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^Situational Analysis Presentation – Vitreo-Retina Department

Sadguru Netra Chikitsalaya

March 18-20, 2014

My life time experiencePerformance summary

2012-13

2013-14

Growth

New OPD

7576 16729 120%

Review OPD

7883 10752 36%

OT 2867 3432 19.7%

My life time experienceHuman resource-Staffing pattern

Manpower -Current

S.no Cadre Available in number

1 CONSULTANT 3

2 JUNIOR CONSULTANT 2

3

LONG TERM COMPREHENSIVE

FELLOW 6

4 LONG TERM RETINA

FELLOW 2

5 PARAMEDICAL STAFF 7

6 HELPING STAFF 4

7 SUPERVISOR 1

Total 25

My life time experienceHuman resource-Training and development

Training Received (in last 3 years) Training needs•Uvea clinic•ROP screening •Oncology services•In house/external training of paramedical staff•Optometrist workshop and conferences

Training- Can offer for external candidates •Structured programs for long term and short term training •Exclusive short term retina fellow can be tagged with one consultant•Advertisements about our training program should be more elaborate •Yearly exams for fellows and affiliations with recognized universities• Internal •ERG Training for the candidates

My life time experienceQuality assurance

• Current Situation

Highly qualified and competent consultants and doctor’s are available

All the world class tests and Investigation procedures are done here.

World class equipment's and instruments are available

All the advanced surgical procedures are performed under Retina Dept.

Monthly clinical audit : internal External audit:6monthly Lack of well defined consent forms. Protocols for Both Clinical procedures

and Non-Clinical interventions has been implemented according to ISO

• Requirements

Medical retina training protocol has to be made

Standard Operating Procedures has to be prepared as per according to NABH Standards and implemented.

My life time experienceInfrastructure-Equipments (Key equipments introduced in the department in

the last 3 years)Equipment No's

B-Scan Probe Cable(29/02/2014) 1

B-Scan (Marvel )with Probe(04/03/2014) 1

Optomed fundus Camera Probe with Adaptor(SL) (26/02/2014) 1

RE-INVERTER(2/09/2013) 1

Visulas-532S (Green Laser) (08/04/2013) 1

OCT (RTVUE)(28/5/2013) 1

Camera (Sony) (30/09/2013) 1

Electrophysiological (ERG)(22/12/2012) 1

Indirect Ophthalmoscope(LED Wireless)(27/8/2013) 2

Fundus Camera(12/9/2012) 1

ACCURUS 800CS (29/05/2012) 1

.S L T YAG Laser (2010) 1

My life time experienceInfrastructure-Physical space/others

Current Situation

Individual Clinic is dedicated for Retina Dept.

Separate ward is dedicated for the Retina subspecialty.

All the essential amenities are present for facilitating the services.

Restricted Waiting Area

Requirements

More space required for Retina OPD.

Patient waiting lounge with pictures/LED screen/information brochures

Proper Space Planning required. Proper sitting arrangements for

the Consultant’s and Doctor’s. Renovation in Retina OPD

needed. Construction and Renovation

needed in Retina Ward.

My life time experienceManagement Information system

Current Situation

Clinical Management System(CMS)is

available.

Qualified Data Entry Operator’s are

assigning for operating CMS.

All the patient related entries like OPD,

Admission, Discharge has takes place.

ICD Codes are in practice but not

been updated since long.

Requirements

New Diagnosis , Procedures & Treatments should be updated (ICD Codes needs to be updated)

Patient Entry report should be generated after 7:00 P.M

Camp Patient Entry option should be available in CMS Software

EMR(Electronic Medical Records) should be developed

Systems should have complete list of doctor’s (Acc. to Doctor’s roster)

System hanging should avoid All the essential patient related information

should incorporate(Both Clinical and Non-Clinical).

Treatment given to the patient section should be adequate/Complete.

There should be proper use of CMS by the Data Entry Operator’s

My life time experienceSWOT

Strength

Efficient & Dedicated clinical and non-clinical staff

Highly competent and qualified Medical personnel (Consultants & Doctor’s)

Treatment for almost all retinal ailments

FFA/OCT/B-Scan/Lasers/ERG Retinal surgeries (RD, VH,

Diabetic Vitrectomy, IOL drop, nucleus drop, IOFB)

Vitrectomy for endophthalmitis

Growth Rate: OPD:40-50% OT:15%

Weakness

Manpower Requirement Equipment’s required Strict Protocols

implementation is lacking Lack of training assessment

and documentation of employees

Research work needs to be enhanced

Behavior of the staff s the prime concern

My life time experience

• Opportunity :

Formulating Marketing Strategies to promote the department. Quality Assurance by implementing quality standards acc. to

NABH Guidelines for ensuring patient satisfaction and increasing the patient volume.

By encouraging the efficient and effective operational activities Enhancing and nurturing the Human Resource by training and

Development. Incorporating the implications for improving the current situation

and to overcome the shortcomings mentioned. For getting the majority of the patients from different places

following Establishments should be done for the same:• Uvea clinic• ROP clinic• Oncology clinic Structured fellowship training Research and Development Initiatives.

My life time experienceSWOT

Threat Departmental Threats (If we will not prompt to take the desired implications then: It may create the unsatisfaction among the clinical personnel and we may

face the difficulty in the retention of the consultants It may leads to Patient unsatisfaction and will create a negative image of

the dept. We may get the low patient volume during the peak time (i.e., from Oct –

March every year) It will hamper the employee satisfaction level We will not achieve the desired departmental objective for its betterment.

We may loose the brand loyalty of the patients who are coming from different premises/ Places.

Hospital related threats:

It may hamper the brand image of Sadguru Netra Chikitsalaya.

We may not get the NABH Accreditation

It will hamper the efficiency and effectiveness of the department.

Both patient and staff will suffer if we will not take the corrective actions.

 

My life time experience

Strategies:

Structured research program Incorporation of Diabetic retinopathy project Focus on urban areas including literate and elite class along with

rural areas Workshops and CME has to be conducted once in 3 months of

every subspecialty On Website – There should be detailed description of team and

services provided by every subspecialty Enhancing the Media publicity Hoardings should be placed in public places (e.g. Railway station,

bus stand) Can add pamphlet/booklet (about services provided with subsidies)

with discharge summary Pamphlets with greetings for treating physicians/ophthalmologists

in surrounding districts about services we offer for referring patients

Establishment of chain of hospitals under the brand name of” Sadguru”

My life time experience

Strategies

In house/external training has to be conducted for paramedical staff (e.g. Optometrist workshop and conferences)

World diabetes day celebration to create awareness w.r.t Diabetic Retinopathy.

Camps organized in surrounding areas for identifying treatable retinal disorders

Monthly internal clinical audit :

External audit : within every 6month

All major disease protocols along with all relevant clinical and non-clinical protocols has to be documented and implemented

Proper training and development programmes for all cadres of Human Resource.

Information Brochures / Pictures has to be prepared.

Incorporation of Consent Forms.

Consultant Panel should be established as per OPD Schedule.

There should be Waiting Lounge with pictures of Retinal Disorders

Key strategies to address weakness

My life time experience

Strategies:

LED should be placed for Demonstration of video related to retinal disorders and services available

Counselors should be hired who are esp. trained in demonstrating Retinal Disorders (Can be Paramedical Staff)

Follow-up : special emphasis on follow –up and its importance Establishing Sadguru Eye Museum for promoting our Hospital and Utilizing

the waiting time of the patients. Organizing Nukkad Natak Review of training of long term comprehensive and long term retina fellows

(Review of complication rate/ OPD performance) Increased space* ( Depending on the shifting of OPD section to new building will be done ) Patient waiting lounge with pictures/LED screen/information brochures

Plan for adding newer surgical /clinical procedures like AUTOFLOURESCENCE IMAGING,ICG IMAGING, Intravitreal ozurdex and lucentis (routinely),Patterned lasers (PASCAL),Sx with use of keratoprosthesis

My life time experienceHow do you visualize SNC and your department by the year 2020

• SNC:• “ Center of Excellence”

• NABH Accredited first eye hospital in central India.• The most renowned Eye Care Institution in India and overseas

and Get collaborated with the international giants.

• Vitreo-Retina Department: • One of the most vital efficient and renowned department.

(People should come at the name of Retina Dept. in SNC)• Benchmark in No. of Retinal surgeries done and the most

trusted institute for the fellowship training aspirants in national and international front.

• “Intellectual pool” with respect to research and publications.

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Thank you