Hi, and welcome. In this movie, we will be reviewing the various positions that you’d encounter in a typical hospital setting. From the Board of Directors to executive leadership to HIM Professionals, we’ll look at each person’s role in the organization. Let’s get started. This is what a typical org chart looks like at a hospital. Now, the actual titles and responsibilities can vary, so please do keep that in mind as we look at each one.
Board of Directors
Let’s start at the very top and look at the Board of Directors. The Board of Directors, also referred to as the Governing Board or even the Board of Trustees, are responsible for the overall strategic direction of the hospital, including the mission, vision, goals and objectives, as well as the quality of patient care. At the end of the day, the Board of Directors has ultimate legal authority and responsibility for the hospital. Now, the board members are elected every 5 years and it may contain anywhere from 6 to 25 members, depending on the size of the hospital. If it’s a local or community hospital, the board will most likely consist of local business leaders and other community reps. If it’s a teaching hospital, the board may include university administrators and even medical school alumni. Just as you’d imagine, there are different positions within the board, including chairman, president, secretary, and treasurer. Sometimes a board will have non-voting members. These people are called ex officio members. On a day-to-day basis, the board helps to establish organizational bylaws and forms committees to conduct business, such as finance, medical staff, physician recruitment, long-range planning, etc. However, the board doesn’t work alone on these issues, as it works closely with the CEO and the executive leadership of the hospital.
Executive Leadership
The executive leadership will vary from hospital to hospital, depending upon its size. However, the primary role of the executive leadership team is to plan, direct, coordinate, and improve the healthcare within the community. Let’s take a look at a few of the key leadership positions.
Chief Executive Officer (CEO)
The Chief Executive Officer, or CEO, is the highest ranking executive within the organization and reports directly to the Board of Directors. Sometimes, this position may be referred to as Hospital Administrator or President. Working with the board, the CEO helps to establish the strategic vision of the hospital, and then it’s the CEO’s job to communicate and implement the mission, vision, goals, and objectives throughout the organization. Ultimately, the CEO is responsible for the overall operations of the hospital and also represents the hospital to the community it serves.
Legal Counsel
Working closely with the CEO is the chief lawyer or Legal Counsel. This person represents the hospital and all its entities from a legal perspective and handles risk management, litigation, medical malpractice, and possibly even compliance issues. It is the Legal Counsel’s job to preserve the financial and ethical standards of the organization. The Legal Counsel does this by supporting the strategic objectives of the hospital through observance of all applicable laws and accreditation standards.
Chief Information Office (CIO)
Let’s talk a little about the Chief Information Officer, or CIO. The CIO is considered senior management and oversees the use of IT (information technology) and data processing within the hospital. The IT Director works for the CIO. Within the IT department, you’ll find programmers, systems analysts, project managers, telecommunications managers, clinical data managers, and more. Also, depending upon how the organization is structured, the HIM Director may report to the CIO. Of course, the HIM Director may also report to the COO, so let’s talk about that job next.
Chief Operating Officer (COO)
The COO, or Chief Operating Officer, is also a senior management position. This job might also be referred to as the Executive Vice President. In any case, the COO reports directly to the CEO. The COO provides day-to-day senior leadership for operations to ensure compliance with the mission, vision, goals, objectives and strategic direction of the hospital. Depending upon the size of the hospital, the COO may also have direct oversight of support or ancillary services, such as pharmacy, nutrition and dining, environmental and housekeeping services, facilities management, and purchasing. And, as was already stated, the HIM Director may also report directly to the COO.
Chief Financial Officer (CFO)
Another senior management position is the Chief Financial Officer, or CFO. Also known as the Director of Finance or Fiscal Affairs Director, this person typically has an accounting or finance background and reports directly to the CEO. The CFO is responsible for the daily financial operations of the hospital, including accounting, payroll, accounts payable and accounts receivable, and budgeting. The CFO is also responsible for the cash and hospital assets. If it’s a large hospital, the CFO may be in charge of a comptroller, who’s the chief accounting officer, the treasurer, who’s the person who oversees financial assets, including cash and bank accounts, and possibly an internal auditor, who’s responsible for ensuring processes are in accordance with generally accepted accounting principles.
Chief Human Resources Officer
The Chief Human Resources Officer is another senior management position. As the head of HR, this person is responsible for all human resources and employee relations, including recruitment and retention, benefits, compensation, disability, EEOC, affirmative action, and diversity.
Chief Quality Officer
Next, let’s take a look at the role of the Chief Quality Officer. This is typically a senior management position, but some organizations have this person report to the Chief of Medical Staff, whom we’ll talk about in a minute. The Chief Quality Officer is generally responsible for all quality management activities, including patient safety, utilization and case management (which could also be under the CNO in some organizations), risk management (if it’s not under Legal Council), and accreditation compliance. In some hospitals, this person may be a nurse, but that’s not always the case.
Chief of the Medical Staff (CMS)
Okay, let’s switch gears a little bit and talk about the medical side of the hospital. The Chief of the Medical Staff, or CMS, is also at the senior management level, but is always a physician. You might hear the CMS referred to as the Medical Director and is considered the senior physician executive. This person’s primary responsibility is to oversee clinical operations and to act as an advocate on the behalf of the patients. The CMS is also responsible for the credentialing and licensure of physicians and other licensed providers in accordance with state and federal laws through clinical privileging for new appointments and reappointments. In addition, the Chief of Medial Staff is responsible for accreditation and other regulatory requirements for clinical care. On a day-to-day basis, the CMS ensures that everyone adheres to the medical staff bylaws, rules, and regulations, which are approved by the organization's government board. Finally, the CMS oversees clinical committees and clinical department heads of medical specialties, such as internal medicine, oncology, radiology, emergency and trauma, family medicine, cardiology, and anesthesia.
Chief Nursing Officer (CNO)
Staying on the medical side of things, the CNO, or Chief Nursing Officer, is also a senior management position. This person is a registered nurse and typically holds a Master’s degree. The CNO is responsible for patient care services, specifically the nursing care for the patients around the clock and oversees the clinical departmental managers, such as the surgical and recovery units, and the intensive care unit, called the ICU. Ultimately, the CNO promotes quality through benchmarking and performance improvement, provides strategic direction for the nursing staff, and establishes nursing policies and procedures that are in accordance with current standards of care.
Mid-Level Management
Okay, that does it for the executive leadership. Let’s take a look at the roles and responsibilities of the Health Information Management Department
Health Information Management (HIM) Director
The head of the HIM Department is the HIM Director. This is typically a mid-level management position, and, as was stated earlier, usually reports to the COO or CIO, depending upon the structure of the organization.
The HIM Director is typically an RHIA or RHIT and has extensive experience in the field. This person oversees all health information management activities, including the assessing, planning, directing, and forecasting of the HIM Department and the protection of the medical record.
The HIM Department
Under the HIM Director is a variety of positions. Let’s take a look at some of these. The Coding Supervisor leads and trains the team of medical coders. It’s this person’s job to ensure compliance with all applicable policies, procedures, and standards. Preferably, this Coding Supervisor is a certified coder.
The HIPAA Privacy Officer is responsible for the compliance of the Health Insurance Portability and Accountability Act, otherwise known as HIPAA. This person works closely with the Legal Counsel, Chief of the Medical Staff, the COO, and the Chief Quality Officer to ensure organizational compliance with Privacy Standards. Similarly, the Release of Information Manager, or ROI Manager, ensures the protection, security, and privacy of patient information through compliance with all federal, state, and local regulations, and accreditation requirements, including HIPAA and all other ROI policies.
This person also responds to ROI requests, verifies information to ensure proper consent, and makes sure they are completed in a timely manner. The Transcription Supervisor oversees the transcriptionists, monitoring their productivity, and outcomes to ensure that transcription is promptly completed in a high quality manner. This person acts as a liaison between transcriptionists and the medical staff, management, and other hospital employees. The Transcription Supervisor usually creates the required productivity statistical reports, including reports on volume and quality.
The Medical Records Supervisor is responsible for all activities and staff in the medical records department to ensure a complete medical record is available for healthcare operations. This person must maintain proper staffing, prepares applicable statistical reports, performs quality reviews, and ensures that all applicable policies and procedures are adhered to.
Finally, the Tumor or Cancer Registrar compiles and maintains cancer or tumor registry records for the hospital. It is this person’s job to extract applicable data from the medical record and then enter it into the tumor registry system for use in case management and federal regulation or compliance requirements. I should also point out that there are many more positions that complete the HIM Department, such as the file clerks, chart analysts, coders, and even receptionists, depending upon the size and type of the healthcare facility.
Each of these positions, while not on the organizational chart, play an instrumental role in the management of the health information content in any type of healthcare organization.
Conclusion
Okay, that wraps up our review of the various positions found in a hospital. As you can see, there are a lot of moving parts and everyone has an important role to play. Thanks for watching.
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