International Journal of Research Foundation of Hospital and Healthcare Administration

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Volume 8, Number 1, January-June 2020
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EDITORIAL

Sunil Kant

Leveraging Technology for Enhancing Medical Research in Healthcare

[Year:2020] [Month:January-June] [Volume:8] [Number:1] [Pages:2] [Pages No:iv - v]

   DOI: 10.5005/jrfhha-8-1-iv  |  Open Access | 

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Original Article

Arushee Bhatnagar, Shakti Kumar Gupta, Narimeti Rakesh, Kshitija Singh

A Study on Prevalence of Firecracker Injury and Outcomes with Demographic Profile of Patients Visiting the Emergency Department of a Tertiary Care Center of North India during the Festive Season of Diwali

[Year:2020] [Month:January-June] [Volume:8] [Number:1] [Pages:6] [Pages No:1 - 6]

Keywords: Diwali, Emergency department, Firecracker

   DOI: 10.5005/jp-journals-10035-1131  |  Open Access |  How to cite  | 

Abstract

Introduction: Avoidable blindness is defined as blindness that could be either treated or prevented by cost-effective or known means. As per the National Programme for Control of Blindness (NPCB), the prevalence of blindness in India was 1.1% in 2001–2002 and 1% in 2006–2007. Aim: To study the demographic and clinical profile of patients sustaining firecracker injuries in the eye during the Diwali festival in the Emergency Department of Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India. Methodology: A self-validated questionnaire was developed after a pilot study for 1 week with a sample of 30 patients. A sample size of 3,374 was taken; of which, 76 patients met the inclusion criterion. The questionnaire had two sections of which the first section describing the demography of patients which was filled by the patient/relative. The other section was concerned with the clinical profile of patients filled by the doctor/nursing staff. The data was analyzed on STRATA 12. Results and observation: Out of 83 patients with eye casualties, 76 patients met our inclusion criteria where 85.11% were males and 14.45% were females. About 93.4% of the affected population belonged to the Hindu religion and 72.37% were residents of Delhi. The age of 10 were below 30.76% and 47.37% belonged to 10–20 year age-group while 3.95% were above 50. Most were bystanders (48.6%) and others were injured (47.3%) by themselves while lighting firecrackers. Major complication observed was the unilateral partial temporary loss of vision (93%) and unilateral permanent complete loss of vision in 1 (1.32%) patient and a bilateral permanent complete loss of vision in 1 (1.32%) patient. Conclusion: Eye injuries (2.3%) due to firecrackers during the festive season of Diwali were males (85.53%), unsupervised children, and teenagers belonging to 10–20 year age-group (47.37%) and the majority were Hindus (93.4%).

244

Original Article

Stuti Verma, Vijay Kumar Tadia, Vikas H, Shakti Kumar Gupta

Analysis of Patient Flow and Workload in the Emergency Service of an Apex Tertiary Care Ophthalmic Sciences Center in India

[Year:2020] [Month:January-June] [Volume:8] [Number:1] [Pages:5] [Pages No:7 - 11]

Keywords: Emergency, Ophthalmic casualty, Patient workload

   DOI: 10.5005/jp-journals-10035-1120  |  Open Access |  How to cite  | 

Abstract

The emergency service is vital for healthcare system in any hospital. We seldom find emergency service that specifically deals in ophthalmic sciences. This study was conducted to analyze the process flow and the workload of patients in the emergency service of a tertiary care ophthalmic center. Aims and objectives: • To study the workload and profile of patients visiting casualty of Dr Rajendra Prasad Centre for Ophthalmic Sciences (RPC), AIIMS, New Delhi. • To study the process flow and workload of patients visiting casualty of Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi. • To analyze the profile of patients visiting casualty of Dr Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi. Materials and methods: A descriptive, cross-sectional, and observational study was carried out for a period of 95 days from December 26, 2017 to March 31, 2018. The medical emergency records were reviewed for a period of 30 days from January 15 to February 15, 2018. The study employed fieldwork case study approach analyzing the triage processes and work practices of clinicians and nonclinicians in delivery of the ophthalmic emergency care. The workflow in casualty was studied and the data were collected using both computerized and paper-based records and forms apart from nonparticipant observations and informal interviews of the staff. • Inclusion criteria: All the patients entering the casualty irrespective of the seriousness of condition or registration done either at the admission counter or ophthalmic outpatient department (OPD) or walk-in patients. • Exclusion criteria: Patients not documented in any form or duplicate records. • Data analysis: Done by the Statistical Package for Social Science (SPSS) software. Observations and results: A total of 1,700 patients had visited the ophthalmic from January 15, 2018 to February 15, 2018. Out of this, 54.21% were registered under casualty registration. Whereas rest (44.03%) were registered in OPD and 1.77% were unregistered and improperly documented cases. The most important finding was that 71.86% patients of the Red Triage category belonged to age group 0–15 years. It was found that 36.76% patients were Green Triage patients belonging to different age groups. It was also observed that 64.18% of the males had attended the ophthalmic casualty and 35.82% female patients belonging to different age groups. About 99.24% cases coming to ophthalmic emergency were non-medicolegal cases (non-MLCs). Conclusion: It was observed that nonemergency patients accounted for maximum workload in ophthalmic emergency. Certain issues during documentation increased the waiting time of the patient in the admission process. The double entry system used by the nurses, initial manual entry in procedure book and later in HIS, leads to prolonged waiting time of patients. Waiting time of casualty patients also prolonged in emergency due to incoming OPD patients and unregistered patients.

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RESEARCH ARTICLE

SMNSM Mallawarachchi, Chandana H Mallawarachchi, Shiranee C Wickramasinghe

Digitalization of Satellite Laboratory System of Base Hospital Warakapola, Sri Lanka

[Year:2020] [Month:January-June] [Volume:8] [Number:1] [Pages:6] [Pages No:12 - 17]

Keywords: Base Hospital Warakapola, Laboratory investigations, Primary level institutions, Satellite laboratory system

   DOI: 10.5005/jp-journals-10035-1117  |  Open Access |  How to cite  | 

Abstract

Introduction: Investigation is a vital component of healthcare. Yet, there are many primary level institutions (PLIs) that do not have the laboratory facilities of their own. Satellite laboratory system (SLS) of Base Hospital Warakapola (BHW) was conceptualized with the aim of offering laboratory facilities for the clients of eight PLIs. The current study aimed to evaluate the impact of digitalization of SLS of BHW. Materials and methods: The process of SLS was extensively studied. The study identified gaps in the process of SLS, BHW (Phase I), implemented the intervention of digitalization of SLS (Phase II), and evaluated the intervention after 3 months (Phase III). Both qualitative and quantitative approaches were used in the study. Patients survey, key informant interviews (KIIs), and desk review of secondary data were the instruments and techniques used. The gaps identified were delay in delivery of reports, errors in transcribing investigation results informed over the phone, poor quality of handwritten reports, and reduced customer satisfaction. The delivery of reports was improved by emailing them to PLIs, which eliminated the requirement of conveying them over the phone. The report was printed at PLIs and issued to patients. The necessary infrastructure facilities to the institutions and training to the staff on use of computers and printers and email were provided. Results: The evaluation of interventions revealed that the availability of reports within 24 hours has improved from 82.19 to 100% significantly reducing the turnaround time of reports. The percentage of reports not collected by patients dropped from 12.92 to 2.87%. The patients’ satisfaction was improved about the availability of reports within 24 hours and convenience in cost and time spent significantly. It was noteworthy that both pre- and post-interventional level clients were satisfied about the trustworthiness of SLS. Both the staff of BHW and PLIs expressed their satisfaction with the interventions and improved turnaround time of reports. In conclusion, the project identified the gaps in the process of SLS and was able to overcome them with the interventions. The improvement in the process leads to enhanced efficiency of the SLS.

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RESEARCH ARTICLE

Pamleila N Ntwiga, Maina Muchara, Peter Kiriri

Influence of Patient Focus on Competitive Advantage within the Hospitals in Nairobi, Kenya

[Year:2020] [Month:January-June] [Volume:8] [Number:1] [Pages:6] [Pages No:18 - 23]

Keywords: Hospital, Patients’ satisfaction, Quality improvement

   DOI: 10.5005/jp-journals-10035-1116  |  Open Access |  How to cite  | 

Abstract

The study examined the influence implementing patient focus has on competitive advantage in hospitals within Nairobi. The study sought to determine the influence patient focus has on competitive advantage within the hospitals in Nairobi. The study looked at the following aspects of patient focus: Reliability, empathy, responsiveness, and staff attitude assurance. While the constructs for competitive advantage were patient satisfaction, employee satisfaction, and operations effectiveness. The study was guided by positivism philosophy and adopted a descriptive correlational research design that entailed testing of hypotheses. The study was limited to both private and public hospitals, within Nairobi, targeting patients, who were admitted in these hospitals for more than 3 days during the study period and senior employees of the same hospitals. The sampling frame for the participants was the senior and clinical administrative staff and the patients or their relatives within the period of study. Simple random sampling was used to select the hospitals of study. While stratified random sampling was used to select the patients. The study collected primary data using self-administered open- and close-ended questionnaires. The collected data were coded into SPSS Version 23 software and the analysis was performed using descriptive and inferential statistics. The findings were presented using tables and figures. The findings illustrated that patient focus significantly influenced competitive advantage. High responsiveness and good attitude, being reliable and empathy and assuring the patients of their state best enhance patients’ and employee satisfaction that led to competitive advantage.

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RESEARCH ARTICLE

Sathish Raju Nilakantam, Melanahalli Dayananda, Jayati Bahuguna

Streamlining the Process of Communicating and Reporting of Hospital Operations by Using Checklists as a Quality Improvement Tool: An Experience of Designing and Implementation at a Large Multispeciality Tertiary Care Teaching Hospital

[Year:2020] [Month:January-June] [Volume:8] [Number:1] [Pages:8] [Pages No:24 - 31]

Keywords: Checklists, Healthcare, Implementation, Quality improvement

   DOI: 10.5005/jp-journals-10035-1119  |  Open Access |  How to cite  | 

Abstract

Introduction: Checklists used in hospitals and healthcare organizations can promote process improvements and increase hospital, employee, and patient safety and can be implemented anywhere in the hospital, whether it is to show adherence to a protocol or to ensure that a certain set of duties are being completed daily. Even with the apparently quick acceptance and dissemination of the checklists, there are limited researches depicting the definite methods of creating and implementing such tools in health care. Aim: The aim of this study is to explore the experiences from checklist development and implementation in a group of three vital departments of the hospital—Medical Records Department, Central Sterile Supplies Department, and Department of Nursing Services. Materials and methods: Execution of customized version of checklists in the three following departments was planned, i.e., Medical Records Department, Central Sterile Supplies Department, and Department of Nursing Services, and after ensuring the changes made after pilot testing were valid, training programs for all the staffs of those three departments was planned, and the checklists were implemented using Plan-Do-Study-Act (PDSA) cycle. Conclusion: Checklists development involves a comprehensive, efficient and systematic approach, especially when implemented in high intensity fields for example the medical field. The checklists will help hospitals and healthcare systems in their endeavors to prevent and lessen preventable errors, which are the ultimate objectives of any healthcare organization.

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RESEARCH ARTICLE

Nivedita Tayal, Sanjeev Bhoi, Jacinta Gunjiyal, Kripal Kaur

Impact of a Structured Nursing Training Program on Self-perceived Competence of Newly Appointed Nurses at Apex Trauma Center in Northern India: A Prospective Observational Study

[Year:2020] [Month:January-June] [Volume:8] [Number:1] [Pages:4] [Pages No:32 - 35]

Keywords: Competence, Effectiveness, New graduate nurses, Structured training program

   DOI: 10.5005/jp-journals-10035-1122  |  Open Access |  How to cite  | 

Abstract

Background: New graduate nurses require an induction program to improve their clinical skills and build confidence during their transition from education to practice. Objectives: To evaluate and compare self-perceived clinical competence among new nursing staff before and after training program. Settings: Apex Trauma Centre in Northern India. Study design: A prospective observational study. Intervention: New graduate nurses joining the institute during study period underwent a comprehensive training module to enhance their skills and confidence. A 20-item validated questionnaire was offered to participants for self-evaluation of their skills before and after receiving the training. Competence level of each nurse was computed by adding score of individual items in questionnaire. Results: A total 136 newly joined nurses underwent training program during study period, of whom 120 participated in the study. There was a significant improvement in all 20 domains of clinical and housekeeping skills after the induction program (all p values < 0.01). Before induction program, less than two-thirds of the staff were confident about competence in key clinical skills. After induction more than 85% of attendees were confident about necessary skills. Conclusion: In our study, the induction by critical care training program was effective in promoting confidence and clinical competence of new nurses.

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COMMENTARY

Subhrojyoti Bhowmick, Partha S Chattopadhyay, Niloy Sarkar, Sudipta Bhattacharya, Sinchan Bhattacharya, Sujit Kar Purkayastha, Krishnangshu Ray

Task Force Approach to Manage the COVID-19 Pandemic in Private Hospitals in India

[Year:2020] [Month:January-June] [Volume:8] [Number:1] [Pages:3] [Pages No:36 - 38]

Keywords: COVID-19, Democratic approach, Eradication, Global health, Socialization, Swine flu, Task force

   DOI: 10.5005/jp-journals-10035-1121  |  Open Access |  How to cite  | 

Abstract

The novel coronavirus (COVID-19) pandemic has gripped the whole world. It was originated in the Wuhan Province of China in December 2019. The World Health Organization confirmed it to be a global healthcare emergency a month later. Gradually, it has spread its tentacles all over the world, and everything is in a virtual standstill after most countries including India issued nationwide lockdown. With hundreds of thousands of confirmed cases and increasing number of related deaths, the situation calls for immediate and specialized management. Task force is a comprehensive mechanism of dealing any serious issues. The concept of task force can be particularly helpful in this trying scenario. The task force consists of specialized personnel and dedicated team for countering similar adverse situation. It has shown fruitful results since the Second World War, eradication of smallpox, and more recently during the fight against swine flu epidemic, among others. In this article, we are stressing on the advantages of using task force in healthcare sector for countering the COVID-19 pandemic. It is suggested in the article that by implementing the task forces in hospitals and healthcare institutions, the handling of the disease would be more robust and eventually the mortality rate would subside over time.

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