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JAYPEE JOURNALS
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1.  ORIGINAL ARTICLE
Policies and Procedures for Sound-alike and Look-alike Medications
Sheetal Singh, Angel R Singh
[Year:2017] [Month:January-June] [Volume:5 ] [Number:1] [Pages:53] [Pages No:15-20] [No of Hits : 952]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10035-1071 | FREE

ABSTRACT

The sound-alike and look-alike (SALA) drug is one of the most common causes of medication error and is of fear globally. Thus, the probability for error due to confusing drug names is very high. The SALA drug names have become a significant challenge to pharmacists, nurses, patients, and doctors . With thousands of drugs currently on the market, the probability for error is significant. The purpose of this article is to formulate a policy that would help in minimizing medication errors arising with the use of SALA medications.

Keywords: Medication errors, Medication management, Patient safety, SALA medications

How to cite this article: Singh S, Singh AR. Policies and Procedures for Sound-alike and Look-alike Medications. Int J Res Foundation Hosp Healthc Adm 2017;5(1):15-20.

Source of support: Nil

Conflict of interest: None

 
2.  ORIGINAL ARTICLE
Accreditation is not a One-time Process: Quality Assessment of Intensive Care Unit during Post-NABH Accreditation Period in a Tertiary Care Hospital
VK Tadia, Monalisa, Suneeta Dubey
[Year:2017] [Month:January-June] [Volume:5 ] [Number:1] [Pages:53] [Pages No:29-41] [No of Hits : 686]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10035-1073 | FREE

ABSTRACT

Accreditation is an integral part of quality and it is not a onetime process. This study was done to know the extent to which hospitals maintain the standards after obtaining accreditation. This study tries to find out the gaps in standards during the postaccreditation period. The objective of the study was to assess the policies of the intensive care unit (ICU) with reference to standard protocols of the National Accreditation Board for Hospital and Health Care Providers (NABH) and measures taken by the management to maintain the standards. Data was collected from a 285-bedded NABH-accredited hospital that had five ICUs and four recovery rooms by means of nonparticipant observation, semistructured interviews. Data on indicators was collected by using the hospital management information system; the questionnaire on satisfaction was filled by 30 patients/relatives who were admitted in the ICU for more than a week. Quality team was interviewed to know the perception of the management toward quality and accreditation. To know the compliance of the staff to the NABH standards, a surprise check was done in three ICUs of the hospital.
Data analysis showed that the organization was not able to maintain the standards, as it had done at the time of accreditation. The quality team strongly accepted that accreditation helps in maintaining and improving quality, whereas the data from ICUs showed a wide variation in compliance. Three ICUs from the same hospital were having different compliance rates for standards, which shows that staff was not aware about the standard protocol to be followed. The patient-satisfaction questionnaire also showed that the patients were not satisfied with the services given.

Keywords: Accreditation, Continuous quality improvement, Postaccreditation, Quality.

How to cite this article: Tadia VK, Monalisa, Dubey S. Accreditation is not a One-time Process: Quality Assessment of Intensive Care Unit during Post-NABH Accreditation Period in a Tertiary Care Hospital. Int J Res Foundation Hosp Healthc Adm 2017;5(1):29-41.

Source of support: Nil

Conflict of interest: None

 
3.  ORIGINAL RESEARCH
Patient Satisfaction in Tertiary Private Hospitals in Najran, Kingdom of Saudi Arabia
Jordan H Llego, Mohammad O Al Shirah
[Year:2017] [Month:January-June] [Volume:5 ] [Number:1] [Pages:53] [Pages No:42-46] [No of Hits : 615]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10035-1074 | FREE

ABSTRACT

Aim: This study is aimed to assess the level of satisfaction of patients in tertiary private hospitals in Najran, Kingdom of Saudi Arabia.

Materials and methods: This study used descriptive crosssectional design through a survey questionnaire.

Results: A great majority (57%) of respondents are male. Almost half (46.7%) of the respondents are 26 to 35 years old, some (30.3%) are more than 35 years old. The majority (54.5%) of hospitalized patients are married. Some (35.8%) of them reached the secondary level and some (31.5%) completed college. A great majority (57.6%) of the respondents’ salary was below 5,000 SR. A great majority pay their hospitalization by themselves (60.6%). Mean scores revealed: For facilities, the mean was 4.12, standard deviation (SD) = 0.85. For general services, the mean was = 4.13, SD= 0.77. The physician services scored mean = 4.06, SD= 0.88. The highest level of satisfaction according to mean is nursing services with mean= 4.22, SD= 0.80 and the lowest among the variables is convenience with mean= 4.05, SD= 0.84. The overall level of patient satisfaction with the services they received indicated by the mean is 3.91, SD= 1.1.

Conclusion: Researchers conclude that patients catered by the private tertiary hospitals in Najran Saudi Arabia are more of males, at middle adulthood, and are married who reached the secondary level and have an income of below 5,000 SR and have no health insurance. The level of satisfaction of patients in the private tertiary hospitals is satisfactory and that nursing service has the highest satisfaction level, which is very satisfactory.

Clinical significance: The findings of this study are beneficial to the success of the organization. A patient who is satisfied will spread his experience to other people. A satisfied patient will also equate to return of investment. Meeting satisfaction of patients will also decrease the risk of malpractice lawsuits.

Keywords: Malpractice lawsuits, Patient satisfaction, Tertiary private hospitals.

How to cite this article: Llego JH, Al Shirah MO. Patient Satisfaction in Tertiary Private Hospitals in Najran, Kingdom of Saudi Arabia. Int J Res Foundation Hosp Healthc Adm 2017;5(1):42-46.

Source of support: Nil

Conflict of interest: Noen

 
4.  ORIGINAL RESEARCH
Analyzing Competencies of Indian Health Care Leaders: Way Forward for Next Generation
SK Patnaik, Shakti K Gupta, S Kant, R Pillay
[Year:2017] [Month:January-June] [Volume:5 ] [Number:1] [Pages:53] [Pages No:47-53] [No of Hits : 567]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10035-1075 | FREE

ABSTRACT

Introduction: Indian health care is experiencing a paradigm shift in terms of requirement of resources and changing demographic patterns. The customer-oriented and quality-conscious competitive environment has intensified the need for health care organizations to attain higher levels of organizational performance. Competencies of health care leaders play a pivotal role in deciding the organizations’ way forward and competencies are the cornerstone of organizational performance and quality standards. A cross-sectional study of select health care leaders of India was done from various hospitals and other health delivery agencies to identify and analyze the gaps in competencies.

Materials and methods: A cross-sectional study was planned amidst health care leaders of India so as to assess their leadership competencies. Health care leaders of India were identified after focused group discussion and senior health care leaders, such as directors, deans, CEOs, and principals were shortlisted for this study. Two structured questionnaires were administered to health care leaders of various hospitals in India. The ratings in the questionnaire were on a Likert scale ranging from very poor to excellent. Respondents were asked to self-evaluate various competencies and the same were analyzed using Statistical Package for the Social Sciences statistical software. Interpretation of results of data analysis was done.

Results: A total of 300 questionnaires were sent of which 106 questionnaires were completed and returned by select health care leaders. About 78 were doctors and 28 were nursing executives. The study has been able to identify deficiencies in the perceived “existing competency” and “required competency” levels in the selected competencies.

Conclusion: The findings of this study suggest that there is deficiency in perceived “existing competency” and “required competency” levels in the selected competencies of health care leaders. Indian health care leaders are operating at operational levels and have not graded themselves highly in transformational roles. There is a need for training to bridge the competency gap of Indian health care leaders.

Keywords: Accountability, Competencies, Health care, Health leaders, Medical technology, Process management, Strategic orientation.

How to cite this article: Patnaik SK, Gupta SK, Kant S, Pillay R. Analyzing Competencies of Indian Health Care Leaders: Way Forward for Next Generation. Int J Res Foundation Hosp Healthc Adm 2017;5(1):47-53.

Source of support: Nil

Conflict of interest: None

 
5.  ORIGINAL ARTICLE
Comparative Analysis of Cost of Biomedical Waste Management in Rural India
Bryal D’souza, Arun MS, Bijoy Johnson
[Year:2016] [Month:January-June] [Volume:4 ] [Number:1] [Pages:50] [Pages No:11-15] [No of Hits : 1632]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10035-1053 | FREE

ABSTRACT

Introduction: The quantum of waste generated from medical care and activities is a global matter of concern. Improper management of biomedical waste (BMW) has a grave health impact on the community, health care professionals, and the environment.1 It is mandatory by law that every medical organization that generates waste should have a system, process, and resources in place for segregating BMW within the organization for proper disposal. The present article deals with the understanding of various costs associated in BMW management process that will help the health care organization to prioritize their spending and focus on areas that require spending to achieve compliance in process of BMW management.

Materials and methods: Descriptive cross-sectional study was carried out, to study the compliance of BMW management at three different hospitals with respect to Bio-Medical Waste (Management and Handling) Rules, 2011. A retrospective study was conducted to analyze cost data for a 1-year time period. Cost involved in BMW management was analyzed and classified as capital and recurring costs. The study was undertaken in Udupi taluk, and the taluk comprises 11 hospitals (1 Government and 10 private hospitals). The hospitals were selected using convenient sampling as taking permission to conduct the study was difficult. Only three hospitals were permitted to carry out the study.

Results and discussion: Compliance was found to be better in accredited hospital than in nonaccredited hospital. This could be attributed to strict adherence to standard operating procedures and regular training of staff. Cost involved in BMW management was analyzed as capital and recurring costs. Since most of the hospital outsource final disposal, capital costs are significantly less compared to recurring costs. Among the recurring costs, maximum expenditure is on consumables like color-coded bags. Cost per bed per day for handling BMW was calculated and it was found to be higher in smaller hospitals.

Keywords: Biomedical waste, Cost analysis, Health care waste, Medical waste.

How to cite this article: Bryal D’souza, Arun MS, Johnson B. Comparative Analysis of Cost of Biomedical Waste Management in Rural India. Int J Res Foundation Hosp Healthc Adm 2016;4(1):11-15.

Source of support: Nil

Conflict of interest: None

 
6.  ORIGINAL ARTICLE
Why switch to Rental? Costing of Laundry Services at an Apex Tertiary Care Hospital from the View of Outsourcing based on Rental Linen Management Services
VK Tadia, SK Gupta, SK Arya, A Lathwal, K Jain, R Ahlawat
[Year:2016] [Month:July-December] [Volume:4 ] [Number:2] [Pages:66] [Pages No:79-88] [No of Hits : 1593]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10035-1064 | FREE

ABSTRACT

Introduction: Modern hospitals are matrix organizations with a high investment in terms of capital, labor, and resources. It is imperative for the hospital administration to provide right material of right quality at the right time. Hospitals that set up in-house laundry operations generally make the decision without thoroughly identifying and accounting for total linen and laundry costs. Now evidence has emerged that hospitals that outsource were seeing improved linen utilization rates. If proper and clean linen is not provided, this can result in patient dissatisfaction. Further, innovations in laundry equipment have led to tremendous increases in efficacy. So, there is a need to ascertain the cost incurred in providing linen and laundry services so as to gauge the plausibility of transitioning to outsourcing-based models.

Aims and objectives: To study the cost incurred in providing linen and laundry services at an apex tertiary care hospital and to evaluate outsourcing model based on rental linen management.

Materials and methods: A descriptive, cross-sectional, retrospective, record-based study was conducted during a period of 1 month from March 1, 2016 to March 31, 2016.

Observations: The quantity of monthly linen washed in Dr Rajendra Prasad Centre was found to be 22,465 kg. The monthly laundry expenditure in Dr RP Centre was Rs. 1,415,295. The linen procurement expenditure per month at Dr RP Centre was Rs. 419,386. So total expenditure on linen and laundry per month at Dr RP Centre was Rs. 1,834,681. Thus, cost/kg (with inclusion of linen cost) was Rs. 82.

Discussion and conclusion: The rate quoted by a leading vendor to supply washed, sterilized linen to the hospital was Rs. 55 per kg. Since the expenditure incurred per kg at Dr RP Centre was Rs. 82, this amounted to a saving of around Rs. 27 per kg. It would mean saving of around Rs. 606,555 per month and Rs. 7,278,660 per annum. So, it was recommended that rental linen management services may be hired for Dr RP Centre after taking care of functional, operational, and strategic contingency.

How to cite this article: Tadia VK, Gupta SK, Arya SK, Lathwal A, Jain K, Ahlawat R. Why switch to Rental? Costing of Laundry Services at an Apex Tertiary Care Hospital from the View of Outsourcing based on Rental Linen Management Services. Int J Res Foundation Hosp Healthc Adm 2016;4(2):79-88.

Source of support: Nil

Conflict of interest: None

 
7.  ORIGINAL ARTICLE
A Small Nudge can make a Difference: Impact of Passive Feedback on Prescription Behavior
VK Tadia, R Ahlawat, SK Arya, DK Sharma
[Year:2016] [Month:January-June] [Volume:4 ] [Number:1] [Pages:50] [Pages No:31-34] [No of Hits : 1352]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10035-1057 | FREE

ABSTRACT

It is generally believed that big changes can be brought about by big interventions. Sometimes, small interventions also can show spectacular results. This case describes the impact of simple intervention, audit and feedback on change in the behavior of clinicians. In this case, the impact of simple intervention in the form of passive feedback has been documented. All the prescriptions received in pharmacy during the period of study were scrutinized for specific prescription errors. An overall error rate of 0.12% was observed in phase 1 of the study, which was reduced to 0.04% during phase 2 of the study after implementation of the intervention, which further dropped to zero during phase 3. It was concluded that a simple audit and feedback nudged the recipients of the feedback to modify their behavior.

Keywords: Audit, Feedback, Nudge, Passive feedback, Prescription behaviour.

How to cite this article: Tadia VK, Ahlawat R, Arya SK, Sharma DK. A Small Nudge can make a Difference: Impact of Passive Feedback on Prescription Behavior. Int J Res Foundation Hosp Health Adm 2016;4(1):31-34.

Source of support: Nil

Conflict of interest: None

 
8.  ORIGINAL ARTICLE
Incidence of Patient Identification Errors observed before Medication and Procedure/Intervention.
Ritwik Chawla, Saakshi Kaushik
[Year:2016] [Month:July-December] [Volume:4 ] [Number:2] [Pages:66] [Pages No:100-106] [No of Hits : 1330]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10035-1066 | FREE

ABSTRACT

Objectives: To identify the number of individuals for whom double identification check was done before administering medication and before procedure/intervention, as per Continual Quality Improvement 3j indicator of National Accreditation Board of Hospitals (4th edition) and hospital policy.

Materials and methods: The study was a concurrent, observational recording of the study population which included doctors/ surgeons, nurses, and/or technicians before administration of any medication and before beginning of any procedure/intervention. The observations were recorded on a prepared checklist to find the compliance of incidence of patients’ double identification.

Results: A total of 34 observations were recorded before administering medication to a patient. In 18 cases, wristbands were not being used, and identification details were incorrect in 4 cases. Of 34 cases, identifiers were illegible in 6 cases. The major area where the error was high was noncompliance to verbal confirmation of identity (ID) and checking it from the patient’s file. Out of 34 observations before a procedure/intervention, 9 errors were identified in cases where the ID band was not used for verification, and identification details on the band were illegible in 5 cases. In six cases, the patient’s name was not verbally confirmed with the patient or carer. Furthermore, in 10 cases, verbally confirmed name was not checked with the patient’s file. Out of 34 cases, double identification was not done in 13 cases.

Conclusion: Many nurses, doctors, and technicians in clinical settings do not verify patient ID before performing a task, resulting in more than one-third of staff not conforming themselves with the double identification procedure. The study also showed that over three-fourths of the total invasive procedures are compliant to double identification. On the contrary, noninvasive procedures showed less than one-fourth compliance to double identification.

Keywords: Band, Compliance, Double identification, Identification, National Accreditation Board for hospitals and health care providers, Wristband.

How to cite this article: Chawla R, Kaushik S. Incidence of Patient Identification Errors observed before Medication and Procedure/Intervention. Int J Res Foundation Hosp Healthc Adm 2016;4(2):100-106.

Source of support: Nil

Conflict of interest: None

 
9.  ORIGINAL ARTICLE
Lead Time in Drug Procurement: A Study of Tertiary Care Teaching Hospital of North India
H Anand, V Siddharth, V Goyal, VK Koushal
[Year:2016] [Month:January-June] [Volume:4 ] [Number:1] [Pages:50] [Pages No:16-19] [No of Hits : 894]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10035-1054 | FREE

ABSTRACT

Pharmaceutical procurement is a complex process that involves many steps, agencies, and manufacturers. Procurement lead time is defined as the time required to acquire the supplies and services and then placing them in the hands of the user. This study was done to study the lead time in drugs procurement at Government Medical College and Hospital, Chandigarh. It was aimed at calculating the average lead time in the procurement of drugs for year 2009-2010 in Pharmacy Department. Observational study along with retrospective record analysis was done to calculate the average internal and external lead time. Standardized format was used to retrieve data from the procurement records. Average lead time between the preparation of indent and receipt of drugs was observed to be 162 days, out of which 117 days (71%) accounted for internal lead time and external lead time was 47 days (29%). Internal lead time was approximately four times that of external lead time. Various reasons were noted for longer duration of internal lead time and every effort should be made to bring it down to the minimum, so as to ensure the availability of the right medicine in the right quantity, in the right time at the right place.

Keywords: Drug Procurement, Lead time, Pharmacy.

How to cite this article: Anand H, Siddharth V, Goyal V, Koushal VK. Lead Time in Drug Procurement: A Study of Tertiary Care Teaching Hospital of North India. Int J Res Foundation Hosp Healthc Adm 2016;4(1):16-19.

Source of support: Nil

Conflict of interest: None

 
10.  ORIGINAL ARTICLE
How Prepared are Hospital Employees for Internal Fire Disasters? A Study of an Indian Hospital
Kasturi Shukla, Priyadarshini Chandrashekhar, Shweta Mehta
[Year:2016] [Month:January-June] [Volume:4 ] [Number:1] [Pages:50] [Pages No:20-24] [No of Hits : 830]
Full Text PDF | Abstract | DOI : 10.5005/jp-journals-10035-1055 | FREE

ABSTRACT

Introduction: In case of internal disasters, such as fire in hospitals, health services to the community are severely hampered with the additional morbidity of victims, such as employees and visitors present when the disaster strikes. Risk assessment and fire preparedness are most crucial proactive measures to prevent fire disasters and minimize the loss in a hospital; however, scanty studies are available on this topic.

Materials and methods: This cross-sectional study was conducted at a multispecialty hospital in Mumbai, Maharashtra (India), during March-April 2014. Fire-Safety Preparedness Framework (FSPF) was designed with four domains (risk and vulnerability assessment, response mechanisms and strategies, preparedness plan and information management) for evaluation of fire safety preparedness of hospital employees. Baseline variables were summarized; instrument was tested for reliability using Cronbach’s alpha and content validity through review by experts. The number of correct responses for each question was further analyzed across the type of employee.

Results: The instrument showed high reliability (Cronbach’s alpha = 0.89, p-value ≤ 0.01) and content validity. A total of 207 employees (mean age 32 ± 8.3 years, 63% females) consented and participated in the study. Out of 20 questions, awareness was high (≥ 90%) only for three questions from “Response mechanism and strategies” domain. For the remaining questions, awareness was moderate to low. The awareness varied highly with the type of employee.

Conclusion: The FSPF is a reliable tool for application in the Indian context for hospital employees. Disaster preparedness training and drill need to involve employees from all departments as awareness levels varied highly with type of employee.

Keywords: Disaster preparedness, Fire safety, Hospital.

How to cite this article: Shukla K, Chandrashekhar P, Mehta S. How Prepared are Hospital Employees for Internal Fire Disasters? A Study of an Indian Hospital. Int J Res Foundation Hospc Health Adm 2016;4(1):20-24.

Source of support: Nil

Conflict of interest: None

 
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