Condemnation & Disposal: 2020

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Purchase Procedure: 2020

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Equipment Maintenance: 2020

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Equipment Management: 2020

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Inventory Control: 2020

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Material Management: 2020

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Financial Record Keeping: 2020

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Financial Audit: 2020

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Health Marketing: 2020

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Health Economics: 2020

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Hospital Financial Management: 2020

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Hospital Budgeting: 2020

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Hospital Cost & Costing: 2020

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Hospital Cost Containment: 2020

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TRANSACTIONAL ANALYSIS: 2020

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Johari Window: 2020

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BEHAVIOURAL CHANGE COMMUNICATION: 2020

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Communication : 2020

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Managing Conflict: 2020

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Leadership: 2020

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Motivation: 2020

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Human Resource Management: 2020

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Human Resource Planning: 2020

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Human Resource Development: 2020

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Organizational Design: 2020

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Change Management: 2020

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Management Technique: 2020

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Principle and function of management: 2020

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HOSPITAL TOTAL QUALITY MANAGEMENT: 2020

Rapid Advance in Health care sector with development of new technology in treatment, operation and modern investigation equipment and peoples knowledge and concern for better facilities has compelled the health institution to flash back in to their system og management of patients.
Over and above the promulgation of CPA act, increase in medical tourism and sensitive media has compelled to look in to their quality system.
Stiff competition in the field of treatment and market management of health has driven all hospitals to ensure full patient satisfaction has resulted in the drive of accreditation of hospitals.
The overall objective is to provide good patient care up to their level of satisfaction.
There is only one answer to this --- developing a carefully planned  hospital quality management system.
The presentation focuses on some areas which helps in maintaining quality in different areas of the hospital as well as to improve the quality function

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BMW MANAGEMENT: 2020

There are three chapters which are related to epidemiology in contest to hospital.
These are ‘BMW’, ‘HIC’ and ‘House Keeping’
In this chapter we will discuss about ‘BMW’.
What is BMW? It is not the BMW car but ‘Bio Medical Waste’. It is the waste containing living cells which is generated in a hospital or laboratory having the potential of spreading infection.
How handling of such waste through a thought ful planning and implementation by a hospital in compliance to ‘BMW Rule’ is called its management.
Hospitals have the potentials of generating a large quantity of such waste on daily basis which needs to be scientifically segregated, collected and disposed off daily to prevent infection.
Therefore to ensure safety of staff, patient and the environment the Govt. has notified ‘Bio medical waste (‘Management & Handling rule’ 1998), under Environmental protection act 1986.
What is Biomedical waste, there classification how it is segregated, collected and to be disposed off have been presented in short in this presentation of ‘Bio Medical Waste Management’.

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Patient Safety: 2020

While Hippocrates, the “father of medicine”, lived in the early 5th century B.C., the famous oath that bears his name emerged a century later. No one knows who first penned it. This oath ethically binds  all the practitioners of modern medicine.
One component of this oath is “I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice”
The discipline of patient safety is the coordinated efforts to prevent harm to patients, during the process of health care itself.
It is generally agreed upon that the meaning of patient safety is…“Please do no harm”
Improving Patient Safety means,  reducing patient harm.
Though the concept of doing no harm to the patient was embedded in the Hippocratic Oath it self , no much concern was shown by the hospitals, though Hospitals were founded to give care to those who need it and to keep patients safe is their moral duty .
The first effective initiative in this regard was started by World Health Alliance (WHA) in Jan 2002  

• In May 2002 – resolution adopted by 55th World Health Assembly
• In May 2004 – WHA support establishing World Alliance for Patient Safety

The principles of patient safety were adopted from the air safety of Aviation industries.

Further with the leadership of WHO, the Patient safety concern became a major issue by all nations in Health sector And various safety measures are initiated by hospitals to reduce harm to the patient by implementing the WHO guidelines. 

In the presentation, a summary of initiatives to be taken by hospitals in different areas for patient safety have been described for the knowledge, practices and implementation of patient safety initiative by hospital managers/Administrators.

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HOSPITAL FIRE MANAGEMENT: 2020

A complete disaster plan needs to be prepared for fire management in the hospital

It is activated when the hospital buildings are affected in fire disaster. Action plan should clearly mention:

•  Alternate site (dharmashala,Temple,Schools,Playground nearby)
•  Stoking of Folding tents, cots, trolleys for temporary shelters
•  Identify a nearby tent house to provide beds, blankets in need 
•  Transport for transportation of cases to alternate sites or hospital
•  First aid and drug kits, portable lights.
•  Portable communication system.
•  Identify local voluntary organization, who can provide services of care, food and water.

There are basically two types of fire management systems.

1. Central
2. Local

Central system comprises of Water tank, water hydrants, connecting pipes water sprinklers, smoke detectors and fire alarms.

• The local system comprises of fire extinguishers, and fire fighting equipments
• The staff is regularly trained to use these equipments.
• Fire protection should be incorporated in the building plan it self
• The “National Building Code of India”, 1980, issued by the Indian Standards Institution, serves as excellent references to safety management for infrastructures.

There should be standard procedure for detection, communication and evacuation in case of fire. The presentation provides an outline about the fire control management and how to act in case of a fire disaster.

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DISASTER MANAGEMENT: 2020

W.Nick carter defined disaster as:

“An Event, Natural / Manmade, Sudden/ Progressive, which impacts with such a severity, that the community has to respond taking exceptional measures.”   

It can also be called as a phenomenon involving extensive ecological disruption leading risk to life, property and health to an extent warranting extra ordinary response from outside the affected area.

When a Disaster takes place it is the expectation of the public that the public authority should immediately respond with adequate support and rescue measures.

This required disaster preparedness based on a scientific, feasible and effective disaster action plan and regular practices.

To make it more effective it requires capacity building of local people to face such a situation boldly with locally available resources till the outside help reaches them.

Tackling a disaster is not only the responsibility of the Public authority, the local people equally should join hands to meet the challenge with a team effort.

The presentation provides a birds eye view of the type of disasters, how to get prepare and manage the effects of disaster, at the site and at the hospital. It also describes the actions to be taken post disaster.

Hope this will guide the administrators to prepare a good disaster plan and effectively deal with such a situation.

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HEALTH CARE ASSOCIATED INFECTION : 2020

Healthcare-associated infections are infections that patients acquire during the course of receiving healthcare treatment for other conditions Healthcare-associated infections (HAIs) are infections caused by a wide variety of common and unusual bacteria, fungi, and viruses during the course of receiving medical care.

Healthcare-associated infections (HAIs) are a major cause of morbidity and mortality around the world. An estimated 6 million healthcare-associated infections occur each year across the United States, Europe and Japan alone.* The Centers for Disease Control and Prevention estimates there are 1.7 million infections resulting in approximately 99,000 deaths annually in the United States, making healthcare-associated infections the fourth leading cause of death

Globally HAI continues as major problem.

Approximately 1 out of every 20 hospitalized patients will contract an HAI.(CDC)

Antibiotic resistant organisms  are growing day by day.

• USA: Up to 2 million healthcare-associated infections per year, of which 80,000 are lethal or may contribute to death (3)  
• Europe: 5 million HAI per year, of which 50,000 (1%) are lethal and contribute to death in 135,000 cases (2.7%) (4)  
• Japan: Resistance Isolation Rate of MRSA (methicillin-resistant Staphylococcus aureus): 40-80%  
• India: An estimated 10 to 30% of patients admitted to hospitals and nursing homes acquire a nosocomial infection (5)  
• Up to 70% of organisms causing HAI are resistant to at least one antibiotic (6) (www.biomerieux-diagnostics.com/upload/HAI_KeyFigures.pdf)

In view of above Hospital infection control stands as a major challenge to the Hospital Administrator’

The presentation describes in brief, what is healthcare  associated infection, how it spreads, and how to control it for present and prevent it in future.

 

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IN PATIENT SERVICES AND WARD DESIGNING: 2020

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MEDICAL AUDIT: 2020

Audit is a systematic and critical appraisal of the planning, delivery and evaluation of service/s in terms of efficiency, effectiveness and quality, within given resources.

It is an important component of Quality Assurance system of any organisation or service. Clinical Audit is a quality improvement process that seeks to improve patient care and outcomes through systematic review of care of health care team against explicit criteria and the implementation of change. 

"Medical Audit" is a component of clinical audit and a planned  review programme which objectively monitors and evaluates the clinical performance of all practitioners, by review and evaluation of selected clinical records by qualified professional personnel to identify, examine, or verify the performance using established criteria.

There by identifies opportunities for improvement, and suggests mechanism through which action is taken to make and sustain those improvements. The systematic critical analysis of the quality of medical care, including the procedures used for diagnosis and treatment, the use of resources and the resulting outcome and quality of life for the patient. The presentation gives an idea of different types of clinical audit and hoe to perform such type of audits to sustain the quality of performance

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Antibiotic Policy: 2020

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HOSPITAL PHARMACY: 2020

Pharmacy is an important supportive component of hospital services. Each hospital has a pharmacy unit to provide drugs to in-patients, outpatient and in emergency.

Pharmacies are premises licensed for retail sale or supply to the hospital, which have qualified licensed persons and indulged in compounding of drugs.

Pharmacy can only be opened under pharmacy act 1948, amended from time to time. It needs a License from Drug controller to open a pharmacy.

The pharmacy is responsible for providing safe medication to the patient by technically qualified trained pharmacists.

Hospitals can have their own pharmacy or run through a contract in the hospital premises. Planning of the pharmacy starts with the planning of different hospital services.

The following presentation discusses the important aspects of planning and organization of pharmacy in the hospital.

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Quality Control In Lab: 2020

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BLOOD TRANSFUSION SERVICES : 2020

Blood has been classified as a drug like any other drug. As a drug blood is more dangerous than narcotic drugs as it is transfuse directly in to circulation.
Though blood saves life of a person in need it can take the life instantly, if it does not match with the blood type of the patient. Therefore blood has to be safe, free from all infections and compatible to recipient blood .

• Blood is the life line of all living organism.
• Once the blood flow  is stopped  the organism is dead.
• Blood is a product not available to purchase from market.
• One individual has to donate blood for others need.
• Collection of blood from one individual and putting in to
•  the body of other is called transfusion.
• Blood needs to be collected and safely stored to be used in emergency.
• The collection , storage, distribution needs to be done in a safe environment.
• That’s why the blood transfusion service is so important

Therefore it needs a well organised blood transfusion service. The objective of this service is to provide “Safe Blood’ to the patient in need. It needs careful planning, organizing keeping in mind the safety and quality of blood.

This service is available to them who has a valid lisence from State Drug Controller. The ‘Blood Transfusion Services’ has been presented in two parts:-

1. Planning and Organization of services
2. Quality and Risk management. 

 

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PLANNING AND ORGANISATION OF IMAGING SERVICES: 2020

Several accidental coincidences lead to the discovery of X- rays by Wilhelm Conrad Roentgen in the year 1895. Since then a long-long way has been covered in this field. No medical science has seen such rapid change as Radiology, especially in the past few decades.

At the same time, No medical science has met the challenge as Radiology to move forward in an era of rapid change in medical technology. Because of these rapid changes in the field of imaging, the Radiology department has got the new name of Imaging department. With rapid change in investigation technology, there is a continuous changing demand in the field of radio diagnosis and imaging service.
Resulting in an advanced, and  detailed systematic planning and organizing.

The major components of Radiology/ Imaging services are:-

1. X- ray Machines
2. Ultrasound Machine
3. Doppler Machine
4. Computer assisted Tomography (CAT Scan)
5. Magnetic Resonance Imaging  (MRI)
6. Position Emission Tomography (PET)
7. Mammography
8. Nuclear Imaging System

To manage such large number of sophisticated machines whose rays/emissions are hazardous to humane population calls for a critical planning taking in to consideration the safety aspect of patient , public and the department staff.
The following presentation shows some important aspects of planning and organizing of Radiology department of a hospital.

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HOSPITAL LAB SERVICES: 2020

Laboratory services are essential to health care delivery. The hospital lab offers the convenience of local service, and familiarity with both the outpatient and his physician. They address both preventive and curative activities, i.e. patient diagnosis, and the selection of drugs for treatment. They are also an indispensable tool in the surveillance and control of diseases. Improved disease recognition will improve the accuracy of statistical reporting, and thus effective national health planning.

The Lab services are broadly divided in to three categories

1. Clinical Lab
2. Pathological Lab
3. Public health lab

Clinical labs are attached to various clinical departments such as:-

1. Cardiac Lab
2. Respiratory Lab
3. Neurology Lab
4. Psychiatric Lab and so on

Pathological Lab comes under one deptt. of pathology having various branches such as:-

1. Hematology
2. Bio- chemistry
3. Microbiology
4. Cytology
5. Histo pathology and so on.

Public Health Lab:
These Lab are responsible for providing promotive and preventive services in the community such as:

1. Water quality tests
2. Sewerage contamination level and effluent levels
3. Vector density and measures like Fogging, spraying etc.

The presentation describes about the planning and organization of a pathology Lab in a hospital.

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DISABILITY AND REHABILITATION APPROACH: 2020

While discussing about 4th stage of disease prevention we have discussed about disability limitation and rehabilitation. Disability is the dysfunction of any part of the body or mind leading to difficulty in performing one or more activities.

This may involve various body systems/parts and may be of various degrees.
Disability may be caused by various pre disposing factors and diseases.
To prevent disability one must be aware of these factors and if disability occurs how to rehabilitate such persons.

It is therefore essential for all hospital administrators to know about the causes and how to prevent them so as to ensure creating such facilities for rehabilitation, and disable compliance facilities, in the hospital structure planning.

All hospitals should be disability friendly, to ensure easy movement of disable patients. The presentation arrives at a solution to the all above disability issues to serve as a guide line.

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