Surgical Care at the District Hospital
Part 1 2 3 4 5 6 Primary Trauma Care Manual
Organizing the District Hospital Surgical Service
Organizational and management of the district surgical service
The District Hospital
Leadership, team skills and management
Record Keeping
Disaster and trauma planning
The surgical domain: creating the envioronment for surgery
Infection control and asepsis
Operating room
Cleaning, sterilization and disinfection
Waste disposal
The District Hospital



The hospital plays a unique role in any community:

:: It is the focus of many health care services
:: It can provide a significant amount of local employment
:: It is a point of intersection for members of different communities
:: It may be a community in its own right
:: It must be involved in community public health education and political solutions to common health problems.

Organizations grow and change; hospitals are no different.

As a doctor or senior health care provider, you may be the most highly trained person in a district hospital. In this capacity, other hospital staff will expect leadership to be a part of your job.

As a leader (especially if you are newly arrived), other members of the health care team or the community may turn to you with frustrations or with hopes for solutions to problems. These tasks may not be directly related to your work on the wards or in the operating room, but they will become part of your job.

When assuming a new role or advanced leadership responsibilities, one of the challenges is to see what is familiar as if you were seeing it for the first time. It is difficult but important to avoid bringing old ideas or grudges to a new position. Use your past experiences, but also begin a new role with a broader view and an attitude unbiased by prejudgements. When you arrive in a new place or take on a new job or role at a familiar place, be alert to the physical and human resources and try to learn as much as possible about the work and culture of the place.

Familiarize yourself with the people, hospital and its resources. Try to get an overview of the organizational and communications systems that are used (not just those that are supposed to be used, but what is really happening).
Approach a new work environment or job as you would approach a patient by taking a full history and examination. Be observant and attentive to all aspects of the encounter. Asking questions is important; be a good listener. Hear what people have to say. Try to understand what works well, where the problems lie and what the hopes of your co-workers are.

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The district hospital is part of a wider community of people and agencies, all of whom are working to improve the health of individuals, communities and society. Remember that these people and groups are your friends and allies. In discouraging times you can help one another and, by working together, can make things better. Find out who the other individuals and groups are and reach out and work with them – you have much to teach and learn from each other.

In addition to identifying the opinion leaders, you must be sensitive to any groups or subgroups whose voices are unlikely to be heard. You must find ways of reaching out and listening to them.

Health is a concern for all people and can provide an opportunity to bring people together across divisions. In areas of conflict, when the district hospital and other parts of the health care system are accessible to all members of society without prejudice, it can provide an example of cooperation and develop the feeling of belonging to a broader and more inclusive group which respects and meets common needs.

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  Kep Points  
Leadership is a part of your job
Apply the medical skills of evaluation and planning to your work as a manager

Respect the knowledge and expertise of senior hospital staff

Every institution has a history and the legacy of what has happened and why things have worked or not worked is held in the memory of the employees

The pride people feel in their workplace and the services they offer is a valuable commodity and is the greatest resource of any health care facility.