Notes

Government Facilities
The government has created many healthcare facilities. The United States has several government hospitals and medical offices. These facilities are supported by taxes. The facilities exist at several levels: international, national, state, and local.

World Health Organization
The World Health Organization (WHO) is an international agency sponsored by the United Nations. The WHO has 192 member states from around the globe. The organization’s goal is that all people should attain the highest possible level of health. This includes physical, mental, and social well-being. Each year, the WHO investigates serious health problems and publishes information on worldwide diseases.

U.S. Department of Health and Human Services
The U.S. Department of Health and Human Services (HHS) is a national health agency. Its goal is to protect the health of American citizens and to provide essential human services, especially for those who cannot help themselves. The HHS has several divisions to help meet the many demands of the agency's goal.
-The United States Public Health Service (USPHS) oversees the divisions of the HHS that cover public health. Here are some of the agencies that fall under the USPHS division of the HHS.
-The National Institute of Health (NIH) and the Center for Disease Control and Prevention (CDC) both research the cause, spread, and control of diseases.
-The Food and Drug Administration (FDA) regulates food and drug products that are sold to the public.
-The Agency for Healthcare Policy and Research (AHCPR) identifies standards for treatment in healthcare facilities.
-Many smaller agencies, at state, county, and local levels, follow Department of Health and Human Services guidelines to provide health services for their communities.

OSHA
The Occupational Safety and Health Administration (OSHA) is a government agency that enforces safety standards in the workplace to protect employees from injury and illness. OSHA is also responsible for creating safety standards that apply specifically to healthcare facilities.

VA
The United States Department of Veterans Affairs (VA) is a federal agency that provides healthcare services to military veterans at VA medical centers and outpatient clinics. The VA also provides veterans with many benefits outside healthcare including disability compensation, vocational rehabilitation, education assistance, home loans, and life insurance. Additionally, eligible veterans and family members receive burial and memorial benefits at national cemeteries.

Nonprofit Agencies
Nonprofit agencies also play a major role in the healthcare industry. They are supported by donations, membership fees, fundraisers, and government grants. Nonprofit agencies often focus on a certain disease or group of diseases. They research the disease, search for a cure, and promote public awareness. They also provide services for victims of the disease. Here are some examples of nonprofit agencies.
-American Cancer Society (ACS): The ACS’s mission is to “Free the world from cancer.” ACS funds research, shares information, supports patients and educates the population about prevention.
-American Heart Association (AHA): The AHA’s mission is to be a relentless force for a world of longer, healthier lives. To that end, the AHA seeks to improve American cardiovascular health through research, education, CPR training, and innovation.
-American Red Cross (ARC): The ARC’s mission is to prevent and alleviate human suffering during emergencies by effectively organizing volunteers and applying donations. The ARC provides disaster relief, education, and assistance to military families; it also promotes and organizes blood donations.
-March of Dimes: The mission of the March of Dimes is to fight to prevent premature births through research, advocacy, education, and newborn intensive care units (NICUs).

Lesson Summary
In this lesson, you learned that:
The goal of the U.S. Department of Health and Human Services is to protect the health of American citizens and to provide essential human services, especially for those who cannot help themselves.
The goal of the WHO is that all people attain the highest possible level of health.
Nonprofit agencies research certain diseases, search for a cure, and promote public awareness.
--------------------------------------------------------------------------------------------------------
Organizational Structure
Every healthcare facility must have an organizational structure. An organizational structure helps a facility to run smoothly by outlining the responsibilities of the employees. The structure may be complex or simple and will vary depending on the facility.
This organizational chart shows four divisions within a healthcare facility: Informational, Support, Diagnostic, and Therapeutic. Each division is broken down into several key functions.

Line of Authority
A line of authority must be decided for every department within a healthcare facility. The line of authority determines a worker's position in a facility's organizational structure. The line of authority also establishes levels of supervision. Healthcare workers must report any questions or problems to their immediate supervisor. If the immediate supervisor is unavailable, the problem should be resolved with the next level of supervision. This organizational chart shows the line of authority for a typical nursing department in a hospital. For example, registered nurses report issues to the head nurse. However, medical assistants should report to a licensed practical nurse.

Medical Office Structure
The organizational structure and line of authority at a community medical office are likely to be very different from those at a large medical facility. The doctor is the primary supervisor at a medical office. However, most medical offices employ an office manager to help oversee the daily functions within the office. This organizational chart shows the structure and the line of authority at a medical office. If a medical assistant has a problem, the issue should be resolved with the supervising registered nurse. However, if the registered nurse is not available, the problem may be discussed with the office manager.

Respecting Chain of Command
The line of authority not only establishes organizational structure, it also dictates the chain of command. In return, following the chain of command reinforces the organizational structure.
Respecting the chain of command provides:
1. Strength: Reporting to the proper person strengthens the structure. Going around supervisors weakens their authority, which weakens the overall structure.
2. Efficiency: Respecting the chain of command also promotes efficiency. An immediate supervisor is typically the best person to handle an issue at that level. If the issue involves other supervisors or input from higher-level roles, the supervisor can consult them.
3. Focus: When the chain of command is not followed, it can leave employees feeling uncertain, as though the ship has no captain. An uncertain environment can negatively impact productivity.


When to Escalate Problems
Respecting the chain of command can make it easier to understand when to escalate issues and to whom.
Each healthcare system or facility should have a process in place that helps healthcare workers determine when to apply problem-solving skills independently and when to escalate the issue to someone above them in accordance with the chain of command. Effective healthcare teams observe the facility’s problem-solving and escalation practices to efficiently and effectively resolve patient and staff issues.

Reporting Issues
When you report an issue to a supervisor or the next person in the chain of command, it is important to follow the process outlined by your healthcare facility.
Along with your facility-specific processes, other important factors need to be considered when reporting issues.
When reporting an issue, follow these guidelines:
1. Follow your facility’s process for reporting issues.
2. Research the existing process.
3. Develop a thoughtful plan for how you'd address the problem.
4. Explain your concern to your supervisor and share your idea for resolving the issue.
5. Be tactful and confident.


Interdependence
Every healthcare worker is part of the healthcare team. All members of the team are dependent on each other: this is commonly referred to as interdependence. If one worker does not fulfill the required duties, the entire team is negatively affected. And when the team is not functioning properly, patients do not receive the quality care they deserve. Imagine what might happen if the secretary at a medical office stopped answering the telephone. Patients would not be able to make appointments, and the team would be unable to perform its duties. Or imagine what could happen if the housekeeping department stopped cleaning. Many patients would feel uncomfortable receiving treatment in a dirty facility. In addition, patients and healthcare workers would be at risk of getting infections.

Lesson Summary
In this lesson, you identified levels within the organizational structure of a healthcare facility. You also explained appropriate interaction in the line of authority.
In this lesson, you learned that:
Organizational structure indicates areas of responsibility and produces efficient operation in a facility.
The line of authority determines a worker's position in the organizational structure and establishes levels of supervision.
All healthcare workers are dependent on each other.