Table 1 Disentangling the differences between traditional and PC hospitals
From: Evaluating organizational change in health care: the patient-centered hospital model
Functional hospital configuration | More recent innovations: converging patterns towards PC hospitals | |
Organizational model/ care delivery model | Functional/divisional model | Lean organization/process-oriented model |
Organizational unit: patients’ care needs and the relationship among specialties | Specialty-based units. Practitioners (doctors and nurses) are grouped into semi-autonomous units depending on their specialty of belonging | Multi-specialty units. Units are aggregated in accordance with patients’ clinical and assistential needs. Doctors might treat patients located in different units and nurses might assist patients with different pathologies |
Model of care | Functional nursing (nurses’ task-oriented job: each nurse is specialized in a single care activity) | Modular nursing (nurses are responsible for the overall assistential practices required by small groups of patients within the ward) |
Use of resources | Separated resources (beds, operating rooms, equipment, nursing staff, other staff) devoted to the individual specialties | Resource pooling: resources are shared by all the functional specialties regrouped |
Managerial roles | Head physicians in charge of their departments | Bed manager/case manager (as distinguished by the clinical activity) for centralized operation management |
Physical environment | Hospitals are built around fixed and focused spaces, with often isolated wings | Newly built hospitals are designed to maximize resource pooling and patient grouping, flexibility and modularity of spaces |