challenges to hospital ad mini start or
TRANSCRIPT
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TEAM MEMBERSTEAM MEMBERS
Dr.Nutan Panda-Introduction & Internal Challenges
Dr.Kalpesh Solanki-External Challenges
Mr.Shrish Kumar-Technological challenges
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Rapid development in med. technology
Increase health awareness of people Rapid urbanization
Increase demand for better facilities
Active participation of media
Legal involvement in hospital affair
Maintaining peaceful environment
Increased political interference
Better and quick communication facilities
Competitive private health care facilities
Increase in senior citizens
Higher level of consumers expectations
RAPID CHALLENGES
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HOSPITALADMINISTRAT
ION
INTERNAL EXTERNAL
TECHNOLOGICAL AND NEW CONCEPTS
Lackof
infrastructure
Lack of adequate
manpowerLack of
motivation of staff
Apathy of
doctor/nurses
Union activities
Financialconstraints
Logistic mgt.
Over crowding
Internal Security
Municipality
Consumer
forum(CPA)
Right to information
Legal issues
Water supply
Electricity
Public relation
MediaPolitical influence
Competitive Health Care
Quality management
NABHPatient safety
Robotic surgery
Modern Investigations( CT, MRI etc.)
High level of Consumer expectation
Shortage of technical manpower
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Technologymgt.
Manpower
mgt.
Power craze
Competitivemarket
Modern ITLeadershipmotivation
Costcontainment
Quality mgt.
Fixed
org.structure
INTERNALCHALLEN
GES
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EXTERNALCHALLENGES
BMW
management
Right toInformation
ConsumerProtectionForum
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PATIENT
OVER
CROWDING
SERVICEEXPANSION
NEWTECHNOLOGY
QUALITYOF CARE
PATIENT
SATISFA
CTION
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HOSPITAL ORGANIZATIONAL
CHALLENGE
Dual Authority
Legal bindings
Product is a service cannot be quantified
Variable and uneven care need, standard not becomparable
Crave for modern technology in operation and invest
Matter of life and death ,needs immediate decision
Nature of duties varies for Doctor, Nurses and other
technical staff Service is personalized professional and highly skilled
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INTERNAL
CHALLENGES
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INTERNAL CHALLENGES OVERCROWDING:- In public hospital it
is due to non-denial of admissions to deservingpatients irrespective of availability of vacant
beds,medicolegal or otherwise poor or rich and
disaster victims.Consequences of overcrowding :-
Riskof poor hygiene
Shorta
ge of drugs,
linen &con
sum
ables
Increase noise level
Reduce personalized attention
Make everyone irritate
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Solutions to overcrowding There should be proper sitting arrangements
outside the O.P.Ds.
Visitors time should be there to meet the patients
in the wards.
Number of visitors per patients should be limited.
Visitors should have to take visitors pass before
meeting the patients.
There must be security guard outside the wards
and I.C.Us.
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LACK OF ADEQUATE MANPOWERHEALTHCARE
POSITION
HIERARCHY
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HR challenges in healthcare A growing number of healthcare professionals are retiring
An increasing number of aging baby boomers requiring care
Fewer younger people are choosing the profession: Shift in view of profession from high tech to low tech
Shift from a secure & prestigious profession to chaotic & unstable Many more employment options for women to choose from
Healthcare workers have less connection with patients due to shift toshorter-stay hospital systems
Shift from mass-production society to information society makes the 24/7schedule demands less attractive
High Nurses turnover Ratio
Retention of Good qualified and skilled physician for longer time
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SOLUTIONS
Providing them better work
environment
Providing rewards, incentives etc.
Providing better career opportunities
Maintaining proper professional and
personal life
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Lack of Motivation
Monotonous type of work
Stressful
Lot of expectation
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Solutions Provide the nurses shifting duties into different wards
Provide them a recreation hall Motivate them by recognizing the NURSE OF THE MONTH and
give them a certain TOKEN OF HONOUR . And judge their
promotions through this process
Form small groups by taking a experience nurse and few new and
inexperience ones
Provide the nurses adequate breaks and rest hours so that their job
doesn't get monotonous
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FINANCIAL CONSTRINTSFINANCIAL CHALLENGES
Medical insurance reimbursement 88%Bad debts 70%
Increasing costs for staff,
supplies, etc.
70%
Inadequate funding for capital
improvements
63%
Managed care payments 51%
Other commercial insurance
reimbursement
42%
Revenue cycle management
(converting charges to cash)
37%
Emergency department 30%
Competition from specialty
hospitals
20%
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SOLUTIONS Outsourcing as a method of reducing capital
cost and getting economies of scale:AREA OF OUTSOUCING
Housekeeping & waste disposal
Laundry
Biomedical equipment maintenance
Food and beverages
CSSD
Blood bank
Pharmacy
Consignment purchase IT both hardware and software
Security
Equipment leasing
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INTERNAL SECURITY High rate of pilferages
DrugsKitchen cutlery
Linen
Thefts of staff and patient belongings
Outsider gang members
Visitor thefts
Threats against patients or staff
Crimes of opportunity.
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SOLUTIONS No-tech.
Policies & proceduresTraining & supervision
Security awareness in the staff
Low-techLocks
Barriers
Good lighting
Landscaping
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Solutions cont. High tech
Alarm systemsAccess control systems
Photo identification
CCTV
Two-way voice communications
Weapons screening systems.
NEW EMERGING TECH. Can enhance security even more
Patient locators
Video pursuit software
Delayed egress hardware
Active asset control systems
Enterprise-wide systems
Digital video
Pager alarms
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EXTERNAL
CHALLENGES
BY-DR KALPESH
SOLANKI
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EXTERNAL CHALLENGES
MUNICIPALITY AND PCBs
CONSUMER FORUMS/RTIs
WATER SUPPLY/ELECTRICITY PRs/MEDIA
LEGAL ISSUES
POLITICAL INFLUENCE
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Hospital waste
Health hazardHospital
Infection like
HIV
,Hepatitis
Environmentalpollution
Air pollution
Water pollution
MUNICIPALITY AND PCBs
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WAYS TO MEET THIS CHALLENGE
SHORTTERM/MEDIUM TERM
All hospitals above a certain minimum bed strength
should install incinerators
All health institutions should have a manual onwaste handling procedure and those made
responsible for it should be provided a training for
it
Strict supervision should be done by Directors/MS
over waste disposal
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WAYS TO MEET contd
No private health establishment should be allowed to
function until and unless they have developed proper
waste disposal system.
Care should be taken that unscrupulous elements are
not involved in recycling the waste.
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WAYS TO MEET THIS CHALLENGE LONG TERM
LEGAL MEASURES: The MoEF has framed
the BIO MEDICAL WASTES (Management
and Handling) Rules,1998 for the purpose.
Compliance should be enforced. Allocation of resources(both Central and State
Governments) for an integrated programme of
biomedical waste management.
Closer co ordination between the various
state/administrative agencies.
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LONG TERM Contd..
There can also be a comprehensive integrated
and commonly managed system of final
disposal of wastes by a group of hospitals in a
particular region. Involvement of NGOs in the form of a well
directed public awareness campaign.
Structured training programmes in the form of
short term/diploma courses/OJT in waste
management for all concerned staff members.
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CONSUMER FORUMS AND RTI
The support that the medical professionals render to
us is the noblest.
Stark changes in the points of view
DOCTOR IS NO MORE A GOD.PATIENT IS JUST A CONSUMER OF MEDICAL
GOODS AND SERVICES.
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WAYS TO PROTECT THE INTERESTS OF
SERVICE PROVIDERS
Group Medical Indemnity Insurance scheme
for all personnel. This will economize on
expenditure incurred by the legal department in
contesting consumer claims. Periodic Medical and Death Audits to
streamline existing practice and point out any
deficiencies/inadequacies in service.
Regular in house staff training/CME
programmes for updating knowledge and
keeping in touch with current trends and
protocols.
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WAYS TO PROTECT THE INTERESTS OF
CONSUMERS
Assurance that the hospital observes
transparency in maintaining hospital records
and vital patient data.
Ready availability of these.
Periodic interaction between Hospital
Administration, Medical Professionals and
patients to reach a consensus so as to keep the
consumers complaints at a minimum.
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WATER SUPPLY AND ELECTRICITY
Ensure judicious use of these resources bystaff/patients by putting placards/sign boards atrelevant places in the hospital about the importanceof their conservation.
Organize felicitation/recognition programmes fordepartments/sections in the hospitals that are usingthese resources efficiently and economically.
Adopt innovative, cost efficient and relatively simpleenergy solutions like Light emitting diodes (LEDs)atall exit signs, CFLs instead of incandescent lamps,occupancy sensors etc.
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ADDITIONAL CHALLENGES FOR HOSPITAL PR
Understanding patient confidentiality and privacy.
Ability to communicate thoughts and ideas effectively
and accurately.
Analytical and problem solving ability.
Knowing the hospital structure, departments and
support group.
Familiar with the community where the hospital is
located.
Writing skills and ability to handle different types of
media.
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POLITICAL INFLUENCE
Ensure that the hiring of employees in a
hospital is kept free of political influence as faras possible.
The administration must develop the ability to
use the incumbent political influence for the
betterment of hospital services.
Development of a patient centric approach
rather than an influence centric one.
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COMMUNITY CARE RIGHTS AND
LEGAL ISSUES
COMMUNITYCARE RIGHTS: -
1. Preparation of MLC
2. Notification of births and deaths
3. Notification of Infectious disease
4. Notification of Unnatural deaths5. Conducting medical examination
6. Issue of fitness & medicalcertificate
7. Conducting post-mortem
8. Notification of all accidental cases
9. Proper completion of casesheets(medical records)
10. Age determination by court orders
11. Furnishing medical opinion oncourt orders
LEGALISSUES :-
1. Compliance of MTP Act
2. Compliance of PNDT Act(Sexdetermination)
3. Compliance of BMW Act
4. Consumers Protection Act5. Right to Information Act
6. Issue of disability certificates
7. Organ transplantation Act
8. Artificial Insemination Act
9. Custody of mentally ill patients10. Food Adulteration Act
11. Ethical issues
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TECHNOLOGICAL
CHALLENGES
BY- Mr SHRISH KUMAR
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TECHNOLOGY
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Robotic Surgery
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Technology
1. Purchase of equipments-
2. Today hospital has major expenditure(more than 40percent) in the
purchase of equipments.
3. Equipment should be of good quality with affordable cost.
4. Equipment should be purchase from known manufacturers.
5. Issue of tenders.
6. While purchasing a witten letter should be taken from
manufacturers for the after sales service.
7. CMC- Comprehensive maintainance contract.
8. AMC- Annual maintainance contract.
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Latest technology should be used like C.T. Scan, M.R.I.(3 Tesla),Lithotriptor, Endoscopy etc.
Patients should be informed about the uses of the latest
technology.
Staffs should be given training time to time so as to use the latest
technology.
Proper coordination between the management and owner
(trustees) about the ues of latest technology.
Technology
Sh t f t h i l
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Shortage of technical manpower
Indian technician in demand all over
world
Due to brain drain we have acute
shortage
We should restore the technician by
giving them advanced training
We should involve them in meeting
related to technology
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Maintaing Bio-medical departments.
Having a good bio-medical department reduces the cost ofhospital.
Faster service in case of equipments breakdown.
Helps in the purchase of proper equipments.
Should be located near the O.T.
BIOMEDICAL DEPARTMENT
C f O
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Controlling the infection in O.T.
Special care should be taken while cleaning of the O.T. O.T. Should be clean in a proper way after every cases. O.T. Must be fumigated at least once a weak. Sterile equipments must be wrapped with a sterile cloth. Whosoever entering the O.T. must clean his/her hands with
disinfectants.
All the material used must be disposed properly if disposable. C.S.S.D. Must take proper care in cleaning of equipments coming
to it. Every equipments must be autoclaved or should be placed in Eto
or sterrard. Decomposable should not be used as reusable. While retuning the instruments to respective departments
equipments must be packed in plastic bags.
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PATIENT SAFETY
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PATIENT SAFETY
Prevention from fire safety
Fire doors
Fire drills
Awareness
TrainingPrevention from over prescription of
doctors
Medical Audit
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ISO (International Organization for Standardization)
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ISO (International Organization for Standardization)
ISO standards contribute more to a company'seconomic sustainability than ever before. An
increasing number of manufacturers and
business customers will not even do business
with a supplier that is not ISO certified.
ISO certification is now effectively a requirement
of doing business in the European Union, even
though it is not a legal mandate.
The biggest advantage of ISO certification is the
perspective of a third party assessment.
This makes it easier to implement new systems,
hire personnel, and understand changes.
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STRATEGIES TO MEET THE CHALLENGES
Clear cut responsibility
Restructuring Reorienting training
Career development
Leadership and motivation
Marketing of hospital services Hospital infection control practice
Relationship with outside agencies
Technological advancement
Power sharing
Awards and Punishment
Increase efficiency
Improve patient safety and care
Developing modern MIS
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