory of Demand and Supply
Inventory control
Purchase cycle
Tender System
Economic order quantity, Safety stock, Lead time
Receipt and Inspection of Stores
Distribution, Standardisation, Codification
Condemnation and Disposal
Stores documentation
Equipment audit
Logistics and Supply chain management
Role of computers in Stores Management
Risk Management
Ergonomics and its application in hospitals
Occupational hazards
Workman Compensation Act
Definition, scope and importance of industrial relations
12.
Information System
Information system analysis and design
HMIS a tool to managerial control
13.
Modern Management Techniques
Quantitative methods of Management
OR techniques and their application in healthcare
Management by objective
14.
Marketing Management
Concept of Marketing
Marketing strategies, evaluation and control
Marketing Information & research
Market & medical ethics
Social Aspects of marketing
Privatization of Health
Public Private Partnership (PPP)
Outsourcing
Medical Tourism
Corporate Social Responsibility
2- Health care and Health Administration
Sl
Topic
Contents
1.
Development of Health Services in India
Evaluation of health care services
Definition & dimensions of health
Review of different reports on Health care
2.
Medical Sociology
Sociological perspectives of Health, illness and healing
3.
Health & Disease
Concept of health & disease
Concept of well being
Natural history of disease and role of hospitals in various levels of prevention
Research Methodology in Health and Hospital Administration
Concept of health indicators
Types of surveys
Selecting a problem, making hypothesis
Research Protocol writing
Determining objectives
Bibliographical data
Sample size determination
Data collection techniques and tools
Questionnaires and Interview techniques
Observation technique
Analysis of data
Report writing
Errors of Measurement
5.
National Health Policy
National Health Policy – 2017
Role of Health education and communication
Health Committees
National Health Programmes
Millennium Developmental Goals and Sustainable development goals
6.
Biostatistics
Concept of Biostatistics
Presentation of data
Frequency of distribution
Measurements of central tendency
Measurement of dispersion
Sampling & Sampling error
Testing of hypothesis
Test of significance
Epidemiology
Evolution and uses of epidemiology
Definitions and terminology
Natural history of disease and role of hospital in various levels of preventions
Types of epidemiology
Methods of epidemiological studies
Socio-economic status and occupation as determinant in disease distribution
Cause and effect relationship
Epidemiology of hospital infection
Epidemiology of
Non-Communicable diseases
Trauma and RTA
Diabetes
Coronary Artery Disease (CAD)
How to investigate an epidemic and role of the hospital in its control
Common diseases in India-their epidemiology and prevention
Screening and surveys
Concept of health Indicators
Disability adjusted life years (DALY’s)
Quality adjusted life years (QALY’s)
Disability adjusted life expectancy (DALE)
Physical quality of life Index (PQLI) etc
8.
Health Statistics and Health Information System in India
Need
Common rates & ratio
Incidence & prevalence rates and
Morbidity
Mortality
Health reports
Notifiable Diseases
Health care Delivery system
ICD -10 & ICD – 11
9.
Hospital Utilization Statistics
Community Indices: Bed population ratio, Hospital admission rate , Per capita Hospitalisation rate
Hospital utilisation Indices: Average daily census, Bed occupancy rate, bed turnover rate, bed turn over interval, Average length of stay
10.
Medical Records
Definition, historical background, types of medical records, retention of records, computerisation of
medical records, medical record audit, MR Department
11.
Health Economics
Basics of health economics
Analysis of demand and supply
Health Insurance Schemes and social
Security scheme like CGHS, ESI in India
Medical care system & Health
Insurance System in different countries
12.
Population Dynamics
Demography and family planning
13.
Ethics Laws and Acts
Code of Medical Ethics and duties of physicians
Legal issues in Hospital administration
Laws and Acts applicable to hospitals
Medico legal Cases
Industrial relations and laws
Patient’s rights & provider’s responsibility – Medical Malpractice
Medical ethics and ethical issues in end of life decisions
Dying Declaration
Importance (section 32 & 157) of Indian Evidence Act and Death Certificate –
3- Hospital Planning and Hospital Administration
Sl.
Topic
Contents
1.
Hospital
History and development of hospitals
Definition, types, control, role and functions
Hospitals in India today, their number, types, size,
distribution, ownership, utilization, issues & trends
2.
Nursing Administration
Introduction to Nursing profession
Nursing organization structure
Nurse as a social and professional entity
Staffing norms in various types of hospitals and different departments.
Recent trends in nursing profession and nursing
3.
Public Relations in Hospital
Public relations
Employees Welfare
Welfare schemes
Occupational safety
Conflict management
Stress management
Counseling
5.
Quality in Health Services
Quality concept
Verifiable standards and parameter
Various Quality Models
Total Quality management
Kaizen
Lean management
Six Sigma in healthcare
Hospital and Healthcare Accreditation
6.
Future of Hospital Administration
Performance Review
Hospital statistics & quality control
Recent trends in hospital
Challenges to administrators
Reengineering
Telemedicine
Artificial intelligence
7.
Hospital Planning- General consideration
Changing system of Health Services concept in planning, designing and space
Site surveys for planning a hospital
Planning for hospitals macro and micro aspects
Hospital building an overview
External architectural aspects and landscaping
Internal arrangements
Hospital hygiene and sanitation
Lighting & HVAC
Design considerations including evidence- based design and Architect Brief
Planning and designing specialised hospitals
Taking over and commissioning a new hospital
Alteration and additions in an existing hospital
Planning the Hospital Engineering Services
Repair and maintenance schedule
Equipment planning for a new hospital
Green buildings
4. Administration of Clinical and Non-Clinical Services and Administrative Procedures
Sl.
Topic
Contents
1.
Clinical Services
Outpatient services
Surgical services
Operating department
Paediatric services
Dental services & Maxillo-facial Surgery
Psychiatric services
Radiodiagnosis
Radiotherapy services
Accident and Emergency services
Hospital Laboratory services
Obstetrics and Gynecology services
Intensive care unit
Dialysis unit
Day care units
Bone marrow transplant unit (BMT)
Nuclear medicine
Lithotripsy centre
Physiotherapy centre
Burns centre
Malignant Diseases Treatment Centre
Trauma centre
Geriatric services
Antibiotic Policy
Standard Precautions
Spill Management
Occupational hazards and safety in healthcare
Non Clinical services and Administrative procedure
Enquiry & registration
Admission office
Inspection, Medical Superintendent’s rounds
Hospital Standing Orders
Hospital Welfare Services
Indian Red Cross society and hospitals
Nursing services
Ward management including welfare and recreational facilities
House-keeping including Pest control
Medical stores and Pharmacy services
Blood Bank and Transfusion-services
Central Sterile Supply Department (CSSD)
Dietary service
Linen and laundry services
Hospital engineering services
Fire Fighting services
Ambulance services
Fatal documents
Mortuary
Equipment management
Transportation in hospitals (Intramural, Extramural)
Biomedical waste management
Solid waste management
Hospital Information system (HIS)
Structural requirement for infection control in hospitals
Hospital formulary
Essential drugs list (EDL)
Patient feedback & Discharge procedure
Disaster Management
Fire Safety in Hospitals
Hospital Safety and Security
Enterprise Resource Planning (ERP) Hospital Media Relations & Marketing Non – Profit Organizations
IV. COMPETENCIES
Presentation and communication skills
• Problem solving skills
• Leadership skills
• Planning and monitoring of the health activities
• Analysis of data
• Evaluation of the activities and programmes
• Research
• Mentoring
• Training and development of manpower
V. LOG BOOK
A candidate shall maintain a log book of operations (assisted / performed) during the training period, certified by the concerned post graduate teacher / Head of the department / senior consultant. The log book should show evidence that the before mentioned subjects were covered (with dates and the name of teacher(s) The candidate will maintain the record of all academic activities undertaken by him/her in log book.
1. Personal profile of the candidate
2. Educational qualification/Professional data
3. Record of case histories
4. Procedures learnt
5. Record of case Demonstration/Presentations
VI. RECOMMENDED TEXT BOOKS AND JOURNALS
BOOKS
General Administration and Management
1. Management: Management: A Global, Innovative and Entrepreneurial
Perspective – Harold Koontz
2. Management – JF Stoner
3. Organisational Behaviour – Stephen P Robbins
4. Management of Organisational Behaviour – Paul Hersey
5. Human Behaviour at work – Keith Davis
6. Personnel and Human Resource Management – David Adenzo, Stephen P Robbins
7. Principles of Operations Research – Harvey M Wagner
8. Industrial Engineering and Management – OP Khanna
9. Material Management Inventory Control and Logistics – AK Dutta
10. Financial Management for Hospital Administration – GB Kulkarni
11. Hospital Stores Management: An integrated approach – Dr Shakti Gupta, Dr Sunil Kant
12. Principles of Marketing – P Kotler & Armstrong
13. Essentials of Healthcare Marketing – E Brokovich
14. How to Market your Hospital without Selling your Philosophy – GD Kunders
Healthcare and Health Administration
1. Parks textbook of Preventive and Social Medicine – K Park
2. National Health Programmes in India: National policies & legislations related to health – Jugal Kishore
3. Understanding health Economics – A guide for healthcare decision makers – Paul R Macrone, UK Kogan
4. Biostatistics & Research Methodology – Mahajan
5. Epidemiology in Health Services Management, – G.E. Alan Dever
6. Epidemiology – Leon Gordis
7. Medical negligence and the Law in India: Duties, Responsibilities, Rights – Tapas Kumar Koley
8. Medico legal aid to hospitals and doctors with consumer protection law – MS Pandit & Shobha Pandit
9. Medical Ethics Challenges and prospects in India – Subrata Sharma
Hospital Planning and Hospital Administration
1. Principles of Hospital Administration – JR Mc Gibony
2. Principles of Hospital Administration and Planning – BM Sakharkar
3. Planning and Approach to Health Facilities (5 Volumes) – WHO
4. Hospital Administration Handbook – HS Rowland & BL Rowland
5. Hospital Planning and Administration – R Lewelyn Davies and HMC Macaulay
6. Planning, Designing and Maintaining of Hospitals – GD Kunders
7. Medical and Dental Space Planning: A comprehensive guide to design, equipment and clinical procedures – Jain Malkin
8. Hospital Infection Control Guideline: Principles and Practice – Sanjeev Singh, Shakti Kumar Gupta, Sunil Kant
9. Juran’s Quality Handbook – Joseph M Juran
10. Handbook of Healthcare quality & patient safety – Gyani G, Thomas A
11. Handbook of Human Factors and Ergonomics in Healthcare and Patient Safety – Pascale Carayon
12. Quality in Healthcare – Al Alassaf
13. Applying quality management in Healthcare – Diane L Kelly
14. Quality & Accreditation of Healthcare Organizations – WHO
15. Accreditation Manual: NABH
16. American Institute of Architects – Hospital & Healthcare Facilities
17. National Building Code 2016 – Bureau of Indian Standards
18. IPHS guidelines
Management of Clinical and Non-Clinical Services
1. Hospital Special Care Facilities – Harold Lauffman
2. Hospital Beds – J Yates
3. Antibiotic Policies: Controlling Hospital Acquired Infection – Ian M Gould Jos Van Der Meer
4. District Healthcare Facilities – WHO
5. Constructional and Functional requirements for road ambulances: (National Ambulance Code) – Department of Road transport and Highways, Govt of india
6. Health Building Note (01-16) (Department of Health Govt. of UK)
7. Hospital and Health Services Administration: Principles and Practices – Tabish Syed Amin
8. Leveraging Lean in Hospital ancillary Services: Charles Protzman and Joyce Kerpchar
9. Handbook of Hospital Security and Safety – James T Turner
10. Emergency Medical Services & Disaster Management – Dr PK Dave, Dr Shakti Gupta, Dr NK Parmar, Dr Sunil Kant
JOURNAL & MAGAZINES
1. Health Policy and Planning
2. Hospital and Health Network
3. Health Service Management & Research
4. Express Healthcare
5. JAHA: Journal of Academy of Hospital Administration
6. Physician Executive Journal
7. Health Service Management Review
8. World Hospitals and Health Services
9. Journal of Healthcare Management (ACHE)
10. Harvard Business Review
11. Journal on Hospital Infection
12. International Journal for evidence-based healthcare
13. Hospital Design Manual
14. International Journal of Research Foundation of Hospital and Healthcare Administration