Projects

INTRODUCTION The issue of noisy ICU is prevalent in most of the clinical setups. The most common manifestation is in the form of irritation/sleeplessness of patients which in turn results in requests or sometimes demands for shifting out of ICU. It is not uncommon especially in elderly to observe science of psychosis also who have stayed in ICUs for longer time. Thefeedbacks from patients and attendants pointed towards the problem of alarm sounds being one of the commonest culprits. Secondly it was observed while interacting with nursing staff and taking their opinion on working conditions in ICU’s that most of them develop anxiety and sleeplessness due to excessive alarm sounds. Keeping these factors in mind upper management decided to take up this project for well being of ICU patients and staff. Project team comprises of Nursing team(Unit head nursing and Selected ICU nurses), Bio Medical Engineer as continuous in puts are required regarding equipment’s and also quality in charge to study the whole process, analyze the results and formulate an action plan.

INTRODUCTION Infection Control and prevention is the most significant aspect of patient care. Hospital Acquired infections have serious implications not only on the patient health but also on the hospital resources. Despite modern surgical techniques and the use of antibiotic prophylaxis, surgical site infection remains a burden for the patient and health system. Through an innovative idea it is ensured that we kept a track of all the operated patients in Belle Vue clinic identify the incidence of SSI, followed by analysis and implementation of appropriate corrective and preventive action

INTRODUCTION The project was implemented based on BAXTER Tubing Misconnections Self-Assessment for Healthcare Facilities guidelines. Top management was involved in the Define to control of the project process. The project team was multi-disciplinary level which included Doctors, Nurses, Technicians, Clinical pharmacists, and Quality team.

INTRODUCTION Medication errors or mistakes may happen at any time in hospital, and they are a major reason for death and harm around the world. Each year, in the United States alone, 7,000 to 9,000 people die due to a medication error. Additionally, hundreds of thousands of other patients experience but often do not report an adverse reaction or other complications related to a medication. The most common reasons for errors include failure to communicate drug orders, illegible handwriting, wrong drug selection chosen, confusion over similarly named drugs, confusion over similar packaging between products, or errors involving dosing units or weight.

INTRODUCTION Training staff with their departmental SOPs in patient care areas was a challenge identified by the process owners. The need identified by the senior-leaders to have standardized workplace, transparent and easily understood by staff and patients. Therefore management introduced visual management tool among the senior-leaders and implemented in all departments accordingly. Visual management is a form of communication used to give a snapshot of daily operations. It is concept of making a workplace effective through visuals. Enhances smooth-flow of information, techniques that makes operation standards visible which eliminate waste. Implemented- who, what, when, where, why & How(5W1H) in five minutes.

INTRODUCTION Delivering right diet to right patient at right time is a team effort in Hospital setting. The Dietician in collaboration with treating consultant prescribes the diet, nursing and Food service department coordinates to ensure that patients receive meals planned specific to health conditions to support recovery and health. There are multiple critical control points to ensure a progressive path of recovery. Patient’s perspective and satisfaction are two important major multidimensional concepts. During routine review of Monthly reports, we noted low PSI scores (patient satisfaction index). Among multiple reasons, we found a strong correlation positive between patient satisfaction level and quality indicators.

INTRODUCTION Rajasthan Hospital wanted to Develop a program to properly use antimicrobial for inpatients to decrease the incidence of resistance, reduce the development of MDROs, hospital length of stay, and health care costs and improve patient care. The ASP necessitates the right drug, the right time, the right amount, and the right duration. A successful ASP was initiated by Top management by providing resources and collaboration between Critical care, pharmacy, Infection control, microbiology and doctors and IT. The TOP management gave priority to infection control and active surveillance for AMS by providing a dedicated budget. We also participated in a national project PARIVARTAN.

INTRODUCTION At least 1/3rd of patients arrive at hospitals malnourished and, if left untreated, many continue to decline nutritionally. The prevalence of malnutrition in intensive care is reported to be as high as 40%. Timely nutrition intervention can reduce complication rates, length of stay in Hospital, mortality rate, and cost of care. Studies have shown a significant inverse linear relationship between mortality and total daily energy received. Malnutrition and development of negative energy balance results in increased infectious complications, impaired immunologic function, and prolonged ventilator dependence..

INTRODUCTION Frequently, the effective implementation of a clinical practice guideline will require clinical pathways to be adapted or developed. Clinical pathways have emerged as a tool for payers to encourage provider adherence to evidence-based care. Pathways are useful tools to ensure effective sequencing, integration, and coordination of care and efficient use of available resources. Pathway adherence thresholds improve care quality by incentivizing appropriate care. Better the adherence to pathway, more standardized is the care & better are the outcomes. With an objective to enhance our mechanically ventilated patient outcomes we adopted a Ventilator pathway at RFH.

INTRODUCTION A medication error is defined as any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of a healthcare professional, patient or consumers. Medication errors (MEs) are preventable events which can lead to increased Morbidity and Mortality rate if not prevented. MEs increase overall healthcare cost to the patient. Few published studies, shows that 5-10% of hospital admissions and 3% of deaths reported in the Swedish population happened due to MEs. Another study shows that in Canada around 50% incidents in primary health care are due to MEs. In

INTRODUCTION Provision of safe Obstetric care in resource challenged LMIC settings is a challenge. World Health Organization (WHO) introduced the Safe Childbirth Checklist (SCC) as a four-page, organized list of evidence-based 28 essential birth practices, targeting the major causes of maternal morbidity and mortality, intrapartum-related stillbirths and neonatal deaths that occur in health-care facilities around the world. The purpose of this project was to adopt and adapt the WHO Safe Childbirth Checklist to raise the quality of Obstetric care provided at the hospital.

INTRODUCTION Critical Care Outreach (CCOT) Services are considered to be an essential and integral part of a hospital wide approach in improving the early identification and management of clinically deteriorating patients in the wards. The CCOT is a nurse-led service provided at bedside clinical area. The Services implement early warning triggers to support healthcare teams to identify deteriorating patients earlier and ensure an appropriate response to the patients needs.Clinical audit committee team in the hospital ,identifies the projects that needs prioritization that will produce in term of quality of care which in turn sent to the management for the prompt approval.

INTRODUCTION Adverse Drug Event is defined as any event that occurs during treatment, and is not necessarily caused by the drug itself. Adverse Drug Reaction is defined as a response to a drug that is noxious and unintended and occurs at doses normally used for the prophylaxis, diagnosis or therapy of disease, or for modification of physiological function. The Drug Information Centre (DIC) is a service offered through Pharmacy department which provides advice and act as a referral service by directing the best available resource to respond to query or concern.” The DIC caters the need of Health care professionals.

INTRODUCTION Chronopharmacology: science concerned with the variation in the pharmacological actions of various drugs over biological timings & endogenous periodicities. Various physiological functions as well as diseases exhibit circadian rhythm; also there are various drugs which follow chronokinetics. Therefore application of chronotherapeutics in such diseases can maximise the efficacy & minimize the adverse effects associated with the drugs resulting in improved therapeutic outcome. This study aims on a synchronizing drug treatment to patient circadian rhythms to minimize toxicity (or) adverse effects and maximize efficacy.

INTRODUCTION The excessive utilization of antibiotics had led to the rise of antimicrobial resistance (AMR) which poses a major threat to individual health globally. Wahat Al Aman being an internationally accredited institution, and one of the leaders in Home Care in the UAE with more than 100 patients, is not exempted to this rising challenge about increased antibiotic use and multidrug resistant organisms. Due to this emergence, the ability to treat various infectious diseases became less effective causing treatment failure, increasing health care cost, and even death. Wahat Al Aman aims to deal with this challenge by optimizing the improvement plans.

INTRODUCTION Discharge planning is the development of a personalized plan to ensure the smooth transition of a patient from a hospital to home. A good discharge planning can help in a better coordination, avoid complications, involve patients and families in the process and results enhanced efficiency. This Hospital had commenced operations from the year 2020, multiple consultants from various institutions had joined the team. The process of planned discharge was something which was not followed by all members of the medical team. This lead to the Medical Administration Head and PCS Team to work on a Project on Enhancing Planned Discharges.

INTRODUCTION State of Qatar is a country occupying the small Qatar Peninsula with 90% expatriates from 94 different nationalities. Hamad Medical Corporation (HMC) is the main provider of secondary and tertiary healthcare in Qatar and manages 12 hospitals including National Cancer Care and Research Centre (NCCCR), the sole cancer care provider in Qatar. Geographical footprint of 2021 revealed that the center with staff from 30 different nationalities catered to patients from more than 60 nationalities. Catering to patients from diverse cultural background, advanced technology and increased patient expectation, an initiative to review and revise the existing Quality Indicators of Cancer Hospital was initiated keeping person centricity as the focus and came up with 6 new indicators including Net Promoter Score (NPS) apart from the existing two indicators.

INTRODUCTION Change in the process owner of the Insurance department in the month of Jan 2022 catalyzed an internal audit through i-Tracker (HMS tracking tool) for the reconciliation of outstanding payments from the insurance companies. Turnaround time (TAT) for outstanding reconciliation and claim process were the areas of concern. Financial year analysis (FY 2019-2022) of outstanding and unreconciled payments were projected to the management and top priority was assigned based on the project charter. The quality tool implemented was Poka Yoke-Mistake proofing. The project team included the process owner, process & finance team, quality tool trainers and senior leadership team.

INTRODUCTION P.D. Hinduja Hospital is a 400 bedded tertiary care hospital with over 90% occupancy. There is a constant waitlist of patients who need timely bed availability. In addition to planned admissions, there are multiple admissions from the emergency department. In regular patient feedback and consultant feedback, bed management in the hospital has been an area of concern. Delay or refusal wrt bed availability affects timely patient care and affects brand image of the hospital. A group of workforce hence identified this area for in depth study and workable solutions.

INTRODUCTION Hinduja Hospital is a renowned Private, Charitable, Trust Hospital in Mumbai; our vision is “Quality Healthcare for All”. Keeping our vision alive, we as an organization have always believed in continuous quality improvement in all our Hospital services and processes. We decided to work on improving our Patient experience and one of the core issues was related to Cashless insurance (TPA) process. Analysing our patient’s feedback, we identified that there was a great scope of betterment of our cashless process, where our patients were facing hurdles right from the Pre-Authorization stage till the time of discharge.