challenges to hospital ad mini start or

8/3/2019 Challenges to Hospital Ad Mini Start Or

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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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