General Hospital Departments

Nancy Weatherhead

Chapter 2: The Organization of Hospitals

General Hospital Departments

Hospital departments may be classified in several ways, including general departments, inpatient units, and outpatient units/clinics. The numbers, functions, and names of hospital departments vary. In general, the HUC can expect that larger general hospitals will have more departments and services than smaller general hospitals as well as more complicated organizational structures.

Image of a section of a large hospital directory sign, organized into two columns with various departments, units, and offices listed alongside letters and numbers to indicate the floor and coloured shapes to indicate zones. — Large hospitals have many different general departments, in-patient units, and out-patient clinics, as this way-finding sign in a U.K. hospital illustrates.

Practice Activity: Hospital Departments

Review the Programs & Services page of the London Health Sciences Centre website. This website provides a good overview of the different outpatient clinics and inpatient units you will find at a large teaching hospital.

As you review these departments, think about how many of these you have seen at hospitals in your community.

General Hospital Departments

It is essential for the HUC to have a solid understanding of the role of general hospital departments, as they must interact with many of them daily in order to effectively complete their job duties. Below is a list of the most common general hospital departments that they may interact with. Note that while these areas do not provide hands-on patient care, they are imperative to the smooth running of the hospital.

In addition to working in patient care units, the HUC may also find employment in many of these general hospital departments, including roles such as admitting clerk, HIM/medical records clerk, pharmacy clerk, OR Bookings clerk, billing clerk, and general clerical support.

Admitting/Patient Flow Department: Responsible for the intake process for all inpatient and outpatient patient encounters and the assignment of all hospital beds according to medical needs and insurance coverage. All patient records flow from the initial patient registration and intake process from this department.

Bookings Departments (Central Bookings/Bookings HUB/OR Bookings): Responsible for booking prescheduled patient tests and surgical procedures. This may include intake of referrals, pre-registration of patient encounters in the system, booking of tests in the clinical schedule, and communicating appointment time to booking physicians and/or patients.

Business Office/Patient Accounts: Responsible for managing and overseeing all aspects of patient billing for insured and non-insured services, including provincial health insurance plans, private health insurance plans, and self-payments. The business office also oversees billing for preferred accommodation such as private or semi-private rooms.

Central Supply Reserve (CSR)/ Sterile Processing Department (SPD): Responsible for sterilizing, storing and distributing reusable medical supplies and equipment (MOAB Healthcare. 2024), such as feeding pumps or metal bedpans. CSR/SPD also supports surgical processes by selecting and arranging the required instruments for specific procedures, ensuring all components are sterilized and ready for use.

Dietary/Nutritional Services: Responsible for providing all patient snacks, meals, and special diets such as tube feeds, as well as cafeteria food for visitors. Some hospitals may prepare all meals in hospital, while others may contract some meal preparation out.

Environmental Services/Housekeeping: Responsible for the cleaning and sanitizing of the hospital facility, including terminal cleaning of isolation rooms (Thompson, 2018). In some hospitals, environmental services are responsible for shared areas, whereas each unit’s environmental service personnel are responsible for the cleanliness of their respective unit.

Health Information Management (HIM): Responsible for maintaining, organizing, storing and archiving all patient records. Also responsible for medical record coding, generation of reports through the medical transcription process, and release of information to patients, providers and insurance companies.

Human Resources (HR): Responsible for recruitment and staffing, onboarding and orientation, employee relations, training and development opportunities, compensation, performance management, workforce planning, and negotiating collective agreements with trade unions representing hospital bargaining units.

IT/Information Services: Responsible for managing and supporting the hospital’s technology infrastructure including communication systems, computer services, and EMR/other software applications.

Linen/Laundry: Responsible for supplying clean, sanitized linens, including gowns, bedding and towels, to all patient care areas in the hospital. Due to cost-saving measures, these services may be subcontracted to off-site services such as London Hospital Linen Services (LHLS) in London, Ontario.

Maintenance: Responsible for routine day-to-day facility maintenance, performing inspections of plumbing, HVAC, and refrigeration systems, ensuring that all buildings meet code, safety and security standards, and implementing energy management initiatives (Accruent, 2024).

Occupational Health/Employee Health: Responsible for employees’ work-related health and wellness needs, including preventing workplace injuries, injury treatment and rehabilitation, return to work plans, immunizations, and worker’s compensation referrals.

Pharmacy: Responsible for all aspects of medication management for hospital inpatients, including storing, compounding, and dispensing drugs; consulting with physicians to make drug-based decisions; providing drug education to patients and staff; and managing the patient medication profile/record. Some hospitals may also have an outpatient pharmacy, where patients may fill prescriptions upon discharge.

Privacy Office: Responsible for ensuring the hospital complies with legislation relating to the privacy and security of personal health information; provides advice, guidance, and education staff on the practical application of the law, including privacy procedures (Trillium Health Partners, 2024). This office may also investigate privacy breaches.

Public Relations: Responsible for managing the hospital’s media relations, internal and external communications, community engagement and marketing events, and social media presence.

Purchasing: Responsible for procuring the goods and services the hospital requires to operate efficiently, including the sourcing, acquisition, distribution, control and disposal of goods (Grand River Hospital, 2024).

Risk Management/Infection Control: Responsible for identifying, evaluating and mitigating risks that could negatively impact patients and staff, including the spread of disease or infections within the hospital. There may be two separate departments in larger hospitals.

Staffing/Scheduling Office: Responsible for the delivery of centralized scheduling and staffing services for the hospital, posting staff schedules, replacing shifts, and preparing accurate time cards for payroll. These services may also be decentralized and completed by the HUC at the unit level.

Stores/Materials Management: Responsible for stocking patient care units with one-time-use equipment and supplies, such as urinary catheters, IV supplies, and paper goods.

Switchboard: Responsible for directing incoming communications to the hospitals. Also called “locating,” this department is also responsible for hospital-wide paging and the first point of contact during hospital emergencies.

Volunteer Services: Responsible for recruiting and onboarding volunteers, training, scheduling and monitoring volunteers, and volunteer recognition and retention activities. In some hospitals, volunteer services may also be responsible for arranging student placements, while in others, this function is handled by HR or clinical educators.